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Dependence of overall correction factor of a cylindrical ionization chamber on field size and depth in medium-energy x-ray beams.

In this paper we examine the depth and field size dependence of the overall correction factor kch for in-phantom dose determinations in orthovoltage x-ray beams. The overall correction factor is considered to be composed of three contributions, i.e., (1) a contribution from the angular dependence of the chamber response free-in-air, derived based on the measured directional response of the NE2571 for different energies combined with Monte Carlo calculations; (2) a displacement effect and (3) a stem effect, both calculated using the Monte Carlo method for different field sizes and depths. The results show a variation of, at most, 2.2% at the lowest photon energies (29.8-keV average photon energy) when going from 2 cm to 5 cm for a small circular 20-cm2 field. In the medium-energy range (> or = 100 kV), variations are limited to, at most, 1.5% for 120 kV-150 kV when comparing the most extreme variations in field size and depth (i.e., 2-cm depth; 20-cm2 area compared to 5 cm depth; 200-cm2 area). Depth variations most importantly affect the overall correction factor by hardening of the photon fluence spectrum, whereas field diameter variations affect the factor by increase or decrease of contributions of photon scattering. The work shows that taking into account the uncertainties adopted in the recent review of data and methods recommended in the IAEA code of practice, the dependence of the overall correction factor on depth and field size is insignificant for the radiation qualities between 100 kV (HVL 0.17-mm Cu, average energy: 52 keV) and 280 kV (HVL 3.41-mm Cu, average energy: 144 keV).

Calorimetry↗

Bronchial carcinoid tumors: importance of prognostic factors that influence patterns of recurrence and overall survival.

PURPOSE: To analyze bronchial carcinoid characteristics that might influence patterns of disease recurrence and overall survival in patients with these tumors. MATERIALS AND METHODS: In a retrospective review, the actuarial rates of local relapse, regional relapse, and overall survival were determined in patients who had undergone resection of bronchial carcinoid tumors. The evaluable files for 87 patients (50 male, 37 female; age range, 15-82 years) who underwent resection of bronchial carcinoid cancer at the authors' institution between 1980 and 1993 were reviewed for pathologic findings, extent of disease, and recurrence patterns after surgery. RESULTS: The actuarial 4-year overall survival, local control, and regional control rates in the entire cohort of patients were 89%, 92%, and 94%, respectively. Univariate analyses revealed that an atypical histologic pattern was the only tumor-related factor that substantially affected local and regional control. Atypical histologic pattern and tumor size were among the multiple factors that independently affected overall survival. CONCLUSION: Atypical histologic findings in patients who had undergone complete resection of bronchial carcinoid tumors were associated with increased local-regional disease recurrence and decreased survival compared with recurrence and survival in patients with typical histologic findings.

Actuarial Analysis↗

Expression of KLF5 is a prognostic factor for disease-free survival and overall survival in patients with breast cancer.

PURPOSE: Kruppel-like factor (KLF5) is a cell growth mediator in various epithelial cells. Higher KLF5 increases cell growth rate and leads to transformed phenotypes. Because tumor cell proliferation is tightly associated with tumor progression, and consequently, with survival of cancer patients, we wanted to examine the prognostic value of KLF5 gene expression for patients with breast cancer. EXPERIMENTAL DESIGN: The gene expression levels of KLF5, ER, PR, HER2, and MKI67 were quantified in the tumor tissues of 90 patients with breast cancer and correlated with disease-free survival and overall survival of the patients. The correlations of gene expression between KLF5 and ER, PR, HER2, and MKI67 were analyzed. In addition, KLF5 expression was also compared with clinical data and age of patients. RESULTS: Statistically significant correlations were found between gene expression of KLF5 and both disease-free survival (univariate analysis) and overall survival (univariate and multivariate analysis). Patients with higher KLF5 expression had shorter disease-free survival and overall survival time, whereas patients with lower KLF5 expression had better survival. Moreover, KLF5 was also found to be positively correlated with HER2 and MKI67, and negatively correlated with age of the patients at diagnosis. CONCLUSION: The gene expression of KLF5 is directly correlated with cell proliferation in vivo and is a prognostic factor for patients with breast cancer. Patients with higher KLF5 expression have shorter disease-free survival and overall survival than patients with lower KLF5 expression. In addition, KLF5 has higher expression in patients ages </=50 years old than in patients >50 years old.

Age Factors↗

Effect of cleft type on overall speech intelligibility and resonance.

The main purpose of this study was to measure and compare the effect of an unilateral cleft lip and palate (UCLP) and a bilateral cleft lip and palate (BCLP) on overall speech intelligibility, nasalance and nasality. An additional objective was to compare the nasalance and nasality patterns of cleft palate children with the available normative data for normal children. The subjects were 37 children with an UCLP (19/37) or a BCLP (18/37) with normal cognitive and motor functions and normal hearing levels. All subjects had a non-syndromic cleft, followed the same surgical protocol and did not undergo secondary pharyngeal surgery. To measure and compare the effect of cleft type, objective and subjective assessment techniques were used. For the objective assessment of nasal resonance the nasometer and the mirror-fogging test were used. Nasalance scores were obtained, while patients produced sounds, read three standard passages or repeated sentences focusing on specific consonants. A perceptual evaluation of speech, the Gutzmann (1913) test and the tests of Bzoch (1989) were used as subjective assessment techniques. The perceptual assessment of the overall speech intelligibility was based on the spontaneous speech and reading or repeating of the nasometric sentences. These samples were judged by three speech pathologists using a 4-category nominal scale. A subjective test (Morley, 1945) was used to evaluate the velopharyngeal mechanism. The findings of the present study show no statistically significant differences for nasalance values, nasality and overall speech intelligibility between the UCLP and BCLP children. Significant differences were found between the data of the normal group and the cleft palate children. These differences included nasalance values as well as nasality data and overall speech intelligibility.

Adolescent↗

Abnormal ventilation scans in middle-aged smokers. Comparison with tests of overall lung function.

We have assessed the uniformity of regional ventilation during tidal breathing using continuous inhalation of krypton-81m in 43 male, lifelong nonsmokers and 46 male, current cigarette smokers (mean daily consumption 24.1 cigarettes/day) between 44 and 61 yr of age and with mild or no respiratory symptoms. All subjects had normal chest radiographs. The results of the ventilation scans were compared with tests of overall lung function (spirometry, maximal expiratory flow-volume curves, and single-breath N2 test). Diffuse abnormalities of the ventilation scan were found in 19 (41%) of the 46 smokers but in none of the nonsmokers. Focal abnormalities were found in 7 smokers and 3 nonsmokers. Smokers showed the expected abnormalities in overall lung function (reduced FEV1 and VC, increased single-breath N2 slope, and closing volume), but in individual smokers there was only a weak relation between the severity of abnormality of overall lung function and an abnormal ventilation scan. Abnormal scans could be found when overall lung function was normal and were not invariably found when significant abnormalities in FEV1/VC or N2 slope were present. There was no relation between the presence of chronic expectoration and an abnormal scan. The prognostic significance of an abnormal ventilation scan in such smokers remains to be established.

Adult↗

Measurement of overall and disease-specific health status: does the order of questionnaires make a difference?

OBJECTIVES: This study was designed to detect any effect of order when modules on disease-specific and overall health status are combined in an outcomes research questionnaire. METHODS: Men with symptomatic benign prostatic hyperplasia (BPH) were prospectively enrolled in a clinical trial of an educational intervention in Group Health Cooperative of Puget Sound, a prepaid group practice. Within the trial, 392 consecutive men were randomized to one of two versions of a baseline questionnaire. One had a 38-item module on BPH-specific health status first, followed by a 30-item module on overall health status; the other had the modules in reverse order. Scores were compared for three BPH-specific scales and eight scales measuring overall health. Data were collected in the form of self-administered questionnaires. RESULTS: Comparing the groups assigned the two versions of the questionnaire, no significant differences in scores on any of the health status scales were found. CONCLUSIONS: In this dataset, we could find no evidence of an order effect when modules on BPH-specific and overall health status were combined in different sequences.

Group Practice, Prepaid↗

Adjuvant chemotherapy in colorectal cancer with high-dose leucovorin and fluorouracil: impact on disease-free survival and overall survival.

PURPOSE: The rationale for using adjuvant chemotherapy in colorectal cancer is to achieve better disease control and thus reduce the high rates of tumor recurrence and mortality in patients who undergo curative surgery. The current literature, including relevant abstracts, on clinical trials of fluorouracil (5-FU) in combination with high-dose leucovorin as adjuvant chemotherapy for colorectal cancer is reviewed. The intent is not to present new data, but to present the reader with a broad perspective and larger patient experience on which to base well-reasoned treatment decisions. DESIGN: Published clinical trials and abstracts presented at the 1996 American Society of Clinical Oncology (ASCO) meeting that assessed 5-FU in combination with high-dose leucovorin as adjuvant chemotherapy for colorectal cancer were surveyed. End points of interest were disease-free survival (DFS), overall survival, and toxicity. RESULTS: In randomized trials that used high-dose leucovorin at doses that ranged from daily-times-five 200 mg/m2 to weekly 500 mg/m2 in combination with 5-FU, significant improvements in both DFS and overall survival were observed over surgery alone (control). In patients treated with high-dose leucovorin/5-FU, DFS rates ranged from 71% to 77% compared with control (58% to 64%). A similar trend was seen in overall survival, with a range of 75% to 84% compared with control (63% to 77%). Toxicities observed for high-dose leucovorin administered on a weekly or daily-times-five schedule were diarrhea, stomatitis, myelosuppression, and nausea. CONCLUSION: Overall, the results of these randomized trials support the use of high-dose leucovorin/5-FU as adjuvant therapy for colorectal cancer. Longer follow-up studies are needed to compare the benefits of these different regimens in terms of survival and to characterize adverse effects, especially those that may not be immediately evident. Adjuvant therapy with high-dose leucovorin/5-FU is an effective regimen that is well tolerated by many patients with colorectal cancer.

Antidotes↗

Lymphovascular invasion is independently associated with overall survival, cause-specific survival, and local and distant recurrence in patients with negative lymph nodes at radical cystectomy.

PURPOSE: We hypothesized that bladder cancer patients with associated lymphovascular invasion (LVI) are at increased risk of occult metastases. METHODS: A multi-institutional group (University of Texas Southwestern [Dallas, TX], Baylor College of Medicine [Houston, TX], Johns Hopkins University [Baltimore, MD]) carried out a retrospective study of 958 patients who underwent cystectomy for bladder cancer between 1984 and 2003. Of patients with transitional-cell carcinoma (n = 776), LVI status was available for 750. LVI was defined as the presence of tumor cells within an endothelium-lined space. RESULTS: LVI was present in 36.4% (273 of 750) overall, involving 26% (151 of 581) and 72% (122 of 169) of node-negative and node-positive patients, respectively. Prevalence of LVI increased with higher pathologic stage (9.0%, 23%, 60%, and 78%, for T1, T2, T3, and T4, respectively; P < .001). Using multivariate Cox regression analyses including age, stage, grade, and number of pelvic lymph nodes removed, LVI was an independent predictor of local (HR = 2.03, P = .049), distant (HR = 2.60, P = .0011), and overall (HR = 2.02, P = .0003) recurrence in node-negative patients. LVI was an independent predictor of overall (HR = 1.84, P = .0002) and cause-specific (HR = 2.07, P = .0012) survival in node-negative patients. LVI maintained its independent predictor status in competing risks regression models (P = .013), where other-cause mortality was considered as a competing risk. LVI was not a predictor of recurrence or survival in node-positive patients. CONCLUSION: LVI is an independent predictor of recurrence and decreased cause-specific and overall survival in patients who undergo cystectomy for invasive bladder cancer and are node-negative. These patients represent a high risk group that may benefit from integrated therapy with cystectomy and perioperative systemic chemotherapy.

Age Distribution↗

Magnetic resonance imaging of overall and regional body fat, estrogen metabolism, and ovulation of athletes compared to controls.

The association of menstrual dysfunction of athletes with changes in body composition has been controversial, because most estimations of body fatness have been indirect. Using magnetic resonance imaging, we quantified the sc and internal fat over a specific volume from the fifth thoracic vertebra to femoral fat in the upper thigh and at 4 other anatomical landmarks of 17 athletes (13 oarswomen and 4 runners) compared to that in 11 nonathletic controls. The magnetic resonance imaging data were also analyzed for the athletes and controls in relation to ovulatory status, which was determined by assay of urinary pregnanediol glucuronide, and in relation to the extent of 2-hydroxylation of estradiol to a nonpotent metabolite, 2-hydroxyestrone, which was evaluated by radiometric analysis. We found that 1) the relative and absolute body fat values of the athletes were significantly less (P < 0.05) than those of the controls overall and at each of the six regional sites, although the body weights of the rowers were significantly heavier than those of the controls, and the runners did not differ from the controls; 2) the ratio of sc fat to internal fat was 80%:20% among both athletes and controls, even though the athletes had significantly less fat; 3) the extent of estradiol 2-hydroxylation was significantly (P = 0.005) inversely related to total fat as a percentage of the total volume and to sc fat as a percentage of the total volume (P = 0.004) overall and at each of the regional fat depots; 4) athletes with menstrual disorders had significantly decreased sc and internal fat overall and at all regional sites compared to controls; and 5) a subgroup of ovulatory rowers had an apparent increase or lack of decrease in internal fat at the level of vertebrae lumbar 4, sacral 1, and sacral 4, compared to controls, whereas their sc fat was decreased at these sites compared to that in controls. Changes in regional fat deposits of both sc and internal fat may be involved in the menstrual dysfunction of the athletes in addition to their decreased overall fatness. The body weight and body mass index of well trained athletes can be a misleading index of body composition.

Adipose Tissue↗

The relationship between six-month progression-free survival and 12-month overall survival end points for phase II trials in patients with glioblastoma multiforme.

Common end points for phase II trials in patients with glioblastoma multiforme (GBM) are six-month progression-free survival (PFS6) and 12-month overall survival (OS12). OS12 can be accurately measured but may be confounded with subsequent therapies upon progression, whereas the converse is true for PFS6. Our goal was to assess the relationship between these end points separately for phase II trials in patients with newly diagnosed GBM and patients with recurrent GBM. Data were pooled from 11 North Central Cancer Treatment Group trials for patients with newly diagnosed GBM (n = 1348). All patients received radiotherapy and pharmaceutical therapy (before, during, or after radiotherapy). Data were pooled from 16 trials that used various pharmaceuticals in treating patients for recurrent GBM (n = 345). All trial regimens were declared nonefficacious by predefined criteria. Overall per-patient concordance was estimated with a kappa statistic. The relationship between OS12 and PFS6 across study arms was assessed by weighted linear regression and Pearson's correlation. Simulation was used to determine the agreement of study outcomes when using PFS6 versus OS12 end points. Cox models with progression status as a time-dependent variable and Kaplan-Meier estimators were used to ascertain the association between progression-free survival status and overall survival. At present, 97% of the patients with newly diagnosed GBM and 95% of those with recurrent GBM have died. The PFS6 and OS12 were 43% and 41%, respectively, for patients with newly diagnosed disease and 9% and 14% for patients with recurrent disease. There was only moderate concordance between the end points on both the patient level and the study level. For the simulation studies, we established phase II efficacy criteria for each end point by using the pooled estimates of OS12 (PFS6) as historical controls. The study decisions made using PFS6 and OS12 were in agreement 88% and 90% of the time for the trials of newly diagnosed and recurrent disease, respectively. Finally, there was a strong association between progression-free survival status and overall survival. PFS6 seems to be a reasonable end point for phase II trials in patients with recurrent glioblastoma.

Antineoplastic Combined Chemotherapy Protocols↗

Final report on the second British Institute of Radiology fractionation study: short versus long overall treatment times for radiotherapy of carcinoma of the laryngo-pharynx.

The second British Institute of Radiology trial of dose fractionation in radiotherapy compared two groups of prospectively randomized patients with squamous carcinoma of the laryngo-pharynx; one group was treated in a short (less than or equal to 4 weeks) and the other in a long (greater than 4 weeks) overall time. Treatment in any one centre could be given, with no planned gap in the course of treatment, either as a conventional, daily (5 fractions per week regime) or as 3 fractions per week. A total of 611 patients were allocated to treatment, of whom nine have had to be excluded from the analysis for a lack of information. Patients were admitted to the trial from January 1976 to December 1985 and were followed up for a maximum of 10 years and a minimum of 3 years. A reduction in total dose was made for use in the short compared with the long treatment regime. This reduction in total dose varied between 18% and 22% depending on whether 5 fractions or 3 fractions per week regimes were used. Overall, no statistically significant differences have been found between the two arms of the trial. The patients treated with 5 fractions per week in a short overall treatment time showed fewer late normal tissue effects. An analysis based on stratification by age, stage and anatomical site gave a relative risk (short/long overall treatment time) for deaths of 1.23 with a 95% confidence interval from 0.96 to 1.59. Analyses stratified for stage and site gave relative risks with 95% confidence intervals of 1 x 10 (0.84-1.44) for local recurrences/tumour persistence, and 1.01 (0.70-1.45) for laryngectomies.

Adult↗

Characterization of the overall rotational diffusion of a protein from 15N relaxation measurements and hydrodynamic calculations.

In this chapter, we discuss experimental and theoretical methods for characterizing the overall rotational diffusion of molecules in solution. The methods are illustrated for the B3 domain of protein G, a small protein with rotational anisotropy of Dpar/Dperp = 1.4. The rotational diffusion tensor of the protein is determined directly from 15N relaxation measurements. The experimental data are treated assuming various possible models for the overall tumbling: isotropic, axially symmetric, and fully anisotropic, and the results of these analyses are compared to determine an adequate diffusion model for the protein. These experimentally derived characteristics of the protein are compared with the results of theoretical calculations of the diffusion tensor using various hydrodynamic models, to find optimal models and parameter sets for theoretical predictions. We also derive model-free characteristics of internal backbone motions in the protein, to show that different models for the overall motion can result in significantly different pictures of motion. This emphasizes the necessity of accurately characterizing the overall tumbling of a molecule to determine its local dynamics.

Binding Sites↗

[Satisfaction with life overall and with specific life domains among elderly persons with a lower limb amputation].

OBJECTIVE: To examine a group of elderly persons who had had a lower limb amputation and who were receiving care at the outpatient clinic of a teaching hospital in Campinas, São Paulo, Brazil, in order to: 1) identify relationships between their perceived overall life satisfaction and their functional capacity; 2) assess their perceived satisfaction with the domains of health, physical functioning/dependence, mental health, and social integration/involvement; and 3) identify relationships between overall life satisfaction and satisfaction with the specific domains. METHODS: An assessment was done of a group of 40 elderly persons (30 men and 10 women) who had had an amputation above the malleolus at least 1 year earlier and who were undergoing rehabilitation between June 1994 and June 1999. Their mean age was 74.5 years (range, 60 to 79 years). A questionnaire was used for data collection to assess: 1) functional capacity (Barthel index); 2) general life satisfaction (Cantrill model); and 3) satisfaction with the domains of health, physical functioning/dependence, mental health, and social integration/involvement, with the 40 elderly persons assessing themselves both in individual terms and in comparison to other persons of the same age group. RESULTS: Among the 40 elderly persons, the level of general life satisfaction was high. Measured on a scale of 1 to 10, the mean was 7.1 and the median 7.5, with a standard deviation of 2.73. There was no correlation between overall life satisfaction and functional capacity. There was no significant difference between individual perceived satisfaction with the specific domains and the perception of these domains in comparison to other persons of the same age group; in both of these cases, the elderly persons who had had an amputation reported a high degree of satisfaction. A positive correlation was found only between overall life satisfaction and the domains of health (individual and comparative) and of physical functioning (comparative). CONCLUSIONS: These results suggest that this group of elderly persons who had had an amputation tended to assess their situation positively. This finding provides new insights into the rehabilitation of elderly persons with lower limb amputations. Taken together with the dearth of studies concerning the subject, this finding also indicates the need for additional research focusing on the subjective well-being of the elderly.

Aged↗

Test-retest reliability of an abbreviated self-report overall health status measure.

STUDY DESIGN: Test-retest reliability study. OBJECTIVE: To assess test-retest reliability and estimate minimal detectable change of an overall measure and 2 summary measures of patient self-report of health status. BACKGROUND: Change in patient self-report of health status is a common outcome measure following rehabilitation. Because collection of health status data takes time and clinicians are required to be productive, selected items from reliable instruments were used to form a new, abbreviated instrument of health status relevant to patients in outpatient rehabilitation. There are no test-retest reliability statistics of these health status measures in this population. METHODS AND MEASURES: A convenience sample of 71 patients (mean age +/- SD, 41.9 +/- 17.9 years; age range, 15-83 years; sex, 35% male), with a variety of orthopaedic diagnoses, seeking rehabilitation in 2 outpatient facilities, volunteered. Patients completed health status questionnaires at initial evaluation and at 24 to 72 hours following evaluation. Intraclass correlation coefficients (ICC2.1) were used to estimate test-retest reliability and to estimate measurement error and minimal detectable changes. RESULTS: ICCs with a 1-sided lower limit 95% confidence intervals (CI) of the Overall Health Status measure and the Physical and Mental Component Summary measures for patients with chronic symptoms were 0.92 (0.85), 0.82 (0.68), and 0.85 (0.74), respectively. Minimal detectable changes (90% CI) were +/-12 (scale range, 100), +/- 9 (scale range, 60), and +/- 9 (scale range, 60) scale points, respectively, for the same measures. CONCLUSIONS: Results support the test-retest reliability of the Overall Health Status measure and summary measures for patients with chronic symptoms and demonstrate ability of the Overall Health Status and Physical Summary Scale measures to detect improvement of patient self-report of health status within the first few days of rehabilitation.

Adolescent↗

Importance of overall treatment time for the response to radiotherapy in patients with squamous cell carcinoma of the head and neck.

In the nineties, several national protocols by the Danish Head and Neck Cancer Study group DAHANCA and other randomized trials, which have included several thousand patients, were performed on squamous cell carcinoma of the head and neck, now the most common malignant disease worldwide. It is a locoregional disease and distant metastases are rarely seen at diagnosis. Radiotherapy and surgery are thus the treatment of choice, with radiotherapy being the treatment modality if organ conservation is required. Since the late eighties there has been a strong focus on the importance of overall treatment time for the outcome of curative radiotherapy for these carcinomas. Based on the results of the Danish protocols it was concluded that the schedule of radiotherapy should be given with the shortest possible overall treatment time. In fact, as a consequence of the loco-regional control rate, the disease-specific and overall survival have shown a significant dependency on the overall treatment time: when this is short, the most beneficial results are achieved. Furthermore, treatment with 6 fractions per week is now the standard radiotherapy in Denmark in most head and neck carcinomas, associated with hypoxic modification using nimorazole. The response to accelerated fractionation is however heterogeneous and until proper predictive factors can be identified and further clarified which are the patients who truly benefit from accelerated fractionation, the radiotherapy schedules should secure a sufficient dose to all patients.

Carcinoma, Squamous Cell↗

[A multi-team case-control study on the effects of psychosocial stress to overall health].

OBJECTIVE: To explore the quantitative relationship between the intensity of psychosocial stress and the degree of overall health damages. METHODS: A multi-group case-control study was designed and implemented. The cases included two groups of out-patients (177) and in-patients (214) in a hospital in Jianyang city, and controls (587) were from the follow-up cohort in the same city. Three groups were studied on the following contents: general demographic characteristics, psychosocial factors and the degree of health damages including mental, physical, and social status. Major statistical analyses were as follows: ranks test, ANOVA, cluster analysis, multinomial logistic regression and ordered-logit regression. RESULTS: Ordered-logit regression model showed that the odds ratio of negative life-events on degree of health damages was 1.335 (P < 0.01). This result showed that there was a positive dose-effect relationship between the negative life-events score and overall health damages. The utility of social support to overall health had protective effect (OR = 0.513). CONCLUSION: Negative life-events were the major risk factors to overall health, and there was a dose-effect relationship between negative events and health damages. Function of social support played a protective factor for health.

Analysis of Variance↗

Cathepsin D concentration in breast cancer cytosols: correlation with disease-free interval and overall survival.

Cathepsin D (CD) is an aspartyl protease implicated in cancer metastasis. In this study of 331 patients, we show that patients with primary breast carcinomas containing high concentrations of CD have a significantly shorter disease-free interval (chi-square = 4.28, P < 0.05) and overall survival (chi-square = 7.7, P < 0.01) than patients with low concentrations. CD as a prognostic marker for overall survival was equally valuable for women younger (chi-square = 4.39, P < 0.05) and older (chi-square = 3.97, P < 0.05) than 50 years. CD was also a significant prognostic marker for overall survival within the estradiol receptor (ER)-positive subgroup of patients (chi-square = 5.79, P < 0.025), but not in the ER-negative subgroup. Patients with tumors containing high concentrations of CD and low concentrations of ER had shorter disease-free intervals (chi-square = 15.1, P < 0.001) and lower overall survival (chi-square = 20.9, P < 0.001) than patients with high concentrations of ER but low concentrations of CD.

Biomarkers, Tumor↗

The variation in blood lipid levels described by various measures of overall and abdominal obesity in Danish men and women aged 35-65 years.

The purpose of the study was to describe the proportion of the variation in blood lipid levels [high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), total cholesterol, very-low-density lipoprotein cholesterol (VLDLC) and triglycerides] explained by different measures of overall obesity [body fat (kg), percentage body fat, or body mass index (kg/m2)] and abdominal obesity [waist/hip ratio, waist/thigh ratio or waist circumference (cm)]. This was done in a Danish population sample of 1523 men and 1464 women aged 35-65 years. This was done to assess, on a population level, the effects on the different lipid levels to be expected from a possible reduction in the level of obesity. The proportion of the variation in lipid levels explained by the various measures of overall obesity differed only slightly, as did the proportion of the variation in lipid levels explained by the various measures of abdominal obesity. In men more of the variation in the blood lipids could be explained by overall obesity than by abdominal obesity, whereas in women the reverse was true. More of the variation in the lipids was explained by overall obesity in men than in women, but more of the variation was explained by abdominal obesity in women than in men. In women the obesity measures predicted between 0% and 11% of the variation in lipid level, and in men the obesity measures predicted between 0% and 14% of the variation. Between 16% and 30% in women and between 5% and 21% in men of the variation in the lipid levels could be explained by obesity, age and several lifestyle variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗