Twenty-eight goats with an artificial heart (AH) were studied pathologically. Several organs except the lung and the kidney were taken up in this paper and finally, general discussion was done.
Noticeable findings were scarecely seen in the brain. In all goats which survived more than 141 hours, the liver gains its weight remarkably in accordance with the occurrence of ascites and microscopical central necrosis.
The infarctions at the alimentary canals were observed in 8 out of 17 goats which survived more than 4 days. In addition, two of them died of diffuse peritonitis caused by thrombogenic intestinal perforation.
There were few findings on the gallblader, pancreas, spleen, but adrenal glands showed moderate bleeding and hypertrophy in several goats.
As a whole, the main pathophysiological status of the animals replaced by the AH are thought conclusively to be peripheral circulatory insufficiency. This would be caused by abnormal hemodynamics, so that, the essential clinical etiology is thought to be AH function itself. Our, control method to regulate the output of the AH since october 1974, brought significant improvement on this point.

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In this paper the relationship between the clinical effect of permanent pacing and the cause of death is discussed.
Of 63 patients with implanted pacemakers, 8 died. The causes of death were cerebellar hemorrhage, sudden death, unknown cause, senility, pneumonia, cerebral embolism, myocardial infarction and mesenteric embolization. The mortality of our paced patients was 12.7 per cent. Post-operative mortality (within 30 days of surgery) was 1.6 per cent (one case). However, the cause of this death was unrelated to the pacemaker (myocardial infarction).
When the patients who have died are compared to the living patients, with relation to the average age at the time of initial pacing, we find that the former group was older than the latter. This may be due to natural history.
Electrocardiographic findings reveal that mortality in the supraventricular arrhythmic group was slightly higher than in the atrio-ventricular block group. In the supraventricular arrhythmic group, systemic embolization as the cause of death was remarkable. This may be due to the irregularity and/or stasis of the blood flow in the atria.
Hemodynamic improvement with pacing was quite obvious not only i n the living, but also i n the patients who had died.
After pacing, no Adams-Stokes attacks or death due to congestive heart failure ever occured.
Although patients derive hemodynamic improvement from pacing, it is no guarantee that they will not die from causes unrelated to the pacemaker. Pacing, therefore, is not always effective in prolonging life.

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Recent advancement of polymer science has made available high quantity plastic polymers. One of these is polymethylmethacrylate. We have made effort to develope capillary type artificialy kidney using this material.
Seven patients were selected to examine validity of this dialyzer. For six of them it was temporalily used and for remaining one dialysis has been continued up to 9 months.
The performance and characteristics of this new membrane dialyzer are as follows: 1) A PMMA hollow fiber kidney is composed of 8000 PMMA fibers and has area of 1.1m². 2) Dialysance in clinical situation; urea 144±9ml/min, creatinine 118±7ml/min and uric acid 108±10ml/min. 3) Ultrafiltration rate is 8±1ml/min/100mmHg. 4) Clinical course of chronically dialyzed patient with this dialyzer has been uneventful. 5) Residual blood volume is much less. 6) Washout of formalin is much easier than other commercially available cellulose kidney.

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Swine carotid arteries were partically digested by the proteolytic enzyme chymotrypsin after being stripped of their surrounding tissues. However, being different from ficin treated bovine arteries reported by N. Rosenberg in 1956, they were keeping elastic fiber after treating. This was evidenced by measuring elongation rates by autography after tanning the treated arteries by glutaldialdehyde. Tanning agents were removed by ultrasonic washing. Fleund's adjuvant mixed solution in which treated and tanned arteries were washed well was infused i. v. to guinea pigs as an antigen and they had no anaphylactic shock.
Thus modified arteriografts (diameter 4.0-5.5mm) were transplanted to 45 dogs and non-treated arteries on 3 dogs as controls. 12 months studies on complications, blood composition, and pseudointima progress by scanning electron microscopes confirmed the function and safety, we have transplanted them at forarms of 34 hemodialysis patients as blood access. In 24 patients for 3 to 8 months after ttransplanation 71% was function and 29% failed (being retransplanted). Major complications were 6 infections, 5 pseudo diaphragm formation and 4 progressive narrowings of efferent veins. Immunomicro-fruorescent study demonstrated noinjury.

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Treatment in refractory heart failure is a difficult therapeutic problem. We experienced a case that was inresponsive to massive diuretics and cardiac glycosides.
Disposable dialyzer was used successfully to remove plasma water from the patient with refractory heart failure, inresponsive to massive diuretic therapy. The blood was removed from inferior vena cava via femoral vein using with Schaldon's cannula and was sent to dialyzer about 150ml per minute by sigma pump. A vaccume was applied to the space between the blood chambers of the dialyzer where the blood was ultrafiltrated and condensed. Then the blood was retuned to the patient's circulation. The ultrafiltration using this method was continued for 3 hours, and resulted in extraction of 1250ml of fluid, when there were subjective improvement, diminished pulmonary edema and decreased hepatomegaly. We concluded the availity of this method in the case of refractory heart failure which was indicated to remove excessive body fluid safely.

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