Management of early prostatic cancer in the Nordic countries: variations in clinical policies and physicians' attitudes toward radical treatment options.

To explore the treatment of patients with early localized prostatic carcinoma, we surveyed the departments of urology and general surgery in Denmark, Finland, Norway, and Sweden. Clinical policies and physicians' attitudes toward the radical treatment options varied widely between the countries. A correlation seems to exist between practice patterns and national attitudes toward special technologies.

[Prostate cancer in Scandinavia. Variations in practice and attitude to radical treatment].

Some controversy persists as to the optimal assessment and treatment of prostate cancer, a lack of consensus reflected in differences in clinical practice. Our survey among departments of urology and general surgery in the Nordic countries showed Danish physicians to be the most conservative, while the most active intervention strategies were found in Finland.

Crucial questions for physiotherapy in Finland.

When planning for health services, questions of production and distribution as well as cost and quality are key issues for health planners and decision makers. The lack of available objective data often makes this work difficult. This paper presents recent efforts in Finland to improve the collection of information needed for planning in the field of physiotherapy.

Medical technology assessment in Finland.

We need five kinds of people to guide us further through the integrated process of medical technology assessment: (a) idea generators; (b) entrepreneurs/product, process and practice "champions"; (c) program managers; (d) gatekeepers/communicators; and (e) sponsors/"coaches." If we focus on idea generators, empirical research quickly points out a significant difference between people who create ideas and those who apply the ideas that others have generated. Entrepreneurs and product "champions" promote change and innovation, take ideas, and attempt to move them forward in organizations to gain their adoption.

Percutaneous absorption of hydrocortisone during and after the acute phase of dermatitis in children.

Percutaneous absorption of hydrocortisone was measured by a four-hour absorption test in 16 children during and after the acute phase of dermatitis. In the acute phase, after the application of 1% hydrocortisone cream the increment in plasma cortisol ranged from 47 to 961 nmol per liter (median 248 nmol/L). After the acute phase the increment was significantly (P less than 0.

Effect of percutaneous absorption of hydrocortisone on adrenocortical responsiveness in infants with severe skin disease.

Percutaneous absorption of hydrocortisone was studied in 18 children (aged from 6 weeks to 14 1/2 years) with atopic or seborrhoeic dermatitis, by measuring their serum cortisol before and after application of 1% hydrocortisone cream. Endogenous secretion of cortisol was suppressed with dexamethasone. A 24 h absorption test was performed on nine children.

Growth in Cushing syndrome.

Pre- and post-operative growth was analysed in eight children with Cushing syndrome. Six children had Cushing's disease; three of them were treated by bilateral adrenalectomy and three by transphenoidal pituitary adenectomy. One child had an adrenocortical adenoma and another primary adrenocortical nodular dysplasia.

Cortisol augments synthesis of growth hormone, but does not alter synthesis of prolactin and proopiomelanocortin, in the 120- to 125-day fetal ovine pituitary.

In adult animal pituitaries or in cultured pituitary tumor cells, glucocorticoids are regulators of GH, PRL, and proopiomelancortin (POMC) synthesis. However, ovine fetal plasma cortisol concentrations are low until shortly before parturition, suggesting that cortisol may not normally regulate hormone synthesis in the fetal pituitary. To investigate whether cortisol could affect fetal synthesis of GH, PRL, and POMC, we obtained fetal pituitary tissue from normal fetuses and from fetuses which had received cortisol infusion for 48 h.

The diagnosis and staging of hypocortisolism in progressing autoimmune adrenalitis.

The course of development of hypocortisolism was studied in 20 patients with autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy (APECED) for 1.3-9.3 years during which time the patients underwent at least three 2-h ACTH tests (2hAT).

Risk of relapse in steroid-sensitive nephrotic syndrome: effect of stage of post-prednisone adrenocortical suppression.

Glucocorticoid therapy has been effective in inducing remission in the majority of children with primary nephrotic syndrome. However, glucocorticoid-induced adrenocortical suppression is associated with early relapse, whereas normal adrenocortical function seems to delay the subsequent relapse. We analyzed 201 episodes of prednisone treatment in 47 children with steroid-sensitive nephrotic syndrome by the life-table method.

Endocrine, histological, and biochemical studies of adrenocorticotropin-producing islet cell carcinoma of the pancreas in childhood with characterization of proopiomelanocortin.

Two 8-yr-old children, a boy and girl, are described with Cushing's syndrome secondary to ectopic ACTH-secreting pancreatic islet cell carcinomas. The girl, seen 28 yr ago, had strong presumptive evidence of ectopic ACTH production and hypercalcemia. The boy, studied recently, had strikingly elevated concentrations of plasma ACTH (1,500 pg/ml) and beta-lipotropin (beta LPH; 2,500 pg/ml) and showed no suppression of urinary 17-hydroxycorticoids or cortisol with low and high dose dexamethasone.

Hormone ontogeny in the ovine fetus. XV. Studies of adenohypophysial hormones after fetal pituitary stalk section: evidence for an extrahypothalamic dopaminergic influence on fetal prolactin secretion.

The administration of a dopamine antagonist, haloperidol, to the ovine fetus in late gestation elevates plasma concentrations of PRL, suggesting tonic dopaminergic inhibition of fetal PRL secretion. The source of this dopaminergic inhibition was investigated in chronically catheterized ovine fetuses (104-135 days of gestation) after hypophysial stalk section (SS; n = 4) and in sham-operated controls (CON; n = 7). Basal PRL levels were similar in the two groups of fetuses.

Synthesis of growth hormone, prolactin, and proopiomelanocortin by intact adult ovine pituitary tissue in vitro.

Synthesis of GH, PRL, and proopiomelanocortin (POMC) by the adult ovine pituitary was examined by culturing intact tissue explants in vitro and analyzing newly synthesized proteins by two-dimensional gel electrophoresis. Spots on autoradiographs of two-dimensional gels were identified by comigration with known standards, by analysis of tryptic peptides, or both. GH and PRL are the predominant proteins synthesized in the adult ovine pituitary, but their syntheses could not be detected in the neurointermediate lobe of the pituitary, the cerebral cortex, hypothalamus, mammillary body, or placenta.

Blood cell polyamines in children with short stature in reference to growth hormone activity.

The molar ratio or two blood polyamines (spermidine to spermine) was investigated in 54 children with shortness of stature. The long-term reproducibility of this ratio was 9.0%.

Effects of physical training on hormonal responses to exercise in asthmatic children.

A 4-month period of physical training increased the physical working capacity of 16 asthmatic children (aged between 9.3 and 13.6 years) by a mean of 11%.

Growth failure from symptomless celiac disease. A study of 14 patients.

In 14 children and adolescents, abnormally short stature was shown to be due to celiac disease (CD) though the patients had no current gastrointestinal symptoms. Growth failure had appeared in the first years of life, and was associated with a marked lag in bone age. Subnormal growth hormone (GH) responses were demonstrated in 4 patients, and subnormal ACTH responses in 2.