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Biomedical subjects

J D Buckley

Publications and source records attributed to J D Buckley.

89 records · Page 5Linked to original sources

Case-control study of the husbands of women with dysplasia or carcinoma of the cervix uteri.

The husbands of married women with cervical dysplasia, carcinoma-in-situ, or invasive carcinoma of the cervix who, in an earlier study, had claimed to have had no sexual partner other than their husband, were interviewed to determine whether the risk of cervical epithelial abnormalities in the women could be related to their husband's sexual background. Of 322 women previously studied, 57 were eligible for this study and the husbands of 31 of them were interviewed together with the husbands of a control group, matched for age and age at first intercourse. The number of sexual partners reported by the husband was found to be a significant risk factor, with a relative risk of 7.8 for 15 or more partners outside marriage. The relative risk for women who smoked was 7.0, and this was independent of any of the sexual risk factors. The findings for subgroups of women with invasive carcinoma and with dysplasia or carcinoma-in-situ were similar. The data strongly support the view that an infectious agent is involved in the aetiology of cancer of the cervix and suggest that smoking may have an independent carcinogenic action.

Adult↗

Can dietary beta-carotene materially reduce human cancer rates?

Human cancer risks are inversely correlated with (a) blood retinol and (b) dietary beta-carotene. Although retinol in the blood might well be truly protective, this would be of little immediate value without discovery of the important external determinants of blood retinol which (in developed countries) do not include dietary retinol or beta-carotene. If dietary beta-carotene is truly protective--which could be tested by controlled trials--there are a number of theoretical mechanisms whereby it might act, some of which do not directly involve its 'provitamin A' activity.

Africa, Eastern↗

Occurrence of tumors and effects on longevity after limited x-irradiation in man.

An analysis was made of survival times and causes of death of patients given local irradiation in small dosage during 1948--1960. The study involved 61 patients with peptic ulcers in whom hyperacidity was treated by partial gastrectomy and gastric irradiation, and their mortality was compared with that of 61 age- and sex-matched gastrectomized but nonirradiated control patients. For both groups the survival rates were related to "normal population" survival rates calculated from age-, sex- and year-specific mortality rates for the population of Victoria. Ten years after irradiation the relative survival rates of the irradiated and control groups began to diverge, due to more deaths than expected in the irradiated group. The irradiated group had a significantly increased number of deaths due to cancer, particularly carcinoma of the stomach, as well as an increase in deaths not caused by cancer. The mortality of the nonirradiated control patients was not significantly greater than that of the normal population.

Adult↗

Pretreatment with acetylaminofluorene enhances the repair of O6-methylguanine in DNA.

Epidemiological and experimental evidence suggests that the interplay of environmental factors may be particularly relevant to the induction of cancer in man. We have investigated the possible interrelationships, at the level of DNA repair, of two chemically different hepatocarcinogens administered to rats. Animals were pretreated for several weeks by inclusion of 2-acetylaminofluorene (AAF) in the diet and a study was made of the capacity of liver to repair lesions subsequently introduced into DNA by a pulse of dimethylnitrosamine (DMN). Of particular interest was the repair of adducts at the O6 position of guanine as this product has been implicated as a critical reaction site for carcinogenesis by the monofunctional alkylating agents. We show here that the capacity of liver to repair O6-methylguanine in DNA is enhanced by prolonged exposure of rats to the chemically unrelated agent, AAF.

2-Acetylaminofluorene↗

Pregnancy in chronic active hepatitis.

The outcome of pregnancy in chronic active hepatitis (CAH) was studied retrospectively, together with a survival analysis of patients and a comparison of fertility with that expected from controls drawn from the normal Australian population. Clinical records of 73 cases of CAH included 37 women who were potentially fertile (aged 15-45 years) and there were 30 pregnancies among 16 of these women. Hepatic and obstetric complications and the outcome for the foetus and the mother were compared with the results from 36 reports accumulated from the literature. The results showed an incremental increase in survival of patients with CAH according to decade of diagnosis from 1950 and similar severity of liver disease in those who did, or did not, become pregnant. Fertility was reduced in patients with CAH. Relapse of CAH occurred during pregnancy in only two patients, hepatic complications were minimal, and there was no consistent pattern of alteration in liver function; 12 of 16 mothers are alive for a mean period of eight years after pregnancy. Obstetric complications included urinary tract infections (six), toxaemia of pregnancy (nine) and prematurity (seven); of the 30 pregnancies, four were terminated on medical advice in the early years of the study, three ended in spontaneous abortion, and there were four perinatal deaths giving a foetal loss rate of 33 per cent. Despite the maternal disease and use of prednisolone and azathioprine during pregnancy, the single congenital abnormality was pyloric stenosis. We conclude that in CAH fertility is reduced but pregnancies which occur can proceed without detriment to the mother provided that prednisolone treatment is maintained; that a higher than normal foetal loss can be expected; and that babies may be born prematurely but will be normal.

Abortion, Spontaneous↗

Social factors and clinical disease: a checklist data base for correlative analysis.

The adequate care of a patient entails consideration of his social and psychological problems in addition to the relevant medical data. To facilitate this integrated approach, a Social Work Indices Checklist (SWIC) is described, and its use in practice is illustrated. A narrative report is generated from a possible 3095 items of information recorded in SWIC.

Attitude↗

A 'profile' of immune responsiveness in multiple sclerosis.

An 'immunological profile' of various indices of B-cell function and T-cell function was developed for the 'early' case of multiple sclerosis (MS). This was compared against two groups of controls comprising age and sex-matched healthy subjects, and patients with other disabling neurological diseases (CNS controls) who were matched for age, sex, and type and duration of disability. Some indices of humoral immune responsiveness, such as the induced primary response to monomeric flagellin and the 'resting' levels of antibody to measles and rubella viruses, showed significant augmentation. Cellular immune deficits were attributed to an illness effect per se because (a) cell-mediated immunity was depressed, but only when compared with that of healthy subjects and not when compared with that of the CNS controls, and (b) transformation responses of lymphocytes to viral antigens were inversely related to disability status. The abnormalities in humoral immune responses demonstrable in this study do not provide an explanation for this disease; if there is a relevant 'immunological fault', the nature of this needs to be sought from within the neuraxis rather than from the systemic circulation.

Adult↗

Factors influencing the secondary antibody response to flagellin in man.

The secondary antibody response to 5.0 microgram flagellin was studied by haemagglutination in 132 healthy or convalescent subjects given a primary challenge with 5.0 microgram flagellin from 1 to 44 months previously. The peak titre, expressed as total antibody, occurred at 2 weeks and was mainly immunoglobulin (Ig)G. The magnitude of the titre of total antibody was influenced predominantly by that of total antibody in the primary response (P less than 0.001), the interval between primary and secondary responses (P less than 0.005) and the subjects' age (P less than 0.05) and sex (P less than 0.08). Together these accounted for 23% of the variability observed in the secondary response, with total antibody titre in the primary response accounting for 11% of the variability. The titre of IgG antibody was likewise influenced by these four variables, but the influence of age or sex on IgG antibody was not statistically significant. In human vaccination programmes, choice of the appropriate interval between primary and booster inoculations could increase prophylactic effectiveness and, if two inoculations were to prove as effective as three, there would be reduced work and increased public acceptance. Moreover, the demonstrable capacity for responsiveness of aged and debilitated persons should encourage the wider use of appropriate prophylactic immunization in these groups.

Adolescent↗

Use of a computer-based postal questionnaire for the detection of hypothyroidism following radioiodine therapy for thyrotoxicosis.

A computer-processed postal questionnaire was devised to detect hypothyroidism in patients treated previously for thyrotoxicosis with radioiodine. In a study of 232 patients treated with 131I at the Royal Melbourne Hospital between four and ten years previously, the sum of symptomatic answers in the questionnaire was a sensitive discriminator of hypothyroidism, and allowed 80% of euthyroid patients to be excluded from further assessment. Questions concerned with general well-being and energy, voice and skin changes, showed the highest sensitivity and specificity. The combination of these questions alone was an effective means of identifying hypothyroidism, with a sensitivity and specificity comparable to the more sophisticated technique of discriminant function analysis. Hypothyroidism had an incidence of between 20% and 35% six to eight years after 131I therapy and was related to a smaller initial goitre size for a given dose of 131I. This postal questionnaire, in conjunction with a computer-based automatic recall system, promises to be an efficient and reliable screening tool for the detection of hypothyroidism in the increasing number of patients "at risk" following 131I therapy.

Australia↗

Thyrogastric autoimmune disease. Studies on the cell-mediated immune system and histocompatibility antigens.

Cell-mediated immune responses were studied in autoimmune diseases of thyrogastric type, Hashimoto's thyroiditis and autoimmune pernicious anaemia-type gastritis. Specific cell-mediated immunity was investigated by the leucocyte migration inhibition procedure, and general cell-mediated immunity (T-cell performance) was studied by standard in vivo and in vitro tests. In thyrogastric autoimmune diseases inhibition of migration of leucocytes was induced by thyroglobulin and gastric parietal cell microsomes; under conditions of presumably low cellular sensitization, stimulation of migration was observed. There was no depression of general cell-mediated immunity, in contrast to what occurs in systemic lupus erythematosus and related autoimmune diseases. A weak association of autoimmune gastritis with HL-A3 and HL-A7 (P LESS THAN 0.05) lost significance when an appropriate correction was applied; this weakness with HL-A clearly does not explain the strong genetic component in thyroid and gastric autoimmunity.

Anemia, Pernicious↗

Risk factors for astrocytic glioma and primitive neuroectodermal tumor of the brain in young children: a report from the Children's Cancer Group.

We conducted a matched case-control study to investigate risk factors for the two most common types of brain tumors in children, astrocytic glioma and primitive neuroectodermal tumor (PNET). Since the study focused on gestational exposures, we restricted it to young children because these exposures would be expected to act early in life. Parents of 155 astrocytic glioma cases, 166 PNET cases, and controls identified by random digit dialing completed telephone interviews. Few associations occurred with the hypothesized risk factors, which were gestational exposure to alcohol, hair coloring products, farms, and substances containing N-nitroso compounds (passive smoking, makeup, incense, new cars, pacifiers, baby bottles, beer). Of the products studied that contain N-nitroso compounds, only beer was associated with a significantly increased risk of either tumor type [odds ratio (OR) for PNET = 4.0; 95% confidence interval (CI), 1.1-22.1; P = 0.04]. Elevated ORs for PNET were observed for farm residence of the mother during the pregnancy (OR = 3.7; 95% CI, 0.8-23.9; P = 0.06) and of the child for at least a year (OR = 5.0; 95% CI, 1.1-46.8; P = 0.04). Significant associations with astrocytoma were observed for mother's use of kerosene (OR = 8.9; 95% CI, 1.1-71.1; P = 0.04) and birth by Caesarean section (OR = 1.8; 95% CI, 1.1-3.2; P = 0.03). History of miscarriage was associated with a lower risk of PNET (OR = 0.5; 95% CI, 0.3-0.9; P = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗

Cigarette smoking and alcohol consumption by parents of children with acute myeloid leukemia: an analysis within morphological subgroups--a report from the Childrens Cancer Group.

Data from a case-control study of childhood acute myeloid leukemia (AML) including 187 matched case-control pairs were examined for evidence of associations between parental cigarette smoking and alcohol consumption and the subsequent development of childhood AML. The cases were stratified by French-American-British morphology in order to evaluate potential differences in risk based on this classification system. There was little evidence of any association between cigarette smoking by parents during the index pregnancy and childhood AML. There was some evidence of an increased risk of AML among children who were diagnosed at or before 2 years of age and whose mothers reported consuming alcohol during their pregnancies (odds ratio, 3.00; 95% confidence interval, 1.23 to 8.35). This finding appeared to be especially pronounced for AML with a monocytic component (M4/M5) (odds ratio, 9.00; 95% confidence interval, 1.25 to 394.5), but a cautious interpretation of these data are advised because of the small number of subjects included in this subgroup analysis. Since this is one of the first case-control studies to evaluate specific French-American-British subtypes of AML, these results may be viewed as generating hypotheses. It is suggested that future studies of childhood AML include: (a) a sufficient number of cases to permit an evaluation of the morphological classification of the cases; and (b) additional questions on the alcohol consumption of the mother during the time of her pregnancy with the index child.

Acute Disease↗