Acid mucopolysaccharides (AMPS) and collagen contents of various portions of the renal arterial system were studied to observe changes with advancing age. The arteries were dissected from 50 cadaver kidneys ranging in age from 18 to 87 years. 23 of the kidneys were used for AMPS content and the rest were for collagen content. The samples were made free of lesions, and divided into three portions according to locations: segmental and interlobar arteries exterior to the renal tissue (branches of the main renal artery before entering the renal parenchyme) were noted as portion A, interlobar arteries within the renal tissue as portion B, arcuate and interlobular arteries as portion C, respectively. Uronic acid measurements showed that the AMPS contents were significantly different between the three portions, with trend of decrease from proximal towards distal portions. With age there was a linear increase of AMPS, which was most marked in the proximal portion. The regressions of the AMPS contents with age were expressed by the equations: Y=0.950×0.0188X (r=0.49, p 0.05), for portion A; Y=0.674+0.0131X (r=0.46, p<0.05), for portion B; Y=0.577+0.0084X (r=0.34, p>0.05), for portion C; Y stands for uronic acid, mg/g dry defatted weight, X age in years. The collagen contents in the portions A, B and C were 5.45, 5.16 and 5.55 hydroxyproline g/100g dry defatted weight, respectively. With age there was a small but significant increase in the hydroxyproline contents for portions A and B. The regressions of the collagen contents with age were expressed by the equations: Y=4.82+0.0122X (r=0.468, p<0.05), for portion A; Y=4.43+0.0143X (r=0.576, p<0.01), for portion B; Y=5.60+0.0098X (r=0.044, p>0.05), for portion C; Y stands for hydroxyproline g/100g dry defatted weight, X age in years. These data were calculated in connection with the concept of gel-fiber ratio, which, according to Sobel, is to decrease with age indicating the biochemical age of connective tissue. In all three portions of the renal arterial system the investigation suggested an increase in the uronic acid to hydroxyproline ratio with advancing age. It should be stressed that the aging process of the vascular system differs in different portions of the renal arterial system.
Plasma fibrinolysis, coagulation and serum lipids were determined in patients with liver cirrhosis, who were divided into three groups according to clinical manifestation at the time of blood withdrawal. Euglobulin clot lysis time (ELT) was shorter in three patients groups than in normals. As compared with compensated group, ELT was significantly shorter in the ascites group. ELT in the hemorrhage group with a ruptured esophagial varices was significantly longer than in the ascites group, and the mean values in hemorrhage group were the same as that in normals. There was a significant decrease in plasma fibrinogen in both groups with ascites and hemorrhage compared with the compensated group. The ascites group showed the lowest values of plasma fibrinogen among three groups. Factor VIII activity in three patients groups was higher than in normal level, and all of the patients showed the activity above 50%. Also there das no difference in the positive percentage of FDP more than 10μg/ml among three groups. Even in hemorrhage group, any patient could not been diagnosed undoubtelly as DIC by coagulation and fibrinolysis abnormality. Positive correlation was found between plasma fibrinogen and serum triglycerides, so that plasma fibrinogen was decreasing in parallel with serum triglycerides concentration in three groups. It is suggested that the simultaneous decrease of plasma fibrinogen and serum triglycerides appeared as a result of reduced production caused by liver damege.
In order to clarify the hereditary and environmental influences on the aging process of the kidney, comparative study has been made histologically and micrometrically on the kidneys obtained at autopsy from Japanese in Hawaii, native Japanese and Caucasians in the United States. The weight of the kidney, thickness of the renal cortex, size and cell number of the glomerulus and size of renal parenchymal cells were generally larger in the Caucasians and the Hawaii-Japanese than the native Japanese. Both the kidney weight and the cell number of the renal parenchym decreased gradually with age, accompanied by hypertrophy of the parenchymal cells. These changes developed more markedly in the native Japanese, moderately in the Japanese in Hawaii and less markedly in the Caucasians. The weight loss of the kidney seemed to be correlated with arteriosclerotic change of the intrarenal arteries relatively clearly in the Japanese compared with in the Caucasians. Arteriosclerotic changes seemed to begin earlier in the arteries of middle caliber than in that of small caliber and later in the arterioles and increased in grade with advancing age. In the native Japanese arteriosclerosis appeared earlier and increased more markedly in grade than in the Caucasians. And in the Hawaii-Japanese, sclerotic changes were somewhat more remarkable than in the native Japanese. Number of the hyalinized glomeruli also increased with age most strikingly in the Hawaii-Japanese which showed heaviest sclerotic changes of the three groups. Decrease in size of glomerulus with age was noticed in the native Japanese but not in the Caucasians at all. In the Hawaii-Japanese, glomeruli decreased sharply in their size after 80 years of age. From above, environmental especially nutritional conditions were considered to play an important part on the difference in the process of the senile changes of the human kidney.
Serial changes in ECG findings and blood pressure were studied in 134 residents over 40 years old in an urban area of Fukuoka City (Male 42, Female 92), who had taken the health examination in the years of 1968 and 1973, and at least two electrocardiograms were available. Records of health examination were also analysed in 26 residents who took the health check in 1968 and died of cerebrovascular diseases or heart diseases during the next five years. 1) The normotensives were Male 78%, Female 48% in forties and Male 27%, Female 38% in sixties, and the rate of normotensives decreased as the age increases. After five years, the rate of boundary hypertensives decreased and the rate of the systolic hypertensives increased. 2) Of the ECG findings of age group, incidence of slight ST-T abnormalities were significantly high in females of fifties and sixties, but the findings of left ventricular hypertrophy were found in 26.2% of males and in 21.7% of females, with insignificant difference. With the time course of five years, slight ischemic changes in ECG were significantly increaed in females of forties and fifties, when compared with males of the same age group. 3) The mean QRS and T vectors of the normotensives with normal ECG group decreased of their magnitude during the five years course. QRS vector rotated clockwisely left, backward and upward. T vector had the tendency to shift counter-clockwisely right, forward and upward. 4) The QTC became longer among the normal group during five years, and it was more apparent among the hypertensive and ischemic change groups. 5) The order of causes of deaths in five years in this district was (1) cerebrovascular diseases, (2) malignant neoplasmas, (3) heart diseases, (4) deaths of exogenous-causes, and (5) liver cirrhosis. Among the deceased during this period who took the health examination in 1968, 16 persons died of cerebrovascular diseases (cerebral hemorrhage 12 cases, encephalomalacia 4 cases) and 10 persons died of heart diseases. i) There were only two cases of encephalomalacia and cerebral hemorrhage among those who were found without abnormalities at the health examination. And the rest of 24 had been all diagnosed as having hypertension, or hypertensive or ischemic heart diseases. ii) The residents who died of cerebrovascular disease were mostly hypertensives (normotinsive 13%) and the systolic hypertension was noted in four cases (25%). Whereas, of heart disease group, the normotensives were four among ten cases, and no systolic hypertensives were noted. iii) Of cerebrovascular disease group, five among 16 cases had normal ECG findings at the first check, and ischemic changes were noted only in 3 cases (19%). In contact, in heart disease group, two of the ten cases had Q, QS pattern in ECG and 9 cases had ischemic changes. Thus, the importance of blood pressure measurement and ECG in health examination was reemphasized.
The purpose of this report was to study changes of blood pressure and body temperature in the early stage of cerebrovascular diseases and their relationship to prognosis of patients and the site of lesions. Materials consisted of 27 cases of cerebral hemorrhage and 34 cases of cerebral infarction. In all cases diagnosis was confirmed by autopsy. Within 3 hours after cerebral hemorrhage, the average of blood pressure was remarkably elevated and the average of body temperature was slightly lowered. During the subsequent 24 hours the average of blood pressure showed a rapid fall and the average of body temperature was remarkably elevated. The more remarkable and rapid were these changes in blood pressure and body temperature during the first 24 hours after stroke, the poorer the prognosis of patients. Pathologically, such patients were most often found in combined type of cerebral hemorrhage accompanied with ventricular bleeding. In most cases of cerebral infarction there were not so great changes in both blood pressure and body temperature after stroke as in cases of cerebral hemorrhage.
Changes of hematocrit value, electrolyte and urea nitrogen concentration during acute stage of cerebrovascular diseases were studied on 27 cases of cerebral hemorrhage and 34 cases of cerebral infarction. In all cases diagnosis was confirmed by autopsy. The results were as follows. 1) In cases of cerebral infarction the average of hematocrit value increased for 3 to 4 days after stroke and then decreased thereafter, while in cases with cerebral hemorrhage it remained almost unchanged for 15 days. 2) In cases of both cerebral infarction and hemorrhage, serum potassium and urea nitrogen concentration showed the tendency to increase after stroke. In most cases serum sodium and chloride concentration were unchanged, and the average of serum protein level began to decrease at the third or fourth day after stroke. 3) The relationship between changes in hematocrit value and water balance was studied. Hematocrit value remained unchanged in some cases of cerebral hemorrhage even when there was a deficiency of water intake. On the other hand hematocrit value showed remarkable increase in cerebral infarction in such situations. It was suggested that there was an impairment of homeostatic control of water metabolism in acute stage of cerebrovascular diseases, especially of cerebral infarction.