Obliterative portal venopathy: A comparative study of 184 cases of extrahepatic portal obstruction and 469 cases of idiopathic portal hypertension

Abstract A total of 184 cases of extrahepatic portal obstruction (EHPO), mostly demonstrated by intraoperative portography and studied at 17 institutes during the period 1957–1983, were compared with 469 cases of idiopathic portal hypertension (IPH) similarly studied. Of the cases of EHPO, there were 101 males and 83 females; 93 were under 20 years of age and the average age was 25.9 years (i.e. much younger than that of IPH cases). There were two age peaks, one before age 19 years and the other at age 40–49 years. One out of three adult cases had a history of abdominal surgery, but otherwise the aetiologic factor was difficult to elicit. Bleeding was the initial symptom in the majority, and splenectomy and haematological findings of hypersplenism were less pronounced compared with IPH. Liver function tests were almost always normal. The liver appeared normal macroscopically in 69% and histologically in 35%. The changes seen in the remainder were similar to those in IPH; they were less frequent in young patients than in cases above age 20 years. Compared with IPH, the wedged hepatic venous pressure in patients with EHPO was lower and the gradient from the portal venous pressure was greater. It is concluded that extrahepatic portal obstruction is less common compared with IPH in Japan, and that there are cases particularly among adults that present clinicopathological features very similar to those of IPH. It is unclear at present whether these two disorders represent two different disease entities, or whether they represent one disorder with differences in the site of involvement along the portal vein system.     

Sleep problems in the aged in relation to senility

Abstract As a part of an epidemiologic survey of dementia in a community of aged persons, correlation between sleep complaints and physical illness and senility were studied. A total of 3302 randomly sampled aged individuals (aged 65 yean) were studied using a questionnaire. In this sample the prevalence of poor sleep and habitual snoring did not increase with age. The prevalence of excessive daytime sleepiness showed an increase with age. Male predominance of habitual snoring and female predominance of poor sleep were observed. Female predominance of excessive daytime sleepiness was noted among the aged 70 and over. Age-related excessive daytime sleepiness was significantly correlated with senility.     

Magnetic resonance imaging study of the brain in aged volunteers: T2 high intensity lesions and higher order cortical function

Abstract The aims of the present study were to clarify the findings of magnetic resonance imaging (MRI) in the aging brain, and to relate the MRI findings to higher order cortical function. A total of 118 healthy aged volunteers (41 men, 77 women) underwent cranial MRI electroencephalography (EEG), Benton visual retention test (BVRT) and interview. The subjects had no past history or clinical evidence of cerebrovascular disorder, head trauma or dementia and were living at home without any difficulty. The majority of the subjects have participated in this series of studies since 1982. Using a 1.5 T superconductive MR instrument, T1-weighted, proton density and T2-weighted images were obtained. The MRI data were rated visually by regarding 12 items according to fixed criteria. T2 high signal intensity (T2HSI) lesions were found in 69.5% of subjects, the prevalence of which increased with age. T2HSI lesions were most frequently found in the basal ganglia (61.9%), followed by the thalamus (39.0%), parietal lobe (37.0%), temporal lobe (12.7%) and pons (8.5%). Among these lesions, lacunar infarction showed low signal intensity in T1-weighted images and was found in 24.6% of subjects, the prevalence also increasing with age. These findings, including brain atrophy determined according to similar criteria, were correlated closely with the subjects' age. The results of BVRT showed a close relation with T2HSI, suggesting that T2HSI may influence cognitive function. When the subjects were classified according to the presence of T2HSI, lacunar infarction and EEG abnormalities, brain atrophy was significantly milder in a group of subjects with T2HSI(-), lacunar infarction(-) and normal EEG than in the other groups. This suggests that changes seemingly representing physiological aging may be promoted by another pathological which also exerts influences on higher order cerebral function.     

A Structure-Relationship Study of the Uptake of Aliphatic Polyamine Compounds by Rat Intestinal Brush-border Membrane Vesicles

The effects of lipophilicity, ion-diffusion potential and membrane surface potential on the uptake of various aliphatic polyamine compounds by rat intestinal brush-border membrane vesicles (BBMV) have been investigated. A valinomycin-induced potassium-diffusion potential (inside-negative) stimulated the initial uptake of diamine compounds, and good correlation was observed between lipophilicity and the amount of diffusion-potential-dependent transport of the diamines. In contrast, because of their much lower lipophilicity, tri- and tetraamine compounds were not affected by the diffusion potential. Tetracaine, which can make the membrane surface potential more positive, inhibited the transport rate of 1,9-nonanediamine, spermidine and spermine by the BBMV. These data suggest that the transport mechanism of diamines is similar to that of monoamine compounds in respect to its dependence on ion-diffusion potential and on the membrane surface potential. The extent of the effect of ion-diffusion potential on the rate of transport of the diamines was closely related to the lipophilicity of the diamine. In contrast, only the surface potential contributed to the transport mechanism of lower lipophilic tri- and tetraamine compounds.     

Uptake Mechanism of Trientine by Rat Intestinal Brush-border Membrane Vesicles

The uptake characteristics of trientine by rat intestinal brush-border membrane vesicles were studied. The uptake characteristics of trientine were similar to those of the physiological polyamines with respect to the excessive accumulation in vesicles, the pH dependency, the temperature dependency and the ineffectiveness of K⁺ diffusion potential (inside negative). The initial uptake of trientine was saturable with a K_m value of 1.13 mM, which was larger than that of spermine and spermidine. Furthermore, the uptake rate of trientine was dose-dependently inhibited by spermine and spermidine. Spermine competitively inhibited the uptake of trientine with a K_i value of 18.6 μM, and it was close to the K_m value for spermine (30.4 μM). These data suggested that the uptake of trientine was similar to that of spermine and spermidine in rat small intestinal brush-border membrane vesicles, and these polyamines seem to inhibit the absorption of trientine from the gastrointestinal tract.     

Remaining mandibular third molars in an adult population

summary Although tooth loss with age has been extensively investigated, there appears to be no literature on the relationship of age to remaining mandibular third molars. The study showed that as age increases so does the frequency of absent vertically erupted mandibular third molars. However, no correlation was found between age and loss of mandibular impacted third molars in men of 71 years of age or older. The evidence presented here suggests that impacted mandibular third molars, which have not been infected, may be more likely to remain compared with other teeth at potential risk.     

EFFECT OF FUSARIC ACID (A DOPAMINE β-HYDROXYLASE INHIBITOR) ON PHAEOCHROMOCYTOMA

Fusaric acid, an inhibitor of dopamine beta-hydroxylase, which converts dopamine to noradrenaline, lowered the blood pressure and induced a subjective improvement in patients with phaeochromocytoma. These effects may be due either to an impairment of catecholamine biosynthesis or to a direct action on the blood vessels. The use of this drug in the treatment of patients with inoperable malignant phaeochromocytoma or neuroblastoma may improve symptoms and prolong survival.     

Blood Group Antibody Levels in Hiroshima

Blood group antibody levels were measured in 526 irradiated survivors ofthe 1945 atomic bombing of Hiroshima and in 516 nonirradiated subjects. Thestudy was undertaken in order to determine the age changes in antibody levelsin irradiated and nonirradiated subjects, as well as to investigate the patternof blood agglutinin levels in the Japanese population for comparison with thatof Caucasians. The following observations were made:

1. In 475 people of group A, 228 of group B, and 339 of group O, the meanserum levels of anti-A and anti-B antibodies were virtually identical irrespective of the blood group of the subjects.

2. In individual group O subjects, the titers of anti-A and anti-B antibodieswere very highly correlated (correlation coefficient of +.92).

3. Females exhibited higher antibody levels, although the magnitude of thedifference was small.

4. Peak antibody titers were reached at age 20-30, with progressive linearregression in levels with advancing age. Peak titers in early adulthood were5-10 times higher than those of the very elderly.

5. No correlation between blood group antibody levels and atomic irradiationwas detected, whether irradiation was represented by (a) presence or absenceof acute radiation symptoms in 1945, (b) distance from the hypocenter, or(c) numerical dosage estimate.

6. As one of a battery of tests of physiologic aging designed for detection ofirradiation induced nonspecific aging acceleration, blood group antibodylevels seem of modest value. After age 30, the linear correlation with chronologic age is -.72.

7. Differences in blood group antibody levels in Japanese and Caucasiansindicate that (a) Caucasians have higher anti-A antibody levels as comparedto anti-B levels than do Japanese, and (b) the peak antibody level occurs atan earlier age in Caucasians than in Japanese. It is not clear whether thesedifferences are related to race and heredity or to external antigenic stimulationwith A and B antigenic materials, but studies of blood group antibody levelsin different racial groups should help elucidate the nature of these differences.

Accepted on January 20, 1961