Coffee, cigarette smoking, and bladder cancer in western New York.

The association between consumption of coffee and bladder cancer and the effect modification of cigarette smoking was investigated as part of a comprehensive case-control study. The study population consisted of 351 case patients with histologically confirmed transitional cell carcinomas of the bladder among white males and 855 white male control subjects selected from Erie, Niagara, and Monroe counties in New York from 1979 to 1985. Usual diet, coffee consumption, and cigarette use were estimated by comprehensive interviews using a detailed food frequency questionnaire. After adjustment for age, education, and dietary risk factors by multiple logistic regression, risk was found to increase with increasing pack-years of cigarette use with an odds ratio in the highest quartile of 2.7 (95% confidence interval, 1.8 to 4.0) when compared to the lowest quartile. Coffee consumption was associated with an increased risk for bladder cancer among the heaviest coffee drinkers after adjustment for cigarette smoking and other dietary risk factors (odds ratio, 2.1; 95% confidence interval, 1.3 to 3.2). The effect was more pronounced among nonsmokers, especially among those 65 years and older. These findings support the contention that coffee is a weak carcinogen.

Drinking water, fluid intake, and bladder cancer in western New York.

Fluid intake and consumption of specific beverages were investigated in a study of 351 white male cases for whom transitional cell carcinoma of the bladder had been confirmed histologically during the time period from 1979 to 1985. A total of 855 white male controls was selected from Erie, Niagara, and Monroe counties of western New York state. Total fluid consumption was composed of alcoholic beverages, bottled beverages, soda, milk, coffee, tea, all juices, and glasses of tap water. Tap water included coffee, tea, juices, and glasses of water taken directly from the tap. Total fluid consumption was found to be a strong risk factor for bladder cancer when a number of potential confounding risk factors were controlled for. Risks were higher among those who were less than 65 y of age (odds ratio [OR] = 6.3, 95% C.I. = 2.8-14.0). The OR was 3.4 (95% C.I. = 1.8-6.2) for the highest quartile of fluid consumption among those 65 y of age and older. The tap water component was associated with increased risk in both age categories, and there was a clear dose-response relationship. Risks associated with tap water consumption were higher among those who never smoked cigarettes. Both biological and nonbiological explanations for these results are evaluated. The findings suggest implications for public health, but the limitations of the present investigation preclude definitive conclusions and stress the urgency for replication.

Diet in the epidemiology of bladder cancer in western New York.

We present the dietary epidemiology of bladder cancer while controlling for a number of lifestyle and environmental risk factors in a study of 351 white male cases with histologically confirmed transitional cell carcinoma of the bladder and 855 white male controls selected from Erie, Niagara, and Monroe counties of western New York from 1979 to 1985. Usual diet was estimated by comprehensive interviews with use of a detailed food frequency questionnaire. An increased risk of bladder cancer was associated with higher kilocalorie intake, but only among those under 65 years of age, with the strongest pattern associated with fat intake. Further analyses of fat, carbohydrates, and protein, with adjustment for total kilocalories, resulted in a positive association of risk with fat intake and a decreasing risk with higher protein intake. Of the vitamins, carotenoid consumption appeared to decrease risk with increased consumption for those under 65 years of age. No significant differences between cases and controls were seen for intake of calcium, retinol, thiamin, riboflavin, niacin, vitamin C, vitamin D, and vitamin E. After adjustment for kilocalories and other confounders, higher intake of dietary sodium was associated with increased risk among both age groups, and the trends were statistically significant. The importance of diet in the etiology of bladder cancer is suggested by our findings.

Paraneoplastic and serologic syndromes of renal adenocarcinoma.

In renal carcinoma, the inappropriate, unscheduled, or aberrant production of hormones and other serologic markers and the resulting clinical or biochemical syndromes are unique manifestations of this tumor. The elaboration of biologically active factors by renal adenocarcinoma may add a metabolic burden to an already compromised host, and thus affect therapy and prognosis; they should be considered before ascribing symptoms to metastasis or dissemination. Similarly it has been suggested that the elaboration of biologically-inactive peptides and proteins is a very common concomitant of neoplasia and the identification of such factors may facilitate earlier diagnosis and novel therapies in patients with renal carcinoma.

The epidemiology of testicular cancer in upstate New York.

In a study of 250 cases of cancer of the testis and of neighborhood- and age-matched controls in upstate New York in 1977-1980, the authors found that risk was enhanced by possession of a number of traits associated with exposure of the testis to heat; occupational exposures to fertilizers, phenols, and fumes or smoke; and trauma to the testis. Risk was also increased for characteristics related to congenital and developmental aberrancies and testis-related abnormalities, e.g., low sperm count, fertility problems, atrophic testis, and cryptorchidism. Several of these risk factors were statistically significant in a multiple regression model that adjusted for all other significant traits, age, and education.

The influence of urinary macromolecules on calcium oxalate monohydrate crystal growth.

The Constant Composition (CC) kinetics method has been used for studying the mineralization of calcium oxalate monohydrate (COM) at sustained supersaturations in the presence of pre-bladder urine and macromolecules isolated from normal urine and kidney and bladder stones. The method is especially sensitive for investigating the inhibitory activities of these urinary macromolecular components (UMMC) and matrix macromolecular components (MMMC) with a coefficient of variation in growth rate of approximately 2%. Significant COM mineral inhibition was observed in a wide molecular weight region of urine components. Urine removed directly from the kidney showed appreciable inhibitory activity towards COM crystallization. Normal urinary proteins and the dissolved precipitate resulting from urine centrifugation were fractionated by gel filtration. The resulting solutions were mostly COM mineralization inhibitors. Electrodialysis was utilized to isolate the MMMC (greater than 7000 d) of renal and bladder calculi. While these solutions inhibited COM crystallization, they were also found to be calcium binders as measured by the calcium electrode.

Further studies of a transplantable rat pheochromocytoma.

Additional histopathological and immunocytological studies were completed on the serially transplanted Warren rat pheochromocytoma. Special efforts were made to characterize features of the primary tumor common to pheochromocytomas, as well as features of the primary tumor commonly found in neuroblastoma. In summary this study found evidence for a composite primary tumor exhibiting a dual differentiative expression of both pheochromocytoma and neuroblastoma. We feel this reflects a possibility that this primary tumor arose from a common progenitor cell in the neural crest.

Endometrial carcinoma of prostate.

Endometrial carcinoma of the prostate is a unique lesion which contrasts markedly to the more ubiquitous prostatic acinar carcinoma with regard to morphology, clinical manifestations, localization stage at diagnosis, and possibly prognosis. Although endometrial carcinoma of the prostate may occur more commonly than previously recognized, wider recognition and study are essential for further delineation of this lesion. Finally, the inherent limits of endoscopic or of enucleative surgery and the propensity of endometrial carcinoma to present at a low stage suggest in appropriately selected cases that radical prostatectomy or possible external radiotherapy may offer the best opportunity for cure.

Kinetics of formation of renotropic growth factor.

In the Wistar/Furth rat, twenty-four hours after unilateral nephrectomy, the remaining contralateral kidney produces maximum amounts of renotropic growth factors. These factors stimulate tumor growth in recipient rats with s.c. Wilms tumor, but have no effect on kidney weight. In tumor-free recipients, kidney hypotrophy results when the factors are administered.

Specificity of renotropin receptors in murine Wilms tumor model.

Contralateral kidneys, removed forty-eight hours after unilateral nephrectomy, contain renotropic growth factors with different effects on normal kidney and Wistar/Furth rat Wilms tumor. Receptors on tumor cells bind factors which, when eluted followed by in vivo bioassay, stimulate the growth of Wilms tumor. Receptors on normal kidney cortex cells bind factors which, when eluted, produce kidney hypotrophy in nontumor-bearing rats.

Traumatic torsion of the testis.

Torsion of the testis is a common urological emergency. Blunt scrotal trauma also may precipitate an emergency. We recently treated 2 adolescent boys in whom blunt scrotal trauma induced testicular torsion. A retrospective review of the charts of 138 patients explored for acute scrotal pain at our hospital revealed a history of scrotal trauma in 3 of 57 patients (5 per cent) with testicular torsion and 7 of 73 (10 per cent) with torsion of the testicular appendages. The possibility of torsion must be considered in cases of scrotal trauma.

Effect of unilateral nephrectomy on growth of the Wistar/Furth Wilms' tumor.

Compensatory renal growth, that is, renal growth following contralateral nephrectomy, is mediated by either the elaboration or the activation of a renotrophic growth factor. Since tumor growth may be modulated by various factors, we evaluated the effect of the renotrophic growth factor associated with compensatory renal growth on the Wistar/Furth rat Wilms' tumor. When compared to tumors grown in sham nephrectomized animals, tumors grown in animals who had undergone unilateral nephrectomy showed an increase in tumor weight and in DNA content. In addition, the rate of new cell formation as reflected by the uptake of tritiated thymidine into tumor cells was significantly higher and did not decline when tumors grown in animals who had undergone unilateral nephrectomy were compared to tumors from sham nephrectomized animals. Our studies therefore suggest that the renotrophic growth factor associated with compensatory renal growth may have ubiquitous growth regulating activity and that further studies may elucidate its role in the modulation of normal and neoplastic growth.

Effect of unilateral nephrectomy on tumor growth of the murine renal cell adenocarcinoma and neuroblastoma.

Compensatory renal growth has been observed following contralateral nephrectomy in man and in certain animals. In a recent study of murine Wilms' tumor, tumor growth was observed to be affected by contralateral nephrectomy; therefore, a murine renal cell adenocarcinoma and neuroblastoma were evaluated. Comparison of tumors in sham-nephrectomized animals to tumors in mice who had undergone unilateral nephrectomy showed no significant increase in tumor weights. However, the contralateral kidney in the uninephrectomized animals had increased in weight as compared to that in tumor-bearing intact mice and the kidneys removed at uninephrectomy. This study demonstrates that factors influencing compensatory renal growth do not affect all renal tumors or other solid tumors.