A clinical investigation on the circulatory system and renal functions was performed on 32 inhabitants (9 men and 23 women) over 90 years of age including a 113 years old man, the oldest in Japan, at Kamaishi on the Sanriku Coast to ascertain the factors relating to longevity. Four persons who were over 20% of the ideal body weight and two who were over 40% showed the abnormality of either glycosuria or high fasting blood sugar. Twenty-six subjects had a systolic blood pressure over 170mmHg. 11 of them (42.3%) had a diastolic blood pressure below 100mmHg and their mean blood pressure exceeded 70mmHg. Most of the persons with high blood pressures were considered to be senile hypertensive. All of them had some degree of albuminuria: trace 12.5%, slight 78.1%, moderate 6.4%. The mean value of BUN was 16.1±2.7mg/dl and the persons who exceeded 15mg/dl reached to 57.7%, but none of them showed extremely high value. In the PSP excretion test, only 11.5% was in the normal range and poor excretors below 10% reached to 42.3%.
In the previous report the author described the results of the investigations on the circulatory system and the renal functions of 32 inhabitants over 90 years of age at Kamaishi on the Sanriku Coast in Northern Japan. In this study the determinations of the serum lipids levels, the examinations of the urinary glucose, the fasting blood sugar, the hepatic functions, surveys of the nutritional conditions and ophthalmologic examinations were performed. The mean serum cholesterol level was 186.3± 22.1mg/dl in the males and 212.6±72.3mg/dl in the females. The serum triglycerids level was normal in all subjects except one who showed of abnormally high level (120mg/dl). The β-lipoprotein was normal in all subjects. Five subjects had fasting blood sugar above 100mg/dl. No glycosuria was, however, present in these subjects. In the urine analysis, 23 cases were negative of glucose but trace or small amount of glycosuria were detected in each two cases and moderately in one. So the fasting blood sugar of the person swho had glycosuria were under 100mg/dl in all that any of them was not considered as a diabetic. In the hepatic function tests, the serum transaminases were normal in all subjects, but 34.4% showed positive in CCF test. In 57.1% of the subjects, it exceeded more than 4 units in TTT, and 15.6% was over 12 units in ZTT. Their visual powers were under 0.3 in all, and the only 13 eyes amoung 54 eyes were found of the retinal grounds faintly. In generally, all had so progressive senile cataractas that could not analized of its degrees of the retinal arteriosclerosis. The protein intake was 1.0∼1.5g per kg of body weight and the animal protein intake was almost qual to the vegitable origins. They had poor intake of vitamins and minerals in general, except the phosphorus, but much intake of vitamin A was observed in 100-year-old female and 113-yearold male, in compared to the total calorie the more vitamin B complex intake was noticed in these centenarians.
The histological picture of the gastric cancer and its growth pattern differ according to the age of the host, and there are problems to be solved clear as to the nature of the differences. One hundred fourty three surgical cases of gastric cancer (30 cases of small-sized mucosal, 35 of large-sized mucosal and 78 of advanced gastric cancer) and 120 autopsy cases of gastric cancer with pulmonary metastases were examined. Comparative study of cancer tissue was performed with special reference to the age of the host and to the stage of cancer growth, and some interesting findings were obtained as follows: 1) In the primary foci In the early stage of gastric cancer growth, the histological picture of cancer tissue was composed mainly of adenocarcinoma in all age groups. With advancement of the stage, the picture of adenocarcinoma became to be less frequently seen, and, instead of adenocarcinoma, pictures of carcinoma simplex and carcinoma disseminata became to be more often noted. This tendency was more marked in the younger age group than in the old; so that the age difference in the histological picture was found to become more marked in the course of cancer growth. 2) In the metastatic foci in the lung The age difference in the histological picture in the pulmonary metastases was less marked than that in the primaries. However, remarkable differences were noted in the pattern of the spread among the hosts with different ages. The picture of interstitial spread was remarkably seen in the young, and the intraalveolar spread was found to become marked with age. 3) These age differences were considered to be due to the environmental conditions, particularly to age dependent character of the interstitia, where the cancer grew.
The clinical and radiologic findings of atherosclerosis of the aorta in a lateral chest film have been compared in 319 subjects above the age of 50 years. We have graded the atherosclerotic involvement with calcification of the aorta in the lateral chest film from class I to class IV. In class III or IV with evidence of marked atherosclerotic involvement of the aorta, postmorten examination confirmed the presence of atherosclerosis. This simple lateral chest X-ray examination constitutes a useful and easily applicable procedure in the detection of aortic atherosclerosis.
Although there are many important nerve centres in medulla oblongata, clinical detection for its lesions is very difficult. Since about 10 years, Mashiko, one of the author has done the electromyographic studies on tongue muscles. In the patients with bulbar lesions, findings of the lower motor neuron lesions were most frequently observed electromyographically. Now, the authors studied on the bulbar lesions in aging. Results obtained were as follows: 1) Fifty-one cases with bulbar lesions were separated in 2 groups; that is, 40 cases as aging above 50 years old and 12 cases below it. Comparative studies were done between these 2 groups. a) Symptoms frequently appeared were in order to dysarthria, headache and swallowing disturbance. Dysarthria was seen in 80.4%. b) In pathogenesis, vascular origins were very frequent in both groups. In aging, cerebral thrombosis was frequently observed associating hypertension and arteriosclerosis in retina. c) Findings of the lower motor neuron lesions were observed high frequently in tongue muscle electromyography. 2) In 50 cases above 70 years old being apparently healthy, findings of the lower motor neuron lesions were oeserved in 46% on the tongue muscle electromyograms. 3) Hypertension was frequently seen in the patients with bulbar lesions. Different responses for blood pressure changes were seen in bulbar lesions compared with controls. If may be concluded that electromyography of the tongue muscles is useful tool in the detection of subclinical bulbar lesions in aging, and early therapy for subclinical bulbar lesions is very important problem.
The incidence of brain tumor is rare in age over 60, and its symptoms are usually atypical. From the clinicopathological analysis a total of 4 cases of meningioma and a case of pinealoma were found and reported. Meningiomas were found in 4 women, whose age ranged from 75 to 82 years old, and a pinealoma was found in a 63 year old man. Location of these tumors in the brain were inconstant, such as left front-temporal, right temporal, right parietal, left subsphenoidal in meningiomas, and the area under the right lateral ventricle in pinealoma. Size of the tumors ranged from 2×1cm. to 5×4.5cm. Histologically, there were 3 cases of meningothelial meningioma, one case of fibroblastic meningioma and one case of anaplastic pinealoma. Clinical diagnosis was cerebrovascular disease in all of the cases, and presence of brain tumor was first noted at autopsy. Retrospective clinicopathological comparison showed that in the first group of 3 cases symptoms arising from tumor were erroneously interpreted as those from cerebral vascular accident, and in the second group of 2 cases tumors are relatively small and the symptoms were pertinently attributed to the cerebrovascular diseases present (silent tumor). In the former group, two cases-showed no changes in the brain substances, and a case (Case 2) showed massive bleeding from the meningioma, which was quite rich in blood vessels, with an extension of bleeding to the subarachnoidal space. These symptom-producing tumor in three cases were found among the 64 cases of cerebrovascular diseases, who died and autopsied during recent 2 years, corresponding to an incidence of 4.7%. Though meningioma is found relatively frequently among autopsies of brain tumor in the aged, it rarely produces clinical symptoms such as due to compression probably due to its slow development. Therefore, it is highly possible that it is undiagnosed or erroneously diagnosed as cerebrovascular disease.