In this compilation the authors are intended to elucidate the commonest clinical features of myocardial infarction in Japan. This disease is believed to be increasing in this country during recent years, belonging also to those diseases which are of the most serious consequence as in the other countries. We sincerely hope that this report will serve as guide-line to those who concern medical practice in Japan.

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(1) Coarsely knitted crimped Dacron prostheses were treated with gelatin sponge with fine pores in order to obtain low porosity at the time of implantation and to allow high fibroblastic permeability through the interstices of fabrics as gelatin was absorbed in host tissue.
(2) The grafts were used in the experimental replacement of the abdominal aorta in 25 dogs, in the implantation of the ascending aorta under profound hypothermia with total circulatory arrest in 8 dogs, and in the inferior vena caval (infrarenal) replacement in 8 dogs. As a control, the untreated grafts were implanted into the abdominal aorta in 18 dogs.
(3) In the abdominal aortic replacement, there was no remarkable difference between the patency rate of the gelatin-treated grafts and that of the untreated ones. The inner surface of the graft was covered with thin and smooth membrane, and the outer coat of fibrous tissue adhered firmly to the graft. Histologic study revealed no delay of organization of the graft. In 3 to 4 weeks, there was nearly complete absorption of gelatin which allowed fibroblastic ingrowth through the interstices. The inner layer of the graft could be lined with the endothelium to its entire length.
(4) Of 8 dogs submitted to the implantation into the ascending aorta, 4 survived operation. The graft could be used safely even though heparin was administered.
(5) There were no patent grafts which were obtained from the inferior vena cava.
(6) Advantages and disadvantages of the gelatin-treated graft and importance of this kind of graft that is neither plastic nor protein were discussed.
(7) The gelatin-treated grafts were applied for clinical use in the treatment of 5 cases of the coarctation of the aorta, 4 cases of the abdominal aortic aneurysm, 3 cases of occlusive disease, and 1 case of arteriovenous fistula. Patients were followed for a period of 1 month to 1 year and 2 months. It had been proved entirely satisfactory in the treatment of aortic and to a less extent, of peripheral lesions.

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In order to detect subclinical mild rheumatic inflammation, Metopirone, or SU-4885, was administered to patients with rheumatic heart disease, in an inactive stage of rheumatic fever. Metopirone lowers blood cortisol levels and activates suppressed inflammatory changes of the disease. Following Metopirone administration clinical manifestations, such as cardiac symptoms, arthralgia and fever, occurred in 3 of 8 patients with rheumatic heart disease, and blood sludge in the bulbar conjunctiva appeared or was enhanced in severity and range in 4 of them. These manifestations are considered to be due to subclinical inflammatory changes activated by Metopirone in rheumatic heart disease. The same procedure was performed in patients with rheumatoid arthritis, lupus erythematosus, and other diseases. Of 5 patients with rheumatoid arthritis, arthralgia was aggravated in 2 patients, cardiac symptoms occurred in 1, and enhancement of blood sludge in the bulbar onjunctiva was found in all of them.
It was suggested that this procedure may aid to detect subclinical rheumatic activity in rheumatic heart disease, and to determine a valvular heart disease whether of rheumatic origin or not.

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A quantitative analysis of VCGs was made on 149 autopsy cases including 63 cases with LVH.
Significant findings in the cases with LVH were (1) the enlargement of QRS loop and (2) the displacement of T loop anteriorly, inferiorly and to the right. The direction of QRS loop was almost the same in both groups with and without LVH.
Although further studies on normal healthy cases are necessary to establish diagnostic criteria, the magnitude of QRS vectors and the directions of T loops are useful parameters for the diagnosis of LVH.

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An epidemiological survey for ischemic heart disease was carried on 10, 439 persons above the age of 40 sampled in 15 population groups. The incidence of ischemic heart disease was 20.7% and that of myocardial infarction was 0.9%. Significant difference between sexes was observed. The prevalence of myocardial infarction was higher in male than in female, while the relation was reversed in the incidence of the other types of ischemicheart disease. Although some regional discrepancies in the incidence were observed in some districts in Japan, further investigation should be required to make conclusion.
The increase of ischemic heart disease has been remarkable in recent years in Japan. The cause of an increase of ischemic heart disease seems to be due to the advancement of diagnostic methods, the change of dietary habitus, and the decrease of infectious diseases etc. in Japanese.
Because of the relative low incidence of myocardial infarction in Japan, it is much difficult at present time to assess the efficacy of anticoagulant precisely. However, it was estimated that the administration of anticoagulant within acute stage lowered the death, reinfarct and thromboembolic complications. The reduction of the death rate in anticoagulant group was obvious in the first one year. No difference was apparent in longer-time treatment over one year, but the numbers were too small to exclude such a difference, and the further investigation must be necessary.

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(1) A case of coarctation and aneurysm of the abdominal aorta manifested by hypertension was reported.
(2) Twenty-six cases reported in Japan were reviewed. A brief statistical study was made as to age and sex distribution, and clinical manifestations comparing with those by Brust.
(3) Possible etiologic factors were discussed. Relationship to the newer concept of "middle aortic syndrome" and "panaortitis syndrome" was mentioned.

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A case of muscular subaortic stenosis has been reported. This case was first considered to be a ventricular septal defect because of the history and a hursh systolic murmur heard over the entire precordium with cardiac enlargement. However, the routine angiocardiogram and brachial pressure curve demonstrated a characteristic pattern of muscular subaortic stenosis. As to the frequent appearance of ECG with short P-R interval, we have suggested that anomalous conduction which may be caused by complicated rheumatic lesion rather than hypertrophied septal muscle.

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An abnormal electrocardiogram was observed in a patient with subarachnoid hemorrhage. Electrocardiographic changes consisted of elevated S-T segments, prolongation of the Q-T interval, diphasic T-waves, deeply inverted T-waves and prominent U-waves. No correlation between these changes and the severity of the patient was detectable. These electrocardiographic changes were not associated with electrolyte disorder and coronary artery disease. Two points of bleeding were revealed in postmortem examination, but which lesion was responsible for this electrocardiographic changes was not decided.

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