Phonoarteriographic study was carried on 41 cases of "aortitis syndrome". Despite the complexity of the arterial murmurs, stenotic arterial murmur is separable from non-stenotic (both accidental and pathological)arterial murmur based on the phonoarteriogram. Irrespective of the loudness, stenotic arterial murmur has crescendo-decrescendo configuration, i.e., early diamond in mild stenosis, mid-diamond in moderate stenosis and mid- to late diamond in severe stenosis. The last one is frequently transsystolic or even continuous. Moderate and severe stenosis are not easily separable on the routine phonoarteriogram, because the involvement of aorta and its branches varies from case to case and the configuration of the arterial murmur is influenced by the degree of involvement of the neighboring arteries and the degree of development of collateral vessels. However, the functional phonoarteriography using amyl nitrite or methoxamine has a value in the quantitative assessment of the degree of stenosis. With amyl nitrite inhalation, the arterial murmur of moderate stenosis increases as in the cases of mild stenosis, whereas the one of severe stenosis decreases and so it does the continuous murmur. Methoxamine has an opposite effect on the arterial murmur. Collateral vessels give no significant murmur except a few cases of kinking with marked angulation of artery, and it is late diamond with delayed onset. It is concluded that the routine as well as functional phonoarteriography has an important diagnostic value in the assessment of the obstructive arterial disease and warrants the use before a patient is submitted to more complicated diagnostic procedures such as aortography or arteriography.

View full abstract

Trends in the incidence of cerebral hemorrhage and infarction in Japan were analyzed based on the 3 kinds of data obtained from death rate, autopsy case and our prospective study on CVD in a selected community, called Hisayama, Kyushu Island, Japan.
From the findings of mortality statistics it appears that cerebral hemorrhage has decreased slightly and, on the other hand, cerebral embolism and thrombosis has increased greatly for the recent 11 years.
Based on the main diagnosis of autopsy cases derived from various parts of this country, cerebral hemorrhage showed no definite change in annual incidence, while cerebral thrombosis had a steady increasing trend for the recent 5 years.
The prospective study on CVD in Hisayama showed a greatly decreasing trend in incidence of cerebral hemorrhage and a slightly increasing trend in incidence of cerebral thrombosis for the recent 3 years.
From these findings it can be supposed that there is some decreasing trend in cerebral hemorrhage and an apparent rising trend of cerebral thrombosis in Japan.

View full abstract

The application of the capacitor discharge type defibrillator for treatment of various arrhythmias was reported.
Methods of treatment, complications, hemodynamic changes and recurrence problems of the cardioversion for atrial fibrillation were discussed.
Clinical experiences with a case of ventricular tachycardia complicated with Uhl's disease and its management were also reported.

View full abstract

Clinical course and prognosis were studied in 103 patients with chronic pulmonary emphysema with special reference to clinical features and pulmonary hemodynamics, and in 78 patients of whom right heart catheterization was performed. The periods of the follow-up were between 1.5 and 10 years (4.4 years on an average).
Thirty cases died during these periods and 73 cases were still alive. Details of 73 living patients in the clinical situation were "improved" in 25 cases (24.2%), "unchanged" in 32 cases (31.3%) and "worsen" in 16 cases (15.5%).
Among 30 cases of "dead", 8 patients died from right heart failure, 5 died from probable right heart failure and the other 17 cases died from other causes such as infection, malignancy and et cetera.
The results suggest that pulmonary hemodynamics, especially pulmonary artery mean pressure (PAm), is an important factor in predicting the prognosis of chronic pulmonary emphysema. Thus, any one of the following items can be taken as a valuable index for judgement of poor prognosis:
(1) PAm of over 30 mm.Hg
(2) Ecg of RVH following the ordinary criteria plus PAm of over 22mm.Hg
(3) PaCO₂ of over 50mm.Hg plus PAm of over 22mm.Hg
(4) WP of over 8mm.Hg (especially of over 13mm.Hg) plus PAm of over 22mm.Hg
(5) PVRI of over 600 dynes•sec.cm.^-5/M.² plus PAm of over 22mm.Hg
(6) MBC of less than 35% plus PAm of over 22mm.Hg Either of the following items could be employed as a useful index for poor prognosis.
(1') SaO₂ of less than 88% plus marked ventilatory disturbance
(2') RVd of over 8mm.Hg

View full abstract

An investigation was carried out to evaluate mainly the influence of bloodpressure and heart rate on coronary blood flow, myocardial oxygen consumption and myocardial oxygen supply by coronary sinus catheterization on 14 cases of coronary sclerosis.
In resting state, mean diastolic pressure calculated from arterial pressure curve was correlated with coronary blood flow significantly.
When mean diastolic pressure was multiplied by heart rate, the relationship with coronary blood flow became to be more linear.
The relation of these factors with coronary blood flow was discussed in reference to the myocardial oxygen consumption.
The similar correlation between mean diastolic pressure or myocardial oxygen suppply was also observed.

View full abstract

(1) The renin-angiotensinogen reaction in the rat was examined in detail under various conditions of pH and temperature. Angiotensinase activity in the kidney extract and the plasma was also determined.
(2) pH-activity curves of angiotensinases in the plasma, red cells, and kidney extracts were determined. Angiotensinases in the kidney tissue had different pH-characteristics from those of the plasma or red cells.
(3) Incubation of the aid-treated extract with the heparinized plasma resulted in the maximum formation of angiotensin at pH 6.5, regardless of the presence of EDTA.
(4) At pH 5.5 formation of angiotensin continued to increase until 40min., and then formed a plateau, by incubating the acid- and alkaline-treated extract of 1/30 concentration at 37°C.
(5) At pH 6.5 formation of angiotensin reached the maximum after 20 to 40min., and then decreased slightly, by incubating the acid- treated extract of 1/30 concentration at 37°C with 3.3×10^-3 M EDTA.
(6) At pH 8.0 incubation of the acid-treated extract at 20°C resulted in a linear increase of angiotensin formation until 80min.
(7) Formation of angiotensin with various concentrations of the kidney extracts was determined under the above 3 conditions, where the effect of angiotensinases was relatively low and formation of angiotensin increased with the incubation time for a sufficient length.
(8) The reaction constants (K) calculated from the above results had a linear relationship with a wide range of concentrations of kidney extract at pH 8.0.
(9) Incubation of the acid-treated kidney extract with the plasma at pH 8.0 and 20°C for 30min. gave a more reliable method for the determination of renin in rat kidney.

View full abstract

The effect of coronary artery constriction and ligation, and graded changes in coronary arterial blood flow on myocardial contractile force was studied in anesthetized open-chest dogs. The coronary constriction and stepwise decreases in coronary blood flow using a Sigmamotor pump decreased myocardialcontractile force essentially in proportion to the decrements of the coronary flow. On the other hand, the increased coronary blood flow beyond physiological ranges did not increase contractile force. The coronary ligation decreased myocardial contractile force of the ischemic or injured areas of the ventricle, but increased the contractile force in the healthy area of the ventricle. Under these conditions, norepinephrine administration increased the contractile force of the healthy portion of the ventricle, whereas the myocardial contractile force of the injured portion remained essentially unchanged.

View full abstract

Administration of Anginin brought remarkable improvement of the clinical manifestations in 3 of our patients with occlusive vascular lesion of the limbs. Alleviations began by diminution of the persistent pain after a 10-day medication of Anginin 250mg.q.i.d. in all cases.
The case of suspected thromboangitis obliterans showed reappearance of pulsation in Aa. dorsalis pedis of his left foot. Gangrene of his left big toe started to heal after 3-week medication. In the second case, there was a great improvement of weakness of his right hand and intermittent claudication as well. The third case, in which severe occlusive lesions were noted in her left iliac and femoral arteries of both sides, responded well with amelioration of sensory impairment and intermittent claudication of her legs.
Pharmacological investigations and our experience suggested that it would be better to avoid administration of Kallikrein preparation when the patient is under the medication of Anginin.

View full abstract