PubMed Health⌕ Search

Biomedical subjects

K R Cooke

Publications and source records attributed to K R Cooke.

At least 37 records · Page 2Linked to original sources
PubMed1996

An experimental model of idiopathic pneumonia syndrome after bone marrow transplantation: I. The roles of minor H antigens and endotoxin.

Idiopathic pneumonia syndrome (IPS) refers to diffuse, non-infectious pneumonia that occurs after allogeneic bone marrow transplantation (BMT). We have developed a model of IPS using a well-characterized murine BMT system (B10.BR-->CBA) in which lung injury after BMT can be induced by minor histocompatibility (H) antigenic differences between donor and host. Lung pathology and broncho-alveolar lavage (BAL) fluid were analyzed in transplant recipients before and after both syngeneic and allogeneic BMT. At 2 weeks after BMT, no specific pathologic abnormalities were noted; at 6 weeks, both pneumonitis and mononuclear cell infiltration around vessels and bronchioles were observed only in mice receiving allogeneic BMT. This injury was associated with elevated BAL fluid levels of endotoxin (lipopolysaccharide [LPS]), neutrophils, and tumor necrosis factor alpha. No pathologic organisms were isolated from the respiratory tract of any animal. We also tested the role of endotoxin in the development of this injury. Injection of LPS 6 weeks after transplantation caused profound lung injury only in mice with moderate graft-versus-host disease; dramatic increases in BAL neutrophils and tumor necrosis factor alpha were observed, with alveolar hemorrhage occurring in 4 of 12 of these mice but in no other group. We conclude that (1) this murine BMT system is a potentially useful model of clinical IPS; (2) minor H differences between donor and recipient can be important stimuli in the pathogenesis of IPS; and (3) endotoxin in BAL fluid is associated with lung injury, and excess endotoxin can cause the development of alveolar hemorrhage in this model.

Animals↗
PubMed1996

The immunopathophysiology of acute graft-versus-host-disease.

The major complication after allogeneic bone marrow transplantation (BMT) is the development of graft-versus-host-disease (GVHD). This disease is initiated during the conditioning of the recipient, when host tissues are damaged. During the afferent phase of the disease, alloreactive donor T cells recognize foreign major and minor histocompatibility antigens of host tissues. The efferent phase includes activation of inflammatory effector cells as well as the secretion of cytopathic molecules which induce pathology in skin, gastrointestinal tract, liver, lung, and the immune system. Substantial experimental and clinical evidence now indicates a central role of cytokines in the immunopathophysiology of acute GVHD, which forms the basis of this review. The balance between cytokines released by T helper 1 (Th1) cells (interleukin 2, interferon-gamma) or by T helper 2 (Th2) cells (interleukin 4, interleukin 10) after allogeneic BMT is hypothesized to govern the extent of the systemic inflammatory response. Because Th2 cytokines can inhibit the production of proinflammatory cytokines such as interleukin 1 and tumor necrosis factor-alpha, a Th1-->Th2 shift in the initial response of donor T cells may interrupt the cytokine cascade and thus offer a new approach to the prevention and treatment of acute GVHD. Successful interventions to modify the response of donor T cells may obviate the need for T cell depletion and thereby avoid the increased risk of relapse of malignancy and impairment of donor cell engraftment.

Acute Disease↗
PubMed1996

Radiologic-pathologic conference of Children's Hospital Boston: new pulmonary nodules in a child undergoing treatment for a solid malignancy.

The appearance of pulmonary nodules in a child with a solid malignancy undergoing chemotherapy is a clinically worrisome event. The diagnosis in such cases is not always metastatic disease, and the differential diagnosis should include granulomatous disease, atelectasis, pneumonia, inflammatory pseudotumor, hamartoma, radiation pneumonitis, and bronchiolitis obliterans with organizing pneumonia. There is no consistent radiologic feature to help distinguish benign from malignant causes of these new lesions. However, repeat chest CT 4-6 weeks after the lesions are first noted can be used to track lesion progression and may obviate the need for biopsy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

The New Zealand Rugby Injury and Performance Project: alcohol use patterns within a cohort of rugby players.

Although heavy drinking has traditionally been associated with rugby, the drinking patterns of New Zealand rugby players have not been examined. Three hundred and forty-eight rugby players (257 males and 91 females), completed the Alcohol Use Disorders Identification Test (AUDIT) at the beginning of the 1993 rugby season. The mean AUDIT scores were 11.2 (SD = 5.1) for the males and 8.7 (4.1) for the females: a cut-off of 8.0 has been recommended by the developers of the instrument for identifying alcohol use disorders. The consumption of large quantities of alcohol, and a high frequency of heavy drinking sessions were the norm for this group. Sixty-one per cent of males and 38% of females consumed six or more drinks in a session at least weekly: typically, men drank 10 or more drinks in a session and women 5-6 drinks. The patterns of drinking exhibited by the cohort give cause for concern regarding the health risks associated with such behaviour.

Adolescent↗
PubMed1996

Male cancer incidence by occupation: New Zealand, 1972-1984.

BACKGROUND: This study was carried out to identify male occupational groups with increased incidence of cancer for the period 1972-1984 in New Zealand. No data on cancer incidence by occupation have been reported previously for New Zealand. METHODS: Age (SIR1) and age and socioeconomic level (SIR2) standardized incidence ratios were calculated for males 15-64 years for all cancers combined and for site-specific cancers by occupational group. Directly age standardized rates were also calculated by socioeconomic level. RESULTS: In general, occupations in higher socioeconomic levels had lower all-cancer incidence ratios and lower socioeconomic levels had higher ratios. However, the highest socioeconomic level (level 1) had a higher all-cancer incidence rate than levels 2-6. After socioeconomic adjustment in increased incidence ratio for lung cancer was found for jewellery and precious metal workers (SIR2 = 241; 95% confidence interval [CI]: 116-146), and bricklayers and carpenters (SIR2 = 130; 95% CI: 120-433), Woodworkers had increased ratios for stomach (SIR2 = 144; 95% CI: 110-186) and rectal cancer (SIR2 = 146; 95% CI: 116-181). Firefighters had an increase for laryngeal cancer (SIR2 = 1074; 95% CI: 279-2776). CONCLUSIONS: Research appears to be warranted to further investigate associations of laryngeal cancer in firefighters, lung cancer in jewellery and precious metal workers and bricklayers and carpenters, and digestive cancers in woodworkers.

Adolescent↗
PubMed1996

Melanoma mortality in middle-aged and older men, and older women in New Zealand.

An analysis was performed of factors that may contribute to the apparent excess of poor prognosis melanomas of the skin among men > or = 45 and women > or = 60 years of age, who experience 75% of all melanoma deaths in New Zealand. Following the start of a national melanoma awareness campaign, relevant general practice consultations with men > or = 55 increased 2.6-fold (95% CI: 2.1 to 3.6); consultations with men < 45 increased 5.1-fold (4.1 to 6.9). Men > or = 55 tended to have a longer duration of symptoms than men < 55. Age-standardized mortality rates increased consistently in the period from 1949 to 1989. The data suggest a birth cohort-dependent increase in melanoma mortality which appears to involve increased incidence and decreased case fatality rates, and which could explain at least part of the high proportion of lesions with poor prognosis that occur in middle-aged and older men, and older women.

Adolescent↗
PubMed1996

Long-term engraftment, graft-vs.-host disease, and immunologic reconstitution after experimental transplantation of allogeneic peripheral blood cells from G-CSF-treated donors.

Peripheral blood cells (PBPC) are an alternative source of bone marrow for allogeneic transplantation. Reports from recent clinical trials granulocyte colony-stimulating factor (G-CSF)-mobilized PBPC for allogeneic transplantation show incidence and severity of graft-vs.-host disease (GVHD) similar to those observed in conventional bone marrow transplantation (BMT), despite the presence of 10- to 20-fold more T cell in the PBPC inoculum. In the present study, we examined the effects of pretreatment of donors with G-CSF on GVHD, long-term engraftment, and lymphocyte reconstitution in a murine parent-->F1 model (B6.Ly-5a-->B6d2F1) using splenocytes as a source of peripheral progenitor cells. Recipients of splenocytes from G-CSF-treated donors experienced less mortality from acute GVHD and showed sustained weight gain by day 100 after transplantation. At that time, there was no histological evidence od GVHD in either liver or gut. Recipients of splenocytes from G-CSF-treated donors showed complete donor engraftment within 1 month, which was sustained until the end of the observation period. In contrast, recipients of T cell-depleted splenocytes showed slower donor engraftment and persistent donor/host chimerism. In addition, lymphocyte phenotype and function in mice receiving splenocytes from G-CSF-treated donors was significantly restored by day 100 after transplantation. Thus, the use of G-CSF-mobilized PBPC may provide significant advantages to conventional BMT by reducing GVHD without impairing long-term engraftment and immunologic reconstruction.

Animals↗
PubMed1995

Cancer incidence in England and Wales and New Zealand and in migrants between the two countries.

Risks of cancer incidence in people born in England and Wales and New Zealand (non-Maoris) living in their home countries, and after migration between the two countries, were analysed using data from their national cancer registries. Since these populations are of similar genetic origin, any real differences in cancer incidence between them are likely to reflect the action of environmental or behavioural risk factors. The greatest differences in risk between the countries were for cutaneous melanoma and lip cancer. In each sex, relative risks of these malignancies were 4 or greater for the New Zealand-born in New Zealand compared with English and Welsh natives in their home country, and risks for migrants in each direction were generally intermediate between those born in the home country in the two countries. Sizeable significantly raised risks in the New Zealand-born in New Zealand compared with English and Welsh natives in England and Wales also occurred for cancers of the mouth, small intestine, colon, thymus, eye and thyroid, and non-Hodgkin's lymphoma in each sex, and for cancer of the prostate. For all of these sites except mouth, small intestine and colon there were also risks around or above New Zealand-born levels for English and Welsh migrants to New Zealand; for colon cancer these migrants had risks close to those in England and Wales. New Zealand migrants to England and Wales had risks of cancers of the colon and prostate that were similar to or above New Zealand levels. Risks of cancers of the stomach, lung, pleura and bladder, and Hodgkin's disease in each sex, and cancers of the cervix, ovary and scrotum and penis, were substantially and significantly lower in the New Zealand-born living in New Zealand than in English and Welsh natives in England and Wales. In English and Welsh migrants to New Zealand risks of bladder cancer in each sex, and of scrotal and penile and pleural cancer in males, approximated to England and Wales risks; cervical cancer risk approximated to the New Zealand risk; and stomach, lung and ovarian cancers showed intermediate risks. Migrants from New Zealand to England and Wales did not gain the lung cancer or clearly the stomach cancer risk of their host country, but did have bladder cancer risks approximating to those in England and Wales.(ABSTRACT TRUNCATED AT 400 WORDS)

Breast Neoplasms↗
PubMed1993

Male cancer mortality by occupation: 1973-86.

AIM: To identify male occupational groups with increased risk of death from cancer in 1973-86. METHOD: Age and social class standardised mortality ratios were calculated for males 15-64 years for all cancers combined and for site specific cancers by occupational group. RESULTS: In general, higher socio-economic groups had a lower all cancer mortality and lower socio-economic groups a higher mortality. After standardisation for age and social class, mortality ratios were increased for lung cancer in bricklayers and carpenters (SMR = 125; 95% CI: 110-141), machine tool operators (SMR = 218; 95% CI: 131-342), and welders (SMR = 140; 95% CI: 120-161), with the first group also having an increased risk for pleural mesothelioma (SMR = 222; 95% CI: 70-522). Malignant melanoma risk was increased in clerical workers (SMR = 147; 95% CI: 106-199) and not in outdoor occupations. Colon cancer mortality risk was increased in managers (SMR = 125; 95% CI: 104-148), and woodworkers (SMR = 147; 95% CI: 115-186). Stomach cancer mortality risk was raised for machine tool operators (SMR = 357; 95% CI: 128-782). Painters had an increased ratio for multiple myeloma (SMR = 352; 95% CI: 140-729) and machine tool operators an increase for leukaemia (SMR = 172; 95% CI: 45-446). CONCLUSIONS: The use of routinely collected data to examine cancer mortality by occupation is a useful method to identify groups with increased risks and provide information for hypothesis generation. Further research may be warranted to investigate lung and digestive cancers in woodworkers and machine tool operators, and cancer of the haemopoietic and lymphatic systems in painters and machine tool operators.

Adolescent↗
PubMed1992

Variation and covariates of the number of benign nevi in adolescents.

Melanocytic nevi of diameter greater than or equal to 2 mm were counted on most of the skin surface of 349 adolescents aged 14-15 years of European race or ethnicity in Dunedin, New Zealand. Total counts are described by means of a form of Poisson-error log-linear modeling suitable for data showing unexplained variation (NE Breslow, Appl Statist 1984;33:38-44). There were marked interpersonal variation in the number of nevi; only some was attributable to observed factors. The mean and median counts were 23.8 and 18 nevi, respectively. The estimated ratio of the number of nevi for females compared with males was 0.7 (95% confidence interval (CI) 0.6-0.8). Greater amounts of sunbathing were associated with greater numbers of nevi. Hair and eye color, socioeconomic status, and sunburn history did not show statistically significant effects. Time since menarche and shaving status also showed no effects. Lack of suntan was associated with lower counts. Freckling was positively correlated with higher counts; the severe freckling group had an estimated ratio of 1.9 (95% CI 1.3-2.8) compared with those with no or very few freckles. The results are consistent with the hypothesis that ultraviolet radiation exposure from recreational sun exposure positively influences the total burden of nevi in normal subjects. Comparison with other epidemiologic studies suggests that the typical ultraviolet radiation dose-nevus yield curve might be steeper in males than females. Unexplained variation of nevus count may reflect heterogeneity of constitutional factors not yet measured in epidemiologic studies.

Adolescent↗
PubMed1991

Endemic giardiasis and municipal water supply.

To test the hypothesis that endemic giardiasis may be transmitted by unfiltered municipal water supplies, the incidence of laboratory-confirmed giardiasis was studied in a natural experiment due to the arrangement of the public water supply of Dunedin, New Zealand. The incidence rate ratio was 3.3 (90% CI = 1.1, 10.1) for the population receiving unfiltered (microstrained) water relative to that using sand filtered water. In a parallel case-control study of incident cases, the odds ratio for giardiasis and unfiltered (microstrained) water supply was 1.8 (90% CI = 0.5, 6.9).

Adult↗
PubMed1990

Targeting early detection of malignant melanoma of the skin.

Incidence and mortality rates, and clinical stage at diagnosis were analysed for malignant melanoma of the skin in recent years to assist in identifying high risk groups. Over 12 years to 1985-6 age standardised melanoma mortality rates in the nonMaori population increased 90% among men and 16% among women. In most age groups the male death rate was twice the female rate. Almost half the deaths from melanoma in 1983-6 were in men aged 45 or older. Age standardised incidence rates, for each sex, continued to increase to 1983-4. Among older age groups melanomas were less likely to be localised at diagnosis. This fall in localisation occurred at much younger ages (about 40) among men than among women. Middle aged men and older men and women are important target groups for education about the early detection of melanoma.

Adolescent↗
PubMed1989

Dysplastic naevi in a population-based survey.

The prevalence of dysplastic naevi was studied in a population-based survey of 380 30 to 39-year-old and 50 to 59-year-old non-Maoris in Milton, a small town in the south of New Zealand. Photographs of all pigmented naevi greater than or equal to 4 mm in diameter were taken during the survey and subsequently evaluated by two experienced reviewers. Nine percent of the group (95% CI, 6%-13%) were judged to have one or more dysplastic naevi. Interobserver agreement over the diagnosis of dysplastic naevi was 85% (kappa = 0.55). Dysplastic naevi were associated with higher counts of moles greater than or equal to 2 mm in diameter; 50 or more such moles increased the likelihood of having three or more dysplastic naevi about 40-fold. Naevi judged to be dysplastic were, therefore, relatively common and were associated with increased numbers of common moles.

Adult↗