Cancer of the urinary bladder in the Pacific Basin

The incidence of urinary bladder cancer differs markedly among the different ethnic and national groups in the Pacific Basin. Because of these differences, the following colaborative studies can be done to identify and characterize factors associated with bladder cancer: 1) study population groups with different levels of bladder cancer risk who reside in the same geographic setting; 2) study ethnically similar groups who differ in risk and reside in different locations; and 3) study population groups who differ in risks and reside in different geographical regions. Factors possibly related to bladder cancer that have been identified and studied by others include occupational exposure to certain chemicals, cigarette smoking, coffee drinking, artificial sweeteners, certain viruses, radiation exposure, phenacetin, bracken fern, Schistosoma haematobium, tryptophan metabolites, nitrosamines, estrogens, hair dyes, vitamin A, and ascorbic acid. In collaborative studies, the pathologic interpretation of histologic material and the content of the questionnaire should be well standardized, and the laboratory tests should be done at one laboratory. Among the population groups in the Pacific Basin, the Japanese in Hawaii and in Japan provide a unique resource for further investigation with respect to bladder cancer.

Augmentation of puerperal lactation by oral administration of sulpiride

The effect of oral administration of sulpiride on PRL secretion and initiation of puerperal lactation was studied in 130 randomly selected primiparous nursing mothers. Sixty-six women were given 50 mg sulpiride orally twice a day during the first 7 days of the puerperium (sulpiride group). Sixty-four women were given a placebo in the same way (control group). The mean (+/-SE) total milk yield during the first 5 postpartum days in the sulpiride group (1211.7 +/- 65.0 ml) was significantly greater than that in the control group (916.0 +/- 66.0 ml). Every other day determinations of serum PRL levels revealed significantly higher concentrations in the sulpiride group than in the control group. A single oral dose of 50 mg sulpiride raised serum PRL levels for 12 h, with a peak level at 2 h after dosing in 7 women on the second postpartum day. These data suggest that sulpiride given orally promotes the initiation of lactation in puerperal women by stimulating PRL secretion.

Fecal bile acids in two Japanese populations with different colon cancer risks

Some workers have associated fecal bile acids with colon cancer frequency. They suggest that the risk for colon cancer increases with a rise in the level of total and degraded fecal bile acids. The Japanese in Hawaii, who are at high risk for this cancer, had higher concentrations of deoxycholic acid (a degraded bile acid) in their fecal specimens than did the people in Akita, Japan, who are at low risk. However, the findings for the other bile acids were unremarkable or inconsistent. These data were suggestive, but not strongly supportive, of a relationship between fecal bile acid patterns and colon cancer risk.

Breast cancer and diet among the Japanese in Hawaii

Eighty-six Japanese men out of 6860 male participants in a prospective study of cancer were married to women who had breast cancer. These 86 men were compared with the remaining men by dietary factors that were identified during two different time periods. Based on the assumption that there is a similarity between husbands and wives in their dietary patterns, it was noted that the spouses of women with breast cancer consumed more beef or meat, butter/margarine/cheese, corn, and wieners than the other men. Furthermore, the breast cancer spouses also consumed less Japanese foods than controls, even though there were minimal differences between the two groups in other Oriental practices. These results suggest that certain American foods are important in the search for possible dietary factors related to the occurrence of breast cancer in women.

Analysis of fecal bile acids and diet among the Japanese in Hawaii

Fecal samples of 165 Japanese men in Hawaii, age 43 to 74, were analyzed for bile acid content by their conversion to the methyl ester and the trimethylsilyl ether derivative followed by separation on a gas chromatograph. The arithmetic mean of total bile acids for the 165 specimens was 10.96 mg/g dry weight feces. Each of the following bile acids was detectable in over 77% of the fecal specimens: cholic, deoxycholic, lithocholic, and cholanic acid. The intake of Western foods was not positively correlated with the fecal content of secondary or modified bile acids, even though other workers have observed that these bile acids predominated in persons from Westernized countries. Two of the Japanese foods were negatively correlated with the levels of modified bile acids, which suggested that these foods contributed to a decrease in modified bile acids in fecal specimens. Fecal bile acid measurements appeared to be associated with age, but not with weight, height, or serum cholesterol levels.

A new micromethod for colorimetric determination of zinc in serum

A simple micromethod with a colorimetric reagent of high sensitivity was developed for the determination of zinc in serum. For the color reagent 2-(2-pyridylazo)-5-dimethylaminophenol (PADAP) was used. Coefficients of variation of the within-day precision were 6.65 and 2.24% for zinc standard at concentrations of 0.1 and 0.5 microgram/ml, respectively. The mean recovery by this method was 101.2% (S.D.: 3.56%). Zinc concentrations measured by the above method showed good agreement with those by atomic absorption spectrophotometry, with a correlation coefficient of 0.934. Serum zinc values of 50 healthy adults (38 females, 12 males) ranged from 63 to 116 microgram/100 ml (mean: 89.68 microgram/100 ml, Sd.: 13.28 microgram/100 ml).

Survivorship from large bowel cancer among Caucasians and Japanese in Hawaii

From 1960 through 1973, the Hawaii Tumor Registry identified 781 Caucasian and 1073 Japanese cases of large bowel cancer. Survivorship analysis revealed that Japanese patients had a 32% higher 5-year relative survival rate than Caucasians. Further analyses showed that colon cancer cases did better than rectal cases, and patients diagnosed before 65 years of age fared better than cases diagnosed at an older age. As expected, patients with localized disease lived much longer than those who had more advanced disease. Men and women were similar in their survival from large bowel cancer. Histologic grade of the lesion, socioeconomic variables, behavioral practices and other factors which may affect survivorship by race could not be included in this study. Until such factors are also incoporated in the analyses, the observed results are only suggestive of a racial difference in survivorship.

Studies on antiviral glycosides. Synthesis and biological evaluation of various phenyl glycosides

A variety of analogues and derivatives of phenyl glycosides were synthesized for examination of their biological activities and of the relationship between structure and antiviral activity. For antiviral activity, a 6-deoxy-6-halogeno-D-glucose residue was most suitable for the carbohydrate moiety and p-alkylphenyl groups for the aglycone moiety. Based on these results, p-(sec-butyl)phenyl 6-chloro-6-deoxy-beta-D-glucopyranoside and p-(sec-butyl)phenyl 6-deoxy-6-iodo-beta-D-glucopyranoside were prepared, and the former compound was found to be the most potent antiviral substance, in this series, against influenza and Herpes simplex virus. The anomeric configuration of phenyl glycosides did not contribute to the antiviral activity.

Assessment of a short dietary method for prospective study on cancer

This study was a trial to develop a short dietary questionnaire for estimating individual calorie and nutrient intakes among Japanese-American women in Hawaii participating in a prospective cancer study. One hundred five women recorded 4-day measured food records, and their average individual daily intakes of calories, protein, fat, carbohydrate, saturated fat, and cholesterol were computed. Individual food items of the 105 records were grouped according to common food categories and types of usage. The amount and frequency of use, and the average serving weights of the food groups were then calculated. Fifty food groups were selected for stepwise regression analyses of the individual nutrient intakes on the daily frequencies of the recorded items. Regression equations for each nutrient were computed from the 4-day records of 53 women and validated against the known intakes of the remaining 52 participants. The equations yielded high multiple R's and, except for protein and carbohydrate, there was resonable agreement between the mean observed and predicted intakes of the 52 women. However, the coefficients of determination of the observed and predicted intakes of the 52 women revealed considerable unexplained variation. Before designing a questionnaire, further studies are needed to develop and validate a precise short method for estimating individual nutrient intakes in large prospective studies.

Errors in reporting cancer and other conditions by persons in a prospective study

The hospital records of 553 men were compared with their medical histories obtained by interviews after hospitalization. Forty men had documentation of cancer in their hospital records stated that they had the specific condition. However, 21 other cancer patients did not give a positive history of their documented disease and 4 who stated that they had a malignancy did not have cancer according to their hospital records. In contrast to cancer, respondents overreported surgery for peptic ulcer and colorectal polypectomy. The greatest extent of agreement between the hospital record and the medical interview was noted for surgical patients with gallbladder disease; all 43 of these patients gave a positive history for this condition.

Epidemiologic cancer research programs of the Cancer Center of Hawaii

Ongoing epidemiologic cancer research programs are described. These programs were developed by the Epidemiology and Demography Unit, Cancer Center of Hawaii, established in July 1974. During the 15-month period prior to the Pacific Basin Conference, many epidemiologic projects were initiated. Major descriptive, epidemiologic studies were undertaken: a) cancer mortality among the Japanese in Hawaii, adjusted by prefecture-of-origin; b) time trend of mortality rates for 80 causes between 1910--70; c) evaluation of race classification in Hawaii; d) survival analysis; and e) increased lung cancer rates among Japanese migrants in relation to smoking. Major analytic, epidemiologic studies were as follows: a) an international case-control study on breast cancer in relation to diet and exogenous estrogens; b) association between height and weight and various types of cancer; c) a follow-up study of about 9,000 shipyard workers exposed to asbestos; d) an epidemiologic survey on a 2- to 3-% sample population of Hawaii; and e) a follow-up study on leprosy patients in relation to their risks for cancer.

Diet and exogenous estrogens in three populations at different levels of risk for breast cancer

A case-control study is being conducted in which a questionnaire is used to collect information on past history of drug usage (including menopausal estrogens) and the normal weekly dietary intake. Breast cancer cases from 3 selected populations (ages 45--74) are identified: 1) the Caucasians in Hawaii, at high risk for breast cancer; 2) the Japanese in Hawaii, at intermediate risk; and 3) the Japanese in Fukuoka, Japan, representing a low-risk population. For each case, a neighborhood and hospital control matched by race and age is interviewed. Attempts are made to verify the drug history with the subject's personal physician, and a subsample of the study population received a repeated dietary interview to assess its reliability. Pathologic slides of the breast cancer cases are reviewed by three consulting pathologists to confirm cancer diagnosis and to identify possible histologic differences in the 3 populations. In all, 200 cases and 400 controls will be interviewed from each study population.

Gastrointestinal carcinoma in the Japanese of Hawaii: a status report

The primary aim of the Japan--Hawaii Cancer Study was to identify factors that could explain the changes in cancer risk experienced by Japanese who migrated to Hawaii. Many investigations were conducted in this long-term prospective study since its inception in 1971. Among the findings that relate to gastrointestinal carcinoma were the following: 1) Bowel transit time does not appear to be related to the occurrence of large bowel cancer or to any of the benign conditions with which it is associated; 2) adenomatous and hyperplastic polyps, as well as diverticula, are much more prevalent among autopsy specimens from Japanese who had lived in Hawaii than of those in Japan; 3) adenomatous polyps and diverticula are positively associated with atherosclerosis in the necropsy population in Hawaii; 4) although the incidence of the diffuse histopathologic type of gastric cancer does not differ appreciably among the Japanese in Hawaii and Japan, the migrants have a significantly lower incidence of the intestinal type of stomach cancer; and 5) case-control studies indicated that the two conditions frequently associated with gastric carcinoma, i.e., gastric ulcer and intestinal metaplasia of the stomach, are associated with high salt intakes and adherence to the traditional Japanese diet.

[Studies of sulfhemoglobin formation by various drugs (3) (author's transl)]

Sulfhemoglobin (SHb) and methemoglobin (MHb) formations by various compounds were examined by single and three consecutive intraperitoneal administrations to mice. With a single administration, methemoglobinemia was induced by diphenylamine (DPA), 1-naphthylamine (NA), phenylnaphthylamine (PNA), N-(1-naphthyl) anthranilic acid (N1) and N-(1'-naphthyl)-2-aminophenylacetic acid (IG240), and was not observed with phenylanthranilic acid (PAA), N-benzoyl-N'-phenyl-2, 6-diaminobenzoic acid (BPAA), flufenamic acid (FA), mefenamic acid (MFA), N-(2-6-dichlorophenyl) anthranilic acid (CPAA), N-(2', 6'-dichlorophenyl)-2-aminophenylacetic acid (CPPA), nine derivatives of N1 and two derivatives of IG240. On the other hand, sulfhemoglobinemia, with a single administration, was found to be induced by NA. Furthermore, with three consecutive administrations, such was induced by DPA, PAA, BPAA and FA even though SHb was not demonstrated with a single administration, and was not observed with MF, CPAA, CPPA and various derivatives of N1 and IG240.

Bowel transit-time and stool weight in populations with different colon-cancer risks

It has been suggested that the risk of cancer, polyposis, and diverticulosis of the large bowel increases with bowel transit-time. Hence, Japanese inhabitants of Hawaii, in whom the risk of these diseases is high, would be expected to have longer transit-times than Japanese in Japan, in whom such risks are low. However, bowel transit-times were similar in Japanese groups. Stools from the Hawaii Japanese did weight significantly less than the specimens from Japan, and this factor may be indirectly related to the risk of colorectal cancer, polyposis, or diverticulosis in the Japanese.

Epidemiologic characteristics of benign breast disease

To see if the risk factors associated with fibroadenoma and cystic disease were similar to those reported for breast cancer, a retrospective study of benign breast tumor in a general population was conducted in Washington County, Maryland. The study population consisted of 320 white women 20 to 49 years of age who had had benign breast disease and 320 age-matched controls. More cystic disease cases than controls had the following characteristics, which had been reported to have been associated with breast cancer in other studies: higher socioeconomic status; fewer pregnancies; and a lack of association with lactation patterns. Nulliparity, late natural menopause and a maternal history of breast cancer were also more common among cystic cases than controls, although these differences could have occurred by chance. Cystic disease cases and controls did not differ with respect to other factors associated with breast cancer, such as early age at menarche, late age at first pregnancy, and negative history of artificial menopause. In contrast to cystic breast disease, fibroadenoma was not associated with most of the risk factors of breast cancer.

[Studies on sulfhemoglobin formation by various drugs (2) (author's transl)]

Sulfhemoglobin (SHb) and methemoglobin (MHb) formations by various aniline erivatives were examined by a single and three consecutive intraperitoneal administrations to mice. It was found that with a single administraion, methemoglobinemia was induced by aniline, 2-methylaniline, 3-methylaniline, 4-methylaniline, 3-trifluoromethylaniline (3-TFMA), 4-trifluoromethylaniline (4-TFMA), 2, 3-dichloroaniline, 2-aminopehnol, acetanilide (AA), 2-hydroxyacetanilide, N-methylaniline (NMA), N,N-dimethylaniline (NDMA), N-ethylaniline (NEA) and N,N-diethylaniline, and was not observed with 2, 3-dimethylanilnie, 2-trifluoromethylaniline, 3-aminophenol, 4-aminophenol, 2. 6-dichloroaniline, 3-hydroxyacetanilide (3-HAA), 4-hydroxyacetanilide (4-HAA), 2-aminobenzoic acid, 3-aminobenzoic acid, 4-aminobenzoic acid and 4-chloro-2-aminobenzoic acid. On the other hand, sulfhemoglobinemia which appeared much more delayed than MHb, with a single administration, was found to be induced by 3-TFMA, 4-TFMA and NMA. Furthermore, with three consecutive administrations, such was induced by AA, 3-HAA, NDMA and NEA even though SHb was not demonstrated with a single administration. Structure-SHb and MHb forming property relationships were discussed.

Antiviral activities of acyl derivatives of 2,2'-anhydro-1-beta-D-arabinofuranosylcytosine and 1-beta-D-arabinofuranosylcytosine in cell culture

Antiviral activities of acyl derivatives (3'-O-octanoyl and 3'-O-decanoyl) of 2,2'-anhydro-1-beta-d-arabinofuranosylcytosine (cyclo-C) and 1-beta-d-arabinofuranosylcytosine (Ara-C) were compared with other antiviral nucleosides, and some biological characteristics of the antiviral activity were investigated. Among those synthesized acyl derivatives, 3'-O-decanoyl ara-C was the most active against deoxyribonucleic acid viruses, with an activity comparable to that of Ara-C. Acyl derivatives of cyclo-C were somewhat less active than their Ara-C counterparts. In the value of therapeutic index, 1-beta-d-arabinofuranosyladenine was superior to the others, followed by 5-iodo-2'-deoxyuridine. In comparing the sensitivity of two serotypes of herpes simplex virus it was found that Ara-C and its ester, as well as its cyclo-C counterpart, were more active against the type 2 than the type 1 strain. The activity of 3'-O-decanoyl Ara-C, like that of its parent, was diminished by treatment with cytidine deaminase from mouse kidney, but 3'-O-decanoyl cyclo-C was resistant to this treatment. In comparative studies of 3'- and 5'-O-acyl Ara-C's, antivaccinia virus activity of 3'-O-palmitoyl Ara-C was significantly superior to its 5'-counterpart. The inhibitory activity of 5'-O-decanoyl Ara-C was markedly reduced by the presence of a threefold molar excess of eserine sulfate, a choline esterase inhibitor, whereas the 3'-acyl Ara-C was not affected by the inhibitor in any combination. This result indicates that enzymatic hydrolysis of the 3'-ester to Ara-C, which is inhibited by eserine sulfate, did not occur in this cell culture.

The reproducibility of dietary intake data in a prospective study of gastrointestinal cancer

To test the reproducibility of the dietary questionnaire used in the Japan-Hawaii Cancer Study and to measure the consistency of dietary patterns over time, 109 men were reinterviewed with the same questionnaire after a 6-month interval and 111 men were reinterviewed after a 2-year interval. The responses for intake of the 33 food items in the questionnaire were fairly reproducible. Food items with substantial correlation coefficients in both groups of men tended to be consumed on a more habitual basis. This finding suggests that if habitually consumed foods are linked to specific cancers, it is less likely that such associations occur by chance. This is of particular importance because when many food items are considered in a dietary study, chance association between a specific food and cancer is not an infrequent event.

Benign breast tumor and estrogenic hormones: a population-based retrospective study

Histories of the usage of oral contraceptives and other estrogens were obtained from 320 women 20-49 years of age who had pathologically confirmed diagnoses of benign breast disease made at Washington County Hospital in Hagerstown, Maryland, during the period 1968 through 1972. Similar histories were obtained from 320 controls matched for race, sex, age, residence in county, and willingness to participate in a health survey. No association could be found between oral contraceptive usage and benign breast tumor. The use of other estrogens, notably diethylstilbestrol, was significantly related to the presence of benign breast disease.