The purpose of this study is to confirm the hypocalciuric effect of rice bran experimentally and clinically. Urinary calcium excretion and its absorption in the intestine were reduced significantly by rice bran or phytin in rats fed high calcium diets, while there were no significant decreases with a low calcium diet. For the clinical study 70 patients with idiopathic hypercalciuria were treated with rice bran (10 gm. twice daily) for 1 month to 3 years. In almost all patients rice bran caused a significant decrease in urinary calcium excretion, which was maintained during treatment. Evidence of stones has decreased clearly among patients treated with rice bran for 1 to 3 years, although this might be a halfway judgment of the long-term treatment. We suggest that phytin should be the most effective substance to reduce the intestinal absorption of calcium and that rice bran treatment should be effective for prevention of recurrent urinary stone disease.
Parathyroid adenoma and hyperplasia are the most common causes for hyperparathyroidism, and distinction between them is controversial based on the current criteria for pathological diagnosis. We studied the clonality of hyperparathyroidism and its correlation with the pathological features, analysing 39 female patients with hyperparathyroidism. Clonality was successfully detected in 12 heterozygous cases by PCR amplification of PGK-1 gene. The 12 cases yielded 14 hypercellular glands, 8 affected by primary and 6 by secondary hyperparathyroidism. The results revealed that 7 of the 8 glands with primary hyperparathyroidism showed monoclonal proliferation. Only 1 gland pathologically diagnosed as adenoma showed a polyclonal pattern. In the 4 cases with secondary hyperparathyroidism, at least one monoclonal tumour was detected in each case. Our data indicate that monoclonal tumours are more common than expected in both primary and secondary hyperparathyroidism. Monoclonal tumours and polyclonal hyperplasia can co-exist in the same patient. Comparative study of the clonality and the pathological features showed that the clonality was consistent with the diagnosis of parathyroid adenoma, whereas it was in conflict with the diagnosis of hyperplasia with multigland involvement. One of the reasons for this is that we are ignorant of the true natures of hyperparathyroidism with multigland involvement.
A series of 182 calcium stone formers with idiopathic hypercalciuria underwent treatment with rice bran for 1 to 94 months. Urinary calcium excretion was considerably reduced, but there was some increase in urinary phosphate and oxalate. Urinary excretion of magnesium and uric acid, serum calcium, magnesium, phosphate, uric acid, parathyroid hormone (PTH) and ALP was unaffected. There were no obvious changes in serum iron, zinc and copper even when patients were treated for long periods. Rice bran was well tolerated in almost all cases and there were no serious side effects; 49 patients have undergone treatment for more than 3 years (average duration of administration 5.09 years). The frequency of new stone formation was drastically reduced (individual stone formation rate (no./year) from 0.720 +/- 0.533 to 0.125 +/- 0.204; group stone formation rate (no./patient-year) from 0.721 to 0.120) compared with the 3-year period before treatment. During treatment, 61.2% of patients remained in remission. Although rice bran therapy should be effective in correcting absorptive hypercalciuria, there may be limits to the overall ability of rice bran monotherapy to prevent recurrence.
Between January 1951 and December 31, 1990 urothelial tumors were detected in 112 of 1,085 male dye workers (10.3%) in Wakayama City who were formerly engaged in manufacturing of benzidine and/or beta-naphthylamine. The period from exposure to the chemicals to development of the tumor was a mean of 24.1 +/- 9.4 years. A peak incidence of urothelial tumors was observed also approximately 25 years after the peak period of manufacturing these intermediate products of dyes. The mean period from exposure to such carcinogenic chemicals to the onset of the disease was estimated to be 25 years. Of the 78 patients with primary bladder cancer diagnosed since 1969, 43 (55.1%) had tumors diagnosed mostly as a result of a positive urinary cytology test obtained as part of a screening program and 35 (44.9%) had tumors diagnosed as the result of symptoms. Ten patients (24.4%) in the screened group had been treated with total cystectomy by the last followup examination compared with 17 (50.0%) in the symptomatic group. The 10-year cumulative survival rates were significantly (p less than 0.05) higher in the screened patients (75.1%) than in the symptomatic patients (55.1%). Our results indicate that screening of high risk populations with urinary cytology tests is effective for early diagnosis and treatment of urothelial tumors, and it improves patient prognosis. Furthermore, the biological behavior of occupational urothelial tumors may be different from that of urothelial tumors in the general population.
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