A study is presented of 3 generations of a family in which cardiovascular disease combined with skeletal anomalies occurs. The cardiovascular disease consists principally of primary pulmonary hypertension, although congenital heart disease with shunt is also to be observed. The skeletal anomalies occur mainly in the radial anlage of the upper extremity.
The mutual occurrence of primary pulmonary hypertension and congenital heart disease with shunt makes logical the conclusion that pulmonary hypertension in the case of congenital heart disease is not always secondary but may be a primary likewise congenital defect. Since up until now the genetic aspect of primary pulmonary hypertension is the only definitely established feature, the disease should really be called familial or hereditary primary pulmonary hypertension.

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(1) Out of 14 cases of aortic arch syndrome experienced during the last 11 years, 13 were diagnosed as pulseless disease described by Shimizu and Sano, reflecting the high frequency of this disease in Japan.
(2) Six cases of atypical coarctation of the aorta seen during the same period of time were also analysed. The pathogenesis of atypical coarctation was interpreted to be identical to that of pulseless disease, based on the comparison of sex and age distribution, several laboratory data and autopsy findings between the both conditions.
(3) It was recommended to describe these apparently different conditions under a single term, for example panaortitis syndrome, and to divide them into subtypes such as aortic arch type, abdominal aorta type and extensive type according to the localization of the lesions.
(4) The prognosis of these patients seemed in general to be not unfavorable despite the persistence of disability of varying degrees.

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The autocorrelation function of the electrocardiogram of 14 subjects with atrial fibrillation were obtained on an automatic analogue correlator. The functions were all aperiodic in 11 out of 14 patients. Detailed analysis of the correlogram showed the existence of 2 periods. Even when the autocorrelation function was rather random, the function over the longer duration of the electrocardiographic record was aperiodic with the same result. This was seen in 3 other cases.
The significance of the findings is obscure, but it has been demonstrated that the arrhythmia is not completely irregular and has a certain periodicity.

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A total of 3, 761 patients with various types of electrocardiographic abnormality were followed up and survivorship was compared in terms of types of electrocardiographic feature and heart disease. Then distribution of cause of death in 1, 090 cases was compared in the same manner.
From the view point of electrocardiographic findings, survivorship is lowest for patients with ST depression and simultaneous T inversion or those with complete left bundle branch block, and secondly low for patients with myocardial infarction. The survival rates for patients with the other types of ST•T change, complete right bundle branch block or atrial fibrillation are not so different from each other. Cases with incomplete right bundle branch block follow rather better course than those. There are conflicting difference in relationship between types of heart disease and prognosis, according to types of electrocardiographic abnormality. In cases with some type of electrocardiographic changes survival for hypertensives is lowest, while in the other type lowest for sclerotics or patients with rheumatic heart disease. Similarly, survivorship is poorest for cases with T inversion in hypertensives, while lowest for ST depression and T inversion in sclerotics and for complete right bundle branch block in patients with rheumatic valvular disease. These discrepancy and some factors affecting them were discussed briefly.
A greater part of deaths in patients with myocardial infarction were sudden death on the other hand, in cases with atrial fibrillation deaths caused by congestive failure were most frequent. The latter represents patients with valvular disease. Both of deaths caused by congestive failure and sudden deaths were seen in patients with ST•T abnormality or coronary sclerosis.

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A case of right atrial thrombus which ensued in sudden death was presented. The literature is surveyed briefly and the pathogenesis of the thrombus formation as well as the cause of the sudden death in this case was discussed.

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Pathological examination of the conductive tissue of the heart has revealed that exact lodgement of the metastatic lesions. The pathogenesis of bilateral bundle branch block due to cardiac metastasis of pulmonary carcinoma has been presented with a brief presentation of the electrocardiographic pattern.

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