Relationship between myocardial infarction and preinfarction angina: a histopathological study of coronary arteries in two sudden death cases employing serial section

Two patients who had previously experienced old myocardial infarction and who died suddenly after an attack of chest pain were examined and discussed. In both cases two of the three main coronary arteries showed severe stenosis with canalization. Ruptured atheromatous plaque was found in the unblocked coronary artery. Fibrin was already formed and surrounded the fractured intimal collagen fiber, foam cells, and cholesterin clefts, but a luminal thrombi had not yet been formed. Fresh occluding thrombi were formed at the site of the ruptured atheromatous plaque. Coronary thrombi containing abscess components such as foam cells, cholesterin clefts, and the fractured intimal collagen fiber were found in our preliminary study. These views support the supposition that this fracture between the lumen and the plaque might precede and be responsible for the formation of the thrombus and the onset of acute myocardial infarction. It was confirmed that the attack of preinfarction angina occurred at the time of the rupture of the atheromatous plaque. The rupture of the atheromatous plaque plays an important part as an initiating factor of peinfarction angina and myocardial infarction. Thus, it is necessary to examine coronary arteries by serial histopathological section method.

Effect of d,l-alpha-tocopheryl esters on vitamin E-deficient rats

The data in our previous paper demonstrated that some alpha-tocopheryl esters administered orally were absorbed in their unchanged form through the lymph, while some other esters were absorbed after being hydrolyzed individually to different degrees. The hydrolysis during absorption seems to be related to the structure of the ester group of alpha-tocopherol at the 6-position. The purpose of this work is to study the metabolism and biological effect of tocopherol esters in vitamin E-deficient rats. Three esters were used on the basis of their behavior during absorption through the lymph, as follows; alpha-tocopheryl acetate (an easily hydrolyzable ester), the nicotinate (a moderately hydrolyzable one) and the pivalate (a scarcely hydrolyzable one). The easily hydrolyzable esters will suffer the same metabolic fate through absorption as alpha-tocopherol. The moderately and scarcely hydrolyzable ones have a tendency to show different physiological effects from alpha-tocopherol due to absorption of the unchanged ester. The effect of these esters on the microsomal enzymes in the liver such as cytochrome P-450, cytochrome b5, aniline and hexobarbital difference spectra and NADPH-dependent cytochrome c reductase was determined. It was shown that the pivalate inhibited the release of NADPH-dependent cytochrome c reductase activity to supernatant in spite of low distribution in the 105,000 X g sediment. The result suggests that the pivalate as a model compound may be interesting to examine for its membrane stabilizing effect of alpha-tocopherol.

Untreated ocular hypertension. A long-term prospective study

A prospective study was designed to determine the course of ocular hypertension without visual field loss if untreated and to estimate the value of various clinical findings in prediction the course of ocular hypertension. Seventy-five patients with intraocular pressure greater than 21 mm Hg but without demonstrable visual field defects were followed up without glaucoma therapy for a minimum of nine years. While under observation, seven of 75 ocular hypertensives developed typical glaucomatous visual field defects. Both the sensitivity and the specificity of each clinical finding in the individuals who later developed visual field defects were determined, and none of the clinical findings was found to be a good predictive indicator.

Electronic interaction of carcinogenic and noncarcinogenic benz(c)acridines and DNA

Electronic interaction of DNA with nine benzacridine derivatives was studied. The interaction system of these benzacridines and DNA was found to show a marked hypochromism in the ultraviolet region. The orderly double helical structure of DNA was found to play an essential role in this spectroscopic change. A high concentration of the interactant, low environmental ionic strength, low pH, and low temperature were beneficial in this interaction. The degree of hypochromism expressed by the integrated and pKa of the benzacridines were found to be in parallel. The hypochromism of the interaction system, in which the carcinogenic benz[c]acridine derivatives took part, was larger than that of the system in which the noncarcinogenic derivatives were involved.

Diurnal variation of intraocular pressure in primary open-angle glaucoma

Intraocular pressure was measured with a Goldmann applanation tonometer in 12 normal individuals (24 eyes), 14 ocular hypertensives (28 eyes), and 14 patients (27 eyes) with primary open-angle glaucoma every hour for 24 hours. In most subjects, pressure was highest sometime during the day and pressure elevation before rising was not demonstrated. The lowest intraocular pressure was most frequently observed early in the morning, whether the patient was normotensive or hypertensive. Fourteen of 27 glaucomatous eyes had intraocular pressure below 20 mm Hg early in the morning.

Chemical sympathectomy with 6-hydroxydopamine in the treatment of primary open-angle glaucoma

Chemical sympathectomy with 6-hydroxydopamine combined with subsequent topical epinephrine therapy was evaluated with regard to intraocular pressure effects in primary open-angle glaucoma. After chemical sympathectomy intraocular pressure was maintained below 20 mm Hg with 1.0% epinephrine three times daily in 29 of 36 eyes of 25 patients for two to 29 weeks. Chemical sympathectomy combined with epinephrine therapy was most effective in patients whose intraocular pressure had been well controlled with pilocarpine and epinephrine and was less effective in patients whose intraocular pressure had not been controllable with maximum medical therapy prior to the administration of 6-hydroxydopamine. The results of this study suggest that chemical sympathectomy combined with topical epinephrine therapy has considerable clinical value in the medical management of primary open-angle glaucoma.