Mothers' perceptions of and feelings towards their babies' crying

The frequency and type of crying and the parents' perceptions of it were evaluated in 281 Finnish infants underthe age of 1 year. Not many mothers [14#pc] claimed that their babies cried often or very often. The infants less than three months old cried significantly more in the evening than the older ones. Most mothers [94#pc] reported that the crying aroused feelings of tenderness, but 4#pc found it irritating. The most common response to the cry [97#pc] was to pick the baby up. Additional help was wanted by 49 mothers because of their babies' disturbing crying spells. These mothers reorted that their infants cried more and they stated that the cry made them feel more irritated and more often gave them a feeling of failure than the mothers not in need of help. The majority of these mothers would have been glad to help, including advice, whent the infants were under 3 months of age.     

Traumatic fistula between the left anterior descending coronary artery and a left ventricular pseudoaneurysm

A 44-year-old man presented with a fistula of the left anterior descending (LAD) coronary artery to a left ventricular pseudoaneurysm 6 months after a stab injury in the left anterior chest. The color Doppler echocardiography suggested, and angiography confirmed, the diagnosis and the lesion was treated successfully. Traumatic coronary artery fistulas are rare complications, and color Doppler echocardiography proved useful for the diagnosis. Received: 0/00/00/Accepted: 0/00/00     

Pilocarpine release from hydroxypropyl-cellulose-polyvinylpyrrolidone matrices

Characteristics of pilocarpine release from cast plasticized hydroxypropylcellulose (HPC) and HPC-polyvinylpyrrolidone (PVP) matrices were studied using tritiated pilocarpine. Increased concentration of PVP and decreased molecular weight of HPC accelerated release of pilocarpine from the matrices. The aqueous solution penetrated rapidly into the matrices, which swelled rapidly to their equilibrium volumes. With increased molecular weight and concentration of HPC in the matrices, the rate of solvent penetration decreased and swollen volume of the matrix increased. Pilocarpine concentration also decreased in the ungelled cores of the matrices, indicating that the solvent had penetrated these cores. Solvent penetration alone did not control the rate of drug release, because penetration was at least twice as rapid as pilocarpine release. In the matrices without polymer dissolution, the best fits of the release data were obtained with diffusional square-root of time dependence, although relaxation of the polymers caused slight deviations from the Fickian diffusion. Thus the rate-limiting step of pilocarpine release was the diffusion of the drug from the matrix. The decreased rate of pilocarpine release with increased molecular weight and concentration of HPC was due to the decreased rate of drug diffusion from the matrix. Retardation of this diffusion was caused by the increased swelling of the matrix and decreased diffusivity of the drug. High initial concentration of PVP resulted in substantial deformation and attrition of the matrices.     

Nandrolone decanoate added to tamoxifen in the treatment of advanced breast cancer

Summary Since 1980 we have been carrying out a prospective randomized trial comparing tamoxifen with the combination of tamoxifen plus nandrolone decanoate in advanced breast cancer. The tamoxifen dose is 30 mg daily and the nandrolone decanoate dose 100 mg i.m. once a week for four weeks and thereafter every other week. 98 post-menopausal patients have been evaluated for the response. The number of patients is 49 in both groups.The overall response rates (CR +PR) to tamoxifen and tamoxifen plus nandrolone decanoate were not significantly different; in the tamoxifen group the response rate was 49% and in the combination group 45%. The mean time to progression in tamoxifen group is over 13 months and in tamoxifen plus nandrolone decanoate group over 12 months. Our results do not suggest a synergistic effect from combining tamoxifen and nandrolone decanoate treatments. The response rates to tamoxifen at different sites of metastases were as follows: bones 47%, soft tissues 56%, and viscera 48%. The respective figures with the combination therapy were 36%, 64%, and 40%.Both treatments were well tolerated and in no patient was withdrawal of the therapy necessary. Mild virilization and hoarseness were experienced by all patients treated with nandrolone decanoate. Side-effects associated with tamoxifen were rare, although five patients experienced nausea and two had hot flushes.     

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.

---

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.

---

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.

     

Methylprednisolone esters of hyaluronic acid in ophthalmic drug delivery: in vitro and in vivo release studies

Films and microspheres were prepared from various esters of hyaluronic acid. A model drug, methylprednisolone, was either physically incorporated into the polymer matrix or chemically bound to the polymer backbone through an ester linkage. In vitro release from films with covalently bound drug was much slower (t_50% = 71 h) than that for physically dispersed drug (t_50% = 2.5−17 h). Methylprednisolone concentrations in the tear fluid of New Zealand rabbits were measured after ocular application of drug (approx. 420 μg) in different dosage forms. When methylprenisolone was physically dispersed in the polymer matrix, in vivo drug release from matrices was slower than that observed in vitro. Compared with a suspension control, peak methylprednisolone concentrations in tear fluid were 9–14 times lower after administration of drug in polymer films and AUC_{0–8 h} values were 4–7 times higher. These results imply that hyaluronic acid ester preparations can increase the residence time of methylprednisolone in the tear fluid of rabbits.     

Challenges and obstacles of ocular pharmacokinetics and drug delivery

Modern biological research has produced increasing number of promising therapeutic possibilities for medical treatment. These include for example growth factors, monoclonal antibodies, gene knockdown methods, gene therapy, surgical transplantations and tissue engineering. Ocular application of these possibilities involves drug delivery in many forms. Ocular drug delivery is hampered by the barriers protecting the eye. This review presents an overview of the essential factors in ocular pharmacokinetics and selected pharmacological future challenges in ophthalmology.     

Serum basal hormone concentrations and muscle mass in aging women: effects of strength training and diet

This study examined the effects of strength training and diet on serum basal hormone concentrations and muscle mass in aging women. Fifty-one women age 49 to 74 y were divided into two groups: strength training and nutritional counseling (n = 25), and strength training (n = 26). Both groups performed strength training twice a week for 21 wk. Nutritional counseling was given to attain sufficient energy and protein intake and recommended intake of fat and fiber. We found that the cross-sectional area of the quadriceps femoris increased by 9.5 +/- 4.1% in the nutritional counseling group versus 6.8 +/- 3.5% in the strength training only group after training (P < 0.052). Nutritional counseling evoked dietary changes such as increases in the proportion of energy from protein and the ratio of polyunsaturated and saturated fatty acids. Strength training increased testosterone and testosterone/sex hormone-binding globulin ratio after the first half of training, but these returned to baseline values at the end of the entire training period. Changes in serum basal hormone concentrations did not differ between the groups. Our results support the conclusion that nutritional counseling can contribute to the increase in the muscle cross-sectional area during prolonged strength training in aging women.