ABSTRACT
OBJECTIVE: Protein-energy malnutrition is a common disorder in the elderly. Although serum albumin is commonly used as a nutritional marker, data is lacking on serum albumin levels in the elderly. The purpose of this study was to determine whether serum albumin levels decrease with advancing age and to establish reference value and interval of laboratory data for elderly people (75 years and over). PARTICIPANTS: Blood samples from 13821 healthy people, 42064 outpatients, and 15959 inpatients were collected during 2008. Blood from 127 of our nutrition support team (NST) patients was also collected during August 2006 and May 2009, and analyzed. MEASUREMENTS: Serum albumin, hemoglobin, total cholesterol levels and lymphocyte count were determined. We analyzed the change in each parameter in accordance with age, compared the data for elderly people with younger people, and established new reference values. Clinical outcomes were examined depending on the improved reference values. RESULTS: Albumin was lower in older persons than in younger persons. The estimated reference value and interval were 42 (48-36) g/l in older persons and was much lower in NST patients. Hemoglobin was decreased while cholesterol and lymphocyte count were not changed in older persons: all were markedly decreased in NST patients. Terms of hospital stay were significantly longer and mortality rates were significantly higher in older persons, comparing from above to below using a new reference value of albumin (36 g/l). CONCLUSIONS: The serum albumin level decreases with advancing age, but it was maintained to some extent in healthy older people. Serum albumin levels related to the clinical outcome. Hemoglobin and cholesterol levels and lymphocyte count were all lower in NST patients. These measurements may be valuable markers of nutritional status and can help in guiding the need for nutritional support.
Subject(s)
Protein-Energy Malnutrition/blood , Protein-Energy Malnutrition/physiopathology , Serum Albumin/analysis , Adult , Aged , Aged, 80 and over , Aging , Biomarkers/blood , Cholesterol/blood , Databases, Factual , Female , Hemoglobins/analysis , Humans , Inpatients , Lymphocyte Count , Male , Middle Aged , Nutritional Status , Outpatients , Reference Values , Regression Analysis , Young AdultABSTRACT
Cholangiography is the most fundamental and reliable examination for diagnosis of the extent of bile duct carcinoma. Hepatic angiography is also informative for diagnosis of vascular invasion. However, an accurate understanding of three-dimensional biliary and vascular anatomy at the hepatic hilum is not easily gained by conventional cholangiography and angiography. We have performed three-dimensional cholangiography and angiography (3D-CG & AG) using rotational DSA (Advantx ACT) and a 3D spinning digital imaging system in 29 patients with hilar cholangiocarcinoma, etc. 3D-CG & AD provides clear three-dimensional visualization of the biliary tract and blood vessels affected by bile duct cancer, and useful information on optimal resection. Of 13 patients with hilar cholangiocarcinoma undergoing resection, curative resection was carried out in 11 (85%). 3D-CG & AG is considered to be an indispensable imaging modality for evaluation of the extent and staging of hilar cholangiocarcinoma.
Subject(s)
Angiography , Bile Duct Neoplasms/diagnostic imaging , Bile Ducts, Intrahepatic , Cholangiocarcinoma/diagnostic imaging , Cholangiography , Angiography/methods , Cholangiography/methods , Humans , Male , Middle AgedABSTRACT
An epidemiological survey on the incidence of chronic lymphocytic thyroiditis in childhood was performed in 11,353 apparently healthy school children in Chiba prefecture, Japan. The present study included 9,416 school children (4,401 boys and 5,015 girls, ages 6--18 yrs) in Chiba City and 1,937 children (744 boys and 1,193 girls, ages 16-18 yrs) in Tateyama City. The first group was selected as a representative of urban area, and the second group was selected as that of seaside area. Children having goiter were selected for testing antihyroblobulin and antimicrosomal antibodies in sera. Final diagnosis of chronic lymphocytic thyroiditis was based on histological specimens obtained by needle biopsies on the antithyroid antibody positive subjects. The overall incidence of chronic lymphocytic thyroiditis in these children with 1.7 per 1,000 children. There was a considerable sex difference in the prevalence. None of the patients were boys. In girls the incidence increased with age: ages 6-12 0.9, ages 13-15 4.6 and ages 16-18 3.1-4.2 per 1,000, respectively. The incidence in the seaside area, 2.6 per 1,000 was not significantly higher than that in the urban area, 1.8 per 1,000. Histologically, all cases were classified as focal thyroiditis.