Biomedical subjects

R Winkelmann

Publications and source records attributed to R Winkelmann.

At least 19 recordsLinked to original sources

PubMed1999

Classic Kaposi's sarcoma as a second primary neoplasm.

Although the incidence of classic Kaposi's sarcoma (CKS) has been investigated, its occurrence following a primary neoplasm and its association with this first neoplasm need to be determined. We analyzed a series of 124 patients with a secondary CKS (8.4% of a total of 1485 incident cases) which occurred between 1961 and 1992 in the Jewish Israeli population. Data on first neoplasms and subsequent Kaposi's sarcoma were retrieved from the Israel Cancer Registry. Acquired-immune-deficiency-syndrome-related Kaposi's sarcomas were excluded from the case series. Four controls were randomly selected for each CKS case among all Cancer Registry cases free from a second neoplasm at the time of diagnosis of the CKS in the case, and matched on gender, year of birth and year of diagnosis of the first neoplasm. The average time lapse between first neoplasm and secondary CKS was 4.5 years, being shorter for prostate cancer and for hematopoietic malignancies. As compared with Israel-born Jews, the risk of a subsequent CKS was significantly increased in immigrants [odds ratio (OR) 3.0]; this risk was particularly high in immigrants from the former Soviet Union (OR 9.4) and Poland (OR 7.0). There was no clear trend with age at immigration; however, low age at immigration and a short length of stay in Israel endowed a higher risk of developing a secondary CKS, markedly among patients suffering from solid tumors as the first primary. There was an excess of secondary CKS following a non-Hodgkin's lymphoma (OR 5.3), a Hodgkin's lymphoma (OR 7.5), a leukemia (OR 5.3) or a breast cancer (OR 2.2). Cancer patients with a first primary in the lung, colon, stomach, larynx, liver, pancreas or kidney showed secondary CKS less frequently. Despite the lack of control of therapy for the first neoplasm, development of secondary CKS seems to be mediated by mechanisms similar to those for hematopoietic neoplasms and selected nonhematopoietic neoplasms, such as breast cancer. The trend toward increased risk after a short time lapse and the difference in risk among immigrants indicate that genetic susceptibility is part of the complex interplay between cellular proliferation and control systems.

Aged↗

PubMed1998

Solution structure of the recombinant oxidized rabbit uteroglobin using homonuclear and heteronuclear multidimensional NMR.

Rabbit uteroglobin (rab-UG) is a 16-kDa homodimeric secretory protein with potent anti-inflammatory/immunomodulatory properties. Its physiological role is still unclear, although it was observed that several small hydrophobic molecules bind to the oxidized and the reduced uteroglobin. It is suggested that the formation and/or disruption of the two disulphide bridges not only regulates this binding itself, but also the affinity to the ligand. The determination of the solution structure has been started with the assignment of 1H, 15N and 13C resonances of the oxidized rabbit uteroglobin, based on several two-dimensional and three-dimensional homonuclear and heteronuclear double and triple resonance experiments. The assignment was possible with the overproduction of the wild-type as well as of uniformly 15N-labeled and 15N/13C-labeled samples of the recombinant protein. A complete assignment of 1H, 15N and 13C resonances, the secondary-structure elements and the tertiary structure in solution is presented. The tertiary solution structure was found to be in good agreement with the previously determined crystal structure of rab-UG and with the solution structure of human uteroglobin (h-UG). h-UG and rab-UG are extremely stable proteins within a wide range of pH and temperatures. Some of the binding characteristics of ligands of rab-UG and a mutant with all cysteine residues exchanged to serine residues are discussed.

Amino Acid Sequence↗

PubMed1998

Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study.

BACKGROUND: The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations, mostly born in Eastern Europe. OBJECTIVE: To describe the incidence on CKS in Israeli Jews and to determine differences in incidence according to their geography origin. DESIGN: We analysed data on 1098 incident CKS cases with known country of origin occurring between 1961 and 1989 in the Jewish Israeli population. Reporting systems were the Israel Cancer Registry, the medical documentation of all-Kaposi's sarcoma cases and the registry of HIV-seropositive patients. Patients who were seropositive for HIV were excluded from the study population. Population figures for groups of migrants and natives were derived from census surveys (1961, 1972, 1983) and inter-census estimates based on the population registry. RESULTS: The overall age-standardized rate of CKS was 16.9 per million in men and 6.3 per million in women. The ratio between genders remained stable during the study period. In both genders, there was a steep increase in CKS incidence between the late 1960s (age-standardized rates per million: 8.0 in men and 2.2 in women) and the early 1970s (17.9 in men and 6.7 in women). No further increase was present after 1971. Overall, immigrants experienced a relative risk (RR) of 1.17 [95% confidence interval (CI) 0.90-1.521 compared with Jews born in Israel. Immigrants from Morocco, Algeria and Tunisia had the highest incidence (RR 2.01; 95% CI 1.52-2.65) compared with Jews born in Israel, followed by those born in Iraq (RR 1.74; CI 95% 1.27-2.37). The lowest incidence was experienced by immigrants from Iran (RR 0.37; CI 95% 0.18-0.77) and from Central European countries (RR 0.45; CI 95% 0.30-0.66). Immigrants from other countries in Asia, Africa, the Americas and Europe had similar rates as Jews born in Israel. CONCLUSIONS: Israeli Jews present one of the highest incidences of CKS reported from developed countries. The incidence varies according to geographical origin. Countries surrounding the Mediterranean sea represent the area of highest CKS incidence.

Adolescent↗

PubMed1998

Avoidable mortality in Europe 1955-1994: a plea for prevention.

OBJECTIVE: To analyse trends of avoidable mortality in Europe, emphasising causes of death amenable to primary prevention through reduction of exposures, secondary prevention through early detection and treatment, and tertiary prevention through improved treatment and medical care. DESIGN: Descriptive study of mortality from avoidable causes for the years 1955 through 1994, for ages 5-64 at time of death. Using the World Health Organisation Mortality Database, five year death rates were standardised to the world population. SETTING: 21 countries of Europe in four regions (northern, central, and southern Europe, Nordic countries). PARTICIPANTS: All causes of deaths for men and women, aged 5-64, at time of death. MAIN RESULTS: Between 1955-59 and 1990-94, the reduction in mortality was somewhat greater for avoidable causes than for all causes: 45.8% v 45.1% (women) and 39.3% v 32.6% among men. Reductions in mortality were greater for causes amenable to improved medical care: 77.9% among women and 76.3% among men. The smallest reduction in mortality was seen in women for causes amenable to secondary prevention (11.0%), and in men for causes amendable to primary prevention including tobacco related conditions (16.6%). From a geographical point of view, there were slight differences in trends between European regions, but overall the patterns were similar. CONCLUSIONS: The greatest reduction of avoidable mortality in Europe from 1955-94 came from causes amenable to improved treatment and medical care for both sexes. Further reductions of avoidable mortality can be achieved through implementation of primary and secondary prevention activities, such as tobacco control, reduction of occupational exposures, and universal access to breast and cervical cancer screening programmes.

Adolescent↗

PubMed1997

Further follow-up of New Zealand participants in United Kingdom atmospheric nuclear weapons tests in the Pacific.

We previously reported a study of deaths and cancer incidence in Royal New Zealand (RNZ) Navy personnel who participated in atmospheric nuclear weapons tests conducted by the United Kingdom in the Pacific in 1957-58. The study involved 528 men known to have participated in the tests, and a control group of 1,504 men who were in the RNZ Navy during the same period but were not involved in the tests. The original follow-up was carried out for the period 1957-87 with an observed increase in risk of leukemia and other hematologic cancers, but little or no increase of non-hematologic cancers or non-cancer deaths in test participants. Follow-up now has been extended for the period 1988-92. For the total follow-up period, there were 97 deaths in test participants and 256 deaths in controls, a relative risk (RR) of 1.1 (90 percent confidence interval [CI] = 0.9-1.3). The RR of death from causes other than cancer was 1.0 (CI = 0.8-1.3), whereas the RR of cancer death was 1.2 (CI = 0.8-1.7) and that of cancer incidence was 1.0 (CI = 0.8-1.4). For cancers other than hematologic malignancies, the RR was 1.0 (CI = 0.7-1.5) for mortality, and 1.0 (CI = 0.7-1.3) for incidence. However, there were eight deaths from hematologic cancers in test participants (RR = 3.8, CI = 1.4-10.8), including four leukemias (RR = 5.6, CI = 1.0-41.7). The RR for incidence of hematologic cancers was 1.9 (CI = 0.8-4.3), and that for leukemia was 5.6 (CI = 1.0-41.6). We concluded that the evidence is still consistent with the hypothesis that some leukemias and other hematologic cancers may have resulted from participation in the nuclear weapons test program, but the further follow-up strengthens the evidence that there is no increased risk for non-hematologic cancers or for causes of death other than cancer in the test participants.

Confidence Intervals↗

PubMed1996

Unskilled labor and wage determination: an empirical investigation for Germany.

"This article contributes to the ongoing debate on native wage impacts of immigration. I propose a mobile-fixed factor distinction as a framework in which to think about the differential impact of immigration on various labor market groups. Skilled workers are treated as a fixed factor of production since the strong reliance on skill certification in Germany inhibits mobility and shelters from competition. Unskilled workers, in contrast, receive competitive wages. Using data from the German Socio-Economic Panel for 1984-1989 I estimate panel wage regressions for groups of workers separated by skill certification. I find that university graduates' wages increase, and the wages of workers without postsecondary degree decrease, as the industry share of unskilled workers increases. The effect for apprentices is ambiguous."

Demography↗

PubMed1996

A computerised cancer registration network in the Veneto region, north-east of Italy: a pilot study.

A cancer registration network based on computerised coded diagnoses has been tested in the Veneto region, north-east Italy, with the goal of estimating cancer incidence during 1987-89. The results of the pilot study based on a population of 1,449,513 (33.1% of the total population of the region) indicate that the computer-assisted system successfully ascertained 61.3% of the cases. The quality indices appear to be close to those from other cancer registries in Europe. The increasing availability of computerised coded information from hospitals, pathology departments and death certificates can provide an important contribution to cancer registration, thus reducing the amount of manual work and consequently allowing cancer registration on larger populations at reduced costs.

Death Certificates↗

PubMed1995

Measuring the prevalence of bronchial hyper-responsiveness in children.

BACKGROUND: The aim of this study was to assess the effectiveness of an asthma prevalence video questionnaire (involving the audiovisual presentation of clinical asthma), a standard written questionnaire (based on the IUATLD Bronchial Symptoms Questionnaire) and a new written questionnaire (designed for an international study of asthma and allergies in childhood [ISAAC]) in predicting bronchial hyper-responsiveness (BHR) (PD20 < or = 7.8 mumol methacholine). METHODS: The IUATLD and video questionnaires were administered to 193 schoolchildren (13-16 years). The ISAAC questionnaire was administered to 87 of these children. All children subsequently underwent bronchial challenge to methacholine. RESULTS: The sensitivity and specificity for predicting BHR were similar for individual questions from the IUATLD and video questionnaires. The video questions with the highest Youden's index related to moderate wheezing at rest (0.46), severe wheezing at rest (0.38), and nocturnal wheezing (0.37). The ISAAC questionnaire was similar in effectiveness to the IUATLD questionnaire in predicting BHR. CONCLUSIONS: The video questionnaire is a valid method of assessing the prevalence of BHR, and may be particularly useful when comparing populations with differing languages and cultures. Some video questions appeared more effective than others in relation to predicting BHR. A new written questionnaire (ISAAC) designed for a large international asthma prevalence study in children also is an effective method for measuring the prevalence of BHR.

Adolescent↗

PubMed1995

Soft tissue sarcoma and non-Hodgkin's lymphoma in workers exposed to phenoxy herbicides, chlorophenols, and dioxins: two nested case-control studies.

We examined the effect of exposure to chemicals present in the production and spraying of phenoxy herbicides or chlorophenols in two nested case-control studies of soft tissue sarcoma and non-Hodgkin's lymphoma. Eleven sarcoma and 32 lymphoma cases occurring within an international cohort were matched for age, sex, and country of residence with 55 and 158 controls, respectively. Exposures to 21 chemicals or mixtures were estimated by three industrial hygienists who were blind to the subject's case-control status. Excess risk of soft tissue sarcoma was associated with exposure to any phenoxy herbicide [odds ratio (OR) = 10.3; 95% confidence interval (CI) = 1.2-91] and to each of the three major classes of phenoxy herbicides (2,4-dichlorophenoxyacetic acid, 2,4,5-trichlorophenoxyacetic acid, and 4-chloro-2-methylphenoxyacetic acid), to any polychlorinated dibenzodioxin or furan (OR = 5.6; 95% CI = 1.1-28), and to 2,3,7,8-tetrachlorodibenzo-p-dioxin (OR = 5.2; 95% CI = 0.85-32). Sarcoma risk was not associated with exposure to raw materials or other process chemicals. In the non-Hodgkin's lymphoma study, associations were generally weaker than those found in the study on sarcoma. These findings indicate that workers exposed to phenoxy herbicides and their contaminants are at a higher risk of soft tissue sarcoma.

Case-Control Studies↗

PubMed1994

A retrospective mortality study of workers exposed to arsenic in a gold mine and refinery in France.

A historical mortality study of a cohort of employees of a gold mining and refining company was carried out in Salsigne, France. A major goal of the study was to investigate the relationship between lung cancer mortality and exposure to arsenic, radon, silica, and other contaminants of the working environment. A twofold excess of lung cancer was found both among miners and smelters, mainly concentrated among workers who had experienced exposure to past levels of arsenic, radon, and silica. The consistency of the results in the mine and the refinery are suggestive of a carcinogenic risk from both soluble and insoluble arsenic, although the potential role of other factors cannot be dismissed.

Arsenic Poisoning↗

PubMed1994

Count data models for demographic data.

"This paper deals with the estimation of single equation models in which the counts are regressed on a set of observed individual characteristics such as age, gender, or nationality.... We propose a generalized event count model to simultaneously allow for a wide class of count data models and account for over- and underdispersion. This model is successfully applied to German data on fertility, divorces and mobility." (SUMMARY IN FRE)

Demography↗

PubMed1993

Occupational exposure to phenoxy herbicides and chlorophenols and cancer mortality in The Netherlands.

As part of the "IARC International Register of Persons Exposed to Phenoxy Herbicides and Contaminants," a cohort of workers who manufacture and prepare chlorophenoxy herbicides was recruited in The Netherlands. The cohort comprised 2,310 workers from two plants, operated by different companies, who were followed during the periods 1955-1985 and 1965-1986, respectively. In 1963, there had been an industrial accident in one factory with concomitant release of dioxin into the environment. Loss to follow-up was 3%. Mortality data on 963 exposed and 1,111 nonexposed men were evaluated by external and internal comparison. Compared with national rates, total mortality (94 deaths, standardized mortality ratio [SMR] = 101; 95% confidence interval [CI], 82-124) and cancer mortality (31 deaths, SMR = 107; 95% CI, 73-152) for exposed workers were not significantly increased. A statistically insignificant increase was observed for non-Hodgkin's lymphoma (2 deaths, SMR = 299; 95% CI, 36-1,078). No cases of soft-tissue sarcoma were encountered. There was no increase in either total mortality (25 deaths, SMR = 111; 95% CI, 72-163) or cancer mortality (10 deaths, SMR = 137; 95% CI, 66-252) among the 139 workers probably exposed to dioxins during the 2,4,5-trichlorophenol production accident or the subsequent clean-up operations. Compared with nonexposed workers, exposed workers did not exhibit a higher total mortality (rate ratio [RR] = 1.28; 95% CI, 0.89-1.82). Mortality due to all cancers (RR = 1.7; 95% CI, 0.9-3.4) and respiratory cancer (RR = 1.7; 95% CI, 0.5-6.3) was insignificantly elevated. These findings suggest that the increases in cancer mortality among workers exposed to phenoxy herbicides and chlorophenols may be attributable to chance. Lack of power prevented evaluation with respect to specific cancers.

Adult↗

PubMed1993

Survival of breast cancer patients from Piedmont, Italy.

A population-based series of 4,764 women from Piedmont, Italy, who were diagnosed with breast cancer during 1979-81 and for whom information on social and demographic factors was available, was followed-up for mortality until 1986 or 1987. Relative survival rates at one, three, and five years were 94.6, 81.6, and 71.1 percent, respectively, and were similar to those of other European series. Women aged 40-49 years at diagnosis experienced a better survival than women in other age groups. The mortality was highest between one and four years after diagnosis, and lowest between five and seven years. Survival rates were lowest for women above the age of 80, and single women had a worse prognosis than married women. Women with less than seven years of education had nonsignificantly lower survival rates than more educated women. No difference in survival was found according to occupation, size of town of residence, place of birth, or type of hospital.

Adult↗

PubMed1993

Descriptive epidemiology of primary cancer of the brain, cranial nerves, and cranial meninges in New Zealand, 1948-88.

We used New Zealand data on occurrence of different types of brain cancer to investigate: (i) a possible secular increase which has been seen worldwide and has generated considerable debate; (ii) possibly higher rates among Maori; and (iii) possibly higher risks related to social class and occupation. Data from the NZ Cancer Registry on the 5,684 brain cancers diagnosed among NZ residents from 1948-88 were used to study the pattern of occurrence by gender, age, race, calendar year, social class, occupation, and histology. Age-standardized brain-cancer incidence rates per 100,000 more than doubled over the 41-year period (from 2.9 to 6.9 in males and from 2.1 to 5.1 in females). A strong trend of increasing incidence with increasing social class is seen in males (Ptrend = 0.01). Among Maori, the proportion of all brain cancer that is medulloblastoma is four times that among non-Maori, and the proportion of all brain cancers that lack histologic confirmation is about 40 percent higher. Elevated risks are seen among: dairy farmers (odds ratio [OR] = 3.4, 95 percent confidence interval [CI] = 1.9-6.0); sheep handlers (OR = 2.7, CI = 1.4-5.3); livestock workers (OR = 3.8, CI = 1.7-8.4); and farm managers (OR = 3.2, CI = 1.4-7.2); as well as among electrical engineers (OR = 8.2, CI = 20-34.7); electricians (OR = 4.6, CI = 1.7-12.2); and other electrical workers. Brain cancer rates in NZ have increased steadily since 1948, but this increase has leveled off in the most recent five-year period. Although brain cancer rates are likely to be underestimated among the Maori, an excess of medulloblastoma is evident in this group.

Adolescent↗

PubMed1993

Cancer incidence and mortality in women occupationally exposed to chlorophenoxy herbicides, chlorophenols, and dioxins.

The association between exposure to chlorophenoxy herbicides contaminated with dioxins and occurrence of cancer has been studied mainly in male populations. In animal experiments, gender differences have been recorded in the cancer response to administered 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Mortality and cancer incidence in an international cohort of 701 women from an International Register of Workers occupationally exposed to chlorophenoxy herbicides, chlorophenols, and dioxins is examined. Cause-specific, national death rates and cancer incidence rates were used as referents. Cancer risk was not increased overall, with a standardized incidence ratio (SIR) of 96 and 95 percent confidence interval (CI) of 64-137, based on 29 cases. Among workers exposed to those chlorophenoxy herbicides contaminated with TCDD, excess cancer incidence (for all sites) was observed (SIR = 222, CI = 102-422, 9 cases); this was highest in the first 10 years after exposure. No excess was observed for breast cancer, the most common cancer in this cohort. Results on cancer mortality were consistent with those on incidence.

2,4,5-Trichlorophenoxyacetic Acid↗

PubMed1993

Development and use of a welding process exposure matrix in a historical prospective study of lung cancer risk in European welders.

A welding process exposure matrix has been developed relating 13 welding process-welded metal combinations to average exposure levels for total welding fumes, total chromium, chromium (VI) and nickel. Quantitative estimates were derived from consultation of literature sources and of some company data. This matrix was applied to the welding histories of 11,092 welders in the framework of an IARC multicentre study. When detailed welding history was not available at the individual level the average company welding practice profile was applied. No dose-response relationship emerged for lung cancer risk with cumulative dose of the carcinogens chromium (VI) and nickel for stainless steel welders. Dilution of the dose-response relationship could result from between-plant and within-plant variability, and exposure in jobs not accounted for in the study, but not from the partial use of company versus individual data. It is also possible that there is no increased risk related to chromium and nickel exposure in this group of workers. Matrix exposure estimates would need to be validated and the matrix possibly refined by comparison with a variety of comprehensive welding exposure data sets.

Air Pollutants, Occupational↗

PubMed1992

Carcinogenic effect of tobacco smoking and alcohol drinking on anatomic sites of the oral cavity and oropharynx.

A series of 359 male patients with 424 cancer lesions of the oral cavity and oropharynx identified at a US Department of Veterans Affairs Medical Center were divided according to site of origin of the lesion and compared with 2,280 controls from the same hospital with respect to exposure to tobacco smoking and alcohol drinking. Sites of origin were: floor of the mouth (153), oral tongue (50), anterior tonsillar pillar (49), soft palate (44), lingual aspect of retromolar trigone (11), alveolar ridge (5), buccal mucosa (4), and hard palate (2). Forty-one patients had cancers in multiple sites. Tobacco smoking was more strongly associated with soft-palate lesions than with lesions in more anterior sites. Patients with cancer of floor of the mouth and oral tongue had higher odds ratios for alcohol drinking than subjects with cancers of other sites. This study supports the hypothesis of the carcinogenic effect of tobacco smoke and alcoholic beverages on the oral mucosa through direct contact.

Adult↗

PubMed1990

A mortality study of a cohort of slate quarry workers in the German Democratic Republic.

Following reports from other countries indicating an excess risk of lung cancer among silicotics, a historical cohort of workers employed for at least one year at a company in charge of slate extraction and processing during the period 1953-1985 in the German Democratic Republic has been constructed and followed up for mortality from 1970 to 1985. The results of the study show a mortality excess for infectious and respiratory diseases. The overall lung cancer mortality is not in excess but shows a tendency to increase with time since first exposure. A mortality excess from lung cancer is concentrated among workers receiving compensation for silicosis, suggesting a possible carcinogenic risk for individuals suffering from this pathological condition.

Cause of Death↗