The purpose of this study is to evaluate physical conditions in elderly people whose age is over 80 years and who apparently look healthy. Blood pressure, ECG, urinalysis, CBC, chest X-ray and blood chemistry examined were analyzed in 455 ambulatory people with 217 men and 238 women. Average ages were 82.7 years in male and 82.9 years in female. Mean blood pressure values were 140.5/75.8 and 144.7/77.3mmHg in male and female, respectively. 198 cases were normotensives where the pressure was below 139mmHg in systole and 89mmHg in diastole. Abnormal ECG findings were observed in 229 cases (65.7%) which were divided as follows: Myocardial infarction in 6.8%, left axis deviation in 7.9%, ST-T changes in 29.5%, left ventricular hypertrophy in 24.0% and bundle branch block in 7.2%. These abnormalities were more frequently seen in male than in female except for ST-T changes. Cardiomegaly defined by CTR greater than 55% was observed in 13.6% of male and 46.6% of female. Routine urinalysis revealed proteinuria in 9.9%, glycosuria in 8.8% and abnormal urobilinogen reaction in 13.1%. Mean values of various blood chemical studies were all within normal limits, but abnormal values in each examination were observed with following percentages; 13.3% of total protein, 16.7% of A/G, 6.4% of GOT, 1.6% of GPT, 7.6% of alkaline phosphatase and 17.5% of SUN. These abnormalities were more frequently noted in male than in female except for alkaline phosphatase. Serum lipid levels are listed with their mean values in male and female, respectively, as follows: Total cholesterol 182.3 and 203.8mg/dl, β-lipoprotein 352.4 and 422.2mg/dl, phospholipid 209.3 and 224.6mg/dl, triglycelide 108.5 and 121.7mg/dl, and NEFA 0.41 and 0.46mEq/l. These lipid levels were higher in female than in male. None of all examinations was abnormal in 22 men and 26 women. This indicates that the majority of the elderly people above 80 years of age who apparently looked healthy showed some abnormal findings and clinically suggests that physicians must be aware of these occult abnormalities when they deal with elderly cases.
Arteriosclerosis obliterans (ASO) involves mainly the vessels of the extremities, but it has been well known that arteriosclerotic lesions may suffer all kinds of visceral arteries in those patients with ASO. Blood pressure, E. C. G., renal function, serum cholesterol level, findings of ocular fundi, chest and abdominal X-ray were studied in about 270 patients with ASO, who admitted to the 1st Dept. of Surg., Univ. of Tokyo and Yoikuin Hospital, Tokyo Municipal Home for past 10 years. Reffered to these clinical data, operative and autopsy findings, the visceral vascular involvements were discussed and the followings were obtained. 1) In all 268 cases, hypertension was found by 70% and hypercholesteremia by 40%. It was seemed that there is positive relationship between these findings and ASO. 2) Cerebral, coronary and renal circulatory insuf ficiency was observed in 129 (48%). Among visceral vascular involvements, cerebrovascular insufficiency, myocardial infarction, aneurysm, renal insufficiency, and angina pectoris were predominant. 3) In 65% of dead 58 cases, the causes of death were attributed to cerebral, coronaty and renel insufficiency. Especially, the incidence of myocardial infarction and cerebral vascular insufficiency was high and accounted for by 21% and 19% respectively. 4) Autopsy was performed in 13 cases. Moderate and severe arteriosclerotic changes were also confirmed in aorta, cerebral, coronary and main branches of abdominal aorta. Somethimes diffuse arteriosclerosis were recognized in all visceral arteries, partly occluded with organized thrombi.
Incidence and related factors of arterial murmur at the inguinal region was studied on 532 subjects over 40 years of age. (375 male and 157 female). Inguinal arterial murmur was present in 12.1% of men, 7.0% of women and 10.3% of total subjects. Incidence of inguinal arterial murmur in men was 1.2% in 40-49 years of age, 8.2% in 50-59 years of age, 14.5% in 60-69 years of age and 40.0% over 70 years of age. That in women was 6.8%, 4.0%, 7.3% and 27.3% respectively. Namely the incidence of arterial murmur increased with advancing age. In case that inguinal arterial murmur was observed unilaterally, it was observed more frequently at the right side than at the left side. Systolic blood pressure of men with murmur was significantly higher than that of men without murmur. Diastolic blood pressure of both men and women with murmur was lower than those without murmur. There was no significant difference in serum cholesterol level between subjects with and without arterial murmur. Diabetes mellitus had also no significant relation to the incidence of arterial murmur. Calcification of abdominal aorta was more common among the patients with arterial murmur than patients without murmur, but the difference between them was not so marked in women as in men.
Calcification of the carotid siphon is not an infrequent finding in the plain skull radiograms. However, there have been a few reports about the clinical significance of the carotid siphon calcification. A radiological observation was performed in 1879 consecutive skull radiograms of subjects who were undergone the population survey and in 750 consecutive skull radiograms of patients who were admitted to our hospital, in order to verify the clinical significance of the carotid siphon calcification. The results obtained in the population survey was as follows. 1) The incidence of the carotid siphon calcification was 4.5%, and it was almost similar to the reprots in Europe. 2) There was a high statistical correlation between the aging and the incidence of the carotid siphon calcification; 0% in the third and fourth decades, 1.2% in the fifth decade, 6.3% in the sixth decade, 15.2% in the seventh decade and 30.0% in the eighth decade. But, sex was not correlated with the incidence of the calcification. 3) Complaints such as headache, dizziness and numbness were not correlated with the incidence of the carotid siphon calcification. 4) Hypertensive cases showed more higher incidence of the carotid siphon than nonhypertensive cases. 5) The sclerotic changes of the ocular fuddi were correlated with the incidince of the calcification. 6) There was a correlation between the values of serum triglycerides and phosphlipids, and the incidence of the calcification. But, values of serum cholesterol and the ratio of linoleic acid to oleic acid (L/O) were not correlated with the incidence of the calcification. The study of the in-patients was summarized as follows. The incidence of the finding was significantly high in the patients with cerebral infarction (29.9%) and in ones with hypertensive intracerebral hemorrhage (16.0%). On the other hand, the incidence of the calcification in the patients with subarachnoid hemorrhage was low (6.3%). These results suggest that the carotid siphon calcification is not an infrequent finding, and it may be of predictive value with regard to the development of cerebrovascular disease, particularly cerebral infarction. Therefore, it might be useful to study the skull radiograms of the atherosclerotic patients.