Physiological changes of the peripheral blood figures and erythropoiesis were studied in the elderly subjects with particular reference to effects of aging. They consisted of 1224 healthy subjects over 60 years of age. The results obtained were as follows: 1) Hemoglobin concentration, erythrocytes counts and hematocrit values in the aged gradually decreased with their advance in years. These parameters were observed to be higher in the males than in the females, although this difference was less evident in the older subjects of the group. Of the erythrocytic indices, MCV slightly increased with aging whereas MCH showed no change. Furthermore, leucocytes counts declined to decrease with aging. Thrombocytes counts showed no change. Absolute counts of the reticulocytes in peripheral blood decreased in those over 70 years of age, indicating the reduction of effective erythropoiesis in the aged. No abnormality of the fragility of erythrocytes was observed. 2) Erythroid stem cells, represented by erythropoietin responsive cells (ERC), decreased significantly in the subjects over 70 years of age, compared with those under 50 years of age. Although ERC showed no relationship to the proportion of erythroblasts in the bone marrow, a significant correlation between ERC size and absolute counts of reticulocytes was observed. From the results described above it is evident that a decrease in erythropoiesis is a contributory factor in “senile anemia”. Although the decrease in erythropoiesis was postulated to ensure from the reduction of hemopoietic stem cells, the mechanism by which the size of hemopoietic stem cells compartment decreases in the aged is not still clear.
Calcification of the carotid siphon is a common radiologic finding in the aged, although little is known about its clinical significance related to cerebrovascular lesions. The purpose of this study is to clarify the incidence and characteristics of carotid siphon calcifications, as well as relationships between grades of calcifications and cerebrovascular lesions. Materials and Methods: Radiological and histological studies were made on 100 autopsy cases over 60 years of age selected at random. At autopsy, carotid siphons were removed en block with surrounding bone tissues. The materials were fixed in 10per cent neutral formol solution. Ultra X-ray photographs were obtained at the condition of 35Kvp, 2mA, 45 seconds, and 40cm of film-focus distance (Softex apparatus). Grades of calcifications were classed into the following four groups; none, spotted (mild), moderately blocked and largely blocked (severe). Histological studies were made on cross or longitudinal sections of the vessels. Results: Calcified lesions were found in 83.3per cent in the seventh, in 68.2per cent in the eighth and in 91.0per cent in the ninth decades. Moderately and largely blocked calcifications were found in 41.0per cent. Blocked calcifications were more frequently observed in the cases over 70 years, as well as in the hypertensives. Calcification was approximately equal on the right and left of the arteries. Sexual difference was not found in this series. Calcified lesions were most prominent in the cavernous portions. Arterial calcification was mainly located in the elastic laminae or thickened subintimal tissues. Calcification was more prominent on the concave inner wall than in other places, while intimal thickening was more prominent on the inner wall of convex side of the arteries. Grades of stenosis of intracranial cerebral arteries were significantly more severe in cases with advanced carotid siphon calcification. Cerebrovascular lesions were found in 39 cases from 41 cases with severely calcified siphons (95.1%), while in cases with none or mild siphon calcifications the cerebrovascular lesions were found in only 50.8per cent. It was shown that atherosclerotic ischemic cerebral infarctions were more common in the cases with severe siphon calcifications, while no significant corelations were found between hypertensive intracerebral hemorrhage and severity of carotid siphon calcification. In 21 cases X-rays of the skull had been clinically obtained. All blocked calcified lesions were manifested in the skull films, while the spotted calcified lesions were found in only 37.5per cent. From our findings it is suggested that the carotid siphon calcification seen in the X-ray films is a risk factor of cerebral infarction.
Vitamin E has an anti-oxidative action in the body. Therefore, if it is lacking, peroxidation of the lipid is induced. Serum lipid peroxide impairs cellmembranes, disturbs blood flow and promotes agglutination of platelets, and hence may be involved in occurrence of cerebral apoplexy. Serum levels of vitamin E (E) and lipid peroxide (MDA) were determined in 135 patients with cerebral apoplexy within 2 weeks after the attack, and in 108 control subjects. The following results were obtained. 1) When values of E were compared, it was 1.6±0.5 in controls, 1.0±0.4 in patients with cerebral infarction, and 1.0±0.4mg/dl in patients with cerebral hemorrhage. It was lower in the group with cerebral apoplexy than in the control group (P<0.001). 2) When the average MDA's were compared, it was 10.3±2.1 in controls, 12.6±2.8 in patients with cerebral infarction and 14.7±2.9nmoles/dl in patients with cerebral hemorrhage. It was higher in the group with cerebral apoplexy than in the control group (P<0.001). 3) There were no differences in E values between those who survived and those who did not survive cerebral apoplexy. However, MDA value was higher in those who died than in those who survived (P<0.001). 4) There were no differences in E value between the group with complications such as hypertension, diabetes mellitus and cardiac disturbance and the group without them. The MDA value was lowest in the group without complications. It was found to be significantly higher in patients with complications than in patients without them. 5) In the control group, there was a correlation among E value, serum cholesterol, neutral lipid and β-lipoprotein. On the other hand, in the group with cerebral apoplexy, although there was a correlation among E value, cholesterol and β-lipoprotein, no correlation between E value and neutral lipid was found. 6) The E value which was low at the onset of cerebral apoplexy tended to increase with the patient's improvement. Among 57 patients who had been followed up for 4 months, it increased in 42 patients, was unchanged in 5 patients and decreased in 10 patients. 7) On the other hand, the MDA decreased with the patient's improvement in 29 out of the 56 patients, was unchanged in 6 and increased in 21.