Earl L. Diamond

Race and Primary Open-Angle Glaucoma

A comparison of racial distributions for three groups of patients showed that 115 of 140 patients (81.6%) with open-angle glaucoma, 221 of 392 patients (56.4%) with ocular hypertension, and 1,028 of 2,109 patients (48.7%) in a random sample were black. Average age at diagnosis was significantly (P = .006) higher for whites than for blacks (69.1 years vs 63.7 years). Black patients with primary open-angle glaucoma had a significantly larger mean cup-disk ratio (P less than or equal to .002) and a higher but not significantly higher mean intraocular pressure at the time of diagnosis. Advanced glaucomatous visual field loss was more frequent at the time of diagnosis in blacks (43 of 129 patients or 33.3%) than in whites (five of 27 patients or 18.5%), but this difference was not significant.

SOME EPIDEMIOLOGICAL ASPECTS OF CANCER OF THE PROSTATE.

Abstract Certain significant characteristics of cancer of the prostate are revealed through a review of previous studies and analysis of new data from thirty-three cities in the United States. These characteristics include a geometrical increase from the critical age of 40–50 onwards; higher frequency among Negroes than among whites and among Japanese Americans than among Japanese in Japan; low frequency among Orientals and Indians; higher northern than southern frequency among whites and nonwhites; low mortality differential between urban and rural areas and between metropolitan and non-metropolitan counties; lower frequency among foreign than native-born whites; higher frequency among the migrants than among the residents in the country of origin; frequency highest among Protestants, lowest among Jews, and intermediate among Catholics; higher frequency among Occidental than among Oriental populations in Israel; higher frequency among ever-married than among single persons, particularly the widowed and divorced, and among the married with children; higher urban than rural frequency among the married; generally no regular socio-economic gradient except that high frequencies are found among professionals and low frequencies among manual workers, agricultural workers, miners, and clerical and kindred workers (the numbers in most occupational groups are small); high frequency among male relatives of prostatic cancer decedents. In addition to genetic factors, some of these characteristics may be traced to certain socio-cultural variables. It is suggested that, as a disease entity in the male genital system, prostatic cancer may be related to a persons sexual behavior. This is suggested by the higher frequency among the ever-married males with children in Australia and by the findings of the KINSEY Report with respect to the higher total sexual outlet among urban married males who are found to have a higher prostatic cancer mortality than their rural counterparts. Special attention should also be given to the differential impact of the socio-cultural environment upon various groups of persons, i.e. foreign and native-born whites; the migrants and the residents in the country of origin; persons of similar racial or religious background living in different geographical areas; persons who have been exposed to different types of communities and/or working conditions for various lengths of time. Further, the possible interaction between nativity and religion should be taken into consideration. A systematic, intensive study of each of these phenomena is necessary in order to gain better insight into possible etiological factors in this site of malignancy.

Genetic and environmental effects on the development of myopia in Chinese twin children

In order to assess the relative and interactive importance of genetic and environmental components on the development of myopia in Chinese school children aged from 10 to 15 years, a population-based sample of 361 same-sexed twin pairs recruited through stratified cluster sampling was studied. Zygosity of twin pairs was determined by Mendelian traits, red cell antigen systems, and continuous dermatoglyphic characteristics; while myopia was diagnosed by both objective and subjective techniques. Studying and reading habit was obtained from cotwins and their parents through a life style questionnaire. Age-sex-adjusted concordance rate derived from multiple regression equation was used in the analysis. Conventional comparison of intrapair concordance between monozygotic (MZ) and dizygotic (DZ) twins was used to assess the importance of a genetic component in the determining of myopia, and a significant genetic influence was observed. Environmental influence on myopia was evaluated through MZ cotwin method, and MZ cotwins with concordant studying and reading habits were significantly more concordant in myopia than those MZ cotwins with discordant habits. The possible effect of gene-environment interaction on myopia was explored, and concordance in myopia was found significantly associated with the interaction between zygosity and habit of studying and reading. These observations suggested that the impact of the environmental factor on the development of myopia may be influenced by genotype, and vice versa.

Body fat patterning in women with endometrial cancer

It has long been known that the risks of some cancers, including endometrial, are associated with obesity. Recent evidence suggests that body fat distribution patterns also affect the risk of developing some diseases. A question that remains is whether cancers are associated with specific distributions of body fat. In this study, women with endometrial cancer were compared to community controls of similar age and race. Participants were interviewed and then measured to determine fat distribution patterns defined by the waist-to-hip circumference ratio. Women with upper body fat distribution had a 3.2-fold (95% confidence limits 1.2, 8.9) higher risk of endometrial cancer than women with lower body fat distribution even with correction for age, parity, and smoking. Obese women with an upper body fat pattern had a 5.8-fold (confidence limits 1.7, 19.9) higher risk of endometrial cancer than nonobese/lower body fat patterned women. Obese women who never smoked had a 3.3-fold statistically significant higher risk of endometrial cancer than nonobese women who never smoked. Current smokers had lower risks than their nonsmoking counterparts. The 3-fold increased risk of endometrial cancer associated with upper body fat did not disappear with adjustment for obesity and smoking.

Cancer mortality among white males in the meat industry

A study was conducted among 13,844 members of a meat-cutters union, from July 1949 to December 1980, to examine cancer occurrence in the meat industry. Separate analyses were carried out for the whole group, and for subgroups defined by job-categories characteristic of the industry, including a control group. Mortality was compared with that of the United States through the estimation of standardized mortality ratios (SMR) and proportional mortality ratios. A statistically significant proportional mortality ratio of 2.9 was obtained for Hodgkins disease among abattoir workers; the SMR of 2.2 was not significant. Among meat-packing plant workers, highly statistically significant SMRs were recorded for bone cancer, SMR = 9.6; cancer of the buccal cavity and pharynx, SMR = 3.4; and lung cancer, SMR = 1.9. The role of oncogenic viruses and other carcinogenic exposures was investigated.

Characteristics of Asthma Mortality and Morbidity in African-Americans

The percent rise in the number of asthma deaths was analyzed using data from the National Center of Health Statistics and compared for African-Americans and Caucasians. The rate of increase for African-Americans in the period 1979-1983 was nearly twice that of Caucasians, and the difference among genders for Caucasians was significantly higher for females. In Baltimore a high percentage (29%) of adult asthma patients (86.8% African-American) seen in an emergency room (ER) and living in the inner city had frequent visits (6 or more annually) to the ER. One-third of the patients used the ER exclusively for asthma management, and 39% delayed for at least 48 hr after onset of symptoms before seeking medical assistance. One-fourth had daily symptoms, and 11% of those regularly employed had missed 10 or more days annually because of asthma. Among the high ER users, 39% required more than one annual hospitalization for management of acute exacerbation of asthma symptoms. Risk factors for mortality and morbidity among inner-city and minority populations as well as potential areas of intervention are discussed.

Comparison of nutrient intake determined by four dietary intake instruments

Abstract We compared nutrient intake estimates among four commonly used food intake instruments: 24-hour recall, a 2-day diet diary, a modified diet history, and a quantitative food-frequency questionnaire. The four instruments were administered to each of fifty people selected by systematic sampling from Washington County, Maryland. Using an analysis of variance for a complete block design, we analyzed data by mean differences across all instruments, and by simple correlations and Kappa statistics between instrument pairs. The food-frequency questionnaire gave the highest mean estimates, and the modified diet history estimate means fell between the food-frequency questionnaire and the other two instruments. However, when adjusted for calories (nutrients/1000 kcal), the food-frequency questionnaire estimates for nutrients were no longer consistently higher than those of the other instruments. Total fat, oleic acid, cholesterol, protein, sodium, iron, thiamin, and niacin were most consistently estimated by two or more instruments as measured by correlation coefficients. Crude fiber, calcium, and vitamins A and C gave the least consistent estimates among all four instruments. The correlation coefficients and Kappa scores were modest for all instrument pair comparisons, but the majority were statistically significant at p ≤ 0.005. All data showed greater consistency between instruments that measured either long-term intake (modified diet history and food-frequency questionnaire) or short-term intake (diet diary and twenty-four hour recall). In addition, demographic variables (age, sex, and marital status), as well as differences in caloric intake, affected instrument estimates of some nutrients.

Prospective study of occupational asthma to laboratory animal allergens: Stability of airway responsiveness to methacholine challenge for one year

The stability of airway hyperresponsiveness was studied in a group of 178 young adults working with laboratory animals. At the time of their entry into the study, 132 of 178 subjects (74%) had less than 20% response to the inhalation of 25 mg/ml methacholine, whereas 26 (15%) had a methacholine dose causing a 20% fall in forced expiratory volume in 1 second after fewer than 80 breath units. The distribution of methacholine responsiveness did not differ at 6 months and 1 year; 155 of 178 volunteers (90.4%) responded during the repeated challenges to doses within one dilution of their results at entry. One hundred forty-one subjects were consistently unreactive during the year, and 17 were consistently reactive. Approximately equal numbers gained and lost reactivity. Those with consistently positive responses to methacholine were more likely to have skin test reactivity and chest symptoms. The presence of consistent chest symptoms was loosely associated with consistent methacholine responsiveness; 55% of those with consistent hyperresponsive airways had symptoms, and 24% of those who consistently had symptoms had hyperresponsive airways. We concluded that the methacholine response is relatively stable during the course of a year in laboratory animal workers who remain at their jobs and that the presence of a positive skin test response to laboratory animals or of chest symptoms does not change the pattern of stable responsiveness.

α- and β-D Galactosidase Activity of Rat Thyroid and Spleen. A Quantitative Study.∗

Summary Rat thyroid gland and spleen contain levels of α and β-D galactosidases which show no significant sex-linked differences. We have no satisfactory explanation for the discrepancy in results from those of others, except that the parathyroid glands. very active for the two galactosidases, are closely related to the thyroid. It is suggested that careful dissection may be required to avoid inadvertent dilution or enrichment of enzyme source by adjacent anatomic structures. The quantitative data reported herein confirm previous histochemical observations of intense reactivity of rat thyroid gland for α- and β-D galactosidases. The differences in values obtained for spleen may reflect variations in numbers of heterophiles and mega-karyocytes which showed high α-D and β-D galactosidase activity by histochemical technics.