Left handedness and breast cancer risk.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
C C Hsieh
Publications and source records attributed to C C Hsieh.
Infarction of placental chorioangioma and associated regression of hydrops fetalis.
Explore the source record for details and available documents.
Female↗
Beyond simple pooling for HIV screening.
We discuss some theoretical features underlying the successful uses of pooling in testing HIV seroprevalence. In particular it is shown that there is a scaling relation for the distribution of positive sera among the pools. A multi-stage pooling method consisting of repeatedly halving the positive pools is proposed. Concentrating on the number of tests required for screening all positive individuals the method is shown to be highly efficient in low prevalence situations.
Biometry↗
A case-control study of coronary heart disease in Athens, Greece.
A case-control study of coronary heart disease (CHD) was conducted in Athens, Greece. The case series consisted of 329 patients with electrocardiographically confirmed coronary infarct or a diagnostic coronary arteriogram, or both, who were admitted during a 16-month period to a major teaching hospital. Controls were 570 patients admitted to the same hospital just before or after the CHD cases for minor surgery; eye, ear, nose or minor urological problems; or chest problems definitely shown to be unrelated to CHD. All cases and controls were interviewed in the hospital wards and selected laboratory data were abstracted. The main analysis was done by modelling through multiple logistic regression, controlling for demographic variables as well as for the mutual confounding effects of the investigated risk factors. Obesity, hypertension, diabetes mellitus, elevated blood cholesterol and excessive coffee intake were significant (P < 0.02) independent risk factors with relative risk estimates in the 2- to 3-fold range. Non-significant positive associations were found with respect to tobacco smoking and modest coffee consumption, whereas non-significant negative associations were noted with respect to alcohol intake and regular exercise. A negative association with duration of afternoon siesta was of borderline statistical significance.
Adult↗
Diet, pregnancy estrogens and their possible relevance to cancer risk in the offspring.
Total estrogens, estradiol and estriol were determined by radioimmunoassay in the blood of 141 pregnant women during their 26th and 31st weeks of pregnancy, and the results were correlated with dietary patterns and nutrient intakes during pregnancy, assessed through a semiquantitative food frequency questionnaire. No food group or nutrient showed a significant (p less than 0.05) association with any of the examined hormones at both the 26th and the 31st week of pregnancy. Relatively more consistent were a positive association between consumption of starchy roots (potatoes) and all the indicated hormones, and a negative association between vitamin A and estradiol and total estrogens; however, the multitude of comparisons hinders a biologic interpretation at this time. There was suggestive evidence that weight gain up to the 31st week of pregnancy was positively associated with both total estrogens (p = 0.09) and estradiol (p = 0.11). The present study has limitations reflecting the relatively small sample size and the problems inherent in epidemiologic methods assessing nutritional intakes. However, the findings suggest that quantitative aspects of diet, as reflected in pregnancy weight gain, may be more important than dietary composition in influencing levels of pregnancy estrogens and in affecting the occurrence of gonadal germ cell tumors and other conditions that may be associated with them.
Body Weight↗
Peripartum cardiomyopathy.
Peripartum cardiomyopathy is a relatively rare complication of pregnancy, characterized by heart failure of obscure etiology during the antepartal or postpartal period. During a 10-year period in our hospital, of 36,882 women who delivered, 6 were diagnosed as having peripartum cardiomyopathy. The incidence in our hospital was estimated as 1:6,147 deliveries. Among these 6 patients, 2 cases with fulminating courses died 1 month after treatment. Two other cases had cardiomyopathy and multiple congestive heart failure and died after 3 years and 6 years. Only one case, whose cardiac size returned to normal within 4 months, completely recovered from this disease. Another survivor with persistent cardiomegaly was followed for 5 years and remained clinically stable. In addition to congestive heart failure, the occurrence of complications such as sepsis, hepatorenal failure, and arrhythmia were the major causes of death. According to the results of our study, return of cardiac chamber size to the normal range indicated a good prognosis. We concluded that the prognosis of peripartum cardiomyopathy depends upon the degree of cardiac dysfunction and the response to therapy.
Adult↗
Pregnancy outcome of preterm premature rupture of the membranes before 28 weeks.
From January 1987 to December 1990 at Chang Gung Memorial Hospital, the fetal membrane ruptured in 47 singleton pregnancies at the 20th to the 28th gestational weeks. Sixty-six percent of the patients delivered within three days and 91.5% within one week. Only six (12.8%) patients carried their pregnancies over the 28th week. Of the 47 patients, 16 (34.0%) developed clinical evidence of chorioamnionitis during the latent period. The development of chorioamnionitis was not related to any of clinical factors [gestational age at rupture of the membranes, duration of rupture of the membranes before admission, positive endocervical culture, tocolysis, latent period or the presence of oligohydramnios (p > 0.05)]. The neonatal survival rate was 12.7% (six out of 47). Neonatal death was mainly attributable to prematurity. Gestational age beyond the 28th week and body weight greater than 1000 gm are two factors contributing to fetal survival. When fetal lung maturity has not occurred expectant management in the absence of infection is an alternative treatment.
Chorioamnionitis↗
Strategies for blood screening for the hepatitis C virus and for the human immunodeficiency virus in high risk groups.
For many infectious agents, seroprevalence rate is low but has serious consequences and must therefore be kept out of donated blood supplies. However, screening to ensure the safety of blood supplies has an associated very high cost. For example, in blood banks, detection of all the harmful items in a large number of samples is an expensive and tedious process. The laboratory and statistical approaches to obtain significant savings by the pooling method were discussed from 1943, recently, there have been further discussions of pooling sera as a means to determining the HIV seroprevalence rate in the general population or the weed out all HIV-positive individuals in blood screening. Here we describe a simple mathematical method to weed out all HIV, and HCV seropositive units. The method is designed to maximize possible savings. Two examples illustrate the application of this method in determining the number to be pooled in each stage, and the resulting savings. When the prevalence rate is lower than 2 percent. our method offers savings of over 80 percent.
Blood Donors↗
Sodium transport in hypertension.
Although most workers in the field agree that salt causes hypertension, but there is no well-established mechanism(s) explaining how salt works. Vast literature exists on abnormal sodium (Na+) transport processes in human and experimental hypertension from various cell systems. We examined the recent developments in the investigation of three important sodium transport pathways: Na+/K+ pump, Na+/Li+ countertransport and Na+/K+ cotransport in hypertension. The activities of these transporters may affect vascular reactivity or may serve as genetic marker for essential hypertension. Selected reports on the abnormalities of these transporters were summarized, potential problems in the interpretation of these data were discussed, and the current view about the physiological or pathophysiological meaning of these studies were presented. The multiple sites of defects and sometime conflicting reports on Na+ transport in hypertension also lead to alternative hypothesis associating membrane abnormalities with hypertension. Two models, considering membrane lipid bilayers and cellular calcium handling as primary sites of defect and the related evidence, were introduced. Finally, the role of natriuretic hormone (or endogenous Na+ pump inhibitor) in influencing Na+ transport was briefly discussed.
Animals↗
Non-mosaic trisomy 20 in cultures of amniotic fluid from a fetus with serious congenital malformation.
We present a case of non-mosaic trisomy 20 in amniotic fluid associated with major congenital anomalies. A detailed prenatal ultrasonic examination was performed, and revealed dilatation of the cisterna magna and the fourth ventricle with hypoplasia of the vermis of the cerebellum. Fetal echocardiography showed overriding aorta and ventricular septal defects with pulmonary atresia. However, the karyotype of the lymphocyte in the cord blood was normal female 46, XX. The occurrence of the Dandy-Walker malformation in non-mosaic trisomy 20 has not been reported before, and the clinical significance of this major defect for prenatal diagnosis is discussed.
Adult↗
[The relationship between weights of fetuses with autosomal trisomies and low maternal serum alpha-fetoprotein].
An association between low maternal serum alpha-fetoprotein (MSAFP) and fetal trisomy has now been thoroughly documented. The mechanisms resulting in low MSAFP are still unclear. In order to determine whether the low values of MSAFP in autosomal trisomies are associated with smaller fetal weights, we compared 11 fetuses with Down syndrome (trisomy 21), 4 with trisomy 18, with 45 normal fetuses. All of them are aborted in the second trimester of pregnancy. No significant difference in the weight distribution between fetuses with Down syndrome and control fetuses was found. In contrast, as compared with the control fetuses, fetuses with trisomy 18 had a significant lower weight distribution. The mean value of MSAFP was 0.72 +/- 0.26 MoM for those with Down syndrome and 0.51 +/- 0.33 MoM for fetuses with trisomy 18; both results being significantly lower than that of normal control (1.01 +/- 0.28). The mean value of amniotic fluid AFP was 0.63 +/- 0.23 MoM for fetuses with Down syndrome. This value was significantly lower than those of the fetuses with trisomy 18 and normal controls (1.02 +/- 0.09 and 1.02 +/- 0.30). A linear relationship between MSAFP and fetal weight was found in normal fetuses at a given gestational age but was not found in trisomy pregnancy. Fetal weight cannot be used to explain the reason for low MSAFP in Down syndrome pregnancy but may partially account for the lower levels noted in fetuses with trisomy 18.
Body Weight↗
Meconium peritonitis-antenatal diagnosis by ultrasound.
Meconium peritonitis is usually the result of prenatal bowel obstruction with subsequent perforation, then the contents spread into the peritoneal cavity, which results in a sterile inflammatory reaction. The incidence ranges from 1/1500 to 1/2000, if without prenatal diagnosis and planned postnatal treatment, the mortality rate is as high as 62%. We describe three children, two with surgically, one with autoptically confirmed meconium peritonitis. All had abnormally prenatal ultrasonographic examinations. The first fetus showed a large 10 x 11 cm intra-abdominal mass with floating echogenic substances inside and with an echogenic rim. The second showed increased echogenicity with dilated bowel in abdominal cavity in one of the twin, and the third had an intra-abdominal cyst with several echogenic bands inside, fetal ascites was also noted. It is remarkable that the ultrasonographic findings were different in the three children. Two of the three children survived postoperation, one died 3 hours later after induction out at 31 weeks of gestational age due to multiple congenital anomalies.
Adult↗
Absence of leukaemia clustering on Greek islands.
Explore the source record for details and available documents.
Adolescent↗
Epidemiologic assessment of interactions of hepatitis-C virus with seromarkers of hepatitis-B and -D viruses, cirrhosis and tobacco smoking in hepatocellular carcinoma.
A recently introduced enzyme immunoassay procedure for antibodies against the hepatitis-C virus (HCV) was used to test samples from 185 cases with hepatocellular carcinoma (HCC) and 432 hospital controls. The anti-HCV results were examined in conjunction with previously reported data from this study concerning hepatitis-B virus (HBV) serology, hepatitis-D virus (HDV) antibodies, presence of cirrhosis and tobacco smoking. There was evidence for interaction between HBV and HCV in the causation of HCC: as previously reported, the rate ratio (RR) linking the presence of anti-HCV to HCC among subjects positive for hepatitis-B surface antigen (HBsAg) was substantially higher than the corresponding RR among those negative for this marker; furthermore, among HCC patients positive for HBsAg, a high proportion (33/61) of those who were positive for hepatitis-Be antigen (HBeAg) or its antibody were positive for anti-HCV, whereas among HBsAg-positive controls who were also positive for HBeAg or its antibody, none was positive for anti-HCV (0/18; p less than 10(-4)). The anti-HCV-related RR for HCC was also higher among HCC patients with cirrhosis than among those without evidence of co-existing cirrhosis (RR 11.4 vs. 4.4; p = 0.06). In addition, there was some evidence of interaction between tobacco smoking and HCV in the origin of HCC; after controlling for age, sex and HBsAg status, the RR for subjects positive for anti-HCV was 6.8 among smokers but only 3.2 among non-smokers (p = 0.26). By contrast, there was no suggestion of an interaction between anti-HCV and anti-HDV, in agreement with the presumed minimal role, if any, of HDV in HCC etiology. These results support the notion that HCV is involved in the etiology of HCC by advancing, through a chronic liver disease process, carcinogenesis initiated by other factors.
Aged↗
Horizontal transmission of hepatitis B virus from siblings and intramuscular injection among preschool children in a familial cohort.
The authors followed 147 children from 113 families who were susceptible to hepatitis B virus infection for a total of 275 person-years. Among these children, 19 became infected with the hepatitis B virus and thus became new subclinical cases. In this cohort study, parents played a minor role in hepatitis B virus horizontal transmission. On the other hand, the estimated incidence rate ratio of hepatitis B virus infection for siblings of a hepatitis B e antigen (HBeAg) carrier was 2.8 (95% confidence interval 1.1-7.4) when compared with those children without a HBeAg sibling carrier as analyzed by multiple logistic regression. The adjusted incidence rate ratio among siblings increased with increased number of HBeAg carriers. In addition, intramuscular injections played an important role in hepatitis B virus transmission in children. It was found that 61.8% (170/275 person-years) of the children had received intramuscular injections. Most of the injections were administered at private clinics over a 2-year period. Hepatitis B virus infection showed a correlation with injection (adjusted incidence rate ratio = 3.3, 95% confidence interval 1.1-9.5) and with frequency of injections. The authors concluded that HBeAg was a valuable marker for infectivity in hepatitis B virus horizontal transmission. Furthermore, the authors found that hepatitis B virus infection is independently transmitted from sibling to sibling, and by iatrogenic injections because improperly sterilized syringes were shared in areas where hepatitis B is prevalent and intramuscular injection is common.
Adult↗
Hepatitis B and C viruses and their interaction in the origin of hepatocellular carcinoma.
Serum taken from patients in a case-control study in Athens, Greece, was used to examine the interactive roles of hepatitis B virus (HBV) and hepatitis C virus (HCV) in the origin of hepatocellular carcinoma (HCC). An enzyme immunoassay for anti-HCV was used to test serum taken from 185 cases with HCC, 35 cases with metastatic liver cancer (MLC), and 432 hospital controls. Weakly positive anti-HCV results were more strongly related to MLC than to HCC, implying that these anti-HCV results are false positive. By contrast, strongly positive anti-HCV results were significantly related to HCC (relative risk [RR], 6.3), whereas no significant association was evident for MLC (RR, 0.6). The association of anti-HCV with HCC was substantially higher among subjects whose radioimmunoassay was positive for hepatitis B surface antigen (RR, 20.0) than among those whose radioimmunoassay was negative for this marker (RR, 4.8). These findings indicate that HCV infection has an interactive role in the origin of HCC.
Aged↗
The effect of non-differential outcome misclassification on estimates of the attributable and prevented fraction.
This paper considers the effect of non-differential outcome misclassification on the population attributable fraction and the population prevented fraction. I examine the bias in the attributable and the prevented fraction derived from a risk ratio estimate as a function of the sensitivity and specificity of the outcome classification, the true risk ratio, the prevalence of the exposure, and the baseline disease frequency. With outcome misclassified, disease frequency is an important determinant of the magnitude of the bias; the rarer the disease, the more severe is the bias. For both the attributable and the prevented fraction, the specificity of the outcome classification has a greater influence on the magnitude of the bias than the sensitivity; this is in contrast to the dominant effect of sensitivity in situations of exposure misclassification. Also, unlike the findings in the exposure misclassification, the bias due to outcome misclassification does not increase monotonically with increased prevalence of exposure. For the attributable and prevented fraction derived from an odds ratio estimate, the specificity of the outcome classification does not have a greater influence on bias than the sensitivity, and a perfect specificity alone does not lead to unbiased effect estimates if the sensitivity of the outcome classification is imperfect.
Bias↗
Birth order and breast cancer risk.
It has been hypothesized that prenatal exposure to maternal estrogens may be a risk factor for breast cancer in the offspring. In two recent studies, maternal estradiol levels in the first pregnancy have been compared to those in the second, and in both studies levels were higher in the first pregnancy. If both the hypothesis and the reported findings were true, women born as their mother's second child would be expected to have lower risk for breast cancer than first-born women. Data from 1,468 cases of breast cancer and 4,175 hospital controls from three previously published studies were modelled through multiple logistic regression to evaluate this possibility. The size of the woman's sibship was not related to breast cancer risk. On the other hand, second-born women had, as predicted, lower breast cancer risk than first-born women, although the difference was nominally significant only among premenopausal women. The relative risk for breast cancer, contrasting second-born to first-born women, and the corresponding 95 per cent confidence intervals, were 0.71 (0.54-0.94) among premenopausal women, 0.94 (0.76-1.17) among postmenopausal women, and 0.86 (0.73-1.02) among all women, controlling for menopausal status.
Birth Order↗