Seventeen adult patients with cerebral arteriovenous malformation were studied on cardiac effects of this disease. Of all 17 patients tested, the electrocardiogram revealed left ventricular hypertrophy in 5, sinus bradycardia in 4, WPW syndrome in one, and no abnormality in 7 others. There were 3 patients having a slight increase in the cardiothoracic ratio over 51%, and 14 having normal heart size determined from the chest X-ray taken.
Of all 11 patients, in whom brain circulation was measured by the intravenous RISA technique, cranial blood flow (CBF) increased significantly in 5, remained within normal value in 4, and slightly decreased in 2 patients. Left ventricular hypertrophy on ECG was observed in 3 of 5 patients with a high CBF, but in none from the patients with normal or subnormal CBF, suggesting that the occurrence of ventricular hypertrophy was highly related with an increased CBF.
The relationship between cerebral arteriovenous malformation and cardiac changes is discussed.

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A newly devised instrument is described which permits recording of cardiovascular sound and electrocardiogram during exercise in man. It consists of a handy magnetic casette tape recorder and a modulator. This assembly is connected to a phonocardiographic microphone which is attached to the thorax with sticky tape. The voice of patient is also recordable, if necessary. Biological transducer will be attached for simultaneous recording. All of the recording will be inscribed on the oscillograph paper. It is demonstrated that the recording is stable even during exercise and represents satisfactory result. Prospect of this instrument is briefly discussed.

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Clinical and autopsy records of our 5 cases of peripartal cardiomyopathy, as well as those of 18 reported Japanese cases, were analyzed and were compared to our findings in 8 non-peripartal female and 34 male patients of primary cardiomyopathy.
The incidence of cardiomyopathy was significantly higher in peripartal period than in the rest of the adult period in 10 married female patients (P<0.002).
The clinical picture of peripartal cardiomyopathy was characterized by acute onset of severe dyspnea and subsequent subacute course leading either to early death or to complete recovery. Short history simulating upper respiratory infection preceded severe symptoms in some cases, and suggestions for viral infection were obtained in a few patients.
Autopsy revealed intracardiac thrombi and pulmonary and systemic thromboembolism, but only minimal histological change of the myocardium in many cases.
The nature of this disease as a primary cardiomyopathy of usual sense was doubted seriously and essential contribution of intravascular blood coagulation under possible participation of viral infection was speculated.

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Effect of pentaerythritol-tetranitrate on the regional blood flow through the anterior wall of the left ventricle has been studied using anes-thetized dogs. The flow was continuously monitored by heated cross-thermocouple.
In the absence of coronary constriction, systemic administration of the agent in doses varying from 0.3 to 3μg./Kg. produced a transient increase in the flow through the outer half, with relative ischemia in the inner half of the ventricular wall.
During constriction of the anterior descending branch, the injections of the agent produced a decrease in the flow through both halves of the wall when the pressure difference between the constricted and non-con-stricted coronary artery was below 60mm.Hg. In the outer half, the decrease lasted more than 5min.
Over 60mm.Hg, the injections caused an increase in the flow through the inner half, with a decrease in the flow through the outer half.
The results illustrate the non-uniform changes of myocardial blood flow which can be produced by systemic administration of pentaerythritol-tetranitrate.

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This study examined the systemic and coronary hemodynamic effects of dipyridamole on experimental myocardial infarcts. Electrograms were recorded from the left ventricular surface 15min. after ligation of the left anterior descending coronary artery. Average ST segment elevation and number of sites with ST segment elevation greater than 2mV., indices of the magnitude and extent of acute myocardial ischemic injury, were increased in 9 dogs following intravenous infusion of dipyridamole (0.01-0.05mg./Kg./mm.) from 4.6±0.3 (Mean value±SEM) during control simple occlusion to 6.8±0.9mV. (p<0.025), and 6.2±0.6 to 8.1±1.2 (p<0.05), respectively. This was accompanied by significant decreases in mean blood pressure from 105±5 to 79±6mm.Hg (p<0.025) and in mean value of coronary perfusion pressure index (Mean blood pressure×Heart rate×Diastolic duration in aortic pressure) from 4, 100±180 to 3, 130±210mm.Hg sec./min. (p<0.01), respectively. Coronary blood flow measured by a flow probe applied around the root of the circumflex coronary artery was markedly increased from the mean value of 115±6 during control occlusion to 284±45 (arbitrary unit, p<0.01).
Thus, we concluded that dipyridamole does have deleteriou effects on acute myocardial ischemic injury by reducing coronary perfusion pressure which importantly influence the blood supply to the ischemic zone of myocardium, in spite of augmented total coronary blood flow.

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Unipolar His bundle electrograms were recorded with the muscle preparation isolated from the rabbit or the dog heart at as various sites as possible on and near the A-V conduction system and changes in appearance time and configuration of the so-called His (H) potential were examined. When the exploring electrode was shifted from the coronary sinus orifice down to the transition between the A-V node and the His bundle, the H potential was small but observed distinctly and its appearance time was rather fixed. The earliest excitation of the His bundle is thus assumed to be not much earlier than 1/3 or 1/4 the P-R interval before the Q wave. The nodal (N) potential appeared in addition to the H potential at variable time points while the electrode was shifted on the A-V node and disap-peared when it was reached the His bundle. The appearance did not give the impression that the N potential changed to the H potential accord-ing to the electrode shift. Over the His bundle the H potential changed its appearance time successively. The H potential was also compared with the action potential obtained from the points as close as possible to the ex-ploring electrode or with the other reference electrogram. It took the electrical field generated by the electrical activity of the whole of the His bundle, but it was influenced more by the local electrical activity than in the case of the electrocardiogram of the whole heart in situ.

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"Das initiale fettfreie Ödem" has been long known by the German school as the initial stage of human atherosclerosis, and a highly similar phenomenon was found by the author and his collaborators (1960)¹⁴⁾ to be regularly produced as an immediate response to a single administration of atherogenic substances like cholesterol or adrenaline in rabbits and rhesus monkeys. Moreover, the authors found that such an edematous arterial response is induced by a reduction of the active selective-permeability of endothelial cells resulting in an acute infiltration of plasma substances such as β-lipoprotein, fibrinogen and γ-globulin into the arterial wall;¹⁰⁾ at the same time, the repelling function of endothelial cells against platelet is reduced.^{14), 16)} As a consequence, the sticking of platelets to endothelial surfaces, as well as the reduction of adhesive platelet count and the shorten-ing of several clotting times due to the release of platelet factors, occur, ^{14), 16)} and ADP-induced platelet aggregability is enhanced.¹⁷⁾ When such an impairment of the function of endothelial cells was observed, these cells exhibited a contraction often accompanied by bleb formation. The contraction and blebbing of endothelial cells are proposed to be a key mechanism of atherogenesis and thrombogenesis by the author.
To prevent or treat atherosclerosis and thrombosis, a substance capable of preventing or restoring the above mentioned fundamental functions of endothelial cells, and of inhibiting the enhancement of platelet aggre-gability due to atherogenic stress, is essential. One such substance is pyridinolcarbamate, which has also been shown to relax endothelial cells and platelets. This compound has been tested experimentally and clini-cally in many countries of the world for almost 10 years, and a survey of the results of the clinical investigations has been briefly made on its efficacy as an antithrombotic and antiatherosclerotic agent.

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The electrocardiogram of 34-year-old male with tetralogy of Fallot showed the left axis deviation, QS pattern in right precordial leads and high R waves in left precordial leads. Autopsy findings confirmed the anatomical diagnosis. Well developed left ventricle in cases with tetralogy of Fallot seemed to be related to the increased longevity of the patients

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A case of early migration of a bullet from the inferior vena cava to the right pulmonary artery passing through the right heart, treated by right upper lobectomy, is presented. Pulmonary scanning, right heart catheterization and angiography are emphasized as valuable methods leading to diagnosis. World literature concerning foreign body migrations to the heart and pulmonary arteries by venous route are briefly discussed.

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