Hemodynamic changes with dietary salt loading were assessed by Doppler echocardiography during different sodium intake (7g/day for 8 weeks, 20g/day for 1 week) in 29 elderly patients with essential hypertension (81.6 ±6.7 years, 4men, 25 women). With salt loading, 24 patients whose mean blood pressure (MBP) increased by 10% or more were defined as salt sensitive (SS) group, and 5 patients whose MBP did not change, or increased by less than 10% were defined as non-salt sensitive (NSS) group. Based on the mitral flow velocity integral, cardiac output (CO) was calculated, and total peripheral resistance (TPR) was calculated as MBP divided by CO. Nine of the 24 SS patients were termed“SS (COdep)” whose CO increased significantly with salt loading. In the remaining 15 SS patients termed“SS (TPRdep)”, TPR increased significantly with sodium repletion. Blood flow in the common carotid, superior mesenteric, or terminal aorta was calculated from each flow velocity intergral. The percent change in peripheral resistance calculated by dividing MBP by each blood flow was obtained. There were no significant percent changes in the common carotid resistance in SS (COdep), SS (TPRdep) or NSS groups. The superior mesenteric resistance increased significantly in all three groups. The terminal aortic resistance increased in the SS (TPRdep) group, but decreased in the SS (COdep) or NSS group. These results indicate that salt sensitivity is ascribable to changes in regional vascular resistances.

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Accumulating evidence has suggested significant roles of apolipoproteins in lipoprotein metabolism. Therefore it is important to measure serum levels of apolipoproteins to understand the pathophysiology of lipid metabolism. The newly developed turbidimetric immunoassay (TIA) method for the determination of serum apolipoprotein concentration is the first method which can be employed with autoanalyzer, and is expected to be used widely. The standard values of serum concentrations of apolipoproteins measured by the TIA method for Japanese adults and children have been reported recently, but not yet for the elderly. Therefore, we investigated serum concentrations of apolipoproteins (A-I, A-II, B, C-II, C-III and E) in healthy normolipidemic elderly, aged 65-99 years, in order to obtain the standard values of apolipoproteins for the elderly. The subjects consisted of 84 males and 91 females. They had normal serum values for total cholesterol (TC) (120-220mg/dl) and triglyceride (TG) (50-150mg/dl). No one demonstrated clinical, biochemical or haematological evidence of cardiovascular, peripheral-vascular, cerebrovascular, hepatic, renal or endocrine disorders. Between-assay and intra-assay coefficient variations were ∼5% and ∼1.5%, respectively, in all apolipoproteins examined. The serum concentrations of apolipoproteins in normolipidemic elderly were 116±17mg/dl, mean±SD, (male: 112±15mg/dl, female: 120±17mg/dl) for apo A-I, 26.1±4.3 (25.7±4.1, 26.5±4.5) for apo A-II, 90±16(87±18, 93 ±15) for apo B, 2.8±1.0(2.6±1.0, 2.0±1.0) for apo C-II, 7.9±2.3(7.2±2.3, 8.5±2.2) for apo C-III and 4.4±1.1 (4.0±0.9, 4.8±1.2) for apo E. Serum concentrations of apo A-I, B, C-III and E in female elderly subjects were significantly higher than those in male elderly subjects. However serum lipids levels were also significantly higher in females than in males. Because of significant correlations between serum lipid levels and apolipoprotein concentrations, sex related differences in apolipoprotein concentrations were further examined by using TC and TG matched subjects. The result demonstrated that serum concentrations of apo A-I and apo E were still significantly higher in females than in males. Age-associated differences in serum apolipoprotein concentrations were investigated separately in males and females. The subjects were divided into 4 age groups (65-69, 70-79, 80-89, 90-years). It appeared that apo C-II decreased significantly with age in elderly females, but other apolipoproteins had no age-associated differences. Examination using TC and TG matched subjects did not show any significant age-associated differences of serum apolipoprotein concentrations either in males and females. This study presents standard serum concentrations of apolipoproteins in the normal healthy aged population. Significant differences were observed in serum concentrations of apo A-I and apo E between males and females, but no age-associated differences in serum concentrations of apo A-I, A-II, B, C-II, C-III and E were observed.

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In order to evaluate the degree of accuracy of measurement of total body bone mineral content (TBBMC) by dual photon absorptiometry (DPA), the TBBMC in four healthy male volumteers were measured serially for 3 to 12 months. In three to six determinations of TBBMC in various stage of radiation source (153-Gd), the coefficients of variation in four subjects were 1.59, 0.74, 1.25 and 1.27%. Thus, the mean CV was 1.22±0.35% (mean ±SD). This indicates that the measurement of TBBMC using DPA is an accurate tool for long-term follow up of bone mineral content and up to 1.6% change of TBBMC might be considered to be a significant change in TBBMC. No apparent drift of TBBMC associated with source decay was noticed in the present study. Subsequently, fifteen females with osteoporosis were studied to evaluate the efficacy of certain therapeutic modes. The ptients were divided into two groups. Group 1 (n=10) given 10 to 40U of elcatonin (eel calcitonin derivative) intramuscullaly every week for 3 to 6 months. Group 2 (n=5) were treated with 0.5μ/day of oral 1-α-OHD₃ for 3 to 6 months. The TBBMC of these fifteen patients were followed by DPA (Lunar DP-4). Seven patients out of ten treated with elcatonin (70%) showed significant (up to 1.6% change in TBBMC compared with baseline) increase in TBBMC after 3 to 6 months treatment. The mean percentage change in TBBMC in group 1 was 101.9±2.7% (mean±SD) when the initial TBBMC was taken as 100%. On the other hand, two patients out of five treated with 1-α-OHD₃ showed significant increase in TBBMC. One patient showed no change and the remaining two patients showed significant decrease in TBBMC (-4.1 and -6.2%) after treatment. In conclusion, the measurement of TBBMC using DPA is considered to be an effective tool for the evaluation of therapeutic effect in osteoporosis.

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COP-BLAM therapy, which has recently been reported to be useful in the treatment of malignant lymphoma, was performed on aged patients with non-Hodgkin's lymphoma, and the results and adverse effects of the treatment were evaluated. The subjects of the present study included 13 patients with non-Hodgkin's lymphoma, aged 60 years or older, treated during the period from October, 1987 to June, 1989. They included four recurrent cases after CHOP therapy. According to the Ann-Arbor classification of pathological stage there were two patients in stage I, one in stage II, two stage III and eight in stage IV. COP-BLAM therapy was conducted using the following procedure, irrespective of the patient's age, intravenous drip infusion of cyclophosphamide (CPM) at a dose of 400mg/m² and intravenous infusion of 1mg/m² vincristine (VCR), and 30mg/m² adriamycin (ADM), on day 1; oral administration of 40mg/m² prednisoone (PSL), and 100mg/m² procarbazine (PCZ), from day 1 through day 10, followed by intravenous infusion of bleomycin (BLM), 10 mg/body on day 14. BLM was withdrawn or decreased to less than 70% of the initial dose in patients who exhibited disturbed pulmonary function. Treatment resulted in complete remission (CR) in 11 and partial remission (PR) in 2 out of the 13 patients. Analyzing results according to pathological stage. CR was obtained in all of those in staged land II, and eight out of the 10 in staged III and IV. The four patients with recurrent disease after CHOP therapy exhibited a CR rate of 50%, indicating that therapy is highly effective in recurrent cases. Adverse effects observed among the ptients included leukocytopenia (15.4%), gastrointestinal symptoms (15.4%), arrhythmia (7.7%), pneumonia (23.1%) and peripheral neuropathy (15.4%). However, all these were of mild or moderate degree, with no case of fatal outcome. The efficacy of COP-BLAM therapy appears to be satisfactory in aged patients with non- Hodgkin's lymphoma. In addition, it may be effective in the treatment of recurrent cases, and it has the advantage of being easily administered to outpatients.

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