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Biomedical subjects

A Kagan

Publications and source records attributed to A Kagan.

At least 55 records · Page 3Linked to original sources
PubMed1987

Postmortem findings in sudden and non-sudden deaths among Japanese-American men in Hawaii.

Analyses were made of the cause of death and major pathologic findings among 1,085 autopsied Japanese-American men in Hawaii to determine the differences between the 167 men who experienced sudden death within 24 hours of being well and the 918 men with non-sudden death. Sudden deaths were further divided into three subgroups according to the interval from the onset of symptoms to death: (less than one hour; one to six hours; more than six hours). Nearly 90 percent of sudden deaths and 25 percent of non-sudden deaths were attributed to cardiovascular disease. The proportion of deaths due to coronary heart disease was highest in sudden deaths less than one hour (72 percent) and lowest in sudden deaths more than six hours (49 percent), whereas the proportion of stroke deaths was highest in sudden deaths more than six hours (37 percent) and lowest in sudden deaths less than one hour (9 percent). The prevalence of myocardial infarction and the grade of coronary atherosclerosis were also significantly greater for sudden deaths (especially sudden deaths less than one hour) than for non-sudden deaths.

Aged↗
PubMed1986

Lipids and lipoproteins as predictors of coronary heart disease, stroke, and cancer in the Honolulu Heart Program.

A group of 2,122 healthy men in the Honolulu Heart Program who participated in the Cooperative Lipoprotein Phenotyping Study, 1970 to 1972, were followed for 10 years by repeated examinations and surveillance of hospital discharge and mortality records in order to diagnose new cases of coronary heart disease, stroke, cancer, and other deaths. Total cholesterol and low-density lipoprotein cholesterol were significantly associated with all clinical types of coronary heart disease in multivariate analyses, whereas high-density lipoprotein cholesterol was inversely associated with nonfatal myocardial infarction and total coronary heart disease, but not with fatal coronary heart disease nor angina. Triglyceride and very-low-density lipoprotein cholesterol were associated with total coronary heart disease by univariate but not multivariate analysis. None of the other specific chronic diseases were significantly associated with any lipid or lipoprotein, although there were trends of inverse associations of all noncardiovascular disease with total cholesterol and low-density lipoprotein cholesterol. Thus, for total disease (coronary heart disease, stroke, cancer, and other deaths), the optimal range for lowest disease incidence was about 200 to 220 mg/dl for total cholesterol and 120 to 140 mg/dl for low-density lipoprotein cholesterol. A strong inverse pattern of total disease with high-density lipoprotein cholesterol indicated that the highest levels were the optimal levels.

Age Factors↗
PubMed1986

The development of a functional rating scale to measure the treatment outcome of chronic spinal patients.

A Functional Rating Scale (FRS) was developed to quantify behavioral changes in chronic pain patients relative to six subcategories. The aim was to demonstrate its validity, test the instrument's reliability, and determine its value in measuring treatment outcome. Five sample populations were examined: a test group of 58 pain clinic patients; a medical control group comprising 29 outpatients with arthritis; and a three-part, healthy control group of 98 subjects. The validation and reliability of the scale were affirmed by clearly differentiating healthy from infirm subjects and through a test-retest check of the four control groups. The difference between means of the test group, before and after treatment, was of high statistical significance, which indicates the practical value of the FRS in measuring relative changes.

Activities of Daily Living↗
PubMed1985

The effect of partial gastrectomy on lipoproteins and other characteristics.

Among 6860 50-77 year old men of Japanese ancestry examined in Honolulu 291 were known to have had a gastrectomy for benign gastric (189) or duodenal (102) ulcer, and 132 had documented peptic ulcer disease treated medically. Total serum cholesterol averaged 12 mg% lower in the surgical group than in the general population (p less than 0.01) while the medically treated men had intermediate values. Fasting lipoprotein determinations done in a sub-sample showed that the lower total cholesterol in the surgical group was due to depressed LDL, while HDL was higher in the operated men than in either the general population or the medically treated patients (p less than 0.01). The surgical patients were heavier users of cigarettes, beer and coffee and averaged about 10 lb. lighter than either the medically treated patients or the rest of the population. However, in multivariate analysis these differences did not not account for the differences in lipoproteins. A small decrement in blood pressure in the surgical patients as compared to the rest of the population became non-significant when weight and others factors were taken into account.

Aged↗
PubMed1984

Ten-year incidence of coronary heart disease in the Honolulu Heart Program. Relationship to nutrient intake.

Nutrient intake was determined in over 8000 men of Japanese ancestry residing on the island of Oahu. Nutrient determination took place at the initial examination during the years 1965-1968. This report relates nutrient intake to the risk of developing coronary heart disease in the 10 years subsequent to the initial examination. Men who developed coronary heart disease had a lower average intake of calories, carbohydrates, starch, and vegetable protein than men who remained free of coronary heart disease. Men who developed coronary heart disease also had a higher mean intake of percentage of calories from protein, fat, saturated fatty acids, and polyunsaturated fatty acids than men who remained free of coronary heart disease. These men also had a significantly lower mean percentage of calories from carbohydrates and a higher mean ingestion of cholesterol per 1000 calories than men who remained free of coronary heart disease. In multivariate analyses including age, systolic blood pressure, serum cholesterol, cigarettes smoked per day, and physical activity index, carbohydrates, vegetable protein, percentage of calories from saturated fatty acids, and percentage of calories from polyunsaturated fatty acids are no longer significantly related to incidence.

Aged↗
PubMed1983

The relation of coronary disease, stroke, and mortality to weight in youth and in middle age.

During ten years of follow-up 701 deaths occurred among 8006 45-68-year-old Honolulu Japanese men who were originally examined in 1965-68. Mortality was highest in both the leanest and fattest men and lowest in the fourth quintile of body mass index (BMI). The excess deaths in the top quintile were due primarily to coronary heart disease which was directly and positively related to BMI. In the bottom two quintiles excess mortality was due to cancer and "other" causes and was confined to men who had lost weight between age 25 and examination. This finding suggests that excess mortality in thin middle-aged men is due to occult antecedent disease rather than leanness per se. When BMI at age 25 was considered, men in the bottom quintile had the lowest mortality in middle age. It is concluded that upward revision of tables of desirable weight for young men would be unwarranted. A modest increase in the upper limit in middle-aged men may be justifiable, but the evidence is incomplete.

Adult↗
PubMed1983

Cultural and biological inheritance of plasma lipids.

A path analytic model for the analysis of nuclear family data is described and used to analyze the results of two major studies of cholesterol (CH) and triglyceride (TG), the Honolulu Heart Study (HHS) of Japanese-Americans and the Cincinnati Lipid Research Clinic (LRC) study of Caucasians. The studies were first analyzed separately to assess evidence for genetic and cultural transmission, marital resemblance, and maternal environmental effects for the two plasma lipids, and then simultaneously to identify the nature and sources of any between-study-heterogeneity. There were significant sources of heterogeneity between the two studies for CH (only marital environmental resemblance and non-transmitted sibling environmental resemblance) and for TG (only non-transmitted sibling environmental resemblance). The two studies were homogeneous with respect to the magnitude of genetic and cultural effects; for CH genetic heritability was estimated as h2 = .594 +/- .041 while cultural heritability was estimated as c2 = .035 +/- .008, and for TG the two heritabilities were estimated as h2 = .259 +/- .034 and c2 = .108 +/- .014. An additional bivariate analysis of the association between the two lipids revealed that all phenotypic resemblance could be explained in terms of an association of non-transmitted residual environments with little evidence for a genetic association. The relevance of these results for an understanding of the genetic epidemiology of plasma lipids is discussed.

Asian People↗
PubMed1983

Family resemblance for fasting blood glucose in a population of Japanese Americans.

The pattern of inheritance of fasting blood glucose was examined in a Japanese cohort of 500 nuclear families living in Hawaii. A principal component of glucose was defined to improve the ranking of diabetics and individuals receiving treatment (medication and/or diet) for hyperglycemia, thereby allowing as well as possible for inability to determine untreated levels in patients. Results from path and segregation analysis show that family resemblance for glucose is low in this population. The additive variation can be explained by a cultural model of inheritance without introducing intergenerational differences, a maternal-paternal effect, or even genetic parameters. Heritability is approximately 0.125. Complex segregation analysis provides no convincing evidence for a major gene, with preliminary support based upon leptokurtic outliers in five families disappearing on further analysis by partial truncation. A claim by other workers of a major recessive gene for hyperglycemia may be due to their failure to allow for treatment, skewness, and multifactorial heritability. In future, the search for major loci acting on liability to hyperglycemia should use multiple determinations of fasting glucose or be addressed to more primary and repeatable variables than fasting blood glucose.

Adult↗