bluuebunny/crossref_metadata_2025 huggingface dataset:
Parental mental health and child protection—making the links through training
Authors: Pearce Jennifer
Published: May 2003

This article refers to the impact on single discipline working on professional understanding of mental disorder, particularly as it relates to child protection. The dilemmas of bringing a multi‐agency group with diverse experiences and knowledge base together into one training event are considered, with suggestions as to how the difficulty might be addressed. Topics of common concern are identified and training techniques and methods described. The benefits and outcomes of joint training across disciplines and agencies is acknowledged in relation to child protection and parental mental disorder Copyright © 2003 John Wiley & Sons, Ltd.
Understanding communication in child protection networks
Authors: Reder Peter , Duncan Sylvia
Published: May 2003

Reviews of fatal child abuse cases regularly identify communication problems between the professionals. Understanding their origins requires an analysis of the psychology of communication as well as its technology, since it is a complex process in which interpersonal factors impact on the meaning that each person attributes to the messages given and received. The contexts within which the communications occur also colour how the messages are comprehended. Examples in practice from the Victoria Climbié Inquiry Report (Lord Laming, 2003) will be cited. Effective communication between professionals requires a mindset that can be developed through training. Copyright © 2003 John Wiley & Sons, Ltd.
Hydrophilic coating aids radial sheath withdrawal and reduces patient discomfort following transradial coronary intervention: A randomized double‐blind comparison of coated and uncoated sheaths
Authors: Kiemeneij Ferdinand , Fraser Douglas , Slagboom Ton , Laarman GertJan , van der Wieken Ron
Published: May 2003

Radial artery spasm may cause severe discomfort during radial artery sheath removal. A hydrophilic‐coated sheath may reduce the force required to remove a radial sheath. This force may be quantified using an automatic pullback device (APD). The objective of this study was to assess if a hydrophilic coating reduces the required force and discomfort associated with removal of a radial sheath following transradial coronary intervention. Ninety patients undergoing percutaneous coronary intervention via the radial artery were randomly assigned to two groups receiving either coated or uncoated introducer sheaths. Radifocus Introducer II (Terumo) 25 cm, 6 Fr radial sheaths and sheaths that were identical apart from the presence of the coating were used in all patients. The APD was used for sheath removal at the end of the procedure. Three patients (7%) in the coated group experienced discomfort during automatic sheath removal, compared to 12 patients (27%) in the uncoated group (P = 0.02). The maximum pullback force (MPF) was significantly lower in the coated compared to the uncoated group (0.24 ± 0.31 vs. 0.44 ± 0.33 kg; P = 0.003). Similarly, the mean pullback force was significantly lower in the coated group (0.14 ± 0.23 vs. 0.32 ± 0.24 kg; P < 0.001). Only one patient (2%) in each group had an MPF greater than 1.0 kg together with clinical evidence of radial artery spasm. Removal of the coated Terumo Radifocus sheath requires less force than an identical uncoated sheath. The coated sheath was also associated with less discomfort for the patient. Cathet Cardiovasc Intervent 2003;59:161–164. © 2003 Wiley‐Liss, Inc.
Rapid thrombectomy for treatment of macroembolization during percutaneous coronary intervention in the setting of acute myocardial infarction
Authors: Lorin Jeffrey D. , Liou Michael C. , Sedlis Steven P.
Published: May 2003

We report the use of the Export catheter as an urgent modality to aspirate thrombus that embolized down the left anterior descending artery during acute myocardial infarction. Cathet Cardiovasc Intervent 2003;59:219–222. Published 2003 Wiley‐Liss, Inc.
Catheter‐induced left main dissection: A treatment dilemma
Authors: Mulvihill Niall T. , Boccalatte Marco , Fajadet Jean , Marco Jean
Published: May 2003

Diagnostic angiography is a routine diagnostic procedure in modern day cardiological practice. However, there are potential life threatening complications which can occasionally occur. We describe one such complication and detail the management and clinical outcome. Cathet Cardiovasc Intervent 2003;59:214–216. © 2003 Wiley‐Liss, Inc.
Trained and supervised physician assistants can safely perform diagnostic cardiac catheterization with coronary angiography
Authors: Krasuski Richard A. , Wang Andrew , Ross Carole , Bolles John F. , Moloney Erica L. , Kelly Larry P. , Harrison J. Kevin , Bashore Thomas M. , Sketch Michael H.
Published: May 2003

Using a prospectively collected database of patients undergoing cardiac catheterization, we sought to compare the outcomes of procedures performed by supervised physician assistants (PAs) with those performed by supervised cardiology fellows‐in‐training. Outcome measures included procedural length, fluoroscopy use, volume of contrast media, and complications including myocardial infarction, stroke, arrhythmia requiring defibrillation or pacemaker placement, pulmonary edema requiring intubation, and vascular complications. Class 3 and 4 congestive heart failure was more common in patients who underwent procedures by fellows compared with those undergoing procedures by PAs (P = 0.001). PA cases tended to be slightly faster (P = 0.05) with less fluoroscopic time (P < 0.001). The incidence of major complications within 24 hr of the procedure was similar between the two groups (0.54% in PA cases and 0.58% in fellow cases). Under the supervision of experienced attending cardiologists, trained PAs can perform diagnostic cardiac catheterization, including coronary angiography, with complication rates similar to those of cardiology fellows‐in‐training. Cathet Cardiovasc Intervent 2003;59:157–160. © 2003 Wiley‐Liss, Inc.
Primary angioplasty in CADASIL
Authors: Raghu Cherukupalli , Loubeyre Christophe , Obadia Edouard , Morice Marie Claude
Published: May 2003

We report an acute coronary event in a young patient suffering from cerebral autosomal dominant arteriopathy with sub‐cortical infarcts and leucoencephalopathy (CADASIL) successfully treated by primary angioplasty and direct stenting. Coronary involvement and pathophysiology of this genetic disorder is discussed. Cathet Cardiovasc Intervent 2003;59:235–237. © 2003 Wiley‐Liss, Inc.
Transjugular percutaneous Inoue balloon mitral commissurotomy in a patient with inferior vena cava obstruction after liver transplantation
Authors: Sullebarger J. Thompson , Coto Humberto , Lopez Enrique , Sayad Dany , Fontanet Hector L.
Published: May 2003

Percutaneous transvenous mitral commissurotomy was performed successfully via the transjugular approach in a patient with severe rheumatic mitral stenosis and obstruction of the inferior vena cava due to prior liver transplantation. This case demonstrates the advantage of the jugular approach in patients with difficult anatomy. Cathet Cardiovasc Intervent 2003;59:261–265. © 2003 Wiley‐Liss, Inc.
Recanalization of chronic and long occlusive in‐stent restenosis using optical coherence reflectometry‐guided radiofrequency ablation guidewire
Authors: Chen Wai‐Hong , Ng William , Lee Pui‐Yin , Lau Chu‐Pak
Published: May 2003

Chronic total occlusions remain a challenge to interventionalists due to failure of crossing or perforation by strong wires. We describe the use of a system using optical coherence reflectometry for navigation and radiofrequency ablation to enable wire passage through occlusions that could not be crossed by conventional guidewires. Cathet Cardiovasc Intervent 2003;59:223–229. © 2003 Wiley‐Liss, Inc.
A Non‐Radical Mechanism for Methane Hydroxylation at the Diiron Active Site of Soluble Methane Monooxygenase
Authors: Yoshizawa Kazunari , Yumura Takashi
Published: May 2003

We propose a non‐radical mechanism for the conversion of methane into methanol by soluble methane monooxygenase (sMMO), the active site of which involves a diiron active center. We assume the active site of the MMOHQ intermediate, exhibiting direct reactivity with the methane substrate, to be a bis(μ‐oxo)diiron(IV) complex in which one of the iron atoms is coordinatively unsaturated (five‐coordinate). Is it reasonable for such a diiron complex to be formed in the catalytic reaction of sMMO? The answer to this important question is positive from the viewpoint of energetics in density functional theory (DFT) calculations. Our model thus has a vacant coordination site for substrate methane. If MMOHQ involves a coordinatively unsaturated iron atom at the active center, methane is effectively converted into methanol in the broken‐symmetry singlet state by a non‐radical mechanism; in the first step a methane CH bond is dissociated via a four‐centered transition state (TS1) resulting in an important intermediate involving a hydroxo ligand and a methyl ligand, and in the second step the binding of the methyl ligand and the hydroxo ligand through a three‐centered transition state (TS2) results in the formation of a methanol complex. This mechanism is essentially identical to that of the methane–methanol conversion by the bare FeO+ complex and relevant transition metal–oxo complexes in the gas phase. Neither radical species nor ionic species are involved in this mechanism. We look in detail at kinetic isotope effects (KIEs) for H atom abstraction from methane on the basis of transition state theory with Wigner tunneling corrections.
Identity Double‐Proton Transfer in (3Z)‐3‐Hydroxy‐1,4‐di(quinolin‐2‐yl)but‐3‐en‐2‐one
Authors: Ośmiałowski Borys , Kolehmainen Erkki , Gawinecki Ryszard
Published: May 2003

Although there is a very fast (on the NMR timescale) double‐proton transfer in (1Z,3Z)‐3‐hydroxy‐4‐quinolin‐2‐yl‐1‐quinolin‐2(1H)‐ylidenbut‐3‐en‐2‐one (the product of the condensation of ethyl oxalate with 2lithiomethylquinoline), it is the only species present in chloroform solution. Comparison of the product of condensation of ethyl oxalate with 2lithiomethyl derivatives of pyridine (recent studies) and quinoline (present studies) shows that benzoannulation considerably affects the tautomeric equilibrium. The observed changes are not only quantitative but also qualitative. Moreover, contrary to the proton transfer in the pyridine tautomers, this process is fast in the quinoline tautomers. Comparison of the experimental and ab initio/DFT GIAO‐calculated 13C and 15N chemical shifts for the transition states in the proton‐transfer reactions between (1Z,3Z)‐ 3‐hydroxy‐4‐quinolin‐2‐yl‐1‐quinolin‐2(1H)‐ylidenbut‐3‐en‐2‐one and its tautomers support the theory that a concerted identity reaction takes place between the enolimine‐enaminone and enaminone‐enolimine tautomeric forms. As a consequence, the most stable tautomeric form, (1Z,3Z)‐1,4‐di(quinolin‐2‐yl)buta‐1,3‐diene‐2,3‐diol, is not present in the tautomeric mixture.
Preparation and Characterization of Organotin–Oxomolybdate Coordination Polymers and Their Use in Sulfoxidation Catalysis
Authors: Abrantes Marta , Valente Anabela A. , Pillinger Martyn , Gonçalves Isabel S. , Rocha João , Romão Carlos C.
Published: May 2003

The organotin–oxomolybdates [(R3Sn)2MoO4]⋅n H2O (R=methyl, n‐butyl, cyclohexyl, phenyl, benzyl) have been prepared and tested as catalysts for the oxidation of benzothiophene with aqueous hydrogen peroxide, at 35 °C and atmospheric pressure. In all cases, the 1,1‐dioxide was the only observed product. The kinetic profiles depend on the nature of the tin‐bound R group and also on the addition of a co‐solvent. For the tribenzyltin derivative, the apparent activation energies for sulfoxidation as a function of the co‐solvent are in the order 1,2‐dichloroethane (5 kcal mol−1)<ethanol<acetonitrile<water (27 kcal mol−1). The solid could be recovered by centrifugation from the three‐phase (solid–liquid–liquid) system containing 1,2‐dichloroethane. The catalyst was reused in a second reaction cycle with no significant loss of activity. Increasing the oxidant/substrate ratio from 2:1 to 6:1 allows the corresponding sulfone to be obtained in quantitative yield within 24 h. Changing the nature of the tin‐bound R group in the catalyst precursors modifies their physical properties and hence their catalytic performance. The variation in hydrophobic/hydrophilic character is important, since the Me, nBu and Cy derivatives crystallize as anhydrous compounds, whereas the other two derivatives are hydrates. The polymers also have different structures, as evidenced by Xray powder diffraction. Mo K‐edge and Sn K‐edge EXAFS spectroscopy confirmed that the structures arise from the self‐assembly of tetrahedral [MoO4]2− subunits and [R3Sn]+ spacers. The Mo⋅⋅⋅Sn separation in the trimethyltin derivative is a uniform 3.84 Å. By contrast, the EXAFS results revealed the coexistence of short (3.67–3.79 Å) and long (3.93–4.07 Å) Mo⋅⋅⋅Sn separations in the other coordination polymers. The catalyst precursors were also characterized in the solid state by thermogravimetric analysis, FTIR, and Raman spectroscopy, and MAS NMR (13C, 119Sn) spectroscopy.
Low‐Temperature IR and NMR Studies of the Interaction of Group 8 Metal Dihydrides with Alcohols
Authors: Gutsul Evgenii I. , Belkova Natalia V. , Sverdlov Maria S. , Epstein Lina M. , Shubina Elena S. , Bakhmutov Vladimir I. , Gribanova Tatiana N. , Minyaev Ruslan M. , Bianchini Claudio , Peruzzini Maurizio , Zanobini Fabrizio
Published: May 2003

The reactions of the octahedral dihydrido complexes [MH2(PP3)] [M=Fe, Ru, Os; PP3P(CH2CH2PPh2)3] with a variety of weak ROH acids have been studied by IR and NMR methods in either CH2Cl2or THF in the temperature range from 190 to 290 K. This study has allowed the determination of the spectral and thermodynamic properties associated with the formation of dihydrogen bonds (DHB) between the terminal hydrides and the OH group. Both the DHB enthalpy values and the hydride basicity factors (Ej) have been found to increase in the order Fe < Ru < Os. The proton transfer process, leading to the DHB complexes, and eventually toη2‐H2products, has been found to depend on the acidic strength of the alcohol as well as the nature of the solvent. Low temperature IR and NMR techniques have been used to trace the complete energy profile of the proton transfer process involving the osmium complex [OsH2(PP3)] with trifluoroethanol.
Supercritical Fluid Synthesis of Metal and Semiconductor Nanomaterials
Authors: Holmes Justin D. , Lyons Daniel M. , Ziegler Kirk J.
Published: May 2003

In the near future physical and economic constraints are expected to limit the continued miniaturisation of electronic and optical devices using current “top‐down” lithography‐based methods. Consequently, nonlithographic methods for synthesising and organising materials on the nanometre scale are required. In response to these technological needs a number of research groups are developing new supercritical fluids methodologies to synthesise and self‐assemble “building blocks” of nanomaterials, from the “bottom‐up”, into structurally complex device architectures. This concept paper highlights some of the recent advances in the synthesis of metal and semiconductor nanoparticles and nanowires by using supercritical fluids. In addition, we describe an efficient supercritical fluid approach for constructing ordered arrays of metal and semiconductor nanowires within mesoporous silica templates.
Organized Nanostructured Complexes of Inorganic Clusters and Surfactants That Exhibit Thermal Solid‐State Transformations
Authors: Camerel Franck , Antonietti Markus , Faul Charl F. J.
Published: May 2003

Facile organization of the inorganic crown‐shaped [Ni3P3S12]3− ion (1) into room‐temperature liquid‐crystalline materials by complexation with double‐tail ammonium surfactants is achieved by the ionic self‐assembly (ISA) route. Small‐angle Xray diffraction, UV/Vis spectroscopy, and 31P NMR analyses reveal that these complexes show an interesting solid‐state structure transition. Upon heating, the inorganic crown species polymerizes to the inorganic polyelectrolyte $\rm{^{1}_{\infty }}$[NiPS4]−. This structural transition is reversible, and involves a solvent/dissolution cycle. The facile preparation and facile optional induction of phase and structural changes make these complexes candidates for a number of applications in which cooperative, metastable switching with sufficient contrast of optical and solid‐state properties is required.
The First Linear Multiphosphazene Having Five Different Types of Side Groups and Its Use as the Core of a Dendrimeric Species
Authors: Magro Germinal , Donnadieu Bruno , Caminade Anne‐Marie , Majoral Jean‐Pierre
Published: May 2003

The step‐by‐step synthesis of the first oligophosphazenes having more than two types of side functions is described. These multifunctionalized oligophosphazenes possess up to four phosphazene linkages and up to four types of functional side groups. These compounds may serve as models for a better understanding of electronic delocalization phenomena in linear inorganic chains, and constitute novel cores for the synthesis of new dendrimeric species possessing several types of functions as end groups, at the level of the core, and within the branches.
The Structure of the Sugar Residue in Glycated Human Serum Albumin and Its Molecular Recognition by Phenylboronate
Authors: Rohovec Jan , Maschmeyer Thomas , Aime Silvio , Peters Joop A.
Published: May 2003

Quantification of the extent of glycation of human serum albumin (HSA) and of haemoglobin provides a record of average mid‐ and long‐term blood‐sugar concentrations, respectively; this is very useful for the management of diabetes. The reaction of D‐glucose with propylamine affords the corresponding Schiff base, N‐propylamino‐D‐glucoside, in the cyclic form. This compound is not stable: upon standing or treatment with acid it is converted, by an Amadori rearrangement, into N‐propylfructosamine. Both amino sugars occur predominantly in the β‐pyranose form. Phenylboronate forms highly stable boronate esters through binding of the cis 1,2‐diol moiety in the furanose form of N‐propylfructosamine. Between pH 5 and 10, an electrostatic interaction between the protonated amino group and the negatively charged boronate moiety affords an additional stabilisation of the ester. The Schiff base, however, has no observable interaction with phenylboronate. In aqueous solution the Schiff base is in equilibrium with propylamine and glucose. Upon addition of phenylboronate, this equilibrium shifts to the side of glucose due to the formation of highly stable phenylboronate esters of the β‐furanose form of this compound. After Amadori rearrangement, the sugar moieties in glycated human serum albumin have a similar structure, they occur as an equilibrium of the β‐pyranose (59 %), α‐furanose (19 %) and β‐furanose (24 %) anomers. The open form was not observed. The β‐furanose anomer is selectively recognised by phenylboronate.
1,3‐Dithiolanes from Cycloadditions of Alicyclic and Aliphatic Thiocarbonyl Ylides with Thiones: Regioselectivity
Authors: Huisgen Rolf , Mloston Grzegorz , Polborn Kurt , Sustmann Reiner
Published: May 2003

The regiochemistry of 1,3‐dithiolanes obtained from thiocarbonyl ylides 9 and thiones 10 shows a striking dependence on substituents. Previously and newly performed experiments indicate that sterically hindered cycloalkanethione S‐methylides and dialkylthioketone S‐methylides react with alicyclic and aliphatic thiones to give the 2,2,4,4‐tetrasubstituted 1,3‐dithiolanes 11 exclusively. Aryl groups in one or both reactants lead to a preference for, or even complete formation of, 4,4,5,5‐tetrasubstituted 1,3‐dithiolanes 12. Several mechanisms appear to be involved, but the paucity of experimental criteria is troubling. Quantum‐chemical calculations (see preceding paper) on the cycloaddition between thioacetone S‐methylide and thioacetone furnish lower activation energies for the concerted process than for the two‐step pathways via C,S‐ or C,C‐biradicals; the favoring of the 2,4‐substituted 1,3‐dithiolanes over the 4,5‐substituted type would be expected to increase with growing bulk of substituents. Aryl groups stabilize intermediate biradicals. Experimental criteria for the differentiation of regioisomeric dithiolanes are discussed. Thiocarbonyl ylides 9 are prepared by 1,3‐cycloadditions between diazomethane and thioketones and subsequent N2 elimination from the usually isolable 2,5‐dihydro‐1,3,4‐thiadiazoles 17; different ratios of the two rate constants lead to divergent product formation scenarios.
Cover Picture: Structure–Nucleophilicity Relationships for Enamines (Chem. Eur. J. 10/2003)
Authors: Kempf Bernhard , Hampel Nathalie , Ofial Armin R. , Mayr Herbert
Published: May 2003

The cover picture shows the exponential decay of the UV/Vis absorption of a diarylmethyl cation in presence of 46 equivalents of 1‐(methylphenylamino)cyclohexene. Using diarylmethyl cations of different electrophilicity E allows us to perform a comprehensive comparison of enamine nucleophilicity (N) on the basis of the depicted correlation equation. Enamines, commonly characterized as strong nucleophiles, show dramatically different reactivities. For a typical s value of 0.85, the nucleophilicity range from N = 16 to N = 4 corresponds to relative reactions times of one minute versus 20 000 years. A detailed report on the relationships between structure and nucleophilicities of enamines is given by H. Mayr et al. on p. 2209 ff.
Are the symptoms of cancer and cancer treatment due to a shared biologic mechanism?
Authors: Cleeland Charles S. , Bennett Gary J. , Dantzer Robert , Dougherty Patrick M. , Dunn Adrian J. , Meyers Christina A. , Miller Andrew H. , Payne Richard , Reuben James M. , Wang Xin Shelley , Lee Bang‐Ning
Published: May 2003

BACKGROUND

Cancers and cancer treatments produce multiple symptoms that collectively cause a symptom burden for patients. These symptoms include pain, wasting, fatigue, cognitive impairment, anxiety, and depression, many of which co‐occur. There is growing recognition that at least some of these symptoms may share common biologic mechanisms.

METHODS

In November 2001, basic and clinical scientists met to consider evidence for a cytokine‐immunologic model of symptom expression along with directions for future research.

RESULTS

The characteristics of cytokine‐induced sickness behavior in animal models have much in common with those of symptomatic cancer patients. Sickness behavior refers to a set of physiologic and behavioral responses observed in animals after the administration of infectious or inflammatory agents or certain proinflammatory cytokines. In some cases, these responses can be prevented by cytokine antagonists. A combination of animal and human research suggests that several cancer‐related symptoms may involve the actions of proinflammatory cytokines.

CONCLUSIONS

Based on the similarities between cancer symptoms and sickness behavior, the authors discussed approaches to further test the implications of the relationship between inflammatory cytokines and symptoms for both symptom treatment and symptom prevention. Cancer 2003;97:2919–25. © 2003 American Cancer Society.

DOI 10.1002/cncr.11382
Role of adjuvant cryosurgery in intralesional treatment of sacral tumors
Authors: Kollender Yehuda , Meller Issac , Bickels Jacob , Flusser Gideon , Issakov Josefin , Merimsky Ofer , Marouani Nissim , Nirkin Alexander , Weinbroum Avi A.
Published: May 2003

BACKGROUND

Cryosurgery is an adjuvant surgical technique for the treatment of benign aggressive, low‐grade malignant and metastatic tumors of long bones. It has been used rarely to treat sacral tumors, mainly because of potential damage to nerves, blood vessels, and intrapelvic organs. The authors described their experience with this procedure and provided medium and long‐term follow‐up results.

METHODS

Fifteen procedures of cryosurgery of the sacrum were performed in 14 patients to improve the therapeutic outcome of a variety of tumors. The patient group included 7 males and 7 females with a mean age of 42 ± 24 years. Three patients were younger than 20 years of age. The procedures were performed at the Tel Aviv Sourasky Medical Center between January 1991 and January 1999. There were seven benign aggressive lesions (four giant cell tumors and three aneurysmal bone cysts), one benign schwannoma, one low‐grade chondrosarcoma, five metastatic carcinomas, and one high‐grade Ewing sarcoma, all localized at level S2 or higher. Eight of the bone tumors also involved significant anterior or posterior soft tissue. All patients had severe preoperative pain radiating to the buttocks, perineum, and lower limbs and 9 (64%) patients had bladder and/or rectal dysfunction. Invasive diagnostic procedures and radiation (if warranted) preceded surgery. Sacral posterior fenestration and burr drilling were followed by two‐cycle cryosurgery using the open pour technique or the argon‐helium–based heat‐freeze system.

RESULTS

All interventions were performed under combined general and regional anesthesia and concluded uneventfully with moderate blood loss. Thirteen patients were discharged home after 8 ± 5 days (one patient remained hospitalized for 30 days). Only two patients experienced local disease recurrence during a 3–11‐year follow‐up period: one was retreated successfully by cryosurgery and the other underwent sacrectomy and radiotherapy elsewhere, with a subsequent loss of visceral functions. No patient suffered chronic pain, deep wound infections, or significant neurologic deficits and all were satisfied with the esthetic outcome.

CONCLUSIONS

Cryosurgery is a conservative, feasible, and safe adjuvant technique in the treatment of sacral tumors. It is associated with minimal permanent neurologic and vascular injury compared with sacrectomy. Cancer 2003;97:2830–8. © 2003 American Cancer Society.

DOI 10.1002/cncr.11383
Malignant fibrous histiocytoma and other fibrohistiocytic tumors in pediatric patients
Authors: Daw Najat C. , Billups Catherine A. , Pappo Alberto S. , Jenkins Jesse J. , Mahmoud Hazem H. , Krasin Matthew J. , Rao Bhaskar N.
Published: May 2003

BACKGROUND

Malignant fibrous histiocytoma (MFH) is a controversial entity. In the current study, the authors reviewed their institutional experience with these tumors to characterize their clinical features in pediatric patients and assess the impact of surgical resection on outcome.

METHODS

The records of the 28 patients who were diagnosed with MFH or MFH variants of soft tissue between January 1971 and December 2000 were reviewed and the tumors were reclassified according to the World Health Organization guidelines.

RESULTS

Seventeen patients had MFH; 10 patients had angiomatoid fibrous histiocytoma (FH), and 1 patient had a plexiform fibrohistiocytic tumor. The median age of patients at the time of diagnosis was 7.3 years. The most common primary tumor site was the extremity (n = 14). Metastatic disease (to the lung) was present in only three patients, each of whom had MFH. Of the 17 MFH tumors, 13 were high grade, 8 were invasive, and 6 measured > 5 cm. All angiomatoid FH tumors and the plexiform fibrohistiocytic tumor were noninvasive, and 10 measured ≤ 5 cm. Surgical treatment was comprised of wide local excision with clear margins (n = 18), amputation (n = 3), excision with positive or indeterminate surgical margins (n = 4), partial resection (n = 2), or biopsy only (n = 1). Primary reexcision was performed for 21 patients. The 5‐year survival and event‐free survival (EFS) estimates for patients with MFH were 76.5% ± 11.2% and 70.6% ± 12.1%, respectively; the 5‐year survival and EFS estimates were 100% ± 0% for patients with angiomatoid FH or plexiform fibrohistiocytic tumor. Compared with partial resection or excision, wide local excision or amputation was found to have a positive impact on the probability of EFS in patients with localized disease (P = 0.008). All four patients with metastatic or unresectable MFH had died by the time of last follow‐up.

CONCLUSIONS

MFH should be distinguished from angiomatoid FH and plexiform fibrohistiocytic tumors, both of which are less aggressive. Wide local excision is the treatment of choice, regardless of the histology or grade of the tumor. Patients with metastatic or unresectable MFH appear to have a poor outcome and would benefit from more effective therapies. Cancer 2003;97:2839–47. © 2003 American Cancer Society.

DOI 10.1002/cncr.11384
Results of a 2‐arm Phase II study of 9‐nitrocamptothecin in patients with advanced soft‐tissue sarcomas
Authors: Patel Shreyaskumar R. , Beach Jennifer , Papadopoulos Nicholas , Burgess M. Andrew , Trent Jonathan , Jenkins Jan , Benjamin Robert S.
Published: May 2003

BACKGROUND

The authors conducted a 2‐arm Phase II trial of 9‐nitrocamptothecin (9‐NC), an oral topoisomerase I inhibitor, to define response rates in patients with gastrointestinal (GI) leiomyosarcomas and other soft‐tissue sarcomas (STS).

METHODS

Patients were required to provide informed consent and have measurable disease, Zubrod performance status ≤ 2, and adequate organ function. 9‐NC was administered orally at 1.5 mg/m2 per day × 5 days every week. Response evaluation was performed at 8 weeks, and those with stable or responding disease continued treatment until maximal response was achieved. A total of 56 patients (30 females and 26 males) with a median age of 55 years (range, 19–79 years) were enrolled on the study. Seventeen patients were enrolled on the GI leiomyosarcoma arm; only 1 minor response, lasting < 8 weeks in a patient with liver metastases, was noted, and so this arm was terminated. Thirty‐nine patients were entered on the other STS arm.

RESULTS

Three patients achieved a partial response (response rate, 8%) for durations of 4, 6, and 13 months, respectively. Fourteen patients had stable disease for a median of 4 months (range, 2–8 months). Two patients died of disease during the first 2 months. Four other patients required hospitalization for nausea, vomiting, and dehydration. Other toxicities included diarrhea (36 patients, 5 with Grade 3 toxicity); fatigue (42 patients, 11 with Grade 3 toxicity); anorexia (32 patients, 1 with Grade 3 toxicity); nausea (37 patients, 2 with Grade 3 toxicity); vomiting (24 patients, 3 with Grade 3 toxicity); neutropenia (14 patients, 5 with Grade 3 toxicity); and thrombocytopenia (16 patients, 5 with Grade 3 or 4 toxicity).

CONCLUSIONS

9‐NC is well tolerated but inactive in GI leiomyosarcomas and has minimal activity in previously treated patients with STS. Cancer 2003;97:2848–52. © 2003 American Cancer Society.

DOI 10.1002/cncr.11385
The Memorial Anxiety Scale for Prostate Cancer
Authors: Roth Andrew J. , Rosenfeld Barry , Kornblith Alice B. , Gibson Christopher , Scher Howard I. , Curley‐Smart Tracy , Holland Jimmie C. , Breitbart William
Published: May 2003

BACKGROUND

The psychological difficulties facing men with prostate cancer are acknowledged widely, yet identifying men who may benefit from mental health treatment has proven to be a challenging task. The authors developed the Memorial Anxiety Scale for Prostate Cancer (MAX‐PC) to facilitate the identification and assessment of men with prostate cancer‐related anxiety. This scale consists of three subscales that measure general prostate cancer anxiety, anxiety related to prostate specific antigen (PSA) levels in particular, and fear of recurrence.

METHODS

Ambulatory men with prostate cancer (n = 385 patients) were recruited from clinics throughout the United States. Prior to routine PSA tests, participants completed a baseline assessment packet that included the Hospital Anxiety and Depression Scale; the Distress Thermometer; the Functional Assessment of Cancer Therapy Scale, Prostate Module; and measures of role functioning, sleep, and urinary functioning. PSA values from the last three tests also were collected. Follow‐up evaluation was completed within 2 weeks after patients learned of their PSA test result using a subset of these scales.

RESULTS

Analysis of the MAX‐PC revealed a high degree of internal consistency and test‐retest reliability for the total score and for the three subscales, although reliability was somewhat weaker for the PSA Anxiety Scale. Concurrent validity was demonstrated by correlations between the MAX‐PC and measures of anxiety. Overall changes in PSA levels were correlated only modestly with changes in MAX‐PC scores (correlation coefficient, 0.13; P = 0.02).

CONCLUSIONS

The MAX‐PC appears to be a valid and reliable measure of anxiety in men with prostate cancer receiving ambulatory care. Cancer 2003;97:2910–8. © 2003 American Cancer Society.

DOI 10.1002/cncr.11386
Cyclooxygenase‐2 expression in human pituitary tumors
Authors: Vidal Sergio , Kovacs Kalman , Bell David , Horvath Eva , Scheithauer Bernd W. , Lloyd Ricardo V.
Published: May 2003

BACKGROUND

Cyclooxygenase‐2 (COX‐2) plays a role in progression of colon, breast, pancreas, and lung carcinomas. The authors investigated COX‐2 expression in pituitary tumors.

METHODS

Expression of COX‐2 was evaluated in 164 surgically removed human pituitary tumors. Correlation of COX‐2 with MIB‐1, a cell proliferation marker, as well as angiogenesis, patient age, gender, tumor type, size, invasiveness, and metastatic potential was investigated.

RESULTS

Cyclooxygenase‐2 immunoreactivity was confined to the cytoplasm of tumor cells, whereas the nuclei were unlabeled. Few normal peritumoral adenohypophysial cells showed slight COX‐2 cytoplasmic immunoreactivity. The staining intensity and the percentage of immunopositive cells were higher in tumors. Most pituitary tumors (96%) were COX‐2–immunopositive. Expression was strong in 60 (44%), moderate in 39 (28%), and weak in 32 (24%). Male gonadotroph adenomas and null cell adenomas showed a high level of COX‐2 expression. Growth hormone‐producing adenomas, prolactin‐producing adenomas, thyrotropic hormone‐producing adenomas, female gonadotroph adenomas, silent adrenocorticotropic hormone‐producing adenomas, and silent subtype 3 adenomas had a low level of COX‐2 expression. Significant correlation was demonstrated with patient age, but not with tumor size, invasiveness, and MIB‐1 labeling indices. Expression was medium to high in 76% of macroadenomas and in only 45% of microadenomas. Strong correlations were noted with angiogenesis markers, such as microvessel density and surface density.

CONCLUSIONS

Correlation with angiogenesis suggests that COX‐2 may be involved in the regulation of angiogenesis in pituitary tumors. Phamacologic inhibition of COX‐2 activity might suppress angiogenesis in pituitary tumors and may provide a novel approach for medical therapy. Cancer 2003;97:2814–21. © 2003 American Cancer Society.

DOI 10.1002/cncr.11387
Therapeutic effectiveness of novel 5‐fluorouracil‐loaded poly(methylidene malonate 2.1.2)‐based microspheres on F98 glioma‐bearing rats
Authors: Fournier Elvire , Passirani Catherine , Montero‐Menei Claudia , Colin Nathalie , Breton Pascal , Sagodira Serge , Menei Philippe , Benoit Jean‐Pierre
Published: May 2003

BACKGROUND

Drug delivery to the central nervous system (CNS) remains a real challenge for neurosurgeons and neurologists, because many molecules cannot cross the blood‐brain barrier (BBB). In recent years, solid polymeric materials have been implanted into animal and human brains either by surgery or using stereotactic methods to assure the controlled release of a drug over a determined period, thus circumventing the difficulties posed by the BBB. Poly(methylidene malonate 2.1.2) (PMM 2.1.2) is a new polymer that was described a few years ago and that allows the fabrication of novel, 5‐fluorouracil (5‐FU)‐loaded PMM 2.1.2 microspheres. The objective of the current study was to assess the therapeutic effectiveness of those particles in a rat brain tumor model, the F98 glioma.

METHODS

Forty‐three rats were used in this study. First, a histologic evaluation of the F98 tumor model was performed on Fischer female rats. Thereafter, different groups of rats were injected and were treated with 5‐FU microspheres in 2 different suspension media: carboxymethylcellulose (CMC) aqueous solution with or without 5‐FU.

RESULTS

The tumor was confirmed as extremely aggressive and invasive, even in early development. The 5‐FU‐loaded microspheres improved rat median survival significantly compared with untreated animals, CMC‐treated animals, and 5‐FU solution‐treated animals when injected in CMC without 5‐FU, demonstrating the interest of a sustained release and the efficacy of intratumoral chemotherapy against an established tumor.

CONCLUSIONS

PMM 2.1.2 microspheres appeared to be a promising system, because their degradation rate in vivo was longer compared with many polymers, and they may be capable of long‐term delivery. Cancer 2003;97:2822–9. © 2003 American Cancer Society.

DOI 10.1002/cncr.11388
Detection of micrometastasis of neuroblastoma to bone marrow and tumor dissemination to hematopoietic autografts using flow cytometry and reverse transcriptase‐polymerase chain reaction
Authors: Sze Tsang Kam , Kong Li Chi , Chiu Tsoi Wai , Leung Yonna , Ming Kong Shing Matthew , Wai Chik Ki , Lee Vincent , Heung Ling Ng Margaret , Man Pan Yuen Patrick
Published: May 2003

BACKGROUND

The identification of neuroblastoma metastases to bone marrow (BM) is requisite in staging disease for risk‐adopted therapy. However, micrometastases were not elucidated fully.

METHODS

Flow cytometry (FCM) with CD45/CD56/CD81 and reverse transcriptase‐polymerase chain reactions (RT‐PCR) for tyrosine hydroxylase (TH) transcripts were used to evaluate neuroblastoma in bilateral BM aspirates at diagnosis, BM autografts, peripheral blood stem cell (PBSC) collections, and CD34+ cell products of 27 children.

RESULTS

TH transcripts were amplified in histology‐negative (H−) BM specimens from seven patients (four patients with Stage 3 disease, two with Stage 4 disease, and one with Stage 4S disease), revealing a prevalence of submicroscopic metastasis. The median number of CD45−CD81+CD56+ cells in four H− TH− BM samples from two patients with Stage 1 and Stage 2 disease, respectively, was comparable to that encountered in 10 normal BM controls (0.003% [range, 0.002–0.004%] vs. 0.004% [0–0.008%], P = 0.724). In six H− TH+ BM specimens from three patients whom were otherwise diagnosed with neuroblastoma Stage 3, 0.031% (0.009–0.06%) CD45−CD81+CD56+ cells were detected. Besides, 1.474% (0.088–3.009%) CD45−CD81+CD56+ cells were identified in four H− TH+ BM specimens from two patients at Stage 4. TH transcripts were evident in four of five BM autografts and in 22 of 45 (48.9%) PBSC specimens. FCM demonstrated 0.018% and 0.049% CD45−CD81+CD56+ cells in two TH+ BM autografts, respectively. The number of CD45−CD81+CD56+ cells was higher in 19 TH+ PBSC specimens than in 20 TH− PBSC specimens (0.026% [0.006–1.128%] vs. 0% [0–0.009%], P < 0.0001). CD34+ cell selection achieved 2.9 (2.1–3.5) log depletion of CD45−CD81+CD56+ cells in four manipulated products, rendering six of seven PBSC autografts TH‐free.

CONCLUSIONS

FCM in combination with RT‐PCR evaluated neuroblastoma micrometastasis and assessed the purity of hematopoietic autografts for transplant. However, the clinical relevance remains to be elucidated. Cancer 2003;97:2887–97. © 2003 American Cancer Society.

DOI 10.1002/cncr.11389
Dexamethasone‐associated toxicity during induction chemotherapy for childhood acute lymphoblastic leukemia is augmented by concurrent use of daunomycin
Authors: Belgaumi Asim F. , Al‐Bakrah Mohammed , Al‐Mahr Mohammed , Al‐Jefri Abdullah , Al‐Musa AbdulRahman , Saleh Mahasen , Salim Mohammed F. , Osman Mohammed , Osman Layla , El‐Solh Hassan
Published: May 2003

BACKGROUND

The goals of the current study were to examine the incidence and severity of toxicity resulting from dexamethasone and prednisone during induction therapy for children with precursor B‐cell acute lymphoblastic leukemia (ALL) and to determine whether the addition of daunomycin affected toxicity.

METHODS

Medical records of patients with precursor B‐cell ALL from January 1996 through June 2000 were reviewed retrospectively for toxicity during the 4‐week induction phase and the 2 weeks after the induction phase.

RESULTS

One hundred seventy‐six patients age < 14 years were diagnosed with precursor B‐cell ALL from January 1996 through June 2000. Of the 156 evaluable patients, 106 were treated with prednisone and 50 with dexamethasone. Fifty‐two patients received steroids, L‐asparaginase, and vincristine, whereas 104 high‐risk patients received daunomycin in addition to these 3 agents. The incidence of gastritis was significantly higher among patients receiving dexamethasone (P = 0.01); incidence rates of hyperglycemia, hypertension, and myopathy were similar for all treatment groups. Dexamethasone led to more weight gain than did prednisone (+11.9% vs. +5.4%; P = 0.002). Serious infections were observed in 27 (25.5%) and 18 (36%) patients receiving prednisone and dexamethasone, respectively (P ≤ 0.2). Five patients, four of whom received prednisone and one of whom received dexamethasone, died of infection. The addition of daunomycin to treatment regimens increased overall toxicity (P < 0.01). When daunomycin was included in treatment regimens, toxicity was greater among patients receiving dexamethasone; in contrast, when daunomycin was not included, toxicity was equal for both treatment groups. Regardless of daunomycin use, there was no difference in the incidence of serious infection between the two groups. ALL treatment was not compromised by steroid‐related toxicity in either group.

CONCLUSIONS

The addition of daunomycin led to a much larger increase in dexamethasone‐related toxicity compared with the increase in prednisone‐related toxicity. Although the use of daunomycin enhanced dexamethasone‐related toxicity, this enhancement did not result in a higher mortality rate or the alteration of planned ALL therapy. Cancer 2003;97:2898–903. © 2003 American Cancer Society.

DOI 10.1002/cncr.11390
Disclosure of the right of research participants to receive research results
Authors: Fernandez Conrad V. , Kodish Eric , Taweel Shaureen , Shurin Susan , Weijer Charles
Published: May 2003

BACKGROUND

The offer of return of research results to study participants has many potential benefits. The current study examined the offer of return of research results by analyzing consent forms from 2 acute lymphoblastic leukemia studies of the 235 institutional members of the Children's Oncology Group.

METHODS

Institutional review board (IRB)‐approved consent forms from 2 standard‐risk acute lymphoblastic leukemia studies (Children's Cancer Group [CCG] 1991 and Pediatric Oncology Group [POG] 9407) were analyzed independently by 2 reviewers.

RESULTS

The authors received replies from 202 of the 235 institutions that were contacted (85%). One hundred eighty‐one institutions had CCG 1991 (n = 96) or POG 9905 (n = 85) protocols that were approved by an IRB. Most institutions provided contact information for the principal investigator (n = 175; 97%) and a member of the institution's research services office (n = 154; 85%). Only 5 (2.8%) institutions provided an indication of a participant's right to receive a summary of research results; most of these institutions provided details on how (n = 5) or when (n = 5) this was to occur. All of these institutions (n = 162; 89.5%) provided a specific statement offering new information that might affect a participant's decision to continue to participate in a study. Only 2 institutional consent forms offered participants the option to receive research results, and only 10 (5.5%) consent forms contained an unambiguous, specific statement offering to provide new information after the study was closed.

CONCLUSIONS

Few institutional review board–approved consent forms explicitly indicate the right of research recipients to receive a summary of the results of the research in which they have participated. Cancer 2003;97:2904–9. © 2003 American Cancer Society.

DOI 10.1002/cncr.11391
Matrix metalloproteinase inhibitor reversion‐inducing cysteine‐rich protein with Kazal motifs
Authors: Span Paul N. , Sweep C. G. J. (Fred) , Manders Peggy , Beex Louk V. A. M. , Leppert David , Lindberg Raija L. P.
Published: May 2003

BACKGROUND

The recently describedreversion‐inducingcysteine‐rich protein withKazal motifs (RECK) inhibits membrane Type 1 matrix metalloproteinase (MMP‐14), MMP‐2, and MMP‐9 secretion and enzymatic activity. Its expression is essential for normal vasculogenesis. Down‐regulation of RECK has been implicated in tumor angiogenesis and progression.

METHODS

The authors assessed the prognostic value of RECK expression in tumor tissue specimens from 278 breast carcinoma patients with a median follow‐up time of 75 months (range, 2–169 months). RECK mRNA levels were measured by real‐time quantitative reverse transcriptase–polymerase chain reaction.

RESULTS

Expression levels of RECK were lower in tumor tissue specimens than in adjacent normal breast tissue specimens from 10 patients (P= 0.028). No relevant associations of RECK with established clinicopathologic factors or treatment regimens were found. RECK expression predicted a longer recurrence‐free survival time (RFS;P= 0.037) at the optimal cutoff value (hazard ratio, 0.66; 95% confidence interval, 0.44–0.98). The 100 patients whose tumors exhibited low levels of RECK had a mean RFS time of 80.4 months and a 61.8% 5‐year RFS rate, whereas the 178 patients with tumors with high RECK expression had a mean RFS time of 91.2 months and a 73.0% 5‐year RFS rate. Multivariate Cox regression analysis showed that RECK expression maintained a significant independent prognostic value for RFS time (P= 0.047).

CONCLUSIONS

These results are in agreement with the notion of RECK being an important tumor‐suppressor gene. Therefore, the possibility of applying RECK, a pharmaceutical mimetic, or drugs activating endogenous RECK expression, as possible therapeutic or preventive agents for breast carcinoma should be explored. Cancer 2003;97:2710–5. © 2003 American Cancer Society.

DOI 10.1002/cncr.11395
A Phase III trial of sequential adjuvant chemotherapy for operable breast carcinoma
Authors: Assikis Vasily , Buzdar Aman , Yang Ying , Smith Terry , Theriault Richard , Booser Daniel , Valero Vicente , Walters Ronald , Singletary Eva , Ames Frederick , Hortobagyi Gabriel
Published: May 2003

BACKGROUND

The current study was performed to assess whether sequential potentially noncross‐resistant chemotherapy prolongs disease‐free survival (DFS) and overall survival (OS) in patients with operable breast carcinoma.

METHODS

Seven hundred eighty‐nine patients were registered and followed for a median of 10 years. They were treated in two groups. In Group 1, patients age < 50 years or age > 50 years but with either negative or unknown estrogen receptor (ER) status were randomized to receive 6 cycles of 5‐fluorouracil, doxorubicin, and cyclophosphamide (FAC) alone or followed by 4 cycles of methotrexate and vinblastine (MV). In Group 2, patients age ≥ 50 years with ER‐positive disease were randomized to receive either tamoxifen or combination chemotherapy (FAC + MV) for 10 cycles. Analysis was performed according to allocated treatment (intention to treat), with all randomized patients included.

RESULTS

In Group 1 there were no significant differences with regard to DFS or OS between the two treatment arms. The DFS at 5 years was 0.70 and 0.76, respectively, for FAC compared with FAC+MV (P = 0.26). The OS was similar for both groups (0.84 vs. 0.83). It is interesting to note that there was a statistically nonsignificant trend for improved DFS in the FAC + MV arm for patients who were ER‐positive. In Group 2, tamoxifen alone led to more prolonged DFS compared to FAC+MV (0.78 vs. 0.66, respectively) but this did not reach statistical significance (P = 0.28). OS also was associated with a trend (P = 0.86) toward prolonged survival for the tamoxifen arm compared with the FAC+MV arm (0.85 vs. 0.74, respectively).

CONCLUSIONS

The results of the current trial concerning sequential adjuvant chemotherapy for operable breast carcinoma, which to our knowledge contains the longest follow‐up presented to date, failed to demonstrate any additional benefit from the addition of 4 cycles of MV to 6 cycles of FAC chemotherapy. Cancer 2003;97:2716–23. © 2003 American Cancer Society.

DOI 10.1002/cncr.11396