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The purpose of this study was to investigate the effect of physicians' gender when sex-specific conditions are being treated in a country where almost half of the physicians are women. Five Finnish surveys originally conducted for other purposes were reanalyzed. Two surveys examined physicians' and medical students' views about hormone therapy during and after menopause, one survey examined medical students' attitudes about medicines, one survey examined physicians' obstetric practices, and one examined contraceptive counselling. All the surveys showed more similarities than differences in the clinical decision-making of women and men physicians. In opinions about menopause the physician's medical specialty was more important than gender. Physicians' obstetrical practices were also similar in five cases out of six, but in one situation where medical factors were not a deciding issue, women physicians acted differently. These results suggest that socialization into the medical profession makes physicians' practices more alike and diminishes gender differences. [ABSTRACT FROM AUTHOR]

Soil core and root ingrowth core methods for assessing fine-root (< 2 mm) biomass and production were compared in a 38-year-old Scots pine (Pinus sylvestris L) stand in eastern Finland. 140 soil cores and 114 ingrowth cores were taken from two mineral soil layers (0-10 cm and 10-30 cm) during 1985-1988. Seasonal changes in root biomass (including both Scots pine and understorey roots) and necromass were used for calculating fine-root production. The Scots pine fine-root biomassaveraged annually 143 g/m^2 and 217 g/m^2 in the upper mineral soil layer, and 118 g/m^2 and 66 g/m^2 in the lower layer of soil cores and ingrowth cores, respectively. The fine-root necromass averaged annually 601 g/m^2 and 311 g/m^2 in the upper mineral soil layer, and 196g/m^2 and 159 g/m^2 in the lower layer of soil cores and ingrowth cores, respectively. The annual fine-root production in a Scots pine stand in the 30 cm thick mineral soil layer, varied between 370-1630 g/m^2 in soil cores and between 210 - 490 g/m^2 in ingrowth cores during three years. The annual production calculated for Scots pine fine roots, varied between 330-950 g/m^2 in soil cores and between 110 - 610 g/m^2 in ingrowth cores. The horizontal and vertical variation in fine-root biomass was smaller in soil cores than in ingrowth cores. Roots in soil cores were in the natural dynamic state, while the roots in the ingrowth cores were still expanding both horizontally and vertically. The annual production of fine-root biomass in the Scots pine stand was less in root ingrowth cores than in soil cores. During the third year, the fine-root biomass production of Scots pine, when calculated by the ingrowth core method, was similar to that calculated bythe soil core method. Both techniques have sources of error. In thisresearch the sampling interval in the soil core method was 6-8 weeks, and thus root growth and death between sampling dates could not be accurately estimated. In the ingrowth core method, fine roots were still [ABSTRACT FROM AUTHOR]

Seasonal variations of the Scots pine (Pinus sylvestris L.), dwarf shrub and grass fine-root biomass and necromass were studied in a polestage Scots pine stand in eastern Finland during three successive growing seasons. The biomass of Scots pine fine roots varied annually and seasonally in the humus layer between 19 ~ 5 g m-2 to 139 ~ 22 g m-2, in the upper mineral soil layer between 90 ~ 14 g m-2 to 279 ~ 0 g m- 2, and in the lower mineral soil layer between 68 ~ 17 g m-2 to 217 ~ 73 g m-2. The seasonal minimum and maximum of understory vegetation fine-root biomass were in the humus layer 35 ~ 6 g m-2 and 235 ~ 42 g m-2 in t e upper mineral soil layer 26 ~ 0 gm-2 and 165 ~ 0 g m-2 and in the lower mineralsoil layer 14 ~ 0 g m-2 nd 36 ~ 5 g m-2. The seasonal fine-root necromass varied in the humus layer from 2 ~ 0 g m-2 to 1398 ~ 236 g m-2, in the upper mineral soil layer from 86 ~ 0 g m-2 to 1267 ~ 366 g m-2, and in the lower mineral soil layer from 8 ~ 0 g m-2 to 753 ~ 306 g m-2. The major part of the living Scots pine fine roots (62%) was in the mineral soil immediately below the humus layer, but almost all dwarf shrub roots and grass roots were in the humus and in the upper mineral soil layers. Most dead fine roots (82%) were in the humus layer and in the uppermost mineral soil layer. The variations of Scots pine fine-root biomass, dwarf shrub and grass fine-root biomass and necromass did not show a distinct and clear pattern within any growing season although there were significant differencesbetween the same month during different growing seasons. Some of theobserved variations could be explained by climatic factors related to drought. [ABSTRACT FROM AUTHOR]

The clinical spectrum of thyrotropin receptor-mediated (TSHR-mediated) diseases varies from loss-of-function mutations causing congenital hypothyroidism to constitutively active mutations (CAMs) leading to nonautoimmune hyperthyroidism (NAH). Variation at the TSHR locus has also been associated with altered lipid and bone metabolism and autoimmune thyroid diseases. However, the extrathyroidal roles of TSHR and the mechanisms underlying phenotypic variability among TSHR-mediated diseases remain unclear. Here we identified and characterized TSHR variants and factors involved in phenotypic variability in different patient cohorts, the FinnGen database, and a mouse model. TSHR CAMs were found in all 16 patients with NAH, with 1 CAM in an unexpected location in the extracellular leucine-rich repeat domain (p.S237N) and another in the transmembrane domain (p.I640V) in 2 families with distinct hyperthyroid phenotypes. In addition, screening of the FinnGen database revealed rare functional variants as well as distinct common noncoding TSHR SNPs significantly associated with thyroid phenotypes, but there was no other significant association between TSHR variants and more than 2,000 nonthyroid disease endpoints. Finally, our TSHR M453T-knockin model revealed that the phenotype was dependent on the mutation's signaling properties and was ameliorated by increased iodine intake. In summary, our data show that TSHR-mediated disease risk can be modified by variants at the TSHR locus both inside and outside the coding region as well as by altered TSHR-signaling and dietary iodine, supporting the need for personalized treatment strategies.

Background: Central hypothyroidism (CeH) is a rare condition affecting approximately 1:16 000- 100 000 individuals. Congenital forms can harm normal development if not detected and treated promptly. Clinical and biochemical diagnosis, especially of isolated CeH, can be challenging. Cases are not usually detected in neonatal screening, which, in most countries, is focused on detection of the more prevalent primary hypothyroidism. Until now, five genetic causes for isolated CeH have been identified. Here we aimed to identify the genetic cause in two brothers with impaired growth diagnosed with CeH at the age of 5 years. We further evaluated the candidate gene variants in a large genetic database., Methods: Clinical and biochemical characterization together with targeted next-generation sequencing (NGS) was used to identify the genetic cause in a family of two brothers presenting with CeH. Screening of insulin receptor substrate 4 ( IRS4 ) variants was carried out in the FinnGen database., Results: A novel monoallelic frameshift mutation c.1712&#95;1713insT, p.Gly572Trp fs*32 in the X-linked IRS4 gene was identified by NGS analysis in both affected males and confirmed using Sanger sequencing. Their mother was an unaffected carrier. In addition to the declined growth at presentation, central hypothyroidism and blunted TRH test, no other phenotypic alterations were found. Diagnostic tests included head MRI, thyroid imaging, bone age, and laboratory tests for thyroid autoantibodies, glucose, insulin and glycosylated hemoglobin levels. Examination of the IRS4 locus in FinnGen (R5) database revealed the strongest associations to a rare Finnish haplotype associated with thyroid disorders (p = 1.3e-7) and hypothyroidism (p = 8.3e-7)., Conclusions: Here, we identified a novel frameshift mutation in an X-linked IRS4 gene in two brothers with isolated CeH. Furthermore, we demonstrate an association of IRS4 gene locus to a general thyroid disease risk in the FinnGen database. Our findings confirm the role of IRS4 in isolated central hypothyroidism., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Patyra, Makkonen, Haanpää, Karppinen, Viikari, Toppari, Reeve and Kero.)

Wrist Fracture is the most common type of fracture with a high incidence rate. Conventional radiography (i.e. X-ray imaging) is used for wrist fracture detection routinely, but occasionally fracture delineation poses issues and an additional confirmation by computed tomography (CT) is needed for diagnosis. Recent advances in the field of Deep Learning (DL), a subfield of Artificial Intelligence (AI), have shown that wrist fracture detection can be automated using Convolutional Neural Networks. However, previous studies did not pay close attention to the difficult cases which can only be confirmed via CT imaging. In this study, we have developed and analyzed a state-of-the-art DL-based pipeline for wrist (distal radius) fracture detection-DeepWrist, and evaluated it against one general population test set, and one challenging test set comprising only cases requiring confirmation by CT. Our results reveal that a typical state-of-the-art approach, such as DeepWrist, while having a near-perfect performance on the general independent test set, has a substantially lower performance on the challenging test set-average precision of 0.99 (0.99-0.99) versus 0.64 (0.46-0.83), respectively. Similarly, the area under the ROC curve was of 0.99 (0.98-0.99) versus 0.84 (0.72-0.93), respectively. Our findings highlight the importance of a meticulous analysis of DL-based models before clinical use, and unearth the need for more challenging settings for testing medical AI systems.

Background: Constitutively active thyrotropin receptor (TSHR) mutations are the most common etiology of non-autoimmune hyperthyroidism (NAH). Thus far, the functionality of these mutations has been tested in vitro, but the in vivo models are lacking., Methods: To understand the pathophysiology of NAH, the patient-derived constitutively active TSHR D633H mutation was introduced into the murine Tshr by homologous recombination., Results: In this model, both subclinical and overt hyperthyroidism was observed, depending on the age, sex, and genotype. Homozygous mice presented hyperthyroidism at two months of age, while heterozygous animals showed only suppressed thyrotropin. Interestingly, at six months of age, thyroid hormone concentrations in all mutant mice were analogous to wild-type mice, and they showed colloid goiter with flattened thyrocytes. Strikingly, at one year of age, nearly all homozygous mice presented large papillary thyroid carcinomas. Mechanistically, this papillary thyroid carcinoma phenotype was associated with an overactive thyroid and strongly increased stainings of proliferation-, pERK-, and NKX2-1 markers, but no mutations in the "hot-spot" areas of common oncogenes (Braf, Nras, and Kras) were found., Conclusions: This is the first study to reveal the dynamic age-, sex-, and genotype-dependent development of NAH. Furthermore, the study shows that a constitutively active TSHR can trigger a malignant transformation of thyrocytes.

Ovarian cancer is a common pathology in the structure of tumors among elderly women. The aim of the work is to identify the leading indicators of interleukin profile to improve the diagnosis of ovarian cancer in the elderly. Enzyme immunoassay studied serum levels of interleukins in 78 patients with ovarian cancer stage IIB-IIIB according to the classification of FIGO at the age of 65-70 years and 42 women of similar age without ovarian cancer at the time of the study and in history. The differentiation of the compared groups is carried out by means of discriminant method. The leading diagnostic interleukins for ovarian cancer in the elderly are IL-1α, IL-1β, IL-8 and TNF-α. The constructed discriminant models allow to differentiate patients with ovarian cancer and control women with an accuracy of 93.2-93.8%. The use of enzyme immunoassay and discriminant analysis improve the diagnosis of ovarian cancer in the elderly., Competing Interests: The authors declare no conflict of interest.

The ovary cancer and chronic salpingoophoritis are among leading pathologies of female's sexual sphere and a main cause of morbidity and mortality of female population. The purpose of study was to select leading differential diagnostic indices of systemic cellular immunity and to carry out a differentiation of patients with ovary cancer and chronic salpingoophoritis using discriminant technique. The differentiated diagnostic of ovary cancer and chronic salpingoophoritis was applied to 92 and 87 patients correspondingly to indices of systemic cellular immunity and analyzed by flow cytometry technique. It is demonstrated that the main differential diagnostic indices of systemic cellular immunity in case of ovary cancer and chronic salpingoophoritis are decreasing of relative content of natural killers, absolute number of B-lymphocytes and T-helpers. The developed discriminant models permit to carry out in 91.8%-92.1% cases a faultless differentiated diagnostic of ovary cancer and chronic salpingoophoritis. The approach like that increases quality of differentiated diagnostic of ovary cancer and chronic salpingoophoritis., Competing Interests: The authors declare no conflict of interest.

The acute endometritis is a the most widespread pathology among women of reproductive age.The immune system plays a leading role in its development. However, there is no data concerning the most informative parameters of cell immunity. The purpose of study is to enhance diagnostic of acute endometritis using immunologic technique with objective evaluation of diagnostic value of indices of systemic cell immunity. The indices of cell immunity are analyzed on sampling of 78 patients with postnatal acute endometritis and 54 healthy women. The technique of flow cytometry was applied with subsequent calculation of index of informativeness and disintegration objectifying selection of diagnostically significant parameters. It is demonstrated that full-fledged diagnostic of acute endometritis requires detection of absolute and relative content of T-helpers and natural killers having high value of informativeness and disintegration. Hence an opportunity to reduce number of analyzed parameters of systemic cell immunity and financial costs of diagnostic of acute endometritis., Competing Interests: The authors declare no conflict of interest.

UDP-N-acetylglucosamine (UDP-GlcNAc) is a glucose metabolite with pivotal functions as a key substrate for the synthesis of glycoconjugates like hyaluronan, and as a metabolic sensor that controls cell functions through O-GlcNAc modification of intracellular proteins. However, little is known about the regulation of hexosamine biosynthesis that controls UDP-GlcNAc content. Four enzymes can catalyze the crucial starting point of the pathway, conversion of fructose-6-phosphate (Fru6P) to glucosamine-6-phosphate (GlcN6P): glutamine-fructose-6-phosphate aminotransferases (GFAT1 and 2) and glucosamine-6-phosphate deaminases (GNPDA1 and 2). Using siRNA silencing, we studied the contributions of these enzymes to UDP-GlcNAc content and hyaluronan synthesis in human keratinocytes. Depletion of GFAT1 reduced the cellular pool of UDP-GlcNAc and hyaluronan synthesis, while simultaneous blocking of both GNPDA1 and GDPDA2 exerted opposite effects, indicating that in standard culture conditions keratinocyte GNPDAs mainly catalyzed the reaction from GlcN6P back to Fru6P. However, when hexosamine biosynthesis was blocked by GFAT1 siRNA, the effect by GNPDAs was reversed, now catalyzing Fru6P towards GlcN6P, likely in an attempt to maintain UDP-GlcNAc content. Silencing of these enzymes also changed the gene expression of related enzymes: GNPDA1 siRNA induced GFAT2 which was hardly measurable in these cells under standard culture conditions, GNPDA2 siRNA increased GFAT1, and GFAT1 siRNA increased the expression of hyaluronan synthase 2 (HAS2). Silencing of GFAT1 stimulated GNPDA1 and GDPDA2, and inhibited cell migration. The multiple delicate adjustments of these reactions demonstrate the importance of hexosamine biosynthesis in cellular homeostasis, known to be deranged in diseases like diabetes and cancer., (© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Hyaluronan synthases (HAS1-3) are unique in that they are active only when located in the plasma membrane, where they extrude the growing hyaluronan (HA) directly into cell surface and extracellular space. Therefore, traffic of HAS to/from the plasma membrane is crucial for the synthesis of HA. In this study, we have identified Rab10 GTPase as the first protein known to be involved in the control of this traffic. Rab10 colocalized with HAS3 in intracellular vesicular structures and was co-immunoprecipitated with HAS3 from isolated endosomal vesicles. Rab10 silencing increased the plasma membrane residence of HAS3, resulting in a significant increase of HA secretion and an enlarged cell surface HA coat, whereas Rab10 overexpression suppressed HA synthesis. Rab10 silencing blocked the retrograde traffic of HAS3 from the plasma membrane to early endosomes. The cell surface HA coat impaired cell adhesion to type I collagen, as indicated by recovery of adhesion following hyaluronidase treatment. The data indicate a novel function for Rab10 in reducing cell surface HAS3, suppressing HA synthesis, and facilitating cell adhesion to type I collagen. These are processes important in tissue injury, inflammation, and malignant growth.

Hyaluronan, a ubiquitous high-molecular-mass glycinoglycan on cell surfaces and in extracellular matrices, has a number of specific signaling functions in cell-cell communication. Changes in its content, molecular mass and turnover rate are crucial for cell proliferation, migration and apoptosis, processes that control tissue remodeling during embryonic development, inflammation, injury and cancer. To maintain tissue homeostasis, the synthesis of hyaluronan must therefore be tightly controlled. In this review, we highlight some recent data on the transcriptional regulation of hyaluronan synthase (Has1-3) expression and on the post-transcriptional control of hyaluronan synthase activity, which, in close association with the supply of the UDP-sugar substrates of hyaluronan synthase, adjust the rate of hyaluronan synthesis., (© 2011 The Authors Journal compilation © 2011 FEBS.)

A single accidental event such as the fallout released from the Chernobyl reactor in 1986 can expose millions of people to non-natural environmental radiation. Ionizing radiation increases the frequency of germline mutations in experimental studies, but the genetic effects of radiation in humans remain largely undefined. To evaluate the hereditary effects of low radiation doses, we compared the minisatellite mutation rates of 155 children born to Estonian Chernobyl cleanup workers after the accident with those of their siblings born prior to it. All together, 94 de novo paternal minisatellite mutations were found at eight tested loci (52 and 42 mutants among children born after and before the accident, respectively). The minisatellite mutation rate was nonsignificantly increased among children born after the accident (0.042 compared to 0.036, OR 1.33, 95% CI 0.80-2.20). Furthermore, there was some indication of an increased mutation rate among offspring born after the accident to workers who had received doses of 20 cSv or above compared with their siblings born before the accident (OR 3.0, 95% CI 0.97-9.30). The mutation rate was not associated with the father's age (OR 1.04, 95% CI 0.94-1.15) or the sex of the child (OR 0.95, 95% CI 0.50-1.79). Our results are consistent with both no effect of radiation on minisatellite mutations and a slight increase at dose levels exceeding 20 cSv.

Background: Acetaldehyde-derived protein condensates (adducts) have been suggested as promising biological markers of alcohol abuse because they represent actual metabolites of ethanol. However, the detection of such condensates in vivo has been hampered by a lack of sensitive and specific methods., Methods: To develop new approaches for the detection of acetaldehyde adducts, we have raised antibodies against condensates with acetaldehyde and lipoproteins, which have previously been shown to be readily modified by acetaldehyde in vitro. The characteristics of these antibodies were compared with those raised against bovine serum albumin/acetaldehyde adduct and against other types of lipoprotein modifications, as induced by malondialdehyde, oxidation, and acetylation., Results: The antibodies raised against low-density lipoprotein (LDL)/acetaldehyde, very low density lipoprotein (VLDL)/acetaldehyde, and bovine serum albumin/acetaldehyde all reacted with protein adducts generated at physiologically relevant concentrations of acetaldehyde in vitro, whereas the antibodies raised against malondialdehyde/LDL, oxidized LDL, or acetylated LDL were not found to cross-react with the acetaldehyde-derived adducts. In assays for acetaldehyde adducts from erythrocyte and serum proteins of patients with excessive ethanol consumption (n = 32) and healthy control individuals (n = 22), the antibody prepared against the acetaldehyde/VLDL condensate was found to provide the most effective detection of acetaldehyde adducts in vivo., Conclusions: Current data indicate that acetaldehyde generates immunogenic adducts with lipoproteins in vivo. Antibodies raised against the VLDL/acetaldehyde may provide a basis for new diagnostic assays to examine excessive alcohol consumption.

Background: Studies in experimental animals have indicated that chronic ethanol ingestion triggers the formation of antibodies directed against proteins modified with reactive metabolites of ethanol and products of lipid peroxidation. However, the nature and prevalence of such antibodies have not been compared previously in alcoholic patients., Methods: Autoantibodies against adducts with acetaldehyde- (AA), malondialdehyde- (MDA), and oxidized epitopes (Ox) were examined from sera of 54 alcohol consumers with (n = 28) or without (n = 26) liver disease, and from 20 nondrinking controls., Results: Anti-AA-adduct IgA and IgG antibodies were elevated in 64% and 31% of patients with biopsy-proven alcoholic liver disease (ALD, n = 28), respectively. The IgA titers were significantly higher than those from nondrinking controls (p < 0.001), or heavy drinkers without significant liver disease (p < 0.001). Anti-MDA adduct titers (IgG) were elevated in 70% of the ALD patients. These titers were significantly higher (p < 0.001) than those from nondrinking controls, or heavy drinkers without liver disease. Antibodies (IgG) against Ox epitopes occurred in 43% of ALD patients, and the titers also were significantly higher (p < 0.05) than those from nondrinking controls. The anti-AA and anti-MDA adduct titers in ALD patients correlated significantly with the combined clinical and laboratory index (CCLI) of liver disease severity (r(s) = 0.449, p < 0.05; r(s) = 0.566, p < 0.01, respectively), the highest prevalences of anti-AA-adducts (73%) and anti-MDA-adducts (76%) occurring in ALD patients with cirrhosis., Conclusions: The present results indicated that autoantibodies against several distinct types of protein modifications are generated in ALD patients showing an association with the severity of liver disease.

Airway diameter and airway wall mechanics (compliance) are important determinants of flow limitation and wheezing. We have previously used the high-speed interrupter technique (HIT) to measure input impedance (Zin) in infants at frequencies up to 900 Hz, including antiresonance phenomena, which are known to be related to wave propagation velocity, and have shown that the frequency at which the first antiresonance occurs (f(ar,1)) is a function of airway wall compliance. We aimed to determine whether f(ar,1) (and thus airway wall compliance) was different in infants with a history of wheezing disorders. We compared 23 asymptomatic infants (aged 36 to 81 wk) with a history of wheezing with an age-matched group of 19 healthy control infants. We found that f(ar,1) was significantly lower in infants with wheezing disorders than in the control group (p < 0. 005), implying differences in airway wall compliance, even when they were clinically asymptomatic. Developmental differences in airway wall mechanics may be important in the pathogenesis of wheezing disorders or, alternatively, alterations in airway wall mechanics might be a consequence of postinflammatory remodeling.

The frequency of point mutations in p53 (exons 4-7) and in Ki-ras, Ha-ras, and N-ras (exons 1 and 2) and the expression of p53 protein were evaluated in the liver tumors of Wistar rats of a 104-week carcinogenicity study on 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (MX), a chlorine disinfection by-product in drinking water. Mutations were analyzed in 16 hepatocellular adenomas, 7 hepatocellular carcinomas, 23 cholangiomas, and 2 cholangiocarcinomas of the MX-treated animals and one hepatocellular carcinoma and cholangiocarcinoma in control animals using PCR-SSCP (polymerase chain reaction-single-strand conformation polymorphism) or PCR-TGGE (temperature gradient gel electrophoresis) and direct sequencing. The expression of the p53 protein (wild-type and mutated protein) was detected by immunohistochemistry (CM5 antibody). The expression of p53 and that of the proliferating cell nuclear antigen (PCNA, 19 A2) were also evaluated in livers of female animals exposed to MX for 1 week, 3 weeks, or 18 weeks. Altogether, four mutations were found in p53 in three tumors, in two hepatocellular adenomas, and one cholangiocarcinoma, all in females receiving the highest MX dose (6. 6 mg/kg/day) of the study. Three of the mutations were G:C --> A:T transitions and one was an A:T --> T:A transversion. The mutations were scattered at different codons and positions of the codon. One hepatocellular adenoma contained two p53 mutations. All cholangiomas and cholangiocarcinomas, but no hepatocellular adenomas and carcinomas, overexpressed the p53 protein. MX treatment did not induce p53 expression at any age in the liver or alter the expression of the PCNA in the liver of younger animals. The p53 protein was overexpressed in hyperplastic bile ducts in aged rats but not in bile ducts of younger rats (up to 24 weeks). No mutations were observed in either Ki-ras, Ha-ras, or N-ras of the liver tumors. These data suggest that point mutations in p53, Ki-ras, Ha-ras, and N-ras are not involved in the MX-induced liver carcinogenesis in rats., (Copyright 2000 Wiley-Liss, Inc.)

Background: The present study was undertaken to determine the prognostic significance of K-ras, p53 and bcl-2 in female rectal carcinoma., Materials and Methods: The mutations in K-ras and p53 genes were analysed using SSCP and direct sequencing. The expression of K-ras, bcl-2 and p53 proteins was determined immunohistochemically., Results: Mutations of K-ras and p53 genes were detected in 12% and 38% of the tumours, respectively. The prevalence of K-ras overexpression was 67%. K-ras mutations were not associated with survival. However, more favourable survival was observed for patients with K-ras overexpression than with normal expression (adjusted hazard ratio from Cox model 0.4, 95% CI 0.2-0.8). Mutation or overexpression of p53 were not associated with survival., Conclusions: It may be possible, that the mutations and protein overexpression of K-ras and p53 in female rectal carcinoma have different clinical impact on patient survival as suggested in previous studies concerning colorectal carcinoma of both sexes.

Objective: To investigate women's and physicians' opinions of IUD use., Design: Two cross-sectional postal surveys; on women in 1987-1988, on physicians in 1988., Setting: Survey on women: southernmost Uusimaa province (including Helsinki). Survey on physicians: whole of Finland., Participants: Of a stratified random sample of 1000 women aged 18-44 years 84% returned the questionnaire (N = 844). Of a sample of 480 physicians (including GPs and gynaecologists) 418 were eligible, 74% of whom responded (N = 311)., Main Outcome Measures: Women's and physicians' opinions of and experiences with IUD use as reported in postal questionnaires., Results: Most women considered that IUDs were a good method of contraception. Users' and physicians' reports on benefits and disadvantages of IUDs metched each other; both most often mentioned ease of use, efficacy, and lack of systemic effects. Major disadvantages reported by women were bleeding, pain, infection, and pregnancy. Physicians further pointed to the risk of ectopic pregnancy. Though reports of side-effects were commonplace, there was reasonable satisfaction with IUD use., Conclusion: This study reveals that most women, and physicians, have a realistic picture of the common problems related to intrauterine contraception. It also emphasizes that, when making contraceptive choices, one is bound to compare possible disadvantages with benefits offered.

Intrauterine contraceptive devices (IUDs) are a popular method of contraception worldwide. However, some serious problems have been associated with them. Finland has developed and now manufactures and exports IUDs. Therefore, drug control and the quality of drug information existing in Finland are significant for other countries, as well. This study analyzes the information in the Finnish commercial drug catalog on copper-releasing IUDs and compares it with the scientific literature, the instructions from the licensing authority, and material in its U.S. counterpart, during the last two decades. The results indicate that the distribution of scientific knowledge to the drug catalogs has often been slow. In the early 1980s Finnish manufacturers did not give any practical information on their products, and then and later the Finnish catalog was less comprehensive than the U.S. catalog. The variations in the control system in different nations were reflected in the contents of the Finnish catalog. For practitioners, drug catalogs are important sources of medical information. The results of this study demonstrate (1) that more attention should be paid to the contents of these catalogs, and (2) the continuous need for up-to-date, unbiased drug information.

Intrauterine contraceptive devices (IUDs) are popular: in Finland, in 1987, about 25% of women of childbearing age used them. We studied Finnish women's knowledge about contraindications for and side-effects of IUD use, with emphasis on current users. In December 1987-January 1988, a postal questionnaire was sent to a random sample of 1000 women of childbearing age, in Uusimaa province, which includes the capital, Helsinki. After three reminders, the response rate was 84%. We compared the answers of current and past users and nonusers of IUDs, and analyzed the associations between IUD use, education, age, and knowledge about side-effects. In contrast to the recommendations for use and information to be given to the contraceptive users, a substantial proportion of current IUD users assumed there are few limitations for IUD use. Some side-effects possibly leading to severe consequences were not considered to be connected with IUD use, not even by users. Although risk of infection was a quite well known fact, infertility was seldom associated with IUD use, and 22% of current IUD users did not associate ectopic pregnancy with IUDs. The results thus suggest that contraceptive counseling is not fully adequate and should receive more attention.

We determined the allele frequencies for three hypervariable DNA loci D2S44, D1S7 and D7S21 using the probes YNH24, MS1 and MS31 in the genetically isolated Finnish population. The allelic length ranges were 1.7- < 6.0 kb for YNH24, 1.7- < 18.0 kb for MS1 and 3.2- < 12.0 kb for MS31. High heterozygosity rates (0.94-0.96) were detected for all three probes. In 48 mother-child pairs no mutations were found using the probes YNH24 and MS31, whereas a mutation rate of 0.064 was observed for probe MS1. In addition, an unexpected four-band pattern was detected in 1 out of 170 individuals using the probe MS1, suggesting complex DNA polymorphism based on both a variable number of tandem repeats and restriction site polymorphism. Our findings also show that all three probes are valuable in individual identification in this genetically isolated population.

Contraceptive practices, especially oral contraceptive and intrauterine device use, were studied in four Nordic countries by recalculating published and unpublished data from previous surveys and statistics and by collecting new data from Finland. The sales of oral contraceptives were presented in defined daily doses, and the percentages of women using oral contraceptives were estimated from them. The percentages of intrauterine device users were calculated taking into account the number of intrauterine devices sold each year and the continuation of use from previous years. The results of the surveys were reanalysed. We found clear differences in contraceptive practices. Oral contraceptive use was most prevalent in Sweden and Denmark, and, especially at the end of the 1970s, Finnish intrauterine device use was very high. In the 1980s the differences dimished somewhat. These disparities in culturally and economically similar countries indicate that further research is needed to evaluate the factors influencing contraceptive practices.