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Biomedical subjects

H Ziegler

Publications and source records attributed to H Ziegler.

At least 19 recordsLinked to original sources
PubMed1992

Monitoring and projecting cancer incidence in Saarland, Germany, based on age-cohort analyses.

STUDY OBJECTIVE: The aims were (1) to monitor and compare incidence rates of cancer from successive birth cohorts in Saarland over the period from 1968 to 1987; (2) to project cancer incidence in Saarland in 1988-2002 in order to provide guidelines for health policy planning. DESIGN: This was an ecological study of overlapping birth cohorts of women and men. SETTING: The study was population based involving the whole state of Saarland. PATIENTS: 80,028 cases of malignant neoplasms (other than non-melanoma skin cancer) diagnosed from 1968 to 1987 and reported to the cancer registry of Saarland were included. MEASUREMENTS AND MAIN RESULTS: Age specific, sex specific, and period specific cancer incidence rates were analysed and extrapolated by multiplicative age-cohort models. Due to a steady rise in birth cohort specific cancer incidence rates in males, a substantial rise in incidence of total cancer is projected, while a moderate decline is expected for females. Analogous analyses are presented for the most common single forms of cancer in women and men. Alternative strategies of analysis, such as age-period-cohort modelling, are discussed. CONCLUSIONS: The age-cohort model is well suited for monitoring incidence of most forms of cancer. The projections provide quantitative guidelines for planning of health care resources and underline and quantify the challenge for primary and secondary cancer prevention in Saarland.

Age Factors↗
PubMed1991

Cs-134/137 contamination and root uptake of different forest trees before and after the Chernobyl accident.

The Cs-134/137 activities were measured from different tree organs of spruce, larch and sycamore maple. Two locations in South Bavaria were monitored during a period of 2.5 years following the Chernobyl accident. Samples taken in 1985 allow to determine the Cs-137 contamination before the accident. Increasing Cs-137 activities from older to younger needle years of Picea abies caused by root-uptake of the global weapons' fallout are due to the high phloem mobility of this element and the remaining of the needles at the tree for about 6-7 years. In contrast, the Cs-137 activity was much smaller in leaves of larch and sycamore maple. After the Chernobyl accident, the higher contamination of spruce greater than larch greater than sycamore maple is dependent on the roughness of bark, absolute bark surface and the existence of leaves during the deposition of Chernobyl-derived radioactivity. The Cs-134/137 activity (Bq/kg d.w.) was about 25-times higher in bark compared to wood of Picea abies and 1.5-4.7 times higher in directly contaminated twig-axes than in leaves. Till the end of the investigation the major contamination of the shoots was due to direct deposition of cesium on the trees. A maximum of 5-15% of the total activity of the directly contaminated branches of the plants was calculated to be part of root-uptake, depending on the amount of initial retention. 20% of the translocated cesium into new leaves of larch and about 50% into sycamore maple resulted from root-uptake 2.5 years after the accident.

Accidents↗
PubMed1991

[Do cancer patients survive longer today than before? Survival analysis of cancer patients in the Saar region from 1972 to 1986].

In the Saarland there is a population-based cancer registry, which has collected information about cancer cases over a long period. An important task of population-based cancer registries is the analysis of its data in respect to incidence, mortality and survival of cancer patients. Not all patients who have been diagnosed with cancer die of that disease. In order to evaluate the survival of cancer patients in respect of their particular disease, survival rates are calculated after the determination of the influence of other causes of death. The so-called relative survival rates (calculated for the first five years after diagnosis) are also used in order to evaluate simultaneously the prognostic importance of variables such as sex, age and year of diagnosis. This analysis with data from the cancer registry of the Saarland deals with 9 tumor localizations: stomach, colon, rectum; breast, cervix uteri and corpus uteri; prostate, lung, malignant skin melanoma. In general the 5-year relative survival rates slightly increased when the time period 1972-1976 was compared with 1982-1986. Cancer of the corpus uteri was one exception, in that the relative survival rate was constant over time, and cancer of the cervix uteri was another, in that a decrease of relative survival rate was found, which together with the decreasing incidence might be ascribed to a successful early detection program. There was no significant improvement in the relative survival time for lung or breast cancer patients.

Adult↗
PubMed1991

The role of socioeconomic factors in the survival of patients with colorectal cancer in Saarland/Germany.

The role of socioeconomic factors in the survival of patients with colorectal cancer was assessed using data from the cancer registry of Saarland/Germany, and census information. Among 2627 patients with colorectal cancer diagnosed from 1974 to 1983, patients from communities in the lowest of three categories defined by socioeconomic factors showed significantly lower survival rates than patients from other communities. After adjustment for potential biological and other sociogeographic risk factors in multivariate analyses, relative hazard of death associated with low socioeconomic status (SES) compared with high SES was estimated to be 1.22 (95% CI: 1.01-1.47) for colon cancer and 1.32 (95% CI: 1.09-1.60) for rectum cancer. The results are in agreement with earlier studies from North America, Hawaii and Sweden and indicate that an attempt to improve health care services and acceptance and possibly other relevant general living conditions in socioeconomically less privileged communities may be a rewarding approach towards increasing survival of patients with colorectal cancer.

Aged↗
PubMed1991

[Fluoride excretion in schoolchildren with differing systemic fluoride care].

The aim of the present study was to collect data on urinary fluoride output in 8-16-year old students exposed to either drinking water fluoridation (DWF), or domestic salt fluoridation (DSF). Spot urine samples were collected in the canton of Basel-Stadt (DWF, n = 123), in the canton of Berne (DSF, n = 264), in the county of Davos (DSF, n = 241), and in the city of Winterthur (DSF, n = 40). Furthermore, fluoride concentrations were determined in plasma samples drawn from 33 students from Winterthur. The urinary fluoride concentrations were higher in Basel and Davos (0.62 +/- 0.35 mg/l; 0.61 +/- 0.42 mg/l) than in Berne and Winterthur (0.46 +/- 0.42 mg/l; 0.50 +/- 0.31 mg/l). A relatively high natural fluoride content (0.3 mg/l) in the drinking water explained the difference in urine fluoride concentration between students from Davos and the two other regions with domestic salt fluoridation (Berne, Winterthur). The average fluoride concentration in plasma was 12.7 +/- 3.8 ng/ml. We concluded that, in general, the supply with fluoride consumed with fluoridated domestic salt is close to the level obtained with drinking water fluoridation. However, in areas with very low systemic fluoride supplementation through the drinking water this level might not be reached with salt as the only source of systemic fluoride. Also, the data confirmed the safety of domestic salt fluoridation.

Adolescent↗
PubMed1991

Management of severe hepatic trauma by two-stage total hepatectomy and subsequent liver transplantation.

Even today major hepatic trauma remains a formidable surgical challenge with considerable deaths from exsanguination. Apart from conservative operative techniques that allow successful management in most cases, liver transplantation may be indicated in a more severe injury. This is a report on a patient with massive, unsalvageable liver trauma on whom the first two-staged procedure was successfully performed. After total hepatectomy as the first step and a prolonged anhepatic period of more than 14 hours, liver replacement by an allograft was carried out in a second operation. The patient recovered completely from the potentially lethal hepatic trauma and is alive more than 17 months later.

Accidents, Traffic↗
PubMed1990

[Antinuclear antibodies as early diagnostic criteria of developing collagen disease in quartz dust exposure--a case report].

One and a half years antinuclear autoantibodies (ANA) against Scl-70 and U1-RNP were found in the serum of a quartz dust exposed worker before the clinical manifestation of the progressive systemic sclerosis (PSS). Only a discrete lung fibrosis and an enlargement of the heart was seen at the time of the first autoantibody detection. Because workers with an intensive and long-lasting quartz dust exposition take a high risk to develop PSS a sensitive ANA-screening is indicated at minimum suspicion of chronic collagen disease. The detection of a high ANA-titer in a clinical healthy person may give a hint for the possible future development of such a disease and requires the observation of the clinical course and the paraclinical and immunological parameters. A lung fibrosis and/or an enlargement of the heart in X-ray photographs would indicate visceral early manifestations of the PSS before skin symptoms appear.

Antibodies, Antinuclear↗
PubMed1990

Magnitude and time trends of the life-time risk of developing cancer in Saarland, Germany.

The probability of developing cancer within defined age-intervals or during life-time was assessed for the population of Saarland, Germany in 1970-1972 and 1980-1985 based on life-tables and age-specific cancer incidence rates. As a result of increasing life expectancy and, for some forms of cancer, increasing age-specific incidence rates, the probability at birth of eventually developing a malignant neoplasm (ICD-9 140-208) increased from 24.12% in 1970-1972 to 32.35% in 1980-1985 in men, and from 24.76 to 29.72%, respectively, in women. Comparable calculations are presented and discussed for all of the most common malignancies in women and men. The relation to common measures of descriptive epidemiology, mainly the cumulative rate and the cumulative risk, is numerically illustrated.

Adolescent↗
PubMed1990

[Progress in the early detection of cervix cancer from the viewpoint of the Saarland cancer register].

The efficacy of the nationwide screening programme for cervical cancer in the Federal Republic of Germany, which has been in effect since 1971, has never been checked by means of controlled epidemiological studies. Therefore routinely collected mortality and morbidity data are up to now the only indicators of potential progress in early detection. Mortality statistics of cervical cancer are of restricted value due to lack of specificity regarding the cause of death on death certificates. Data of the population based cancer registry of Saarland are used to investigate trends in terms of age, stage and birth cohort-specific detection rates of cervical cancer and its preinvasive precursors. There was a substantial decrease in incidence rates of invasive cervical cancer, which was most pronounced for advanced tumour stages and young and middle-age groups and which is consistent with comparable results in other countries following the introduction of screening programmes. However, a selection effect of the screening programme suggested by a decrease in survival rates of women with invasive cervical cancer in the 1980ies, must also be taken into account.

Adult↗
PubMed1990

[Incidence of secondary tumors following cervical neoplasia in Saarland 1968-1987].

In 4468 patients diagnosed with invasive cancer or carcinoma in situ of the uterine cervix in Saarland/W-Germany in 1968-1987, 149 secondary cancers were observed compared to 150.6 which would have been expected had the same risk prevailed as in the general population (SMR = 0.99, 95% confidence interval 0.84-1.17). There were, however, substantial differences between the relative risks for specific cancer sites. For example, the risk of breast cancer was clearly lower than in the general population (SMR = 0.62, 95% confidence interval 0.43-0.88), while the risk of cancer of the urinary bladder was significantly increased (SMR = 2.88, 95% confidence interval 1.53-4.93). The results are consistent with findings from other countries, with current knowledge of risk factor profiles of different malignancies and with hypotheses on possible side effects of radiotherapy.

Carcinoma in Situ↗
PubMed1990

[Incidence and prognosis of breast cancer in young women in relation to changes in the risk factor profile].

Trends in breast cancer incidence in women aged 25-44 years are assessed in detail based on data from the population-based cancer registry of Saarland-Germany. Compared to 1968-72, from 1978-82 and 1983-87, a highly significant increase in age-standardised incidence by more than 30% was observed. The increase in incidence was most pronounced among women of 25-29 years of age (relative incidence rate 1978-87, compared to 1968-77: 2.03, 95% confidence interval: 1.11-3.71). The role of changes in prevalence of known and suspected risk factors, mainly the age at the onset of menarche, the age at first birth, parity and early and long-term use of oral contraceptives in adolescence, which may partly explain the observed trends, are discussed. The results have important public health implications, such as the need for extended cancer surveillance and epidemiologic research in the Federal Republic of Germany, and offer a quantitative basis for the development and implementation of future early detection programmes as well as the need for medical care facilities.

Adult↗
PubMed1989

The common occurrence of furan fatty acids in plants.

The observation that F-acids (1) occur in rat chow initiated a search for F-acids in human diet. We observed that the amount of F-acids with a pentyl side chain in alpha-position taken up with a one-day diet correlates well with the amount of excreted degradation products, the pentyl urofuran acids (2), (3) and (4). Therefore it can be concluded that F-acids with a pentyl side chain are not produced in the human body but are introduced through the diet. The origin of F-acids carrying an alpha-propyl side chain is less clear. The amount of propyl-urofuran acids (2) and (3) excreted in urine was found in one case out of three to be five times higher than the amount of F-acids carrying a propyl group in alpha-position taken up by the diet. Therefore, it can presently not be excluded that a portion of the propyl F-acids is produced by the body. F-acids found in human food are mainly introduced into the body by vegetables and fruits. F-acids were found also in birch leaves in considerable amounts, as well as in grasses, dandelion and clover leaves. Thus, we can conclude that F-acids are common constituents of plants.

Chromatography, Gas↗
PubMed1989

[Descriptive epidemiology and prognosis of malignant gynecologic tumors].

Based on data from the Saarland (W. Germany) Cancer Registry, epidemiology and prognosis of gynaecological malignancies is presented for the period 1971-1985. Breast cancer is the most frequent gynaecological tumour followed by tumours of the uterus (cervix + corpus). This is in accordance with worldwide observations. The age distribution of all analysed tumour localisations follows approximately a normal distribution with a maximum between 60 and 65 years of age. Tumours of the breast, cervix and corpus have almost the same prognosis (5-year-survival-rate greater than 60%); the prognosis of ovarian cancer is distinctly poorer. A clear decrease in the incidence is observed only for cervical cancer. The indications are that the proportion of aged patients is continually rising. The mortality, on the other hand, does not increase to the same extent, which indicates a progressive success of therapy of gynaecological malignancies. Since the Saarland Cancer Registry is the only population-based unit functioning for a sufficiently long period, the results represent a model of the situation in the Federal Republic of Germany.

Adolescent↗
PubMed1989

[Model calculations of the effect of demographic changes on the incidence of cancer in Saarland].

Resulting from the population structure and current fertility and mortality rates, a rapid aging of the West German society is to be expected. The impact of these demographic changes on numbers of cancer cases and incidence rates is quantitatively assessed for the Saarland, which is the only state with reliable population-based cancer registration in the FRG. Despite a projected decrease in population size during the next decades, numbers of incident cases are expected to rise substantially in males and to remain almost constant in females for all of the most common forms of cancer. The projected changes have model character for other parts of the FRG.

Cohort Studies↗