Biomedical subjects
Publications and source records attributed to W D Thompson.
Collagen stimulating factors, previously described in experimental liver injury and healing skin wounds, have now been found in experimental paraquat lung injury. These factors are active not only in culture but also in vivo. The evidence from this third example of tissue injury points to an important pathological role in chronic inflammation.
Population-based tumor registries collect data on all cancer patients within a defined geographic area. The information they provide on demographic factors and tumor characteristics contribute greatly to the conduct of etiologic studies. Illustrations based on data reported to the Connecticut Tumor Registry include examples from case-control and retrospective cohort studies, from investigations of multiple primary cancers and precursor lesions, and from a plan to develop a surveillance system for cancers related to occupation and smoking. This statewide project calls for hospitals to collect, on admission of all in-patients, basic data on occupation/business and smoking status and to enter this information on the patient's admission form. These data are to be included subsequently in the tumor record of each cancer patient in the State, thus enhancing the value and usefulness of the Connecticut Tumor Registry.
A cohort of 3,139 obstetric patients, who delivered children between 1946 and 1965, was followed retrospectively to assess the relationship between exposure to diethylstilbestrol [(DES) CAS: 56-53-1; alpha, alpha'-diethyl-4,4'-stilbenediol] or other estrogenic substances during pregnancy and subsequent cancer incidence. Among the 1,531 women exposed to DES, the relative risk (RR) for all cancers was 1.46 [95% confidence interval (CI), 1.07-2.00]. The RR for cancers of the breast, cervix, and ovary were 1.37 (adjusted), 1.40, and 2.83, respectively, but none of these estimates was statistically significant. For breast cancer an RR in excess of 2.28 can be excluded, with 95% CI for doses averaging 2,100 mg. Within the exposed group there was no evidence for a dose-response relationship.
Immunoperoxidase staining of 125 gastric carcinomas showed pepsinogen in tumour cells of seven (5.6%) cases. Carcinomas from other sites were negative. The phenomenon is probably too uncommon to be useful in identifying secondary carcinomas as gastric in origin, but it is of some biological interest.
Sections of lung from four maternal deaths have been stained with an antibody raised to human keratin. This method has been found to be a more sensitive technique for determining amniotic fluid emboli than other special stains and has shown a higher incidence than expected.
The authors applied seven different sets of diagnostic criteria for alcoholism to data obtained by using the Schedule of Affective Disorders and Schizophrenia (SADS) in a community sample. They found that the different diagnostic schemes for alcoholism are hierarchical in the sense that some definitions identify smaller groups of subjects as alcoholic than do other definitions. This study illustrates a potentially useful empirical approach to comparing diagnostic criteria for psychiatric disorders in epidemiologic or clinical studies.
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Using a combined indirect immunoperoxidase (PAP)/direct immunofluorescence (IF) staining technique, pregnancy associated alpha 2-glycoprotein (alpha 2-PAG) has been shown to be present solely in the IgA producing plasma cells. alpha 2-PAG was undetectable in plasma cells synthesizing any of the other immunoglobulin isotypes (IgG, IgM, IgD and IgE). Furthermore, we have observed increased numbers of alpha 2-PAG positive cells in sites recognized for their local IgA production e.g. lactating breast, salivary gland, respiratory and gastrointestinal mucosae. In support of this cellular association with IgA, alpha 2-PAG was measured by enzyme immunoassay in colostrum, breast milk, saliva, jejunal secretions, bile and urine. The relevance of this novel and preferential association of immunosuppressive alpha 2-PAG with IgA is discussed with regard to the regulation of gut immunoresponsiveness.
This methodologic study assessed the accuracy of family history data in ascertaining psychiatric disorders in relatives. Comparison of diagnoses based on family history with diagnoses based on direct interview indicated that the specificity for the family history method is high, but that the sensitivity is generally low. Accuracy was better for affective disorders and alcoholism than for less severe disorders; spouses and offspring provided more accurate information than parents and siblings. The use of multiple information increased sensitivity somewhat, with little adverse effect on specificity. However, because errors were often correlated when more than one person provided information about a particular relative, the use of multiple informants generally did not improve accuracy substantially. Analysis of family-genetic studies should take account of the differential quality of data obtained by the family history method vs direct interview.
It is important for genetic, epidemiologic, and nosological studies to determine accurate rates of lifetime psychiatric diagnoses in patient and nonpatient populations. As part of a case-control family study of major depression, lifetime psychiatric diagnoses were made for 1,878 individuals. Sources of information used in making diagnostic estimates included direct interview, medical records, and family history data systematically obtained from relatives. Diagnostic estimates were made by trained interviewers, experienced clinicians, and by computer program. The results indicate that it is possible to make lifetime best estimate diagnoses reliably among both interviewed and noninterviewed individuals for most diagnostic categories and that diagnoses based on interview data alone are an adequate substitute for best estimate diagnoses based on all available information in a limited number of diagnostic categories.
Discrepancies between the symptoms of depression, as found in a self-report questionnaire (Center for Epidemiologic Studies--Depression Scale [CED-D]), and the diagnosis of major depression as made by the Research Diagnostic Criteria (RDC) occurred in a community survey. The discrepancies can be explained by the subject's psychiatric or medical disorders other than depression, by nay saying during the interview, or by the exclusion criteria of the RDC (duration of symptoms, role impairment, or help seeking) that are not part of the CES-D. Results show that the discrepancies can be readily explained.
This study compares information on the diagnosis of depression obtained by family history reports with the formation obtained by direct interview. Reports were obtained from family members on the psychiatric status of 696 individuals for whom direct SADS-L interviews were also available. The effects on family history reports of subjects characteristics, treatment status, age of onset of depression, and endogenous symptoms were examined. Sensitivity and specificity for family history reports on the specific symptoms of depression are also reported. The specificity of family history reports for the diagnosis of depression was consistently high but sensitivity varied as a function of subject and illness characteristics. Sensitivity was somewhat higher for females than males and appreciably higher for probands than for their first-degree relatives and spouses. Sensitivity was increased whenever treatment, hospitalization or endogenous symptoms were present in the subject, indicating that family history reports are most accurate for detecting the severest cases of depression. Finally, the symptoms of depression that are least accurately reported by relatives are identified and suggestions for modifying the family history criteria for depression are proposed.
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This study compares matched and unmatched case-control designs in terms of the precision with which one can estimate an exposure-disease association while controlling for the effects of a confounding variable. Provision is made for the cost of the matching process by calculating the reduction in the number of controls that can be studied for fixed study cost. The purpose is to provide epidemiologists with guidelines and quantitative procedures for making rational decisions as to which is the more appropriate study design for specific research problems. The results indicate that when the cost of the matching process is negligible, a matched design is usually more efficient than an unmatched one. The difference in efficiency is generally slight, however, and is found to depend primarily on the strength of the confounder-disease association, the prevalence of exposure, and the strength of the exposure-disease association. When the cost of the matching process is not negligible, a matched design is likely to be less efficient than an unmatched one.
Data on the current prevalence of depression and its treatment derive from a longitudinal community survey conducted in 1975-1976 in New Haven, Conn. The results show the high prevalence of depression based on the Research Diagnostic Criteria. While persons with a depression use the psychiatric and general medical health care systems more frequently than those without a depression, the overall number of those who see a psychiatrist, receive a tricyclic antidepressant, or receive any treatment for their emotional problems from any source is low. Persons with a depression who do not receive treatment especially for their emotional problems make relatively frequent visits to nonpsychiatric physicians. Men and older persons who are depressed receive the least treatment.
This investigation was designed to evaluate the forces developed in supporting structures by removable partial dentures with attachment retainers. The attachments tested were the (1) Sterngold type 7, (2) Dalbo MK, and (3) Thompson dowel. The study utilized a photoelastic model with stress areas recorded photographically. The results showed that: 1. Splinted abutments are indicated when using the tested attachment retainers. 2. With single abutments, the attachment retainers induced distal force on the teeth which resulted in unfavorable horizontal bone forces. 3. The Dalbo MK attachments produced the most force on the edentulous regions and the least force on the abutment teeth. 4. The Thompson dowel and Sterngold type 7 attachment retainers induced similar stress patterns on single abutments and both produced distal abutment forces. 5. The Thompson dowel induced more favorable stress patterns when the abutments were splinted.
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