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R Kerber

Publications and source records attributed to R Kerber.

17 recordsLinked to original sources
PubMed2001

Paternal and maternal components of the predisposition to preeclampsia.

BACKGROUND: There is an inherited maternal predisposition to preeclampsia. Whether there is a paternal component, however, is not known. METHODS: We used records of the Utah Population Database to identify 298 men and 237 women born in Utah between 1947 and 1957 whose mothers had had preeclampsia during their pregnancy. For each man and woman in the study group, we identified two matched, unrelated control subjects who were not the products of pregnancies complicated by preeclampsia. We then identified 947 children of the 298 male study subjects and 830 children of the 237 female study subjects who had been born between 1970 and 1992. These children were matched to offspring of the control subjects (1950 offspring of the male control group and 1658 offspring of the female control group). Factors associated with preeclampsia were identified, and odds ratios were calculated with the use of stepwise logistic-regression analysis. RESULTS: In the group whose mothers had had preeclampsia (the male study group), 2.7 percent of the offspring (26 of 947) were born of pregnancies complicated by preeclampsia, as compared with 1.3 percent of the offspring (26 of 1973) in the male control group. In the female study group, 4.7 percent of the pregnancies (39 of 830) were complicated by preeclampsia, as compared with 1.9 percent (32 of 1658) in the female control group. After adjustment for the offspring's year of birth, maternal parity, and the offspring's gestational age at delivery, the odds ratio for an adult whose mother had had preeclampsia having a child who was the product of a pregnancy complicated by preeclampsia was 2.1 (95 percent confidence interval, 1.0 to 4.3; P=0.04) in the male study group and 3.3 (95 percent confidence interval, 1.5 to 7.5; P=0.004) in the female study group. CONCLUSIONS: Both men and women who were the product of a pregnancy complicated by preeclampsia were significantly more likely than control men and women to have a child who was the product of a pregnancy complicated by preeclampsia.

Adult↗
PubMed1999

The shape of the hazard function in breast carcinoma: curability of the disease revisited.

BACKGROUND: The question of curability of breast carcinoma remains controversial. Because the probability of cure essentially is an asymptotic notion, the corresponding estimation problems call for special statistical methods. Such methods should account for an intimate connection between the probability of cure and the shape of the hazard function. METHODS: The study was performed on survival data for 13,166 women with breast carcinoma identified through the Utah Cancer Registry and stratified by clinical stage and age at diagnosis. For these patients, the follow-up period was 30 years. Three estimation procedures were used for estimating the hazard function from the data: the life table estimator, a kernel counterpart of the Nelson-Aalen estimator, and a parametric estimator specifically designed for two-component hazards. The parametric estimate of the hazard function was used to provide estimates of cure rates for each category of patients. RESULTS: For all categories of patients under study, the estimated hazard functions passed through a clear-cut maximum, showing a tendency to decrease as time approached the end of a follow-up period. The hazards appeared to be nonproportional across the strata. The estimated values of the cure rate and the corresponding confidence intervals were determined for each stratum of patients with breast carcinoma. CONCLUSIONS: The results of the current study strongly suggest that cure is a possible outcome of breast carcinoma treatment. The condition of proportionality of risks is not met in breast carcinoma survival data.

Adult↗
PubMed1998

Automated tracking of left ventricular wall thickening with intracardiac echocardiography.

OBJECTIVE: We developed and evaluated a new method to automatically measure regional left ventricular wall thickening by analyzing the radiofrequency backscatter signal from an intracardiac echocardiographic catheter. METHODS: We inserted 10-MHz echocardiographic catheters in 11 dogs. Wall thickness was perturbed by altering loading conditions and inotropic state. The backscatter signal from a single selected radial scan line was digitized. An automated algorithm identified the digitized endocardial and epicardial signals, tracked them throughout the cardiac cycle, and plotted the spatial difference over time. Pressure-thickness loops were generated. RESULTS: End-systolic and end-diastolic thickness and percent wall thickening from the unedited, unsmoothed signals compared favorably with independent manual analysis of transthoracic echocardiographic images of the same region: r = 0.89 for wall thickness and 0.81 for systolic thickening. CONCLUSION: The backscatter signal from an intracardiac echocardiographic device can be analyzed automatically to continuously assess regional left ventricular wall thickening and generate pressure-thickness loops.

Animals↗
PubMed1998

Intracardiac echocardiography: computerized detection of left ventricular borders.

A semi-automated method for two- and three-dimensional analysis of intracardiac echocardiography (ICE) images and image sequences is reported based on detection of epicardial and endocardial borders using graph searching. The border detection method was applied to 50 ICE images acquired in vivo in five dogs and to 108 images in 16 volumetric ICE image sequences from eight cadaveric pig hearts. The ICE images from the in vivo study showed good correlation between computer-detected and observer-defined left ventricular (LV) cavity areas and epicardial areas (r = 0.99, y = 0.98x + 0.43 [cm2]; r = 0.99, y = 0.98x + 1.11 [cm2]; respectively). In the cadaveric hearts, the LV volumes were determined with the volume measurement error of 7.6 +/- 7.7% and 11.3 +/- 11.2% for the aortic valve and mitral valve image sequences, respectively. Our method facilitates an accurate and computationally efficient approach for the quantitative assessment of ICE image data in 2D and 3D.

Animals↗
PubMed1998

Exercise groups in an insight-oriented, evening treatment program.

Exercise groups form an integral part of an insight-oriented, psychodynamic evening treatment program for a patient population characterized predominantly by mood and personality disorders. Clinical examples illustrate how the exercise groups are integrated with other therapy groups in the program. Therapists, who lead and participate in the exercise groups, attempt to maintain professional boundaries while they facilitate permissive activities where enactment of patient conflicts can occur. Events from the exercise groups frequently provide material for work in the more traditional psychodynamic groups of the program. A number of benefits of exercise groups are highlighted.

Adult↗
PubMed1995

The Utah Thyroid Cohort Study: analysis of the dosimetry results.

Above ground testing of nuclear weapons at the Nevada Test Site (NTS) during the 1950s created radioactive fallout that was dispersed into the atmosphere and deposited over a large geographical area of the U.S. One area believed to have received a considerable amount of exposure to radioiodines (131I and 133I) in the fallout was southwest Utah and southeast Nevada. This paper describes the estimates of doses to the thyroid for a cohort of 3,545 subjects who were children during the atmospheric testing period. This group of children was examined for thyroid disease during 1965-1970 and again in 1985-1986. The cohort was made up of children who lived in three counties in 1965: Washington County, Utah; Lincoln County, Nevada; and Graham County, Arizona (originally thought to be an unexposed group). Pathway analysis was used in the dosimetry, considering exposures through the ingestion of milk and vegetables, inhalation of iodine during the passage of the fallout cloud, and external exposure. Specific data were obtained on diet (including sources and levels of milk and vegetables consumed, residence history, and lifestyle) by interviewing the parents or nearest living relative of subjects. The final dosimetry file for each member of the cohort contained specific doses to the thyroid glands and uncertainties (reported as geometric standard deviations, GSD) related to each dose estimate. The mean absorbed dose to the thyroid for subjects living in Washington County, Utah, was 170 mGy; for Lincoln County, Nevada, 50 mGy; and for those living in Graham County, Arizona, 13 mGy. The maximum dose to any subject was 4,610 mGy. There were 10 subjects who had doses greater than 1 Gy. The majority of uncertainty values calculated in this study were GSD values between 2.0 and 4.0. The results of the dosimetry were combined with the results of clinical examinations of the cohort to determine if a causal relationship exists between dose to thyroid from NTS generated radioactive iodines and the incidence of thyroid disease.

Adult↗
PubMed1995

Coancestry in apparently sporadic primary pulmonary hypertension.

OBJECTIVE: To examine sporadic cases of primary pulmonary hypertension of coancestry. DESIGN: An epidemiologic study of families of patients with primary pulmonary hypertension. SETTING: A university-affiliated referral population. PARTICIPANTS: Family members of 13 patients with primary pulmonary hypertension. MEASUREMENTS: Family pedigrees involving grandparents, parents, siblings, and children were supplemented by genealogic records. Coefficients of kinship (Ck) were calculated for the patients with primary pulmonary hypertension who demonstrated coancestry and compared with 500 sets of controls drawn at random from genealogic records. RESULTS: Two patients with sporadic primary pulmonary hypertension demonstrated coancestry. The great-great grandfather and great-great grandmother of one patient were the great-grandfather and great-grandmother of the other patient. No other cases of primary pulmonary hypertension were identified in these two families. The CK of the affected individuals (CK = 10.02 x 10(-5)) suggests strongly that the observed relationship did not occur by chance alone. Among 500 random sets of matched controls, only two sets yielded CK of 10.02 x 10(-5) or greater (p = 0.004). Coancestry could not be identified for the other five families of patients with sporadic primary pulmonary hypertension for whom genealogic records were available. CONCLUSIONS: The finding of coancestry in patients with sporadic primary pulmonary hypertension suggests that a genetic basis exists for some patients with apparently sporadic primary pulmonary hypertension. Familial primary pulmonary hypertension may be more common than previously recognized.

Adult↗
PubMed1994

A computerized diet history questionnaire for epidemiologic studies.

OBJECTIVE: To describe methods used to computerize the diet history questionnaire developed for the Coronary Artery Risk Factor Development in Young Adult (CARDIA) study and to describe quality-control procedures used in conjunction with dietary assessment. DESIGN: The computerized diet history is being used in a case-control study. Because of the computerized nature of the questionnaire, we developed quality-control procedures that incorporate listening to an audiotape of the interview while visually reviewing recorded data. SETTING: Three centers involved in a population-based epidemiologic study of colon cancer. SUBJECTS: Men and women between the ages of 30 and 79 years. RESULTS: Quality-control results showed that 100% of the computerized forms would be free of errors if the data were subjected to visual review only. Probing errors, which accounted for 47.3% of all errors, were the most commonly encountered errors. In probing errors the interviewer did not probe in a nondirective manner, or the interviewer failed to verify responses that might be considered questionable. APPLICATIONS: The CARDIA diet history was computerized for use in epidemiologic studies of the association between diet and disease. Review of the audiotapes of the interviews showed that most errors made in obtaining a dietary assessment were not detectable from visual review of the data. Although the quality-control procedures were developed for a computerized diet history questionnaire, they are applicable to other dietary assessment methods.

Adult↗
PubMed1990

Comparison of two-dimensional echocardiography and ultrafast cardiac computed tomography for evaluating intracardiac thrombi in cerebral ischemia.

Two-dimensional echocardiography has a high specificity for the detection of intracardiac thrombi, but technically difficult studies are often encountered. Ultrafast cardiac computed tomography may be useful in such cases. Using transthoracic two-dimensional echocardiography and ultrafast cardiac computed tomography, we studied 36 patients with cerebral ischemia; one patient had the studies performed on two occasions, making a total of 37 sets of studies. Technical difficulties occurred in 12 echocardiographic (32%) and two ultrafast cardiac computed tomographic (5%) studies. The two techniques agreed in 29 sets of studies (78%). Among the eight discrepant sets of studies, two-dimensional echocardiography was positive for a left ventricular thrombus while ultrafast cardiac computed tomography was negative in three and equivocal in one and echocardiography was equivocal while ultrafast cardiac computed tomography was negative in two and positive in one. In the latter case, a left ventricular thrombus was confirmed at autopsy. In the other discrepant set of studies echocardiography was negative while ultrafast cardiac computed tomography revealed a left atrial and appendage thrombus. Because of its ease of performance and safety, two-dimensional echocardiography is the appropriate initial screening test for left ventricular thrombus. Ultrafast cardiac computed tomography can provide additional information in patients with technically difficult or equivocal two-dimensional echocardiographic studies or patients with cardiac disorders predisposing to atrial thrombi formation.

Adult↗
PubMed1990

Physical activity and colon cancer: a comparison of various indicators of physical activity to evaluate the association.

We compare categories of physical activity, based upon self-reported leisure time and occupational activity, with categories of activity based upon coded job titles using the Dictionary of Occupational Titles. For people under 65 years of age, self-reported total activity, total nonintense activity, and occupational activity were not strongly associated with coded occupational activity in men (Spearman r = 0.36, 0.27, and 0.32, respectively); even weaker associations were noted in women (r = 0.23, 0.27, and 0.10). Associations between total activity and coded occupational activity were generally weaker for people who were 65 or older. Despite these weak associations, all indicators of physical activity assessed were associated with a decreased risk for colon cancer in men. Comparing those in the highest category of activity with those in the lowest, the OR for total self-reported activity was 0.7; for self-reported occupational activity, 0.7; and for coded occupational activity, 0.6. Whereas self-reported total activity was associated with colon cancer among women, estimates of activity based upon occupation (both self-reported and coded from job titles) were not.

Age Factors↗
PubMed1983

Left atrial myxoma and unrelated mitral valve disease.

Two cases of left atrial myxoma and concomitant, but unrelated mitral valve disease are reported. The first patient had severe mitral stenosis and mitral regurgitation due to rheumatic heart disease in addition to a large immobile left atrial myxoma. At surgery, the tumor was considered unresectable because of its size and widespread attachment to the left atrium. A mitral commissurotomy was performed with temporary improvement. The second patient had mitral regurgitation due to mitral valve prolapse (myxomatous degeneration) and an unrelated tumor. The patient's condition improved after mitral valve reconstruction and resection of the tumor. In both cases, the relatively immobile tumor was not physically in contact with the mitral valve and probably was not responsible for the valve disease. Both patients presented with dyspnea, to which the tumors may have contributed by causing partial obstruction of the pulmonary veins. Diagnostic and therapeutic problems resulting from the association of atrial myxoma and unrelated mitral valve disease are discussed.

Echocardiography↗
PubMed1982

Panic attacks in families of patients with mitral valve prolapse.

One explanation for the association between mitral valve prolapse (MVP) and panic attacks in clinic populations is that panic attacks represent a set of symptoms caused by mitral prolapse. Since mitral prolapse is often familial, this hypothesis predicts a higher incidence of panic attacks in relatives of persons with prolapse than the general population and the incidence of panic attacks in the relatives should be independent of panic attacks in the proband. We interviewed 50 probands with mitral prolapse and obtained family history data on panic attacks in their first degree relatives. The incidence of panic attacks in these relatives was 4.5 +/- 1.4% which is consistent with control rates which we have reported in previous studies. Twelve MVP probands also had panic attacks. The incidence of panic attacks in their relatives (15.7 +/- 5.1%) was significantly higher than the rate found among relatives of 38 probands without panic attacks (1.2 +/- 0.8%). These findings are consistent with the hypothesis that mitral prolapse and panic attacks are segregating independently in these families.

Adult↗
PubMed1981

Does mitral prolapse occur in mitral stenosis? Echocardiographic-angiographic observations.

An association between rheumatic fever/rheumatic heart disease and mitral prolapse has been suggested. Since mitral stenosis in adults is a reliable indicator of rheumatic heart disease, we undertook this study to define the association between rheumatic heart disease and prolapse by estimating the frequency with which mitral stenosis and mitral prolapse coexist in the same patient. A second purpose was to assess the usefulness of two-dimensional and standard M-mode echocardiograms in making the diagnosis of mitral prolapse in the presence of mitral stenosis. Twenty patients with moderate to severe mitral stenosis were studied. Standard M-mode echocardiographic criteria for prolapse were used; in the two-dimensional echocardiograms, we searched for arching of the mitral leaflets cephaloposteriorly above the atrioventricular ring. Left ventricular angiograms were evaluated for prolapse both subjectively and objectively by using the posterior medial scallop length index criteria. We found that the majority of these mitral stenosis patients satisfied the M-mode criteria for prolapse, whereas movement of the mitral leaflets into the left atrium by two-dimensional echocardiography and angiography occurred in fewer patients. Three patients met all echocardiographic and angiographic criteria for prolapse, but none had clinical evidence of prolapse. We conclude that the coexistence of mitral prolapse and mitral stenosis, if it occurs at all, is uncommon. M-mode echocardiography alone is unreliable to diagnose prolapse when mitral stenosis is present, since the M-mode criteria for prolapse are met by the majority of mitral stenosis patients.

Adult↗