PubMed Health⌕ Search

Biomedical subjects

G N Stemmermann

Publications and source records attributed to G N Stemmermann.

At least 37 records · Page 2Linked to original sources
PubMed1995

Infection with Helicobacter pylori strains possessing cagA is associated with an increased risk of developing adenocarcinoma of the stomach.

To determine whether infection with a Helicobacter pylori strain possessing cagA is associated with an increased risk of development of adenocarcinoma of the stomach, we used a nested case-control study based on a cohort of 5443 Japanese-American men in Oahu, Hawaii, who had a physical examination and a phlebotomy during 1967 to 1970. We matched 103 H. pylori-infected men who developed gastric cancer during a 21-year surveillence period with 103 H. pylori-infected men who did not develop gastric cancer and tested stored serum specimens from patients and controls for the presence of serum IgG to the cagA product of H. pylori using an ELISA. The serum IgG assay using a recombinant CagA fragment had a sensitivity of 94.4% and a specificity of 92.5% when used in a clinically defined population; serological results were stable for more than 7 years. For men with antibodies to CagA, the odds ratio of developing gastric cancer was 1.9 (95% confidence interval, 0.9-4.0); for intestinal type cancer of the distal stomach, the odds ratio was 2.3 (95% confidence interval, 1.0-5.2). Age < 72 years and advanced tumor stage at diagnosis were significantly associated with CagA seropositivity. We conclude that infection with a cagA-positive H. pylori strain in comparison with a cagA-negative strain somewhat increases the risk for development of gastric cancer, especially intestinal type affecting the distal stomach.

Adenocarcinoma↗
PubMed1995

Diet, alcohol, smoking and cancer of the upper aerodigestive tract: a prospective study among Hawaii Japanese men.

A cohort study of upper aerodigestive tract cancer was conducted among 7,995 Japanese-American men who were interviewed and examined from 1965 to 1968. Information was collected about smoking history and alcohol and dietary intake. After 24 years, 92 incident cases with histological confirmation of diagnosis were identified. Current cigarette smokers at time of examination had a 3-fold risk for upper aerodigestive tract cancer compared with never-smokers. A dose-response relationship was present with increasing amount and duration of cigarette use. Consumption of beer, wine, spirits and total alcohol was strongly associated with increased risk. Of 23 food and beverage categories, only candy/jelly/soda pop consumption had a statistically significant inverse trend. Frequent consumption of fruit was also inversely associated with this cancer. In contrast, the risk tended to be positively associated with consumption of rice, seaweed, tofu or tsukudani (a mixed dish of fish, sugar, soy sauce and seaweed), but the dose-response relationship was not statistically significant. For nutrient intake, increased calcium and fat intake decreased the risk for this cancer.

Aged↗
PubMed1995

Gastric cancer among the Japanese in Hawaii.

The incidence rate of gastric cancer among men of Japanese ancestry living in Hawaii is about one-third as high as that of their counterparts living in Japan. Because of this difference, a prospective study was conducted to identify factors related to the development of gastric cancer in Hawaii. Eight thousand and six (8,006) men born from 1900-1919 were examined from 1965 to 1968 and followed for over 25 years. During this time, 250 incident cases of gastric cancer were identified. The study has found the following: 1) prior infection with Helicobacter pylori bacteria increased the risk for stomach cancer; 2) cigarette smoking was positively associated with gastric cancer with age at which smoking started being an important risk factor; 3) after taking cigarette smoking into account, alcohol intake was not related to stomach cancer risk; 4) a low pepsinogen I level identified subjects at increased risk for the intestinal histologic type of gastric cancer; 5) a low serum ferritin level was a marker for increased risk of stomach cancer; 6) there was a weak indication that the intake of vegetables and fruits was inversely related to gastric cancer; 7) there was no association of stomach cancer with levels of serum cholesterol, serum uric acid, serum micronutrients (retinol, beta-carotene or alpha-tocopherol) or blood hematocrit; 8) there was also no association of gastric cancer with body mass index or physical activity.

Age Factors↗
PubMed1994

Intestinal metaplasia of the stomach. A status report.

Intestinal metaplasia in the stomach increases the risk of gastric cancer, and the increased risk is proportional to the extent of the metaplasia. This risk could be generated by one or more mechanisms: (1) the metaplastic tissue is an early step in a multistep induction process; (2) the metaplastic tissue is an epigenetic change that raises the pH of gastric juice by replacing oxyntic mucosa, favoring the growth of a bacteria capable of generating endogenous mutagens; and/or (3) the metaplasia is only a marker for chronic gastritis due to H. pylori infection or pernicious anemia. With the last mechanism, the inflammatory response favors intramural mutagenesis that might result in metaplasia or neoplasia as independent events. Finding gene rearrangements common to both metaplastic and neoplastic tissue may establish a direct link between them, but too few have been identified to account for the large number of stomach cancers that develop in high risk populations. Histochemical and immunochemical stains that identify enzymes or mucosubstances may suggest that metaplastic epithelial cells resemble small or large intestinal cells, but they are distinctly different from both. Moreover, these stains do not indicate whether a given cytologic change is genetic or epigenetic; therefore, they cannot be used to define the relationship between metaplasia and neoplasia. It is unnecessary for practicing physicians to await resolution of this question. It can be assumed that any person with extensive metaplasia is at high risk for gastric cancer and should be subject to periodic screening. The extent of the metaplastic process is probably more important than the metaplastic subtype.

Animals↗
PubMed1994

International comparison on ras gene mutations in latent prostate carcinoma.

Latent carcinomas of the prostate, discovered at autopsy in men with no prior treatment for prostatic disease, were studied for ras proto-oncogene mutations. Subjects included 21 Japanese, 15 U.S. whites, 15 U.S. blacks, 20 Hawaiian Japanese and 10 Colombians. PCR and sequence-specific oligonucleotide hybridization identified mutations in 5 Japanese, in 1 Hawaiian Japanese, in 1 U.S. black, in 1 U.S. white and in 3 Colombians. The 5 Japanese tumor samples contained 3 point mutations in codon 12 of K-ras and 2 mutations in codon 12 of N-ras respectively. One tumor in a Hawaiian Japanese man also showed a K-ras point mutation at codon 12. Two Colombians and one U.S. black man had tumors with mutations at codon 61 of H-ras, while 1 Colombian showed an N-ras mutation at this codon. The overall frequency of ras gene mutations was low, but point mutations in codon 12 were most common in latent tumors of Japanese, who experienced the lowest incidence and mortality from this tumor. Latent tumors in men from ethnic groups with high mortality and incidence rates showed fewer ras mutations than the Japanese, and these were more likely to involve codon 61. This finding is consistent with prior studies of more aggressive clinical cancers in Japanese men that indicated a higher frequency of mutations at codon 61.

Aged↗
PubMed1994

Helicobacter pylori infection and the risk for duodenal and gastric ulceration.

OBJECTIVE: To determine whether a preexisting Helicobacter pylori infection increases the risk for developing duodenal or gastric ulcer. DESIGN: A nested case-control study based on a cohort of 5443 Japanese-American men who had a physical examination and a phlebotomy from 1967 to 1970. SETTING: All 10 general hospitals on the Hawaiian island of Oahu. PATIENTS: 150 patients with gastric ulcer and 65 patients with duodenal ulcer identified in the cohort of study participants after a hospital surveillance period of more than 20 years. MEASUREMENTS: Stored serum specimens from patients and from matched controls were tested for the presence of serum IgG antibody to H. pylori using enzyme-linked immunosorbent assay. RESULTS: 93% of the 150 patients with gastric ulcer and 78% of the matched controls had a positive antibody level for H. pylori-specific IgG, yielding an odds ratio of 3.2 (95% CI, 1.6 to 6.5). For duodenal ulcer, 92% of the 65 patients and 78% of the matched controls had a positive test result, yielding an odds ratio of 4.0 (CI, 1.1 to 14.2). As the level of antibody to H. pylori increased, a statistically significant increase was noted in the risk for gastric and duodenal ulcer. The association with H. pylori infection was statistically significant for both types of ulcer, even when the diagnosis was made 10 or more years after the serum sample had been obtained. CONCLUSION: Preexisting H. pylori infection increases the risk for subsequent development of either duodenal or gastric ulcer disease.

Aged↗
PubMed1994

A prospective study of weight, body mass index and other anthropometric measurements in relation to site-specific cancers.

The association of weight, body mass index and other anthropometric measurements with cancer was investigated in a cohort of 7,840 men, examined and interviewed from 1965-1968 in Hawaii. After 23 years of follow-up, histologically confirmed incident cases of prostate (n = 306), colon (n = 289), lung (n = 236), stomach (n = 229) and rectal (n = 108) cancer were identified. Body weight was positively associated with prostate cancer. This direct association was stronger for cases diagnosed 11 or more years after examination than for those diagnosed earlier. A similar pattern was also present for the risk of colon cancer in association with weight and body mass index. For lung cancer, increased subscapular and triceps skinfold thickness were each associated with decreased risk with adjustment for cigarette smoking, but the inverse association did not persist as the time interval from exam to cancer diagnosis lengthened. There was no significant association between anthropometric measurements and stomach or rectal cancer.

Aged↗
PubMed1994

Immunocytochemical identification of a relaxin-like protein in gastrointestinal epithelium and carcinoma: a preliminary report.

Immunostaining with antibodies to human relaxin (H2) suggests the presence of a relaxin-like peptide in the gastrointestinal tract and its tumours. The peptide is present in the cytoplasm of non-neoplastic cells at sites of cell exfoliation: the surface cells of the stomach, the small intestinal villi and the surface cells of the colon. It also occurs in the cytoplasm of gastric parietal cells and carcinomas of both the stomach and the colon. Relaxin has been shown to stimulate collagenase gene expression and to down-modulate collagen synthesis and secretion in human skin fibroblasts. The distribution of relaxin shown here suggests that it could play a role in the detachment of non-neoplastic cells from their basement membranes at the end of the cell cycle and in the penetration of carcinoma cells through the basement membrane.

Adenoma↗
PubMed1993

A prospective study of alcohol, diet, and other lifestyle factors in relation to obstructive uropathy.

The association of alcohol, diet, and other lifestyle factors with obstructive uropathy was investigated in a cohort of 6581 Japanese-American men, examined and interviewed from 1971 to 1975 in Hawaii. By studying this migrant population with its heterogeneous exposures, it increases the probabilities of identifying potential risk factors of this prostate disorder. After 17 years of follow-up, 846 incident cases of surgically treated obstructive uropathy were diagnosed with benign prostatic hyperplasia. Total alcohol intake was inversely associated with obstructive uropathy (P < 0.0001). The relative risk was 0.64 (95% confidence interval: 0.52-0.78) for men drinking at least 25 ounces of alcohol per month compared with nondrinkers. Among the 4 sources of alcohol, a significant inverse association was present for beer, wine, and sake, but not for spirits. Buddhist (vs. other) religion, rural (vs. urban) birthplace, and the presence of prostate symptoms were each associated with increased risk of obstructive uropathy, but no association was found with education, number of marriages, or cigarette smoking. Increased beef intake was weakly related to an increased risk (P = 0.047), while no association was found with the consumption of 32 other food items in the study.

Age Factors↗
PubMed1993

A prospective study of diet, smoking, and lower urinary tract cancer.

The association of diet and smoking with bladder cancer was investigated in a cohort study conducted in Hawaii. The study included 7995 Japanese-American men who were born between 1900 and 1919, and were examined from 1965 to 1968. After 22 years of follow-up, 96 incident cases of bladder cancer were diagnosed. Current cigarette smokers had a 2.9-fold risk of bladder cancer, compared with nonsmokers. A direct dose-response relation was observed, based on pack-years of cigarette smoking. Consumption of fruit was inversely associated with the risk of bladder cancer (P = 0.038). The relative risk was 0.6 among subjects who had the most frequent (> or = 5 times/wk) intake of fruits compared to those with the least intake (< or = 1 time/wk). A weaker inverse association with milk intake was also observed (P = 0.07). Frequent consumption of fried vegetables, pickles, or coffee increased the risk of bladder cancer, but none of these foods showed a significant dose-response relationship. There was no association of other selected foods, alcohol, total calories, protein, fat, or carbohydrates with bladder cancer risk.

Aged↗
PubMed1992

Adenocarcinoma of the proximal small intestine. A marker for familial and multicentric cancer?

BACKGROUND: Adenocarcinoma of the small intestine is uncommon. The Hawaii Tumor Registry (HTR) has identified 49 of these tumors since 1960, and the Japan-Hawaii Cancer Study (JHCS) has identified only four of these tumors among a cohort of 8006 Hawaiian-Japanese men followed up for a period of 22 years. Each of the four men reported by the JHCS had multicentric gastrointestinal cancers. METHODS: Newly diagnosed cancers are recorded separately by the HTR and JHCS, and linkage is maintained between the two files. Family histories are available from the JHCS, and these are supplemented by a state population file maintained by the Department of Genetics, University of Hawaii. RESULTS: Five men, all Japanese, were found to have carcinoma of the proximal small intestine. Each had multicentric carcinomas of the gastrointestinal tract. Carcinoma of the stomach and colon was found in the primary relatives of each of four men whose families lived in Hawaii. CONCLUSIONS: The familial clustering of uncommon neoplasms (small bowel carcinoma and multicentric large bowel carcinoma), and the concurrence of gastric and colonic carcinoma suggests that these subjects have a genetic trait that increases susceptibility to a broad range of carcinogens.

Adenocarcinoma↗
PubMed1992

Mutations of p53 gene in hepatocellular carcinoma: roles of hepatitis B virus and aflatoxin contamination in the diet.

BACKGROUND: Mutations of the p53 tumor suppressor gene have been reported in 50% of patients with hepatocellular carcinoma (HCC) from China and South Africa. These reports suggested an association of p53 mutations with high levels of aflatoxin in the diet. Most studies of p53 and HCC, however, have not fully evaluated the possible role of the hepatitis B virus (HBV). Aflatoxin is a substance produced by food mold that is known to cause HCC in experimental animals. PURPOSE: The purpose of this study was to evaluate the relationship of p53 gene mutation to high or low levels of aflatoxin in the diet and to HBV infection. METHODS: p53 protein and hepatitis B surface antigen (HBsAg) were evaluated by immunohistochemistry using the avidin-biotin-peroxidase system in paraffin-embedded specimens of HCC and of adjacent nontumorous liver tissue from 43 patients. Tissue specimens from three normal human livers were also evaluated. HCCs and adjacent nontumorous liver tissues were obtained from 23 patients from Qidong, China, where aflatoxin levels in the diet are high, and from 20 patients from two regions in the United States (patients from the National Institutes of Health, Bethesda, Md., and Kuakini Medical Center, Honolulu, Hawaii), where aflatoxin levels in the diet are low. RESULTS: Mutant p53 protein was detected in the nuclei of HCCs from 14 (61%) of 23 patients from China and from three (30%) of 10 patients and six (60%) of 10 patients, respectively, from the two regions of the United States. A statistically significant association between detection of mutant p53 protein in HCC cells and the detection of HBsAg in hepatocytes of the adjacent nontumorous liver tissue was observed in patients from China and the United States considered together. CONCLUSION: Mutations of the tumor suppressor gene p53 in hepatocellular carcinomas are not limited to patients from geographic regions where the ingestion of aflatoxin is high. In many patients, these mutations may be associated with HBV infection. IMPLICATIONS: The possible interaction of chronic HBV infection and p53 gene mutation, suggested by these data, indicates a mechanism by which HBV infection beginning early in life could contribute to the subsequent development of HCC.

Adult↗
PubMed1992

A prospective study of gastric and duodenal ulcer and its relation to smoking, alcohol, and diet.

The effects of environmental exposures on the development of gastric and duodenal ulcers were investigated in a prospective study of 7,624 American men of Japanese ancestry in Hawaii. After 149,291 person-years of observation, there were 280 incident cases of gastric ulcer and 149 incident cases of duodenal ulcer. The risk of both gastric and duodenal ulcers progressively increased with increasing pack-years of cigarette smoking. In contrast, alcohol intake was not associated with either type of ulcer. The risk of gastric ulcer was positively associated with the use of table salt/soy sauce, but there was no association with the consumption of other oriental foods. The risk of duodenal ulcer was inversely associated with western style diet around 1940 and with bread intake of two or more servings per day. The authors did not find any protective or adverse effect of milk and fruit consumption on peptic ulcer risk.

Age Factors↗
PubMed1992

Prospective study of the association of alcohol with cancer of the upper aerodigestive tract and other sites.

The association of alcohol consumption with cancers of the upper aerodigestive tract, hepato-biliary-pancreatic system, urogenital organs (except for prostate), and lymphohematopoietic tissue was evaluated in a prospective study of 6,701 American men of Japanese ancestry living in Hawaii. Compared with cancer-free subjects, subjects who subsequently developed cancers of the upper aerodigestive tract (oral-pharynx, esophagus, and larynx), liver, biliary tract, and lymphohematopoietic tissue consumed significantly larger amounts of total alcohol--mainly in the form of beer. Subjects who developed oral-pharyngeal and esophageal cancer also consumed larger amounts of wine and spirits. Because the upper aerodigestive tract cancers were associated positively with cigarette smoking, age-adjusted relative risks (RR) were calculated, based on joint exposure to cigarette smoking and heavy alcohol intake (greater than or equal to 30 ml/day) in this population. A markedly increased risk was observed among subjects who were both heavy alcohol drinkers and smokers (RR = 17.3, 95 percent confidence interval [CI] = 6.7-44.2), compared with subjects who who did not smoke and did not drink heavily. The risk for these cancers also was increased among heavy alcohol drinkers who were nonsmokers (RR = 8.6, CI = 2.1-36.0).

Aged↗
PubMed1992

Prospective study of clinical gallbladder disease and its association with obesity, physical activity, and other factors.

The association of anthropometric measurements, serum tests, and life-style factors with the risk of clinical gallbladder disease was investigated in a prospective study of 7831 American men of Japanese ancestry in Hawaii. After 152,831 person-years of observation, 471 incident cases of gallbladder disease were diagnosed by histology or radiology. There was an increase in risk of gallbladder disease with a progressive increase in body mass index, height, pack-years of cigarette smoking, and diastolic blood pressure. There was a decrease in risk with an increase in physical activity, after controlling for the effect of other variables. There was also an inverse association with total caloric intake that could be related to dietary restriction in obese subjects or to the limitations of the 24-hr diet history. Serum cholesterol levels and the intake of total fat were not related to clinical gallbladder disease in this cohort.

Age Factors↗
PubMed1992

Prospective study of serum cholesterol and site-specific cancers.

From 1965 to 1968, 7716 Japanese-American men were examined and tested for serum cholesterol. After 22 years, 1380 incident cancer cases were identified. Of the site-specific cancers, only colon cancer cases had a significantly lower mean serum cholesterol value than that of noncases (213.0 mg/dl vs 219.0 mg/dl). When the study subjects were separated into either a low, middle or high group, based on their serum cholesterol values, there was a significant inverse trend for cases of oral/pharyngeal/esophageal cancer combined. The association was present for cases diagnosed within 10 years of examination (p = 0.012), but not for cases diagnosed after 10 years. This suggests that the inverse association is due to the metabolic effects of undiagnosed oral/pharyngeal/esophageal cancer upon serum cholesterol levels. These results are discussed in relation to other studies on serum cholesterol.

Aged↗
PubMed1992

Determinants of sex hormone levels in men as useful indices in hormone-related disorders.

Because the determinants of serum sex hormone levels in men have been infrequently studied, we investigated the relation of several personal characteristics to serum levels of testosterone (T), dihydrotestosterone (DHT), estrone (E1), estradiol (E2) and sex hormone-binding globulin (SHBG) among 98 Japanese American men in Hawaii, aged 52-74. The SHBG levels and T/(E1 + E2) ratios decreased progressively with increasing body mass index. The SHBG levels were also inversely associated with hematocrit levels. Serum androgen and estrogen levels did not correlate with smoking, alcohol intake, serum cholesterol, serum uric acid and blood pressure. Some of the associations observed in the present study may be implicated in the etiology of hormone-related neoplasms in men.

Aged↗