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Biomedical subjects

M J Goodman

Publications and source records attributed to M J Goodman.

At least 19 recordsLinked to original sources
PubMed1991

Breast cancer in multi-ethnic populations: the Hawaii perspective.

The five major ethnic groups in Hawaii's population of 1.1 million are the Japanese, comprising 23%; Caucasians, 23%; ethnic Hawaiians, 19.9%; Filipinos, 11.3%; and Chinese, 4.8%. Only 14% of the population is foreign born. Breast cancer incidences are 29.2 per 100,000 among Filipinos, 51.3 for Japanese, 64.1 for Chinese, 104.3 for Hawaiian, and 105.6 for Caucasian women. The Caucasian incidence is similar to mainland US rates, but the incidence among Hawaii's Japanese is more than twice the rate in Japan. Japanese in Hawaii have less postmenopausal breast cancer than Caucasians, fewer axillary lymph node metastases, and a greater proportion of non-invasive tumors. Late stage at diagnosis is common among Filipino and ethnic Hawaiian woman, and their risk of death is 1.5-1.7 times that of Caucasian, Chinese, and Japanese women with the disease, even after adjustment for age, extent of disease, and socio-economic status. In the BCDDP screening study, only 20% of breast cancers detected in ethnic Hawaiians were not yet palpable and were found by mammography alone. Comparative studies of diet and estrogen levels in the ethnic groups of Hawaii and the parental populations in Japan and the West do not account for the degree of variation observed in breast cancer incidence and tumor pathology. Future research directions are suggested with a view to accounting for these differences.

Breast Neoplasms↗
PubMed1991

Estimating the sensitivity of breast cancer screening--experience with the Honolulu BCDDP data.

The 'capture-recapture' models for estimating breast cancer screening sensitivity can be generalized to include factors that affect sensitivity such as cancer size. Including such factors can help reduce the covariance between mammographic and physical exam sensitivity, which will improve the estimates. One model relating sensitivity to cancer length is presented and tested using data from the Honolulu Breast Cancer Detection Demonstration Project (BCDDP). The model predicts sensitivity fairly well for large breast cancers, but underestimates sensitivity for small cancers. Using both mammography and physical examination, the total screening sensitivity is estimated as 0.91 +/- 0.03 for cancers longer than 12 mm (for the second through fifth screenings for Honolulu and Tucson screening data combined). Limited data suggest similar screening sensitivities for Orientals and Caucasians in Hawaii. Shortcomings of the BCDDP data include inaccurate measurements of cancer length. Suggestions to improve data for future work are given.

Breast Neoplasms↗
PubMed1991

Microscopic activity in ulcerative colitis: what does it mean?

To determine the prognostic importance of microscopic rectal inflammation we followed up 82 patients (aged 21 to 78 years, 44 men) with chronic quiescent ulcerative colitis over 12 months. At trial entry each patient underwent a rectal biopsy and sections were graded independently by two histopathologists. A chronic inflammatory cell infiltrate of varying severity was present in all biopsy specimens, and 58% had crypt architectural irregularities. In addition, 32% had evidence of acute inflammatory activity: 28% acute inflammatory cell infiltrate, 11% crypt abscesses, and 22% mucin depletion. Agreement between the two histopathologists for the presence of each of these features was 94% (90-98%). During the 12 month follow up 27 patients (33%) relapsed after a mean interval of 18 weeks (range 3-44 weeks). Relapse rates were unrelated to duration or extent of disease or to the type of maintenance drug treatment. In patients with an acute inflammatory cell infiltrate 52% relapsed, whereas in the absence of such an infiltrate only 25% relapsed (p = 0.02). Similarly, relapse rates were higher in the presence of crypt abscesses (78% v 27%, p less than 0.005), mucin depletion (56% v p less than 0.02), and breaches in the surface epithelium (75% v 31%, p = 0.1). The presence of a chronic inflammatory cell infiltrate or crypt architectural irregularities, however, bore no relation to the frequency of colitis relapse.

Adult↗
PubMed1979

Factors associated with breast structure in breast cancer patients.

The breast duct patterns and radiographic density, or dysplasia, of 104 breast cancer patients in Hawaii were examined by mammography. The proportions of the four types of breast structure were analyzed for possible relation with age, menopausal state, height, weight, and race. Multiple regression analysis indicated that menopausal state appears to be more important than age per se for the general change in breast structure. Low body weight, but not race, is associated with prominent duct patterns and dysplasia.

Adult↗
PubMed1978

Age at menopause in relation to reproductive history in Japanese, Caucasian, Chinese and Hawaiian women living in Hawaii.

A multiple regression analysis was undertaken to examine the relationship between age at menopause and selected biological and sociological variables in the reproductive history of Caucasian, Japanese, Chinese and part-Hawaiian post-menopausal women living in Hawaii. The analysis was conducted using the medical history records of 196 Caucasian, 181 Japanese, 72 Chinese and 60 Hawaiian women. Age at menarche, parity and months spent breast-feeding were found to have no significant effect on age at menopause. Regression models were not found to be heterogeneous among ethnic groups and no substantial interaction of ethnic group was found with age at menarche, parity or months spent breast-feeding.

Asian People↗
PubMed1977

Mammographic screening. Value in diagnosis of early breast cancer.

Analysis of the two-year results of a project screening asymptomatic women for breast cancer is presented. There were 10,008 women examined and 490 biopsies completed. There were 97 cancers found, of which 55 were nonpalpable; 36 of the 97 cancers were in women under 50 years of age. The incidence of axillary metastasis was 7% in the nonpalpable lesions. We suggest that mammography is useful in discovering curable breast cancer, even among younger women at least down to the age of 40. The potential benefit seems to greatly outweigh the theoretical carcinogenic hazard. Selection of candidates for mammography should be based on all risk factors, not just age. An attempt is made to correlate the results with the theoretical risks as proposed by others.

Adult↗
PubMed1977

Patterns of menopause: a study of certain medical and physiological variables among Caucasian and Japanese women living in Hawaii.

Comparisons were made between menopausal women and nonmenopausal controls among Caucasians and Japanese living in Honolulu, to investigate the extent of physical changes and clinical symptoms associated with menopause. The analysis was conducted using the multiphasic screening records of 170 menopausal cases and 162 nonmenopausal controls in Caucasians, and of 159 menopausal women and 187 nonmenopausal controls in Japanese. Discriminant function analysis was employed with relevant anthropometric, medical, and physiological variables. After adjusting for the linear and non-linear effects of age, only surgery and medication were retained as significant discriminant variables. Discriminant functions for Caucasian and Japanese groups were not found to be significantly heterogeneous. With regard to the discrimination of the menopausal and nonmenopausal groups, the data suggested that, while no clinical conditions other than those attributable to the effects of aging were significantly associated with the menopausal state, medication and surgical procedures for female disorders were significantly related to menopause.

Adult↗
PubMed1977

Glucosamine synthetase activity of the colonic mucosa in ulcerative colitis and Crohn's disease.

Glucosamine synthetase is the first enzyme in glycoprotein biosynthesis, catalysing the formation of glucosamine-6-phosphate, from which N-acetylglucosamine is formed. The levels of this enzyme in normal human colonic mucosa (in colectomy specimens and rectal biopsies) were found to be 13-8 +/- 4-0 micron mol glucosamine synthesised/h/g wet wt. In the colonic mucosa in ulcerative colitis and Crohn's colitis the enzyme level was diminished when there was loss of epithelial cells in the mucosa, although not when there was just loss of goblet cells. In patients recovering from an acute attack of ulcerative colitis, the enzyme levels rose to a peak above the normal range, an effect which did not occur in patients who did not recover promptly. This recovery peak may be related to the synthesis of gastrointestinal mucus, or immunoglobulin, or the secretory component of IgA, all of which contain large amounts of N-acetylglucosamine.

Carbohydrate Epimerases↗
PubMed1977

Glucosamine synthetase activity of the colonic mucosa in membranous colitis.

Glucosamine synthetase, the first enzyme in glycoprotein synthesis, has been measured in serial rectal biopsies in four patients with membranous colitis. In two of the patients the levels of the enzyme were very high initially and in the other two patients the enzyme levels rose to a peak above the normal range after a delay of up to 10 days. These high levels may be related to the mucus hypersecretion which is a feature of membranous colitis but it seems more likely that they represent the healing of the mucosa.

Aged↗
PubMed1977

Usefulness of rectal biopsy in inflammatory bowel disease.

With careful "standardized" technique and proper handling, rectal biopsies can be useful diagnostic and therapeutic adjuncts in the initial evaluation and then long term observation of patients with chronic inflammatory bowel disease.

Biopsy↗
PubMed1977

Inhibition of glucosamine synthesis by salicylates, hydrocortisone and two non-ulcerogenic drugs.

The in vitro inhibition of the glucosamine synthetase activity of rat gastric mucosal homogenates by sodium salicylate and phenylbutazone has been previously reported and has been adduced as a possible mechanism for the ulcerogenic effect of these drugs. This inhibition has been confirmed in human gastric and colonic mucosal homogenates and it is also shown by acetylsalicylic acid and by hydrocortisone hemisuccinate. However, paracetamol and gentamicin, neither of which is known to be ulcerogenic, also inhibited the enzyme to a similar degree to the ulcergenic drugs. This refutes glucosamine synthetase inhibition as the mechanism of the ulcerogenic action of anti-inflammatory drugs.

Acetaminophen↗
PubMed1976

Abnormalities in the apparently normal bowel mucosa in Crohn's disease.

The uninvolved intestinal mucosa away from the affected areas in Crohn's disease has always been considered to be macroscopically and microscopically normal. Rectal biopsy specimens from 13 patients who had had Crohn's, disease elsewhere in the bowel, but never in the rectum, showed significant increases in the plasma-cell density in the lamina propria, in the volume of the lamina propria, and in the glucosamine-synthetase activity of the specimens, compared with a control series of patients with the irritable-colon syndrome. It is suggested that the colonic mucosa is always abnormal in Crohn's disease even if macroscopical and histological examination shows an apparently normal mucosa.

Biopsy↗