Lp(a), an independent risk factor of thrombotic and arteriosclerotic diseases, was determined in subjects undergoing helath examinations, and the significance of the determination of Lp(a) in such examinations was investigated by studying its relation with other risk factors for arteriosclerosis, etc. The subjects were 838 individuals. Lp(a) was determined by latex immunoassay (LIA). The mean Lp(a) value for all of the subjects was 10.9±7.2mg/dl. Both gender groups were compared by age, but no significant changes were observed. In a study of Lp(a) in accordance with complications, there was no significant difference between the DM group and the non-DM group. There was also no significant difference between the IHD group and the non-IHD group. In the hyperlipemia group, the value of Lp(a) tender to be higher than in the non-hyperlipemia group. In the abnormal ECG group, the Lp(a) value was significantly higher than in the normal ECG group. When the relation between Lp(a) and other factors was studied, there was positive correlation with TC, β Lp and LDLC, and a significant netative correlation with TRG. There was significant negative correlation with GOT, GPT and TTT. When the incidence of disease was compared by cut-off value, the incidence of abnormal ECGs was significantly higher at Lp(a) values of 25mgdl or higher. In this study, Lp(a) showed positive correlations with TC, βLp and LDLC, the atherogenic risk of Lp(a) was evident. Because of the significant incidence of abnormal ECGs at the Lp(a) cut-off value of 25mg/dl or higher, the risk range for Lp(a) should probably be considered as 25mg/dl or higher. These results indicated the significance of Lp(a) in health examinations.

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Blood glucose levels were continuously monitored in 70 subjects during a 75g orla glucose tolerance test (OGTT). Subjects were divided into normal (N=15), borderline (N=31), diabetes with fasting glucose levels below 140mg/dl (DM₁) (N=15) and diabetes with levels above 140mg/dl (DM₂) (N=9). Three patterns of blood glucose curves were observed in each subject group; domed, biphasic and upward. The frequency of blood glocose patterns in each class of glucose tolerance group was as follows: in the normal group; domed 33.3%, biphasic 66.7%; in the borderline group; domed 67.7%, biphasic 29.0%, upward 3.2%; in the DM₁ group; domed 66.7%, biphasic 13.3%, upward 20.0%; in the DM₂ group; domed 77.8%, upward 22.2%. The frequency of patients with a biphasic pattern was significantly higher in the normal group than in the other groups. In the borderline group, almost all patients with a biphasic pattern were young or middle aged (<60 years old). When the patients with fasting glucose levels below 140mg/dl were analyzed, the mean peak time and peak value of blood glucose levels were significantly higher in patients with domed patterns than those with biphasic patterns. Indices of early insulin response to glucose load were significantly lowre in patients with domed patterns than in those with a biphasic pattern. In conclusion, the pattern of the glucose curve in an OGTT is mainly dependent on the patient's early insulin reponse. Glucose intolerance with aging resembles diabetes from the standpoint of the pattern of glucose tolerance curves.

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It has been generally agreed that muscle strength decreases with advance of age in adulthood. In order to study the effect of aging in abdominal muscle strength, abdominal muscle strength, height, body weight and grip strength were measured in 144 healthy subjects aged from 20 to 88 years old. The abdominal muscle strength was measured using a grip dynamometer. Curve between aging and strength revealed that the abdominal muscle strength gradually decreased with aging during many decades, but rapidly decreased in the fifth decade and over in males and seventh decade and over in females. Among these data, significant correlations were observed between abdominal muscle strength and age (only in males; r=-0.64), abdominal muscle strength and grip strength (in males; r=0.75, in females; r=0.47), age and grip strength (in males; -0.72, in females; r=-0.60), and, age and height (in males; r=-0.55, in females; r=-0.46). The results suggest that decrease of abdominal muscle strength is due to aging, although the degree of the decrease is affected by the generation studied. The method to measure abdominal muscle strength originally developed by us is easy and useful to understand changes of age-related muscular strength.

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An epidemiological analysis of deaths occuring while taking a bath was carried out in Tochigi Prefecture. Data concerning the numbers of deaths were obtained from the Tochigi Central Police Office. Long-term assessments from 1978 to 1992 were completed for a total number of 1, 348 persons (793 men and 555 women). The annual number of deaths during taking a bath increased gradually from 43 in 1978 to 140 in 1992. Death occurred 1.43 times more frequently in males than in females. The number during summer was only one eighth that of the winter peak. In addition, the increase in mortality was proportional to age. The mortality figures per 100, 000 were, 10 for 40-49 age group, 31 for 50-59, 79 for 60-69, 251 for 70-79 and 469 for those 80 and over. It is concluded that the number of deaths occurring while taking a bath has increased gradually in those 80 or over.

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A total of 34 patients, aged 43 to 86 years old (mean 65), consisting of 26 males and 8 females, with thrombotic or arteriosclerotic diseases were orally given highly purified icosapentaenoic acid ethylester formulation (IPA-E) for 12 weeks without changing regular food intake. Changes in platelet count (PLT), mean platelet volume (MPV), plateletcrit (Pct) and change of distribution width of platelet size (PDW), and factors affecting the changes were studied. Factors studied were platelet parameters before administration, dose of IPA-E, age, sex, smoking habits, complications of diabetes mellitus and hyperilipidemia, and concomitant drugs such as calcium antagonists or diuretics. With daily administration of 1800 or 900mg of IPA-E, PLT and Pct began to decrease after four weeks and decreased significantly after eight weeks until the completion of administration. After the 12th week, the MVP became smaller than the preadministration level, while PDW did not change significantly during the entire period of administration. The volume and rates of changes in PLT, MPV and Pct during administration for 12 weeks correlated negatively with those preadministration values. The PLT, MPV and Pct decreased significantly in both the 1800 and 900mg groups compared to values before administration. There were no significant differences in changes between the two groups. The plasma IPA concentration in the 12th week of the 1800mg group was significantly higher than that of the 900mg group. The rate of changes in Pct had a significantly negative correlation with the achieved IPA concentration. The age, smoking habits, complications of diabetes mellitus, or concomitant drugs of calcium antagonists or diuretics did not affect the changes of platelet parameters significantly. The PLT and Pct in male patients decreased significantly, but no significant changes were observed in female patients. The PLT and Pct in patients with IIb and IV hyperlipidemia decreased significantly compared to those in normolipidemic or IIa hyperlipidemic subjects. The study demonstrated that IPA-E improved pletelet parameters, suggesting IPA-E could prevent progression of thrombotic and arteriosclerotic diseases, IPA-E was paticularly effective in male patients or patients with Type IIb or IV hyperlipidemia. Although a daily dose of 900mg was effective, 1800mg was even more effective.

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Red blood cell count (RBC), hemoglobin level (Hb), hematocrit value (Ht), and white blood cell count (WBC) were determined periodically in 499 subjects (274 males, 225 females) aged 60 and over. RBC, Hb, and Ht showed a significant decrease after 5 years in both younger (60-64) and older (65 and over) male groups, and in the female groups except for the Hb level in the older group. Comparison between the younger and older group (cross-sectional study), revealed that the older male group showed lower levels of RBC, Hb, Ht than the younger male group, but the situation was completely the reverse in the females. No significant age-related changes were observed in WBC, but it was significantly higher in both the younger and older male groups than in the female groups. A significant decline with age was observed in both male and female MCV values. On the contrary, from a cross-sectional standpoint, the MCV values in the older female group were higher than those in the younger group.
These findings revealed a completely reverse outcome in some parameters, when studied longitudinally and cross-sectionally. Therefore, the data should be evaluated longitudinally to elucidate the real effect of aging. It is pertinent to apply the WHO criteria (male 13g/dl, female 12g/dl) to the diagnosis of anemia of elderly people.

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A 69-year-old woman was admitted to our hospital with a 7-month history of sensory disturbance of the bilateral lower extremities. Since she developed paraplegia of the extremities, urinary incontinence and left hemiplegia several days after admission, neurologic involvement both in the lumbar cord, and in the cervical cord or the brain was suspected. While no abnormalities were noted by computerized tomography of the brain. T2-weighted magnetic resonance imaging (MRI) clearly demonstrated foci in the periventricular and the basal ganglia regions bilaterally. Furthermore, the levels of immunoglobulin G and interleukin 6 were increased in the cerebrospinal fluid (CSF). From physical and other laboratory findings in addition to the MRI and CSF findings, she was diagnosed as having systemic lupus erythematosus with central nervous involvement. The administration of prednisolone resulted in marked improvement in her neurologic symptoms in two months. Thus, it is considered that the MRI and CSF examinations are useful for the diagnosis and treatment of central nervous involvement of systemic lupus erythematosus.

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