bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards a fully synthetic substitute of alginate: Optimization of a thermal gelation/chemical cross‐linking scheme (“tandem” gelation) for the production of beads and liquid‐core capsules
Authors: Cellesi F. , Weber W. , Fussenegger M. , Hubbell J.A. , Tirelli N.
Published: November 2004

Fully synthetic polymers were used for the preparation of hydrogel beads and capsules, in a processing scheme that, originally designed for calcium alginate, was adapted to a “tandem” process, that is the combination a physical gelation with a chemical cross‐linking.

The polymers feature a Tetronic backbone (tetra armed Pluronics), which exhibits a reverse thermal gelation in water solutions within a physiological range of temperatures and pHs. The polymers bear terminal reactive groups that allow for a mild, but effective chemical cross‐linking. Given an appropriate temperature jump, the thermal gelation provides a hardening kinetics similar to that of alginate. With slower kinetics, the chemical cross‐linking then develops an irreversible and elastic gel structure, and determines its transport properties. In the present article this process has been optimized for the production of monodisperse, high elastic, hydrogel microbeads, and liquid‐core microcapsules. We also show the feasibility of the use of liquid‐core microcapsules in cell encapsulation. In preliminary experiments, CHO cells have been successfully encapsulated preserving their viability during the process and after incubation. The advantages of this process are mainly in the use of synthetic polymers, which provide great flexibility in the molecular design. This, in principle, allows for a precise tailoring of mechanical and transport properties and of bioactivity of the hydrogels, and also for a precise control in material purification. © 2004 Wiley Periodicals, Inc.
Transdiaphragmatic pleural lavage in penetrating thoracoabdominal trauma
Authors: Zellweger R , Navsaria P H , Hess F , Omoshoro-Jones J , Kahn D , Nicol A
Published: November 2004

Background

The purpose of this study was to determine the incidence of thoracic sepsis following a systematic thoracic cavity washout through the injured diaphragm in patients with penetrating thoracoabdominal trauma.

Methods

Prospectively collected data on all patients presenting with penetrating thoracoabdominal trauma between July 1999 and July 2002 were analysed. Patients with peritoneal biliary–gastroenteric (BGE) contamination and a diaphragmatic laceration were managed by laparotomy and transdiaphragmatic thoracic lavage.

Results

A total of 217 patients had penetrating thoracoabdominal injuries, of whom 110 had BGE contamination of the peritoneal cavity with spillage into the pleural cavity. The mean Injury Severity Score was 38·1. Gunshot and stab wounds occurred in 79 (71·8 per cent) and 31 (28·2 per cent) respectively. Contamination was from the stomach (55·4 per cent), large bowel (37·3 per cent), small bowel (29·1 per cent), gallbladder and bile ducts (9·1 per cent) and pancreas (6·4 per cent). Thoracic complications occurred in six patients (5·5 per cent): empyema in two, Escherichia coli-related pneumonia in three and pleuritis in one. There were no deaths.

Conclusion

A thoracic washout through the injured diaphragm in patients with penetrating thoracoabdominal trauma and BGE contamination was associated with a low rate of intrathoracic septic complications.
An 11-year experience of enterocutaneous fistula
Authors: Hollington P , Mawdsley J , Lim W , Gabe S M , Forbes A , Windsor A J
Published: November 2004

Background

Enterocutaneous fistula has traditionally been associated with substantial morbidity and mortality, related to fluid, electrolyte and metabolic disturbance, sepsis and malnutrition.

Methods

A retrospective review of enterocutaneous fistula in 277 consecutive patients treated over an 11-year period in a major tertiary referral centre was undertaken to evaluate current management practice and outcome.

Results

Most fistulas occurred secondary to abdominal surgery, and a high proportion (52·7 per cent) occurred in association with inflammatory bowel disease. A low rate of spontaneous healing was observed (19·9 per cent). The healing rate after definitive fistula surgery was 82·0 per cent, although more than one attempt was required to achieve surgical closure in some patients. Definitive fistula resection resulted in a mortality rate of 3·0 per cent. In addition, one patient died after laparotomy for intra-abdominal sepsis and an additional 24 patients died from complications of fistulation, giving an overall fistula-related mortality rate of 10·8 per cent.

Conclusion

Early recognition and control of sepsis, management of fluid and electrolyte imbalances, meticulous wound care and nutritional support appear to reduce the mortality rate, and allow spontaneous fistula closure in some patients. Definitive surgical management is performed only after restitution of normal physiology, usually after at least 6 months.
Semi‐Empirical Equations for the Residence Time Distributions in Disperse Systems – Part 1: Continuous Phase
Authors: Ham J.‐H. , Platzer B.
Published: November 2004

Residence time distributions (RTD) are often described on the basis of the dispersion or the tanks in series models, whereby the fitting is not always good. In addition, the underlying ideas of these models only roughly characterize the real existing processes. Two semi‐empirical equations are presented based on characteristic parameters (mean, minimum, maximum residence time) and on an empirical exponent to permit better fitting. The determination of the parameters and their influence on the RTD are discussed. The usefulness of the models is shown in this first part for single‐phase systems and for the continuous phase of multiphase systems using data from literature for laminar and turbulent flows in different apparatuses. A comparison with the results of other models is also done.
Mythologies and panics: twentieth century constructions of child prostitution
Authors: Brown Alyson
Published: November 2004

This paper examines twentieth century social constructions of child prostitutes and child prostitution, the origins of these representations and the extent to which they have been used as metaphors for other perceived social, economic and political problems. It is important to recognise that these children have been sexually abused and that discourses that have portrayed them as either assertive and blameworthy seducers or as abducted and coerced innocents are constructed myths which detracted from recognition of the actual problems these children have faced.
Solare Verfahren zur Wasserstofferzeugung
Authors: Roeb M. , Rohner N. , Sattler C. , Möller S.
Published: November 2004

No abstracts.
CO2‐Abtrennung mittels Feststoffsorbentien und Anwendung zur sorptionsintegrierten CO‐Shift
Authors: Gauer C. , Heschel W.
Published: November 2004

No abstracts.
Osteosarcoma of the spine
Authors: Ozaki Toshifumi , Flege Silke , Liljenqvist Ulf , Hillmann Axel , Delling Günter , Salzer‐Kuntschik Mechthild , Jürgens Heribert , Kotz Rainer , Winkelmann Winfried , Bielack Stefan S.
Published: November 2004

BACKGROUND

Due to the low incidence rate, the optimal strategy for the treatment of patients with spinal osteosarcoma is unknown.

METHODS

Twenty‐two patients with osteosarcoma of the spine (15 with tumors of the sacrum and 7 with tumors at other sites) who received chemotherapy according to the Cooperative Osteosarcoma Study Group protocol were analyzed. Six patients presented with metastasis, and 16 patients had no evidence of metastasis at the time of entry into the protocol. Of 12 patients who underwent excision of their tumors, 2 patients underwent wide excision, 3 patients underwent marginal excision, and 7 patients underwent intralesional excision. Eight patients received irradiation: Six patients received conventional radiotherapy only, one patient received neutron beam therapy, and one patient received samarium‐153‐ethylene diamine tetramethylene phosphonate therapy. Follow‐up ranged between 24 months and 105 months (median, 47 months).

RESULTS

The median survival was 23 months, and three patients have survived without disease for > 6 years. Patients with primary metastases (P = 0.004), large tumors (P = 0.010), and sacral tumors (P = 0.048) had lower overall survival compared with patients who had no metastasis, small tumors, and nonsacral tumors, respectively. There was a significant difference in overall survival between 5 patients who underwent either wide or marginal surgery and 17 patients who underwent either intralesional surgery or no surgery (P = 0.033). Among 17 patients who underwent no surgery or intralesional surgery, overall survival tended to be better in 7 patients who received irradiation compared with the overall survival in 10 patients who did not receive irradiation (P = 0.059).

CONCLUSIONS

Patients with metastases, a large tumors, and sacral tumors had a poor prognosis in the current study with small numbers of patients. Wide or marginal excision of the tumor improved survival. Patients with osteosarcoma of the spine should be treated with a combination of chemotherapy and at least marginal excision for those with surgically accessible tumors. Postoperative radiotherapy may be beneficial. Cancer 2002;94:1069–77. © 2002 American Cancer Society.

DOI 10.1002/cncr.10258
Immunohistochemical staining of GLUT1 in benign, borderline, and malignant ovarian epithelia
Authors: Kalir Tamara , Wang Beverly Y. , Goldfischer Michael , Haber Richard S. , Reder Ilan , Demopoulos Rita , Cohen Carmel J. , Burstein David E.
Published: November 2004

BACKGROUND

Aberrant expression of the facilitative glucose transporter GLUT1 is found in a wide spectrum of epithelial malignancies. The authors describe an immunohistochemical study of GLUT1 expression in benign, borderline, and malignant ovarian epithelia.

METHODS

One hundred forty one formalin‐fixed, paraffin‐embedded sections were immunostained with rabbit anti‐GLUT1 using the streptavidin‐biotin method. The samples were as follows: 3 endometriotic cysts, 9 serous cystadenomas, 15 mucinous cystadenomas, 17 noninvasive borderline implants, 3 invasive borderline implants, and 3 endosalpingiosis. In addition, 35 borderline tumors (26 serous, 7 mucinous, 2 seromucinous) and 56 adenocarcinomas (50 serous, 4 endometrioid, 2 mucinous) were stained.

RESULTS

Benign serous and mucinous cystadenomas and endosalpingiosis were non‐staining with GLUT1 antiserum. Twenty‐eight of 35 borderline tumors (80%) stained positively, with weak to moderate (1‐2+ out of 3) staining intensity and focal or patchy distribution. Seventeen noninvasive serous borderline implants were negatively stained; however, three invasive serous borderline implants were positively stained with GLUT1 antiserum. Fifty four of 56 ovarian carcinomas (96%) stained positively, with moderate to strong (2‐3+ out of 3) intensity and multifocal distribution.

CONCLUSIONS

GLUT1 is a consistent marker of ovarian epithelial malignancy. GLUT1 staining is absent in benign ovarian epithelial tumors, and shows progressively more staining in invasive tumors as compared to borderline tumors. Anti‐GLUT1 antibody may be useful in distinguishing invasive from noninvasive serous borderline implants. Cancer 2002;94:1078–82. © 2002 American Cancer Society.

DOI 10.1002/cncr.10280
Surgical view of the treatment of patients with hepatoblastoma
Authors: Schnater J. Marco , Aronson Daniël C. , Plaschkes Jack , Perilongo Giorgio , Brown Julia , Otte Jean‐Bernard , Brugieres Laurences , Czauderna Piotr , MacKinlay Gordon , Vos Anton
Published: November 2004

BACKGROUND

Surgical resection is the cornerstone of treatment for patients with hepatoblastoma (HB). The Society of Pediatric Oncology Liver Tumor Study Group launched its first prospective trial (SIOPEL‐1) with the intention to treat all patients with preoperative chemotherapy and delayed surgical resection. The objective of this article was to assess the assumed surgical advantages of primary chemotherapy.

METHODS

Between 1990 and 1994, 154 patients age < 16 years with HB were registered on SIOPEL‐1. The pretreatment extent of disease was assessed, and, after undergoing biopsy, patients were treated with cisplatin 80 mg/m2 intravenously over 24 hours and doxorubicin 60 mg/m2 intravenously over 48 hours by continuous infusion (PLADO). Generally, tumors were resected after four of a total of six courses of PLADO.

RESULTS

One hundred twenty eight patients underwent surgical resection (13 patients underwent primary surgery, and 115 patients underwent delayed surgery after PLADO). A pretreatment surgical biopsy was performed in 96 of 128 patients (75%). Biopsy complications occurred in 7 of 96 patients (7%). Twenty‐two patients showed pulmonary metastases at the time of diagnosis, and 7 patients underwent thoracotomy. Operative morbidity and mortality were 18% and 5%, respectively. Complete macroscopic surgical resection was achieved in 106 patients (92%), including 6 patients who underwent orthotopic liver transplantation. The actuarial 5‐year event free survival (EFS) rate for all 154 patients in the study was 66%, and the overall survival (OS) rate was 75%. For the 115 patients who were included in the surgical analysis that followed the exact protocol, the EFS and OS rates were 75% and 85%, respectively.

CONCLUSIONS

Biopsy is a safe procedure and should be performed routinely. Preoperative chemotherapy seems to make tumor resection easier. Reresection of a positive resection margin does not necessarily have to be performed, because postoperative chemotherapy showed good results. Resection of lung metastases can be curative if there is local control of the primary tumor; however, results showed that the patient's prognosis was worse. Surgical morbidity or mortality rates were not necessarily higher in large multicenter studies. More importantly, countries of lesser economic status also can contribute effectively to these trials. Cancer 2002;94:1111–20. © 2002 American Cancer Society.

DOI 10.1002/cncr.10282
Survival differences among Asian subpopulations in the United States after prostate, colorectal, breast, and cervical carcinomas
Authors: Lin Scarlett S. , Clarke Christina A. , Prehn Angela W. , Glaser Sally L. , West Dee W. , O'Malley Cynthia D.
Published: November 2004

BACKGROUND

Information is limited for Asian subgroups regarding survival after diagnosis of the common cancers amenable to routine screening. The authors examined survival after carcinomas of the prostate, colon/rectum, breast, and cervix separately for Chinese, Japanese, Filipinos, and non‐Hispanic whites in the United States.

METHODS

Using data from the Surveillance, Epidemiology, and End Results program, the authors compared the distributions of stage at diagnosis and computed 5‐year cause specific survival probabilities, overall and by stage of disease, for cancer patients whose diagnosis was in 1988–1994 and who were observed through 1997.

RESULTS

Among males, Filipinos were more likely to be diagnosed with advanced stage colorectal and prostate carcinomas than other Asians and non‐Hispanic whites; they also experienced worse survival after these cancers. This survival deficit occurred across all stages of colorectal carcinoma and remained apparent within distant stage prostate carcinoma. Among females, Chinese were less likely to receive diagnoses of early stage colorectal carcinoma than Japanese and Filipinas. In addition, their survival was consistently lower across more advanced stages of disease. Chinese also experienced somewhat worse survival after diagnosis of early stage cervical carcinoma. Japanese were more likely to be diagnosed with early stage carcinomas but also tended to experience better survival after prostate, colorectal, and breast carcinomas regardless of stage.

CONCLUSIONS

Chinese, Japanese, and Filipinos experienced unequal survival after these screenable carcinomas, indicating that certain groups may benefit from more aggressive screening efforts. The heterogeneity of cancer outcomes observed within the community classified as Asian reinforces the need for cancer statistics to be reported for disaggregated subgroups. Cancer 2002;94:1175–82. © 2002 American Cancer Society.

DOI 10.1002/cncr.10319
Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy
Authors: Bouzourene Hanifa , Bosman Fred T. , Seelentag Walter , Matter Maurice , Coucke Philippe
Published: November 2004

BACKGROUND

Locally advanced rectal carcinoma has a poor prognosis. However, since the introduction of preoperative radiotherapy, the outcome of patients with rectal carcinoma has been reported to have improved. Nevertheless, to the authors' knowledge few data are available regarding the histopathologic response to radiotherapy as assessed on surgical specimens as a potential predictive factor for outcome.

METHODS

To estimate the effect of radiotherapy on rectal carcinoma, the authors retrospectively reviewed the surgical specimens of 102 patients with T3‐4, N0 or ≥ N1 rectal carcinoma and 1 patient with T2 but N1 rectal carcinoma. All patients were treated preoperatively with a hyperfractionated accelerated radiotherapy schedule in a prospective protocol (Trial 93‐01). Using a standardized approach, tumor regression was graded using a system that varies from Grade 1 (tumor regression Grade [TRG] 1) when complete tumor regression is observed to Grade 5 (TRG5) when no tumor regression is observed.

RESULTS

Radiotherapy resulted in tumor downstaging in 43% of the patients. There were 2 pT1 tumors (2%), 21 pT2 tumors (20%), 66 pT3 tumors (64%), and 14 pT4 tumors (14%) after treatment. Regional lymph nodes were involved in 55 patients (53%). None of the patients demonstrated a complete tumor regression after radiotherapy, but in 79% of the specimens a partial tumor regression was observed (TRG1: 0%; TRG2: 20%; TRG3: 39%; TRG4: 20%; and TRG5: 21%). The median actuarial overall survival (OS) and disease‐free survival (DFS) were 52 months. Actuarial local recurrence rates at 2 years and 5 years were 6.4% and 7.6%, respectively. Univariate analysis showed the actuarial DFS to be significantly lower in patients with lymph node metastases (P = 0.0004) and advanced pT stages (pT3‐4) (P = 0.03). A favorable outcome for OS, DFS, and local control was observed in patients with TRG2‐4 (i.e., responders) compared with patients with TRG5 (i.e., nonresponders), but also in patients with low residual tumor cell density (TRG2, 3, and 4). On multivariate analysis, TRG remained an independent prognostic indicator for local tumor control.

CONCLUSIONS

Tumor regression as well as residual tumor cell density were found to be predictive factors of survival in rectal carcinoma patients after preoperative radiotherapy. Even after preoperative radiotherapy, the pathologic stage of the surgical specimen remained a prognostic factor. The use of a standardized approach for pathologic evaluation must be implemented to allow comparison between the results of various treatment approaches.
Clinicopathologic correlates of solitary fibrous tumors
Authors: Gold Jason S. , Antonescu Cristina R. , Hajdu Cristina , Ferrone Cristina R. , Hussain Mustafa , Lewis Jonathan J. , Brennan Murray F. , Coit Daniel G.
Published: November 2004

BACKGROUND

Solitary fibrous tumors (SFTs) are rare fibrous neoplasms. Since their initial description as arising from the pleura, SFTs have been reported at a wide range of anatomic sites. To the authors's knowledge, there are no large series reporting both thoracic and extrathoracic SFTs nor are there any large series that analyze clinicopathologic correlates of tumor behavior.

METHODS

Institutional soft tissue tumor and pathology databases were reviewed to identify patients. Pathologic material was reviewed by an experienced soft tissue pathologist and scored for the presence of a histologically malignant component. Clinical information was obtained from medical records and phone calls to patients. Statistical analysis was performed using the Student t test, Pearson chi‐square test, and log‐rank test.

RESULTS

Seventy‐nine patients with SFTs treated at a single institution over an 18‐year period were identified. These tumors arose in a wide range of anatomic sites. Thoracic and extrathoracic SFTs had similar clinical and pathologic features, although extrathoracic tumors were more likely to be symptomatic on diagnosis. Seventy‐five patients underwent surgical excision of a SFT at our institution. Overall, SFTs had a low rate of local recurrence and metastasis after surgical treatment. Extrathoracic SFTs had an increased risk of local recurrence that was small but statistically significant. There was no difference in metastasis‐free survival between thoracic and extrathoracic SFTs. Positive surgical margins and the presence of a histologically malignant component were factors predicting worse local recurrence‐free survival. Positive surgical margins, tumor size greater than 10 cm, and the presence of a malignant component predicted worse metastasis‐free survival.

CONCLUSIONS

Solitary fibrous tumors are rare tumors that occur at all anatomic sites. Most SFT patients fare well after surgical treatment. Closer surveillance is warranted for those tumors that are larger than 10 cm or with the presence of a histologically malignant component. Cancer 2002;94:1057–68. © 2002 American Cancer Society.

DOI 10.1002/cncr.10328
Outpatient cancer drug costs
Authors: Halbert R. J. , Zaher Carol , Wade Sally , Malin Jennifer , Lawless Grant D. , Dubois Robert W.
Published: November 2004

BACKGROUND

To the authors' knowledge, no analysis has examined the specific components of drug spending for overall cancer care. The authors' objective was to quantify and characterize trends in outpatient drug expenditures for cancer patients.

METHODS

The authors retrospectively analyzed pharmacy and outpatient professional claims data from commercial and Medicare health maintenance organization enrollees with a solid tumor diagnosis in 1995 and 1998. Charges were subdivided by type of drug (antineoplastic drugs, chemotherapy adjuncts, supportive drugs, and drugs unrelated to cancer treatment).

RESULTS

In 1995, 14,663 cancer patients received outpatient drug treatment and 13,829 patients in 1998. Total charges increased from $17.9 million (mean charge of $1218 per patient) to $27.9 million (mean charge of $2003 per patient), an average annual increase of 16%. Antineoplastic therapy constituted the largest component of cancer‐related drug costs (67%) and represented 76% of the increase from 1995 to 1998. Most charges were incurred in the professional setting for agents administered by injection. The primary explanation for the increases appeared to be a shift in treatment patterns toward newer, more expensive antineoplastic agents. Supportive therapy represented 17% of the increase in cancer drug costs, followed by chemotherapy adjuncts (7%). Charges for drugs unrelated to cancer therapy increased by 21% per year.

CONCLUSIONS

Antineoplastic therapy administered in an office or clinic was the single most important cost driver, with newer more expensive agents replacing older, less expensive drugs. Attempts to understand and control outpatient drug cost increases for cancer patients should focus primarily on antineoplastic therapy, especially the appropriate substitution of newer agents for older, less expensive alternatives. Some nonchemotherapy cancer drugs may offer an opportunity to improve quality of life with a relatively small effect on overall cancer drug costs. Cancer 2002;94:1142–50. © 2002 American Cancer Society.

DOI 10.1002/cncr.10347
Nonperioperative strokes in children with central nervous system tumors
Authors: Bowers Daniel C. , Mulne Arlynn F. , Reisch Joan S. , Elterman Roy D. , Munoz Louis , Booth Timothy , Shapiro Kenneth , Doxey Deborah L.
Published: November 2004

BACKGROUND

Nonperioperative strokes are rare yet potentially devastating events for children with central nervous system (CNS) tumors. The incidence of and risk factors for nonperioperative strokes in children with CNS tumors is unknown.

METHODS

The authors performed a retrospective review of children from their institution with CNS tumors. The incidence of stroke in the nonperioperative period and the influence of patient demographic factors, coexisting genetic diseases, tumor type, and treatment modality on the subsequent occurrence of a stroke were determined.

RESULTS

Eight hundred seven consecutive patients from the authors' institution with CNS tumors were observed for a combined 3224 nonperioperative years. Thirteen patients (1.6%) had a nonperioperative stroke, for an incidence of 4.03 strokes/1000 years of nonperioperative patient follow‐up. Eight patients were males, and the median age at diagnosis of a CNS tumor was 4.8 years (range, 0.3–18.6 years). The median duration from diagnosis of a CNS tumor until the occurrence of stroke was 2.3 years (range, 0.3–15.8 years). Among numerous potential risk factors individually examined by chi‐square analysis, only treatment with radiation therapy was associated with the subsequent development of a stroke (chi‐square, P = 0.007). By logistic regression analysis, treatment with radiation therapy and a diagnosis of an optic pathway glioma were the only statistically significant variables associated with a stroke.

CONCLUSIONS

Strokes are much more common among children with CNS tumors. Children treated with radiation therapy and those with optic pathway gliomas have a higher association with the occurrence of a subsequent nonperioperative stroke. Because children with optic pathway gliomas may be at particularly high risk of stroke after radiation therapy, the desired beneficial therapeutic effects of irradiation must always be weighed against its potentially adverse effects, including stroke. Cancer 2002;94:1094–101. © 2002 American Cancer Society.

DOI 10.1002/cncr.10353
Metastatic nonseminomatous germ cell tumors of the testis
Authors: Hendry William F. , Norman Andrew R. , Dearnaley David P. , Fisher Cyril , Nicholls Judy , Huddart Robert A. , Horwich Alan
Published: November 2004

BACKGROUND

A mass may persist in the para‐aortic region after patients undergo chemotherapy for metastatic, nonseminomatous germ cell tumor of the testis (NSGCT). Retroperitoneal lymphadenectomy removes the mass, which may contain residual active malignancy, and allows histologic assessment of the effectiveness of the chemotherapy. Whereas some have favored early, elective removal of such masses, others have chosen to observe them, reserving salvage surgery for patients who experience disease recurrence. A retrospective analysis was undertaken to define the outcome in these two groups of patients.

METHODS

After receiving chemotherapy for metastatic NSGCT, 442 men underwent lymphadenectomy for residual masses (measuring ≥ 1 cm in greatest dimension) between 1976 and 1999, inclusive. Three hundred thirty men underwent elective surgery within 3 months of the completion of chemotherapy, and 112 men underwent salvage surgery after receiving reinduction chemotherapy for tumor recurrence.

RESULTS

The residual mass was removed completely in 87% and 72% of patients in the elective and salvage lymphadenectomy groups, respectively; was removed with difficulty and possibly incompletely in 9% and 21% of patients, respectively; and was definitely removed incompletely in 4% and 7% of patients, respectively. The operative mortality rate was 0.9% in the elective surgery group and 1.8% in the salvage surgery group. There was malignant teratoma, undifferentiated in 8.5% of patients in the elective surgery group and in 49% of patients in the salvage surgery group (P < 0.001). Differentiated teratoma and necrosis/fibrosis were present in 66.0% and 25.4% of patients in the elective surgery group, respectively, and in 38.4% and 12.5% of patients in the salvage surgery group, respectively. The authors were unable to produce a clinically useful model to predict the presence of necrosis/fibrosis only in either group. The 5‐year recurrence free and overall survival rates were 83% and 89%, respectively, in the elective surgery group and 62% and 56%, respectively, in the salvage surgery group. For the salvage surgery group, the completeness of surgical excision and the presence of undifferentiated teratoma were of overriding importance for overall survival. A variety of other patient‐related, tumor‐related, and surgery‐related factors also were significant in the final model for the elective surgery group.

CONCLUSIONS

The current results demonstrate the low level of morbidity that can be obtained, even in the salvage surgery group, and the importance of complete surgical resection in this setting. Because it is not possible to predict with sufficient accuracy which patients will have favorable pathology (necrosis/fibrosis), the authors continue to recommend elective surgery for all suitable men with residual masses after they receive first‐line chemotherapy. Cancer 2002;94:1668–76. © 2002 American Cancer Society.

DOI 10.1002/cncr.10440
Racial differences in knowledge, attitudes, and cancer screening practices among a triracial rural population
Authors: Paskett Electra D. , Tatum Cathy , Rushing Julia , Michielutte Robert , Bell Ronny , Foley Kristie Long , Bittoni Marisa , Dickinson Stephanie
Published: November 2004

BACKGROUND

Low‐income, minority, and rural women face a greater burden with regard to cancer‐related morbidity and mortality and are usually underrepresented in cancer control research. The Robeson County Outreach, Screening and Education Project sought to increase mammography use among low‐income, minority, and rural women age > 40 years. The current article reports on racial disparities and barriers to screening, especially those related to knowledge, attitudes, and behaviors.

METHODS

A baseline survey was administered to 897 women age > 40 years who lived in rural Robeson County in North Carolina. The sample consisted of three principal racial groups: whites, African Americans, and Native Americans. Survey comparisons were made among racial groups with respect to knowledge, attitudes, and behaviors regarding breast and cervical carcinoma screening.

RESULTS

Overall, Native American and African‐American women had lower levels of knowledge, more inaccurate beliefs, and more barriers to screening compared with white women. Among the notable findings were that 43% of the patient population did not mention mammograms and 53% did not mention Pap smears as breast and cervical carcinoma screening tests, respectively; furthermore, compared with white women, significantly fewer African‐American and Native American women mentioned these tests (P < 0.001). Sixty‐seven percent of all women reported that a physician had never encouraged them to receive a mammogram, although 75% reported having received a regular checkup in the preceding year.

CONCLUSIONS

Although all low‐income rural women experienced significant barriers to receiving cancer screening tests, these barriers were more common for minority women compared with white women. More research is needed to identify ways to overcome such barriers, especially among Native American women. The results of the current study have important implications with respect to the designing of interventions aimed at improving cancer screening for all women. Cancer 2004. © 2004 American Cancer Society.
The equivalence and difference between the English and Chinese versions of two major, cancer‐specific, health‐related quality‐of‐life questionnaires
Authors: Cheung Yin‐Bun , Thumboo Julian , Goh Cynthia , Khoo Kei‐Siong , Che William , Wee Joseph
Published: November 2004

BACKGROUND

English and Chinese are two of the most widely used primary languages in the world. Patients in many cancer centers have a variety of ethnic backgrounds and primary languages. The comparability of version 4 of the English and Chinese versions of the Functional Assessment of Cancer Therapy‐General (FACT‐G) and version 3 of the European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ‐C30) have not been established.

METHODS

In total, 1136 ethnic Chinese patients with cancer were recruited from the National Cancer Centre of Singapore. Patients chose to answer an English or Chinese questionnaire, according to their own preference. Multiple regression analysis was used to adjust for differences in demographic and health characteristics. Equivalence was confirmed if the 90% confidence intervals of the adjusted mean difference fell completely within an equivalence zone of ± 0.25 standard deviations (SD).

RESULTS

The English and Chinese versions of the Total, Emotional, and Functional Well Being Scales of the FACT‐G and the Physical and Emotional Functioning Scales of the EORTC QLQ‐C30 were equivalent. Scores for the other scales on the two questionnaires, at most, had a small differences that did not exceed 0.5 SD. Nevertheless, the Chinese translation of the question “I have a lack of energy” in the Physical Well Being Scale of the FACT‐G produced results that differed from the results produced by the original English version.

CONCLUSIONS

Data collected from English‐speaking and Chinese‐speaking respondents were capable of being pooled, and either version could be used for bilingual respondents. Nevertheless, the authors recommend modification of the Physical Well Being question that produced different results (“I have a lack of energy”). Cancer 2004. © 2004 American Cancer Society.
Therapeutic potential of antisense Bcl‐2 as a chemosensitizer for cancer therapy
Authors: Kim Ryungsa , Emi Manabu , Tanabe Kazuaki , Toge Tetsuya
Published: November 2004

Bcl‐2 protein plays a critical role in inhibiting anticancer drug‐induced apoptosis, which is mediated by a mitochondria‐dependent pathway that controls the release of cytochrome c from mitochondria through anion channels. Constitutive overexpression of Bcl‐2 or unchanged expression after treatment with anticancer drugs confers drug resistance not only to hematologic malignancies but also to solid tumors. The down‐regulation of Bcl‐2 protein by the antisense (AS) Bcl‐2 (oblimesen sodium) may be a useful method for targeting the antiapoptotic protein and thereby increasing the chemotherapeutic effect of anticancer drugs. Several randomized, controlled, Phase III trials have compared standard chemotherapy with a combination of AS Bcl‐2 and standard chemotherapy for the treatment of patients with chronic lymphocytic leukemia, multiple myeloma, malignant melanoma, and nonsmall cell lung carcinoma. Nonrandomized clinical trials and preclinical evaluations of AS Bcl‐2 also are underway for patients with other malignancies. Here, the authors review the current clinical and preclinical evaluations of AS Bcl‐2 and discuss its potential to act as a chemosensitizer and to enhance the therapeutic effect of cancer chemotherapy. Cancer 2004. © 2004 American Cancer Society.
Understanding of an aggregate probability statement by patients who are offered participation in Phase I clinical trials
Authors: Weinfurt Kevin P. , DePuy Venita , Castel Liana D. , Sulmasy Daniel P. , Schulman Kevin A. , Meropol Neal J.
Published: November 2004

BACKGROUND

There is concern that patients with poor numeracy may have difficulty understanding the information necessary to make informed treatment decisions. The authors sought to characterize a special form of numeracy among patients with advanced cancer who were offered participation in Phase I oncology clinical trials.

METHODS

Surveys were administered to 328 cancer patients who were considering Phase I trials. Their frequency‐type numeracy was assessed using a multiple‐choice question involving a hypothetical scenario in which a physician stated that an experimental treatment would control cancer in “40% of cases like yours.” In univariate and multivariable analyses, patient characteristics that were associated with better numeracy were identified.

RESULTS

The correct frequency‐type interpretation was selected by 72% of respondents. Fourteen percent of respondents incorrectly selected a belief‐type answer, “The doctor is 40% confident that the treatment will control my cancer.” In a multivariable model, patients who answered incorrectly tended to have less formal education and less experience with experimental therapies.

CONCLUSIONS

Because the misunderstandings some patients demonstrated may influence their treatment decision making adversely, it is critical to identify such patients and to give them special consideration when communicating information about potential risks and benefits of treatment. Cancer 2004. © 2004 American Cancer Society.
Middleware for real‐time distributed simulations
Authors: McLean Thom , Fujimoto Richard , Fitzgibbons Brad
Published: November 2004

Distributed simulation applications often rely on middleware to provide services to support their execution over distributed computing environments. Such middleware spans many levels, ranging from low‐level support for data transmission through object request brokers to higher level, simulation specific functionality such as time management. We discuss design alternatives for realizing such middleware for hard real‐time distributed simulations such as hardware‐in‐the‐loop applications. We present the results from tests of a prototype implementation of real‐time Run‐Time Infrastructure middleware. Its performance is compared with a non‐real‐time implementation. The context for this work is the High Level Architecture standard that has been defined by the U.S. Department of Defense. Copyright © 2004 John Wiley & Sons, Ltd.
On the dimorphy between the variscite and clinovariscite group: refined finestructural relationship of strengite and clinostrengite, Fe(PO4) . 2H2O
Authors: Taxer K. , Bartl H.
Published: November 2004

The isodimorphy of the ortho‐ and clino‐minerals in the variscite group has been suggested by Strunz & von Sztrókay [6], but, so far the common stereo‐chemical patterns within the monoclinic and orthorhombic modifications had not been recognized. Structure refinements of the hydrated phosphate minerals strengite and clinostrengite, which are re‐ presentative members of the variscite and clinovariscite group (Strunz [7]), are presented, and by appropiate axis transformations their structural relationship is illustrated. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Effect of Probe Surface Ablation on Laser Photodetachment Signals
Authors: Kajita S. , Kado S. , Shikama T. , Xiao B. , Tanaka S.
Published: November 2004

An electric probe exposed to laser irradiation during negative ion density measurement by applying the laser photodetachment technique may suffer ablation even though the laser power is not significantly high. In this paper, the ablation effects on laser photodetachment signals were examined in a linear plasma device using plasmas of both helium and a mixture of helium and hydrogen. It was found that there was a specific threshold laser power necessary to cause the ablation, and that it depended on the electron density. The ablation signals were also detected using a negatively biased probe. A method for monitoring the ablation phenomena is then presented. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Plasma Flow Measurements in Linear Divertor Simulator MAP‐II Using Mach Probe and Directional Langmuir Probe
Authors: Kado S. , Shikama T. , Kajita S. , Oishi T. , Tanaka S.
Published: November 2004

The plasma flow in a steady‐state fusion divertor/edge plasma simulatorMAP‐II is measured using both aMach Probe and a Directional Langmuir Probe. Errors caused by the non‐thermal high‐energy electrons in estimating the flow velocity were demonstrated. The difference of the local flow velocities measured by these probes is observed. In order to verify these values, the Doppler shift of the ion line emission along the line‐of sight was measured in order to evaluate the absolute value of the flow velocity. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Interpretive yields of screening Pap tests and diagnostic Pap tests
Authors: Stelow Edward B. , Gulbahce H. Evin , Kjeldahl Klint , Oprea Gabriela M. , Savik Kay , Pambuccian Stefan. E.
Published: November 2004

Recently, our laboratory has introduced the Medicare classification “diagnostic Papanicolaou (Pap) test” (DPT) for both conventional and liquid‐based Pap tests. Because little is known regarding the diagnostic yield of DPT, we review our experience with these tests in a community with a low incidence of squamous intraepithelial lesions and contrast this with our experience with screening Pap tests (SPTs). A search of our laboratory's computerized data system identified all Pap tests classified as SPT and DPT from December 3, 2002 to December 2, 2003. The interpretations were tabulated and statistical comparisons were made. Between December 3, 2002 and December 2, 2003 63,626 Pap tests were interpreted (57,922 SPTs and 5704 DPTs). DPTs were far more likely to yield abnormal results (atypical squamous cells or worse, P < 0.001) and were especially more likely to yield malignant results. These differences have numerous possible implications regarding screening, rescreening, and the design of studies that investigate the screening value of the Pap test. Diagn. Cytopathol. 2004;31:427–429. © 2004 Wiley‐Liss, Inc.
Developmental changes in baseline cortisol activity in early childhood: Relations with napping and effortful control
Authors: Watamura Sarah E. , Donzella Bonny , Kertes Darlene A. , Gunnar Megan R.
Published: November 2004

Development of the hypothalamic–pituitary–adrenocortical (HPA) axis was examined using salivary cortisol levels assessed at wake‐up, midmorning, midafternoon, and bedtime in 77 children aged 12, 18, 24, 30, and 36 months, in a cross‐sectional design. Hierarchical linear modeling (HLM) analyses were used to characterize cortisol production across the day and to examine age‐related differences. Using area(s) under the curve (AUC), cortisol levels were higher among the 12‐, 18‐, and 24‐month children than among the 30‐ and 36‐month children. For all five age groups, cortisol levels were highest at wake‐up and lowest at bedtime. Significant decreases were noted between wake‐up and midmorning, and between midafternoon and bedtime. Unlike adults, midafternoon cortisol levels were not significantly lower than midmorning levels. Over this age period, children napped less and scored increasingly higher on parent reports of effortful control. Among the 30‐ and 36‐month children, shorter naps were associated with more adultlike decreases in cortisol levels from midmorning to midafternoon. Considering all of the age groups together, effortful control correlated negatively with cortisol levels after controlling for age. These results suggest that circadian regulation of the HPA axis continues to mature into the third year in humans, and that its maturation corresponds to aspects of behavioral development. © 2004 Wiley Periodicals, Inc. Dev Psychobiol 45: 125‐133, 2004.
Molecular characterization of conditionally immortalized cell lines derived from mouse early embryonic inner ear
Authors: Germiller John A. , Smiley Elizabeth C. , Ellis Amanda D. , Hoff Jessica S. , Deshmukh Ian , Allen Susan J. , Barald Kate F.
Published: November 2004

Inner ear sensory hair cells (HCs), supporting cells (SCs), and sensory neurons (SNs) are hypothesized to develop from common progenitors in the early embryonic otocyst. Because little is known about the molecular signals that control this lineage specification, we derived a model system of early otic development: conditionally immortalized otocyst (IMO) cell lines from the embryonic day 9.5 Immortomouse. This age is the earliest stage at which the otocyst can easily be separated from surrounding mesenchymal, nervous system, and epithelial cells. At 9.5 days post coitum, there are still pluripotent cells in the otocyst, allowing for the eventual identification of both SN and HC precursors—and possibly an elusive inner ear stem cell. Cell lines derived from primitive precursor cells can also be used as blank canvases for transfections of genes that can affect lineage decisions as the cells differentiate. It is important, therefore, to characterize the “baseline state” of these cell lines in as much detail as possible. We characterized seven representative “precursor‐like” IMO cell populations and the uncloned IMO cells, before cell sorting, at the molecular level by polymerase chain reaction (PCR) and immunocytochemistry (IHC), and one line (IMO‐2B1) in detail by real‐time quantitative PCR and IHC. Many of the phenotypic markers characteristic of differentiated HCs or SCs were detected in IMO‐2B1 proliferating cells, as well as during differentiation for up to 30 days in culture. These IMO cell lines represent a unique model system for studying early stages of inner ear development and determining the consequences of affecting key molecular events in their differentiation. Developmental Dynamics 231:815–827, 2004. © 2004 Wiley‐Liss, Inc.
Targeted insertion of the Cre‐recombinase gene at the phenylethanolamine n‐methyltransferase locus: A new model for studying the developmental distribution of adrenergic cells
Authors: Ebert Steven N. , Rong Qi , Boe Steven , Thompson Robert P. , Grinberg Alexander , Pfeifer Karl
Published: November 2004

To evaluate the developmental distribution of adrenergic cells in vivo, we inserted the Cre‐recombinase gene into the locus encoding for the epinephrine biosynthetic enzyme phenylethanolamine n‐methyltransferase (Pnmt) and crossed these Pnmt‐Cre mice with ROSA26 reporter (R26R) mice to activate LacZ (encoding β‐galactosidase) expression in cells that were selectively derived from the adrenergic lineage. Our data show the following: (1) Insertion of Cre‐recombinase into the Pnmt locus created a functional knockout of Pnmt expression with concomitant loss of epinephrine in homozygous PnmtCre/Cre mice; (2) Despite the reduction in Pnmt expression and epinephrine production in PnmtCre/Cre mice, these mice were viable and fertile, with no apparent developmental defects; (3) When crossed with R26R mice, Pnmt‐Cre activation of LacZ expression faithfully recapitulated Pnmt expression in vivo; and (4) LacZ expression was activated in substantial numbers of pacemaking, conduction, and working cardiomyocytes. Developmental Dynamics 231:849–858, 2004. © 2004 Wiley‐Liss, Inc.
Pigment pattern formation in zebrafish during late larval stages: A model based on local interactions
Authors: Moreira Joana , Deutsch Andreas
Published: November 2004

We present a model to explain pigment cell pattern formation in the late larval stages of zebrafish, Danio rerio, and its mutants, based on new time sequence experimental data. The model stresses the importance of differential intercellular adhesion and the mechanisms of stem cell regulation to explain pigment pattern formation in zebrafish. All interactions included in the model are local in contrast to the previous models for pattern formation, which are based on long range interactions. The hypotheses of the model are tested through a mathematical (cellular automaton) model. Simulations show that differential cellular adhesion together with an appropriate mechanism of stem cell regulation are able to reproduce the main characteristics of pattern formation in the wild‐type zebrafish and mutants. The results obtained with the simulations are compared with experimental data and specific experimental tests to the predictions of the model are provided. Developmental Dynamics 232:33–42, 2005. © 2004 Wiley‐Liss, Inc.