Irving I. Kessler

Venereal factors in human cervical cancer: evidence from marital clusters.

All Caucasian women in a large Eastern city who developed pathologically confirmed cervical cancer between 1950 and 1969 are being prospectively followed in an epidemiological test of the venereal hypothesis of cervical carcinogenesis. We are attempting to identify all men who were married to these probands at any time prior to the date of their cancer diagnosis. The ultimate objective is the identification of all the other wives of the proband husbands in order that their risk of cervical cancer be assessed. A random sample of control wives similar to the other wives in age, race, date and place of marriage as well as prior marital status is also being followed. To date, a total of 1,087 other wives and 659 control wives has been fully traced. Cervical cancer or carcinoma in situ was detected in 29 (2.7%) of the other wives and in seven (1.1%) of the control wives. A total of 14.0% of the other wives had either cervical cancer or a cervical cytological specimen which was other than normal. The corresponding statistic for the control wives was 8.0%. These differences in the prevalence of cervical cancer and of non‐normal cervical cytology are statistically significant. In the course of this investigation so far, we have identified 29 “marital clusters” of cervical cancer in which two women married to the same man have all developed cervical neoplasms. The observed number of 29 clusters may be compared with an expected number of 11.6. This investigation, as yet incomplete, offers confirmatory evidence of the possible role of venereal factors in the pathogenesis of human cervical neoplasia. While the genital herpesvirus is the likeliest candidate, other venereal elements might also be involved.

The Community as an Epidemiologic Laboratory: A Casebook of Community Studies

The case method has long been accepted as an effective teaching technique. Legal education consists mainly of case teaching from the courtroom and the textbook. Bedside teaching is the cornerstone of clinical training in undergraduate and postgraduate medical education. Social casework has used this technique effectively, and more recently it has been adopted in medical care teaching. The United States Public Health Service published a series of case studies for use in medical care teaching,1 and this method has been used by Penchansky as a teaching device in health services administration.2 The community as a case study in medical sociology is illustrated by Pauls work in 1955.3 In THE COMMUNITY AS AN EPIDEMIOLOGIC LABORATORY, Irving I. Kessler and Morton L. Levin have edited a book that attempts to apply the case study method, long a favored teaching technique in epidemiology, to a varied group of studies that originated in communities. The result is an uneven but instructive volume that deals more effectively with epidemiology and methodology than with the relation between research studies and communities.

Non-nutritive Sweeteners and Human Bladder Cancer: Preliminary Findings

The non-nutritive sweeteners, saccharin and cyclamate, were not associated with the risk of human bladder cancer in a controlled investigation. The prior intake of such sweeteners in any and all forms was not greater or more prolonged among 209 recently diagnosed bladder cancer patients than among 209 otherwise similar patients without bladder disease. These findings were unaffected by case-control differences in diabetic histories or smoking practices.

Perspectives in The Epidemiology Of Leukemia

Publisher Summary This chapter presents the epidemiological aspects of leukemia. The infrequency of leukemia makes it extremely difficult to obtain morbidity data for a sufficiently large population, and therefore, it is necessary to rely upon the available routinely collected mortality statistics. Variations in the reported mortality from different countries, mentioned in the chapter, for any given disease may reflect constitutional differences in susceptibility, environmental differences in carcinogenic exposure, or artifactual differences in reporting. One method for assessing the relative influence of each one of these factors on leukemia death rates is to compare the rates among natives of a particular country with the rates of those who have emigrated to another country. Additional clues to the etiology of leukemia are suggested by the study of regional differences in leukemia mortality within a particular country or geographic region. Other factors that influence the mortality rate in leukemia include secular trends, age, sex, and the type of leukemia. The secular trends in leukemia and the differences in its prevalence among various countries indicate that this disease varies over time and over space. Epidemiological studies have shown that leukemia in humans can be caused by exposure to ionizing radiation. The evidence that certain chemicals have an effect on the bone marrow suggests the possibility that certain chemicals may be leukemogenic. A firmly established epidemiological relationship is that of leukemia with mongolism. This has been determined by the study of the frequency of mongoloids among cases with leukemia and the frequency of mortality from leukemia among mongoloids. The chapter also presents an overview of several models and conceptual frameworks to explain the various epidemiological features of leukemia.

Parkinson's disease: Perspectives on epidemiology and pathogenesis

Abstract Though first described over a century and a half ago, Parkinsons disease remained something of an enigma to the clinician and the neurophysiologist until recently. The past few years have seen spectacular advances in our understanding of the pathogenesis of this condition and its therapy. Among the epidemiological aspects considered here are the significantly reduced risk of parkinsonism in Negroes and the question of whether, as suggested by some, the disease is a cohort phenomenon destined to disappear within the decade. Data on the genetics of Parkinsons disease are summarized and the evidence on its possible viral etiology is weighed. Finally, the metabolic pathways of the catecholamines are reviewed and consideration is given to possible relationships between melanin, dopamine, and nicotine which might explain the pathogenesis of Parkinsons disease. Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; with a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured (54).

Lymphoid tissues in neoplasia. A pilot study and review

Relationships between cancer and prior appendectomy and tonsillectomy were studied in a series of 919 consecutive autopsies as well as by interview and physical examination of 461 cancer patients and 223 controls. In the autopsy series, 11.0 appendectomies were expected among the male cancer patients compared with 7 observed. Among female cancer patients, 11.0 appendectomies were expected, while 10 were observed. Neither of these differences was statistically significant. In the interview series, the appropriately weighted relative risk of appendectomy was 0.72 in men and 1.12 in women with cancer. Neither value deviated significantly from the null value, 1.00. For tonsillectomy, the relative risks were 1.26 and 1.06, respectively, both insignificantly increased. There is no evidence from the present study that prior lymphoid tissue surgery substantially affects the subsequent risk of cancer. However, sample sizes in this as well as 9 other studies which were reviewed are inadequate to permit rejection of an actual two‐ or threefold relative risk deviation in patients with certain types of cancer. Restrospective and prospective approaches for subsequent investigation of the role of lymphoid tissues in neoplasia are suggested.