(1) Surgical results of mitral valve replacement were studied especially in reference to the functional tricuspid insufficiency observed in 31 patients with advanced mitral diseases.
(2) Eighteen patients were complicated with right heart failure manifested by hepatomegaly, oliguria and ascites at the time of admission, and 13 patients did not reveal this manifestation. Cardiothoracic ratios were 70% in the former and 66% in the latter, the pulmonary artery pressures 73.5mm.Hg and 66.5mm.Hg, and the right atrial pressures 16.2mm.Hg and 7.5mm.Hg, respectively.
(3) Mitral valves were replaced with Starr-Edwards' prostheses in all cases. Isolated mitral valve replacement was performed in 17 patients, mitral valve replacement combined with tricuspid annuloplasty in 7 patients and simultaneous mitral and tricuspid valve replacement in 7 patients. There were 3 early deaths and 2 late deaths.
(4) Hemodynamic studies on the follow-up state revealed that the pulmonary artery pressures were reduced in most cases, but on the contrary, the right atrial pressures were variable. In patients with right heart failure undergoing isolated mitral valve replacement, there was a higher incidence of the unsatisfactory results in the follow-up period.
(5) From the results of this series, the authors propose that the functional tricuspid insufficiency should not be left alone but treated surgically according to its severity, that is, moderate tricuspid insufficiency in patients without right heart failure should be intervened by tricuspid annuloplasty and severe tricuspid insufficiency in patients with right heart failure needs tricuspid valve replacement.

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The ingestion of 100mg. of bromelain did not cause any of the commonly measured blood parameters to change appreciably.
Although there were changes in the antiprotease levels during the course of the test, none of the changes seemed to correlate with the ingestion of the enzyme.
There appeared to be a time related change in the amount of serum obtained from a given amount of blood and in the bleeding time.
The possible importance of this finding is discussed.

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A concept of prognosis of hypertension in population was showed applying the time-sequential transition probability, calculated by stratified probability matrices.
Transition probability matrix shows a probable prognosis of each subgroup in a population quantitatively, in other words, the matrix shows a prediction or an estimation on blood pressure in the future.
The matrix, of course, is changeable or variable itself in various condition of the population; management of the patient, measures of disease control or prevention, socio-economic background of disease, and so on. Then, the difference of time-sequential matrices could show an appreciation of the management or the measures and, in other hand, could show the tendency of the disease before the background, namely, an appreciation of disease control or prevention could be estimated by the matrices under a certain condition.
There would be two approaches to disease control; clinical approach through individual and patient management and preventive approach through population. The concept and methodology, here introduced, is available especially for the latter approach.

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In dogs weighing about 10Kg. anesthetized with pentobarbital, resistances of the collateral flow channels of the common carotid and femoral arteries were studied during occlusion of these arteries. When the common carotid artery was occluded, collateral resistance gradually decreased in about 30sec., from initial collateral resistance (ICR) of 0.842±0.165mm.Hg/ml./min. (mean with SE from 6 dogs) to steady state collateral resistance (SCR) of 0.519±0.111 (-39.4±3.6%, significant at P<0.001). Intravenous injection of a long-active nitrite, N-ethoxy-carbonyl-3-morpholinosydnonimine (SIN-10), at a dose of 1mg./Kg., diminished ICR (-37.5±5.3%, n=6, P<0.001, 15min. after administration) but not SCR, thus ICR approached SCR. This effect was marked 5-60min.after the intravenous injection. ICR of the femoral artery was also decreased by SIN-10 (-48.7±5.8%, n=6, significant at P<0.001).Nitroglycerin had a similar effect of dilating the collateral vessels for both arteries, though its effect was more evanescent in the time course and almost disappeared 5min. after injection. It is concluded that nitrites dilate almost the same collateral vasculature which would gradually open during arterial occlusion without nitrites.

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(1) The whole course of the active state was determined by the graphical, experimental and instantaneous methods in the strip preparation of the frog ventricle. These curves were compared with each other.
(2) By the graphical method the active state was drawn as the sum of the isometric tension curve, P(t), and the velocity-dependent tension-loss, which was obtained from P(t), converting through the force-velocity curve and the tension-extension curve of SEC. By this method not only the active state during isometric contraction but also during isotonic and afterload contractions were drawn.
(3) The force-velocity curves on stretching by the load as well as on shortening were determined at various muscle lengths, applying the controlled release near the peak tension.
(4) The tension-extension curve of SEC was directly obtained by the controlled release method. It was independent of temperature.
(5) The active state was determined experimentally by plotting the troughs after quick-stretch and the peaks after quick-release. This curve was diminished in the later phase of tension development, compared with the curve obtained by the graphical method.
(6) The active state was recorded simultaneously with P(t), as the sum of P(t) and dP/dt, and the changes produced by various inotropic effects were examined.
(7) The active state, P(t), dP/dt, and Vmax were discussed as the indicator of myocardial contractility.

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The applicability of heat clearance for assessments of regional myocardial blood flow was examined in dogs.
The axial and radial temperature field around the heated junction of the cross-thermocouples, sewn into the subepicardial layers of normally beating left ventricle of open-chest dog, was about 3.5mm. The heated tissue volume was approximately 0.31ml. The blood outflow from the cylinder introduced into the ventricular wall and the deflections in the thermoelectromotive voltage generated between the heated and reference junctions of the cross-thermocouples showed nearly a linear relationship, when the blood outflow was within 15ml./cm.²/min.
Alterations in the temperature of a block of the myocardium, at the center of which the cross-thermocouples were settled, caused no obvious change in the thermoelectromotive voltage. At the room temperature of 26±0.4°C, a temperature gradient of about 1°C was observed between the subendocardial layer and the subepicardial layer of the normally perfused left ventricle. In the ventricular wall of open-chest dog, the difference in the temperature alteration of the 2 different sites produced by coronary occlusion and by isoproterenol injection was within 0.026°C in most instances with an exception of 0.032°C, when the difference in distance of the measuring sites from the epicardium was within 2mm.
The atmospheric temperature and the luminal flow caused no obvious change in the thermoelectromotive voltage, when the 2 junctions were implanted into the layers 2 and 1.5mm. apart from the epicardium and the endocardium, respectively. The change in voltage generation by constantan which composes the cross-thermocouples is about 0.8 μV. in the range from 30 to 40°C.
It is concluded, that the mean value of the alterations in the thermoelectromotive voltage caused by the non-uniform changes in the myocardial temperature was within 2.1 μV. when the difference in the distance of the 2 thermo junctions from the epicardium was within 2mm., that an alteration over 2.1μV. in the thermoelectromotive voltage is attributable to a change in the blood flow.

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A case is presented in which marked eosinophilia was associated with cardiomegaly, apical holosystolic murmur, atrial fibrillation and congestive heart failure. Loeffler's parietal fibroplastic endocarditis with blood eosinophilia was strongly suspected and the diagnosis was confirmed by endomyocardial biopsy performed antemortem. There was no abnormality of Philadelphia chromosome. A high serum level of vitamin B₁₂ was noted.

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