39 age 34) died of a genitourinary infection complicating diabetes even though she (along with the other cases) had been placed on oral therapy with for all age groups, a relatively low figure com- pared with that for Japanese and American societies. Orinase (tolbutamid tablets). (It was later found Thyroid Metabolism that these patients did not take the tablets con- Table 24 showsresults of protein bound iodine, sistently.} Table 26 compares the mortality from diabetes in the United States*’ and the Marshail Islands. The incidence appears higher in the Marshall total iodine, and butanol extractable iodine deter- minations. The 12 samples obtained in 1959 showed values definitely lower than the 1958 values, although several readings werestill some- Islands and on Rongelap Island (based onits what high. It was thought that the high 1958 levels must have been due to contaminatedglass- small population), It should be noted that, since only routine urine examinations were done on the Rongelap people, the incidence of diabetes may actually be higher. The greater incidence of deaths due to diabetes in the Marshall Islands than in the United States in 1956 and 1957°' isstatistically significant (0.01 >p>>0.001). ware in spite of the great care taken to maintain strict cleanliness. Glucosuria On routine urine analysis during the 1959 sur- a| vey one male andfour females(all in the unexposed group) were found to have glucosuria; all but one of these also had an elevated fasting blood sugar level* (see Table 25). These individuals were considered to have mild diabetes mellitus. Later during the year one ofthese cases (#854,F, *We are grateful to Dr. W.W. Fennel at Kwajalein for having the blood sugar analyzed. Serum Vitamin B,, Analysis of the 15 serum samples obtained in 1959 again showed, as in 1958, vitamin B,, levels slightly higher than normal. The mean value was 714 pug/mil, with a range of 312 to 1500. A scatter- gram oflevels for both years was plotted against white blood count, since it has been shownthat in leukemia the white cells have a higher B,, binding Table 23 Results of Complement Fixation Tests on Rongelap People, 1959, by Age and Sex No.in FluA Age, age yr group No. Flu B &% No. % HA 1 HA 2 Long (Respiratory CA (Parainfluenza 3) (Parainfluenza 1) (Parainfluenza 2) syncitial. CCA) No. Fo No. To No. LGV Adeno To No. % No 1 1 4 5 6 14 6 35 58 30 14 16 10 82 67 50 2 3 26 43 40 2 1 10 6 4 6 5 33 29 29 3 6 15 4 41 Mumps % No (Psittacosis group) rom (Positive Reactions of Serum Dilutions 1-10) QF (Q fever) % No. % No. % 2 6 12 25 1 3 l 6 13 5 2 2 1 12 8 5 66 8 13 #5 8 5 68 1 ll 11 9 100 92 52 53 3 5 14 2 1 l 3 8 5 18 1 8 29 32 63 8 16 #5 10 1 2 37 72 64 16 14 10 9 6 65 Females 1-5 0 6-15 16-40 >40 17 24 20 4 4 17 20 9 7 38 35 8 19 16 47 79 80 Total 61 8 13 16 26 43 70 0 . 1- 5 6-15 16-40 >40 1 12 21 17 1 4 6 8 i9 35 2 8 12 17 38 71 11 18 14 92 86 82 Total 51 I 22 22 43 43 84 0 Total 112 19 17 38 34 86 77 0 fia Males Females Plus Males 3

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