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Biomedical subjects

E White

Publications and source records attributed to E White.

At least 145 records · Page 8Linked to original sources
PubMed1996

Nutrient intake in relation to bladder cancer among middle-aged men and women.

This population-based case-control study examined the association between selected nutrients, foods, and diet behaviors and bladder cancer. Bladder cancer cases (n = 262) were identified from the Surveillance, Epidemiology, and End Results Program cancer registry for western Washington, and controls (n = 405) were identified through random digit dialing. Cases were diagnosed between January 1987 and June 1990, and eligible subjects were Caucasian, aged 45-65 years, and residents of King, Pierce, or Snohomish counties. Subjects completed a self-administered, 71-item food frequency questionnaire and a structured telephone interview. Analyses were conducted by logistic regression analysis and included adjustment for age, sex, smoking (current, former, never), and county. Odds ratios and their 95% confidence intervals for highest versus lowest level of intake were examined. An inverse association was found between the risk of bladder cancer and dietary retinol (odds ratio (OR) across quartiles: 1.00, 1.09, 0.97, and 0.52; 95% CI 0.29-0.97; trend p value = 0.03) and dietary vitamin C (OR across quartiles: 1.00, 0.96, 0.67, and 0.50; 95% CI 0.28-0.88; trend p value = 0.009), adjusted for calories. The use of multivitamin supplements daily over the 10-year period ending 2 years before diagnosis versus no use was associated with a decreased risk of bladder cancer (OR = 0.39; 95% CI 0.24-0.63) as was use of supplemental vitamin C (OR for > 502 mg/day over the 10 years vs. none = 0.40; 95% CI 0.21-0.76). Increased intake of fruit was associated with a decreased risk of bladder cancer (OR across quartiles: 1.00, 1.24, 0.72, and 0.53; 95% CI 0.30-0.93; trend p value = 0.01, adjusted for calories), while increased use of fried foods was associated with an increased risk of bladder cancer (OR across quartiles: 1.00, 1.51, 1.81, and 2.24; 95% CI 1.25-4.03; trend p value = 0.006). This study provides modest evidence that certain nutrients, foods, and supplementation may affect the incidence of bladder cancer.

Aged↗
PubMed1996

Physical activity in relation to colon cancer in middle-aged men and women.

A population-based case-control study was conducted to assess the relation between physical activity and colon cancer among men and women aged 30-62 years. Cases were 251 men and 193 women diagnosed with colon cancer in 1985-1989 in three countries in the Seattle metropolitan area who were identified from the Seattle-Puget Sound Surveillance, Epidemiology, and End Results registry. Controls were 233 men 194 women identified by random digit telephone dialing who were selected by stratified random sampling to approximate the age, sex, and county distribution of cases. Physical activity was assessed by questions on frequency and duration of types of recreational and occupational activities during the 10-year period ending 2 years before diagnosis. Each activity was classified as low intensity (< 4.5 METs ) or moderate to high intensity (> or = 4.5 METs). For men and women combined, moderate or high intensity recreational activity was associated with a decreased risk of colon cancer (relative risk (RR) for two or more times per week vs. none = 0.70, 95% confidence interval (CI) 0.49-1.00). This relation was stronger for men than women. Occupational activity was not associated with colon cancer, except among men younger than 55 (RR for > or = 14.5 hours per week of moderate activity vs. none = 0.29, 95% CI 0.12-0.69). Among men and women combined, total moderate or high intensity activity (occupational plus recreational) was marginally related to colon cancer (RR for > or = 5 hours per week vs. none = 0.78, 95% CI 0.55-1.10). These results were adjusted for age (and sex in the combined sex analyses) and were not confounded by body mass index, dietary factors, or other measured health behaviors. The results of this study provide modest support to the growing number of studies showing that recreational and/or occupational physical activity is associated with a reduced risk of colon cancer.

Adult↗
PubMed1996

Effect of estrogen replacement therapy on the specificity and sensitivity of screening mammography.

BACKGROUND: Previous studies have demonstrated that mammographic breast density increases following the initiation of estrogen replacement therapy (ERT). The effect, if any, that this increase in density has on the specificity (related to false-positive readings) and the sensitivity (related to false-negative readings) of screening mammography is unknown. PURPOSE: Using a retrospective cohort study design, we assessed the effects of ERT on the specificity and the sensitivity of screening mammography. METHODS: Participants (n = 8779) were postmenopausal women, aged 50 years or older, who were enrolled in a health maintenance organization located in western Washington state and who entered a breast cancer screening program between January 1988 and June 1993. Two-view mammography was performed as part of a comprehensive breast cancer screening visit. Menopausal status, as well as demographic and risk-factor information, was recorded via self-administered questionnaires. Hormonal replacement therapy type and use were determined from questionnaire data and from an automated review of pharmacy records. Individuals diagnosed with breast cancer within 12 months of their first screening-program mammograms were identified through use of a regional cancer registry. Risk ratios (RRs) plus 95% confidence intervals (CIs) of false-positive as well as false-negative examinations among current and former ERT users (with never users as the reference group) were calculated. Reported P values are two-sided. RESULTS: The specificity of mammographic screening was lower for current users of ERT than for never users or former users. Defining a positive mammographic reading as any non-normal reading (either suspicious for cancer or indeterminate), the adjusted RR (95% CI) of a false-positive reading for current users versus never users was 1.33 (1.15-1.54) (P < .001); for former users versus never users, the RR (95% CI) was 1.00 (0.87-1.15). The adjusted mammographic specificities (95% CIs) for never users, former users, and current users of ERT were 86% (84%-88%), 86% (84%-87%), and 82% (80%-84%), respectively. Defining a positive reading more rigorously (i.e., as suspicious for cancer only), the adjusted RRs (95% CIs) of false-positive readings for current users and former users (versus never users) were 1.71 (1.37-2.14) (P < .001) and 1.16 (0.93-1.45), respectively. Sensitivity was also lower in women currently receiving ERT. The unadjusted RR (95% CI) of a false-negative reading for current users versus never users was 5.23 (1.09-25.02) (P = .04); for former users versus never users, the RR (95% CI) was 1.06 (0.10-10.87). The unadjusted mammographic sensitivities (95% CI) for never users, former users, and current users of ERT were 94% (80%-99%), 94% (69%-99%), and 69% (38%-91%), respectively. CONCLUSIONS AND IMPLICATIONS: Current use of ERT is associated with lower specificity and lower sensitivity of screening mammography. Lower specificity could increase the cost of breast cancer screening, and lower sensitivity may decrease its effectiveness.

Aged↗
PubMed1996

Changes in [Ca2+]i, [Na+]i and Ca2+ current in isolated rat ventricular myocytes following an increase in cell length.

Isolated rat ventricular myocytes were stretched using carbon fibres to investigate the mechanisms underlying the increase in contraction following stretch. 2. [Ca2+]i and [Na+]i were monitored using the fluorescent indicators fura-2 and sodium-binding benzofuran isophthalate, respectively. The L-type Ca2+ current was recorded simultaneously with contraction using the perforated patch-clamp technique. 3. Mechanical stretch caused an immediate increase in contraction, followed by a slow increase. Contraction was prolonged immediately after the stretch, but did not change during the slow phase. 4. The Ca2+ transient did not change immediately after the stretch. The slow increase in contraction was accompanied by an increase in the amplitude of the Ca2+ transient. However, diastolic [Ca2+]i did not change significantly following stretch. 5. [Na+]i did not change significantly either immediately, or during the slow increase in contraction, after the stretch. 6. The L-type Ca2+ current was not significantly altered either by mechanical loading of the cell with carbon fibres or by stretching the cell. 7. These results suggest that: (1) the rapid increase in contraction following a stretch is due to an increase in myofilament Ca2+ sensitivity rather than to changes in the L-type Ca2+ current or [Na+]i; and (2) a slow increase in the Ca2+ transient underlies the slow increase in contraction in isolated myocytes, but is not caused by either an increase in diastolic [Ca2+]i or a change in [Na+]i (and hence Ca2+ influx via Na(+)-Ca2+ exchange) or a change in myofilament Ca2+ sensitivity.

Animals↗
PubMed1996

The E1B 19K protein blocks apoptosis by interacting with and inhibiting the p53-inducible and death-promoting Bax protein.

The E1B 19K protein is a potent apoptosis inhibitor and the putative adenovirus Bcl-2 homolog. To investigate the mechanism of apoptosis regulation, 19K-interacting cellular proteins were identified using the yeast two-hybrid system, and Bax was one of seven 19-K interacting clones. Residues 50-78 of Bax containing a conserved region designated Bcl-2 homology region 3 (BH3) were sufficient for specific binding to both the E1B 19K and Bcl-2 proteins. The Bax-E1B 19K interaction was detectable in vitro and in lysates from mammalian cells, and Bax expression antagonized E1B 19K protein function. bax mRNA and protein levels were p53-inducible with kinetics identical to that of p21/Waf-1/Cip-1, and E1B 19K and Bcl-2 expression did not affect Bax or p21/Waf-1/Cip-1 accumulation. In cells where p53 was mutant, Bax expression induced apoptosis, suggesting that Bax was sufficient for apoptosis, and acted downstream of p53. p53 may simultaneously activate the transcription of genes required for both growth arrest (p21/Waf-1/Cip-1) and death (bax), and E1B 19K and Bcl-2 may act distally and function through interaction with and antagonism of Bax to prevent apoptosis. With the death pathway disabled, induction of growth arrest by p53 can then be manifested.

Adenovirus E1B Proteins↗
PubMed1996

Constitutional factors and sun exposure in relation to nevi: a population-based cross-sectional study.

A survey of benign melanocytic nevi (moles), suspected precursors or markers for melanoma, was conducted in Washington State among 717 randomly selected 18- to 50-year-old white adults who participated in a telephone interview in 1990-1991. Participants were questioned about constitutional factors, time spent in the sun, and severe sunburns over three time periods and were asked to count the raised nevi on both their arms. Logistic regression was used to examine the risk for 2+ nevi compared with none. An odds ratio (OR) of 2.0 (95% confidence interval (CI) 1.3-3.1) was seen for current freckling. Skin color, tendency to burn, and inability to tan were important risk factors but were not independent of each other. Individuals with a history of severe sunburns had an increased risk of nevi: OR = 1.9 (95% CI 0.9-3.9) for 3+ severe sunburns compared with none in the last 5 years; OR = 2.0 (95% CI 1.2-3.1) for 4+ severe teenage sunburns; and OR = 3.1 (95% CI 1.7-5.3) for 4+ severe childhood sunburns. Furthermore, childhood sunburns were related to nevi independently of sun sensitivity and teenage and recent sunburns: OR = 2.0 (95% CI 1.0-4.0) for 4+ severe sunburns. These data suggest that childhood sunburns are important in the etiology of nevi. This study supports prior studies of the relation between melanoma and early sun exposure.

Adolescent↗
PubMed1996

Nevi and migration within the United States and Canada: a population-based cross-sectional study.

A survey to ascertain factors associated with benign melanocytic nevi or moles was conducted among randomly-selected White adults (aged 18 to 50 years) in Washington State (United States). Participants of the telephone interview in 1990-91 were questioned about lifetime places of residence and constitutional factors. Subjects counted raised nevi on their arms at the end of the survey. Logistic regression was used to examine the risk for two or more nevi compared with no nevi. Individuals who resided in warmer areas and lower latitudes than Washington State were at higher risk of having multiple nevi. This association held for residence at birth, during childhood, adolescence, and over lifetime: an odds ratio (OR) of 2.3 (95 percent confidence interval = 1.2-4.3) for lifetime average daily maximum temperature of > or = 64 degrees F compared with 58.9 degrees F, and similar ORs of 2.1 for adolescence and 1.8 for childhood. These associations remained significant after adjusting for potential confounding effects of constitutional factors and for childhood sunburns as a potential mechanism. Risk of multiple nevi was reduced for both early age at migration and longer duration of stay in Washington. These data are consistent with the importance of childhood and adolescent sun exposure in the etiology of nevi, but also suggest an effect of lifetime sun exposure.

Adolescent↗
PubMed1996

A population-based study of contralateral breast cancer following a first primary breast cancer (Washington, United States)

To evaluate predictors of contralateral breast cancer risk, we examined data from a nested case-control study of second primary cancers among a cohort of women in western Washington (United States) diagnosed with breast cancer during 1978 through 1990 and identified through a population-based cancer registry. Cases included all women in the cohort who subsequently developed contralateral breast cancer at least six months after the initial diagnosis, but prior to 1992 (n = 234). Controls were sampled randomly from the cohort, matched to cases on age, stage, and year of initial breast cancer diagnosis. Information on potential risk factors for second primary cancer was obtained through medical record abstractions and physician questionnaires. Women who were postmenopausal due to a bilateral oophorectomy (i.e., a surgical menopause) at initial breast cancer diagnosis had a reduction in contralateral breast cancer risk compared with premenopausal women (matched odds ratio [mOR] = 0.25, 95 percent confidence interval [CI] = 0.09-0.68), whereas no reduction in risk was noted among postmenopausal women who had had a natural menopause (mOR = 0.90, CI = 0.39-2.09). Among postmenopausal women, there was a suggestion of a lower risk associated with relatively high parity (2+). A family history of breast cancer was associated with an increased risk (mOR = 1.96, CI = 1.22-5.15) and varied little by menopausal status. Having an initial tumor with a lobular component (c.f. a ductal histology) was not related strongly to risk (mOR = 1.47, CI = 0.79-2.74). The results of the present and earlier studies argue that we have limited ability to predict the occurrence of a contralateral breast tumor. Better predictors will be required before diagnostic and preventive interventions can be targeted to subgroups of patients with unilateral breast cancer.

Adult↗
PubMed1996

Community organization to promote breast cancer screening ordering by primary care physicians.

Community organization has been viewed as a promising approach to changing preventive behaviors. We evaluated the impact of community organization strategies to promote breast cancer screening ordering by primary care physicians in Washington State. Physicians practicing in two intervention and two control communities were surveyed by mail pre-intervention (1989) and post-intervention (1993). Intervention activities targeting the health care sector included the formation of local physician planning groups, a series of informational mailings, medical office staff training sessions, and reminder system support. There were no significant post-intervention differences in the self-reported mammography ordering of physicians practicing in the intervention and control areas. Over the four-year study period, the proportions of physicians who ordered regular mammography increased by 36%. By 1993, over 80% of the respondents routinely used mammographic screening. Concerns about the high price of mammograms and inadequate insurance coverage were significantly reduced over time in both community pairs. Also, use of patient reminder systems increased significantly between 1989 and 1993. Secular trends resulting from diffusion of strategies to promote mammography were responsible for increases in physician ordering of the procedure. Year 2000 goals for breast cancer screening use by physicians may already have been met in some communities.

Aged↗
PubMed1996

How can nurse teachers be more effective in practice settings?

This paper reports on selected aspects of a research project commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the relationship between teaching, support, supervision and role modelling in clinical areas, within the context of Project 2000 diploma courses. The paper will focus upon findings which related to the role of the nurse teacher in practice settings. These were derived from interviews with students, practitioners and nurse teachers in three Project 2000 centres in England, and from a series of case studies in practice settings providing learning experiences for students undertaking the adult and mental health branches of Project 2000 diploma courses. Findings are discussed in relation to four broad areas: establishing a role for nurse teachers within the practice team; preparation of practitioners for their role in student learning; helping students to link theory and practice; and the nurse teacher's role in developing practice.

Adult↗
PubMed1996

Lamin proteolysis facilitates nuclear events during apoptosis.

Expression of the adenovirus E1A oncogene stimulates both cell proliferation and p53-dependent apoptosis in rodent cells. p53 implements apoptosis in all or in part through transcriptional activation of bax, the product of which promotes cell death. The adenovirus E1B 19K product is homologous in sequence and in function to Bcl-2, both of which bind to and inhibit the activity of Bax and thereby suppress apoptosis. The E1B 19K protein also interacts with the nuclear lamins, but the role of this interaction in the regulation of apoptosis is not known. Lamins are, however, substrates for members of the interleukin-1 beta-converting enzyme (ICE) family of cysteine proteases that are activated during apoptosis and function downstream of Bcl-2 in the cell death pathway. lamins are degraded during E1A-induced p53-dependent apoptosis. Lamin A and C are cleaved into 47- and 37-kD fragments, respectively, and the site of proteolysis is mapped to a conserved aspartic acid residue at position 230. The cleavage of lamins during apoptosis is consistent with the activation of an ICE-related cysteine protease down-stream of p53. No lamin protease activity was detected in cells expressing the E1B 19K protein, indicating that 19K functions upstream of protease activation in inhibiting apoptosis. Substitution of the aspartic acid at the cleavage site produced a mutant lamin protein that was resistant to proteolysis both in vitro and in vivo. Expression of uncleavable mutant lamin A or B attenuated apoptosis, delaying cell death and the associated DNA fragmentation by 12 h. Mutant lamin expressing cells failed to show the signs of chromatin condensation and nuclear shrinkage typical of cell death by apoptosis. Instead, the nuclear envelope collapsed and the nuclear lamina remained intact. However, the late stage of apoptosis was morphologically unaltered and formation of apoptotic bodies was evident. Thus, lamin breakdown by proteolytic degradation facilitates the nuclear events of apoptosis perhaps by facilitating nuclear breakdown.

Adenovirus E1B Proteins↗
PubMed1996

Perinatal factors and risk of breast cancer.

A high level of endogenous estrogen in utero has been hypothesized to be a possible risk factor for breast cancer. We used information from two population-based case-control studies to investigate the relation between perinatal factors and risk of invasive breast cancer among women age 21-45 years (746 cases, 960 controls) and women age 50-64 years (401 cases, 439 controls). Breast cancer cases were ascertained through a population-based cancer registry, and controls were selected by random digit dialing. After adjustment for age, menopausal status, and maternal smoking, the birthweight-breast cancer association in women age 21-45 years followed a J-shaped curve, with women whose birthweight was less than 2,500 gm [odds ratio (OR) = 1.3; 95% confidence interval (CI) = 0.9-2.0] and 4,000 gm or more (OR = 1.7; 95% CI = 1.1-2.5) at increased risk. Women age 50-64 years who were 4,000 gm or more at birth appeared to be at slightly reduced risk of breast cancer (OR = 0.6; 95% CI = 0.3-1.1). With the exception of maternal smoking, there was little effect of other perinatal factors on breast cancer risk in either group. These results support the hypothesized association between intrauterine estrogen exposure and subsequent risk of breast cancer.

Adult↗
PubMed1996

Length-dependent mechanisms in single cardiac cells.

This brief review looks at recent work investigating length-dependent mechanisms in single cardiac cells. Studies using the mechanically simple single cardiac cell have confirmed much of the data previously reported in multicellular preparations, although some differences between single cell and multicellular studies have been found. Electrical studies have been able to investigate the effects of stretch on ion channels and have concentrated upon the exciting discovery of many types of stretch-activated channels in the heart. These channels may explain the occurrence of length-dependent changes in pacemaker activity and stretch-activated arrhythmias in the whole heart. Prolonged stretch can lead to hypertrophy, and single cell studies have been able to characterize the sequence of events leading from membrane stretch to altered protein expression. It appears from these studies that the role of angiotensin II is important.

Animals↗
PubMed1996

Induction of apoptosis by human Nbk/Bik, a BH3-containing protein that interacts with E1B 19K.

The E1B 19-kilodalton protein (19K protein) is a potent apoptosis inhibitor and the adenovirus homolog of Bcl-2 (E. White, Genes Dev. 10:1-15, 1996). To obtain a better understanding of the biochemical mechanism by which the E1B 19K protein regulates apoptosis, proteins that interact with 19K have been identified; one of these is Bax (J. Han, P. Sabbatini, D. Perez, L. Rao, D. Mohda, and E. White, Genes Dev. 10:461-477, 1996), and another is Bak (S. N. Farrow, J. H. M. White, I. Martinou, T. Raven, K.-T. Pun, C. J. Grinham, J.-C. Martinou, and R. Brown, Nature (London) 374:731-733, 1995). Bax and Bak are Bcl-2 family members which contain Bcl-2 homology regions 1, 2, and 3 (BH1, BH2, and BH3), which interact with E1B 19K and Bcl-2 and promote apoptosis. Like Bax and Bak, Nbk was cloned from a yeast two-hybrid screen for proteins that interact with E1B 19K. Nbk contained BH3 but not BH1 or BH2. It also interacted with Bcl-2 but not with Bax. Both Bcl-2 and E1B 19K interacted with Nbk in vitro, and this interaction was highly specific. In vivo, the Nbk and E1B 19K proteins may colocalize with cytoplasmic and nuclear membranes. Nbk expression functionally antagonized 19K-mediated inhibition of apoptotic cell death and completely prevented transformation by E1A and E1B 19K. Nbk was sufficient for induction of apoptosis in the presence of mutant p53 and thus low levels of Bax, suggesting that Nbk functions independently of Bax to induce apoptosis. Nbk may therefore represent a novel death regulator which contains only a BH3 that interacts with and antagonizes apoptosis inhibitors such as the E1B 19K protein.

Adenovirus E1B Proteins↗
PubMed1996

Do beliefs, knowledge, and perceived norms about diet and cancer predict dietary change?

OBJECTIVES: We hypothesized that belief in an association between diet and cancer, knowledge of dietary recommendations and food composition, and perceived norms would predict healthful dietary changes. METHODS: Data are from a population-based sample of Washington State residents (n = 607). Psychosocial constructs measured at baseline (1989/90) were used to predict changes in dietary practices, fat intake, fiber intake, and weight over 3 years. RESULTS: Adults who strongly believed in a diet-cancer connection decreased the percentage of energy consumed from fat by 1.20 percentage points and increased fiber intake by 0.69 g, compared with decreases of 0.21 percentage points and 0.57 g among those with no belief (P < .05). Adults with knowledge of the National Cancer Institute fat and fiber goals decreased their percentage of energy from fat by 1.70 points compared with an increase of 0.27 points among those with little knowledge (P < .05). Food composition knowledge and perceived pressure to eat a healthful diet were not significant predictors of changes in fat intake, fiber intake, or weight. CONCLUSIONS: Interventions that increase the public's beliefs in diet and health associations and communicate diet recommendations can encourage healthful dietary change.

Adult↗