Functional phonocardiography using methoxamine was performed in 400 cases of various cardiovascular diseases including normal subjects.
Intravenous administration of methoxamine (0.08 to 0.1mg./Kg. within 20 to 30sec.) caused the rise in systemic arterial pressure in an average of 45% and the subsequent bradycardia. During the maximum effect (1 to 3min. from the start of the injection), the heart sounds are affected significantly and the heart murmurs changed in the following fashion.
The left-sided regurgitant murmurs were intensified, whereas the rightsided ones were not affected significantly or decreased except the increase in the pulmonic regurgitant murmur in Eisenmenger syndrome. The ejection systolic murmurs were changed insignificantly or slightly decreased except the case of tetralogy of Fallot. The pulmonic systolic murmur of atrial septal defect may be intensified. The ventricular filling as well as the atriosystolic murmurs of organic mitral stenosis decreased, whereas the murmur of relative mitral stenosis increased.
In some cases, atypical murmur changed into typical configuration, and the silent or latent state of left-sided valve lesion was disclosed in many cases.
Discussions were made on the mechanism of the above-mentioned effect and the usefulness as well as the limitation of this functional test.

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(1) Autopsy data observed in the National Cancer Center Hospital in Japan were analyzed with reference to cardiac metastasis.
(2) Between a period from 1962 to 1965, among 765 deaths from malignant neoplasm which did not include leukemia, over-all incidence of cardiac metastases was 9.7%.
(3) Incidences of cardiac metastases in the patients with carcinoma of esophagus, carcinoma of stomach, carcinoma of rectum, carcinoma of lung, reticulum cell sarcoma, carcinoma of breast and carcinoma of tongue were 4.0%, 4.3%, 8.3%, 18.0%, 20.6%, 25.0% and 50.0%, respectively.
(4) Number of cases with great vessels' involvement was 13 (1.7%).
(5) Seven cases with direct invasion and 5 cases with disseminated pericardial metastases out of 28 cases with pericardial involvement were observed.
(6) No effect of radiation therapy on either incidence or distribution of cardiac metastases was observed in all cases except cases with carcinoma of tongue.

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(1) A comparative study on determination of cardiac output by simultaneously recorded earpiece and brachial arterial cuvette curves was made on 23 subjects, both in resting state and during leg-exercise on a bicycle ergometer.
(2) The values for resting cardiac output were well agreed in both methods, with close correlation and no deviation of regression line from unity.
(3) Relative cardiac output during exercise determined by both methods were compared in terms of percentage value of the reciprocal of area under the curves, in comparison to each resting value. Close correlation was again obtained between the values by the 2 methods. Although there was a minor tendency for less increases in cardiac output by the earpiece method during exercise, the difference between the values by the 2 methods was small enough to be disregarded for the practical purpose. The physiological reaction of the ear capillaries to exercise may be suggested to contribute in part to this difference.
(4) It was concluded that with the use of a reliable equipment and with careful preparations before procedure, the earpiece indicator-dilution technique offers a potential promise in evaluation of the central circulation of the human beings in both resting and working state.

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The type-specific streptococcal antibody was investigated on sera of 337 patients, including rheumatic fever and rheumatic heart diseases, using Boyden's tannic acid hemagglutination technique. The previously reported results were reaffirmed and some new results were obtained. The mechanism concerning the development of rheumatic fever was discussed.
While rheumatic fever and rheumatic heart diseases had a close connection with streptococcal infections, rheumatoid arthritis seems to have less intimate relationship with streptococcal infections.

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(1) A vectorcardiographic analysis was made in 30 subjects of WPW syndrome, in correlation to the electrocardiographic classification of Ueda's criteria.
(2) In type A (14 cases) whose QRS complex in V₁ is characterized by R or Rs pattern, the initial QRS vector was directed superiorly or inferiorly, followed by the main body of QRS loop oriented anteriorly or left-anteriorly, and T loop was situated slightly posteriorly to QRS loop with narrow QRS-T angle.
(3) Type B (8 cases) showing rS pattern in V₁, had many vectorcardiographic values similar to type C, but had a definite forward deflection in its initial vector with the following QRS loop showing a wide range of leftward direction with variable QRS-T angle.
(4) In type C (8 cases) that has QS or W pattern in V₁, it was shownthat the initial QRS vector and the following QRS loop were directed straight to the left, slightly anteriorly or posteriorly with wide QRS-T angle.
(5) Investigations were also made on the polar vector of QRS and T loops, which was found to occupy the spatial octant characteristic of the foregoing respective type. The polar vector of T loop of WPW syndrome was suggested to have some resemblance to that of bundle branch clock.

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The authors observe the contour and location of the U loop in normal, hypertension, aortic insufficiency and infarction.
(1) In normal cases, the horizontal U loop is located leftanteriorly with the small loop or V shape, and the left sagittal U loop is located anteroinferiorly with small loop. The U loop in frontal plane is located leftinferiorly with hookor γ type.
(2) In hypertension, the U loop in horizontal plane is dislocated from leftanteriorly to rightanteriorly. The contour of the U loop is γ or V shape and in cases with the T loop located rightanteriorly with clockwise inscription, the U loop is V shape with clockwise inscription. The authors call those U loop as the secondary U loop change.
(3) In aortic insufficiency, the U loop change in horizontal plane is similar to that in hypertension, but, in some cases the middle portion of the horizontal U loop is located rightanteriorly, the terminal portion remaining leftanteriorly. This characteristic type corresponds to the third type in hypertension and might be due to diastolic overloading.
(4) In some cases with hypertension and many cases with anterior or anterolateral infarction, the horizontal U loop is dislocated to the right or rightposteriorly or is shaped with round or ellipse. These changes of the U loop are called as the primary U loop change.
(5) The genesis of the U loop is discussed with those results.

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Effects of the electrical stimulation of the central gray stratum of the midbrain on the blood and myocardial catecholamine were studied in 26 normal dogs anesthetized with intravenous injection of α-chloralose.
(1) Blood pressure showed a biphasic pressor response consisting of a sharp rise with tachycardia during stimulation and a relatively slow elevation with bradycardia after stimulation.
(2) The concentration of both arterial and adrenal venous catecholamine was determined simultaneously by the fluorimetric method. Adrenal venous catecholamines secretion increased most strikingly during stimulation. In the animal with the intact lumboadrenal veins both peripheral arterial norepinephrine and epinephrine levels elevated also immediately after stimulation. The arterial norepinephrine concentration when adrenal venous flow was separated from systemic circulation increased during stimulation, and the epinephrine level of the artery elevated immediately after stimulation.
(3) The release of norepinephrine from the heart was confirmed by measuring the plasma norepinephrine level in bloods obtained simultaneously from the coronary sinus and femoral artery using coronary sinus catheterization under fluoroscopy.
(4) The myocardial norepinephrine content increased significantly by stimulation, but the epinephrine level remained almost unchanged.
A few possible explanation for these data was discussed.

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