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On the MVK stochastic carcinogenesis model with Erlang distributed cell life lengths.

This paper proposes extending the MVK carcinogenesis model by adopting the Erlang distribution for the life length of the intermediate cells. The investigation concentrates on the survival function and the mean value functions. The approach is basically numerical, making use of the Mathematica software system. The paper also provides a closed form expression for the survival function for a variation of the original MVK model, where all the model parameters are piecewise constants.

Algorithms

Valve replacement for calcified aortic stenosis in septuagenarians infers normal life-length.

Aortic valve replacement because of pure or predominant stenosis was performed in 1970-1986 on 101 patients aged 70-78 years, including 80 in NYHA function class III or IV. There were 16 deaths within 30 days, and coronary artery disease (unbypassed in all but 1 case) was found in 11 of the 13 with autopsy or preoperative arteriography. None of the 12 patients without significant coronary artery disease at angiography died perioperatively,but one of 12 with combined valve replacement and coronary artery bypass grafting died. Cumulative 1-year survival among the 101 patients/the 85 survivors of the first 30 days and/a normal population matched for sex, age and year of operation was 75/90/96%. Corresponding percentages for 5 years were 64/75/77, for 10 years 43/52/52, and for 15 years 35/42/27. Advanced disease with kidney failure or left ventricular end-diastolic pressure greater than 20 mmHg independently increased the overall mortality rate. The linearized rat of cerebral events (haemorrhage, embolism) was 2.7/100 patient years (age-specific background rate 1.6-1.9/100 patient years). The 30-day mortality among septuagenarians was reduced to 3% in 1988-1989 by routine revascularization in significant coronary artery disease. The patients who survived the first 30 days had normal life expectancy. Early operation may further improve the results.

Aged

Length of life in the ancient world: a controlled study.

The length of life for a population of ancient Greek and Roman men with quoted dates of birth and death has been compared statistically with three sample populations from different periods. It was found that the ancients who were born before 100 BC lived as long as the moderns who died before 1950; they lived significantly shorter lives than those who have died in the present half century.

Adult

A stratified randomized study of intradermal BCG in patients with carcinoma of the bronchus: prolongation of quality but not length of life in inoperable patients.

This paper reports the results of a stratified, randomized trial of monthly intradermal injections of Glaxo BCG in addition to conventional therapy (surgery, radiotherapy or no treatment) in a consecutive series of 75 men with confirmed bronchial carcinoma. BCG treatment did not significantly prolong survival but had consistenly more effect in prolonging the period in good general condition and in "acceptable" clinical condition. These were significantly prolonged among the BCG patients (all histopathologies) treated with a full course of radiotherapy (p = 0.01, p = 0.005) and among the 43 patients with squamous carcinoma after adjustment for treatment and general prognostic factors (ratio of observed to expected deaths (O/E) for BCG 0.65, P = 0.025). There was a tendency for BCG patients with oat cell carcinoma to survive less well than controls (O/E for BCG 1.40 not significant). Within comparable groups of patients with squamous carcinoma the delay in decline of general condition was accompanied by reduced weight loss.

Aged

Body weight increment and length of life: the effect of genetic constitution and dietary protein.

Groups of inbred A/J and C57BL/6J mice and hybrid F1 mice were fed low dietary protein (4% casein) or normal dietary protein (26% casein), with 50 mice in each of the six subgroups. For individual mice within subgroups, growth rate was negatively related to longevity; i.e., the slower the rate of growth the greater the life-span. Between subgroups, the longer the mean growth duration, the longer the mean lifespan. Positive relationships were obtained within subgroups for peak body weight and longevity. It is concluded that, for mice, slowing the rate of growth and increasing growth duration results in a significant increase in the life-span, and the life-span increment is not related to high peak body weight since high body weight, per se, was not correlated with life-span.

Animals

Integrated reporting of quality and length of life--a statistician's perspective.

The reporting of trials has been dominated by a concentration on single measures of response, such as survival or extent of side-effects, perhaps selected as giving an impressive P value for treatment comparisons. Relevant questions about trade-offs are seldom answered or even envisaged in the trial design. Cardiovascular trials should provide evidence on quality of life after myocardial infarction or during antihypertensive therapy. Examples from oncology are used to illustrate how the robustness of treatment recommendation can be explored through a grid of quality adjustments, ranging from complete intolerance of side-effects to absolute acceptance of them. Treatment recommendations may need to be specific to patients unless they are independent of the system of quality adjustment used.

Aged