Today, the mean age of in-patients of National Sanatorium Oshima Seosho-en became 62.2 years, and the inpatients whose ages were 60 years and over occupied 60.4 percents of all patients.
The mass examinations for in-patients of Ohima Seisho-en were at 3 times in all inpatients except long out-stayers between June 1982 and September 1983. The object of examinations was narrowed down to finding out of diseases of circulatory system, because the diseases were found most frequently in old peoples.
The number of examined in-patients were as follows; the first mass examination at June 1982: a total of 408 cases except long out-stayers, the second mass examination at October 1982: a total of 240 cases (237 cases with abnormal ECG findings found at the first mass examination and other 3 cases), the third mass examination at September 1983: a total of 215 cases in whom abnormal ECG findings, hypertension and apoplexy were found at the second mass examination and/or by physicians' diaries.
The kinds of examinations were as follows; ECG except load test, blood pressure, routine blood examinations (number of RBC, number of WBC, hematocrit and hemoglobin), routine urine examinations (protein, pH, sugar, occult blood, acetone, sediment and urobilinogen), biochemistry of serum (total protein, albumin, total bilirubin, direct bilirubin, indirect bilirubin, ZTT, total cholesterol, uric acid, urea nitrogen, alkali phosphatase, cholin esterase, LAP, GOT, GPT, γ-GTP, LDH, β-lipoprotein, HDL-cholesterol, triglyceride, CPK, Na, K and Cl), CRP and ESR.
A total of 190 (myocardial injury 22 cases, block 48 cases, coronary insufficiency 108 cases and low voltage 12 cases) out of the 215 cases were found to have some abnormal ECG findings at the mass examination.
Fourty four out of the 240 cases who were cases examined at the second mass examination showed their maximum blood pressure over 160mmHg, 33 cases their minimum blood pressure over 95mmHg, and 20 not only their maximum blood pressure over 160 mmHg but also their minimum blood pressure over 95mmHg. A total of 119 cases were diagnosed as hypertension at the second mass examination and/or by physicians' diaries.
Eighty five out of the 119 cases were administered some medicines for reducing blood pressure. Other 34 cases were not administered any medicines for blood pressure.
Sixty four (44 out of the 85 cases who were administered some medicines for reducing blood pressure and 20 out of the 34 cases who were not administered any medicines for reducing blood pressure) could keep not only their maximum blood pressure below 160 mmHg but also their minimum blood pressure below 95mmHg.
One hundred and seven out of the 119 cases were divided into 4 groups by ECG findings (myocardial injury group 9 cases, block group 24 cases, coronary insufficiency group 52 cases and normal finding group 22 cases). The biochemical data of serum of the 4 groups, such as total cholesterol, β-lipoprotein, neutral fat, HDL-cholesterol, GOT, GPT, LDH and CPK, were examined. All of the mean values except LDH of myocardial injury group were within normal range. The mean value of LDH of the group showed relative high value (498.8 CW. U) as compared with that of other groups. All of the mean values of β-lipoprotein (368.2mg/dl), triglyceride (133.3mg/dl), GOT (37.0 KU) and CPK (390.3IU/L) of coronary insufficiency group were higher relatively than those of other groups. All of the values of block group were within normal range.
Six out of the 107 cases showed the values 250mg/dl of total cholesterol and within/ below normal range of triglyceride. Thirty out of the 107 cases showed the values within/ below normal range of total cholesterol and over 140mg/dl of triglyceride.
The 119 cases diagnosed as hypertension were divided into 2 cases, a group administrated thiazide for blood pressure and another group not administrated thiazide,

View full abstract

It is said that "many diseases show apoplexy-like outbreak and morbid conditions in the aged". On the other hand, it can be said that cerebral blood vessel disorder is easy to be dealed with as mere dementia or senile decay. But in the meantime, the treatment and care of decay or abnormal action based on the cerebral blood vessel disorder is different from those of mere senile decay or dementia.
In order to investigate the present state of such problems in National Sanatorium Oshima Seisho-en, investigations attaching importance to clinical progress were made on a total of 24 cases. Those cases were composed of 12 cases having cerebral blood vessel disorder found by the investigation of clinical record of 458 in-patients, and 12 cases whose basal disease of direct cause of death was regarded as apoplexy, among 33 cases who died from January, 1981 to the end of March, 1984.
The items of 24 cases were 3 cases of cerebral hemorrhage (2 males and 1 female) and 21 cases of cerebral infarct (15 males and 6 females). And the items of 12 dead cases were 2 cases of cerebral hemorrhage and 10 cases of cerebral infarct.
The number of cases increased as the patients became older. The mortality was 33% in their fifties, 33% in their seventies, 67% in their eighties, and 100% in their nineties. The percentage of cases whcse direct cause of death was apoplexy was 42.
Among living 12 cases, the half existed over 5 years from the outbreak of illness. In 6 cases, their functions were recovered, and they were possible to keep the nearly same life as that of healthy person.
The examinations of blood, serum lipid and kidney function did not show any specific result. The percentage of cases having abnormality in electrocardiogram was 60.
On the other hand, in Hasegawa's simple intelligence test made on all patients of eighty years and over and patients requiring special attention of seventy years and over, 50% belonged to dementia and semidementia group. Five out of 6 cases in whom dysfunction in daily life remained, among the patients having anamnesis of apoplexy, belonged to dementia and semidementia group. When the signs of fit of apoplexy become fixed, neural and mental symptoms which are hard to be differentiated from Altzheimer type may be shown. Accordingly, it is considered that careful daily observation together with measurement of blood pressure and examination of electrocardiogram is important.

View full abstract

In Leprosy a skin test has been prepared by Rees from armadillo tissues carefully freed from armadillo antigen. This reagent is called Leprosin A. Several healthy normals, contacts and leprosy patients negative to Leprosin A were vaccinated with a mixture of M. leprae plus BCG. Forty four Leprosin A positive sites were biopsied following the vaccination. Immuno peroxidase technique with monoclonal antibodies has been used to identify T cells, T helper cells and T suppressor cells. Enumeration of the T Cell subsets shows that the large number infiltrating the positive skin test sites are T helper-induce subset. Multibacillary leprosy patients following the vaccination demonstrated large numbers of T helper-inducer lymphocytes. We speculate that the T helper cells are due to the immunostimulating properties of the M. leprae plus BCG.

View full abstract

M. lepraemurium, strain Hawaiian, has been maintained by mouse passage in our laboratory since 1955. This strain was devided into two substrains, Hawaiian M (HM) and Hawaiian B (HB), the former being attenuated and the latter having original virulence, as described in Part 1 of this series.Following the subcutaneous infection, clinical features of subcutaneous and visceral lesions, at the 50th generation, were observed in 8 inbred mouse strains, CBA⁄J, C3H, C3H⁄He, BALB⁄c, KK, C57BL⁄6, DDD and DBA.As a result of the observations, virulence of HB strain still maintained the original one, whereas that of HM strain was founed to be attenuated and assumed to be stable, because the lesions of the 50th generation showed nearly the same to those of the 40th generation.

View full abstract