Shibanosuke Katsuki

Decreasing trend in incidence and mortality from stroke in Hisayama residents, Japan.

The incidence and mortality from stroke during the period 1961 to 1976, among 1,621 subjects aged 40 and over at entry, in Hisayama community, Kyushu Island, Japan, were analyzed. A major agerelated decline in the incidence of cerebral hemorrhage and infarction occurred in both sexes. The average annual incidence of cerebral infarction also fell continuously in both sexes throughout the whole observation period. The 5-year annual mortality rate from cerebral hemorrhage also showed a decrease in men, but fluctuated in women. The 5-year mortality from cerebral infarction slightly increased in both sexes. Stroke, Vol 12, No 2, 1981

Pathological studies on the intracerebral and retinal arteries in cerebrovascular and noncerebrovascular diseases.

Histological examinations of the intracerebral and retinal arteries were performed in patients who had cerebrovascular disease and in those cases who did not. Fibrinoid degeneration, fibrous nodule, and splitting, which are most frequently found in putamen, thalamus and pons, are thought to be the main changes in cerebral hemorrhage and infarction. Fibrous and fibro-hyalinoid thickenings of the retinal arteries were found mainly in the neighboring region of the optic disk, which reflects the changes of the intracerebral arteries. Hyalinoid thickening was found in the ora serrata, which does not reflect the changes of the intracerebral arteries. Our results suggest that patients with these retinal artery changes in the region near the optic disk, if moderate to severe, have an increased risk of having or incurring cerebral hemorrhage and infarction, but the arterial changes in the ora serrata do not always indicate risk of cerebral hemorrhage and infarction.

Epidemiological and Clinicopathological Study on Cerebrovascular Disease in Japan

Publisher Summary This chapter discusses the epidemiological and clinicopathological study on Cerebrovascular Disease (CVD) in Japan. The frequency of CVD exceeds that of heart disease as far as death from these diseases is concerned, and cerebral hemorrhage seems more common than cerebral infarction. The hemorrhagic lesions as well as cerebral infarction are most frequently seen in particular areas of the brain. The degree of atherosclerotic changes in the arteries at the base of the brain was evaluated. These criteria are based on the nature of degenerating changes of the arterial wall and the extent of the lesions. In 157 autopsy cases aged over 40, the atherosclerotic changes were far more advanced in cerebral hemorrhage and infarction. No marked difference in Brocas index was found between CVD and the other diseases. The degree of cardiac hypertrophy indicative of pre-existent hypertension was significantly increased in both cerebral hemorrhage and infarction. These results indicated that CVD was closely related to atherosclerosis at the base of the brain and to cardiac hypertrophy. It is found that the paramedian arteries and the Aa. circumferentes breves, often branch in retrograde fashion from the caudal portion of the basilar artery, but less frequently from the oral portion of the artery.

Cerebral and aortic atherosclerosis in Hisayama, Japan

This study of autopsy cases in the general population of the town, Hisayama, describes the incidence and severity of aortic and cerebral atherosclerosis in Japan. Atherosclerosis was more severe in the aorta than in the cerebral arteries of all age groups and its disparity became more conspicuous with age. In hypertensive cases, atherosclerosis was more severe in both the aorta and the cerebral arteries from and beyond the 6th decade of age. The severity of atherosclerosis in the aorta in those with systolic hypertension was lower under the age of 79 and higher after the age of 80 than in diastolic hypertension; the cerebral arteries were afflicted similarly by the two forms of hypertension. The serum cholesterol level correlated better with the severity of aortic than cerebral atherosclerosis.

Acute Changes in Blood Pressure Following Vascular Diseases in the Brain Stem

The relationship of the type of acute change in blood pressure to the site of the brain lesion, following cerebral hemorrhage and infarction, were studied in 108 patients in whom autopsy was performed. No significant changes in blood pressure were observed in cases with lesions localized rostral to the midbrain and in the medulla oblongata. The pressor response characteristic in primary pontine lesions, either hemorrhage or infarction, also was demonstrated in the cerebral hemorrhage with fourth ventricular and pontine extension. Blood pressure elevation was more marked with tegmental pontine lesions than when the lesion was in the basilar pons. Extension of the lesion into neighboring portions of the pons did not cause further change in blood pressure. The present results seem to suggest a positive role of the caudal brain stem, especially the pons, in the blood pressure elevation following the cerebrovascular accidents.

Blood glucose and plasma insulin responses to xylitol administrated intravenously in dogs

Abstract Xylitol is a pentitol which is a normal intermediate in the glucuronate-xylulose pathway. Recently it was reported by Prellwitz and Bassler (1963) that the xylitol administrated intravenously was rapidly metabolized in both nondiabetic and diabetic subjects. Although there has been no previous report concerning a hypoglycemic effect of xylitol injection, we report in this paper a significant hypoglycemia produced in the normal dog following the intravenous administration of xylitol, which may stimulate strongly the insulin secretion of the pancreatic beta-cells.

Clinicopathological study of the heart and coronary arteries of autopsied cases from the community of Hisayama during a 10 yr period—I. Ischemic myocardial lesions☆

Abstract A clinicopathological study of myocardial infarction was made in a Japanese community with autopsy rate of approximately 82% during 10 yr (from 1 November 1961 to 31 October 1971). Myocardial infarct (1 cm or more in 1 dimension) was found in 12.4 and 10.8% of 193 males and 167 females, aged 20 yr or over, respectively. Frequency of myocardial infarct among the autopsied cases remained almost constant in the 6th through 9th decade of life in both sexes. Approximately one half of the larger infarcts (5 cm or more in 1 dimension) and all of the smaller infarcts were found initially by postmortem examination. Unequivocal cardiac pain was found in one half of the patients with larger infarcts. Approximately one fourth of the larger infarcts and more than one half of the smaller infarcts were asymptomatic. This emphasizes the importance of close follow-up of cohorts in the epidemiological study of coronary heart disease.

Clinicopathological study of the heart and coronary arteries of autopsied cases from the community of Hisayama during a 10-year period. Part IV. QS waves in the precordial leads

During a ten-year period, from November 1, 1961, to October 31, 1971, 339 residents aged 40 years or over at death were nonselectively autopsied in a Japanese community, Hisayama town (mean autopsy rate: 84%). One or more standard 12-lead ECGs plus V4R and V7 electrocardiograms taken at periodic medical examinations were available for 308 of them. In 46 persons, QS waves were localized in one or more leads from V1 to V4. By transverse sectioning of the hearts, old myocardial infarction extending into the interventricular septum was found in nine of these 46 persons. Frequency of myocardial infarction cases in each category for QS localization was as follows: Lead V1 to V4, three of three; Leads V1 to V3, six of nine; Leads V1 and V2, three of 15; Leads V2 and V3, none of two; Lead V3, none of one; Lead V2, one of eight; and Lead V1, one of 25.

Pulmonary edema induced by renal extracts originating from rats with experimental hypertension

Abstract In an attempt to elucidate a vascular injury factor of renal origin in relation to renin, renal extracts of varying renin content originating from rats with experimental hypertension were injected intraperitoneally into bilaterally nephrectomized rats. Experimental hypertension was produced by unilateral main renal artery constriction and also by salt ingestion associated with uninephrectomy, or uninephrectomy plus resection of the half of the remaining kidney. Renin content was increased in the extract of clipped kidney, but much less in the extracts of the kidney contralateral to the clipped and also of the salt-treated kidney. Early death within 15 hours following the injection occurred more frequently in the rats given the extracts of three types of hypertensive kidneys than in those similarly treated with the extract of normal kidney. The extract of clipped kidney was most injurious of all. The major cause of death was considered to be pulmonary edema. The significance of these findings was discussed.

Effects of Intravenous Injection of Xylitol on Blood Sugar, Blood Pyruvic Acid and Plasma Insulin Levels in the Dog

SummaryXylitol was injected intravenously in nine normal dogs and five alloxanized dogs with diabetes. Dosage of xylitol administered was 0.4 g per kg body weight. Changes of blood sugar, blood pyruvic acid and plasma insulin were as follows:1.Significant decrease of blood pyruvic acid level was shown in all of the nine normal dogs receiving xylitol, and the lowest level of blood pyruvic acid was found at 5 min after the injection.2.Remarkable increase of plasma insulin was observed in the normal dogs following xylitol injection, and the highest peak of plasma insulin concentration was at 20 min after the injection. The increase of plasma insulin was much higher than that produced by injection of the equivalent dosage of glucose.3.Hypoglycemia following administration of xylitol occurred in the normal dogs. The lowest level was shown at 30 min after injection of xylitol.4.These characteristic responses of blood pyruvic acid, blood sugar and plasma insulin to xylitol were not found in all of the five diabetic dogs.5.These results suggested that the hypoglycemia produced by xylitol might be caused by the hypersecretion of endogenous insulin from pancreatic beta cells.ZusammenfassungXylit wurde neun gesunden Hunden und fünf solchen, bei denen künstlich durch Alloxan ein Diabetes erzeugt worden war, intravenös injiziert. Die verabreichte Xylitdosis betrug 0,4 g/kg KG. Folgende Veränderungen von Blutzucker, Blutbrenztraubensäure und Plasmainsulin wurden beobachtet:1.Ein deutlicher Abfall von Brenztraubensäure ließ sich bei allen neun gesunden Hunden nachweisen, die Xylit erhalten hatten. Der niedrigste Wert zeigte sich 5 min nach der Injektion.2.Plasmainsulin zeigte einen ausgeprägten Anstieg in den gesunden Hunden auf Xylitverabfolgung. Der höchste Aktivitätsgipfel fand sich 20 min nach Xylitinjektion. Der hierbei beobachtete Plasmainsulinanstieg war viel höher als der nach Injektion einer gleich großen Dosis von Glucose.3.Xylit verursachte eine Hypoglykämie in allen gesunden Hunden, wobei die niedrigsten Werte 30 min nach Injektion lagen.4.All diese für Xylit charakteristischen Veränderungen der Blutglucose, Blutbrenztraubensäure und Plasmainsulin ließen sich in den diabetischen Hunden nicht nachweisen.5.Die Ergebnisse lassen vermuten, daß die durch Xylitinjektion hervorgerufene Hypoglykämie durch eine Hypersekretion von endogenem Insulin aus denβ-Zellen des Pankreas verursacht wird.