Two cases of paroxysmal supraventricular tachycardia were documented, and its underlying mechanism was discussed. 1) An antegrade A-V conduction pathway was found to be more refractory than a retrograde A-S conduction pathway because an antegrade A-V block was usually accompanied by a retrograde A-S conduction, resetting the sinus cycle. 2) A single supraventricular premature beat did not initiate paroxysmal tachcardia. 3) Paroxysmal tachycardia consisting of an alternate appearance of a retrograde P wave and a QRS complex of normal configuration (reciprocation) always followed a pair of two premature beats. 4) The first premature beat showed an aberrant ventricular conduction, indicating that the impulse spread the same way as that of the preceding sinus impulse. 5) The second premature impulse with an antegrade P wave showed a QRS complex of normal configuration similar to those appearing during paroxysmal tachycardia with a shorter coupling interval, indicating that the second premature impulse spread the pathway which had not been discharged by the preceding premature impulse. 6) Even when the reciprocating supraventricular tachycardia was suppressed by oculovagal reflex, these two premature beats appeared as a pair, indicating that the second premature impulse is causally linked to the first, i.e., an atrial echo via the S-A node. 7) It was inferred that this echo impulse via the S-A node spreads the pathway which has not been discharged by the first premature impulse and turns back to the atria through the pathway which has been discharged by the first premature impulse but has then recovered, thus initiating a sustained reciprocation of an impulse.

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1) Using toad bladder, the effects of phospholipase C on the vasopressin-, cyclic AMP-, and theophylline-activated SCC and osmotic flow were examined. The effect of phospholipase C on the vasopressin-activated urea permeability across the toad bladder was also examined. 2) Phospholipase C inhibited the vasopressin-cyclic AMP-, and theophylline-activated osmotic flow of the toad bladder. 3) Phospholipase C did not affect the vasopressin-, cyclic AMP-. and theophylline activated SCC. 4) Phospholipase C caused no effect on vasopressin-induced increment of the urea permeability across the toad bladder membrane. 5) The results suggest that phospholipase C might affect directly the barrier for water, and shows no effect on the barrier for solutes. Some possible characteristics of the barriers are discussed in the point of view of the "double barrier series theory".

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The importance of selective coronary arteriography associated with treatment of ischemic heart disease was stressed. Of 45 patients with selective coronary arteriography, 23 cases were performed by Sones technic, and 21 cases by Judkins technic. These both technics are necessary to be chosen according to respective situation. Mixture of Conraxin-H^(R) and Conraxin-L^(R) seemed to have advantage to be employed without hazards over other contrast media. Reported cases were two cases of internal mammary artery implantation, two cases of aorto-coronary bypass graft, a case of medical treatment and a case of ventricular aneurysmectomy. Surgical procedures concerning ischemic heart disease were discussed in detail from the view point of advantage and effective-ness of each procedure. For the further progress in this field, cooperation of internists should be necessary.

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An experimental study on the arterial implantation in the skeletal muscles of the thigh in the dogs is presented. In an attempt to supplement the disadvantage of lack of sinusoid system and periodic contraction in the skeletal muscle, a 2 to 3mm caudad arteriovenous fistula was provided. Patency of the implanted vessel was demonstrated in 13 out of 15 dogs at 2 months follow-up examination. Arteriovenous fistulae either spontaneously closed approximately one month after implantation or were operatively closed 14 to 59 days after implantation. The implanted artery in 7 of the 11 surviving animals remained patent for 4 to 7 months after implantation and were sacrificed for histological examination. The implanted arteries showed no significant alteration of the vessel wall. Formation of anastomosis was demonstrated in these 7 animals 74 to 121 days after implantation both on angiograms and on histological sections with injections of Micropaque. It is evident that both the control of size of arteriovenous fistula and the proper time of closing the fistula are of extreme important for the success of skeletal muscle implantation. This Study gives us reason to believe that the clinical application of skeletal muscle revascularization can be expected in the future.

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The cardiac index and the circulating blood volume and its distribution in the heart, lung and body were determined by analog computer analysis of the radiocardiogram in thirty four normal subjects and 135 patients with cardiac and pulmonary disorders. Among the 135 patients, thirty four had congestive heart failure and thirteen patients were re-examined after the amelioration of the congestive heart failure. 2. Among the normal subjects, the mean value of the circulating blood volume was 2496 ml/m², of which 10.8% (268 ml/m²), 10.9%, (272 ml/m²) and, 78.3%(1955 ml/m²) were distributed in the heart, lung and body, respectively. 3. In patients with valvular diseases, the circulating blood volume and the heart volume increased in accordance with the severity of the disease. The increase in the pulmonary blood volume was also evident in most of the groups but the extent of the incerase was by far smaller than that of the heart volume. The increase of the volume of blood in the body was insignificant in most of the groups. The heart volume was shown to have an important role in terms of the increase in the circulating blood volume. 4. Thirty four patients with congestive heart failure were classified into three groups according to the radiocardiographic data. Among the patients in Group A, there was an increase in the volume of blood in the body; in Group B, there was an increase in the volume of blood in the heart and a decrease in the cardiac index; and in Group C, although the change in the distribution of the blood volume was insignificant, the decrease in the cardiac index was remarkably high. This classification was convenient because it corresponded to observable clinical features, that is, those in Group A had right heart failure, those in Group B had congestive heart failure caused by valvular diseases-mainly by mitral valvular lesions, and those in Group C had heart failures caused by hypertensive and myocardial diseases. 5. After the amelioration of the congestive heart failure, the decrease in the volume of body blood was shown in most patients in the Groups A and B. A slight increase in the cardiac index was the only notable change in Group C.

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Different principles and variant types of exercise have been employed in effort tolerance test to evaluate the functional status of cardiovascular system in health and diseases. Mainly electrocardiographic evaluation in effort tolerance test has been used for early detection of coronary heart disease and for the prediction of the probability of developing cardiovascular diseases. To clarify the comparative sensitivity evaluation of Master's double 2 step test and Levy's hypoxemia test in coronary suspected subjects, both electrocardiographic tolerance tests were employed. Because the mechanism of production of coronary insufficiency in both stress tests is quite dirrerent, but the electrocardiographic changes are similar. Also, the sensitivity of the stress tests depends on its severity, i.e. the greater the load, the greater the number of positive response. Method and Materials 241 cases of coronary suspected subjects aged from 2nd to 7th decade for Master's double 2 step test and 181 cases of separated follow. group with same category for Levy's test were subjected. 53 cases of them were received Master's double 2 step test during later short intervals. The interpretations of Master's and Levy's test were based on Master's positive creterion of 1967 and Levy-Patterson's positive criterion of 1942. Furthermore, Minnesota code was employed for interpretation of both Master's and Levy's test as a sensitive indicator of same base. (a) Master's double 2 step test Master's double 2 step test was performed manual carefully. The criterion of positive response to Master's double 2 step test are as follow. (1) RS-T segment depression of more than 2 mm. (2) "Junctional" RS-T depression with QX/QT>50% or QT ratio>1.08 (3) frankly "Ischemic" RS-T segment depression of more than 0.5 mm. a) horizontal plane depression type b) sagging depression type (4) distinct inversion of the "U" wave depression of T-U segment (5) signifincant T wave inversion (at least 1.5 mm) (6) manifested major arrhythmias

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