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2.
Ann Hum Genet ; 72(Pt 1): 115-25, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18042270

RESUMEN

The Regression of Offspring on Mid-Parent (ROMP) method is a test of association between a quantitative trait and a candidate locus. ROMP estimates the trait heritability and the heritability attributable to a locus and requires genotyping the offspring only. In this study, the theory underlying ROMP was revised (ROMP(rev)) and extended. Computer simulations were used to determine the type I error and power of the test of association, and the accuracy of the locus-specific heritability estimate. The ROMP(rev) test had good power at the 5% significance level with properly controlled type I error. Locus-specific heritability estimates were, on average, close to simulated values. For non-zero locus-specific heritability, the proposed standard error was downwardly biased, yielding reduced coverage of 95% confidence intervals. A bootstrap approach with proper coverage is suggested as a second step for loci of interest. ROMP(rev) was applied to a study of cardiovascular-related traits to illustrate its use. An association between polymorphisms within the fibrinogen gene cluster and plasma fibrinogen was detected (p < 0.005) that accounted for 29% of the estimated fibrinogen heritability. The ROMP(rev) method provides a computationally fast and simple way of testing for association and obtaining accurate estimates of locus-specific heritability while minimizing the genotyping required.


Asunto(s)
Enfermedades Cardiovasculares/genética , Núcleo Familiar , Padres , Sitios de Carácter Cuantitativo , Proyectos de Investigación , Simulación por Computador , Fibrinógeno/genética , Humanos , Corea (Geográfico) , Familia de Multigenes , Polimorfismo Genético , Análisis de Regresión
3.
J Thromb Haemost ; 5(8): 1617-23, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17663734

RESUMEN

BACKGROUND: Variations in platelet function among individuals may be related to differences in platelet-related genes. The major goal of our study was to estimate the contribution of inheritance to the variability in platelet function in unaffected individuals from white and African American families with premature coronary artery disease. METHODS: Platelet reactivity, in the absence of antiplatelet agents, was assessed by in vitro aggregation and the platelet function analyzer closure time. Heritability was estimated using a variance components model. RESULTS: Both white (n = 687) and African American (n = 321) subjects exhibited moderate to strong heritability (h(2)) for epinephrine- and adenosine diphosphate-induced aggregation (0.36-0.42 for white and >0.71 for African American subjects), but heritability for collagen-induced platelet aggregation in platelet-rich plasma was prominent only in African American subjects. Platelet lag phase after collagen stimulation was heritable in both groups (0.47-0.50). A limited genotype analysis demonstrated that the C825T polymorphism of GNB3 was associated with the platelet aggregation response to 2 muM epinephrine, but the effect differed by race. CONCLUSIONS: Considering the few and modest genetic effects reported to affect platelet function, our findings suggest the likely existence of undiscovered important genes that modify platelet reactivity, some of which affect multiple aspects of platelet biology.


Asunto(s)
Plaquetas/fisiología , Enfermedad de la Arteria Coronaria/sangre , Adulto , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/etnología , Salud de la Familia , Femenino , Fibrinógeno/metabolismo , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Agregación Plaquetaria , Polimorfismo Genético , Trombosis/complicaciones , Trombosis/diagnóstico , Tromboxano B2/sangre , Factor de von Willebrand/metabolismo
4.
J Hum Hypertens ; 20(4): 281-9, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16437129

RESUMEN

Blood pressure (BP) reactivity to orthostatic tilt may be predictive of cardiovascular disease. However, the genetic and environmental influences on BP reactivity to tilt have not been well examined. Identifying different influences on BP at rest and BP during tilt is complicated by the intercorrelation among multiple measurements. In this study, we use principal components analysis (PCA) to reduce multivariate BP data into components that are orthogonal. The objective of this study is to characterize and examine the genetic architecture of BP at rest and during head-up tilt (HUT). Specifically, we estimate the heritability of individual BP measures and three principal components (PC) derived from multiple BP measurements during HUT. Additionally, we estimate covariate effects on these traits. The study sample consisted of 444 individuals, distributed across four large families. HUT consisted of 70 degrees head-up table tilting while strapped to a tilt table. BP reactivity (deltaBP) was defined as BP during HUT minus BP while supine. Three PC extracted from the PCA were interpreted as 'general BP' (PC1), 'pulse pressure' (PC2) and 'BP reactivity' (PC3). Variance components methods were used to estimate the heritabilities of resting BP, HUT BP, deltaBP, as well as the three BP PC. Significant (P<0.05) heritabilities were found for all BP measurements, except for systolic deltaBP at 1 and 3 min, and diastolic deltaBP at 2 min. Significant genetic effects were also found for the three PC. Each of these orthogonal components is significantly influenced by somewhat different sets of covariates.


Asunto(s)
Presión Sanguínea/genética , Hipertensión/genética , Postura/fisiología , Pruebas de Mesa Inclinada/métodos , Adolescente , Adulto , Anciano , Niño , Femenino , Predisposición Genética a la Enfermedad , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Ohio/epidemiología , Prevalencia , Factores de Riesgo
5.
Am J Med Genet C Semin Med Genet ; 121C(1): 71-80, 2003 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-12888987

RESUMEN

Obesity is thought to have a genetic component with the estimates of heritability ranging from 0.25-0.40. As part of an ongoing study of obesity in the Old Order Amish, seven two- and three-generation families (157 individuals) were assessed for 21 traits related to obesity, including body mass index (BMI) and BMI-percentile (a standardized distribution of BMI adjusted for age and sex). Genotyping was performed using a panel of 384 short-tandem repeat markers. In this sample, the estimates of heritability ranged from 0.16-0.31 for BMI and from 0.40-0.52 for BMI-percentile. Model-independent linkage analysis identified candidate regions on chromosomes 1, 5, 7, 8, and 11. Given that several markers on 7q were significant for both BMI and BMI-percentile (P < or = 0.001) and that the structural locus for leptin was located on 7q, this region was considered to be the primary candidate region. Subsequent typing of additional flanking markers on 7q corroborated the original findings. Tests of intrafamilial association for alleles at markers in this candidate region were significant at similar levels. Although there is some evidence for linkage and association in the region containing leptin, there appears to be stronger evidence for linkage (P < or = 0.001) and association (P < or = 0.00001) with BMI in a region 10-15 cM further downstream of leptin, flanked by markers D7S1804 and D7S3070 with peak values from D7S495-D7S1798. Evidence from linkage and association studies suggests that this region (D7S1804-D7S3070) may be responsible, at least in part, for variation in BMI and BMI-percentile in the Old Order Amish.


Asunto(s)
Etnicidad/genética , Ligamiento Genético/genética , Obesidad/genética , Alelos , Índice de Masa Corporal , Cromosomas Humanos Par 7/genética , Humanos , Protestantismo , Secuencias Repetidas en Tándem/genética
6.
Am J Med Genet ; 103(4): 308-13, 2001 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-11746011

RESUMEN

It is well known that the Haseman-Elston (H-E) sib-pair linkage method does not assume that the genetic model underlying the trait phenotype is known without error, although this assumption is made for marker loci. However, misspecification of allele frequencies at the marker locus decreases power when some or all parental genotypes are unknown. In this study, the power of the H-E sib-pair method was compared for different types of traits when some or all parental data were missing and allele frequencies at the marker loci were misspecified. Data were generated for a quantitative trait and marker loci in nuclear families using G.A.S.P. (V3.3). Three types of traits were simulated with two equifrequent alleles with a random environmental effect (10%, 30%, and 50%). The simulated data were analyzed using (i) one of the parent's marker data, and (ii) no parental marker data, with both correct and incorrect marker allele frequencies. This test is found to be robust in most of the situations considered except for a slight decrease in power when sample size is small and when the marker locus is not very polymorphic.


Asunto(s)
Mapeo Cromosómico/métodos , Mapeo Cromosómico/estadística & datos numéricos , Ligamiento Genético/genética , Carácter Cuantitativo Heredable , Frecuencia de los Genes , Marcadores Genéticos , Genotipo , Humanos , Análisis por Apareamiento , Modelos Genéticos
7.
J Appl Physiol (1985) ; 91(5): 2173-81, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11641359

RESUMEN

Currently accepted techniques utilize the plateau concentration of nitric oxide (NO) at a constant exhalation flow rate to characterize NO exchange, which cannot sufficiently distinguish airway and alveolar sources. Using nonlinear least squares regression and a two-compartment model, we recently described a new technique (Tsoukias et al. J Appl Physiol 91: 477-487, 2001), which utilizes a preexpiratory breath hold followed by a decreasing flow rate maneuver, to estimate three flow-independent NO parameters: maximum flux of NO from the airways (J(NO,max), pl/s), diffusing capacity of NO in the airways (D(NO,air), pl x s(-1) x ppb(-1)), and steady-state alveolar concentration (C(alv,ss), ppb). In healthy adults (n = 10), the optimal breath-hold time was 20 s, and the mean (95% intramaneuver, intrasubject, and intrapopulation confidence interval) J(NO,max), D(NO,air), and C(alv,ss) are 640 (26, 20, and 15%) pl/s, 4.2 (168, 87, and 37%) pl x s(-1) x ppb(-1), and 2.5 (81, 59, and 21%) ppb, respectively. J(NO,max) can be estimated with the greatest certainty, and the variability of all the parameters within the population of healthy adults is significant. There is no correlation between the flow-independent NO parameters and forced vital capacity or the ratio of forced expiratory volume in 1 s to forced vital capacity. With the use of these parameters, the two-compartment model can accurately predict experimentally measured plateau NO concentrations at a constant flow rate. We conclude that this new technique is simple to perform and can simultaneously characterize airway and alveolar NO exchange in healthy adults with the use of a single breathing maneuver.


Asunto(s)
Óxido Nítrico/metabolismo , Adulto , Algoritmos , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Modelos Biológicos , Valores de Referencia , Pruebas de Función Respiratoria , Mecánica Respiratoria/fisiología , Espirometría , Capacidad Vital/fisiología
8.
J Appl Physiol (1985) ; 91(1): 477-87, 2001 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-11408466

RESUMEN

Current techniques to estimate nitric oxide (NO) production and elimination in the lungs are inherently nonspecific or are cumbersome to perform (multiple-breathing maneuvers). We present a new technique capable of estimating key flow-independent parameters characteristic of NO exchange in the lungs: 1) the steady-state alveolar concentration (C(alv,ss)), 2) the maximum flux of NO from the airways (J(NO,max)), and 3) the diffusing capacity of NO in the airways (D(NO,air)). Importantly, the parameters were estimated from a single experimental single-exhalation maneuver that consisted of a preexpiratory breath hold, followed by an exhalation in which the flow rate progressively decreased. The mean values for J(NO,max), D(NO,air), and C(alv,ss) do not depend on breath-hold time and range from 280-600 pl/s, 3.7-7.1 pl. s(-1). parts per billion (ppb)(-1), and 0.73-2.2 ppb, respectively, in two healthy human subjects. A priori estimates of the parameter confidence intervals demonstrate that a breath hold no longer than 20 s may be adequate and that J(NO,max) can be estimated with the smallest uncertainty and D(NO,air) with the largest, which is consistent with theoretical predictions. We conclude that our new technique can be used to characterize flow-independent NO exchange parameters from a single experimental single-exhalation breathing maneuver.


Asunto(s)
Modelos Biológicos , Óxido Nítrico , Intercambio Gaseoso Pulmonar/fisiología , Ventilación Pulmonar/fisiología , Adulto , Homeostasis , Humanos , Masculino , Métodos , Alveolos Pulmonares/fisiología , Capacidad de Difusión Pulmonar
9.
Genet Epidemiol ; 21 Suppl 1: S794-9, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11793780

RESUMEN

An extension of the traditional regression of offspring on midparent (ROMP) method was used to estimate the heritability of the trait, test for marker association, and estimate the heritability attributable to a marker locus. The fifty replicates of the Genetic Analysis Workshop (GAW) 12 simulated general population data were used to compare the ROMP method with the variance components method as implemented in SOLAR as a test for marker association, and to a standard analysis of variance (ANOVA) method. Large sample statistical properties of the ROMP and ANOVA methods were compared using 2,000 replicates resampled from the families of the original 50 replicates. Overall, the power to detect a completely associated single nucleotide polymorphism (SNP) marker was high, and the type I error rates were similar to nominal significance levels for all three methods. The standard deviations of the estimates of the heritability of the trait were large for both SOLAR and ROMP, but the estimates were, on average, close to those of the generating model for both methods. However, on average, SOLAR overestimated the heritability attributable to the associated SNP marker (by 256%) while ROMP underestimated it (by 26%).


Asunto(s)
Mapeo Cromosómico/estadística & datos numéricos , Marcadores Genéticos/genética , Predisposición Genética a la Enfermedad/genética , Modelos Genéticos , Polimorfismo de Nucleótido Simple/genética , Análisis de Varianza , Pruebas Genéticas , Genética de Población , Genotipo , Humanos , Fenotipo , Análisis de Regresión
11.
Respir Physiol ; 120(3): 231-49, 2000 May.
Artículo en Inglés | MEDLINE | ID: mdl-10828340

RESUMEN

The diffusing capacity, DL, is a critical physiological parameter of the lung used to assess gas exchange clinically. Most models developed to analyze experimental data from a single breath maneuver have assumed a well-mixed or uniform alveolar region, including the clinically accepted Jones-Meade method. In addition, all previous models have assumed a constant DL, which is independent of alveolar volume, VA. In contrast, experimental data provide evidence for a non-uniform alveolar region coupled with sequential filling of the lung. In addition, although the DL for carbon monoxide is a weak function of VA, the DL of nitric oxide depends strongly on VA. We have developed a new mathematical model of the single breath maneuver that considers both a variable degree of sequential filling and a variable DL. Our model predicts that the Jones-Meade method overestimates DL when the exhaled gas sample is collected late in the exhalation, but underestimates DL if the exhaled gas sample is collected early in the exhalation phase due to the effect of sequential filling. Utilizing a prolonged constant exhalation method, or a three-equation method, will also produce erroneous predictions of DL. We conclude that current methods may introduce significant error in the estimation of DL by ignoring the sequential filling of the lung, and the dependence of DL on VA.


Asunto(s)
Modelos Biológicos , Alveolos Pulmonares/fisiología , Capacidad de Difusión Pulmonar/fisiología , Humanos , Mediciones del Volumen Pulmonar , Intercambio Gaseoso Pulmonar
12.
Respir Physiol ; 120(3): 251-71, 2000 May.
Artículo en Inglés | MEDLINE | ID: mdl-10828341

RESUMEN

The diffusing capacity of the lung, DL, is a critical physiological parameter, yet the currently accepted clinical model (Jones-Meade) assumes a well-mixed alveolar region, and a constant DL independent of alveolar volume, VA, despite experimental evidence to the contrary. We have formulated a new mathematical model [Tsoukias, N.M, Wilson, A.F., George, S.C., 2000. Respir. Physiol. 120, 231-249] that considers variable alveolar mixing through a single parameter, k (0

Asunto(s)
Alveolos Pulmonares/fisiología , Capacidad de Difusión Pulmonar/fisiología , Adulto , Algoritmos , Humanos , Análisis de los Mínimos Cuadrados , Mediciones del Volumen Pulmonar , Masculino , Modelos Biológicos , Sensibilidad y Especificidad
13.
Genet Epidemiol ; 19(1): 30-51, 2000 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10861895

RESUMEN

When sampling full-sibs for linkage studies, half-sibs are often available. Not only are half-sibs convenient to sample, but they can sometimes offer greater power than full-sibs. We propose a method to combine the information from full-sibs and half-sibs into a single test for linkage. This method is based on the Haseman and Elston [1972] method of regressing the squared trait-difference for a pair of sibs (either full- or half-sibs) on the estimated proportion of alleles shared identical by descent. To approximate the distribution of the test statistic, we propose a correction factor that considers the correlation among sibs, and demonstrate by simulations that this approximation works well in many situations, although there are some conditions for which the statistic can have an inflated Type-I error rate. The main appeal of our proposed method is the speed at which it can be computed, offering a rapid way to perform genome-wide linkage screens.


Asunto(s)
Ligamiento Genético , Modelos Estadísticos , Alelos , Simulación por Computador , Enfermedades Genéticas Congénitas/genética , Marcadores Genéticos , Variación Genética , Humanos , Modelos Lineales , Núcleo Familiar , Linaje
14.
Med Hypotheses ; 54(4): 660-2, 2000 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10859661

RESUMEN

Transcendental meditation (TM) is a stylized form of physical and mental relaxation which is associated with changes in the secretion and release of several pituitary hormones. The hormonal changes induced by TM mimic the effects of the inhibitory neurotransmitter gamma aminobutyric acid (GABA). It is hypothesized that TM produces changes in pituitary hormone secretion by enhancing hypothalamic GABAergic tone as a result of TM associated ketosis. Ketosis enhances the entry of glutamate, the amino acid substrate of GABA into synaptosomes, making more glutamate available for conversion to GABA through the glutamate decarboxylase pathway.


Asunto(s)
Cetosis , Meditación , Ácido gamma-Aminobutírico/metabolismo , Encéfalo/metabolismo , Humanos
15.
Hum Hered ; 50(2): 126-32, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-10799971

RESUMEN

Linkage analyses of simulated quantitative trait data were performed using the Haseman-Elston (H-E) sib pair regression test to investigate the effects of inaccurate allele frequency estimates on the type I error rates of this test. Computer simulations generating a quantitative trait in nuclear families were performed using GASP [1]. Assuming no linkage, several data sets were simulated; they differed in marker allele numbers and frequencies, number of sib pairs and number of sibships. Each set of simulated data was analyzed using (1) all parental marker data, (2) half of the parental marker data, and (3) no parental marker data, using both correct and incorrect allele frequencies in the latter 2 cases. The H-E sib pair linkage method was found to be robust to misspecification of marker allele frequencies regardless of the number of alleles.


Asunto(s)
Mapeo Cromosómico/normas , Frecuencia de los Genes , Simulación por Computador , Heterocigoto , Humanos , Carácter Cuantitativo Heredable , Proyectos de Investigación , Programas Informáticos
16.
Psychoneuroendocrinology ; 25(5): 453-61, 2000 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10818280

RESUMEN

We have previously shown that serum gonadotropins, particularly LH, decline after acute exercise in male volunteers. The mechanism for this decline is unknown. Plasma leptin and IGF-I concentrations were measured in seven male volunteers after acute exercise to exhaustion using the Bruce protocol. Leptin concentrations declined following exercise reaching nadir values 30-120 min after exercise. As anticipated, plasma IGF-I concentrations showed a transient rise immediately after exercise falling thereafter to nadir levels 60-90 min after exercise before returning towards baseline levels. In view of the previously described decline in gonadotropin release after acute exercise, the decline in plasma leptin levels, perhaps related to the rise in IGF-I, may play a role in exercise-induced inhibition of gonadotropin release presumably by inhibition of GnRH secretion.


Asunto(s)
Ejercicio Físico/fisiología , Factor I del Crecimiento Similar a la Insulina/metabolismo , Leptina/metabolismo , Adulto , Humanos , Cinética , Masculino , Persona de Mediana Edad
17.
Am J Hum Genet ; 66(5): 1610-5, 2000 May.
Artículo en Inglés | MEDLINE | ID: mdl-10762546

RESUMEN

The reintroduction of biallelic markers, now in the form of single-nucleotide polymorphisms (SNPs), has again raised concerns about the practicality of the use of markers with low heterozygosity for genomic screening for complex traits, even if thousands of such markers are available. Like the early blood-group markers (e.g., Rh and MNS), tightly linked biallelic SNPs can be combined into composite markers with heterozygosity similar to that of short-tandem-repeat polymorphisms. The assumptions that underlie the equivalence between single-locus multiallelic and composite markers are presented. We used computer simulation to determine the power of the Haseman-Elston test for linkage with composite markers when not all of these assumptions hold. The Genometric Analysis Simulation Program was used to simulate continuous and discrete traits, one single-locus four-allele marker, and six biallelic markers. We studied composite markers created from pairs, trios, and quartets of biallelic markers in nuclear families and in independent sib pairs. The power to detect linkage with a two-point approach for composite markers and with a multipoint approach that incorporated all six biallelic markers was compared with that for a single-locus, four-allele reference marker. Although the power to detect linkage with a single biallelic marker was considerably less than that of the reference marker, the power to detect linkage with two- and three-locus composite markers was quite similar to that of the reference marker. The power to detect linkage with four-locus composite markers was similar to that of a multipoint approach.


Asunto(s)
Alelos , Mapeo Cromosómico/métodos , Marcadores Genéticos/genética , Polimorfismo de Nucleótido Simple/genética , Mapeo Cromosómico/estadística & datos numéricos , Simulación por Computador , Frecuencia de los Genes/genética , Ligamiento Genético/genética , Haplotipos/genética , Heterocigoto , Humanos , Análisis por Apareamiento , Modelos Genéticos , Núcleo Familiar , Sensibilidad y Especificidad , Programas Informáticos
18.
Ann Thorac Surg ; 69(2): 388-93, 2000 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10735668

RESUMEN

BACKGROUND: Lung volume reduction surgery (LVRS) is being actively investigated for palliative treatment of severe emphysema. Considerable focus is directed toward patient selection and outcomes of LVRS. However, there is little information available regarding surgical methods to guide optimal extent of resection. We hypothesized that acute improvement and long-term survival after bilateral staple LVRS would be related to the extent of tissue resected. METHODS: The relationship between acute improvement in forced expiratory volume in 1 second and forced vital capacity was examined as a function of the total grams of lung tissue resected in 237 patients who underwent bilateral staple LVRS by a single group of surgeons. Overall survival was assessed based on extent of resection by quartiles of tissue weight resected using Kaplan-Meier survival methods. RESULTS: Improvement in forced expiratory volume in 1 second and forced vital capacity correlated with extent of tissue resected (p < 0.01), although there was considerable variability to individual response (r = 0.3). In contrast, there was no apparent relationship between the amount of tissue resected and overall postoperative survival (p = 0.7). CONCLUSIONS: There is a correlation between the amount of tissue resected and improvement in forced expiratory volume in 1 second and forced vital capacity after bilateral staple LVRS, with generally greater postoperative improvement after larger volume resections. However, there does not appear to be greater long-term survival with larger volume resections despite greater improvement in spirometry. This study suggests that factors other than improvement in spirometric variables may govern optimal LVRS resection volumes and long-term outcome. Future studies will clearly be needed in this important area of LVRS emphysema research.


Asunto(s)
Neumonectomía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonectomía/métodos , Neumonectomía/mortalidad , Enfisema Pulmonar/cirugía , Mecánica Respiratoria , Análisis de Supervivencia , Cirugía Torácica Asistida por Video , Resultado del Tratamiento
19.
J Thorac Cardiovasc Surg ; 118(6): 1101-9, 1999 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-10595985

RESUMEN

OBJECTIVE: Bilateral staple lung volume reduction surgery (LVRS) immediately improves pulmonary function and dyspnea symptoms in patients with advanced heterogeneous emphysema to a greater degree than do unilateral procedures. However, the long-term outcome after these surgical procedures needs to be critically evaluated. We compare 2-year survival of patients who underwent unilateral versus bilateral video-assisted LVRS in a large cohort treated by a single surgical group. METHODS: The cases of all 260 patients who underwent video-assisted thoracoscopic stapled LVRS from April 1994 to March 1996 were analyzed to compare results after unilateral versus bilateral procedures. Overall survival was calculated by Kaplan-Meier methods; Cox proportional hazard methods were used to adjust for patient heterogeneity and baseline differences between groups. RESULTS: Overall survival at 2 years was 86.4% (95% CI 80. 9%-91.8%) after bilateral LVRS versus 72.6% (95% CI 64.2%-81.2%) after unilateral LVRS (P =.001 for overall survival comparison). Improved survival after bilateral LVRS was seen among high- and low-risk subgroups as well. Average follow-up time was 28.5 months (range, 6 days to 46.6 months) for the bilateral LVRS group and 29.3 months (range, 6 days to 45.0 months) for the unilateral LVRS patients. CONCLUSIONS: Comparison of unilateral versus bilateral thoracoscopic LVRS procedures for the treatment of emphysema reveals that bilateral LVRS by video-assisted thoracoscopy resulted in better overall survival at 2-year follow-up than did unilateral LVRS. This survival study, together with other studies demonstrating improved lung function after bilateral LVRS, suggests that bilateral surgery appears to be the procedure of choice for patients undergoing LVRS for most eligible patients with severe heterogeneous emphysema.


Asunto(s)
Neumonectomía/métodos , Enfisema Pulmonar/cirugía , Factores de Edad , Anciano , Estudios de Cohortes , Intervalos de Confianza , Disnea/fisiopatología , Disnea/cirugía , Femenino , Estudios de Seguimiento , Volumen Espiratorio Forzado/fisiología , Humanos , Estudios Longitudinales , Pulmón/fisiopatología , Masculino , Oxígeno/sangre , Modelos de Riesgos Proporcionales , Volumen Residual/fisiología , Factores de Riesgo , Grapado Quirúrgico , Tasa de Supervivencia , Cirugía Torácica Asistida por Video , Capacidad Pulmonar Total/fisiología , Resultado del Tratamiento , Capacidad Vital/fisiología
20.
Genet Epidemiol ; 17 Suppl 1: S193-8, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10597435

RESUMEN

Multipoint linkage analysis was used to screen for evidence of linkage between alcoholism and five alcoholism-related quantitative traits. The results suggest that a susceptibility locus that influences monoamine oxidase activity and P300 amplitude at the Pz lead, and increases the risk of alcohol dependence may be linked to markers in the 12q24 region. Furthermore, the susceptibility for alcoholism may be associated with allele 3 (allele size 144) of D12S392.


Asunto(s)
Alcoholismo/genética , Cromosomas Humanos Par 12 , Potenciales Relacionados con Evento P300/genética , Ligamiento Genético , Monoaminooxidasa/genética , Alcoholismo/enzimología , Alcoholismo/epidemiología , Alcoholismo/fisiopatología , Mapeo Cromosómico , Marcadores Genéticos , Pruebas Genéticas , Genoma , Humanos , Escala de Lod , Carácter Cuantitativo Heredable , Estadísticas no Paramétricas
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