The the earlier report, we have described that the aged hyponatremia with unknown etiology could be devided into two subgroups. The first group of hyponatremia with urinary sodium concentration below 50mEq/L (Group I) showed the characteristics compatible with volume depletion and/or decreased exchangeable sodium. The other one of hyponatremia with urinary sodium concentration over 50mEq/L. (Group II) showed the characteristics compatible with dilutional hyponatremia. The purpose of this study was to clarify the renal function in these two subgroups of hyponatremia. Twenty four hours creatinine clearance (CCr.; 19.7±2.7ml/min.), PSP dye excretion rate at 15 minutes after injection (11.3±3.7%) and maximum urinary concentration ability (1013±1.3 from basal urine specific gravity of 1011±1.8) in group I were significantly lower than those of age matched controls. On the other hand, urinary dilution ability to the low serum osmolality showed normal responce. Creatinine clearance (40.3±4.6ml/min.) and PSP dye excretion rate (17.1±2.5%) in group II were significantly lower than those of age matched controls (66.3±3.9ml/min. and 25.6±0.8%, respectively). The urinary concentration ability to the water restriction in group II was slightly disturbed. On the other hand, the urinary dilution ability to low serum osmolality in this group was markedly disturbed when compared with control subjects. In group I, the reabsorption rate of sodium in distal tubulus was higher than that in group II in spite of the presence of disturbed renal function (sodium excretion 35.0±5.2mEq/day). On the other hand, it might be thought that the diminished CCr. and disturbed urine dilutional ability in group II were closely related to the low rate of sodium reabsorption (sodium excretion 108.0±5.2mEq/day). These data suggested that in group II the impaired renal function might play an important role in the pathogenesis of hyponatremia. In contrast, it was possible that the disturbances of renal function in group I could not be considered the causative factor in the pathogenesis of hyponatremia.
Efforts to standardize the turbidometric method for the measurement of platelet aggregation (PA) are hampered by the factors influencing PA. The time elapsed after blood withdrawal, speed of stirring, concentration of the aggregating agent, number of platelets of platelet-rich plasma (PRP) and centrifugation to obtain PRP are all factors influencing platelet aggregation. This report describes how these factors influence PA tests. These tests were performed on patients in convalescence of various diseases and control subjects. The following conclusions were drawn from this study. 1. Three types of induced aggregation were studied. The aggregation agents employed were ADP in a final concentration of 2×10-6M, adrenaline in a final concentration of 1×10-6M and collagen solution using bovine tendon. All of these three types of aggregation were increased with time from the withdrawal of samples and the time after separation of PRP was important to evaluate. ADP-, and collagen-induced aggregation measured between 60 and 120 minutes after withdrawal and adrenalineinduced aggregation between 90 and 180 minutes showed high reproducibility. 2. PA was measured at the speed of stirring of 1000, 2000 and 3000rpm. All of three types of PA were enhanced with the increase of the speed. 3. Parameters of PA were measured in various final concentrations of ADP, collagen and adrenaline. A collagen suspension was prepared by shaking 200mg bovine collagen with 10ml Tris buffer. The mixture was centrifuged, and the supernatant was diluted by Tris buffer. It seemed to be suitable to use final concentration of ADP of 2×10-6M and of adrenaline of 1×10-6M and 1:1 diluted supernatant collagen. 4. The number of platelets of PRP influenced PA, but it was considered not to be relevant to physiology to adjust the platelet count by diluting with platelet-poor plasma because adjustment of platelet count may produce changing of platelet sensitivity. 5. PA at the centrifugation of 130g to obtain PRP was increased compared to PA at 200g.
The aim of this report is to clarify the significance of platelet aggregation (PA) in arteriosclerosis compared to healthy subjects (both groups were studied during a period of rest.). One hundred and forty arteriosclerotic patients including ischemic heart disease and cerebral infarction in chronic state and 81 controls were examined. Three types of induced aggregation were studied by the turbidometric method. The aggregation agents employed were ADP in a final concentration of 2×10-6M, adrenaline in a final concentration of 1×10-6M and collagen solution using bovine tendon. Plasma fibrinogen (Fbg), euglobulin lysis time (ELT), serum total cholesterol (TC), triglyceride (TG), beta-lipoprotein and free fatty acid (FFA) were also measured at the same time. The following conclusions were drawn from this study. 1. All of these three types of induced PA were increased in arteriosclerosis compared to control. The maximum optical density (Max. O.D.) showed the most significant difference, Max. O. D. in ADP induced PA was 67.0±19.3% in arteriosclerosis and 48.9±19.1% in controls (P<0.001), Max. O.D. in collagen-induced PA was 72.2±18.3% in arteriosclerosis and 51.3±29.2% in controls (P<0.001), Max. O.D. in adrenaline-induced PA was 78.1±13.9% in arteriosclerosis and 60.3±21.2% in controls (P<0.001). 2. Fbg was significantly increased in arteriosclerosis compared to control (P<0.05). As for ELT, Fbg/ELT, TC, TG, beta lipoprotein and FFA, there was no significant difference between arteriosclerosis and control. 3. In arteriosclerosis significant correlation of ADP-induced PA to Fbg (r=0.23, P<0.01), to TC (r=0.26, P<0.01) and to beta lipoprotein (r=0.22, P<0.05) was found. In arteriosclerosis and control there was no significant correlation of ADP-induced PA to ELT, Fbg/ELT, TG and FFA. 4. Significant correlation of adrenaline-induced PA to TC (r=0.29, P<0.05) was found in arteriosclerosis and not in control. In arteriosclerosis and control there was no significant correlation of collagen or adrenaline-induced PA to Fbg, ELT, Fbg/ELT, TG, beta-lipoprotein and FFA. These results show that PA in arteriosclerosis is enhanced in chronic state and suggest that enhanced PA may play a role in atherogenesis with relation to blood coagulation, fibrinolysis and lipids.
Platelet aggregation (PA) at rest was estimated in 113 patients with ischemic heart disease (IHD) in chronic state and 81 healthy controls. The effect of submaximal exercise using a bicycle ergometer on PA was studied in 20 patients with IHD and 17 controls. Three types of induced PA were studied by the turbidometric method. The aggregation agents employed were ADP in a final concentration of 2×10-6M, adrenaline in a final concentration of 1×10-6M and collagen solution using bovine tendon. Plasma fibrinogen (Fbg), euglobulin lysis time (ELT) and serum lipids were also measured at the same time. The following conclusions were drawn from this study. 1. All of these three types of induced aggregation at rest were increased in IHD compared to the controls. The maximum optical density showed most significant difference in all of these three types of PA (P<0.001). There was a tendency that ADP- and collagen-induced PA in patients with myocardial infarction was increased compared to patients with angina of effort, or ischemic ST depression on the electrocardiogram with or without hypertension. 2. There was a tendency that in IHD Fbg at rest was increased and ELT was shortened compared to the controls. 3. In both IHD and the controls the post-exercise values of ADP-induced PA were increased significantly compared to the pre-exercise values (control P<0.001, IHD P<0.01), but collagen-induced aggregation increased significantly only in IHD after exercise (P< 0.01). 4. There was a tendency that in both IHD and the controls platelet number increased, Fbg increased and ELT shortened after exercise. These results show that PA in IHD is enhanced in the chronic state and that exertion induces changes in PA, platelet number and Fbg which may predispose to a thrombotic tendency and that fibrinolysis is increased by exertion. By the maintenance of hemostatic balance of platelet function, coagulation and fibrinolysis, the blood circulation and metabolism of vascular wall should be supported normally, so it is concluded that medical examination covering every aspect of hemostatic balance is recommended before exertion, especially before physical reconditioning in IHD.
An evaluation of regional traits on nutritional standards of aged groups in the Okinawan community has been proceeded by the technique of principal component analysis. The data were collected at the time of periodical health examinations with the survey of nutritional intakes for these groups which were consisted of healthy 118 subjects including twenty-eight aging between 60 and 69, forty-one aging between 70 and 79, thirty-five aging between 80 and 99, and fourteen aging between 100 and 104. Among these collected data, the biological variables which were most reliable and closely related to the manifestation of nutritional standards such as hemoglobin volume, total protein and albumin, serum cholesterol and neutral fat, furthermore, height, weight and systolic/diastolic blood pressures were selected. In addition, the data including caliculated total caloric intake, intakes of carbohydrate, fat, protein and sodium chloride which were obtained by the inquiry sheets and interview approaches have been selected. These fourteen variables of 118 subjects are processed together through the principal component analysis using Facom 230-35 computor with the standardized Fortran 7000 language program, and the results for eigin values, eigin vectors, factor loadings and value of components on each principal component are obtained. Regarding the first principal component, the major positive factor loadings were existed on the variables of total caloric intake, intakes of protein and fat, body weight, thus represented as “Factor of Intake Amount”. Also “Factor of Blood Pressures” was conjectured for the second principal component with the major positive factor loadings of systolic/diastolic blood pressures and serum total protein and albumin. Regarding the third principal component, “Factor of Fat” was considered for the factor loadings of intakes of fat, sodium chloride and total cholesterol were positively prominent. For the fourth principal component, “Factor of Carbohydrate” was estimated due to the positive findings of factor loadings on blood pressures, intakes of total calories, carbohydrate and fat. For the value of components (scores) of individual subjects on the dimensions between the first and second principal components, the negative values were existed in the most of advanced age group, therefore, thus indicated the characteristics of these nutritional standards with an advancement of ages summarized as the factor of intakes and blood pressures. Meanwhile, it was found that the total caloric intakes in the advanced age group is less than that of the 60 and 70 decades groups, however, the intake amounts of fat and carbohydrate were not comparatively decreased in that group, and these findings were in accord with the results of principal component analysis which is seemed to be represented the characteristics of nutritional standards of aged groups in the Okinawan community. As a conclusion, although the individual disparity was observed, these analysed results were indicative of sustaining tendency of comprehensive metabolic phases due to suppressed caloric intakes with relatively extended intakes of fat or carbohydrate proportions in the advanced age group, however, these tendency is thought to be concerned in the compensative effort to their health and longevity.
The role of the sympathetic nervous system in essential hypertension was evaluated by examining the response of urinary catecholamines to intramuscular injection of glucagon in both young and elderly normal subjects and in patients with essential hypertension. Urine was collected for two hours before glucagon injection and two and four hours after injection for determination of adrenaline and noradrenaline. The increments of urinary adrenaline and noradrenaline after glucagon injection were significantly higher in young hypertensive subjects than in young normotensive or in normotensive and hypertensive elderly subjects. But, there were not any significant differences in urinary catecholamine responses between in young and elderly normotensive subjects, also between in hypertensive and normotensive elderly subjects. Our observation that the reactivity of the sympathetic nervous system is increased in young patients with essential hypertension lends support to the hypothesis that the sympathetic nervous system is more important in the maintenance of hypertension in young individuals with essential hypertension than in elderly hypertensives. Whereas, we could not find out an overreactivity of sympathetic nervous system in elderly essential hypertension and the alteration of sympathetic nervous response due to ageing in normotensive subjects.
In order to clarify the hereditary and environmental influences on the aging process, histological and micrometrical findings of the liver and its arteries of the Costa Ricans have been compared with those of Hawaii and native Japanese and U. S. Caucasians. In case of the Costa Ricans and U. S. Caucasians, decrease in number of hepatic cells was similar up to 70 years of age, but after 80 years of age the decrease was more marked in the Costa Ricans. The difference in the process of age changes among these four groups suggests that the environmental, especially nutritional, conditions during their childhood and adolescence play an important role. Difference in arteriosclerotic changes in the liver between Costa Ricans and other groups was also discussed in relation to nutritional conditions.
Effects of 15-hydroperoxy arachidonic acid (15-HPAA) and non-purified hydroperoxides (HPO) from arachidonic acid (AA) to blood vessels were observed in rabbits. 15-HPAA was converted from AA (100mg/50ml Na2CO3) by incubation with lipoxidase (50mg/750ml botate buffer) at room temperature for 10 minutes. and purified by thin layer plates (silica gel). HPO was made from that was radiated by ultraviolet lamp (250W) for 8-10 days. HPO was quantified as the malondialdehyde (MDA) value by TBA reaction. and was used in concetration of 126 nmoles MDA/ml. With aggregometer in vitro, 137μM (41.7μg/ml) of AA aggregated markedly rabbit platelets by 75% in light transmittance, however the same dosages of neither 15-HPAA or HPO aggregated. The effects to microcirculation were observed by evans blue leakage in the skin after subcutaneous injection of 15-HPAA. or histamine. The leakage was graded by spectrometry (620nm) after dye extraction from the skin spot. The optimal density was 0.05±0.004 by 10μg, 0.18±0.024 by 10μg and 0.38±0.017 by 500μg of 15-HPAA, and 0.16±0.009 by 1μg and 0.22± 0.014 by 10μg and 0.34±0.027 by 100μg of histamine as a control study. Effects to the aortic wall were evaluated by edema in the intima and media in histology. The aortic wall showed marked edematous arterial changes 30 minutes after intravenous injection of 15-HPAA (3mg/kg) or HPO (5mg/kg). The grade of edematous changes were 68.3±4.30% by 15-HPAA, and 70.8±11.46% by HPO and 40.8±6.77% by pretreatment of phthalazinol (5mg/kg i.v.). Both responses by 15-HPAA and HPO were not different significantly. and the edematous changes induced with 15-PHAA was suppressed significantly by pretreatment of phthalazinol. These results suggested that the vascular permeability increased dose-dependently in both microvessels and aortic wall by 15-HPAA and it seemed to be caused by a cytotoxic effect. It is probable that 15-HPAA might accelerate atherogenesis by marked increase of aortic wall permeability.