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Biomedical subjects

W H Chow

Publications and source records attributed to W H Chow.

At least 145 records · Page 8Linked to original sources

Correlations of choriocarcinoma mortality with alcohol drinking and reproductive factors in China.

This country-based correlation study examined associations of choriocarcinoma mortality with reproductive characteristics and lifestyle factors using data from an ecological survey in 49 Chinese rural counties. Univariate correlation and multivariate regression analyses showed that choriocarcinoma mortality rates among Chinese women were significantly related to alcohol consumption, number of pregnancies and age at menopause, and inversely associated with age at first birth. No clear association was seen between choriocarcinoma mortality and smoking, body mass index, dietary factors and levels of serum nutrients, sex hormones, and antibodies to herpes simplex virus. Limitations of these ecological data preclude causal inferences, but the findings add to the limited evidence of the role of reproductive characteristics in choriocarcinoma risk and provide additional clues to other risk factors for this rare and seldom examined cancer.

Adult↗

Occupation and hematopoietic and lymphoproliferative malignancies among women: a linked registry study.

Using a nationwide linked registry, we evaluated the incidence of several hematopoietic and lymphoproliferative (HLP) malignancies among Swedish women from 1961 to 1979 by industry and occupation. The risks of one or more types of HLP cancers (including the leukemias, non-Hodgkin's lymphoma, multiple myeloma, and mycosis fungoides) were significantly increased among women working in the agriculture and textile industries, housekeepers, and post office employees. Limitations of these linked-registry data include lack of detailed information on specific exposures and duration of employment, and the relatively small sizes of specific occupational cohorts. Nevertheless, as the proportion of women entering the workforce continues to increase, this data resource may provide additional clues to occupational determinants of HLP and other malignancies.

Female↗

Diet, serum markers and breast cancer mortality in China.

This county-based correlation study examined associations of breast cancer mortality with dietary habits and certain serum biochemical markers, utilizing data collected from an ecological survey in 65 Chinese rural counties. Univariate correlation and multivariate regression analysis showed that consumption of animal foods, including eggs, fish and meat, was positively linked to county-wide mortality rates of breast cancer in Chinese women. No clear associations between breast cancer mortality rates and consumption of green vegetables, carrots and fruits were observed in this study. A modest inverse correlation between serum vitamin C levels and breast cancer mortality was observed, while selenium levels were positively related to the mortality rates. Positive correlations for serum ferritin and hemoglobin were found, in agreement with recent reports of an elevated cancer risk with increased body iron stores. Limitations of these ecological data preclude causal inferences, but the findings provide clues to breast cancer risk and protective factors in a low incidence area of the world.

Adult↗

Dextrocardia with single coronary artery ostium in a patient with aortic regurgitation and supraventricular tachycardia. A case history.

A sixty-year-old man who presented with dyspnea and palpitations was investigated in this institution and was found to have dextrocardia, single aortic coronary ostium, severe aortic regurgitation, and atrioventricular nodal reentrant tachycardia. The association of single aortic coronary ostium and this combination of cardiac abnormalities has not been previously reported.

Amiodarone↗

Hematopoietic malignancies and related disorders among benzene-exposed workers in China.

Although the relationship between benzene and acute nonlymphocytic leukemia (ANLL) is well established, most of the analytic cohort investigations examining the relationship between benzene and hematologic neoplasms have evaluated only death certificates to validate diagnoses. In a follow-up study of 74,828 benzene-exposed and 35,805 non-exposed workers in China, pathology reports, medical records, and/or histopathologic material were reviewed for all patients with hematopoietic malignancies to ensure correct classification and to provide clinicopathologic descriptions. Eighty-two patients with hematopoietic neoplasms and related disorders were identified among benzene-exposed workers, including 32 cases of acute leukemia, 7--myelodysplastic syndrome (MDS), 9--chronic granulocytic leukemia (CGL), 20--malignant lymphoma or related disorder (ML), 9--aplastic anemia, and 5 others. Among the comparison group, 13 hematologic malignancies were observed, including 6 patients with acute leukemia, 2--CGL, 3--ML, and 2 others. The hematopathologic characteristics of the benzene-exposed ANLL cases resembled those following chemotherapy or radiotherapy. ANLL in workers exposed to benzene may represent a distinct clinicopathologic entity, with characteristics similar to treatment-related ANLL, including a preceding preleukemic phase in some patients. Results in our series, one of the largest to data, also indicate that a greater diversity of hematologic neoplasms is evident among benzene-exposed workers than previously described.

Adult↗

Gender differences in hematopoietic and lymphoproliferative disorders and other cancer risks by major occupational group among workers exposed to benzene in China.

Gender differences in risk for leukemia and other selected and combined disease categories were examined by major occupational category for 74,828 benzene-exposed workers compared to 35,805 unexposed workers from 12 cities in China. No significant differences in the relative risks for total mortality and cancer mortality were found between female and male benzene-exposed workers, although risks tended to be somewhat higher among male than among female employees. Both female and male workers in several occupational categories had notably increased risks for all hematopoietic and lymphoproliferative (HLP) malignant and nonmalignant disorders combined and for total leukemia. Variation in risk for HLP disorders by occupational category was observed in both genders, with highest risks for male and female chemical manufacturing workers, female nonproduction employees, and male printers. However, the numbers of leukemia and other HLP malignancies in each category were small. The findings suggest that both female and male benzene-exposed workers in several occupational categories experience excess leukemia and other HLP disorders with relatively minor gender differences. Although this population is one of the largest cohorts of benzene-exposed workers studied to date, evaluation of the observed variation in risk for HLP neoplasms among the occupational groups for workers of each gender is limited by the small numbers of these relatively rare malignancies.

Benzene↗

Signet-ring mucinous adenocarcinoma of the pancreas.

An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing the common bile duct and invading the liver with multiple hepatic metastasis. The tumor showed a unique and uniform histological appearance, consisting of signet-ring neoplastic cells floating in mucin pools. The rapid clinical course and widespread hepatic metastasis of this patient suggest that this pure, signet-ring variant of mucinous adenocarcinoma of the pancreas might have a poorer prognosis.

Adenocarcinoma, Mucinous↗

Gemfibrozil induced myositis: a case report with light microscopic and ultrastructural study.

A 49-year-old woman with chronic renal failure was given gemfibrozil for hyperlipidemia. She developed gemfibrozil-induced myositis which precipitated an acute compartment syndrome, necessitating emergency fasciotomy. The muscle biopsy showed prominent degeneration of the skeletal muscle fibers, associated with moderate chronic inflammatory infiltration. Electron microscopy revealed myofibrillary fragmentation and mitochondrial disorganization. The clinicopathologic features of gemfibrozil-induced myositis appear to be distinct from those of clofibrate-induced muscular syndrome. Extreme caution should be exercised in the use of gemfibrozil in patients with impaired renal function.

Biopsy↗

Occupational risks for colon cancer in Sweden.

Using the Cancer-Environment Registry of Sweden, which links census information (1960) with cancer incidence data (1961 to 1979), we conducted a systematic, population-based assessment of colon cancer incidence among cohorts defined by industry and occupation for all employed persons in Sweden. Small but statistically significant excesses of colon cancer were observed among white-collar occupations, including administrators, professionals, and clerical and sales workers, whereas a reduction in incidence was found among workers in agricultural and related jobs, such as farmers, fishermen, and hunters. Analysis by subsite within the colon revealed little difference in results. The observed risk patterns are consistent with previous reports on colon cancer risk and occupational physical activity levels, ie, elevated risk among sedentary white-collar workers and reduced risk among agricultural workers. Few craftsman and production processing jobs were linked to colon cancer, although statistically significant excesses were observed among shoe and leather workers, metal smiths, and foundry workers in the metal manufacturing industry. The findings indicate that occupation in general is likely to play a relatively small role in colon cancer etiology, with perhaps its major contribution an indirect one via physical activity.

Cohort Studies↗

Risk factors for cancers of the nasal cavity and paranasal sinuses among white men in the United States.

A case-control analysis of cancer of the nasal cavity and sinuses was performed using data from the 1986 National Mortality Followback Survey. Data on cigarette smoking, alcohol consumption, usual diet, and other factors from 147 white men who died from nasal cancer and from 449 controls who died from other causes were compared. Cigarette smoking was related to an increased risk of nasal cancer, with a doubling of risk among heavy or long-term smokers and a reduction in risk among long-term quitters. Among nonsmokers, having a spouse who smoked was associated with a significantly elevated risk of nasal cancer. After adjustment for smoking, a significant dose-response relation was also noted between alcohol drinking and risk of nasal cancer. High consumption of salted/smoked foods was associated with elevated risk, and risk tended to decrease with increasing intake of vegetables. Associations were more pronounced for cigarette smoking and certain dietary items when the analysis was restricted to maxillary sinus cancer. The study confirms that cigarette smoking is a risk factor for nasal cancer, and provides further evidence that dietary factors may play a role in the etiology of this malignancy.

Aged↗

Tobacco use and nasopharyngeal carcinoma in a cohort of US veterans.

The risk of nasopharyngeal carcinoma (NPC), a relatively rare neoplasm in the United States, was examined in relation to tobacco use in a cohort of nearly 250,000 US veterans whose mortality experience was followed for 26 years. A total of 48 NPC deaths were identified during the follow-up period. Current smokers had a nearly 4-fold increase in risk of NPC compared with non-users of any tobacco, with risk increasing to 6.4 among those smoking more than 2 packs daily. After adjustment for age and number of cigarettes smoked, risks were inversely associated with age at starting to smoke, with the highest risk observed among those who started smoking before age 15, although no clear trend associated with duration of smoking was observed. Former cigarette smokers had a small excess risk of NPC, but no association was detected for cigar/pipe users. This study adds strong evidence to the increasing literature linking cigarette smoking to NPC.

Adolescent↗

Variation in colorectal cancer incidence in the United States by subsite of origin.

BACKGROUND: Colorectal cancer incidence rates vary widely internationally, by race and gender, and have changed over time. Investigation of the patterns by subsite within the colorectum may suggest clues of possible etiologic significance for further study. METHODS: Using population-based data on more than 120,000 cases diagnosed 1976-1987 in the United States Surveillance, Epidemiology, and End Results program, colorectal cancer incidence was evaluated by subsite of origin. RESULTS: Little racial variation was evident for cecum and ascending colon cancers; rates were higher among blacks than whites for transverse and descending colon cancers but lower for sigmoid, rectosigmoid, and rectal cancers. Rates generally increased over time for most colon sites, especially sigmoid colon among white men, but declined slightly for rectal cancer among whites. The sex ratio increased among whites monotonically from 1.12 for cecum to 1.71 for rectal cancers. The distal colon cancer excess among men was most notable at older ages, contrasting with slightly higher rates among women at younger ages. Geographic differences were particularly notable for transverse and rectosigmoid colon cancers. CONCLUSIONS: It may be fruitful for future studies to evaluate factors affecting colorectal carcinogenesis by subsite of origin.

Adult↗

Occupational physical activity and the incidence of cancer of the breast, corpus uteri, and ovary in Shanghai.

BACKGROUND: A sedentary life style has been consistently associated with an increased risk of colon cancer, but the evidence for its association with breast and other gynecologic cancers is limited. METHODS: Occupational information for 3783 incident patients with cancer (breast, 2736; corpus uteri, 452; and ovary, 595) whose disease was diagnosed during the period 1980-1984 was compared with 1982 census data on employment in Shanghai urban areas. The standardized incidence ratios (SIR) of these cancers were estimated for each occupational group classified by job titles and physical activity levels. RESULTS: A significantly increased incidence of breast cancer was found among professionals (SIR = 158), government officials (SIR = 131), and clerical workers (SIR = 143); the incidence was reduced among service workers (SIR = 87) and craftsmen (SIR = 91). Occupational physical activity, as measured by sitting time and energy expenditure, was inversely related to breast cancer incidence, with SIR of 127-131 for inactive jobs (sedentary or low-energy expenditure) and 79-93 for active jobs (long periods of standing or high energy expenditure). Similar associations, although to a lesser extent, were also seen for cancer of the corpus uteri and ovary. CONCLUSIONS: Women with low physical activity occupations had an increased incidence of cancer of the breast, corpus uteri, and ovary; the incidence was reduced among women with high-activity jobs. These findings were consistent with observations from earlier studies and provided further evidence that physical activity may lower the risk of these female hormone-dependent cancers.

Breast Neoplasms↗

Pulmonary arteriovenous malformation. Progressive enlargement with replacement of the entire right middle lobe in a patient with concomitant mitral stenosis.

OBJECTIVE: To present a case of pulmonary arteriovenous malformation (AVM) that showed progressive enlargement in a patient with concomitant rheumatic mitral stenosis. CLINICAL FEATURES: A 73-year-old woman first presented eight years ago because of an uncomplicated acute myocardial infarction. She was noted to have rheumatic mitral stenosis. Six years later, she developed symptomatic sick sinus syndrome for which a permanent pacemaker was implanted. Chest x-ray revealed new development of an opacity in the middle zone of the right lung. Two years later, she was admitted to hospital because of progressive dyspnoea. Chest x-ray showed further increase in size of the right middle zone opacity. OUTCOME: She died of cardiopulmonary failure on the 18th day in hospital. Autopsy revealed a pulmonary AVM, replacing the entire right middle lobe. CONCLUSION: The elevated pulmonary vascular resistance caused by mitral stenosis may have increased the preferential flow of blood through the AVM, leading to its rapid enlargement. Patients with concomitant pulmonary AVM and mitral stenosis need to be recognised, as close follow-up and early treatment may be desirable.

Aged↗

Acute compartment syndrome: an unusual presentation of gemfibrozil induced myositis.

OBJECTIVE: To present a case of gemfibrozil-induced myositis which precipitated an acute compartment syndrome. CLINICAL FEATURES: A 49-year-old woman with chronic renal failure was given gemfibrozil for hyperlipidaemia. She developed myositis in the sixth week of therapy. Her symptoms initially persisted despite withdrawal of gemfibrozil and she developed an acute compartment syndrome. INTERVENTION AND OUTCOME: Emergency fasciotomy was performed. She gradually improved and complete recovery occurred eight weeks after cessation of gemfibrozil therapy. CONCLUSION: Gemfibrozil may induce a local myositis which, in our patient, precipitated an acute compartment syndrome. One should be alert to symptoms of possible drug-induced myositis in patients receiving gemfibrozil. Extreme caution should be exercised in its use in patients with impaired renal function.

Acute Disease↗