As a part of a series of investigation of lipid formation by blood cells from normal and arteriosclerotic subjects, we have studied patterns of incorporation of 14C-Acetate into fatty acids in major lipid fractions. Method: After 4 hours incubation of whole blood at 37°C, with 14C-Acetate-Na, lipids were extracted and fractionates through silisic acid column chromatography into fatty acid methyl esters of major lipid fractions; free, glycerides, sterol, and phospholipids fatty acids according to the method of Börgstrom's and Hennes'. Upon further separation by gas liquid chromatography, peaks were trapped separately and the radioactivity was determined. In order to study the effect of linoleate on the incorporation of 14C into lipids, 5μl of linoleate was added to one of the two identical samples prepared simultaneously while the other was used as the control. Results: 1. Most cases of arteriosclerosis with hyper-cholestolemia incorporated less 14C into fatty acids than the controls and the myristic and palmitic acid synthesis was also suppressed. On the other hand, the per cent radioactivity in peaks of stearic, oleic, 20 carbons' and more longer chains' fatty acids showed significant relative increase. 2. Female subjects incorporated more radioactivity into fatty acid and present 14C incorprated more radioactivity into fatty acid and per cent 14C incorporation into myristic and palmitic acid increased significantly. 3. Radioactivity in total cholesterol had a tendency to be higher in diabetics than in arteriosclerotics or in controls. 4. The fatty acids of glycerides consistently contained more radioactivity than did the phospholipids. The greatest percentage of 14C was usually in non-esterifled fatty acid (50-70%). 5. The pattern of fatty acid radioactivity in each fraction was strikingly distinct. Non-esterifled fatty acid had 67.38% of myristic and palmitic acid in control and 58.38% in arteriosclerotics. These fatty acids synthesized by malonyl CoA pathway probably represent the most transportable type of fatty acid and a decrease of per cent radioactivity of this group's fatty acid in arteriosclerotics expresses a disturbance of fatty acid metabolism or transportation. Glyceride fatty acid in arteriosclerotics contained 13.55% of oleic acid that was conspicuously higher than controls (7.98%) This phenomenon is thought to be a key to the hyperlipidemia in the atherogenic state, if this product of esterification resists hydrolysis. Phospholipid incorporated relatively high percentage of stearic acid and unexpectedly low percentage of oleic acid into esters. In view of the published data the stearic acid combining phospholipid appears to have a high speed of metabolism in our living body. 6. In order to clarify the turn over rate of each fatty acid in each fractions, these results are to be more broadly analyzed, conferring with already published work, if more spaces to discuss might be endowed. 7. Effect of linoleate preparation, containing 500mg ethyl linoleate, 0.5mg Vitamin E acetate and 0.25mg vitamin B6, on incorporation of 14C acetate into fatty acids and cholesterol was as follows: 1) Incorporation into cholesterol fraction decreased clearly. 2) Fatty acid synthesis tended to diminish. 3) Per cent radioactivity in stearic and oleic acid decreased, particularly in oleic acid and also in each major lipids fractions. 4) Per cent radioactivity into fatty acids of phospholipid was rectified to about 20%.
The definition of chronic Cor pulmonale in W. H. O. report (1961) is based on right ventricular hypertrophy (RVH), or the definition of an anatomical change in heart, and it grades RVH according to both the thickness and weight of the right ventricle. That definition is therefore neither helpful to clinically diagnosis nor convenient for the evaluation of the extent and prognosis of the disease. Many recent studies have made it clear that such classification is anatomically and physiologically incomplete. For that reason, anatomical, physiological, and clinical studies were done coordinately on the advice of W. H. O. report, and these studies led us to make this new clinical criteria of chronic Cor pulmonale based on spirography, blood gases, and ECG. Our criteria are very practical and useful for the prognosis. A) The presence of chronic obstructive lung disease. The diagnosis depends on the subjective symptomes and on the chest films. Similar clinical and physiological manifestations which may originate from congenital heart disease or left heart failure must be ruled out before the diagnosis is made. a) Obstructive ventilatory disturbance (irreversible more than 3 to 6 months) FEV1.0 less than 70% less than 55% b) Restrictive ventilatory disturbance (irreversible more than 3 to 6 months) %VC less than 80% less than 40% c) Mixed ventilatory disturbance a)+b) d) Impairment of diffusion DLCO decrease PaO2 decrease (rest and exercise) e) Pulmonary vascular disorders (Especially pulmonary embolism. Even when a)-d) are not seen, the course of the disorders must be carefully observed) pulmonary scincigram. B) The assessment of chronic Cor pulmonale (exclude cardiac cathetelization). 1) MBC less than 40% (irreversible more than 3 to 6 months) 2) PaO2 i) less than 70mmHg ii) less than 55mmHg (irreversible more than 3 to 6 months) 3) PaCO2 i) more than 47mmHg ii) more than 60mmHg (irreversible more than 3 to 6 months) 4) ECG RVH (W. H. O.) ST depression (in II, III, aVF, V) including flatt T. Master's test(±) (+) at rest (±) (+) 5) The presense or the previous history of systolic trust, congestion, edema (increased venous pressure). Notes: a) Below than 2) ii) column in the table; highly supspected. Below than 3) ii) column in the table; definite. b) RVH (W. H. O.) in the ECG column include hemondynamic overload and or decompensation, apart from anatomical hypertrophy. c) In the case of pulmonary vascular disturbance, ECG is most important. d) In the case of acute Cor pulmonale too, this criteria of A) will be applied by cnanging the period. e) About the cases with complications (senile lung, senile heart, coronary sclerosis, hypertension, diabetes mellitus etc.) this criteria will not be applied perfectly.
The difference in weight between the left and right kidney was studied in 591 autopsied cases over 60 years. Of these, 99 or 16.9per cent were found to have unilateral renal diseases. Included were 47 cases of pyelonephritis, 24 cases of kidneys with cysts, 11 cases of renal artery diseases, 10 cases of malignant tumors, and 11 cases of malformation. Of the 47 patients with pyelonephritis, 7 or 14.9per cent were complicated by hydronephrosis. A statistical analysis was made of kidneys without renal diseases in order to determine the rejection region of the difference (left-right kidney) g. The critical values for the rejection region were found to be -33.0, +46.4 for males and -28.2, +41.6 for females at the 1% level. In more than 80per cent of the patients with hydronephrosis or renal artery diseases, the weight differences were beyond the critical values.
Adhesive index of the platelet by the use of a glass wool filter (Moolten's method) and other blood clotting factors were determined in the experimental atherosclerosis in the rabbits to assess their relations to the development of atherosclerosis. The materials were 63 adult, normal rabbits, devided into 5 groups depending on the various pretreatment as follows: lanolin-feeding, with injection of celite (Filter-Cel), injection of celite, celite and phenylindanedion and no pretreatment as the control. The results were summarized as follows: 1) The intravenous injection of celite into the rabbits produced an increase in blood coagulability as represented by the increase of adhesive index of the platelet. The slight decrease in the clotting factors in the blood as serum fibrinogen and prothrombin could be explained as the results of increased consumption of these factors in the animals. 2) The development of atheroma of the aorta in the lanolined rabbits was accerelated and the adhesive index was increased after the celite injection. 3) Intravenous injection of celite into the rabbits produced a localized thickening of the endothelium at the pulmonary arteries. 4) Administration of phenylindanedion (anticoagulant) produced no significant changes in the adhesive index but the pathological alterations were inhibited.
The choroidal circulation of white and black rabbits was studied. Choroidal vessels of the white rabbits were easily seen because of the defect of the pigmental layer. In order to differentiate the choroidal circulation from the retinal circulation, the choroidal circulation was cut before subjecting the remaining retinal vessels to fluorescence photography, which made it possible to see only retinal vessels clealy. Continuous observation did not reveal any choroidal flush by this method. By cutting the central retinal artery and vein it became possible to stady the choroidal circulation of black rabbits by the method of fluorescence photography. By this method, the choroidal flush was seen at the time when the fluorescence shifted from the arterial phase to the venous phase. This fact seems to indicate that the choroidal flush represents the capillary plexus.
It is well recognized that the body composition varies with age. Since there is a constant potassium concentration in lean tissue, while fat contain little or no potassium, it might be possible to use body potassium concentration as an index of the body composition. Recently, the availability of the human whole body counter has openned a new area in the study of body potassium metabolism. In this study, the authors measured whole body potassium content, with the plastic scintillator type human counter, in 217 normal volunteers, namely 136 males, ranging in age from 6 to 82 years, and 81 females, from 6 to 80 years. In the old persons over 60 years of age, strict physical examinations were carried out in order to rule out subjects with latent illness. Skin-fold thickness was also measured in these old persons In both sexes, body potassium concentration decreased linearly after 40 years of age. In the subjects over 60 years of age, body potassium concentration showed highly significant negative correlations with the each value of skin-fold thickness of various parts of the body. In all of these old persons, the proportion of fat in the whole body calculated from the present potassium data according to the formula of G. B. Forbes, differed markedly from that calculated from skinfold thickness according to Nagamine's formula to be used in young adults. As one of the reasons of this discrepancy, the authors pointed out the infiltration of fat in the various organs and the increase of connective tissue which were usually found in the old persons.