Biopsied muscles in 53 cases of the neuromuscular diseases and in 20 cases of the aged were examined electron microscopically. Measurement of the thickness of capillary basement membrane was made on their minimum width. Following results were obtained. 1) Normal value: Examination on the 9 cases, which showed no remarkable changes in the muscle, revealed average 1080Å, maximum 2750Å in the thickness of their capillary basement membrane. 2) In thirteen cases of diabetes mellitus, the basement membrane of all capillaries showed prominent thickening and some capillaries were degenerated with collagen proliferation in or around the basement membrane. Average thickness was 5550Å and maximum value was 10000Å. 3) In some cases of the neuromuscular diseases other than diabetes mellitus, especially in the polyneuropathies due to alcohol intoxication and arsenic intoxication and also in parkinsonism, thickening of the capillary basement membrane was noticed. 4) In the aged the capillary basement membrane showed moderate thickening, average 1580Å, maximum 3580Å. In the cases with malignant tumor, the basement membrane was thicker in width. 5) Thickness of the basement membrane had no relationship with the biopsy sites.
Influence of bronchial asthma to the life in Japan was studied in the present paper, using five epidemiological approaches on the basis of the statistics of mortality and following results were obtained. 1) Rank of asthma in 15 leading causes of death. As for the rank of causes of death in Japan, asthma was ranged between the 12th and 15th leading cause of death in recent 20 years from 1950 to 1969. Although asthma is not within the 10 leading causes of death, it holds still important position in total deaths. 2) Annual trend of the death rate from asthma. During this twenty years, death rates from asthma for total age group and for the group at ages from 35 to 64 had been slightly decreasing in both sexes. On the contrary, the death rates from asthma for the groups at ages from 5 to 9, 10 to 14 and 15 to 19 had been increasing after 1959. 3) Annual trend of the rate of life lost from asthma. During this twenty years, the rate of life lost from asthma had been decreasing year by year untill 1958. Since then, the rate of life lost had not been decreasing and it seems to reflect that the death rate from asthma for the younger age group had been increasing. 4) Prefectural difference of deaths from asthma. The standard death ratio from asthma for each prefecture was calculated. Among the prefectures with high ratio, there were no significant differences of standard death ratio. 5) Asthma in life table. In our clinic 3, 092 (1, 605 male, 1, 487 female) asthmatic patients had been treated in the period of 15 years from 1957 to 1971. Deaths of 52 male and 39 female patients were reported, in whom 18 male and 14 female patients died from asthmatic attack. Abridged life tables for these asthmatic patients and for all Japanese in 1968 were constructed. The expected survival (1x) of asthmatic patients per 100, 000 born alive was smaller than that of the general population after 10 years of age in both sexes. Life expectancy at birth of all asthmatic patients were 62.79 for male, 66.52 for female and these of asthmatics died from asthmatic attack were 56.55 for male and 57.91 for female. On the contrary, life expectancies of all Japanese in 1968 were 69.06 for male and 74.21 for female. It is concluded that bronchial asthma is by no means a less important disease.
Although there are many investigations of the inorganic matter of bone from senile osteoporosis, the relation between bone collagen and osteoporosis is not obscure yet. To investigate these problems, priviously we reported that the number of lysyl residues from skin collagen of normal rat depended on its solubility. The lowering of solubility is explained by the decrease of collagen crosslinks. There are several forms of crosslinks in collagen. Allysine and hydroxyallysine which are the δ-aldehydes formed following enzymatic oxidative deamination of the ε-amino groups of peptide bound lysine and hydroxylysine are the precursors of collagen crosslinks. Their basic linkages are aldimine bond, reduced aldimine bond and aldol condensation product. However, reduced aldimine bond and aldol condensation product can not be hydrolyzed to produce any lysine or hydroxylysine molecules. As the number of collagen crosslinks increase, so we have the probability to get less lysyl or hydroxylysyl residues in the hydrolysate of collagen. On these knowledge, we explained the lowering of collagen solubility by the decrease of these residues. The relation of bone collagen crosslinks to osteoporosis is not elucidated well. Thus the question of collagen structure related to crosslinks has led us to search for it at the amount of lysyl and hydroxylysyl residues of collagen from bone. At first we reported the lysyl and hydroxylysyl residues in the rat bone collagen of experimental osteoporosis by low calcium diet. For the lysine determination, a microdiffusion method in the Conway vessel was devised by using purified L-lysine decarboxylase. Hydroxylysine was determined by the method of Blumenkrantz-Prockop. The lysyl residues increase parallel to the increase of the grade of experimental osteoporosis, but the hydroxylysyl residues have no difference between normal group and experimental osteoporosis groups. This result shows the decrease of crosslinks of bone collagen with experimental osteoporosis. Now we proceed to the next problem of human senile osteoporosis. Specimens of cortics of femurs from marked senile osteoporosis, the age 69 to 80 years, 5 females were obtained during surgical treatments. Cortics of normal femurs were collected by the same way, the age 18 to 49 years, 4 males and 1 females. The lysyl residues increase in the senile osteoporotic bone collagen, but the hydroxylysyl residues are not statistically different between them. The number of lysyl residues from insoluble collagen of osteoporotic bone are larger than that of normal bone. This result suggests the decrease of bone collagen crosslinks with osteoporotic change.
Although there have been a number of reports on the incidence of extrasystoles in various diseases or on its relation to aging, few of them are concerned with the occurrence of extrasystoles in a large number of patients with different ages and diseases. In this report, observations are made on the relationship between ventricular or supraventricular extrasystoles and age, sex and various conditions of consecutive and well documented 8000 cases hospitalized to the 2nd Department of Internal medicine, University of Tokyo. Extrasystoles were found in routine ECG in 553 cases (6.9%); ventricular in 343, atrial in 137, A-V nodal in 45 and undetermined supraventricular (either atrial or nodal) in 28. The incidence of extrasystoles was found to be increased with age, especially in higher age groups. This tendency was most marked in ventricular extrasystoles. The incidence was generally higher in male patients than in females. The incidence of ventricular extrasystoles in various conditions was as follows: 15.1% in coronary heart disease, 13.4% in valvular and congenital heart diseases, 2.0% in hypertension and 2.6% in other conditions, whereas that of atrial extrasystoles was 5.3% in coronary heart disease, 2.0% in valvular and congenital heart diseases, 1.7% in hypertension, and 1.4% in other conditions. The influence of aging on the percentage of patients with extrasystoles was examined in coronary and valvular heart diseases compared with non-cardiac diseases as a control. In valvular heart disease the difference between different age groups was not significant. The percentage of patients with extrasystoles was markedly increased with age in coronary heart disease and was slowly increased in non-cardiac diseases. The coupling interval of extrasystoles was, on the average, showed no significant relation to aging. In non-cardiac diseases, the direction of ventricular extrasystoles was leftwards more frequently than rightwards. The relative frequency of rightward directed extrasystoles was increased in ischemic heart disease. No definite relation existed between the direction of extrasystoles and age.