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Biomedical subjects

G A Kune

Publications and source records attributed to G A Kune.

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

History of colorectal polypectomy and risk of subsequent colorectal cancer.

In a case control study, which formed part of a large, population-based investigation of the incidence, aetiology and survival of colorectal cancer, 24 of 715 cases and 4 of 727 age/sex group matched controls gave a past history of bowel polypectomy (X21 = 17, P less than 0.001, relative risk = 6.37, 95 per cent confidence interval = 2.2-18.6). There was no significant sex or site difference associated with a history of previous polypectomy. These findings are consistent with the view that colorectal polyps are markers of risk (sixfold in the present study) for the subsequent development of colorectal cancer. The data also support the emerging practice that those with adenomatous polyps need regular surveillance of their large bowel as a screening measure.

Adenocarcinoma↗
PubMed1987

The Melbourne Colorectal Cancer Study. Characterization of patients with a family history of colorectal cancer.

The characteristics of 702 colorectal cancer patients are described in relation to the presence of absence of a family history of colorectal cancer in near relatives. No statistically significant associations were found between those with a family history of colorectal cancer and age at detection, sex, country of birth, religion, number of cancers (single, synchronous, or metachronous), previously removed benign colorectal polyps, and adenomatous polyps found in the resection specimen. The family history rate of colorectal cancer for colon cancer cases was statistically significantly higher than for rectal cancer cases (chi 2(1) = 3.8, P = .05) and there was a gradient of decreasing risk from colon to rectum. The family history rate of colorectal cancer in parents of those who were less than 50 years old was twice that of those 50 or older (P = .07), consistent with the view that earlier age of onset is a characteristic of those with a family history of colorectal cancer. There was a statistically significantly higher family history rate of colorectal cancer in respondents who knew of the disease compared with those who did not (chi 2(1) = 5.5, P less than .05). It is unclear if this effect represents recall bias or self-selection bias. In contrast, the rates for a family history of heart disease and stroke were similar, irrespective of the respondent's knowledge of their colorectal cancer status. Thus in the Melbourne study, the family history rate of colorectal cancer was higher in colon cancer than in rectal cancer, there was a decreasing gradient of risk from colon to rectum, and a tendency for earlier age of onset of colorectal cancer in those with a history of this cancer in a parent.

Age Factors↗
PubMed1987

The nutritional causes of colorectal cancer: an introduction to the Melbourne study.

The Melbourne study has shown that dietary factors and alcohol are important in the cause and prevention of colorectal cancer (CRC). A high intake of fat and beef probably causes CRC, and a high intake of beer possibly causes rectal cancer. The beef and beer effects were both independent of other dietary variables, but further research is indicated to explore the mechanisms of their actions. Foods of plant origin protected against CRC, and the "plant food hypothesis" now replaces the dietary fiber hypothesis. Further study is needed on the interrelationships between various foods of plant origin. Vitamin supplements were protective, and again clarification is needed on the mechanism of action. In high-risk populations, nutritional risk and causal factors are likely to be difficult to find, whereas protective factors are likely to be found with greater ease. Further analysis of the Melbourne data will reveal the importance of diet in CRC causation, relative to the other hypothesized causal and protective factors.

Animals↗
PubMed1987

Observations on the reliability and validity of the design and diet history method in the Melbourne Colorectal Cancer Study.

The paper is a description of, and a practical guide to, the questions, problems, and pitfalls that can arise in the planning and execution of a large-scale epidemiological study of diet and disease; this study was an eight-year project in which diet histories were collected from over 2,000 people. Qualified dietitians obtained a quantitative diet history, which covered all foods eaten in Australia, and assessed as the most representative of the previous 20 years. Because over half of both cases and controls changed their diets in the previous 20 years, the period of recall nominated varied, but this was not a major bias. There was no effect of seasonality on recall. The average duration of the interview was one hour for both cases and controls. The response rate was 84% for cases and 94% for controls, suggesting that the time for interview of the diet history method is not a deterrent for a high response rate. In general, between-interviewer variation was small, although the intakes of total vegetables, cruciferous vegetables, and leafy green vegetables were the least repeatable. Between-interviewer differences were not found to affect the relative risks. Reproducibility of placing a dietary factor into a particular quintile of consumption was good for most foods, but it was lowest for cruciferous and leafy green vegetables. Interviewer bias regarding the dietary causes of colorectal cancer was not a major bias. Analysis of within-interviewer variation over time and analysis of recall bias were not major biases, as far as could be assessed in this study. Indirect validation of the nutritional data in the study (by comparison with other studies, by national per capita consumption, and by a comparison of energy intake with estimated energy requirements based on height, weight, and activity levels) suggested that the data are not an overestimate of intake. Cases and controls were both overestimating and underestimating their dietary intakes to a similar degree. For epidemiological studies of diet and disease, the quantitative diet history method as used here is recommended, particularly if the main objective of the study is to confirm hypotheses.

Australia↗
PubMed1987

Case-control study of dietary etiological factors: the Melbourne Colorectal Cancer Study.

As part of a large-scale investigation of colorectal cancer (CRC) incidence, etiology, and survival, a case-control study was conducted to identify dietary factors associated with the risk of CRC. The study compared 715 cases with 727 age- and sex-matched community controls. A quantitative diet history, assessed to be the most representative of the previous 20 years, was obtained from each subject and analyzed for both food groups and nutrients. The combination of a high-fiber and high-vegetable intake was found to be protective against large bowel cancer. Cruciferous vegetable intake was also found, although with less certainty, to be protective. Dietary vitamin C was protective for estimated intakes greater than 230 mg/day. Dietary Beta-carotene had no separate association with the risk of CRC. Beef intake was a risk factor in males but not in females. Fat intake was a risk factor for both males and females. A low intake of milk drinks was a risk for both males and females. A high intake of pork and fish was protective. The use of vitamin supplements was highly protective. A risk score, which was calculated as the number of risk factors an individual has in his or her diet, showed an increasing monotonic relationship with risk of CRC. The effects of the dietary variables were similar for colon and rectal cancer and, with the exception of beef, were similar for males and females.

Age Factors↗
PubMed1987

Case-control study of alcoholic beverages as etiological factors: the Melbourne Colorectal Cancer Study.

As part of a large-scale investigation of colorectal cancer incidence, etiology, and survival, a case-control study was conducted to identify whether diet and alcohol, among other variables, were associated with the risk of colorectal cancer. This study compared 715 cases with 727 age- and sex-matched community controls. Findings from the dietary data are presented in the previous paper (Nutr Cancer 9, 21-42, 1987). The total life intake of specific alcoholic beverages was obtained from each subject. Data were classified by consumption of beer, wine, spirits, and alcohol. There was little evidence of an association of any of the alcohol variables with the risk of colon cancer. However, beer was found to be a risk factor for rectal cancer. This effect was more marked in males than in females, but the relative risks for females were consistent with those for males. Relative risk estimates changed only slightly when adjusted for the other alcohol variables and for the variables in the diet model; this suggests that the beer effect is separate from that of other alcohol variables and also from dietary variables. The age differences among beer consumers were found to be associated with cancer risk. Consumption of spirits was associated with a low risk for male rectal cancer. The risk of rectal cancer appeared to depend on beer drinking patterns in the previous 15-20 years.

Age Factors↗
PubMed1986

The Melbourne colorectal cancer study: incidence findings by age, sex, site, migrants and religion.

During a 12-month period, age, sex, site, country of birth and religion data were obtained on all new cases of colorectal cancer (CRC) in Melbourne (population 2.8 million) yielding 1150 cases, this being the incidence study arm of a large-scale epidemiological and clinico-pathological investigation of CRC in Melbourne. The age, sex, site and subsite findings had, as expected, the characteristics of a high-risk population for CRC. Unexpectedly, rectal cancer rates were some of the highest recorded in the world. Incidence was greater in males than in females except for colon cancer between ages 35 and 58 where there was a female excess. There was an increasing male to female ratio from caecum to rectum and the crossover age to male excess had a monotonic pattern as it became younger from caecum to rectum. This site and subsite sex pattern may represent an aetiological difference and warrants further study. The data on first generation migrants supported the concept that with migration from low-risk to high-risk countries for CRC, such as Australia, there is a transition of rates towards the risk levels of the new country. Migrant rates for CRC were lower for each subsite than in the Australian born, but became closer to the Australian rate the further the distance down the bowel. Jews had rates nearly double those of the Melbourne population, a hitherto unreported finding in Australia. The possible causes of the very high rectal rates, the transition in migrant rates and the high Jewish rate will be reported in the case-control arm of the study.

Adult↗
PubMed1985

Oestrogen receptors in focal nodular hyperplasia of the liver.

Two patients with focal nodular hyperplasia of the liver and positive results of tests of oestrogen receptor status are described. Both patients were women, both had used oral contraceptive agents and in both the lesion was symptomatic and was surgically resected. The biological and potential therapeutic implications of positive results of tests of oestrogen receptor status in focal nodular hyperplasia is discussed.

Adult↗
PubMed1985

Wound infection in elective biliary surgery: controlled trial using one dose cephamandole.

In a prospective randomized double-blind trial using a 1 g single dose of cephamandole versus placebo, given 1 h before surgery, the wound infection rate after elective surgery for gallbladder stones in 200 consecutive cases was 11%, being 15% in the placebo group and 7% in the cephamandole group (chi 2 = 4.03; P less than 0.05). The average hospital stay was 7.7 days in the absence of wound infection and 13.6 days in the presence of wound infection. Contaminated bile was significantly positively related to wound infection, and cephamandole significantly protected the culture-positive group from wound infection.

Adult↗
PubMed1984

Rapid cytological diagnosis of rectal cancer.

A simple, safe, rapid and accurate technique is described for cytological diagnosis of ulcerated or nodular rectal cancer done while performing digital rectal examination or sigmoidoscopy. In 21 cases, there were 17 true positives and no false positives for cancer. There were two true negatives and one false negative for rectal cancer. It is important to exclude prostatic cancer if, in the male, the lesion is anterior and situated at or near the level of the prostate gland, and this can be done using an immunoperoxidase technique which will identify cancer cells of prostatic origin.

Adenocarcinoma↗