Authors reported already that adrenaline combined with phospholipid (lecithin) on SAISHIN IGAKU 29: 585, 1974, and in 15th Annual Meeting of Japanese Geriatr. Society in November 1973, and that in human plasma platelet aggregation was inhibited with incubation of catecholamine and lecithin in vitro, while it was induced by catecholamine, on Jap. Circul. J. 38: 579, 1974.
On this paper, authors observed that lecithin combined not only with adrenaline, but also with noradrenaline or dopamine in vitro: The radioactivity of ¹⁴C-noradrenaline and ¹⁴C-dopamine was detected on phospholipid area on thinlayerchromatography (Silica-Gel), while no radioactive areas were detected on the others (cholesterol, cholesterol-ester, triglyceride or free fatty acid). Furthermore, we observed that the contraction of smooth muscle in rabbit aortae was inhibited perfectly by preincubation of noradrenaline and lecithin for one hour at 37°C, whereas it occurred in noradrenaline solution. This inhibitory effect of lecithin did not result from destruction of noradrenaline, because the contraction of aortae again occurred in noradrenaline solution incubating for one hour at 37°C. It was concluded that noradrenaline and/or dopamine combined with lecithin in vitro as same as adrenaline did, and that the contraction of smooth muscle in aortae of rabbit induced by noradrenaline was inhibited by preincubation of noradrenaline and lecithin.

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The Marinesco body, first described by Marinesco in 1902, is an acidophilic intranuclear body in the neurons of the substantia nigra and the locus coeruleus. In Japan, Shiraki pointed out the occurrence of these bodies in hepatic encephalopathy in 1960. Since his report, some observations have been made on the close relationship between these bodies and ageing. However, there have as yet been relatively scarce literatures concerning the Marinesco body.
The purpose of this study was to determine more quantitatively the correlation of the Marinesco bodies, age of the patients and the underlying diseases.
Ten μ thick cross sections were prepared through the brainstems of 80 randomly chosen autopsied materials at the level between the superior and the inferior colliculi and stained with hematoxylin and eosin.
In each cross section, the total numbers of the pigmented neurons in the substantia nigra and of the Marinesco bodies in their nuclei were counted. The frequency of appearance of the inclusions in each case was expressed as per cent of the total number of the pigmented neurons in the same preparation.
The results were as follows:-
1) Melanin-pigmented neurons in the substantia nigra decreased significantly with advancing age.
2) Intranuclear bodies in the pigmented neurons could be classified into two groups. Group I bodies were acidophilic, while group II bodies were basophilic. Therefore, only group I bodies were designated as the Marinesco bodies, which could further be divided into three types according to their morphological characteristics.
3) The Marinesco bodies could not be found in cases before the age of 40 and they showed significant linear increase with aging.
4) The Marinesco bodies were more numerous in patients with pulmonary emphysema or pulmonary fibrosis than those found in patients of comparable age without these diseases. The difference in the numbers of these bodies between these two groups was statistically significant (p<0.01).

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Relationship between change of blood pressure (BP) and age was studied from the result of cardiovascular survey on 10, 210 apparently healthy employees of Tokyo Metropolitan Government, ranging in age from 15 to 84 years. Right-arm sitting BP was measured by specially trained paramedical personnels. Differences of BP among 27 groups classified by age and sex were statistically analyzed. The data showed a continuous increase of systolic BP with aging, starting from 20-24 years in male and from 30-34 years in female. Diastolic BP also increased gradually, from third decade in male and fourth decade in female, until 54-59 years of age, after which there was no significant change. As a result pulse pressure rose markedly after 50-54 age, but a increase of mean BP was recognized in the period of age from 20-24 to 60-64 in male and from 30-34 to 65-69 in female. Females had lower BP than males.
Systolic BP was positively related to diastolic BP in each age groups. All of these correlation coefficients were over 0.5 except for two younger groups. Linear regression equations were computed and regression lines of systolic BP to diastolic BP were compared among each groups. There was a constant slope of those lines in 30-54 in male and in 15-49 in females. After sixth decade the slope became steeper with advancing age, indicating systolic hypertension in older people.

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Recording of His bundle electrogram (HBE) including atrial overdrive suppression test was carried out in 57 patients (28 males and 29 females). In 27 cases of them atrioventricular block was observed, in 19 cases bundle branch block and in 11 cases sick sinus syndrome (SSS). 33 cases of them (57.9%, ) were over 60 years as shown in Table 1. The conduction abnormalities within the His bundle, in the His-Purkinje system and in both of them went on increasing with advancing years and were closely correlated with Adams-Stokes attacks. In sick sinus syndrome, sinus node recovery time (SRT) exceeding 1.4sec. was observed in all cases, but SRT was not always strictly correlated with Adams-Stokes attacks. HBE and SRT with overdrive suppression test were very useful for the diagnosis of the conduction disturbances, but routine electrocardiographic evaluation and careful observations of clinical symptomes were also necessary to predict the prognosis of these diseases.

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The purpose of this paper is to clarify the clinical-pathological characteristics of the duodenal ulcer in the aged.
Materials and methods: Forty nine cases of the duodenal ulcer from 1137 concecutive autopsies of geriatric patients over 60 years of age were studied morphologically and functionally in comparison with the gastric ulcer, gastric polyp and the so-called “normal” stomach having no localized lesions.
Results: The mucosal patterns of the stomach were divided into two groups; the one having the so-called “ordinary” pattern which shows the full thickness area of fundic gland mucosa on the lesser curvature, and the other having the so-called “atrophic” pattern which shows no complete area of fundic gland mucosa on the lesser curvature. A distinctive characteristic found was that the gastric mucosa having the duodenal (and gastric) ulcer showed 79.5% of the ordinary pattern. while the so-called “normal” mucosa showed only 32.7% of the ordinary pattern. The groups of gastric ulcers and gastric polyps, on the other hand, showed 28.8% and 7% of the ordinary pattern respectively.
The coincidence of morphological findings to functional conditions was confirmed also from the acidity of the gastric juice.
50% of the inducing factors to duodenal ulceration were apoplexia, severe infection, shock, jaundice and ulcerogenic drugs.
Conclusion: Hence, upon examination of the duodenal ulcer condition in the aged, it was concluded that a necessary prerequisite was a well preserved fundic gland mucosa with the gastric mucosa showing the ordinary pattern. Also, it was found that inducing factors to this condition (duodenal ulcer) in the aged, in comparison to younger patients, were stress and/or ulcerogenic drugs.

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In order to investigate the indices of aging, a mass examination was undertaken in 1963 on subjects (724 males, 1239 females, more than 65 years of age, who live in the Tokyo Metropolitan Home for the aged).
The results obtained were as follows:
1) Arcus senilis which was found more frequently according to age was considered to be a good index of aging.
2) Nocturnal frequency of micturition also increased in the advanced aged of both sexes, and this tendency was more marked in females than males.
3) Modified Broca's index become lower with aging in females, while no remarkable change was observed in males. Skin fold also showed some tendencies, and it was considered to be a better indicator than the modified Broca's index.
4) Systolic blood pressure tended to rise with increasing age, while diastolic blood pressure did fall. These tendencies were significant in females.
5) Electrocardiographic findings which reflected aging process were ST-T abnormalities, right bundle branch block, P-Q prolongation, atrial fibrillation, and left axis deviation. ST-T abnormality was the best index of all findings.

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It has been accepted that amino acids in brain play an important role in metabolism and maintenance of nerve function in brain and vary in the condition of ischemia or hypoxia of the brain. This study measured the contents of amino acids such as glutamate, glutamine, GABA, aspartate, glycine, alanine and taurine in brain during the process of absorption of cerebral hematoma in rats, for the purpose of investigation of the brain metabolism in the repairing process of cerebrovascular accident.
The cerebral hematoma was prepared by local injection of 0.25ml of autologous blood into the region about capsula interna, putamen and caudata nucleus of light cerebral hemisphere of the rat. The amino acids contents were examined with certain interval until 28th day after the preparation of experimental hematoma.
The extent of hematoma in the hemisphere had been maintained equal volume to the injected amount until 3rd day after the preparation and then reduced graduallyto half at the 7th day after. Two weeks after the preparation the hematoma had been almost completely absorbed.
Glutamate content in hematomal (H) and non-hematomal (N-H) hemisphere increased by 33% and 31% on the 3rd day, and 41% and 42% on the 4th day, respectively, and then recovered to normal level. Glutamine content in H and N-H hemisphere markedly increased by 125% and 112% respectively, on the 4th day, and abruptly decreased but maintained high level till third week. GABA content in H and N-H hemisphere also increased by 67% and 100% on the 4th day, and then was normalized. The contents of the other amino acids increased temporarily on the 4th day same as GABA, and recovered to normal level. There was no significant difference in the contents of amino acids between H and N-H hemisphere. No change of amino acids contents in the liver was observed throughout the period of the present study.
The significant increase in amino acids contents at the early stage of absorption of cerebral hematoma may suggest that the amino acids metabolism play an important role in the repairing process of cerebrovascular accident.

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Type III hyperlipoproteinemia (Type III), which is characterized by an abnormal accumulation of intermediate density lipoprotein (ILDL, remnant), cannot be diagnosed by the measurements of the serum cholesterol and triglyceride only. Proving “β-VLDL” by ultracentrifugation and lipoprotein electrophoresis has been a specific diagnostic test for Type III. However, electrophoretic determination of the presence of β-migrating VLDL requires subjective interpretation and yields only qualitative information. In fact, “β-VLDL” has recently been proved not to be specific for Type III. Thus, various chemical criteria have been proposed to be more specific and sensitive for Type III by many authors, but none of these criteria are satisfactory at present.
In an effort to find a more specific and sensitive chemical criteria, we made serial determinations of serum lipids and lipoproteins in three patients who are thought to be typical Type III by the clinical features and the presence of broad-β and β-VLDL, and compared the results with those of other types of hyperlipoproteinemia.
The results were as follows:
1) The serum cholesterol and triglyceride levels of Type III ranged from 182 to 540mg/dl and from 142 to 898mg/dl respectively. Type III could not be differentiated from Type IIb and IV by the serum levels of cholesterol and triglyceride only. The cholesterol/triglyceride ratio in Type III was within 0.53-1.75 range and showed overlap with the ratios in normal subjects, Type IIb and IV.
2) The VLDL-cholesterol levels in all samples of Type III were greater than 50mg/dl, but in one of nine Type IIb and one of five Type IV the VLDL-cholesterol levels were greater than 50mg/dl.
3) The VLDL-cholesterol/VLDL-Triglyceride ratios in Type III were between 0.27 and 1.93, and were found to be useful in differentiating Type III from normal subjects, Type IIa and IIb. However, it was impossible to differentiate Type III from Type IV by the ratio.
4) The VLDL-cholesterol/cholesterol ratios in Type III were above 0.15 in contrast to normal subjects, Type IIa and IIb, but the ratio was of little use in differentiating Type III from Type IV.
5) The VLDL-cholesterol/triglyceride ratios in Type III were greater than 0.20, but a few patients with normal serum lipids, Type IIa and IIb showed ratios greater than 0.20. Ratio above 0.30, which is the criterion for Type III introduced by Fredrickson et al., was proved to be definite for Type III. However, in 13 out of 28 samples of Type III the ratios were less than 0.30.
6) From the present study, it seemed to be logical to conclude that the VLDL-cholesterol/VLDL-triglyceride ratio above 0.33 should be considered as diagnostic of Type III, when the VLDL-cholesterol is above 55mg/dl.

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A light and electron microscopic examination of the Alzheimer's neurofibrillary changes in the subcortical areas of 100 autopsied brains of the aged was performed. Results were as follows:
1) Neurofibrillary tangles were observed in the subcortical areas, as well as cerebral cortex; in the nuclei such as putamen, hypothalamus, subthalamus, midbrain (central grisea, oculomotor nucleus, dorsal raphe nucleus) pons (pontine nucleus, locus caeruleus, trigeminal nucleus), medulla oblongata (hypoglossus nucleus, olive) and cerebellar dentate nucleus.
55% cases showed neurofibrillary tangles in locus caeruleus, 25% in midbrain tegmentum and 6% in substantia nigra; while 55% in Ammon horn. Cases which showed neurofibrillary tangles mainly in subcortical areas were 5%.
2) Fine structure of the neurofibrillary tangles in the subcortical area was twisted tubules such as those in cortical area.
Exceptionally a case with parkinsonism showed straight tubules (150A diameter) of progressive suprauclear palsy.
These findings conclude that subcortical neurofibrillary tangles were the same as cortical ones in the the aged brain, and suggest that some cases of the aged which showed neurofibrillary changes in subcortical areas may be related to the progressive supranuclear palsy, which pathogenesis is not yet clear.

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The effects of decreased physiologic activity (ie, bed rest) on metabolisms, especially those on the metabolic phase chiefly of glucose, were comparatively studied in a group of the aged and a group of the youth. The fasting blood sugar and insulin remained stable during the first one to two weeks of bed rest, but tended to increase in three or four weeks. The blood sugar curve on OGTT showed a rise week after week during the bed rest, causing the appearance of its peak to delay, and the blood insulin also proved very responsive. These abnormal behaviors of the blood sugar and insulin were more striking in the group of the aged than in the group of the youth. The insulin tolerance test proved the bed rest to reduce the hypoglycemic effect. This reduction in the hypoglycemic effect was more prominent in the group of the aged. During the prolonged bed rest, the blood insulin and triglycerides were distinctly increased in the group of the aged, there being a positive correlation between these two parameters. The serum free amino acids increased with the bed rest; these increases were larger in the group of the youth than in the group of the aged, and the increases in the glucogenic and branched chain amino acids were particularly striking. These findings suggested that glucose metabolic abnormalities at bed rest would be a metabolic phase derived from changes in the peripheral cells, and become more striking with ageing.

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