Effect of cooking classes for housewives on salt reduction in family members: a cluster randomized controlled trial.

OBJECTIVES: Sodium reduction is very important in preventing cardiovascular diseases, especially in regions with high salt intake such as Japan. One strategy for salt reduction is to raise consumer awareness of the need to reduce daily salt intake. We investigated whether cooking classes given to housewives focussing on salt reduction would influence not only their own consumption behaviour but also that of their family members. STUDY DESIGN: Single-blinded, cluster randomized trial. METHODS: We randomly assigned housewives to participate in cooking classes focussing on salt reduction (intervention group) or lectures about a healthy lifestyle (control group). The main outcome measure was the difference in estimated daily salt intake by spot urine sampling of housewives and their family members 2 months after intervention between the groups. RESULTS: A total of 35 housewives and 33 family members were randomized. The mean daily salt intake was 10.00 (standard deviation [SD] 1.75) g/day in the control group (17 housewives and 15 family members) and 9.57 (SD 2.45) g/day in the intervention group (18 housewives and 18 family members) at baseline. Two months after the intervention, the mean salt intake was 10.30 (SD 1.78) g/day in the control group and 8.95 (SD 2.45) g/day in the intervention group. The mean difference was -1.19 g/day (95% confidence interval -2.29, -0.09; P = 0.034). A similar tendency was observed in the subgroups of housewives and family members. CONCLUSIONS: Our trial suggested that the effects of cooking classes focussing on salt reduction for housewives could be transferred to family members (UMIN-CTR: 000018870).

Risk modification in lung cancer by a dietary intake of preserved foods and soyfoods: findings from a case-control study in Okinawa, Japan.

To disclose the association of dietary intake of preserved foods and soyfoods with lung cancer risk, we analyzed the data from a case-control study conducted in Okinawa, Japan, from 1988 to 1991. The analysis, based on 333 cases and 666 age-, sex- and residence-matched population controls, provided the following major findings. (1) The more the miso soup intake, the higher the risk (test for trend: P = 0.001 for males; P = 0.043 for females). (2) Frequent intake of pickles (excluding salted fish) tended to be linked with an elevated risk in males. The adjusted odds ratio (OR) for once or twice per week or more, relative to less than once a month was 1.88 (95% confidence interval (CI): 1.26-2.81). (3) Frequent intake of soybeans was associated with a decreased risk in men (OR: 0.63, 95% CI: 0.40-0.98 for once or twice per week or more, relative to less than once a month). (4) Daily consumers of tofu were at a decreased risk, particularly for squamous cell carcinoma; the OR (95% CI) being 0.55 (0.34-0.89) in males and 0.14 (0.02-0.89) in females. These findings suggested deleterious effects of preserved foods and protective ones of soyfoods rich in isoflavones.

Smoking habits, local brand cigarettes and lung cancer risk in Okinawa, Japan.

To disclose the association between smoking habits and lung cancer in Okinawa, Japan, we analyzed the data from a case-control study conducted from 1988 to 1991. The analysis, based on 333 cases and 666 age-, sex- and residence-matched population controls, provided the following major findings. (a) The odds ratios (ORs) for current smokers relative to nonsmokers were much greater for squamous cell carcinoma than for adenocarcinoma. The OR was 9.82 for squamous cell carcinoma and 2.18 for adenocarcinoma in males, 28.2 and 1.14, correspondingly, in females. (b) Males who quit smoking for 20 years or more demonstrated no elevated lung cancer risk. (c) Among male current smokers, the more the number of cigarettes smoked per day, the higher the lung cancer risk for both cell types, but particularly for squamous cell carcinoma. In contrast, deep smoke inhalation significantly increased the risk for adenocarcinoma in particular. (d) Okinawan brand cigarettes were more strongly associated with the risk, compared with other brand ones. This finding might partly explain the higher frequency of lung cancer in males with the relatively lower smoking rate in Okinawa.

Experimental study of the therapeutic effects of folate, vitamin A, and vitamin B12 on squamous metaplasia of the bronchial epithelium.

BACKGROUND: Vitamin deficiency may be related to carcinogenesis. Cytologic examinations of sputum have already found that the administration of folate and vitamin B12 suppressed the development of squamous metaplasia and atypia in smokers' airways. The authors investigated the effect of folic acid, vitamin B12, and vitamin A on the formation of metaplasia and hyperplasia in methylcholanthrene (MCA)-treated rats. METHODS: The SD strain of rats received 10 mg of MCA intratracheally and was divided into six groups as follows: (1) vitamin A; (2) folic acid; (3) vitamin B12; (4) vitamin B12 with folic acid; (5) a combination of vitamin A, folic acid, and vitamin B12; and (6) no vitamins. The Lower respiratory tract epithelia of the rats were examined histologically 20, 32, and 36 weeks after MCA administration and at the end of the experiment. RESULTS: A clear difference was detected between the group receiving folic acid and that receiving vitamin A. In the former group, metaplasia was found in only one rat, atypia was not found, and hyperplasia with marked changes was present in less than 50% of other groups. In the latter group, atypia was found in all of the metaplastic foci. CONCLUSIONS: It was suggested that the epithelial hyperplasia and metaplasia of respiratory tract induced by MCA can be suppressed by the administration of folic acid.

Large, benign osteoblastoma of the temporal bone--case report.

Benign osteoblastoma is a rare tumor of bone, usually confined to the long bones and vertebrae. Its occurrence in the calvaria is extremely rare. The authors report a case of a temporoparietal lesion in a 29-year-old male. Computed tomography revealed a low-density mass, which was irregularly enhanced by contrast medium. Magnetic resonance imaging demonstrated a mass of low intensity on T1- and high intensity on T2-weighted images. Angiography confirmed the presence of a large epidural mass in the left temporal region. The tumor was excised and the pathological diagnosis was benign osteoblastoma.

[Hypernatremia due to hypothalamic tumor: ADH response to changes in plasma osmolality].

A case of a patient with the syndrome of chronic hypernatremia and hypodispia due to hypothalamic tumor was studied to evaluate the change of ADH response to plasma osmolality during the clinical course. A 23-year-old man was admitted for investigation of anorexia, hypodipsia and gait disturbance. Examination showed memory disturbance and generalized muscle weakness. Investigation showed marked hypernatremia (177 mEq/l) and hypopituitarism. Water loading test showed that ADH was not stimulated by hyperosmolality but continued to be secreted at a more or less constant level approximating normal basal state. CT scan revealed hypothalamic tumor. The tumor was suspected to be germinoma due to its radiosensitivity and high serum hCG level. After irradiation, the tumor lesion disappeared. ADH secretion came to be responsive to changes in osmolality but the response of the system was markedly reduced compared with the normal response, and hypodipsia and hypernatremia still remained. We conclude that the adipsia and complete destruction of the osmoreceptor in the patient caused marked hypernatremia and the destruction of ADH osmostat improved partially after irradiation. We believe it very useful for analyzing the disturbance of osmoregulatory system to evaluate the relationship of plasma ADH to plasma osmolality.

A comparative epidemiologic study on geographic distributions of cancers of the lung and the large intestine in Japan.

To examine what kinds of factors could have caused the geographic variation observed in lung cancer morbidity in Japan, a correlation study was performed comparing various regional traits. The same study was also conducted on large intestinal cancer, aiming to distinguish the possible urban factors associated with both cancers. Lung cancer was highly correlated with industrialization-related factors such as localization of manufacturing industries, automobile traffic and air pollution, whereas colon cancer was correlated with the population density of workers in the tertiary industries such as services, trade and government. A multiple regression analysis could not detect any single factor with an exceptionally strong influence on either cancer. The present findings suggest that the hazardous environmental condition of urban areas has, to some extent, contributed to the recent increase of lung cancer cases in this country.

[Pineal metastasis--a case report and a review of literature].

This is a report of a rare case of pineal metastasis from gastric adenocarcinoma. A 75-year-old male with a previous medical history of subtotal gastrectomy for cancer of the cardia was diagnosed as having hydrocephalus 6 months later. After undergoing a V-P shunt operation, he was transferred to Kyoto First Red Cross Hospital. The patient had neurological abnormalities: bilateral paralysis of upward eye movement, and bilateral sluggish reflex to light. Ten days later the patient suddenly fell into a coma due to intratumoral hemorrhage. The patient soon regained consciousness and received Cobalt-therapy. However he died two months later of pulmonary malfunction due to pulmonary metastasis. An autopsy revealed a pineal tumor metastasized from gastric adenocarcinoma. The tumor involved the body of the pineal gland, and was expanded having a sharply defined margin which extended to the posterior portion of the third ventricle and the bilateral basal ganglia.

[A trial of sustained-release anticancer chemotherapy with silicone].

Mitomycin C (MMC) was incorporated into liquid silicone which was then vulcanized into solid form. Pellets of MMC were implanted at 5 different sites within the mediastinum of 9 dogs. Implants were removed at regular intervals after sacrificing the test animals. Though the mean doses of MMC released leveled off during 4 weeks, it began to increased rapidly after the 5 week with the result of, this one month delay compared with in vitro. Necrosis appeared to prevent MMC from liberating itself from the implants. Further, the cumulative doses of MMC released were found to be superior in the subaortic and subcarinal sites than in the other three places. No serious complications were encountered in this study.

[Familial predisposition to cancer: a cohort study of participants in a cervical cancer screening program].

A numerous number of case-control studies have already demonstrated a certain extent of familial clustering for most human cancers. This is the first report of follow-up study with respect to familial predisposition to cancer. About 40 thousands women who participated in a cervical cancer screening program in 1977 were followed up until 1985 by using the population-based cancer registry. Cancer patients who were detected in the cohort population and their controls were compared for the family history of cancer and female reproductive history both of which had been recorded in a computer file beforehand. For large bowel cancer and breast cancer, positive effect of familial predisposition was observed, though not statistically significant.

[Spontaneous epidural hematoma--report of two cases].

We report two cases of spontaneous epidural hematoma associated with the hemorrhagic diathesis and the paranasal sinusitis. Case 1: A 31-year-old man with a history of subtotal gastrectomy because of gastric cancer. He complained of headache at left temporal region, but CT scan showed no abnormal finding. After about 12 hours, he was found in comatose state. Emergency CT scan showed left epidural hematoma. He had the thrombocytemia and hemorrhagic diathesis which were supposed to be the side effect of the chemotherapy or DIC. Although the epidural hematoma was removed at emergency, he died 5 days after the operation, because of severe brain swelling. Case 2: A 34-year-old woman with a history of paranasal sinusitis. At 3 weeks after her fourth delivery, she had a headache and a right orbital swelling. She was admitted to the otorhinolaryngologist under the diagnosis of the acute paranasal sinusitis and orbital phlegmone. After admission, the level of consciousness became worse, she was given neurosurgical consultation. Angiogram showed right temporal mass lesion. At operation, the epidural hematoma was found and evacuated. She was discharged without any neurological deficits.

[Results of surgical treatment for large cell carcinoma of the lung].

Twenty-six patients with histologically confirmed large cell carcinoma of the lung were evaluated. The overall five-year survival of these cases was 19.9%. Fifteen patients who had undergone surgical resection, excluding one operative death, had a five-year survival rate of 33.8%. None of the nonresected cases survived more than six months after the beginning of treatment. Among prognostic factors in surgical treatment of large cell carcinoma, survival correlated well with clinical stage, extent of lymph-node metastasis, curative resection and histological subtypes. As for histological subtypes, stratified subtype by division of nongiant cell carcinoma revealed poorer prognosis than that of nonstratified subtype and appeared to have some correlation with the frequency of vascular invasion by the tumor. From the clinical viewpoint, giant cell carcinoma should be regarded as a distinct clinical entity. Two cases, however, had benefit of long-term survival due to surgical modality. The clinicopathological analysis of those cases remains to be resolved in the future.

[The clinicopathological effects of infusion of cis-platinum into the bronchial artery on lung cancer].

Ten patients with histologically and/or cytologically confirmed lung cancer were treated with cis-platinum (CDDP) infused into the bronchial artery (BAI). Radiological findings on chest X-rays taken two weeks after BAI were evaluated according to Takeuchi's criteria. The radiological results were judged to be quite effective in one case of squamous cell carcinoma, with more than 50% shrinkage of the tumor shadow, and to be effective in nine others, with more than 20% shrinkage. As for the histological effects, grade III in one case of squamous cell carcinoma and grade IIa in two cases of adenocarcinoma and one of large cell carcinoma were obtained by Shimosato's criteria. In conclusion, BAI with CDDP was sufficiently useful as a chemotherapeutic modality for lung cancer, especially squamous cell carcinoma, because higher local dosage of CDDP can be delivered without systemic toxicity.

[Effects of infusion of cis-platinum into the bronchial artery in lung cancer].

5 patients with histologically and/or cytologically confirmed lung cancer were treated with Cis-platinum (CDDP) infused into the bronchial artery (BAI). 2 patients with squamous cell carcinoma disclosed hypervascular type and 3 patients with adenocarcinoma demonstrated avascular or hypovascular type on bronchial arterial angiography. All patients showed more than 20% shrinkage of the tumor shadow on chest X-ray taken 2 weeks after BAI and were evaluated to be radiologically effective by Takeuchi's criteria. One patient with squamous cell carcinoma who underwent lobectomy after BAI with 100 mg of CDDP showed grade III histological effects by Shimosato's criteria. The other patient had superior vena cava syndrome and showed regression of a tumor which occluded the orifice of the right upper and showed lobe after BAI with 100 mg of CDDP. By of contrast, only 1 out of the 3 patients with adenocarcinoma who under went resection showed a grade IIa histological effect after BAI with 50 mg of CDDP. Side effects included mild gastrointestinal toxicity in 1 out of the 5 patients. In conclusion, BAI with CDDP was shown to be sufficiently useful as a chemotherapeutic modality for lung cancer, especially for patients with squamous cell carcinoma, because higher local doses can be delivered without systemic toxicity.