Short-term effects of danazol and medroxyprogesterone acetate on cytosol and nuclear estrogen and progestin receptors, 17 beta-hydroxysteroid dehydrogenase activity, histopathology, and ultrastructure of human endometrial adenocarcinoma

We measured concentrations of cytosol and nuclear estrogen, as well as progestin receptors and activities of 17 beta-hydroxysteroid dehydrogenase (17-HSD), and examined histopathology and ultrastructure of endometrial carcinoma specimens taken before and after one-week danazol (200 mg, 3 times daily) or medroxyprogesterone acetate (MPA, 100 mg daily) treatments in 14 and 16 patients, respectively. A typical progestin effect, a significant increase in the activity of 17-HSD, was observed after both treatments. The post-therapy 17-HSD activities correlated significantly with the pretreatment cytosol progestin receptor concentrations in both treatment groups. Both MPA and danazol decreased the proliferative activity and increased the secretory activity of the malignant epithelial endometrial cells. These biochemical and morphological results support the concept that danazol has progestin-like actions on the human endometrium, and might therefore be an alternative for hormonal treatment of endometrial carcinoma.     

The prognosis of demented patients — one-year follow-up study of a population sample

Functional decline and mortality after 1-year follow-up of 93 demented elderly subjects from a random population sample (N =795) were studied in Helsinki, Finland. Seventeen (18%) of the demented patients died as compared to only 5% of the non-demented subjects. The age-adjusted risk ratio for 1-year mortality of demented patients was 3.2 (95% confidence interval 1.8–5.6). Forty-four per cent (26/59) of the surviving patients who were not bedridden and incontinent at the very beginning of the study suffered further impairment in the following functions: institutionalization (6/21), losing the ability to walk (5/57) or beginning of incontinence (17/30). Sixteen (21%) surviving subjects were already bedbound, incontinent and institutionalized at the beginning of the study. Age, sex or the degree of dementia did not correlate to mortality or functional decline. The number of patients who were institutionalized during the follow-up was small. The appearance of incontinence and other recorded risk factors (age, degree of dementia or motility) did not seem to predispose to institutionalization. Subjective factors, such as caretaker's burden, probably have a great influence on the ending of home care.     

Papillary thyroid carcinoma: The new,age-related TNM classification system in a retrospective analysis of 199 patients

The new, age-related TNM classification system of papillary thyroid carcinoma was applied in a retrospective analysis of 199 patients operated on during the 24-year period from 1956 through 1979 at the Second Department of Surgery, Helsinki University Central Hospital. According to the new staging system, 103 patients (under 45 years of age) and 96 T1 patients (45 years of age and older) were categorized into stage I. The incidence of carcinoma-positive cervical lymph nodes was highest among patients under 30 years of age at primary surgery. During the follow-up period of 6–29 years, cervical lymph node involvement was verified at reoperation in 20 patients (10%). Distant metastases (bone or lung) developed in 11 patients (5.5%). thirty-one patients (16%) died from carcinoma. The prognostic value of stage grouping, in terms of metastatic tendency and cancer mortality, was clearly demonstrated in the present material, suggesting the suitability of this simplified, new, age-related staging system in clinical practice.

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Resumen La nueva clasificación TNM relacionada con la edad, del carcinoma papilar de la tiroides fue aplicada en un análisis retrospectivo de 199 pacientes operados en un período de 24 anos entre 1956 y 1979 en el Segundo Departamento de Cirugía del Hospital Central de la Universidad de Helsinki. De acuerdo con el nuevo sistema de estadificación, 103 pacientes menores de 45 años y 96 pacientes T1 de 45 años o más, fueron categorizados como estado I. La incidencia de ganglios cervicales positivos fue maxima entre los pacientes menores de 30 anos en el momento de la primera cirugía. En el curso del seguimiento de 6–29 años, se verificó invasión glanglionar cervical en reoperación en 20 pacientes (10%). Metástasis distantes (hueso o pulmón) aparecieron en 11 pacientes (5.5%). Treinta y un pacientes (16%) murieron por carcinoma. El valor pronóstico de la agrupación por estadificación, en términos de metastásis y mortalidad por cáncer, fue bien demostrada en este material chínico, lo cual sugiere la confiabilidad del nuevo y simplicado método de clasificación segÚn la edad, en la cual todo paciente menor de 45 años, no importa cuales sean las categorias T y N, son clasificados como estado I.

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Résumé Le nouveau système TNM de classification du carcinome papillaire de la thyroÏde en fonction de l'âge a été appliqué dans l'analyse rétrospective de 199 patients opérés sur une période de 24 ans, de 1956 à 1979, dans le 2ème Département de Chirurgie de l'Hôpital Central de l'Université d'Helsinki. Selon cette nouvelle classification, 103 patients T1 âgés de moins d 45 ans et 96 patients T1 de 45 ans et plus ont été répertoriés dans le stade I. L'incidence des adénopathies cervicales était plus fréquente chez les patients âgés de moins de 30 ans lors de la première intervention. Pendant la période de suivi allant de 6 à 29 ans, l'état des ganglions du cou a été contrôlé par réopération chez 20 patients (10%). Des métastases à distance (os ou poumon) se sont développées chez 11 patients (5.5%). Trenteet-un patients (16%) sont morts du cancer. La valeur pronostique du regroupement par âge, en terme de tendance métastasique et de mortalité, a été clairement démontrée dans cette étude, suggérant l'emploi de ce nouveau système de classification simplifié en fonction de l'âge dans la pratique clinique.

     

Sequentially combined estradiol valerate plus levonorgestrel therapy decreases 18:1 trans-fatty acid content of plasma lipids in healthy postmenopausal women.

Trans-fatty acids (TFA) have been classified as atherogenic dietary constituents but the effect of hormone replacement therapy (HRT) on their concentrations is not known. We used a washout protocol to study the effect of long-term estrogen and combined estrogen-progestin HRT on plasma elaidate (18:1t), which is the trans isomer of oleate and the major TFA in the diet. The study group comprised 15 women receiving estradiol valerate HRT and 15 women receiving combined HRT with estradiol valerate and levonorgestrel. The concentrations of elaidate in plasma phospholipids, cholesteryl esters and triglycerides were determined by gas chromatography. At baseline, the total plasma elaidate concentration was lower in the combined HRT group than in the estradiol valerate HRT group (p < 0.01). In the combined HRT group, the concentration of elaidate increased significantly after withdrawal of HRT (p < 0.001) and decreased again to the baseline level after restart of therapy (p < 0.001). These changes were due to decreases in the concentrations of phospholipids and triglycerides; in phospholipids there was also a proportional decrease of elaidate. There were no changes in elaidate in women receiving estradiol valerate alone. Our results suggest that long-term combined HRT treatment decreases plasma TFA, which is not achieved by estrogen alone.     

Smoking and Parkinson's disease

A total of 443 patients with Parkinson's disease and a similar number of age and sex matched controls were interviewed as regards their smoking habits. A lower proportion of the patients (26.4 %) had smoked when compared with the controls (32.7 %). Similarly, the patients had more often stopped smoking (76.1 %) than the controls (53.8 %). The difference in the proportions of persons who smoked in these two groups may be explained by selective mortality, or alternatively, by premorbid behavior of Parkinson's disease patients.     

Influenza A(H1N1) viruses of the 1977/78 outbreak: isolation and haemagglutination properties.

During the H1N1 outbreak of 1977/8, the virus was isolated in embryonated eggs from 59 out of 76 patients (78%) with the serologically confirmed infection. A similar isolation frequency has been achieved during a period of six H3N2 outbreaks since 1972/3. The H1N1 strains were isolated less frequently from late specimens (collected 4--6 days from the onset of illness) and more often only in the second passage compared with the H3N2 viruses. The new H1N1 strains resembled those prevalent in the 1950s with respect to their ability to agglutinate erythrocytes of certain laboratory animals and to be eluted from these, and thus differed from the H3N2 viruses.     

Intraocular lens-capsular bag imaging with ultrahigh-resolution optical coherence tomography Pseudophakic human autopsy eyes

PURPOSE: To compare in vitro ultrahigh-resolution optical coherence tomography (UHR OCT) cross-sectional images of the pseudophakic human autopsy eye with histology to evaluate the potential of this imaging technique for enhanced visualization of the anterior segment, especially the capsular bag, intraocular lens (IOL), and posterior capsule opacification (PCO) formation after cataract surgery. SETTING: Department of Medical Physics and Department of Ophthalmology, University of Vienna, Vienna, Austria, and Department of Oral and Maxillofacial Surgery Institute of Dentistry, University of Turku, Turku, Finland. METHODS: Ultrahigh-resolution OCT images were acquired from 7 pseudophakic human autopsy eyes using 1.4 microm axial x 3.0 microm transverse resolution. The axial resolution with UHR OCT is 1.4 microm compared to 10.0 microm with the commercially available OCT. Plastic-embedded histologic sections were obtained in precise alignment with the OCT tomograms. RESULTS: Ultrahigh-resolution OCT cross-sectional tomograms corresponded to the histologic sections. With the wavelength used (800 nm), the anterior and posterior capsules, area of lens epithelial cell growth and extracellular matrix proliferation, and IOL could be clearly visualized. The extent of capsular bag adhesion to the IOL could be detected, as well as the amount of PCO formation. CONCLUSIONS: The improved resolution makes UHR OCT a powerful tool in anterior segment imaging and evaluation of the capacity of IOL materials and models to induce capsular bag adhesion. Ultrahigh-resolution OCT may also help in determining the area of origin of PCO after cataract surgery.