This study was done at the Yokufukai Geriatric Hospital to examine the relationship between Sulfonylureas and the incidence of Myocardial Infarction in 387 cases. The cases were necropsied; they had abnormal glucose intolerance; and they were sixty years or over. I. The incidence of Myocardial infarction (MI) in the Tolbutamide Group (T) was 38.1%, and that in the Sulfonylurea Group (SU), including T, was 40.9%, significantly higher than in the Free Group (F) consisting of dieters alone. The cases were divided into two groups: one with Mild Glucose Intolerance (MGI) and the other with Diabetes Mellitus (DM). In the MGI group, the incidence of MI in T was 40.7%, significantly higher than the 16.1% for F. II. Luminal narrowing of the coronary artery was considered to be the most important factor in the evolution of myocardial ischemic lesions. We studied the relationship between the incidence of MI, the coronary artery system and diabetic therapeutic methods. The left descending, left circumflex and right coronary arteries were dissected at about 5mm intervals. The grade of stenosis was estimated macroscopically and expressed as a luminal narrowing percentage. Cases who had 75% or more arterial stenosis were classified as group A and the others as group B (less than 75% stenosis). 1) In group A, the incidence of MI was 52% for T, 55.6% for SU and 34.6% for F. T and SU were significantly higher than in F. In group B, there were no significant differences in the incidence of MI between T, SU and F. 2) In MGI and group A, the incidence of MI in T was 57.9%, significantly higher than the 34.4% in F. In DM, it did not change significantly. 3) All cases were divided into two groups: those 74 years and under and those 75 years and over. In those 75 years and over and in group A, the incidence of MI in SU was significantly higher than in F. However, in those 74 years and under, there was no significant difference in the incidence of MI between groups SU and F.
To investigate the pathogenesis of the onsets of atherosclerosis, myocardial infarction and cerebral thrombosis, we studied the effets of the extracts obtained from aortic tissues on platelet aggregation, as these onsets are closely related to arterial thrombosis, formation of which depends on platelet aggregability, arterial wall constituents and so on. Seven human aortas were collected at autopsy within 5 hours after death. Samples were taken from intima and medial layers of uninvolved aortas, fibrous plaques and meidal layer beneath the plaques. They were shaken gently with 0.15M sodium chloride (1:5w/v), pH7.4, at 4°C for 24 hours and them centrifuged at 1.000G for 30 minutes. The residues were homogenized with 0.15M sodium chloride (1:5w/v), pH7.4, and then centrifuged at 1.000G for 30 minutes. The middle layers which were floated by centrifugation were used for the estimation of the effects of the extracts on platelet aggregation. None of the extracts obtained by gentle shaking aggregated platelets. But platelet aggregations induced by ADP which was mixed with any kind of extracts prepared by gentle shaking were inhibited markedly compared to that of equimolar ADP. The aggregations by premixed epinephrine or norepinephrine with the extract prepared by gentle shaking were more accentuated than that of epinephrine or norepinephrine. Almost no effect on platelet aggregability was found by pre-mixed collagen with any kind of extracts by gentle shaking. All of the extracts prepared by homogenization aggregated platelets. The extract-induced aggregation curves were similar to that of collagen. This fact may suggest that the extraced substance which aggregates platelets is arterial collagen. From the results of this experiment, we can say that a condition which causes release of high amounts of catecholamines tends toward thrombus formation by platelet aggregation. Moreover, it may induce the onset of atherosclerosis, myocardial infarction and cerbral thrombosis.
The purpose of the present study is to clarify the clinical significance of platelet changes in cerebral vascular disorders. Mean platelet volume (MPV) and platelet count (PLT) were measured by a Coulter Counter Model S-Plus and platelet retention rate (RR) was measured by the glass beads column method. The subjects consisted of 154 normal subjects (54±3 y.o.), 12 patients with cerebral arteriosclerosis (68±9 y.o.), 20 patients with cerebral infarction (69±9 y.o.) and 9 patients with Alzheimer type dementia (74±7 y.o.), twelve out of 32 patients of arteriosclerosis or infarction had cerebral vascular dementia (71 ±8 y.o.). The following results were obtained. MPV was significantly increased in cerebral infarction as compared to normal subjects, but not singificant in cerebral arteriosclerosis. PLT was significantly decreased in cerebral infarction and cerebral arteriosclerosis as compared to normal subjects. In patients with arteriosclerosis and infarction, MPV and PLT exhibited a significant negative correlation. MPV was also significantly increased in cerebral vascular dementia as compared to Alzheimer type dementia, and PLT was significantly decreased in cerebral vascular dementia. No significant difference of RR was observed among cerebral infarction, cerebral arteriosclerosis and Alzheimer type dementia. These results indicate that the above-mentioned platelet parameter changes may reflect cerebral vascular lesion so that the measurement of MPV and PLT may be useful in foreseeing stroke attack in patients with cerebral disease, and in understanding of the pathophysiology of dementia.
The study was performed to investigate the decline of intellectual functioning with aging in the elderly population. Subjects were 11, 374 (92.6%) out of 12, 280 entire elderly population (older than 65yrs) who had registered census in Yonago in March, 1980. Attending distric welfare commissioners interviewed the subjects in their own homes. Interview schedule explored physical condition, medication, social activities and others, and included an assessment of intellectual functioning by using the revised Mental Status Questionnaire (Kuhn et al.). The number of the elderly subjects suspected to be intellectually impaired (intellectually impaired subjects) increased with aging, and were much more in women than in men (p<0.005). Correlation was observed between intellectual impairment and physical condition. Furthermore, the degree of the intellectual and physical correlation changes with aging. In the group of elderly with surviving spouse, intellectually impaired subjects were significantly less than in the subjects without spouse (p<0.005). The way of passing free time was different by sex and age groups. Though men usually engaged in activities which required some intellectual function, such as reading magazines, newspapers and etc., and volunteer activities, women comsumed free time mostly in watching TV, listening to the radio, and talk with their family members and neighbours, which did not always require use of intellect. The way of passing free time of men gradually declined to the type of women with aging. From these results, it was suggested that the senescence could be divided into 3 age groups or periods: former senescence (65-75 or 79yrs), middle senescence (80-89yrs) and later senescence (above 90yrs). This classification may be beneficial in investigational and/or practical situations in gerontology.
Age and sex related changes of the γ-carboxyglutamic acid (Gla) content in the rat bone was examined γ-carboxyglutamic acid in the rat femur, tibia, humerus and calvaria was measured by high pressure liquid chromatography. Gla content in each bone was significantly greater in the shaft than in the epiphysis. It was found that Gla content in each bone significantly increased with advancing age and at 3 and 6 months of age, Gla content was significantly greater in the male than in the female. Significant positive correlation was found between Gla content and calcium and phorphorus in the bones respectively. These findings suggest the role of Gla in the mineralization of the bone.
Serum concentration of γ-carboxyglutamic acid containing protein (BGP) was measured by the radioimmunoassay using anti-serum to bovine BGP which crossreacts with human BGP in normal subjects (108 male and 49 female), aged 30-80 years and 39 cases with thyroid diseases, 6 cases with chronic renal failure and 21 cases of postmenopausal osteoporosis. There was no age and sex difference in the serum level of BGP in the normal subjects. Serum level of BGP was significantly higher in hyperthyroidism and in chronic renal failure and it was significantly lower in postmenopausal osteoporosis than in the normal subjects. It was concluded that serum level of BSP was high in subjects with high bone turnover.
Six healthy volunteers were fed with the diet of same composition for two days. Thirthy gr of oil (P/S ratio: 1.2) were administered with each meal on the second day. Blood was collected at fasting, one and three hours after breakfast, and two and four hours after lunch and supper. The activities of LCAT and the levels of total cholesterol (TC), triglyceride (TG), free cholesterol (FC), free fatty acids (FFA), glucose (BG), and immuno-reactive insulin (IRI) in the plasma were estimated. LCAT activities were 59.9±14.2 (mean±SD) nM/ml/hr on the first day and 58.4±13.3nM/ml/hr on the second day resepectively in the fasting state. No significant diurnal changes were observed in LCAT activities. Fat load did not affect the LCAT activities. Plasma TG levels reached the peak at two hours after lunch and decreased afterward. Fat load increases the postprandial TG levels in the plasma. However, the diural changing curves of plasma TG levels were same on both days. Plasma TC, FC and HDL-C levels stayed constant throughout the day and the effects of fat load were almost nil. Plasma FFA levels were highest in the fasting state. They decreased repidly after breakfast and increased slightly afterward. Fat load significantly increased plasma FFA levels after lunch and kept FFA at higher levels until the night. Diurnal changes of BS were relatively small and fat load did not affect BS levels. Plasma IRI levels stayed at high levels after lunch until the night and fat load did not affect plasma IRI levels. Correlation coefficients between LCAT activities and other parameters mentioned above were calcluated. LCAT activities has positive correlations with TC (r=0.632, p<0.05), TG (r=0.793, p<0.01), FC (r=0.855, p<0.001) and HDL-C (r=0.577, p<0.05) in the fasting state, but had no correlation with FFA, BS and IRI. When correlation coefficients were calculated based on all data in both fasting and postprondial states, LCAT activities had positive correlations with TC (r=0.403, p<0.001), TG (r=0.508, p<0.001), FC (r=0.415, p<0.001), HDL-C (r=0.855, p<0.001), and FFA (r=0.266, p<0.02), but had no correlations with BS and IRI.
The pathological basis for dementia in Parkinson's disease (PD) is related to the simultaneous presence of Alzheimer disease (AD)-like changes, thus suggesting a close link between PD and AD. Recently AD is though to be associated with degeneration of cholinergic nervous system, as evidenced by selective loss of neurons in the Nucleus basalis of Meynert (NbM), the principal source of cholinergic projection to the neocortex. In order to examine the neuropathological changes of the cholinergic nervous system in PD with dementia, “diffuse Lewy body disease” and SDAT, comparative cell counts in the NbM were carried out. The examined cases were as follows; PD without dementia (five cases, mean age 76.4 yeras), PD with dementia (five cases, 78.4 years), “diffuse Lewy body disease (DLBD)” (five cases, 84.2 years), SDAT (five cases, 76.4 years), PSP (three cases, 75.0 years), SND (two cases, 63.5 years) and five cases of normal control (mean age of 80.3 years). Compared to the control cases, the cell density (measuring 200um by 150um) and the total number of neurons (neurons mainly located between the optic tract and the anterior commissure) of the NbM in patients with SDAT, DLBD, and PD with dementia showed a statistical sifnificant reduction; the cell density was reduced by 26.6% (SDAT), 28.6% (DLBD) and 64.8% (PD with dementia), respectively. The total number of cells was also reduced by 26.05 (DSAT), 26.1% (DLBD) and 60.9% (PD with dementia), respectively. There was no statistical difference in cellular population of the NbM between PD without dementia, PSP, SND nd normal controls. Our results show that the demented patients with PD as well as SDAT or “DLBD” have a loss of neurons in the NbM, suggesting a disturbance of cholinergic nervous system, which might be in part, related to dementia in these cases. On the other hand, according to the distributing pattern of Lewy bodies, the demented patients with PD and “DLBD” may have a degeneration of meso-limbic-cortical dopaminergic pathways. Therefore, it may be postulated that PD with dementia and “DLBD” may have a system degeneration of both dopaminergic and cholinergic nervous systems in the brain. We also discussed the nosological situation of “DLBD”, regarding it as one distinct disease entity.
The present study aims at evaluating serum albumin concentration (Alb) as an indicator for ageing. Relationship of Alb to both ageing and survivorship were longitudinally observed among community volunteers. The survey was carried out in 1976 and 1981. The subjects were 422 community volunteers aged 69-71 at the first survey. The serum was obtained in 242 of 422 in 1981 (group A). Fourty-seven of 422 died before the second survey (group B). In 133 of 422 the serum was not obtained, but all of them were known to be alive in 1981 (group C). 1) At the first survey, Alb was significantly lower in the deceased group (group B) than in the survived groups (group A and C). Alb in the deceased group was lower by 0.25g/dl in men and 0.12g/dl in women. The 422 subjects were divided into the quartiles according to Alb level at the first survey, and its relation to the relative mortality was examined. Relative mortality ratio was 201% in the first interquartile range (Alb≤4.1g/dl in men, Alb≤4.2g/dl in women). Relative mortality tended to be lower at higher Alb. 2) Alb significantly decreased during the 5 years; 4.41 to 4.14g/dl in men, 4.47 to 4.22g/dl in women (group A). It can be concluded that serum albumin concentration is an appropriate indicator for ageing. This study was carried out as a part of the Koganei Study, in Tokyo.