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Biomedical subjects

W M O'Fallon

Publications and source records attributed to W M O'Fallon.

At least 325 records · Page 18Linked to original sources
PubMed1982

The incidence of retinal detachment in Rochester, Minnesota, 1970-1978.

We studied the incidence of rhegmatogenous retinal detachment in Rochester, Minnesota, for the nine-year period from 1970 through 1978. The age-adjusted rate for idiopathic rhegmatogenous retinal detachment was 10.1 per 100,000 population per year (45 cases). Including 12 cases of aphakic retinal detachments, the age-adjusted incidence was 12.9 per 100,000 population per year. Not surprisingly, the incidence rate increased with age in both sexes. By extrapolation from the Rochester rates, the number of cases per year of idiopathic retinal detachment in the United States would be expected to be about 22,000, and the number of both aphakic and idiopathic phakic cases per year would be expected to approach 28,000.

Age Factors↗
PubMed1982

The effects of oversize donor buttons on postoperative intraocular pressure and corneal curvature in aphakic penetrating keratoplasty.

Forty-one consecutive aphakic corneal transplants performed by the same surgeon were studied in order to determine the effects on intraocular pressure and corneal curvature of using 8.0-mm donor buttons in 7.5-mm recipient openings. One half of the grafts had oversize donor buttons, and all were followed for 13 months. The intraocular pressure in the oversize donor group was statistically significantly less during the first five days after keratoplasty, but not subsequently. Eliminating eyes with preoperative glaucoma, more transplants in the same size donor group (P = 0.08) needed glaucoma therapy 13 months after operation. The anterior corneal curvature (mean keratometry reading) was statistically significantly greater in the oversize donor group throughout the postoperative period. Concurrently, the oversize donor group was less hyperopic after all sutures were removed. There was no difference in keratometric astigmatism or corneal thickness between the two groups. Thus, the use of 0.5-mm oversize donor tissue in aphakic corneal transplants reduced the intraocular pressure and increased the central corneal curvature after keratoplasty.

Aphakia↗
PubMed1982

Reversible ischemic neurologic deficit (RIND) in a community: Rochester, Minnesota, 1955-1974.

This study defines the incidence, prevalence, and long-term prognosis of 120 patients with reversible ischemic neurologic deficit (RIND) in the population of Rochester, Minnesota. The average annual incidence rate for first episodes of RIND was was 16 per 100,000 population. The probability of subsequent ischemic stroke or RIND was six times greater in patients with RIND than in a normal age- and sex-matched population. RIND patients whose initial symptoms resolved within the first week were at greater risk for subsequent ischemic stroke or RIND than those whose symptoms resolved in the second or third week (p = 0.01). The survival of patients with RIND was not significantly different from that of the general population.

Adult↗
PubMed1982

Neck dissection: is it worthwhile?

Data on 1,048 neck dissections in 881 patients were studied to evaluate the effectiveness of treatment in controlling cervical metastasis. Of the 881 patients, 74.5% were treated by surgery alone, and most of the remainder had either planned preoperative or postoperative radiation to the primary site and the entire neck. Planned preoperative or postoperative radiation was defined as the delivery of 4,000 rads or more to the entire neck 123 days before (preoperative) or after (postoperative) neck dissection. In these groups, most patients received more than 5,000 rads. Ninety-six patients received preoperative radiation that did not satisfy these criteria and were grouped separately. The group with neck dissection alone had recurrence rates in the dissected side at 2 years of 7.5, 20.2, and 37.4%, respectively, for No, N1, and N2 staged necks. There were no differences in recurrence rates for the groups with radiated necks in the stage II (N2) necks compared with each other or with the group having surgery alone. Most recurrences, when they occurred in the neck, were manifest by 2 years. Mean follow-up in the entire study was 3.5 years. Two patients were lost to follow-up and were presumed to have died from cancer. When compared with pathologic staging, clinical staging was imprecise in one-third of the cases.

Adolescent↗
PubMed1982

Laboratory diagnosis of gastrinoma. I. A prospective evaluation of gastric analysis and fasting serum gastrin levels.

In a small percentage of patients with ulcer disease, a gastrinoma may be ultimately discovered. In most institutions, a fasting serum gastrin determination and gastric analysis are as first-line tests to identify this subgroup of patients with ulcer disease. The blood test is relatively inexpensive and well accepted by patients. Gastric analysis is uncomfortable and required a well-equipped facility staffed by skilled personnel. A prospective study designed to assess the diagnostic usefulness of these tests and, particularly, whether combining both tests adds to the individual value of each, revealed that gastric analysis does not improve the diagnostic ability of the fasting serum gastrin test. Therefore, gastric analysis probably is not indicated for determining whether a patient with active ulcer disease has a gastrinoma. The fasting serum gastrin test will suffice, and abnormal values on this test should be verified by the use of other tests such as responses to gastrin provocative tests.

Adolescent↗
PubMed1981

Cholecystectomy and carcinoma of the colon.

After cholecystectomy the concentration of secondary bile acids in the bile increases. These bile acids have been incriminated in the pathogenesis of carcinoma of the colon. Hence the hypothesis that cholecystectomy predisposes to the development of carcinoma of the colon. To test this hypothesis, 1681 residents of Rochester, Minnesota (460 males and 1221 females), who underwent cholecystectomy during 1950-69, were followed up. Carcinoma of the colon developed in a higher-than-expected number of patients. However, the association was significant only in females (relative risk 1.7; 95% confidence interval 1.1-2.5) and even stronger for right-sided carcinoma of the colon (relative risk 2.1; 95% confidence interval 1.1-3.6). These data support the hypothesis that cholecystectomy may be a predisposing factor in the development of cancer of the colon in women.

Aged↗
PubMed1981

The natural history of unruptured intracranial aneurysms.

This study defines the natural history of a selected group of 65 patients with 81 unruptured intracranial saccular aneurysms who did not undergo surgery. Eight of the 65 patients with aneurysms had intracranial hemorrhage due to aneurysmal rupture over a mean follow-up interval of slightly over eight years. We performed a multivariate discriminant analysis to assess the relation of several independent variables to aneurysmal ruptures. These variables included age, sex, aneurysm size, number of aneurysms, presence of multilobed aneurysms, aneurysmal symptoms other than rupture, aneurysm location, and hypertension at or before the identification of the aneurysm. The only variable of unquestionable significance was aneurysm size, which was noted in 73 instances. None of the 44 aneurysms smaller than 1 cm in diameter ruptured, whereas eight of the 29 aneurysms 1 cm or more in diameter eventually did. We conclude that unruptured intracranial saccular aneurysms smaller than 1 cm in diameter have a very low probability of subsequent rupture.

Adolescent↗
PubMed1981

Leukemia and prior malignant and hematologic diseases: a case-control study.

Records of 138 patients with leukemia diagnosed between 1955-1974 in Olmsted County, Minnesota, and 276 controls were examined for the occurrence of prior malignancies and hematologic diseases. No significant excess of malignancy was observed when all types of malignancy and all types of leukemia combined were considered. When they were analyzed separately, however, a fivefold increase in the risk of prior skin cancer was found in patients with chronic lymphocytic leukemia. Because of the relatively small numbers, this difference is of borderline statistical significance. The presence of prior hematologic disorders was also examined, and the findings are discussed.

Female↗
PubMed1981

Incidence and secular trend of multiple myeloma in Olmsted County, Minnesota: 1965-77.

The average annual age-adjusted incidence rate of multiple myeloma for Olmsted County, Minnesota, for 1965-77 was 2.7/10(5) person-years. The sex-specific rates for males and females were 3.5 and 2.2/10(5) person-years, respectively; the male-to-female incidence ratio was 1.6:1.0. These rates were similar to rates reported for white people from the Third National Cancer Survey and the New York and Connecticut tumor registries. This average incidence rate did not appear different from the rate for the 20-year period 1945-64 in Olmsted County. The incidence of multiple myeloma was not shown to have increased in the past 33 years, and the observed increase in mortality from this disease reported in other parts of the country indicated improved case ascertainment during recent years, a factor not likely to be important in Olmsted County.

Adolescent↗
PubMed1981

A prospective study of peripheral occlusive arterial disease in diabetes. IV. Platelet and plasma functions.

Platelet factor 4-like activity, circulating platelet-aggregate ratios, ristocetin cofactor, Willebrand antigen, ADP-induced platelet aggregation-enhancing factor, and quantitative platelet aggregation response to ADP, epinephrine, and collagen in platelet-rich plasma were measured in four groups of subjects with similar age and sex distribution. Neither platelet factor 4-like activity nor circulating platelet-aggregate ratios differentiated these four groups. Platelet aggregation studies with ADP a subthreshold concentration support the concept of hypersensitivity of diabetic platelets in males. Male and female subjects differ significantly in their quantitative response to aggregating agents when such studies are done under similar conditions. Willebrand factor activity and Willebrand antigen normally increase with age. Elevation in these activities above that accounted for by age characterizes the presence of vascular disease but not diabetes mellitus in the absence of vascular disease. A plasma factor enhancing platelet aggregation could not be demonstrated in most diabetic patients in this study.

Age Factors↗
PubMed1981

A prospective study of peripheral occlusive arterial disease in diabetes. I. Clinical characteristics of the subjects.

This paper describes the clinical characteristics of a group of normal control subjects, patients with clinical peripheral occlusive arterial disease, patients with diabetes and no clinical peripheral arterial disease, and patients with diabetes and peripheral arterial disease at the time of the enrollment of all subjects in a 5-year study of the factors involved in the progression of peripheral occlusive arterial disease in diabetes. Obesity and hypertension were more common in subjects with diabetes or peripheral occlusive arterial disease (or both) than in the control subjects. Smoking was more common in both groups with occlusive arterial disease than in those without it. The diabetic patients with occlusive arterial disease had a longer duration of diabetes mellitus and a higher rate of other diabetic complications than those without arterial disease.

Aged↗
PubMed1981

A prospective study of peripheral occlusive arterial disease in diabetes. II. Vascular laboratory assessment.

Noninvasive tests of the peripheral circulation were used to quantify the presence and severity of occlusive arterial disease in the lower extremities in 707 subjects on entry into a prospective study. Four groups were studies: 124 normal subjects, 157 patients with clinically evident occlusive arterial disease, 295 patients with diabetes mellitus without clinically evident occlusive arterial disease, and 131 patients with diabetes mellitus and clinically evident occlusive arterial disease. The lower extremity-to-arm systolic blood pressure ratios at rest, ankle-to-arm systolic blood pressure ratios after exercise, and segmental plethysmographic recordings accurately identified the groups with occlusive arterial disease and quantified the spectrum of severity in each of the groups. The 1-minute postexercise ankle-to-arm systolic blood pressure ratio was the single best indicator in discriminating between normal subjects and patients with occlusive arterial disease. The exercise electrocardiogram was positive in 30 of the 583 patients and in none of the group of normal subjects. The systolic blood pressure was falsely elevated as a result of sclerotic, noncompressible arteries in the segment of the limb under the pneumatic cuffs in 12 of the patients but in none of the normal subjects.

Aged↗
PubMed1981

A prospective study of peripheral occlusive arterial disease in diabetes. III. Initial lipid and lipoprotein findings.

Lipid and lipoprotein findings are described in a group of 707 persons consisting of normal control subjects, patients with clinical peripheral occlusive arterial disease, patients with diabetes and no occlusive arterial disease, and diabetic patients with occlusive arterial disease. The mean serum triglycerides were elevated in all groups compared with the normal controls and varied, depending on the type and treatment of the diabetes and fasting plasma glucose concentration. Mean total serum cholesterol did not change among the groups. Unexpectedly, the mean level of low-density lipoprotein cholesterol was significantly lower in patients with diabetes who had no occlusive arterial disease than in normal subjects. The mean high-density lipoprotein cholesterol level was higher in normal-weight, insulin-treated diabetic patients than in obese diabetics regardless of their treatment. Disturbances in triglyceride metabolism and the related lipoproteins appear to characterize both diabetes and occlusive arterial disease, with the highest mean levels of serum triglycerides being found in subjects with both diabetes and occlusive arterial disease.

Aged↗
PubMed1981

Surgical treatment of ulcerative colitis in children.

Our finding in 100 patients indicate that elective surgical treatment of ulcerative colitis in children has a low mortality rate in contrast to emergency surgery (2.3% versus 23%). Morbidity associated with these procedures is moderate and appears to be decreasing (13%), as shown by the comparison between the experience in the 1960s and that in the 1970s. Results with the newer surgical procedures have been encouraging; 60% of patients with Brooke ileostomy have been very satisfied as compared with 90% of patients with Kock pouch and of those with rectal mucosectomy with ileoanal anastomosis. Ileorectostomy was not a satisfactory procedure in this series. Additionally, after surgical treatment, the median height percentile increased from the thirty-ninth to fifty-seventh percentile. Finally, and important, 96% of the patients in this series reported that their general health at follow-up was good to excellent and that they had minimal limitation in their activities.

Adolescent↗
PubMed1981

Population-based requirements for thoracic surgery.

In order to determine the population-based requirement for thoracic surgery, we identified of the thoracotomies undertaken upon Olmsted county, Minnesota, residents in a 10 year period. There were 674 initial operations and 78 reoperations among 689 residents. The age-adjusted incidence rate for all thoracotomies in the community was 99.6 per 100,000 person-years. Rates generally increased with age and were greater for men, with an age-adjusted male: female ratio of incidence rates of 2.1 : 1. Age-adjusted rates for urban residents were nearly twice as great as those for rural residents of the county. Sixty percent of the operations were performed for cardiovascular disease, 30% for pulmonary disease, and 10% for all other chest conditions. The incidence of operations for all three of these subgroups increased substantially during the 10 year study period. If the Olmsted County experience for 1976-1979 is applied to the 1980 United States population, an estimated 300,000 thoracic operations would be required. The operations could entail the use of nearly 6 million hospital bed-days and over 1 million operating room hours.

Adolescent↗
PubMed1980

Reserpine and breast cancer. A community-based longitudinal study of 2,000 hypertensive women.

To supplement several case-control studies questioning whether use of reserpine is associated with occurrence of breast cancer, we conducted a longitudinal study of nearly 2,000 hypertensive women residing in Rochester, Minn. Exposure to antihypertensive agents and subsequent incidence of breast cancer were ascertained. Expected numbers of cases, derived from local population data and from the Connecticut Tumor Registry, were compared with the numbers of cases observed in exposure groups of interest. No evidence was found of any association of reserpine use, thiazide use, or untreated hypertension with subsequent occurrence of breast cancer in these hypertensive women. In addition, several issues were investigated that warrant consideration in evaluating reports published to date, especially before conclusions are drawn as to the questionable contention that reserpine has caused breast cancer in women.

Benzothiadiazines↗
PubMed1980

Low-dose radiation and leukemia.

We investigated the effect of diagnostic and low-level therapeutic radiation (less than 300 rads to the bone marrow) on the development of leukemia. During this study, 138 patients with leukemia (representing all known incidence cases of leukemia in residents of Olmsted County, Minnesota, between 1955 and 1974) were each matched with two controls, and the lifelong experiences of both groups with regard to diagnostic and therapeutic radiation were ascertained. No statistically significant increase was found in the risk of developing leukemia after radiation doses of 0 to 300 rads (3 Gy) to the bone marrow when these amounts were administered in small doses over long periods of time, as in routine medical care.

Bone Marrow↗