Clinical symptoms before and after permanent artificial cardiac pacing in 71 patients (35 male and 36 female; averaged age 65.1 years old) with bradyarrhythmia were described. These patients were diagnosed and classified into the following three groups: (1) A-V block (36 cases), (2) Sick sinus syndrome (31 cases), and (3) Atrial fibrillation with slow ventricular response (4 cases). The clinical symptoms shown before pacing were Adams-Stokes attack (66.7%), the limitation of physical activity (22.2%), heart failure (19.4%), palpitation (19.4%), vertigo (16.7%), anginal pain (13.9%) and dyspnea (8.3%).
After the implantation of the pacemaker, Adams-Stokes attack disappeared in all the cases. The limitation of physical activity was improved in younger patients, but such improvement was slightly depressed in the older patients. General symptoms caused by heart failure were also disappeared except in the patients with valvular heart disease. Palpitation was observed more frequently in sick sinus syndrome than in A-V block; it was difficult to eliminate this by pacing. Anginal pain, dyspnea and vertigo were disappeared by pacing.

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For the purpose of early diagnosis of thrombosed valve, sound spectral analysis were performed in 113 cases on 196 times, using real time sound spectral analyzer. This system consisted of 30 mechanical band pass filters, 10 kilowords of memory, logic circuit and display system. Types of valves used in this study were Starr-Edwards #6520, #6120, #2320, #1260, Kay-Shiley and Björk-Shiley prosthesis. F 1/6 value of opening clicks, which represents the amount of high frequency components, ranged from 1580Hz to 2150Hz in noncomplicated cases, and differd according to the types of prosthesis. F 1/6 value of prosthesis with occuluder, made of silastic rubber, were significantly lower than that of prosthesis with occuluder, made of comparatively harder materials, such as Stellite, Derlin and pyrolite carbon. In Björk-Shiley prosthesis, F 1/6 value of closing clicks were significantly higher than that of opening clicks, but no definite correlations were observed in the other types of prostheses. Four cases of thrombosed valves were experienced in this series. Two MVR cases with Kay-Shiley valves demonstrated F 1/6 value of less than 1000Hz in closing clicks alone or both closing and opening clicks. The other case was TVR case with Starr-Edwards #6520, demonstrating markedly reduced F 1/6 of both opening and closing clicks, less than 750Hz. Reduced F 1/6 value of opening click of the last case, who underwent MVR with Starr-Edwards #6120, suggested thrombosed valve, however, other studies such as UCG, PCG, and cineangiography did not give proof to the findings in sound spectral analysis. Details of the last case was also reported, discussing clinical efficiency of this technique.

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As previously reported, circuit B can yield less blood trauma with sufficient gas exchange than circuit A or C does. With this circuit, however, pressure in the membrane lung elevates higher than the arterial pressure and there may be potential hazard of blood leakage from the membrane lung.
The new circuit described in this paper can eliminate this trouble. It has two pumps. One locates proximal to and another locates distal to the membrane lung.
These two pumps were controlled by servomechanism so that internal pressure of the membrane lung is kept constant and minimizes the difference of pulse pressure before and after the membrane lung.
With use of this new circuit, experimental perfusion was carried out with satisfactory results.
In this new circuit, we can use any kind of membrane lung more easily and more conviniently by setting adequate condition; initial pressure and pressure difference between before and after membrane lung.

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An ascites pump, which pumps ascites from the peritoneal cavity to the venous system, namely, a peritoneocaval shunt pump, was devised.
One end of the shunt pump made of silicone rubber is operatively positioned in the peritoneal cavity to collect ascites. The other thinner end, which has a slit valve at a tip, is inserted via the jugular vein and advanced into the superior caval vein to infuse ascites. Both parts are subcutaneously extended and connected to a flush bulb with a second valve mechanism. Three to 6ml of ascites can be pumped per stroke by squeezing the bulb with fingers.
Initial clinical trials were performed in four diuretic-refractory patients. A typical case showed 30cm reduction in abdominal girth and 25kg decrease in body weight in a month.

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In a 14 year old girl a cardiac pacemaker with a pair of myocardial electrode has been implanted since 8 years old. As the first pair of the electrode fractured near its tip, the second pair was added. Thus, the patient had two pairs of myocardial electrodes with one demand pacemaker implanted. When she was readmitted to hospital because of light-headedness, ECG monitor revealed the frequent suppression of pacemaker emission consequent on transcutaneous waving of pacemaker unit. Application of the magnet over the generator resulted in no inhibition even on moving the unit. The pacemaker pocket was reopened. Waving of the active myocardial electrode or pacemaker unit did not inhibit the demand pacemaker, but manipulation of the inactive lead induced the suppression of pacemaker emission. Such manipulation produced interference waves of about 10mV in amplitude, which were caused probably by the motion of the cut end of the inactive leads in the patient's abdominal muscle. The exchange of the demand pulse generator to a fixed mode was followed by complete disappearance of light-headedness in this case.

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