The life of the living organism is drived by its own biological clock. The time axis of the clock points towards the increase of its entropy. However in the living organism the increase of the entropy is regulated so as to prevent the occurrance of the spontaneous reaction. Truly, according to the thermodynamics of the irreversible system the condition for the minimum entropy production is defined by the steady state reaction. From this point of view, aging can be defined as the deviation from the steady state and the deviation can be explained by two causes: the breakdown of the steady state and the disappearance of the restoration ability to the original state. The breakdown of the steady state could take place at least in two cases: accumulation of the metabolic end product and de-coupling between synthesis and decomposition. The inability to restore the origninal state is mostly due to the failure of the homeostasis, including hormonal regulation and immune response. One of the reasons for aging would be the decrease of pool size of homeostasis.
It is well known that the bone mineral content in male is significantly higher than that in female in all over the age. In addition, the loss of bone mineral after age 50 is significantly greater in females than in males. Little informations about quantitative and qualitative difference in bone mineral content between male and female were available. In order to clarify the difference in the loss of bone mineral with aging between male and female, we have examined the bone mineral status in 407 elderly subjects (201 males and 206 females; aged over 60) lived in Yoikuin home for aged. The bone mineral status was measured by the method of microdensitometry developed by Inoue et al. This method could measure metacarpal index (MCI) and maximal calcified rate in metacarpal cortex (ΔGSmax). MCI and ΔGSmax in the male subjects were significantly (p<0.01) higher than those in females. MCI and ΔGSmax were decreased with aging in both sexes. In male subjects, loss of ΔGSmax with aging was greater than that of MCI with aging. On the other hand, the loss of MCI with aging was predominant when compared with that of ΔGSmax in the females. Subsequently, we have calculated the correlation coefficients between MCI and ΔGSmax, and other physical and chemical parameters in both sexes. In the male, MCI was significantly correlated with age (p<0.05), serum calcium levels (p<0.01) and serum Al-P activity (p<0.01) and ΔGSmax was significantly correlated with age (p<0.05), body height (p<0.01), body weight (p<0.01), blood pressure (p<0.01), power of grasping (p<0.05), serum uric acid levels (p<0.05) and serum Al-P activity (p<0.01). In the female, MCI was significantly correlated with age (p<0.01), thickness of skin (p<0.01), power of grasping (p<0.05) and serum Al-P activity (p<0.05), and ΔGSmax was significantly correlated with age (p<0.01), body height (p<0.01), body weight (p<0.01), thickness of skin (p<0.01), power of grasping (p<0.01), serum total protein levels (p<0.05) and serum Al-P activity (p<0.01). Thus the bone mineral content was qualitatively and quantitatively different between aged males and females. This sexual difference in bone mineral content in the aged might be explained by the difference in hormonal enviroment and by physical status.
The effect of chemotherapy on acute nonlymphocytic leukemia 60 years of age and older are evaluated in comparison to that under 60 years of age. The complete remission was obtained in 24 of 35 patients (68.5%) under 60 years of age and in 7 of 13 patients (53.8%) 60 years of age and older. In 6 patients 70 years of age and older, only 2 patients (33.3%) achieved the remission. The median of remission duration and survival time were 10.9 and 17.1 months in patients under 60 years of age. On the other hand, they were 6.3 and 10.9 months in patients 60 years of age and older. Pneumonia, sepsis and gastrointestinal bleeding were highly complicated in elderly patients. The effect of reinduction chemotherapy was also found to be poor. These results indicate that elderly patients respond to initial chemotherapy in mostly similar manner to younger patients with this disease. However, induction chemotherapy in patients 70 years of age and older, maintanance therapy and reinduction chemotherapy should be further studied.
Effects of β-blocker, bunitrolol, on essential hypertension were evaluated comparatively in two different age groups. They were divided in patients of 60 years or older and those of 59 years or younger. The study was carried out with 66 cases in monotherapy (aged patients: 23 cases of 63.8 years on an average, younger patients: 43 cases of 49.9 years) and with 61 cases in combined therapy (aged patients: 28 cases of 66.2 years, younger patients: 33 cases of 49.8 years) according to double blind method. Hypotensive effects (blood pressure fall by 20/10mmHg or more) were observed in 73.9% of the aged patients and 62.8% of the younger patients on monotherapy, and 71.4% of the aged patients and 66.7% of the younger patients on combined therapy, respectively. There was no statistically significant difference in the rates of efficacy between the two age groups of patients on either therapy. The incidence of side effects was 8.7% in the aged patients and 7.0% in the younger patients on monotherapy, while the incidence for combined therapy was 14.3% and 15.2% respectively. There was no significant difference in the incidence between the two age groups of patients on either therapy. The results indicated bunitrolol to have its usefulness (“useful” or above) at 78.3% in the aged patients and 69.8% in the younger patients on monotherapy, while the rates in the patients on combined therapy were 75.0% and 60.6% respectively. There was also no significant difference between the two age groups on either therapy. Beta blocker bunitrolol was thus esteemed to be equally useful for the treatment of both aged and younger patients with essential hypertension.
In order to investigatet he responses of plasma glucose (PG), insulin (IRI) and C-peptide (CPR) to varying glucose loads in elderly, 50g and 75g glucose tolerance test (GTT) were performed in 52 subjects who were aged 60 years or more. Thirty-five of them revealed diabetic glucose tolerance (Group I) during 50g GTT (1-hour PG value≥185mg/dl and 2-hour PG value≥150mg/dl) and the others revealed either slightly impaired or normal glucose tolernace (Group II). In Group I, the 2-hour and 3-hour values during 75g GTT were significantly higher than those during 50g GTT (p<0.01 and p<0.001, respectively). In Group II, only the 3-hour value was higher in 75g GTT than in 50g GTT (p<0.05). The ratios of increment of insulin to that of plasma sugar (ΔIRI/ΔPG) at 30 minutes after glucose loading were not different between 50g and 75g GTT in both groups, but the sum of the insulin values (ΣIRI) during the GTT was significantly higher in 75g GTT than in 50g GTT in both groups (p<0.01 and p<0.001, respectively). The sum of CPR (ΣCPR) during GTT was significantly higher in 75g GTT than in 50g GTT in Group I (p<0.01), but not in Group II. The slope of the regression line between ΣIRI and ΣCPR in 50g GTT was identical to that in 75g GTT. The result may indicate that the kinetics of insulin secretion was not changed by increasing glucose loading from 50g to 75g in the aged subjects. Furthermore, highly significant correlation between plasma glucose levels after 50g glucose load and those after 75g glucose load was observed. Plasma glucose levels at 1 hour after 75 glucose load correspond to the same levels of those at 1 hour after 50g glucose load. Plasma glucose levels of 200, 140 and 120mg/dl at 2 hours after 75g glucose load correspond to those of 180, 130 and 110mg/dl, repectively, at 2 hours after 50g glucose load.