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Young Group (young + group)
Selected AbstractsFunctional map and age-related differences in the human face: nonimmunologic contact urticaria induced by hexyl nicotinateCONTACT DERMATITIS, Issue 1 2006Slaheddine Marrakchi Variation in human skin reactivity to various irritants in association with age and body region has been reported. Hexyl nicotinate (HN), a lipophilic nicotinate ester, was used to induce nonimmunologic contact urticaria in human volunteers of 2 age groups: 10 young subjects [24,34 years, mean ± standard deviation (SD) 29.8 ± 3.9 years] and 10 older volunteers (66,83 years, mean ± SD 73.6 ± 17.4 years); and to define skin function and potential age-related differences in various facial areas. About 5 mM of HN in ethanol was applied to 8 locations on the face, neck, and volar forearm. A laser Doppler flowmeter was used to determine baseline blood flow and to monitor the skin blood flow changes after HN application. In the contralateral areas, stratum corneum turnover was determined using 5% dansyl chloride in petrolatum. In the young group, the perioral area exhibited the strongest reaction to HN. In the older group, the chin was the most sensitive site. In both the groups, the forearm was the least responsive. The older group demonstrated a stronger reaction than the younger group in 3 sites (forehead, cheek, and nasolabial area). Stratum corneum turnover was slower in the nasolabial area and in the forearm in both age groups, whereas the fastest was in the perioral area and the chin in the younger group and in the chin and the forehead in the older group. Compared to the older group, the younger group showed a slower stratum corneum turnover in the nose and the neck. This study demonstrates the regional and the age-related variability of the stratum corneum turnover and the skin reactions to HN. These observations may help explain some aspects of the cutaneous intolerance in skin care of the face. [source] Crohn's Disease runs a more aggressive course in young asian patientsINFLAMMATORY BOWEL DISEASES, Issue 1 2006Kelvin Teck Joo Thia MRCP Abstract Background: Crohn's disease is a heterogeneous inflammatory bowel disease. The impact of age at diagnosis on the clinical course of patients varies widely as reported in the Western literature. Using the Vienna Classification, we seek to determine whether young Crohn's disease patients in an Asian population followed a different clinical course than old patients. Methods: The case records of 100 Crohn's disease patients who were treated at the Inflammatory Bowel Disease Center, Singapore General Hospital, were studied retrospectively. The age group and location of disease and behavior according to the Vienna classification were determined at diagnosis. Results: A1 group (age <40 years) defined as "young" and A2 group (age ,40) defined as "old" contained 65 and 35 patients, respectively. Median age for the young group was 27.4 years and that for the old group was 52.6 years. Of the young patients, 66.7% flared at least once compared with 28.6% of the old patients, odds ratio of 5.0 (P < 0.001). Young patients were more likely to be steroid dependent (20.0% of A1 versus 8.6% of A2, P = 0.14), received azathioprine (38.5% of A1 versus 5.7% of A2, P < 0.001) and experienced complications (31% of A1 versus 20% of A2, P = 0.25)-numerically higher rates that did not reach statistical significance. There was no significant difference between the age groups for the location and behavior of disease as well as requirement for surgery. Conclusion: In this first Asian study looking specifically at the impact of age at diagnosis of Crohn's disease, we found that young patients underwent a more aggressive clinical course. [source] Age- and Genotype-Specific Triggers for Life-Threatening Arrhythmia in the Genotyped Long QT SyndromeJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 8 2008TOMOKO SAKAGUCHI M.D. Introduction: Patients with long QT syndrome (LQTS) become symptomatic in adolescence, but some become at age of ,20 years. Since it remains unknown whether clinical features of symptomatic LQTS patients differ depending on the age of onset, we aimed to examine whether triggers for cardiac events are different depending on the age in genotyped and symptomatic LQTS patients. Methods and Results: We identified 145 symptomatic LQTS patients, divided them into three groups according to the age of first onset of symptoms (young <20, intermediate 20,39, and older ,40 years), and analyzed triggers of cardiac events (ventricular tachycardia, syncope, or cardiac arrest). The triggers were divided into three categories: (1) adrenergically mediated triggers: exercise, emotional stress, loud noise, and arousal; (2) vagally mediated triggers: rest/sleep; and (3) secondary triggers: drugs, hypokalemia, and atrioventricular (AV) block. In the young group, 78% of the cardiac events were initiated by adrenergically mediated triggers and 22% were vagally mediated, but none by secondary triggers. In contrast, the adrenergically mediated triggers were significantly lower in the intermediate group. The percentage of secondary triggers was significantly larger in the older group than in the other two groups (0% in young vs 23% in intermediate vs 72% in older; P < 0.0001). Concerning the subdivision of secondary triggers on the basis of genotype, hypokalemia was only observed in LQT1, drugs mainly in LQT2, and AV block only in LQT2. Conclusion: Arrhythmic triggers in LQTS differ depending on the age of the patients, stressing the importance of age-related therapy for genotyped LQTS patients. [source] Focal lymphocytic infiltration in aging human palatal salivary glands: a comparative study with labial salivary glandsJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 1 2001Marilena Vered Abstract: Investigation of age-related prevalence of various types of focal lymphocytic infiltration (FLI) and degrees of histomorphologic changes was conducted on 120 biopsies of palatal and labial salivary glands (PSG and LSG, respectively) obtained from autopsy subjects free of salivary gland tumors/diseases. Biopsies were divided into young (<30 years, n=30), adult (30,60 years, n=45) and old (>60 years, n=45) age groups. A modified Chisholm & Mason grading system was used to record grades of FLI and a modified Greenspan et al. system was used to evaluate the severity of histomorphologic changes. The prevalence of FLI in PSG increased significantly from 10% in the young group to 46.6% in the old group (P=0.0012). No significant changes were found with aging in LSG. FLI was significantly more prevalent in the adult and old age groups in PSG as compared with LSG (P=0.015 and P=0.003, respectively). Both glands demonstrated significant histomorphologic changes among age groups (p<0.0001); however, these changes were significantly less common in the old age group in PSG as compared to LSG (P=0.003). In cases showing severe histomorphologic changes, FLI was not present. Therefore, FLI should not be considered as part of the deteriorating histomorphologic changes that are usually encountered in salivary glands with aging. The immunologic profile of these infiltrates should be further clarified to understand their role, both in physiologic and pathologic conditions. [source] Cross-cultural assessment of the Contextual Memory Test (CMT)OCCUPATIONAL THERAPY INTERNATIONAL, Issue 4 2000Health Studies, Naomi Josman PhD, OTR Faculty of Social Welfare Abstract The Contextual Memory Test (CMT) measures aspects of memory and metamemory of people with cognitive disabilities. The assessment tool was originally developed and standardized in the United States. The objectives of this study were: (1) to evaluate the applicability of the CMT to an Israeli population; (2) to further investigate the construct validity of the CMT to discriminate among age groups; and (3) to analyse the 40 items on the CMT from a cultural point of view. The CMT was administered to 217 typical Israeli adults, grouped into three age categories, closely matching those in the US normative study (Toglia, 1993). Similar levels of performance were obtained for Israelis and Americans on the various test components. Statistically significant differences between American and Israeli subjects' performance levels were evident in three memory components in the elderly groups (group 3) and in only two memory components in the young group (group 1). In addition, within-sample comparisons of the three Israeli age groups yielded significant age effects for recall, recognition, strategy use and general awareness. This study confirmed discriminant validity for the CMT. The tool seems to be highly appropriate for use by occupational therapists in assessing memory and metamemory with American and Israeli adult subjects. The relatively small size of the age groups and the lack of random selection of subjects are limitations of this study. Therefore, it is recommended that the study be replicated with a larger and randomized sample. The multifaceted nature of the assessment provides much more information than traditional recall scores, and the metamemory components enhance both differential diagnosis and appropriate planning of treatment. Copyright © 2000 Whurr Publishers Ltd. [source] Scotopic spatiotemporal sensitivity differences between young and old adultsOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2010Cynthia L. Clark Abstract Background:, Our lab has previously demonstrated losses in contrast sensitivity to low spatial frequencies under scotopic conditions with older adults. It is not clear, however, whether the temporal frequency of a stimulus alters the relation between age and the spatial contrast sensitivity function (sCSF) under scotopic conditions. Methods:, A maximum-likelihood, two-alternative, temporal forced-choice QUEST procedure was used to measure threshold to spatially and temporally modulated stimuli in both young (mean = 26 years) and old (mean = 75 years) adults. Results:, In general, the shapes of the spatial and temporal CSFs were low-pass for both young and old observers; contrast sensitivity decreased at approximately the same rate with increasing spatial frequency and temporal frequency for both age groups, although the overall sensitivity of the old group was lower than that of the young group. The high-frequency resolution limit was lower for the old group compared to the young group. Conclusions:, The differences in contrast sensitivity between the young and old groups suggest a uniform loss in sensitivity of the channels mediating spatial and temporal vision. Because of this loss, the spatial and temporal window of visibility for the older adults is compromised relative to the younger adults. [source] Age-related lens yellowing per se contributes little to the increase in Farnsworth-Munsell 100 hue error scores with ageOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2008Raymond O. Beirne Purpose:, To investigate the effects of real and simulated age-related changes in crystalline lens yellowing on Farnsworth,Munsell (FM) 100 hue total and partial error scores. Methods:, FM 100 hue total and partial error scores were measured in a group of younger (n = 10, mean age 22.2 ± 2.65 years) and a group of older (n = 10, mean age = 54.5 ± 2.64 years) normal observers along with psychophysical estimates of crystalline lens optical density and pupil size measurements. Three younger observers underwent repeated FM 100 hue testing using a variety of simulated age-related lens yellowing conditions, using filters with well-defined absorption properties which mimicked the real age-related lens yellowing changes of the older group. FM 100 hue scores were also measured under different levels of background illumination and pupil size in the 3 younger observers. Results:, FM 100 hue total and partial error scores were significantly higher in the older age group compared to the younger group (p <0.01). Lens density measures were significantly higher in the older age group compared to the young group (p<0.01), but showed less scatter with age than FM 100 hue error scores. Pupil size was significantly larger in the younger group compared to the older group (p<0.01). Simulated lens yellowing in the three younger observers, equivalent to the level of that of the older observers, did not affect any of their FM 100 hue total or partial error scores. Reductions in pupil size and illumination significantly affected the younger observers' performance, with increases in error score equivalent to the observed age-related decline between the younger and older group. Conclusions:, Lens yellowing per se makes little contribution to the increase in Farnsworth,Munsell 100 hue error score with increasing age. Retinal illumination levels and pupil size can significantly affect the error score and should be considered when interpreting FM 100 hue error scores in older subjects. Clinicians should also consider iris colour and macular pigment density when interpreting FM 100 hue error scores. [source] Role of Laryngeal Movement and Effect of Aging on Swallowing Pressure in the Pharynx and Upper Esophageal Sphincter,THE LARYNGOSCOPE, Issue 3 2000Masato Yokoyama MD Abstract Objectives Describe contribution of laryngeal movement to pressure changes at the upper esophageal sphincter (UES) and the effect of aging on the swallowing function. Study Design Manofluorography on 56 nondysphagic adults divided into three age groups: the 21- to 31-year-old group (n = 32), the 61- to 74-year-old group (n = 12) and the 75- to 89-year-old group (n = 12). Analyses of the bolus transit time, the amplitudes and durations of pharyngeal pressures, the timing of a pressure fall at the UES and the laryngeal movements. Methods Intraluminal strain-gauge sensors recorded pressure changes in the oropharynx, hypopharynx and the UES. Motion pictures of the videotapes were fed into a personal computer, and movements of the hyoid bone were measured in both the horizontal and vertical directions as an indication of laryngeal movement. Results In 26- and 70-year-old men with calcification of the thyroid cartilage, it was determined that the larynx and hyoid bone moved in consonance until the end of the rapid hyoid movements in both the superior and anterior directions. In the 21- to 31-year-old group, the magnitude of the pressure fall at the UES was maximal before or almost at the same time as the bolus arrival, in preparation for smooth passage of the bolus from the pharynx to the esophagus. The rapid superior movements of the hyoid bone started significantly early as compared with its anterior movements (P = .0001). The rapid anterior movements of the hyoid bone started simultaneously with the pressure fall at the UES. In the elderly, all segmental transit times were significantly increased. The timing of the pressure fall at the UES was significantly delayed and the UES pressure reached its minimum value after arrival of the bolus at the UES. The minimum pressure at the UES increased to a significantly positive value. The rapid anterior movements of the hyoid were significantly delayed, suggesting that this delay causes the delay in the pressure fall at the UES. Conclusions The rapid superior and anterior movements of the hyoid bone are considered to start at the same time as those of the larynx. In the young group, it is suggested that superior laryngeal movement protects the lower airway prior to the anterior laryngeal movement, causing the pressure fall at the UES to enable the passage of a bolus into the UES. In the elderly, smooth passage of the bolus from the pharynx to the esophagus is hindered and the system that prevents aspiration is rendered inefficient by changes in the swallowing pressures and laryngeal movements with aging. [source] The use of patient-controlled epidural fentanyl in elderly patients,ANAESTHESIA, Issue 12 2007T. Ishiyama Summary We studied whether delivering postoperative analgesia, using a patient-controlled epidural analgesia (PCEA) device was effective and safe in elderly patients. We enrolled 40 patients aged >,65 years (elderly group) and 40 patients aged 20,64 years (young group) scheduled for elective major abdominal surgery. PCEA infusion was started following completion of surgery. Mean (SD) fentanyl consumption (10.7 (3.7) compared with 10.5 (2.7) ,g.kg,1, p = 0.76) and number of times patients pressed the bolus switch (32 (36) compared with 44 (38), p = 0.16) during the first 24 h postoperatively were similar in the two groups. Pain scores, which were similar in both groups at rest, were significantly lower in the elderly on coughing (at 24 h, p < 0.05). In addition, average pain scores were similar at the time of PCEA bolus demands in the two groups. Elderly and young adult patients therefore required similar amounts of patient-controlled epidural fentanyl to produce satisfactory pain relief. [source] A single-nucleotide polymorphism in the XPG gene, and tumour stage, grade, and clinical course in patients with nonmuscle-invasive neoplasms of the urinary bladderBJU INTERNATIONAL, Issue 4 2006SHIGERU SAKANO OBJECTIVE To evaluate whether the single nucleotide polymorphism (SNP), Asp1104His (G3507C), in the XPG gene affects malignant phenotypes of nonmuscle-invasive urinary bladder neoplasms (NIBN), by investigating associations between the SNP and clinicopathological variables in patients with NIBN. PATIENTS AND METHODS The 233 patients constituted newly diagnosed cases of primary NIBN in the Stockholm area. The Asp1104His polymorphism in the XPG gene was genotyped using a polymerase chain reaction-restriction fragment length polymorphism technique. RESULTS The GC + CC genotypes were more frequent in stage pT1 tumours at initial diagnosis than pTa (odds ratio 1.9, 95% confidence interval 1.0,3.5, P = 0.048). The difference was larger in the young group (4.6, 1.9,11.8, P = 0.001). In the young group, the GC + CC genotypes were significantly more frequent in high-grade than in low-grade tumours (3.1, 1.5,6.8, P = 0.004) whereas in the older group the genotypes were less frequent in high-grade tumours (0.3, 0.1,0.7, P = 0.007). The XPG genotypes were not associated with tumour recurrence, stage progression or survival. CONCLUSION These results suggest that the SNP in the XPG gene might be related to tumour invasiveness in NIBN. [source] Pathologic features of endometrial carcinoma associated with HNPCCCANCER, Issue 1 2006A comparison with sporadic endometrial carcinoma Abstract BACKGROUND Endometrial carcinoma is a common malignancy in hereditary nonpolyposis colorectal carcinoma (HNPCC). Like colon carcinoma, endometrial carcinoma is diagnosed at an earlier age in women with HNPCC. In contrast to colon carcinoma, the pathologic features of endometrial carcinoma in HNPCC have not been studied in detail. It was the purpose of this study to pathologically characterize a series of HNPCC associated endometrial carcinomas. METHODS Fifty women with HNPCC and endometrial carcinoma were analyzed from four different hereditary cancer registries. H&E stained slides and pathology reports were reviewed for clinically important pathologic features of endometrial carcinoma. These results were compared with those for two different groups of sporadic endometrial carcinoma , women younger than age 50 years (n = 42) and women of all ages with tumors demonstrating microsatellite instability (MSI-high) secondary to methylation of MLH1 (n = 26). RESULTS Nearly one-fourth of HNPCC patients in this study had endometrial tumors with pathologic features that would require adjuvant therapy after hysterectomy. There was a trend toward the HNPCC patients having more nonendometrioid tumors; all of these patients were carriers of MSH2 mutations. Such nonendometrioid tumors were extremely rare in the MLH1 methylated group. A subset of MLH1 methylated sporadic tumors demonstrated a unique, ,undifferentiated' histology that was not observed in HNPCC or the young group. CONCLUSION Data suggest a genotype,phenotype relation in which microsatellite instability resulting from MLH1 methylation is almost exclusively associated with classical or ,undifferentiated' endometrioid tumors, whereas microsatellite instability secondary to MSH2 mutation can result in a more variable histologic spectrum of endometrial carcinoma. Cancer 2006. © 2005 American Cancer Society. [source] Does internal longitudinal microstructure of retinal veins change with age in medically healthy persons?ACTA OPHTHALMOLOGICA, Issue 2009KE KOTLIAR Purpose We demonstrated previously that roughness of the retinal arterial blood column measured along the vessel axis, termed longitudinal arterial profile (LAP) increases significantly in anamnesticly healthy volunteers with increasing age. Recently we have demonstrated age related changes in LAP of medically healthy persons. Whether longitudinal retinal venous profiles (LVP) are altered with age in this group is investigated. Methods 83 medically healthy volunteers were examined by Dynamic Vessel Analyzer (IMEDOS, Jena, Germany) using stimulation with flickering light. 3 age groups were formed: young (N=28, 30,2±4,3 years), middle age (N=28, 42,3±3,3 years) and seniors (N=27, 64,0±5,0 years). Included in the analysis were volunteers without medical vascular risk factors defined as: blood pressure < 140/90 mmHg, HDL > 35 mg/dl, LDL < 190 mg/dl and glucose levels < 110 mg/dl. Retinal venous diameters were measured along 1 mm vessel segments to obtain LVP. Differences were analyzed using Fourier transformation. Results In all age groups power spectra of LVP do not change during all stages of the venous response to the stimulation. There were no significant differences in LVP between the age groups. Venous diameters in middle-age group were reduced in comparison to the young group at all stages of vessel reaction (p<0,05). Conclusion Our results indicate that in contrast to retinal arteries retinal veins of validated healthy volunteers do not undergo age related microstructural changes. Hence previously reported age related decrease of retinal venous diameter might have physiologic origin due to reduced blood flow in retinal microcirculation with age, not because of structural changes of venous wall. [source] Microstructural alterations of the retinal arterial blood column along the vessel axis in healthy volunteers with ageACTA OPHTHALMOLOGICA, Issue 2009IM LANZL Purpose We demonstrated previously that roughness of the retinal arterial blood column measured along the vessel axis increases in anamnestically healthy volunteers with increasing age. We termed it longitudinal retinal arterial profile (LAP). Whether LAP is altered with age in medically supervised healthy persons is investigated. Methods 82 medically healthy volunteers were examined by Dynamic Vessel Analyzer (IMEDOS, Jena, Germany) using stimulation with flickering light. 3 age groups were formed: young (N=27, 30,5±4,3 years), middle age (N=28, 42,3±3,3 years) and seniors (N=27, 64,0±5,0 years). Included in the analysis were volunteers without medical vascular risk factors defined as: blood pressure < 140/90 mmHg, HDL > 35 mg/dl, LDL < 190 mg/dl and glucose levels < 110 mg/dl. Retinal arterial diameters were measured along 1 mm vessel segments to obtain LAP. Differences were analyzed using Fourier transformation. Results In all age groups LAP do not change during all stages of the arterial response. Arterial diameters in the senior group were reduced in comparison to the young group at all stages of the vessel reaction (p<0,05). There are differences in LAP between the age groups. Compared to young persons, seniors showed significantly diminished waves with a period of 417 µm at all stages of the arterial reaction, whereas young volunteers showed less pronounced waves with a period of 208 µm (p<0,05). Conclusion Our results represent the healthy aging process in retinal vasculature. Age related microstructural changes in longitudinal profiles of retinal arteries in medically healthy persons might be an indication for alterations in the vascular endothelium and smooth musculature. [source] HLA-A and HLA-B transcription decrease with ageing in peripheral blood leucocytesCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 2 2001C. Le Morvan Immunosenescence involves modifications of humoral and cellular immunity. In a previous study, we have shown a locus-dependent reduction of HLA class-I cell surface expression on peripheral lymphocytes and monocytes with advancing age. Here we report the quantitative analysis of HLA-A and -B transcripts from PBL of 54 healthy subjects aged 21,90 years. Using a competitive RT-PCR method, we observed a significant decrease of HLA-A (P < 0·0001) and -B (P = 0·0025) mRNA contents with increasing age. Secondly, to investigate this locus-dependent alteration of HLA class-I transcription, we performed EMSA using nuclear extracts from PBL of five young (24,31-year-old) and 5 elderly (58,69 years old) donors with locus A and B sequences of the Enh-A as probes. No qualitative variation of EMSA profiles appeared between the two groups of donors with 6 and 4 bandshift for the locus A and B, respectively. Quantitatively, we observed a significant increase of B4 intensity in the elderly group compared to the young group (P < 0·05). These results suggest that the variation of DNA binding protein could contribute to the lower transcription of HLA-A and -B with ageing. These alterations of HLA class-I expression at the transcriptional level could lead to the unresponsiveness of CD8 T cells due to default of antigen presentation with ageing. [source] Diurnal rhythms of serum total, free and bioavailable testosterone and of SHBG in middle-aged men compared with those in young menCLINICAL ENDOCRINOLOGY, Issue 6 2003Michael J. Diver Summary background Conflicting views are reported on the association between advancing age and gradually diminishing concentrations of serum total testosterone in men. The putative loss of diurnal rhythm in serum total testosterone in older men is reported to be in part due to low concentrations in the morning when compared to concentrations found in young men. We have measured total, free and bioavailable testosterone along with SHBG in samples taken every 30 min throughout a 24-h period in 10 young and eight middle-aged men. results Both young and middle-aged men displayed a significant diurnal rhythm in all variables, with a minimum fall of 43% in total testosterone from peak to nadir in all subjects. Subjecting the data to a time series analysis by least squares estimation revealed no significant difference in mesor (P = 0·306), amplitude (P = 0·061) or acrophase (P = 0·972) for total testosterone between the two groups. Comparing bioavailable testosterone in the two groups revealed no significant difference in mesor (P = 0·175) or acrophase (P = 0·978) but a significant difference (P = 0·031) in amplitude. Both groups display a significant circadian rhythm (middle-aged group P < 0·001; young group P = 0·014). Free testosterone revealed a highly significant rhythm in both the young group (P < 0·001) and the middle-aged group (P = 0·002), with no significant difference between the groups in mesor (P = 0·094) or acrophase (P = 0·698). Although analysis of the SHBG data revealed a significant rhythm in the young group (P = 0·003) and the older group (P < 0·001), the acrophase occurred in the mid afternoon in both groups (15·12 h in the young and 15·40 h in the middle-aged). The older men had a significantly greater amplitude (P = 0·044) but again no significant difference was seen in mesor (P = 0·083) or acrophase (P = 0·477) between the two groups. Acrophases for total, bioavailable and free testosterone occurred between 07·00 h and 07·30 h; for SHBG the acrophase occurred at 15·12 h in the young group and 15·40 h in the middle-aged group. conclusions The study suggests that the diurnal rhythm in these indices of androgen status is maintained in fit, healthy men into the 7th decade of life. [source] Liver transplantation in patients aged 65 and over: a case,control studyCLINICAL TRANSPLANTATION, Issue 5 2010R. Montalti Montalti R, Rompianesi G, Di Benedetto F, Ballarin R, Gerring RC, Busani S, De Pietri L, De Ruvo N, Iemmolo RM, Guerrini GP, Smerieri N, Gerunda GE. Liver transplantation in patients aged 65 and over: a case,control study. Clin Transplant 2010 DOI: 10.1111/j.1399-0012.2010.01230.x. © 2010 John Wiley & Sons A/S. Abstract:, Introduction:, The average age of patients undergoing liver transplantation (LT) is consistently increasing. The aim of this case,control study is to evaluate survival and outcome of patients ,65 yr compared to younger patients undergoing LT. Materials and methods:, From 10/00 to 4/08 we performed 330 primary LT, 31 (9.4%) of these were in patients aged 65,70. Following a case,control approach, we compared these patients with 31 patients aged between 41 and 64 yr and matched according to sex, LT indication, viral status, cadaveric/living donor, LT timing, and Model for End-Stage Liver Disease (MELD) score. Results:, There were no statistically significant differences in demographic and surgical donor characteristics. The mean MELD score was under 18 in both groups. Post-LT complications occurred with a similar incidence in the two groups. one-, three-, and five-yr survival was 83.9%, 80.6%, and 80.6%, respectively, for the elderly group, and 80.6%, 73.8%, and 73.8%, respectively, for the young group (p = 0.61). Discussion:, Patients aged between 65 and 70 with low MELD score who undergo LT have the same short- and middle-term survival expectancy, morbidity, and outcome quality as younger patients with the same indication and same pre-LT pathology severity, whatever they might be. Thus, chronological age alone should not deter LT workup in patients >65 and <70. [source] Superficial papillary urothelial carcinomas in young and elderly patients: a comparative studyBJU INTERNATIONAL, Issue 3 2004Mario Migaldi OBJECTIVE To compare the clinicopathological and immunohistochemical findings of superficial papillary transitional cell carcinomas in ,young' and ,elderly' patients, as the natural history and prognosis of bladder tumours in young patients remains a matter of debate. PATIENTS AND METHODS Tumours from 50 patients with superficial urothelial tumours of the bladder diagnosed before 45 years old (,young' group, follow-up 25,119 months) were compared with 90 similar tumours developed in patients aged >55 years (,elderly', follow-up 24,102 months). All the patients had a transurethral resection with curative intent, and none had received any therapy before surgery. After surgery only patients diagnosed with pT1 tumours were treated by intravesical bacille Calmette-Guérin (BCG) instillations; all received intravesical BCG if there was a recurrence. The clinicopathological variables, recurrence and disease-free interval to recurrence were assessed. Proliferative activity (MIB-1) and expression of cell-cycle regulation proteins cyclin D1, p53 and p27kip1 were detected by immunohistochemistry in the tumours of both groups. RESULTS There were statistically significant differences in tumour grade, stage and occurrence between the ,young' and ,elderly' groups. The ,young' group had a longer disease-free interval to recurrence. Among the immunohistochemical markers analysed, only MIB-1 and cyclin D1 were associated with an increased risk of recurrence in the ,young' group (P < 0.04 and <0.01, respectively) in a univariate analysis. CONCLUSIONS Superficial papillary urothelial tumours of the bladder in ,young' patients had a better prognosis than those in the ,elderly' group, showing a lower grade and stage at diagnosis, and a lower recurrence rate. Proliferative activity and cyclin D1 expression levels were of prognostic significance for the risk of recurrence in these patients. [source] | ||||||||||