bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term outcome of patients with monostotic Ewing's sarcoma treated with combined modality
Authors: Gasparini Marco , Lombardi Fabrizio , Ballerini Emanuela , Gandola Lorenza , Gianni Maria C. , Massimino Maura , Rottoli Luigia , Fossati‐Bellani Franca
Published: February 2007

One hundred and twenty‐one consecutive patients with monostotic Ewing's sarcoma (ES) were treated according to three consecutive combined modality programs from 1974 to 1986. Their 3‐year progression free survival (PFS) rate from diagnosis of 59% was identical to the event free survival (EFS) rate, since all the 50 events occurring within 3 years from diagnosis were tumor recurrences. Primary tumor was treated with radiotherapy in 75 cases, surgical resection plus radiotherapy in 38, and radical surgery in 8. Chemotherapy was given to all patients and each program included adriamycin, vincristine, and cyclophosphamide ± dactinomycin. Median follow‐up was 12 years, ranging from 6 to 19 years. The PFS rate decreased to 49% at 6 years and plateaued at 46% after the 7th year from diagnosis, even though some relapses were observed as late as 14 years from diagnosis. Second malignancies developed in 7 patients free from progressive ES and were represented by osteogenic sarcoma in previously irradiated bone in 4 cases and by breast carcinoma in 3. No other event but tumor relapse or second malignancy occurred in this series. EFS rate was 47% at 6 years and 39% at 12 years, further decreasing in the following years because of a number of late events. A continuous PFS longer than 7 years may be consistent with cure in the majority of patients with monostotic ES. However, these patients should be followed indefinitely because of risk of second malignancies. © 1994 Wiley‐Liss, Inc.
Interphase cytogenetic study of childhood acute lymphoblastic leukemia
Authors: Berger Angelika , Strehl Sabine , Hekele Andreas , Ambros Peter F. , Haas Oskar A. , Gadner Helmut
Published: February 2007

We used the fluorescence in situ hybridization (FISH) technique and centromere‐specific probes for chromosomes 1, 6, 8, 10, 12, 17, 18, X, and Y to investigate the presence and number of the respective chromosomes in interphase nuclei of 14 cases of childhood acute lymphoblastic leukemia (ALL) which were shown to be hyperdiploid by DNA flow cytometry irrespective of their cytogenetic pattern. Numerical anomalies for one or more chromosomes were detected in all 14 cases. The FISH results were compared with those obtained by conventional cytogenetic analysis. A hyperdiploid karyotype was evident in 5 cases, the others were either normal or lacking cytogenetic results because of technical failure. In the 5 cytogenetically hyperdiploid cases, 14 numerical abnormalities were observed with both techniques, whereas 4 numerical deviations were found only with FISH. In 9 other cases which had a DNA content indicating hyperdiploidy, 34 trisomies and 2 tetrasomies were detected by FISH analysis. Furthermore, in 1 case duplication of the Y chromosome and in 3 male cases duplication of the X chromosome were evident. Double‐target FISH experiments in 2 patients allowed the correlation of numerical aberrations of 2 chromosomes in one and the same cell. By such analyses, detection of subpopulations of tumor cells was found to be relatively easy. Our results indicate that the FISH technique with chromosome‐specific repetitive centromeric probes is a rapid, simple to use, and easy to interpret technique for the evaluation of numerical chromosomal aberrations in interphase nuclei of leukemias. © 1994 Wiley‐Liss, Inc.
Intensive conditioning regimen for bone marrow transplantation in children with high‐risk haematological malignancies
Authors: Cole Catherine H. , Pritchard Sheila , Rogers Paul C. J. , Davis Jeffrey E. , Phillips Gordon , Chan Ka Wah
Published: February 2007

Between September 1987 and May 1991, 21 children aged 10 months to 15 years (median 9 years) underwent bone marrow transplantation (BMT) for advanced haematological malignancies using a conditioning regimen consisting of total body irradiation (TBI), etoposide 1.8 g/m2 by continuous infusion, and cyclophosphamide 2 g/m2 on 3 consecutive days. The patients included 14 with acute lymphoblastic leukaemia (ALL), 1 with chronic myeloid leukaemia (CML), 1 with juvenile CML, 4 with non‐Hodgkin's lymphoma and 1 with acute nonlymphocytic leukaemia. Eleven had an allogeneic BMT from an HLA‐matched sibling, and 1 from an unrelated donor. Nine patients received 4‐hydroperoxycyclophosphamide purged autologous marrow. Median time to myeloid engraftment (ANC > 500/μl) was 19 days in allogeneic BMT patients and 28 days in autologous BMT patients (P < .01). Mucositis was the major regimen‐related toxicity (RRT). GI toxicity in the form of diarrhoea affected ten patients and five had veno‐occlusive disease of the liver. Two patients had mild bladder toxicity and one died of renal toxicity. There was no CNS or cardiac toxicity. There was no significant difference in the incidence of toxicity according to the type of BMT (autologous or allogeneic), total dose, or sequence of TBI. With a median follow‐up of 44 months, ten patients are alive (6/12 allogeneic BMT patients and 4/9 autologous BMT patients). Of the 11 deaths, four were related to toxicity (2 aspergillus, 1 haemorrhage following liver biopsy, and 1 from haemolytic‐uraemic syndrome), and 4/12 allogeneic and 4/9 autologous BMT patients died from relapsed disease. This conditioning regimen is well tolerated in children, demonstrating mild and reversible RRT. © 1994 Wiley‐Liss, Inc.
Neurourologic consequences of accidental intrathecal vincristine: A case report
Authors: Zaragoza Michael R. , Ritchey Michael L. , Walter Andrew
Published: February 2007

Inadvertent intrathecal administration of vincristine results in severe neurotoxicity. Motor and sensory bladder dysfunction have been reported but the long‐term urologic consequences are unknown due to the associated high mortality. We report a case of accidental intrathecal vincristine administration with patient survival and follow‐up of 24 months. The child developed a lower motor neuron neuropathic bladder requiring intermittent self‐catheterization of the bladder. Urinary tract management of these children should be based on the urodynamic findings. © 1995 Wiley‐Liss, Inc.
A simple exam to screen superficial masses: Fine‐needle aspiration cytology
Authors: Gamba P. G. , Messineo A. , Antoniello L. M. , Boccato P. , Blandamura S. , Cecchetto G. , Dall'Igna P. , Guglielmi M.
Published: February 2007

Fine‐needle aspiration cytology (FNAC) is now considered a useful tool in the evaluation of adult patients with mass lesions. We reviewed the experience with FNAC in our Paediatric Surgical Department.

One hundred and eleven FNACs were performed in children with a superficial mass and no definite diagnosis. All the exams were done by the same physician using a fine needle and no anesthesia. We routinely used May‐Grünwald‐Giemsa and Papanicolaou staining. Patients age ranged from 20 days to 17 years, with a mean age of 6.5 years.

A clinically benign pathology was cytologically confirmed in 90 cases (81%). All children did well at follow‐up. Malignancy was diagnosed in eight cases (7.2%) and in all was confirmed with a surgical biopsy. In nine children (8.1%) the specimen was considered insufficient for definite diagnosis. In four cases (3.6%) the pathologist diagnosed a possible malignancy that was excluded at surgical biopsy. The sensitivity was 100% and the specificity was 96%.

Our experience confirms that FNAC is a fast, cheap, simple, and accurate diagnostic method and should be used for screening in all children with doubtful superficial masses. © 1995 Wiley‐Liss, Inc.
Survival after retinoblastoma: Long‐term consequences and family history of cancer
Authors: Byrne Julianne , Fears Thomas R. , Whitney Charles , Parry Dilys M.
Published: February 2007

Retinoblastoma (Rb) is a rare childhood tumor of the eye. In the heritable form, tumors are often bilateral and survivors have a greatly increased risk both for a second malignancy and for having children with Rb. Familial patterns of both cancer and birth defects are poorly understood in families with a heritable cancer, and little is known of the ways that a heritable cancer affects the lives of long‐term survivors. To find out more about these and other issues in the lives of long‐term survivors of childhood and adolescent cancer, we interviewed 56 adult survivors of retinoblastoma (15 with the heritable form) and 84 brothers and sisters as controls, who formed part of a large retrospective cohort study. Rb survivors were interviewed between 1980 and 1983, when they were 30 years old on average. Types of employment and health problems did not differ between survivors and controls, regardless of sight, but the income of blind survivors was considerably less than that of partially sighted survivors. Despite similar marriage rates, fewer survivors than controls reported a pregnancy (RR = 0.45; 95% Cl; 0.24–0.83 for both sexes combined). Parents of children with heritable Rb seemed more likely to have had cancer than parents in families with nonheritable Rb (P = 0.06), and mothers were more likely than fathers to be affected (P = 0.01).

This small series suggests that having retinoblastoma may have many long‐term consequences, reaching beyond genetic and physical effects to touch family life and income attainment and the health of other family members. Follow‐up of more modern cohorts and the use of molecular tools will clarify the long‐term consequences of more recent therapies, and patterns of familiar cancer. © 1995 Wiley‐Liss, Inc.
Carboplatin in childhood Medulloblastoma/PNET: Feasibility of an in vivo sensitivity test in an “up‐front” study
Authors: Mastrangelo Renato , Lasorella Anna , Riccardi Riccardo , Colosimo Cesare , Iavarone Antonio , Tornesello Assunta , Mastrangelo Stefano , Ausili‐Cefaro Giampiero , Di Rocco Concezio
Published: February 2007

Sixteen patients with high risk MB/PNET at diagnosis were included in a pilot study employing carboplatin (CBDCA) as a single drug prior to conventional therapy. The main goal of the study was to identify in a short‐term trial a significant response that would predict further response to CBDCA in the single patient. Exploration of CBDCA activity was focused on response after the first course as compared to the response following the second course. A course consisted of CBDCA 600 mg/m2 on days 1 and 2 administered in a 1 h infusion to be repeated 3–4 weeks later. After two cycles we observed 1 CR and 9 PR, that is a 62% response rate. The first course resulted in 5 PR, 5 MR, 5 SD, and 1 PD; after the subsequent course in all responding patients, response persisted or improved whereas in no patient with SD any improvement was observed. The correlation of response to the first course with response to the second course was statistically significant (P = 0.0009). The main toxicity of the single course was hematologic and consisted of rapidly reversible grade 3–4 neutropenia and thrombocytopenia in 94% of patients. Pharmacokinetic studies showed a very limited interpatient variability of both Cmax (57.6 ± 9.9 μg/ml) and AUC (15.3 ± 1.5 mg/ml · min) of free CBDCA, which eliminates an important variable in the evaluation of response. In conclusion, this “in vivo test” appears effective, reasonably safe, and reproducible in identifying patients likely to benefit from CBCDA: after a period of time as short as 3–4 weeks following the first course, multidrug chemotherapy including CBDCA may be employed in the responding patients, whereas an alternative regimen would be indicated in the non‐responding patients. © 1995 Wi1ey‐Liss Inc.
Effect of trimethoprim‐sulphamethoxazole in langerhans' cell histiocytosis: Preliminary observations
Authors: Tzortzatou‐Stathopoulou Fotini , Xaidara Athina , Mikraki Vasiliki , Moschovi Mary , Arvanitis Dimitris , Ageloyianni Panagoula , Prodromou Phivos
Published: February 2007

Twenty‐three children with Langerhans' cell histiocytosis (LCH) have been treated with trimethoprim‐sulphamethoxazole (T‐S) in a 4‐year period. The children are classified in two main groups according to the extent of their disease. Group A includes 16 children with single system disease and group B, seven children with multisystem disease. All patients were treated for 4 weeks to 3 months. The results of treatment are evaluated in terms of response in individual organs involved. All children with single system disease had a good response to the drug. Children with multisystem disease had a good response to some organs but a poorer outcome for the lungs and for the blood. These patients did not respond even to conventional chemotherapy. © 1995 Wiley‐Liss, Inc.
Outcome after first relapse in children with acute lymphoblastic leukemia: A population‐based study of 315 patients from the nordic society of pediatric hematology and oncology (NOPHO)
Authors: Schroeder H. , Garwicz S. , Kristinsson J. , Siimes M. A. , Wesenberg F. , Gustafsson G.
Published: February 2007

This study reports the outcome after relapse of acute lymphoblastic leukemia (ALL) in a population‐based study of 809 children over 1 year of age diagnosed July 1981 through June 1986 and with non‐B acute lymphoblastic leukemia in the five Nordic countries. By January 1994, 315 children had suffered at least one relapse. The bone marrow was involved in 216 cases. There were 69 isolated CNS relapses, 25 isolated testicular recurrences and five relapses in other extramedullary sites.

Of the 315 children with relapse, 94 are still in a second complete remission 12–138 (median: 78) months after relapse. The overall probability of a second event free survival (P‐2.EFS) and survival after relapse was 0.28 and 0.33 respectively. The probability of remaining in second remission at 11 years was significantly correlated to the duration of first remission (P< 0.001), the site of relapse (P< 0.001) and gender (P= 0.004). TheP‐2.EFS for early, intermediate, and late bone marrow involved relapses were 0.08, 0.19, and 0.50 respectively. For early, intermediate and late isolated CNS relapses theP‐2.EFS were 0.21, 0.38 and 0.61, respectively.

TheP‐2.EFS for boys with isolated testicular relapses was 0.69. Girls with isolated CNS relapse (P< 0.001) and with bone marrow involved relapse (P= 0.04) had a significantly better prognosis than boys.

Children with initial high risk criteria, especially T‐ALL and mediastinal mass who relapsed, had a very poor prognosis. Conclusion: In this population‐based study, about 30% of children with ALL obtained a long second remission and possible cure. © 1995 Wiley‐Liss, Inc.
Gradient crystal plasticity as part of the computational modelling of polycrystals
Authors: Ekh M. , Grymer M. , Runesson K. , Svedberg T.
Published: February 2007

This paper describes how gradient hardening can, in a thermodynamically consistent fashion, be included into a crystal plasticity model. By assuming that the inelastic part of the free energy includes contributions from the gradient of hardening along each slip direction, a hardening stress due to the second derivative of the hardening along each slip direction can be derived. For a finite element model of the grain structure a coupled problem with displacements and gradient hardening variables as degrees of freedom is thereby obtained. This problem is solved using a dual mixed approach. In particular, an algorithm suitable for parallelization is presented, where each grain is treated as a subproblem. The numerical results show that the macroscopic strength increases with decreasing grain size as a result of gradient hardening. Finally, the results of different prolongation assumptions, i.e. how to impose the macroscopic deformation gradient on a representative volume element, are compared. Copyright © 2007 John Wiley & Sons, Ltd.
Proteomics of lipid oxidation‐induced oxidation of porcine and bovine oxymyoglobins
Authors: Suman Surendranath P. , Faustman Cameron , Stamer Sheryl L. , Liebler Daniel C.
Published: February 2007

Myoglobin (Mb) redox state affects meat color and is destabilized by lipid oxidation products such as 4‐hydroxy‐2‐nonenal (HNE). Our objective was to investigate lipid oxidation‐induced oxymyoglobin (OxyMb) oxidation in Mb from two major meat‐producing livestock species utilizing MS and proteomics tools. Porcine OxyMb was incubated with HNE and analyzed for metmyoglobin (MetMb) formation. MetMb formation was greater in the presence of HNE than controls at pH 7.4 and 37°C (p <0.05). MALDI‐TOF MS was used to identify adduct formation; only mono‐adducts of HNE (via Michael addition) with porcine Mb were detected. LC‐ESI‐MS/MS identified three histidine (HIS) residues in porcine Mb that were readily adducted by HNE (HIS 24, 36 and 119), whereas in bovine Mb seven histidine residues (HIS 24, 36, 81, 88, 93, 119 and 152) were adducted. Quantitation of HNE‐adducted peptides using isotope‐labeled phenyl isocyanate indicated that, initially, HIS 36 was preferentially adducted in porcine Mb whereas HIS 81, 88 and 93 were the predominant sites of early HNE adduction in bovine Mb. Preferential HNE adduction at the proximal histidine (HIS 93) was observed exclusively in bovine OxyMb and may explain why lipid oxidation‐induced OxyMb oxidation appears more extensive in beef, than in pork.
Screening the human serum proteome for genotype–phenotype associations: An analysis of the IL6 –174G>C polymorphism
Authors: Hegedus Christine M. , Skibola Christine F. , Bracci Paige , Holly Elizabeth A. , Smith Martyn T.
Published: February 2007

Interleukin (IL)‐6 is a circulatory, pleiotropic cytokine with multiple roles in the immune system. Both IL‐6 and the IL6 –174G>C promoter polymorphism have been linked to various diseases associated with inflammation. However, the mechanism by which the polymorphism influences disease risk is unclear. We postulated that serum proteome analysis of individuals with different IL6 –174G>C genotypes would provide insight on genotype–phenotype associations of this polymorphism and its role in disease susceptibility. Serum from a random sample of control participants in an ongoing population‐based case‐control study of non‐Hodgkin lymphoma was pooled by IL6 genotype and used to screen for the optimal SELDI‐TOF MS arrays for analysis. We report differences in serum protein expression of individuals with specific genotypes based on pooled and individual sample analysis. In particular, we report an association of the –174C allele with increased apolipoprotein C‐I (ApoC‐I). Additionally, we corroborate previous findings of an association of the –174C allele with lower autoantibodies to heat shock protein 60 and confirm the absence of any association between the IL6 –174G>C genotype and serum IL‐6 levels. This study illustrates that proteome analysis can enhance our understanding of genotype–phenotype relationships. Additional studies are needed to clarify the interaction between the IL6 –174G>C polymorphism and ApoC‐I.
Comparison of SDS‐ and methanol‐assisted protein solubilization and digestion methods for Escherichia coli membrane proteome analysis by 2‐D LC‐MS/MS
Authors: Zhang Nan , Chen Rui , Young Nelson , Wishart David , Winter Philip , Weiner Joel H. , Li Liang
Published: February 2007

Both organic solvent and surfactant have been used for dissolving membrane proteins for shotgun proteomics. In this work, two methods of protein solubilization, namely using 60% methanol or 1% SDS, to dissolve and analyze the inner membrane fraction of an Escherichia coli K12 cell lysate were compared. A total of 358 proteins (1417 unique peptides) from the methanol‐solubilized protein mixture and 299 proteins (892 peptides) from the SDS‐solubilized samplewere identified by using trypsin digestion and 2‐D LC‐ESI MS/MS. It was found that the methanol method detected more hydrophobic peptides, resulting in a greater number of proteins identified, than the SDS method. We found that 159 out of 358 proteins (44%) and 120 out of 299 proteins (40%) detected from the methanol‐ and SDS‐solubilized samples, respectively, are integral membrane proteins. Among the 190 integral membrane proteins 70 were identified exclusively in the methanol‐solubilized sample, 89 were identified by both methods, and only 31 proteins were exclusively identified by the SDS method. It is shown that the integral membrane proteins reflected the theoretical proteome for number of transmembrane helices, length, functional class, and topology, indicating there was no bias in the proteins identified.
The proteome survey of an electricity‐generating organ (Torpedo californica electric organ)
Authors: Nazarian Javad , Hathout Yetrib , Vertes Akos , Hoffman Eric P.
Published: February 2007

Torpedo californica is a species in class Chondrichthyes. Electric rays have evolved the electric organ, which is similar to the mammalian neuromuscular junction (NMJ). Here, we took a combined cDNA sequencing and proteomic approach to define the molecular constituents of the T. californica electric organ. For soluble proteins, 2‐DE was used and 224 protein spots were mapped. Plasma membrane fractions were analyzed using the shotgun approach (LC‐MS/MS). A Torpedo cDNA library was constructed and 607 cDNA clones were sequenced. Identification of electric organ proteins was done using cross‐species comparisons, and a custom database was constructed from cDNA translations. We unambiguously identified 121 proteins and transcripts, 103 of which were novel additions to the existing databases of Torpedo fish. Fifteen proteins of known function, but not previously associated with either the electroplaque or NMJ, were present at high abundance. These included the heat shock and oxidative stress proteins, annexin V (calelectrin), and plectin 1. Most interesting were the unambiguous matches to 11 human ORFs of unknown function, including four potential RNA splicing proteins, a vacuolar sorting protein, and a tetraspanin containing protein. This analysis identified proteins that may play a role in the higher vertebrate neuromuscular junction or other electrical synapses.
Arginine deficiency in preconfluent intestinal Caco‐2 cells modulates expression of proteins involved in proliferation, apoptosis, and heat shock response
Authors: Lenaerts Kaatje , Renes Johan , Bouwman Freek G. , Noben Jean‐Paul , Robben Johan , Smit Egbert , Mariman Edwin C.
Published: February 2007

Arginine is classified as a conditionally essential amino acid required exogenously during catabolic disease states and periods of rapid growth, both characterized by increased arginine utilization. Arginine plays an important role in the intestine, where it is extensively metabolized, and enhances its immune‐supportive function and mucosal repair. Cell proliferation is important for the latter process. This study aimed for a better molecular insight in the response to arginine deprivation/supplementation of preconfluent and 5‐day‐confluent, differentiated Caco‐2 intestinal cells. The potential of citrulline to counteract the effects of arginine deprivation was investigated in preconfluent cells. 2‐DE combined with MALDI‐TOF‐MS and the antibody microarray technology were applied. Evidence is provided that arginine deficiency modulates the protein expression profiles of preconfluent Caco‐2 cells differently than that of postconfluent differentiated cells. In preconfluent cells, certain proteins changed in direct response to arginine deficiency, whereas other proteins did not, but instead responded during the recovery phase after an arginine/citrulline resupplementation. The protein changes suggest that arginine deprivation decreases cell proliferation and heat shock protein expression, and enhances the cells susceptibility to apoptosis. These processes are critical for proper cell function, and hence a state of arginine deficiency can be detrimental for intestinal cells which proliferate actively in vivo.
Proteomic and functional alterations in brain mitochondria from Tg2576 mice occur before amyloid plaque deposition
Authors: Gillardon Frank , Rist Wolfgang , Kussmaul Lothar , Vogel Johannes , Berg Matthias , Danzer Karin , Kraut Norbert , Hengerer Bastian
Published: February 2007

Synaptic dysfunction is an early event in Alzheimer's disease patients and has also been detected in transgenic mouse models. In the present study, we analyzed proteomic changes in synaptosomal fractions from Tg2576 mice that overexpress mutant human amyloid precursor protein (K670N, M671L) and from their nontransgenic littermates. Cortical and hippocampal tissue was microdissected at the onset of cognitive impairment, but before deposition of amyloid plaques. Crude synaptosomal fractions were prepared by differential centrifugation, proteins were separated by 2‐D DIGE and identified by MS/MS. Significant alterations were detected in mitochondrial heat shock protein 70 pointing to a mitochondrial stress response. Subsequently, synaptosomal versus nonsynaptic mitochondria were purified from Tg2576 mice brains by density gradient centrifugation. Mitochondrial proteins were separated by IEF or Blue‐native gel electrophoresis in the first dimension and SDS‐PAGE in the second dimension. Numerous changes in the protein subunit composition of the respiratory chain complexes I and III were identified. Levels of corresponding mRNAs remain unchanged as shown by Affymetrix oligonucleotide array analysis. Functional examination revealed impaired state 3 respiration and uncoupled respiration in brain mitochondria from young Tg2576 mice. By immunoblotting, amyloid‐beta oligomers were detected in synaptosomal fractions from Tg2576 mice and reduced glucose metabolism was observed in Tg2576 mice brains by [14C]‐2‐deoxyglucose infusion. Taken together, we demonstrate alterations in the mitochondrial proteome and function that occur in Tg2576 mice brains before amyloid plaque deposition suggesting that mitochondria are early targets of amyloid‐beta aggregates.
Depression and tumor stage in cancer of the head and neck
Authors: Baile Walter F. , Gibertini Michael , Scott Linda , Endicott James
Published: February 2007

A study was undertaken to explore the relationship between depression and tumor invasiveness in a group of 45 patients with cancer of the head and neck at different stages. Patients were assessed for depression at the time of their first visit to a tertiary care cancer center, before definitive diagnosis was made and treatment initiated. Depression was assessed by using the DSM‐III derived dysthymia scale of the Millon Clinical Multiaxial Inventory and by clinical interview which elicited symptoms of major depression. We hypothesized that if depression were related to the physical effects of the tumor then patients with more advanced cancer would be more depressed due to associated pain, discomfort and nutritional deficits. Contrary to expectations, results showed that depression scores were distributed equally throughout all stages. However, stage × gender analysis showed a significant effect with females having early stage (1 and 2) cancer being most depressed. Physical symptoms and nutritional factors were not associated with depressed affect but marital status (unmarried) and stress scores were. The high frequency of depression reported in head and neck cancer patients is not necessarily the result of the malignant process or a response to treatment but may be related to premorbid factors of which social support is one variable.
Further development of a quality of life measure for cancer patients: The rotterdam symptom checklist (revised)
Authors: Watson M. , Law M. , Maguire G. P. , Robertson B. , Greer S. , Bliss J. M. , Ibbotson T.
Published: February 2007

Further development of existing measures of health‐related quality of life (QL) is indicated. The present study examined the factor structure of the Rotterdam symptom checklist (RSCL), a self‐rating scale developed for determination of QL among cancer patients which was recently recommended by the UK Medical Research Council Cancer Therapy Committee Working Party on Quality of Life. A comparison is also reported of the RSCL with the Hospital Anxiety and Depression Scale (HADS) and the Psychosocial Adjustment to Illness Scale (PAIS) in a separate sample of patients, selected because they showed evidence of psychopathology. The data indicate that the RSCL can be used as a two‐factor measure for assessing psychological and physical morbidity. Scores for both sub‐scales were found to be higher for female patients. An observed positive association between HADS depression scores and the physical symptoms sub‐scale of the RSCL, in our selected sample, suggests some caution is needed when interpreting levels of physical morbidity and depression among cancer patients, as physical symptom scores may be associated with depression‐related somatic symptoms. Although the RSCL does not measure all dimensions of psychosocial functioning, it is a useful and brief method of assessing physical and psychological morbidity in cancer patients.
Anxiety and depressive symptoms at different stages of malignant melanoma
Authors: Brandberg Yvonne , Bolund Christina , Sigurdardottir Valgerdur , Sjödén Per‐Olow , Sullivan Marianne
Published: February 2007

The HAD scale was used to assess anxiety and depressive symptoms in three groups of individuals visiting an oncology clinic, healthy persons with hereditary melanoma (group DNS), patients treated for cutaneous malignant melanoma stage I (group MM1), and patients with generalized disease (group MM2). No differences were found on the anxiety subscale, although MM2 scored higher than the other groups on two out of seven anxiety items. The depression subscale, and six out of seven items in this subscale showed higher scores for MM2 than for the other two groups. In group MM2 as compared to the other two groups, there was a higher proportion of individuals scoring above the cut‐off point for potentially clinical cases on the depression subscale, but not on the anxiety subscale. A principal component analysis yielded an‘anxiety’ factor, a‘depression’ factor and a‘restlessness’ factor. Of these factors, anxiety and‘depression’ showed higher values for MM2 than for the other two groups, while no differences were found for‘restlessness’.
Suicide and euthanasia: Patient attitudes in the context of cancer
Authors: Owen Cathy , Tennant Christopher , Levi John , Jones Michael
Published: February 2007

One hundred oncology patients from a major teaching hospital were asked about their attitudes to a number of final life events including active withdrawal from treatment, the refusal of cardiopulmonary resuscitation, suicide and euthanasia. A descriptive approach was used incorporating semi‐structured interviews and established questionnaire measures. One third of the patient sample anticipated some role for taking active steps to end their own lives. This was not restricted to those currently psychologically disturbed nor to any particular demographic subgroup. Patients with more severe illness or poor prognosis did not express interest in suicide and euthanasia. A positive past psychiatric history increased the potential for seeing suicide as an option. The results have significant implications for the establishment of patient care protocols in final life events.
Changes in marital and sexual functioning in long‐term survivors and their spouses: Testicular cancer versus hodgkin's disease
Authors: Hannah Mo Therese , Gritz Ellen R. , Wellisch David K. , Fobair Pat , Hoppe Richard T. , Bloom Joan R. , Sun Guo‐Wen , Varghese Anna , Cosgrove Malcolm D. , Spiegel David
Published: February 2007

This study compares the effects of the cancer experience on various aspects of marital and sexual functioning (e.g., communication, emotional support, body image, sexual satisfaction and frequency) for two groups of long‐term cancer survivors (testicular cancer and Hodgkin's disease) and their spouses. Comparisons between the two patient groups showed significantly more survivors of Hodgkin's disease than testicular cancer reporting the emergence of special issues and changes in the marital relationship. No differences emerged between the spouse groups on sexual functioning variables; however, spouses of survivors of Hodgkin's disease were more likely than spouses of survivors of testicular cancer to report the development of special issues and communication difficulties. A substantial proportion of both survivor groups disclosed negative changes in body image and sexual frequency. Majorities of both survivors and spouses acknowledged that the illness had drawn them closer together. When representative marital/sexual functioning variables were used to predict Family Environment Scale (FES) scores for survivors and for spouses, changes in the spouse's importance, influence of the illness on the relationship, and changes in sexual frequency emerged as significant predictors. The clinical significance of long‐term changes in marital and sexual functioning for the couple and the need for therapeutic interventions are discussed.
Children's understanding of cancer
Authors: Eiser Christine , Havermans Trudy
Published: February 2007

Explanations of cancer need to take into account developmental changes in children's cognitive and emotional abilities to understand illness. Children below 5 years of age are usually informed by parents, and older children by medical staff. Information tends to focus on details of treatments and procedures, and less on the seriousness of the disease and length of time involved. There are indications that early and honest information is associated with better behaviour and adjustment in the child, communication within the family and compliance with treatment, although methodological inadequacies in assessment of adjustment and knowledge of cancer limit the ability to generalize these findings. Communication with children should take into account developmental changes in children's ability to understand illness information. Communicators should also provide emotional support to deal with the threatening nature of this information.
Surviving childhood cancer: A descriptive approach to understanding the impact of life‐threatening illness
Authors: Gray Ross E. , Doan Brian D. , Shermer Peter , Fitzgerald Annette Vatter , Berry Martin P. , Jenkin Derek , Doherty Mary A.
Published: February 2007

Descriptive findings are presented from a study of adult survivors of childhood cancer. Most survivors reported having coped well with illness. When asked about various life domains, in all cases a majority saw cancer experience as having had a positive impact over the long term. Despite the overall good adaptation of survivors, illness experience was traumatic at the time and it continued to cause difficulties. School, work and physical symptoms caused problems for a proportion of survivors—with greater representation from among those treated for brain tumours. One‐quarter of survivors felt that they currently had insufficient medical information. Interpersonal relationships, although greatly valued and heavily invested in by survivors, were also frequently characterized by heightened sensitivity and cautiousness. Finally, a small minority of cancer survivors showed considerable adjustment difficulties, most notably in the area of social relations. Descriptive findings are integrated with findings from comparisons of survivors to a group of healthy peers. Implications of study findings for research directions and program development are discussed.
Psychosocial variables associated with mental adjustment to cancer
Authors: Grassi Luigi , Rosti Giovanni , Lasalvia Antonio , Marangolo Maurizio
Published: February 2007

To investigate the role of psychosocial variables and psychological vulnerability on adjustment to cancer, a study was undertaken on 157 cancer patients. Assessment of adjustment to cancer (Mental Adjustment to Cancer‐MAC‐scale), social support (Social Support Index), external locus of control (ELC scale), psychiatric history and present mental status (DSM‐III‐ R) was carried out. The results indicated that the MAC dimension Fighting Spirit (FS) was related to low ELC and high social support, while an opposite association was shown for Helplessness (H) and Fatalism (F). According to MAC cut‐off scores, ‘cases’ reported higher ELC and lower social support than ‘non‐cases’. Patients with a lifetime history of emotional disorders, as well as a present DSM‐III‐R diagnosis, showed a style of mental maladjustment to cancer (low FS, high H, F and Anxious Preoccupation). The findings seem to confirm the utility of using the MAC in oncologic settings and the importance of prior psychological problems, present emotional disorders, external locus of control and inadequate interpersonal support in favouring less effective strategies of adjustment to cancer.
Repressiveness: Cause or result of cancer?
Authors: Kreitler Shulamith , Chaitchik Samario , Kreitlers Hans
Published: February 2007

Repression is commonly assumed to be a major characteristic of the cancer‐prone personality. Main supporting evidence includes studies showing that cancer patients are low in emotional expression and that repressives have shorter survival. The evidence did not seem compelling, mainly because of contrary findings, overlooking the age factor and the assessment instruments. Thus, we examined whether repression is a response to the threat posed by the cancer diagnosis and whether cancer patients are more repressive, using a new assessment method combining anxiety and defensiveness scores and controlling age. The subjects were 98 women comprising three groups comparable in demographic characteristics: (a) breast biopsy showed they were healthy (n= 40), (b) biopsy showed they had breast cancer (n= 32), and (c) underwent surgery unrelated to cancer (n= 26). Only post‐surgery groups a and b knew the diagnosis. Questionnaires of information and repression were administered to all women pre‐ and post‐surgery. Before surgery, the groups did not differ in repression, anxiety and defensiveness. Post‐surgery, there were no differences in anxiety but MANOVA andX2analyses showed that, in the malignancy group, defensiveness and the number of repressors increased more than in the other groups. The results indicate that repression could be a response to the threat posed by the cancer diagnosis and a means for keeping anxiety at a tolerable level rather than a personality trait of cancer patients.
The validity of the national adult reading test in estimating premorbid intellectual ability in long‐term survivors of hemispheric glioma and whole brain irradiation—a pilot study
Authors: Ebmeier Klaus P. , Booker Kerry , Cull Ann , Gregor Ann , Goodwin Guy M. , O'carroll Ronan E.
Published: February 2007

We have examined the validity of using the National Adult Reading Test (NART) to estimate premorbid intellectual levels in long‐term survivors of glioma who had received whole brain prophylactic irradiation. Sixteen controls matched for age, sex, education and social class were compared with 16 patients. Patients made significantly more errors in the NART than controls, even after controlling for demographic variables. NART errors were compared with demographically predicted NART errors and NART‐predicted Wechsler Adult Intelligence Scale‐Revised (WAIS‐R) with pro‐rated WAIS‐R scores. While predicted and measured error scores were similar for the controls, for patients NART errors were higher than those predicted by demographic variables, while NART‐predicted WAIS‐R scores were higher than pro‐rated WAIS‐R. NART performance, therefore, appears to be detrimentally affected by brain changes due to the primary tumour or received treatment. This conclusion was supported by the finding that, in patients, NART errors were correlated with current IQ, but not with IQ predicted by socio‐demographic variables. After excluding four demented patients, this pattern of results was largely preserved. After excluding four patients with left temporal lobe involvement, the correlation of NART errors with current IQ disappeared, whereas that with NART errors predicted by socio‐demographic variables became significant. These results suggest that the NART can only be used with caution in survivors of malignant primary brain tumors, particularly if left temporal lobe structures are involved.
Psychiatric aspects of bone marrow transplantation: Part I: Special issues during pre‐transplant assessment and hospitalization
Authors: Lesko Lynna M.
Published: February 2007

Bone marrow transplantation (BMT) has become an important innovative treatment for hematological malignancies, solid tumors, immunodeficiency diseases and metabolic disorders. It has evolved over the last decade from a controversial research procedure to a standard therapeutic modality, which prolongs remission of some patients and cures others. Historically, the BMT procedure is divided into several stages, each of which have accompanying emotional problems. In providing psychological care for transplant recipients, donors and families, care‐givers must be familiar with the psychological stages of the procedure, the psychological themes such as body image, rebirth and the patient's mechanisms of coping with the extreme stress of such protocols. Its complex medications, high‐dose chemotherapy, total‐body irradiation (TBI), germ‐free environment, graft‐versus‐host disease (GvHD), Broviac or Hickman line catheterization and total parenteral nutrition (TPN), can precipitate significant psychological sequelae with immediate and long‐term consequences. In response to their illness, transplant patients may also develop emotional disturbances of anxiety, depression, agitation, non‐compliance and rare suicidal thoughts. These reactions, and the occasional presence of concurrent psychiatric illness, require recognition and development of guidelines for management.

This paper is the first in a series of two and will inform the reader about: (1) the biology, epidemiology, history and economics of BMT; (2) informed consent issues and the psychological/social assessment of patients and families prior to BMT; (3) the psychological care of patients during BMT; and (4) address special issues concerning donation of marrow, donor registries, family issues, children as patients and prevention of staff burn‐out. Part II of this series will review the psychosocial adjustment and quality of life of BMT patients as they convalesce and re‐enter normal daily routines. A summary is given of research into which psychosocial factors predict better post‐BMT outcome.
A survey of cancer support groups provided by national cancer institute (NCI) clinical and comprehensive centers
Authors: Presberg Burton A. , Levenson James L.
Published: February 2007

The 42 National Cancer Institute Clinical and Comprehensive Cancer Centers were surveyed about their group support programs. All responding centers (81%) offered group support programs, an average of 3.5 groups per center. There were an average of 6.0 members per group. About an equal number of groups were composed of patients or family members only; more groups included both patients and family members. About one‐third of the groups were limited by site, most commonly breast cancer. One‐quarter limited membership by treatment, and a few groups limited membership by stage of disease. Most of the groups were open‐ended in structure. Nearly all groups met with a frequency between weekly and monthly. Support and education were the primary focus of groups, rather than cognitive‐behavioral or psychotherapy. Social workers and nurses led the majority of groups. Almost all of the groups were provided without payment. Implications of the survey's findings for research and clinical applications of support groups for cancer patients are discussed.
Quality of life following surgery for colorectal cancer: A literature review
Authors: Sprangers Mirjam A. G. , Velde Adrienne Te , Aaronson Neil K. , Taal Babs G.
Published: February 2007

Colorectal cancer patients are faced with the debilitating consequences of either sphincter‐sacrificing or sphincter‐conserving surgery. The question central to the current literature review is: what is the prevalence of physical, psychological, social and sexual dysfunction among colorectal cancer patients with a colostoma (ostomates) compared with those patients whose sphincter function has been conserved (non‐ostomates). Although the extant literature yields some inconsistent findings, a number of clear trends can be identified: (a) both patient groups are troubled by frequent or irregular bowel movements and diarrhea, and consequently often require dietary restrictions; (b) ostomates report higher levels of psychological distress than do non‐ostomates; (c) psychological problems tend to be more frequent among younger patients and among women; (d) while both ostomates and nonostomates report restrictions in their level of social functioning, such problems appear to be more prevalent among patients with a colostoma; (e) the sexual functioning of male colostomists is consistently more impaired than that of patients with intact sphincters; and (f) a considerable number of women whose sphincter function has been sacrificed suffer from dyspareunia. There is need for more methodologically sound studies that: (1) employ well validated quality‐of‐life measures; (2) assess patients' quality of life prospectively in order to examine patients' psychosocial adaptation over time; and (3) identify those subgroups of patients who are at greatest risk to the adverse psychosocial sequalae of the disease and its surgical treatment.
The ethics and conduct of cross‐cultural research in developing countries
Authors: Olweny Charles
Published: February 2007

Bioethics is the study of moral problems as they relate to health‐care delivery. The Hippocratic Oath laid the foundation of medical ethics as we know it today. Advances in medical technology have moved attention away from traditional ethical concepts, which are now either taken for granted or have been accorded the back seat. Contemporary ethical issues that occupy the minds of ethicists include euthanasia, advance directives, in vitro fertilization, surrogate motherhood and transplantation. Some of these are of less concern in developing countries than in the developed world. In developing countries, the ethics of cross‐cultural research, the ethics of scarcity and sacrifice, and the activities and ethics of multinational companies assume far greater importance. This discussion will concentrate on the ethics and conduct of cross‐cultural research in developing countries. The other important topics of scarcity, sacrifice and multinational activity will be covered elsewhere. Culture is the integrated patterns of human knowledge, beliefs and behaviour of a given community. Culture provides individuals with their identity. To work effectively with people it is necessary to view the world from their perspective. This is particularly important when dealing with people from cultures different from one's own. The world is functionally shrinking and there is interdependence not only in the traditional areas of communication and information transfer but also in the economic, environmental, demographic and migration areas. The concept of ‘global health village’ has now become a reality. In the past, researchers seem to have been motivated to conduct studies in developing countries for a variety of reasons. Whereas some of these are laudable, others are of more dubious ethical implications. This article focuses on issues related to the structural design, process and outcome of such research. Anyone contemplating conducting research in developing countries, especially cross‐cultural research, must keep three main points in mind. In particular, the collective wisdom of both foreign and local investigators should be pooled to determine the appropriate research question(s) relevant to the needs of the target population. If human subjects are required for the study, ethical obligations based on the principle of respect for the person and respect for the autonomy of study subject must prevail. Finally constant checks and balances must be in place to ensure benefit of the research, not only to science and society but to individual subjects as well.