Among 28 patients with corrective surgery of the tetralogy of Fallot, 3 patients died early postoperatively and 1 died 4 months after surgery. Early deaths were all due to incomplete relief of the obstruction of the right ventricular outflow tract.
A preliminary observation of the hemodynamic changes after betaadrenergic inhibition was tried in order to classify the type of the obstruction and revealed some interesting facts.
The author discussed the relationship between the type of the obstruction and the surgical mortality, and that between some operative techniques and the degree of surgical relief of the obstruction, and emphasized that it was the most important to endeavour to relieve the obstruction as completely as possible for improvement of the surgical result.

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The effects of 4 coronary vasodilators, i.e. N-[3'-phenyl-propyl-(2')]-1, 1-diphenyl-propyl-(3)-amin (Segontin), 2.6-bis (diaethanolamino)-4, 8-dipiperidino-pyrimido-(5, 4-d) pyrimidin (Persantin), Papaverine hydrochloride and 7-chlorethyitheophylline (ETE) were studied on 19 cases of coronary sclerotic patients by the method of coronary sinus cathetherization.
Segontin, Persantin and ETE increased the coronary blood flow, although Papaverine hydrochloride decreased it. Among 4 drugs, only Persantin decreased the coronary vascular resistance, although the tested drugs except ETE decreased or had the tendency to decrease the coronary-systemic resistance ratio, i.e. the relative coronary resistance. At the same time, the oxygen unbalance in the myocardium was slightly improved by Persantin, unchanged after Segontin and Papaverine hydrochloride and became worse after theophylline derivative.
The changes of coronary blood flow by these drugs were brought about in part by the changes of mean diastolic pressure or mean diastolic pressure×heart rate, however some other direct or indirect effects of these drugs on the coronary vasculature may be present. Some discussions concerning these points are presented.

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(1) The instrumental aspects of apexcardiography were studied with particular emphasis on the significance of decay characteristics of recording equipments in relation to wave form.
(2) The time constant of broadly used Sanborn pulse wave attachments (#373 etc.) was different from unit to unit. And, most of them were not sufficiently long for recording such a low frequency phenomena as in systolic wave of apex-beat.
(3) The source of short time constant of commercial pick-ups would be due to an air leak within its housing.542 MASHIMO, ET AL. Jap. Heart J. November, 1966
(4) A consideration was made about the feasibility of apexcardiogram with short time constants as a reference tracing of phonocardiogram.

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The reflex control of systemic blood pressure by the right subclavian baroreceptor was studied in normal and hypertensive rabbits anesthetized with α-chloralose, and the following findings were obtained.
(1) In both normal and hypertensive rabbits, a relationship between raising perfusion pressure and decrease in systemic blood pressure, showing sigmoid blood pressure to perfusion pressure-response curve, was obtained.
(2) In control rabbits, the threshold of the vasodepressor response was 20.0±8.2mm.Hg; the perfusion pressure at the upper limit and the middle point of the maximum sensitivity area of the curve were 118.2±13.6mm.Hg and 81.3±11.2mm.Hg respectively; and the maximum fall of systemic blood pressure was 24.4±8.4mm.Hg. The average mean systemic pressure of control rabbits was 86.6±10.6mm.Hg, and thus nearly coincident with the perfusion pressure of the middle point.
(5) The curves obtained during infusion of angiotensin II was nearly coincident with that obtained before infusion.
(4) In 4 cases of renal hypertensive rabbits within 2 weeks, the curves shifted to lower pressure levels in parallel with that of control rabbit. In 6 cases from 3 to 4 weeks' duration, the curves were found at control level. In 4 cases of 5 weeks, the curves shifted to higher levels than control. In 6 cases over 5 weeks' duration of hypertension, the curves shifted to more higher pressure levels and the middle point of the maximum sensitivity area was nearly coincident with the average mean systemic pressure of hypertensive phase. In 4 treated cases without hypertension, the curves were found at control level.
In conclusion, the right subclavian baroreceptor was reset at higher arterial pressure levels over 4 weeks' duration in experimental renal hypertension of rabbit.

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In order to study myocardial protein metabolism in cardiac hypertrophy and failure, the changes in concentrations of various proteins, nucleic acids, and amino acids, and in activities of protein synthetic enzymes and transaminases were observed in the heart muscle of dogs with experimentally produced cardiac hypertrophy.
Cardiac hypertrophy, especially left ventricular hypertrophy, which was ascertained by measurement of the ratio of heart to body weight, right to left ventricular weight and RNA to DNA, was produced by aortic valve lesion.
(1) In the early stage of hypertrophy and in acute failure hydration of myocardium proceeds.
(2) The myocardial concentrations of total, noncollagen and contractile protein were decreased due to hydration of the myocardium in the early stage, but the total contents of them were increased progressively except a temporary initial decrease in total protein.
(3) The concentrations of soluble protein, microsomal protein and mitochondrial protein were elevated throughout the course of time.
(4) The activities of GOT and GPT in the myocardium were elevated both in the early and late stage of hypertrophy. This tendency is similar to those of some amino acids.
(5) The activities of amino acid activating enzyme were elevated early, and returned rapidly to the control level. They were, however, lowered in another group of dogs which were in the acute and chronic cardiac decompensation tsage.
(6) The changes in the myocardial concentrations of free amino acids were varied with its sort. In the acute phase, increases in fraction A₁ and N₃ were noticeable, and in relatively stable phase of hypertrophy decreases in fraction A₁, N₂, N₄ and N₅ were remarkable.
(7) The increased concentrations of mitochondrial and cytoplasmic protein, RNA, transaminases, some amino acid fractions (A₂, N₃) and the increased activity of amino acid activating enzyme are suggestive of increased energy metabolism and of accerelated protein synthesis.

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(1) The U vector loop of ventricular premature beats was studied in 32 cases. Vectorcardiograms were taken by Frank's method.
(2) In contrast to the U vector loop of normal beats of healthy subjects, which showed a small return movement from the T-U junction and frequently a small circle at the tip of the U vector, the U vector loop of ventricular premature beats showed a much smaller return movement and rarely a small circle.
(3) The U vector loop of ventricular premature beats from apparently normal subjects was inscribed usually in the direction of the terminal limb of the T loop, but that from cardiac patients extended in various directions, often by having a marked bend at the T-U junction.

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(1) A case of coarctation of the aortic arch having a long narrowing between the left common carotid artery and the left subclavian artery is reported.
(2) The case had a large saccular aneurysm, from which the left subclavian artery arose.
(3) There was no other cardiovascular malformation except for the abnormal distribution of the left innominate vein situated behind the ascending aorta.

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