Uncertainties in Geriatric Data. Ii. Organ Size

Calloway, N. O.; Foley, C. F.; Lagerbloom, Philip

doi:10.1111/j.1532-5415.1965.tb00569.x

Cited by 74 publications

(28 citation statements)

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“…A significant correlation between normal liver volume and age was indicated in [3, 47–49]; this was confirmed in [1] or our study (Table 2). Reports also did not agree on the correlations between liver volume and patient’s height [1, 2, 28, 39, 47] or liver volume and patient’s age [1,3, 47–49]. The sensitivity and specificity of the H-score to detect hepatomegaly using consensus reports as reference standard were 97.6% and 86.4% respectively with 0.98 area under the ROC curve.…”

Section: Discussionsupporting

confidence: 89%

Assessing Hepatomegaly

et al. 2012

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Rationale and Objectives To define volumetric nomograms for identifying hepatomegaly and retrospectively evaluate the performance of radiologists in assessing hepatomegaly. Materials and Methods Livers were automatically segmented from 148 abdominal contrast-enhanced CTs: 77 normal and 71 hepatomegaly cases (diagnosed by visual inspection and/or linear liver height by radiologists). Quantified liver volumes were compared to manual measurements using overlap/error (VO/VE). Liver volumes were normalized by patient body-surface-area (BSA) from which hepatomegaly nomograms were defined (H-score) by analyzing the distribution of liver sizes in the healthy population. The H-score was validated against consensus reports. The performance of radiologists in diagnosing hepatomegaly was retrospectively evaluated. Results The automated segmentation of livers was robust with VO/VE of 96.2/2.2%. There were no significant differences (p>0.1) between manual and automated segmentations for either normal/hepatomegaly subgroups. The average volume of normal/enlarged livers was 1.51±0.25/2.32±0.75 liter. One-way ANOVA found BSA (p=0.004) and gender (p=0.02), but not age significantly affected normal liver volume. No significant effects were observed for two-/three-way interactions among the three variables (p>0.18). The H-score cutoffs of 0.92/1.08 l/m2 were used to define mild/massive hepatomegaly (+/−0.02 l/m2 95% CI). Using the H-score as the reference standard, the sensitivity of radiologists in detecting all/mild/massive hepatomegaly was 84.4/56.7/100.0% at 90.1% specificity, respectively. Radiologists disagreed in 20.9% (n=31) of the diagnosed cases. The area under the ROC curve of the H-score criterion for hepatomegaly detection was 0.98. Conclusion Nomograms for the identification and grading of hepatomegaly from automatic volumetric liver assessment normalized by body-surface-area (H-score) were introduced. The H-score matches well with clinical interpretations for hepatomegaly and may improve hepatomegaly detection compared with height measurements or visual inspection commonly used in current clinical practice.

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Section: Discussionsupporting

confidence: 89%

Assessing Hepatomegaly

et al. 2012

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“…That the LBM tends to shrink with advancing age was reported by pathologists from postmortem examinations as early as 1900 [ 1,2], There is an average atrophy of about 30% from age 30 to age 75 in the sizes of liver, kidneys, brain and pancreas. Since 1950, cross-sectional and longitudinal measurements of total body K have shown that from age 40 to 80, LBM declines in men at an average rate of 5% per decade and in women at 2.5% per decade [1,3.…”

Section: Iiow Body Composition Changes With Advancing Agementioning

confidence: 99%

Effects of Human Growth Hormone on Body Composition in Elderly Men

et al. 1991

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Body composition changes progressively in mid and late adulthood. Lean body mass in men over 50 years old contracts at an average rate of-0.6% per year. Body weight tends to remain stable because of a reciprocal expansion of adipose mass. The shrinkage of the lean body mass reflects the atrophy of skeletal muscles, skin and visceral organs. Because growth hormone causes expansion of the lean body mass and contraction of the adipose mass, and because growth hormone secretion tends to diminish in late adulthood, it has been postulated that geriatric hyposomatotropism is a contributory cause to the body composition changes described above. The authors have tested this hypothesis by recruiting 45 independent men over 61 years old with plasma somatomedin C level below 0.35 U/ml, indicating little or no detectable growth hormone secretion. The 21-month protocol was as follows: baseline period 0–6 months, experimental period 6–18 months and post-experimental period 18–21 months. During the experimental period, 26 men (group I) received approximately 0.03 mg/kg of biosynthetic human growth hormone (hGH) subcutaneously 3 times a week, while 19 men (group II) received no treatment. Plasma somatomedin C was measured monthly. The following outcome variables were measured at 0,6, 12 and 18 months: lean body mass, adipose mass, skin thickness (dermis plus epidermis), sizes of the liver, spleen and kidneys, the cross sectional areas often muscle groups, and bone density at 9 skeletal sites. Lean body mass and adipose mass were also measured at 21 months. In group I, hGH treatment raised the plasma somatomedin C level and maintained it in the range 0.5–1.5 U/ml. Significant changes occurred in the following outcome variables, expressed as percent change at 18 months over baseline: lean body mass +6%, adipose mass -15%, skin thickness +4%, liver volume +8%, spleen volume + 23%, sum of ten muscle areas +11 %. Three months after hGH treatment stopped, about one half of the hGH-induced increment in lean body mass had disappeared and about one third of the hGH-induced decrement in adipose mass had reappeared. During hGH treatment, 9 subjects developed carpal tunnel syndrome and 4 subjects developed gynecomastia. The adverse side effects disappeared spontaneously within 3 months after cessation of hormone treatment. In group II, the somatomedin C level remained below 0.35 U/ml. At the 18-month time point, there was a significant decline in lean body mass to 96% of initial baseline and in skin thickness to 94% of initial baseline. These observations are consistent with the hypothesis that diminished growth hormone secretion in the later years of adulthood is a contributory cause to the body composition changes which occur with advancing age.

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“…demonstrated a series of changes in the pancreas with age, all of them appearing to be essential destructive in regard to the function or at least the capacity to function of this organ. C a llo w a y et al [3] and F ik ry [4] have given some data on age effect on the weight of human pancreas and F ik ry [4] and M eyer and N echeles [21] have reported changes with age in the pancreatic secretion and enzyme activity in the secretion fluid. We have already mentioned that only proenzymes are found in the pancreas itself (see Material and Methods) but that the methods used for extracting the enzymes from pancreas tissue give a complete activation of the proenzymes.…”

Section: Discussionmentioning

confidence: 99%

Elastolytic Enzymes and Elastin in the Aging Rat

Loeven¹,

Baldwin²

1971

Gerontology

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Since improved methods make it possible to determine both elastoproteinase and elastomucase activity in crude pancreatic extracts, the effect of age on enzyme titer in the pancreas was studied in virgin Wistar rats of both sexes. In males, the elastoproteinase concentration (in elastoproteinase unit [EU] per gram acetone-dried pancreas) decreased with age over the whole period of 0–24 months; the elastomucase Em-I and Em-S concentrations (in elastomucase unit [Em-U] per gram acetone-dried pancreas) rapidly decreased with age up to 12 months (Em-S) and 18 months (Em-I), remaining nearly constant after that age period. In female rats, the elastoproteinase concentration remained constant during the 1st year of life, increased rapidly between 15 and 18 months, then decreasing to the 15-month level at an age of 27 months. The titer of both elastomucases fell during the growth of the females, remaining constant between 6 and 15 months of age and showed a rapid increase in enzyme level between 15 and 18 months. Although there was a tendency for the enzyme concentration to decrease after 18 months, the fall was not statistically significant. The data obtained with rat pancreas were compared with those for human pancreatic enzymes and for human serum ‘elastoproteinase’ reported previously. Similar age-relationships were found.

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Uncertainties in Geriatric Data. Ii. Organ Size

Cited by 74 publications

References 3 publications

Assessing Hepatomegaly

Assessing Hepatomegaly

Effects of Human Growth Hormone on Body Composition in Elderly Men

Elastolytic Enzymes and Elastin in the Aging Rat

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