This paper deals with 2 female cases, aged 21 and 17, diagnosed as the Romano-Ward syndrome. They belonged to different families. Both showed autosomal dominant inheritant traits. From their traits one case (Case 1) was suspected as being in the heterozygous state, while the other (Case 2) in the homozygous. The severity in clinical symptoms did not differ from each other. By studying our cases and the literature so far published, the combined use of propranolol, diphenylhydantoin, and phenobarbital was inferred to act effectively for the prevention of arrhythmias seen in the present syndrome.

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Right and left heart catheterizations were performed on 53 patients with myocardial infarction (10 hours to 7 years after the initial attacks). Twenty-five patients with angina and without infarction as well as 7 patients with pulmonary diseases were evaluated with the same methods.
Right atrial, pulmonary arterial and pulmonary capillary pressures were elevated in the infarction group compared to the angina and pulmonary patients. However, pulmonary capillary pressure was most sensitive to detect the left ventricular dysfunction due to myocardial infarction. Left ventricular stroke work index, maximal dp/dt, and mean circumferential shortening rate were significantly lower in infarction patients compared to angina patients.
The left ventricular dysfunction of infarction patients was mostly encountered in acute period and several years after the initial attacks and was rare between these periods.
Coronary circulation was evaluated with N₂O method, however, there was no significant difference in the coronary circulatory disturbances of infarction and angina groups.
The prognosis of the patients was evaluated in terms of pulmonary arterial wedge pressure, left ventricular mean circumferential shortening rate and stroke work index. Seventy-five per cent of those who showed abnormal values in all of these parameters died during the follow-up period of 5-10 years after the measurements. Left ventricular stiffness was assessed with left ventricular diastolic pressure-volume relationship and the stiffer left ventricle showed the worse prognosis.

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Using a group of 419 Japanese infants with congenital heart disease with increased pulmonary blood flow, a scoring system for assessment of severity was devised. The parameters chosen for objectivity and ease of evaluation were body weight, respiratory rate, maternal history of feeding difficulty, cry and wheeze or cough. Prognosis improved with higher scores. It is felt that this system can be used to aid in communication among physicians and ancillary personnel who care for infants with congenital heart disease.

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There were 177 cases of complete right bundle branch block (RBBB) among 3, 698 aged people more than 60 years of age, which was an incidence of 4.8%. Electrical axis was normal in 44 cases (24.8%), left in 92 cases (52.0%) and right in 41 cases (23.2%). RBBB with left axis deviation rather constituted the most important population among the RBBB in the aged. Development of RBBB and axis deviation was examined, and about a half of cases showed stepwise development of both conduction disturbances.

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This paper shows the result of plasma aldosterone which was measured by radioimmunoassay method using aldosterone-3-carboxymethoxamine-BSA or aldosterone-hemisuccinate-BSA. Normal control value at recumbency or upright, primary aldosteronism, uremia, essential hypertension and miscellaneous diseases were examined.
By diuretica, plasma aldosterone of normal volunteer was increased but that of patients with edema was decreased temporarily. The response of plasma aldosterone in edematous patient to the constant infusion of Angiotensin II, was stronger than that of normal volunteer. But primary aldosteronism with adenoma showed the sequentially decreased plasma aldosterone by the constant infusion of Angiotension II. Some of the primary aldosteronism showed the normal response to the sodium loading and restriction. By the pressure dose Prostaglandin A₂ or E₁ infusion, the plasma aldosterone showed a tendency to increase.

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It is well known that the carotid sinus reflex affects the blood flow in the coronary artery. Previous studies from this laboratory have indicated that the catecholamine in the canine blood increased during both common carotid arteries occlusion.
The present experiment employed 18 mongrel dogs (weighing 10 to 20Kg) which were investigated by the open chest method after being anesthetized with the sodium pentobarbital.
The cardiac output, the blood flow in the descending branch of the left coronary artery, and the femoral artery pressure were all simulatneously measured with the electromagnetic flow meter and the electromagnetic transducer. These machines recorded blood pressure, coronary blood flow and cardiac output before and during the stimulations caused by the carotid occlusion or the exogenous catecholamine infusion. Both the occlusion and the infusion were investigated under 3 conditions (with nonadrenergic blockade, with an alphareceptor blockade, and with a beta-receptor blockade). Bilaterally, the common carotid occlusion revealed a noticeable increase of the coronary blood flow and the blood pressure without any increased cardiac output.
The alpha-receptor blockade inhibited the change caused by the common carotid occlusion but the beta-receptor blockade did not. This study suggests that the increased blood pressure and the alpha-adrenergic receptor during the common carotid arteries occlusion play a part in an increase of the coronary blood flow.

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Previously, carotid chemoreflex and baroreflex have been reported, although for the most part of these mechanisms have not been clarified.
In this experiments, circulatory effects of the carotid chemoreflex were investigated in the anesthetized dogs. Chemoreflex was performed with Lobeline (0.02mg, 1ml) and potassium cyanide (KCN, 1%, 1ml) through the catheter inserted to the carotid sinus. Continuously, during experiments, systolic blood pressure (S. P), diastolic blood pressure (D. P), systolic pulmonary blood pressure (SPaP), diastolic pulmonary blood pressure (DPaP), respiration and pulse rate were recorded simultaneously in the closed chest dogs. Cardiac output, pulmonary blood flow, coronary blood flow, S. P, D. P, SPaP, DPaP, and pulse rate were examined in the controlled breathing of the open chest dogs.
In each experiment, during and after reflex, blood gas, HCO₃^-, and pH were measured. However, none of them were changed by these reflexes.
In the case of the closed chest dogs, chemoreflex by Lobeline did not change S. P and D. P, but SPaP was increased by 22.54%, significantly. DPaP was increased by 18.14%. Respiration rate was increased by 26.46% significantly. Heart rate was decreased by 9.15%.
In the open chest dogs, chemoreflex by Lobeline increased S. P and D. P by 13.05% and 14.58% significantly. SPaP and DPaP were increased by 22.19% and 21.97% significantly. Pulmonary resistance was increased by 28.57% significantly. Pulmonary blood flow was decreased by 9.7% significantly.
In the open chest dogs, chemoreflex with KCN increased S. P, D. P, and SPaP by 21.59%, 21.39%, and 41.02% significantly. Pulmonary resistance was increased by 20% significantly. Pulmonary blood flow was decreased by 10.43%. Cardiac output was not changed but coronary blood flow was increased by 6.50% significantly.
It should be noted here that the carotid chemoreflex caused the hyperrespiration, the changes of pulmonary arterial blood pressure, pulmonary resistance, and pulmonary blood flow significantly, but these hemodynamic changes are capable of being separated from the effects of hyperrespiration through the chemoreflex mechanism.

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We operated upon a patient with syphilitic aortic insufficiency, and performed aortic valve replacement, aortoplasty and vein graft from the aorta to the right coronary artery. This surgical procedure implies that aortic insufficiency of syphilitic origin is the resultant of primary aortitis and relates possibly to another concomitant complication of aneurysm and coronary ostial stenosis as processes of chronic progression of the disease.

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The indirect pulmonary artery pulse in the second right intercostal space, hitherto undescribed, was reported in a case of complex congenital heart disease with transposition of great vessels, atrial septal defect, tricuspid atresia, ventricular septal defect and pulmonary hypertension. It was illustrated that the indirect pulmonary artery pulse in the second right intercostal space indicates the existence of the transposed great vessels. In addition, the significance of the precordial impulse in the third left sternal border was discussed.

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