Precordial and intracardiac phonocardiographic correlation was investigated in 28 cases with ventricular septal defect (VSD) to confirm the diagnostic value of intracardiac phonocardiography and to clarify the clinical as well as physiological significance of the point of maximum intensity (PMI) of the regurgitant systolic murmur of VSD. At the same time, the teleological use of catheterization was documented and the recent concept of the auscultatory area was modified.
(1) The regurgitant systolic murmur of VSD was localized within the right ventricle (RV) or partially transmitted toward the pulmonary artery (PA) and had the PMI somewhere in the RV. The murmur was pansystolic in timing and had a wide frequency span. A few exceptional cases were described, but the murmur of these cases became typical following the administration of methoxamine. The findings due to the associated anomalies were documented. The fact that the presence of regurgitant systolic murmur within the RV is the most sensitive diagnostic clue of VSD was confirmed.
(2) The PMI of the regurgitant systolic murmur within the RV was so localized that it was easy to locate the site of the septal defect in almost all cases.
(3) The localized PMI within the RV was the best site for the sampling of any measurements. The oxygen content was significantly high at this point when compared to those of randam sampling. This fact enables us to utilize teleologically the catheterization to detect the shunt. Methoxamine administration made the oxygenation of the sample conclusive in doubtful cases.
(4) In a dorsoventral projection to the chest wall, intracardiac PMI of the regurgitant systolic murmur coincided with the precordial PMI in all cases. Therefore, the sampling at the site immediately beneath the precordial PMI was also recommended instead of the intracardiac PMI whenever the intracardiac phonocardiography was not available. Moreover, the site of septal defect could be anticipated in many cases with a reasonable accuracy based on this topographical correspondence of both PMIs.
(5) The correspondence of the 2 (intracardiac and precordial) PMIs suggests that there is a direct transmission of the murmur from the origin to the chest wall. In this regard, the present authors made a minor modification to the "revised auscultatory areas" for the sake of the regurgitant systolic murmur of VSD and reserved a name of "interventricular septal area" to the precordial PMI.

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A total of 8 cases of subendocardial infarction was presented. Pathological analyses classified them into 3 subgroups; pure, mixed and scattered types. In the pure type, the circumferential subendocardial lesion was fresh and homogeneous with strict limitation within the inner 1/3 or 1/2 of the left ventricular wall. The mixed type showed fresh and old lesions with more extensive involvement though most portions were located within the inner 1/2 layer. The scattered type showed numerous small fibrotic foci densely accumulated in the inner 1/2 layer. The common characteristic finding in 3 types was a balanced severe stenosis of both right and left coronary arteries with an atheromatous plaque narrowing the right coronary ostium. The pure type had the stenosis only at the proximal parts, the mixed type had more extensive stenotic lesions and the scattered type had the stenosis located distally. There was a high incidence of hypertension. The balanced proximal stenosis and hypertension were considered to be related with diffuse circumferential infarction.

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The contents of adenine nucleotides of myocardium from rats treated with isoproterenol and/or dietary Mg- or K-deficiency were measured. And also, the fatty acid composition of phospholipid fractions of liver from rats fed control diet, a Mg- and/or K-deficient diet for 20 days is pre-sented.
Both the administration of isoproterenol and the dietary Mg- or K-deficiency produced the significant decrease of ATP. However, the re-lative ratio among ATP, ADP and AMP did not show any remarkable changes.
By feeding a diet containing low K and/or Mg, the fatty acid compositions of phospholipids from rat liver were changed.

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Responses of the sympathetic receptors of the left ventricle to various substances, including those which increase following myocardial ischemia and algesic agents, were examined in dogs anesthetized with pentobarbitone sodium under artificial respiration and the following results were obtained:
(1) The injection of dopamine, epinephrine and norepinephrine into the right femoral vein or the left atrium resulted in a rise in the left ventricular pressure (LVP) and left ventricular tension (LVT) as well as a marked increase in the number of the afferent impulses per beat. The injections of l-dopa, dihydroxymandelic acid and vanilmandelic acid, on the contrary, were little effective.
(2) Angiotensin II and isoproterenol produced an increase in LVP, LVT and in the number of the impulses. Also, the impulses increased following the injection of acetylcholine.
(3) LVP and LVT showed various response patterns to the injections of l- and dl-lactic acids and pyruvic acid. However, the impulses increased markedly even when LVP, LVT and heart rate were reduced following the administration of these agents in most experiments. On the other hand, LVP, LVT and the impulses decreased at first and then increased slightly following the injection of sodium lactate and sodium pyruvate in large doses. Acetic acid and HCl produced the same responses with those produced by lactic or pyruvic acid.
(4) LVP and LVT decreased following the injection of histamine and bradykinin. The impulses were decreased or slightly increased by histamine, but were increased markedly by bradykinin. LVP, LVT and the impulses increased following the administration of serotonin.
(5) Adenosine and its phosphorylated derivatives reduced LVP and LVT, but increased the impulses slightly.
(6) A large dose of KCl produced a fall in LVP and LVT, but a slight increase in the number of the impulses in some cases. The impulses increased slightly following the injection of a large dose of NaCl. On the other hand, CaCl₂ and MgCl₂ were little effective.
(7) Phenoxybenzamine, propranolol and nitroglycerin reduced LVP, LVT and the number of the impulses, whereas ethyl-alcohol was little effective.
From the findings obtained in the present studies, it was concluded that the sympathetic receptors in the wall of the left ventricle were activated by various substances including those which increase during myocardial ischemia and algesic ones. It was supposed that they might be activated directly by several substances, while indirectly by some other substances through increased left ventricular contraction or through other mechanisms, and that these receptors have the characters of both mechanoreceptor and chemoreceptor.

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Responses to vertebral and aortic injection of synthetized angiotensin II of the systemic arterial pressure and heart rate were examined in humans and the following results were obtained:
Angiotensin II injections in the dosages from 0.016 to 0.06μg./Kg. caused the following effects.
1) Vertebral injection produced a higher rise in the systemic arterial pressure than that produced by aortic injection of the same dose.
2) Heart rate was increased by vertebral injection of a small dose, but was decreased by aortic injection.
From these data, it was considered that vertebral injection of angiotensin II in humans caused a rise in blood pressure partly by increasing the sympathetic nerve activity.

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In 101 autopsy cases, the degrees of stenosis, hyalinization, and fibro-elastic hyperplasia of arterioles and small arteries of the kidney were quan-titatively determined and the correlations of each change with age and with antemortem blood pressure level were studied. Renal vascular changes are caused by factor(s) related to age, but markedly accelerated by hypertension. In the presence of hypertension the progression of stenosis of arterioles is nearly the same as that of small arteries. Hyalinization of arterioles and fibroelastic hyperplasia of arterioles and of small arteries progress with age, but hyalinization of arterioles is related more closely to hypertension than to aging, and fibroelastic hyperplasia is more closely related to aging than to hypertension.
The degree of stenosis of renal vessels is more closely correlated with systolic than with diastolic blood pressure, particularly in small arteries; arteriolar hyalinization is somewhat more closely correlated with an increase in diastolic than in systolic blood pressure. The correlation between fibroelastic hyperplasia and blood pressure is relatively poor.

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In order to solve a problem that there is the different predilection of atherosclerosis depending on location of artery and/or race, the studies on energy-metabolism of the bovine artery were undertaken.
In a previous paper, it was reported that oxygen uptake, the incor-poration of Pi³² into the adenine nucleotides, the content of DNA, and the nucleotide content of the sliced coronary artery of cattle were almost twice of those of aorta.
In this paper, column chromatographic analyses of the nucleotides and nucleosides of the sliced coronary artery and aorta of cattle were studied and compared with those of bovine myocardium and rabbit skeletal muscle. And the effects of incubation for 60min. at 37°C were also investigated.
The contents of nucleotides and nucleosides of the coronary artery were 1.5 and 0.2 folds of those in aorta and myocardium respectively, and approximately 90% of nucleotides were adenine nucleotides. During the incubation, approximately 40% of nucleotides and nucleosides were released into the reaction medium. Approximately 60 to 70% of the released nucleotides and nucleosides were Hypoxanthine in the coronary artery.

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Thirty-one normal subjects and 16 subjects with documented myocardial infarction were studied. The Frank system of vectorcardiography was used. The polar vector and 0.04 polar vector were calculated in all. The 0.04 polar vector was abnormally directed in all cases of documented infarction, including 2 subjects with a documented infarction but a "suggestive" electrocardiogram. The results of this preliminary study suggest that this method of vectorcardiographic analysis may be of a clinical value in those cases with a previous myocardial infarction in which the present electrocardiogram is suggestive but not diagnostic of an infarction. The results also demonstrate the greater diagnostic value of the 0.04 polar vector over the polar vector in detecting myocardial infarction.

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