Age differences in the cortisone induced changes of mouse hepatic cell mitochondria were studied electronmicroscopically, using female mice of SM strain of different ages. In the young and old mice, the mitochondria decreased in number and increased in size by cortisone treatment, more markedly in the old. In the middle aged, though the mitochondria were decreased in number, they did not significantly increase in their size. Before treatment, mitochondrial cristae were arranged most compactly in the old aged. After treatment, mitochondrial cristae became more compact accompanied with the decrease in number of mitochondria. The increase of the length of the cristae and its recovery were most remarkable in the young aged. In the middle aged, mitochondrial cristae were sparcely arranged during the course of the experiment. In the old aged mice, each mitochondrion with compactly arranged cristae seems to function more actively to compensate for the numerical loss of cells and their mitochondria.
Many reports have been published on the role of platelets in thrombogenesis. The balance between TX A2, produced from C20:4 liberated from platelets, and PGI2, derived from the blood vessel wall, is considered to be important from the viewpoint of fatty acid metabolism. We investigated platelet agglutination and the ratio of TX B2 to 6-keto-PGF1α to find a correlation between both prostanoids in patients with ischemic heart diseases. The ratio of TX B2 to 6-keto-PGF1α was found to be especially high in angina and A. M. I. This suggests that the metabolic production of C20:4 and PGs from platelets may be accelerated in patients with ischemic heart diseases and that TX A2 may be related to the severity of the disease. In the present study, we used 3 agents with different mechanisms of action. A 300mg daily dose of either aspirin, dipyridamole, or trapidil was administered orally to patients with angina, A. M. I., and cerebral infarct for 4 weeks. The following results were obtained: 1) The proportions of constituent fatty acids in phospholipids (PE and PC) and of NEFA in plasma and platelets were not significantly influenced by any drug. This was particularly demonstrated by the very small change in the C20:4 ratio. 2) The ADP-induced agglutination of platelets was significantly reduced in the aspirin and trapidil groups, particularly in the aspirin group. 3) The TX B2 to 6-keto-PGF1α ratio was significantly decreased in the aspirin and trapidil groups. These changes were explained by a significant reduction of TX B2 in the trapidil group and by the marked reduction of TX B2 in conjunction with an elevation of 6-keto-PGF1α in the aspirin group. The reduced ratio in the dipyridamole group was similar to that in the trapidil group in mechanism. 4) These results suggest that trapidil and aspirin can be clinically effective in the prevention and treatment of thrombosis and in improving blood circulation in cases of arteriosclerosis.
In order to know the characteristics in the acute myocardial infarction in elderly, we evaluated the hemodynamical parameters, the localization of infarction, and the mortality rate within a month of patients, comparing with those of the youger patients. The initial hemodynamics using Swan-Ganz catheter were measured among 105 patients, admitted to CCU within 48 hours from the onset of infarction. The patients were divided into two groups according to the age. The elder group (above 70 years old) consisted of 36 patients, and the younger group (below 69 years old), 69 patients. The mortality rate of the elder group was 28%, which higher than the 16% obtained from the younger group. There was no significant difference between the two groups in the heart rate, mean blood pressure, and pulmonary capillary wedge pressure, but the cariac index, stroke volume index and stroke work index were significantly lower in the elder group (p<0.001). According to the hemodynamic classification, the 77% of the younger group showed a 35gm⋅m/m2 or higher stroke work index, while 69% of the elder group and 90% of the death case in the elder group showed values lower than a 35gm⋅m/m2. Thus, the stroke work index appeared to provide a useful predictor of the prognosis in the acute myocardial infarction. In both groups, the localization of infarction was frequently found in the anterior wall. Eighty-three percent of the subendocardial infarction was found in the elder group. The mortality rate by the localization of infarction was as follows; the anterior wall infarction in the elder group had the highest mortality, i.e., 50%, while no death case observed among the case of subendocardial infarction.
To evaluate sympathetic nervous system in essential hypertensive patients, two different stimuli to sympathetic nervous system were carried out in normotensive controls and essential hypertensive patients. All subjects were hospitalized in our clinic and received a constant sodium diet of 120mEq per day during examination. All hypertensive patients were either untreated or withdrawn antihypertensive and diuretic drugs at least two weeks before studies. Groups studied were age-matched. Essential hypertensive patients were classified as stage I and II according to WHO stage classification. 1) Head-up tilt test (normotensives: n=33, WHO I hypertensive patients: n=31, WHO II hypertensive patients: n=46): Plasma catecholamine concentration was increased with age but not significant. Plasma catecholamine concentration on tilt increased significantly in all groups. Increase in plasma catecholamine concentration of WHO I hypertensive patients was significantly greater than those of normotensives and WHO II hypertensive patients. Excretion of urinary catecholamine during and after head-up tilt in normotensives and WHO I hypertensive patients was significantly higher than that in WHO II hypertensive patients. 2) Cold pressor test (normotensives: n=12, WHO I hypertensive patients: n=12, WHO II hypertensive patients: n=12): Plasma catecholamine concentration on cold pressor test increased significantly in all groups. Increase in plasma catecholamine concentration of WHO I hypertensive patients was significantly greater than that in WHO II hypertensive patients. 3) Administration of reserpine (normotensives: n=10, WHO I hypertensive patients: n=10, WHO II hypertensive patients: n=10): Urinary catecholamine excretion in control period in WHO I hypertensive patients was significantly higher than those in normotensives and WHO II hypertensive patients. Increase in urinary catecholamine excretion after administration of reserpine in WHO I hypertensive patients was significantly greater than those in normotensives and WHO II hypertensive patients. These results indicate that the function of sympathetic nervous system elevates in the early stage of essential hypertension and decreases with hypertension progress.
In 85 aged patients above 60 years of age, admitted to the CCU of Tokyo Metropolitan Geriatric Hospital with acute myocardial infarction (AMI) between January, 1977 and March, 1981 (group A), we analyzed the relation between the individual prognostic factors; i.e., risk factors, physical status on admission, clinical course after the admission and the early prognosis by multivariate analysis and direct probability. We developed a cathegolical discriminant function and applied the function to a subsequent 28 aged cases with AMI (group B) to assess the validity of the discriminant function. Results are as follows: 1. The prognostic factors that influenced the early prognosis, estimated by direct probability method, were age, diabetes mellitus, location of AMI, severity of congestive heart failure (by Killip's classification), systolic blood pressure on admission, hemodynamic derangement (Forrester's classification), Q, QS pattern on previous electrocardiogram, newly developed bundle branch block (p<0.05). 2. A cathegolical discriminant function showed ten factors influenced on early prognosis within 30 days. These include age, diabetes mellitus, hyperlipidemia, smoking, history of ischemic heart disease, Killip's classification of congestive heart failure, systolic blood pressure on admission, location of AMI, early complication and arrhythmias after the admission. 3. In group A, we could identify 85.4% of death and 88.6% of survivor by this prognostic function. In group B, we were able to predict death with 66.8% accuracy and survival with 89.5% accuracy.
Seven hundred and ninety muscle biopsies were examined for the incidence and the ultrastructure of the intraaxonal polyglucosan body in the intramuscular nerve fibers. The results were as follows: 1) Among the nerve fibers found in 86 muscles, polyglucosan body was positive in 8 muscles (9.3%). 2) Polyglucosan body was positive in the cases age above 54. 3) There was no distinct disease, such as diabetes mellitus, in the positive cases. 4) Polyglucosan body was observed in muscles which showed neurogenic or myogenic change. 5) In half of the nerve fibers, which showed polyglucosan bodies, demyelination and fibrosis were observed. 6) Polyglucosan body was PAS positive and showed fibrillar structure electron-microscopically, which is a characteristic feature of the corpora amylacea. Therefore, this change is thought to be one of the nonspecific axonal degenerations appeared in the aged.