It has been reported that serum glycoprotein is increased in diabetecs (DM), hypertensives (HT) and patients with aortic arch calcification (AAC) than in healthy persons (HP). Serum glycoprotein was separated in this study into several fractions with gel chromatography (GC) and cellulose acetate electrophoresis (CA), and the relationships between these fractions and the diseases related to arteriosclerosis were studied. GC was performed in 148 subjects of which HP were 51 cases, DM 40, HT 37, and AAC20, totaling 148 cases. Both GC and CA were performed in 10 cases of HP, 10 cases of DM, 11 cases of HT and 10 cases of AAC. The subjects were classified into three groups according to their age, a young group consists of those under 40, a middle age group from 40 to 59, and an old group above 60 years of age. The results obtained were as follows. 1) Influence of aging on serum GP was not observed. 2) Serum GP was fractionated into Fraction I (FrI) and Fraction II (FrII) by GC. The molecular size was in order of FrI<FrII. GP concentration in FrI was higher in DM, HT and AAC than in HP, but there was no difference in FrII among any groups. The cause of higher level of serum GP was attributed to the higher level of FrI in those diseases. 3) FrI was further separated into three fractions, α1-, β- and γ-GP by CA. The serum concentration of α2- and γ-GP were higher in DM, HT and AAC than in HP, but β-GP was increased in DM. FrII was separated into four fractions α1-, α2-, β- and γ-GP by CA. The serum concentration of α1-GP was higher in HT and AAC than in HP, but γ2-GP was decreased only in AAC. There were no differences in β- and γ-GP between HP and those diseases. It is believed that both HT and DM are of similar importance as risk factors for arteriosclerosis. However, these two diseases might play different roles in arteriosclerosis as suggested from observed differences in the components of serum GP. We conclude that SGP are increased in the diseases related to arteriosclerosis than in HP. The separation of SGP into subfractions with GC and CA further facilitates detailed analysis of increase in various components.
Interest in human high density lipoprotein (HDL) has grown because of the finding that plasma HDL-cholesterol levels are negatively associated with the incidence of coronary heart disease. Classically, HDL has been divided in two density classes: HDL2 (d, 1.063-1.125mg/dl) and HDL3 (d, 1.125-1.21mg/dl). In the present study, HDL subfractions were separated by the precipitation and ultracentrifugal methods, and we have investigated cholesterol levels in HDL subfractions in healthy, hyperlipoproteinemic subjects and in patients with ischemic heart disease. The results were obtained as follows: HDL-cholesterol levels were significantly higher in healthy females than in males (males 50±12mg/dl, females 57±11mg/dl). HDL2-cholesterol levels were 20.8±8.3mg/dl for men and 27.5±6.6mg/dl for women. Females had also significantly higher HDL2-cholesterol levels than males. On the other hand, healthy male and females had approximately similar HDL3-cholesterol levels. Thus, this finding reported here indicated that variations in HDL-cholesterol levels were largely due to changes in HDL2-cholesterol levels. The ratio of HDL2-cholesterol to HDL3-cholesterol was 0.42±0.08 for men and 0.48±0.09 for women. Females had significantly greater ratio than males. In the invitation of the relationship of cholesterol levels in HDL subfractions to other lipid and lipoprotein parameters, inverse correlations were found between HDL2-cholesterol and fasting plasma TG levels and obesity index. Furthermore, HDL2-cholesterol were positively correlated with HDL-cholesterol. In contrast, no correlations were found with plasma TG levels and HDL3-cholesterol levels. Accordingly, this present study suggests a relationship between the metabolism of TG and HDL2-cholesterol. Patients with hypertriglyceridemia, such as subjects with type IIb and type IV hyperlipoproteinemia, had significantly lower HDL-cholesterol and HDL2-cholesterol levels than healthy subjects. However, type IIa hyperlipoproteinemia was not observed in the magnitude of HDL-cholesterol depression. HDL-cholesterol levels were significantly lower in patients with ischemic heart disease than in healthy subjects. When divided into HDL subfractions, both HDL2 and HDL3-cholesterol levels were significantly diminished as compared to healthy subjects.
An analysis was made of the high density lipoprotein-cholesterol (HDL-CH) levels of 18 patients (5 males, 13 females) suffering from ischemic cerebrovascular disorders (2 suffered transient ischemic attacks) and who had experienced apoplectic strokes. Their HDL-CH levels had been determined several times prior to the strokes. The HDL-CH levels were determined by the enzyme method (TC-Kit, Nippon Shoji) after centrifugation and precipitation of low density lipoproteins (LDL) and very low density lipoproteins (VLDL) in 4% NaPhT and 2M MgCl2. In some cases, HDL-CH levels were arrived at, through use of a conversion formula, from HDL-phospholipid levels which are directly convertible to HDL-CH levels. The HDL-CH levels of both males and females determined at more than six months before a stroke were below the normal level (40 to 67mg/dl) in most cases while those within six months were lower still, and there was a tendency to descend to even lower levels immediately (24 hours) after a stroke. These results suggest that the lowered HDL-CH levels of patients with ischemic cerebrovascular disorders are due to several factors, one such factor being the existence prior to strokes of lowered HDL-CH levels which had contributed to accelerate the development of atherosclerosis, and another the lowered HDL-CH levels appearing several months before or immediately after strokes, indicating a direct correlation between such lowered levels and the occurrence of strokes.
In order to investigate the correlation i) between the accumulation of lipofuscin and aging or other factors, ii) among the accumulation of lipofuscin in the heart, liver and adrenal cortex and iii) between the accumulation of lipofuscin in the different sites within these three organs, the grade of accumulation of this pigment was examined by its occupied area and density in the cells. Histological sections were obtained from the cases of 109 pathological autopsies (0-84 years old), 28 legal autopsies and 34 liver biopsies. Other factors except the aging were as follows: 1) presence or absence of severe morphological lesion in each organ, 2) difference of disease in autopsy diagnosis, 3) the duration of clinical history, 4) sex difference and 5) atomic bomb survivors or non-exposed patients. Quantitative analysis was made statistically. Significant correlation was noted between the aging and the accumulation of lipofuscin in cardiac, adrenal and hepatic cells. However, only the accumulation of lipofuscin in cardiac muscle cell seems to be applicable to the criteria for a basic biological aging process. In the cases with severe morphological lesion in these organs, the correlation rate was decreased in adrenal and cardiac cells compared with normal organs. The same tendency was noted in each group of disease except the cases of cardiovascular disease and legal autopsy. The cases with severe morphological lesion in the liver or hepatic disease, in which regeneration and proliferation of hepatocyte was increased, revealed no correlation between the accumulation of lipofuscin in hepatocyte and aging, but the accumulation of lipofuscin in these cases was significantly lower than that of normal hepatocyte. The accumulation of lipofuscin was larger in the central zone than in the peripheral zone of liver with or without severe morphological lesion. This seems to be interesting in association with the contrary localization of reductase in the liver. The above-mentioned results suggest that the accumulation of lipofuscin is not only regulated with linear rates of increase with aging, but also it is modified by the kinds of organ and its sites. No correlation was noted between the duration of clinical history and the accumulation of lipofuscin in any factors and decades. The ratio of accumulation of lipofuscin in the cardiac, adrenal and hepatic cells showed 3:2:1. The organ correlation was higher between cardiac and adrenal cell and lower between the hepatic and adrenal cell. In atomic bomb survivors, the accumulation of lipofuscin was not different from that of non-exposed patients.
Achilles tendon xanthoma is an early clinical feature of familial hypercholesterolemia. The radiographic measurement of achilles tendon thickness provides a method for the detection of achilles tendon xanthoma. In routine examination, however, achilles tendon xanthoma can be detected by inspection or palpation without radiographic examination in the majority of cases. To assess the diagnostic value of examination of achilles tendon thickness by palpation rather than radiographic examination, we measured achilles tendon thickness of 36 familial hypercholesterolemias (FH), 27 normolipidemic subjects, 8 mixed hyperlipidemic subjects, 12 non-FH hypercholesterolemic subjects, 11 hypertriglyceridemic subjects by skin fold caliper at the point of maximal thickning of achilles tendon. The results were as follows. 1) Achilles tendon thickness measured by skin fold caliper (ATT) was thicker in FH (28.3±2mm) than in normolipidemic (22.5±2mm), mixed hyperlipidemic (22±1mm), non-FH hypercholesterolemic (20±1mm), hypertriglyceridemic (25±2mm) subjects. 2) In non-FH subjects, ATT was thicker in obese subjects (percent ideal weight≥120%) (25.3±4mm) than in non obese subjects (percent ideal weight<120%) (19.3±3mm). A significant positive correlation was found between ATT and percent ideal weight in non-FH, but was not in FH. 3) A significant positive correlation was found between ATT and achilles tendon thickness measured by radiographycally in FH. 4) ATT/percent ideal weight ratio was higher in FH (0.26±0.05) than in normolipidemic (0.2±0.03), mixed hyperlipidemic (0.2±0.01), non-FH hypercholesterolemic (0.18±0.01), hypertriglyceridemic (0.2±0.01) subjects. 5) ATT/percent ideal weight ratio was found a significant positive correlation with cholesterol levels, but not with triglyceride levels. From these data, it was concluded that the measurement of achilles tendon thickness by skin fold caliper seemed to be as useful as by radiographycally for descrimination of FH and non-FH.
Several reports showed that HDL-cholesterol concentration was significantly reduced in patients with cerebral infarction as well as in those with myocardial infarction. A question arises as to whether or not an intervention correcting the abnormally reduced HDL-cholesterol concentration can fortunately protect against these diseases. To assess the effect of pantethine-a precursor substance of coenzyme A- on lipoprotein abnormalities, it was orally administered to 12 male survivors of cerebral infarction for 3 months in a dose of 1000mg a day. At the beginning of this study, at least 2 months had elapsed after the onset of cerebral infarction and a preceding “wash out” period of one month had elapsed too. Before and after the administration of pantethine, venous blood was drawn and lipoproteins-very low density (VLDL), low density (LDL) and two subfractions of high density (HDL) lipoproteins-were sequentially separated by an ultracentrifugal method according to Havel. Cholesterol was determined by an enzymatic method and triglyceride by an acetylacetone method. Phospholipid was measured by digestion with sulfuric acid and manganese dioxide and protein by Lowry's method. Serum cholesterol, triglyceride, phospholipid, VLDL and LDL concentrations tended to decrease. The content of triglyceride in LDL was slightly decreased, suggesting the reduction of triglyceride-rich LDL molecule. On the other hand, HDL-cholesterol concentration and HDL:LDL-cholesterol ratio were significantly increased. When HDL was divided into two subfractions, HDL2 and HDL3, HDL2-cholesterol concentration significantly increased, whereas HDL3-cholesterol concentration remained virtually unchanged. Hence, HDL2:HDL3-cholesterol ratio increased to a level of statistical significance. The chemical composition of HDL2 changed slightly: the contents of cholesterol and triglyceride tended to decrease, while the content of phospholipid tended to increase. These results suggest that pantethine gave rise to a significant change in the amount, chemical composition and function of HDL, favoring the antiatherogenic action.
Only a few investigations have been reported concerning prognosis of mental disorders in the aged residing in the community. With recent increase of the aged population in Japan, prognostic data of mental disorders of the aged is considered quite essential to establish medical, sociological and psychological policies for the aged. It has been suggested that in the evaluation of prognosis of mental disorders in the aged, outcome study for the aged residing in the community should be conducted, because hospitalization is more likely to occur when demented people fall ill with somatic illnesses. In 1973 authors carried out a geronto-psychiatric investigation and reported that prevalence rate of the aged with age-related dementia was 4.5% in 4716 aged people with the age 65 years and over residing in Tokyo Metropolis by random sampling. The purpose of the present study is to clarify prognosis of the aged with age-related dementia residing in the community, prognostic difference between senile and cerebrovascular dementias and factors affecting their prognosis. Subject: In the initial census, 565 aged persons (incl. 182 aged people with age-related dementia) were interviewed individually with suspicion of physical or psychiatric illnesses among 4716 aged people. In the present 5 years outcome study, 433 aged people (incl. 161 aged persons with age-related dementia) were followed up. Method: Investigation period was Dec. 1st, 1978 to March 31st, 1979. Individual interviews were conducted by a team consisted of a psychiatrist and a psychologist to assess physical and psychiatric conditions of the aged. Hasegawa's dementia scale was employed for the assessment of intellectual level of the aged. Activity of daily life, also, evaluated by the ADL evaluating form. According to the results mentioned above, outcome of the aged was divided into four categories, that is, death, deterioration, un-change and improvement. Result: The present study revealed that mortality rate of the aged with age-related dementia was significantly high, compared with that of the aged without age-related dementia. The mortality rate increased with advancement of dementia and with deterioration of physical conditions such as incontinence and bedridden state. There was no significant difference of mortality rate between senile and cerebrovascular dementias. Factors associated with the highest mortality of the aged with age-related dementia were severe dementia, bedridden state and incontinence. The implications of those factors in the prognosis of the aged with age-related dementia were discussed.
The hypercholesterolemia has been considered as one of the important risk factors in developing atherosclerosis. Recent studies have demonstrated the negative correlation between the high density lipoprotein (HDL) cholesterol levels and the incidence of coronary heart disease. The HDL contains more phospholipids than cholesterol. There are, however, not enough discussions upon HDL-phospholipids concerning clinical availabilities. In the present study, HDL-cholesterol and HDL-phospholipids were mesured by precipitation method (Phosphotangstate-Mgcl2) in 253 normal subjects and in 24 patients with ischemic heart disease. The relationship between HDL cholesterol and HDL phospholipids, and effects of age, sex and obesity were discussed. The results were as follows: (1) Plasma total cholesterol, plasma total cholesterol minus HDL cholesterol (VLDL, LDL cholesterol), and VLDL, LDL cholesterol/HDL cholesterol ratio (cholesterol ratio) had significant positive correlations with aging. There was, although, no correlation between HDL cholesterol and aging. (2) HDL cholesterol levels and HDL cholesterol/HDL phospholipids ratio (HDL c/p ratio) in female were significantly higher than those of male. (3) Plasma total cholesterol, VLDL, LDL cholesterol, and cholesterol ratio had significant positive correlations with obesity index in both sexes. HDL cholesterol, HDL phospholipids, and HDL c/p ratio had significant negative correlation with obesity index in male. There was significant positive relationship between plasma triglycerides and obesity index in male. (4) The levels of HDL cholesterol and HDL-phospholipids in patients with ischemic heart disease were significantly lower than those in normal subjects in both sexes. HDL c/p ratio in patients with ischemic heart disease were significantly lower than that of normal female. (5) HDL cholesterol significantly correlated with HDL phospholipids both in normal subjects and in patients with ischemic heart disease. (6) HDL c/p ratio of female was higher than that of male. These findings suggest that sex, obesity and presence of ischemic heart disease correlated with the levels of HDL cholesterol and cholesterol ratio as well as HDL phospholipids and HDL c/p ratio. HDL cholesterol and HDL phospholids were not influenced by aging, but cholesterol ratio and HDL c/p ratio were influenced by aging. HDL c/p ratio in normal subjects distributed within narrow limits. In patients with ischemic heart disease, plasma, content of HDL phospholipids as well as HDL cholesterol was significantly decreased.