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Biomedical subjects

M S Tockman

Publications and source records attributed to M S Tockman.

At least 73 records · Page 4Linked to original sources
PubMed1980

Is ABH nonsecretor status a risk factor for obstructive lung disease?

In a multidisciplinary study of risk factors for chronic obstructive pulmonary disease (COPD), a significantly more impairment of forced expiration was observed in ABH nonsecretors than in ABH secretors among 1017 white adults. (ABH refers to the "A" and "B" antigens of the ABO blood group system and "H", the heterogenetic substance which is found in persons of all ABO types including type "O".) Nonsecretors had significantly lower mean values of forced expiratory volume in one second as a percentage of forced vital capacity (FEV1/FVC%) and a significantly larger proportion of them had aberrant values, defined as FEV1/FVC% less than 68. These differences remained when mean values or rates of aberrancy were adjusted for other factors reported to alter risk of airway obstruction. In view of the known COPD-peptic ulcer and nonsecretor-duodenal ulcer associations, these findings suggest that the ability to secrete ABH antigens into secretions of the respiratory and gastrointestinal tract may have a protective effect on epithelialized organs in general, or on the lung and portions of the gut specifically.

ABO Blood-Group System↗
PubMed1980

Alcohol consumption and airway obstruction.

To clarify the basis of the reported association between alcohol and pulmonary disease, the relationship between intake of alcohol and pulmonary function was examined in 2,539 community-dwelling adult participants in an ongoing longitudinal study of risk factors for airway obstruction. Forced expiratory volume in 1 s, expressed as a percentage of forced vital capacity, was used as the indicator of airway obstruction, and forced vital capacity expressed as a percentage of the predicted value was used as an index of restriction. Although crude (unadjusted) mean values of the ratio of forced expiratory volume in 1 s to forced vital capacity were significantly lower for heavy than for light drinkers, the difference disappeared when adjustment was made for numerous confounding factors (including such recognized risk factors for pulmonary disease as cigarette smoking, low socioeconomic status, male sex, and age). There was also no evidence of an association between consumption of alcohol and airway restriction. Although these findings do not rule out a possible effect of alcohol on pulmonary disease, its impact, if any, is probably the result of interaction with other factors associated with alcoholism, if not derived primarily from those other factors.

Adult↗
PubMed1980

Patterns of forced expiratory flows in groups at risk for chronic obstructive pulmonary disease.

In a modified case-control study of obstructive pulmonary disease (COPD), airways obstruction has been found to be associated with age, sex, protease inhibitor type, socioeconomic status (SES) and smoking. In this paper patterns of forced expiratory flows are examined in persons demonstrating various risk factors. Two broad patterns of flow limitation emerge. The first pattern, characterized by lower flows at high lung volumes, is found in first-degree relatives of patients with COPD and subjects with a low SES. This pattern, consistent dysfunction of large airways, may reflect reversible decreases of airway caliber. The second pattern, characterized by lower flows at low lung volumes, is found in older subjects. This pattern, consistent with nonhomogeneously emptying lungs or dysfunction of small airways, may reflect more chronic irreversible changes. Smokers and male subjects exhibit both patterns of flow limitation when compared with subjects who had never smoked and female subjects. It is possible that the combination of the patterns reflects a particularly high risk for the development of COPD in male smokers.

Adult↗
PubMed1979

Increased risk of thrombosis due to oral contraceptives: a further report.

In a previously reported case-control study of the relationship between oral contraceptives and thromboembolism, there were 461 cases and 1302 controls, individually matched on age, race, marital status, hospital, and date of admission. Initially, the control patients had not been matched with the cases for the presence or absence of six factors thought to predispose to or precipitate thromboembolic disease. The present paper reports the effects of taking into consideration these factors in the controls. Two methods of analysis (matched set, and logistic regression) gave closely similar results. Where the case series consisted of idiopathic cases, the revised estimate of the relative risk was reduced from 7.2 to 4.7 by these procedures; for predisposed cases, it was increased from 1.2 to 2.2. The explanation suggested in the previous report for the failure to find an increased risk for cases with predisposition receives support from these findings. Variation in the relative risk was examined for four separate diagnostic categories: venous thrombosis alone, pulmonary embolism alone, venous thrombosis and pulmonary embolism together, and myocardial infarction. The relative risk estimates were greater than unity for each thrombosis category for both predisposed and non-predisposed cases. The relative risk was not found to vary significantly according to age or smoking status.

Adolescent↗
PubMed1979

Standardized respiratory questionnaires: comparison of the old with the new.

Two standardized respiratory questionnaires were administered to 946 white male participants in a long-term study of respiratory symptoms in Washington County, Md. One half of the men were given the 1960 respiratory questionnaire developed by the British Medical Research Council (MRC) at the start of the interview and a new questionnaire developed by the American Thoracic Society and the Division of Lung Diseases (ATS-DLD) at the end. The order was reversed for the other half of the subjects. No important differences were found in the responses. To obtain a minimal basic history for evaluation of chronic obstructive pulmonary disease, either the MRC questionnaire or the corresponding questions from the ATS-DLD questionnaire may be used. More detailed information on a wider variety of historical items may be obtained by using the ATS-DLD questionnaire.

Evaluation Studies as Topic↗
PubMed1979

The indications for transcervical mediastinoscopy in patients with small peripheral bronchial carcinoma.

A series of 80 patients with roentgenographic evidence of bronchial carcinomas 3 centimeters or less in size was analyzed as to the incidence of mediastinal lymph node metastases. Forty patients underwent transcervical mediastinoscopy prior to thoracotomy and 40 patients did not. Three patients with large cell undifferentiated carcinoma had mediastinal lymph node metastases which could be detected by transcervical mediastinoscopy. None of the 40 patients who did not undergo mediastinoscopy had palpable evidence of mediastinal lymph node metastases at thoracotomy. The survival rates for the two groups of patients were similar. On the basis of this study, we have concluded that mediastinal exploration is not routinely indicated in patients with peripheral T1, N1, M0 lesions.

Adenocarcinoma↗
PubMed1978

Sister chromatid exchanges in the peripheral blood of cigarette smokers and in lung cancer patients; and the effect of chemotherapy.

Peripheral blood sister chromatid exchange (SCE) rates in chronic cigarette smokers and in subjects with cancer do not differ from those in healthy nonsmokers. SCE patterns were normal in 69 chronic cigarette smokers, including 62 patients with untreated lung cancer. In three chronic smokers with lung cancer, high SCE levels were related to recent intravenous chemotherapy.

Aged↗
PubMed1978

Agreement rates between oral contraceptive users and prescribers in relation to drug use histories.

A comparison between prescriber records and patient-reported oral contraceptive histories obtained during a case-control study of thromboembolism and oral contraceptive use served as the basis for evaluating the extent of agreement between these two sources of information. Agreement between oral contraceptive user and prescriber was highest on the name of the most recently-used product (89% agreement), and dropped to 62.5% on the name of the product taken before the more recent one. For total duration of oral contraceptive use (to within one month of hospital admission), agreement (defined as differences not exceeding one month) was 36%, while 39% showed the users reporting longer duration of use, and 25% showed users reporting shorter duration. Cases showed a higher rate of agreement with prescriber records than the controls on both the name of the product and the total duration of use. Disagreement from prescriber records in the direction of reporting longer duration of use was 45% for the controls compared to 27% for the cases. These results indicate that while user information in connection with the most recently used oral contraceptive can be acceptable in studies employing the case-control research strategy, user reports about previous oral contraceptive use may be less useful.

Adolescent↗
PubMed1978

Radiographic screening in the early detection of lung cancer.

A prospective study designed to detect early lung cancer in a high risk outpatient volunteer population is in progress. At present all 10,362 volunteers have been recruited into the project. A review of the radiographs of patients with lung cancer identified on the initial screen, or in retrospect, has led to the following conclusions: (1) Independent double reading is important in a screening project. (2) There are no reliable radiographic criteria to distinguish early lung cancer from benign disease. (3) The lateral chest radiograph is useful in the high risk patient. From these conclusions the authors have three recommendations for the practicing radiologist. (1) Since double reading improves sensitivity, attempt to doubly read a chest radiograph by removing your eyes from the film and look at it a second time before finalizing your report. (2) Consider any newly appearing, noncalcified lesion in the chest radiograph of a high risk individual as primary lung cancer until proven otherwise. (3) Consider the "routine chest radiograph" in a high risk patient as a challenge to detect early lung cancer rather than the drudgery of day to day clinical practice.

Aged↗
PubMed1977

A common familial component in lung cancer and chronic obstructive pulmonary disease.

First-degree relatives of lung-cancer patients and of patients with chronic obstructive pulmonary disease had significantly higher age-sex-race-smoking-adjusted rates of impaired forced expiration than first-degree relatives of patients with non-pulmonary disease or community-derived comparison series (neighbourhood controls and teachers). Subclassification of the data and multiple adjustment for smoking, race, sex, and other confounding factors emphasised the consistency of the pattern. These findings strongly suggest that lung cancer and chronic obstructive pulmonary disease share a common familial component other than smoking. The clinical manifestation may depend on the presence of one or more other cofactors as yet undefined.

Adult↗
PubMed1977

Risk factors in chronic obstructive pulmonary disease (COPD).

In a genetic-epidemiologic study of chronic obstructive pulmonary disease (COPD) observations adjusted for age, sex, race, and smoking indicate certain factors to be associated with increased pulmonary function aberrancy, and suggest that they are risk factors for COPD. These presumptive "risk factors" include not only cigarette smoking, but also alpha1-antitrypsin (Pi system) variation, one or more other familial components, low socioeconomic status (SES), and, in whites, ABO blood type (either absence of "B" or presence of "A").

ABO Blood-Group System↗
PubMed1975

Thrombosis with low-estrogen oral contraceptives.

A retrospective study of the relationship of oral contraception to thrombosis was made in 104 idiopathic cases, 357 other thrombotic cases (exclusive of cerebrovascular thrombosis), and 1302 matched controls. The relative risk for idiopathic case users was 7.2 times that for non-users; for the whole series it was 1.9. The apparent low risk for non-idiopathic cases is considered to be due to selective prescription of this method of contraception. The risk for women using formulations containing 100 mug or more of estrogen was higher than that for users of lower doses. Among the controls, the risk of gallbladder surgery was twice as high for users as non-users. Several theoretical sources of bias were searched for and shown not to be present. Histories of oral contraceptive use were found to be accurate. A definite risk of thrombosis exists even with the low-estrogen dosage currently employed in oral contraceptive steroids.

Adolescent↗
PubMed1975

A genetic-epidemiologic study of chronic obstructive pulmonary disease. I. Study design and preliminary observations.

Although certain environmental agents (e.g., cigarette smoking) are known to be causally related to chronic obstructive pulmonary disease (COPD), differential response to their deleterious effects suggests the importance of constitutional (host) factors. The voluminous literature on the familial occurrence of COPD as well as the association between genetically determined serum alpha 1-antitrypsin (alpha 1-at) deficiency and COPD, however, reveals many aspects yet to be clarified. Studies of alpha 1-at indicate that neither its nature nor its relationship to COPD is simple. Moreover, other familial factors are likely involved. To obtain a better understanding of the etiology and pathogenesis of COPD, both genetic and environmental factors are being examined in a multifaceted investigation. The preliminary observations are summarized. COPD patients have a higher frequency of Pi variant phenotypes than those without lung disease. Among other subjects, both cigarette smoking and Pi variant phenotypes are associated with increased pulmonary function abnormality. Finally, there is familial aggregation of pulmonary impairment that cannot be explained entirely by Pi type or smoking.

ABO Blood-Group System↗
PubMedDate not supplied

Serum carotenoids are associated with increased lung cancer risk among alcohol drinkers, but not among non-drinkers in a cohort of tin miners.

To examine the association between pre-diagnostic serum carotenoid levels and lung cancer risk and the effects of alcohol intake on the carotenoid-lung cancer relationship, we conducted a case-control study in an occupational cohort from the Yunnan Tin Corporation in China. During 6 years of follow-up, 339 cases of confirmed lung cancer were diagnosed. Among these cases, those who donated pre-diagnostic blood (n = 108) were eligible for this study. For each case, two individuals alive and free of cancer at the time of case diagnosis, matched on age, sex, and date of blood collection, were selected as controls. Serum beta-carotene (odds ratios (ORs) for tertiles: 1, 1.3, 2.0) and beta-cryptoxanthin (ORs for tertiles: 1, 1.8, 2.9) levels were positively associated with lung cancer risk after adjustment for tobacco use and radon exposure. Among alcohol drinkers, higher serum carotenoid levels were significantly associated with increased lung cancer risk (alpha-carotene OR 2.2, 95% confidence interval (CI) 1.1-4.4, beta-carotene OR 7.6, 95% CI 3.1-18.6, lutein/zeaxanthin OR 2.3, 95% CI 1.2-6.6 and beta-cryptoxanthin OR 7.6, 95% CI 2.7-21.5). Conversely, risk estimates among non-drinkers suggest a possible protective association for higher carotenoid levels.

Adult↗