We investigated serum lipids, lipoproteins and apolipoproteins in various arteriosclerotic diseases such as coronary artery sclerosis, cerebral artery sclerosis, aortic artery sclerosis and peripheral artery sclerosis, and compaired each other to clarify whether or not there were any organspecific abnormalities of lipoprotein metabolism among these diseases. In comparison to the values of age-, sex-, TG-, TC-matched myocardial infarction, there were significant lower levels of HDL-TG (Aneurysma, male-CVD), %HDL-TG (Aneurysms, male-CVD), %LDL-TC (ASO), TC/B (male-CVD) and %Apo A-I (male-CVD). Although it is necessary to take other effectors on lipoprotein metabolism into consideration, these results suggest that there are some organ-specific abnormalities in lipoprotein metabolism among various arteriosclerotic diseases.

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心筋梗塞患者125名につき,血清脂質,リポ蛋白,アポ蛋白の常法による測定およびPAG等電点電気泳動法によるアポ蛋白E isoformsの分析を行い,冠動脈硬化重症度とアポ蛋白E phenotype,血清リポ蛋白および動脈硬化危険因子との関係にっいて検討した.心筋梗塞患者におけるアポ蛋白E phenotypeの出現頻度は,健常者と比べ, E 4/3が高く, E 3/3は低い傾向にあった。E 3/3群では,冠動脈硬化重症度と血清TC, TG,アポB,アポCII値が正の, HDL-C,アポAI値が負の関係を示したが, E 4/3群では, E 3/3群に比べHDL-C値が有意(p<0.05)に低値だが,冠動脈硬化重症度と血清リボ蛋白の間こは,一定の傾向は認めなかった.

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We studied the lipid transfer protein (LTP) activity in 23 men with old myocardial infarction (OMI) and 25 outpatients without ischemic heart disease as the control. LTP activity was measured according to Albers' method. Lipoproteins were fractionated by ultracentrifugation, and the lipids were measured by an enzymatic method. Apolipoprotein levels were measured by the TIA method. Compared with control plasma, OMI plasma showed significant decreases in HDL-C (p=0.0003) and Apo-A1 (p=0.0002) and significant increases in TG (p=0.0070), VLDL-C (p=0.0022) and Apo-B (p=0.0070). There was a significant increase in LTP activity in OMI plasma (p=0.0157). LTP activity was negatively correlated with HDL-C (r=-0.3384, p=0.0247), Apo-A1 (r=-0.3969, p=0.0084) and the HDL-C/HDL-TG ratio (r=-0.4352, p=0.0025). From these results we concluded that in patients with OMI, high LTP activity may lead to decreased plasma HDL-C and changes in HDL composition.

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The association between apolipoprotein E (Apo-E) polymorphism and the response of plasma cholesterol to dietary therapy (cholesterol intake of less than 300mg/day) was investigated for about 8 weeks in 208 nonfamilial hypercholesterolemia patients (E3/3 161, E4/3 47). The baseline lipoprotein concentration and the intake of energy and lipids were not significantly different between subjects with E3/3 and those with E4/3 phenotypes. After the dietary therapy plasma total cholesterol and low density lipoprotein cholesterol were significantly decreased in both phenotype groups (p<0.05). The patients with E4/3 had significantly smaller reductions of LDL-C than the patients with E3/3. The changes of LDL-C showed a significant difference between the patients with E3/3 and E4/3 by the Kruskal Wallis test (p=0.041). The presence of E4/3 predicted the degree of cholesterol reduction following dietary therapy.

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Diurnal changes in plasma apoprotein levels were measured in 6 healthy volunteers. The same meal was given on two consecutive days and 30gr of fat (P/S ratio: 1.2) was administered with each meal on the second day. Blood samples were taken at fasting, at 1 and 3 hours after breakfast, at 2 and 4 hours after lunch and supper. Plasma total cholesterol, triglyceride, HDL-cholesterol and apoprotein A_I A_II, B, C_II, E levels were measured. Plasma apoprotein levels were measured with the method of single radial immunodiffusion (SRID).
Plasma triglyceride levels reached the peak at 2 hours after lunch and declined slightly afterwards. Fat administration increased the postprandial triglyceride levels but had no effects on the curve of the diurnal change. Plasma total cholesterol and HDL-cholesterol levels did not show any diurnal changes and were not affected by oral fat administration. The levels of plasma apoprotein A_I, A_II, B, C_II, E did not show any diurnal changes and were not influenced by oral fat administration. Therefore, the postprandial levels of total cholesterol, HDL-cholesterol and apoproteins can be considered as the same values as the fasting values.

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Effects of palmitic acid (PA), linoleic acid (LA), glycerol (G) and L-α-palmitoyl-lysolecithin (LL) on cholesterol esterification in LDL and HDL₃ were investigated. Plasma fraction of the density greater than 1.25 was used as LCAT. LDL (1.019<d<1.055) and HDL₃ (1.125<d<1.21) was collected by ultracentrifugation. LCAT, LDL and HDL₃ were dialyzed exhaustively at 4°C against 0.15M NaCl solution (which contained 5mM EDTA, pH 7.4). Palmitic acid, LA, G and LL were disolved in 3% FFA-poor BSA containing 0.15M NaCl buffer. ³H-FC labeled LDL or HDL₃, LCAT and the test substance were incubated at 37°C for two hrs.
Cholesterol esterification rate in LDL was approximately one-tenth of that in HDL₃. Glycerol did not affect LCAT activity in both LDL and HDL₃ up to 10mM. Palmitic acid did not inhibit cholesterol esterification in LDL up to 5mM but did inhibit cholesterol esterification in HDL₃. The inhibition of cholesterol esterification by PA increased almost linearly up to 2.5mM and the inhibition rate of cholesterol esterification was more than 80% at 2.5mM. Linoleic acid and LL had strong inhibitory effects on cholesterol esterification in both LDL and HDL₃. The inhibition of cholesterol esterification by LA and LL reached the maximum at the concentration of 1.0mM and the inhibition rate was more than 90%.

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東京都調布市を事例として, 花木・軍花の生育型別・花色別開花時期について同一フィールドで総合的に調査した。現地調査の結果より, 花木は5色, 草花は6色に大別できた。花木の樹形を高木4タイプ, 低木3タイプ, 草花の草形を草姿と花の着き方によって4タイプ, 草丈によって3タイプに種別した。造園的応用を図るため花による植栽設計の基礎的資料となる月・季節別, 樹形・草形別, 花色別の開花特性表の作成を試みた。

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Effects of Intralipid on the increase of esterified cholesterol (EC) in each lipoprotein fraction in the fresh fasting plasma (FP) or triglyceride lipaserich plasma (PHP) from normal, and type V hyperlipoproteinemic subjects were investigated. FP or PHP was mixed with ¹⁴C-FC-albumin solution and was preincubated at 4°C for two hours. The mixture was incubated with Intralipid or with 0.15M NaCl solution. Incubation mixtures were collected at 0, 120 and 240 minutes. Chylomicron, VLDL, IDL, LDL and HDL were fractioned ultra-centrifugally at 4°C. Lipids were extracted with chloroform-methanol (2:1) and EC and FC were separated by TLC. The radioactivities of them were measured with a liquid scintillation counter. In the normal FP, Intralipid significantly increased ¹⁴C-EC in chylomicron, and VLDL fractions. However, Intralipid reduced cholesterol esterification, and this was solely due to the complete suppression of ¹⁴C-EC increase in HDL in normal PHP. The specific activities of EC in HDL were significantly lower than those in LDL in normal PHP with Intralipid. In FP of type V hyperlipoproteinemia, the increase of ¹⁴C-EC was more in chylomicron and VLDL fractions and less in LDL and HDL fractions than that in normal FP. The effect of Intralipid addition was very small in FP of type V hyperlipoproteinemia. In PHP of type V hyperlipoproteinemia, the results were very similar to those in normal FP with Intralipid. No increase of ¹⁴C-EC was observed in HDL. The effect of Intralipid addision was also small as in FP. Therefore, we concluded as following. Intralipid worked like chylomicron. There were two pathways for cholesterol esterification in the plasma. One was active in HDL and was blocked almost completely by Intralipid or chylomicron during the lipolysis. The other was active in other lipoproteins and was not inhibited by Intralipid or chylomicron during lipolysis.

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近年, 高齢者心不全例が増加しており, 死亡率も急増しているため, その病態解明と適切な治療法の確立が急務となっている. 高齢者心不全の特徴は, 基礎疾患に虚血性心疾患が多く, 臨床症状が非特異的になりやすく発見が遅れ多臓器合併症も多いため, 重症になりやすいことである. 心不全では自己防衛機構として, 交感神経活性・レニン-アンギオテンシン系の活性が亢進するが, これが破綻し悪循環に陥りやすい. 急性心不全では, 利尿薬, 強心薬を中心として治療し, 心筋虚血が存在するときは積極的に冠動脈インターベンションを考慮する. 慢性心不全では大規模臨床治験によってACE阻害薬, β遮断薬, ジギタリスが病態の悪循環を断ち切り, 予後を改善することが明らかにされている.

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To analyze the characteristics of lipid metabolism in ischemic heart disease, lipoprotein composition, lipoprotein particle size, and activity of enzymes related to lipid metabolism (lecithincholesterol-acyltransferase (LCAT), lipoprotein lipase (LPL), hepatic triglyceride lipase (HTGL)) were studied and compared in patients with myocardial infarction and healthy controls. 24 inpatients with acute myocardial infraction (AMI), 22 outpatients with myocardial infarction in the past (OMI), and 22 healthy controls (C) were analyzed in the study. There was no significant difference in plasma lipid and lipoprotein cholesterol levels among the three groups. Analysis of the lipoprotein composition ratio (as the percentage composition in each lipoprotein fraction LDL and HDL) showed significantly higher HDL-TG% in the OMI group than in C group. HDL particle size was significantly larger in the AMI group than in the C group. LCAT activity was significantly lower in the AMI and OMI groups than in the C group. HTGL activity was lower in the AMI group than in the C group, while LPL activity showed no significant differences among the groups. It is well known that HTGL plays a fundamental role in the delipidation of HDL particle size (changing HDL2 to HDL3). Consequently, low HTGL activity in AMI patients may explain the high HDL-TG% composition and large HDL particle size in this group when compared to the corresponding composition and particle size in the control subjects. On the other hand, low LCAT activity in patients with myocardial infarction is more difficult to understand in light of its primary function. The activity of lipid transfer protein, another important component of lipid exchange reaction, must be analyzed together to elucidate better the mechanisms involved in the lipid metabolism in patients with ischemic heart disease.

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Selectivity of LDL removal by double filtration (DF) and dextran-sulfate cellulose (DSC) column plasmapheresis (PP) was compared in six heterozygous familial hypercholesterolemic (FH) and a non-familial type IIb hyperlipoproteinemic patients. And, probucol, cholestyramine or CS 514, a newly developed inhibitor of HMG-Co A reductase was tested to elongate PP intervals. Two and half liters of plasma were treated at each PP. DFPP or DSC column PP was purformed alternatively to each patient. Probucol (1g/day), cholestyramine (12g/day) or CS 514 (10-20mg/day) was administered after PP without any combination. Plasma total cholesterol (TC), TG, VLDL-C, LDL-C, HDL-C and apoproteins A-I, A-II, B, C-II, C-III, E were measured serially. Lipoproteins were separated by ultracentrifugation and apoproteins were measured by RID method.
Sixty five percent of LDL-C, 45% of HDL-C, 43% of apo A-I, 65% of apo B, 56% of apo C-II, 54% of apo C-III and 75% of apo E were removed on average by DFPP with a second membrane filter of average pore diameter 300Å. The removal rate of LDL-C was significantly higher than that of HDL-C by DFPP. Fifty nine percent of LDL-C, 0% of HDL-C, 12% of apo A-I, 11% of apo A-II, 61% of apo B, 50% of apo C-II, 50% of apo C-III and 85% of apo E were removed on average by DSC column PP. Therefore, the selectivity of LDL removal was much better by DSC column PP than by DFPP. Plasma TC reached 250mg/dl within a week and 280mg/dl within 2 weeks without medication. On probucol treatment, it reached 250mg/dl between 13 and 16 days, and 280mg/dl between 26 and 41 days. TC reached 280mg/dl between 48 and 56 days on cholestyramine. On CS 514, it reached 250mg/dl between 8 days and days longer than 84, and reached 280mg/dl between 11 days and days longer than 84 days.
We concluded that plasma TC of heterozygous FH could be kept normal for long time by the combination therapy with PP and drugs.

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We evaluated the usefulness of dietary therapy given to patients with hypercholesterolemia at Honjyo Public Health Center. An educational program by physicians, public health nurses and nutritionists was developed and changes in their eating habits were evaluated.
Patient ages in thirty-seven males and eighty females (living at home in Sumida-ku, Tokyo) ranged from 35 to 64 years old. The level of serum cholesterol was 240 to 299mg/dl. Participants in this program were instructed to change their eating patterns and life styles. After three to six months (mean; four months), serum cholesterol levels were measured to evaluate changes in cholesterol levels after rigorous dietary therapy.
The mean plasma cholesterol level significantly decreased from 256·}25 to 237·}31mg/dl (p<0.01). The mean reduction of total cholesterol was 5.9% in males and 8.4% in females. Of one hundred seventeen, fiftyfive (47%) had a 10% or greater average decrease in total cholesterol. This high response group co prised 49% of males and 46% of females. Serum total cholesterol decreased fourteen percent in males and seventeen percent in females in the response group. Sixty-two patients showed less than 10% reductions in serum cholesterol level. They were classified into the low-response group. In the low-response group, 39 had low compliance with the regimen, while 23 people followed their dietary manual.
Compliance with dietary therapy is thought to be the main factor in responsiveness, but other factors such as gender and alcohol intake are found to weaken the effect of dietary therapy.
In treating patients with hyperlipidemia, we should observe which patients benefit from dietary therapy and which from medical consultation.

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