bluuebunny/crossref_metadata_2025 huggingface dataset:
Domestic violence and child abuse: developing sensitive policies and guidance
Authors: Humphreys Catherine , Mullender Audrey , Lowe Pam , Hague Gill , Abrahams Hilary , Hester Marianne
Published: August 2002

Domestic violence is everywhere and nowhere. No statutory organization or health service has work with either perpetrators or survivors of domestic violence (usually women and children) as the primary focus of their service, yet all agencies will have very significant numbers among their clients/service users. It is therefore crucial that the policy framework is developed both within and between agencies to address the need, and scope, of intervention in this area and particularly the impact on children. Currently, significant steps have been taken by some agencies in the UK to address this previously neglected issue, though the developments are patchy. This paper draws on a UK‐wide research study which mapped the extent and range of service provision for families where there is domestic violence and also developed a framework of good practice indicators for provision in this area. This article examines one of the indicators of good practice arising from the research—that of policy development—within social service departments and within the multi‐agency arena. Copyright © 2001 John Wiley & Sons, Ltd.
Effects of mandatory notification training on the tendency to report hypothetical cases of child abuse and neglect
Authors: Hawkins Russell , McCallum Christy
Published: August 2002

The objective of this study was to examine the effect of mandated notification training upon the tendency of individuals to report hypothetical cases of abuse and neglect. A second objective was to investigate the factors that influence the decision to report and to determine whether mandated notification training had an effect on these factors. Comparisons were drawn between a no training and a recent training group (with random allocation). An additional group of participants who had received training some time ago was included. Five hypothetical vignettes were responded to by 41 teachers and school personnel who had recently completed training, 31 people who had not completed training and 73 people who had completed training some years previously. Where the quality of evidence of abuse and thus suspicion of abuse was relatively high, there were no differences in the likelihood of reporting between trained and untrained participants, all of whom were very likely to report. Ambiguous evidence of abuse had a strong negative influence on reporting likelihood, although mandatory reporting training reduced this inhibition. Copyright © 2001 John Wiley & Sons, Ltd.
Supporting families with a mentally ill parent: European perspectives on interagency cooperation
Authors: Hetherington Rachael , Baistow Karen
Published: August 2002

This paper reports on the findings of a cross‐country comparison of cooperation between services for community mental health and child protection in 11 states. The authors consider the implications of the findings for English practice. When children have a parent with mental health problems, they have needs over and above those of other children. Often these needs are met by the family, but this is not always possible. There are increasing numbers of these children, and they feature disproportionately in the case loads of child welfare professionals, health visitors and social workers. The cross‐country comparisons demonstrate the ways in which differences in structures, resources, expectations and attitudes affect professional responses and the experiences of families. The findings provide information on several levels. A comparison of commonalities and differences highlights the problems that are shared across countries, and alternative ways of responding to them at ground level are discussed. The factors that facilitate a good outcome are analysed in relation to English practice and service structures. The research findings are relevant for British social welfare strategies, and the paper highlights the implications of the findings for policy and practice. Copyright © 2001 John Wiley & Sons, Ltd.
The child abuse victim as a hostage: Scorpion's story
Authors: Mudaly Neerosh , Goddard Chris
Published: August 2002

This case study is drawn from research in progress that seeks the views and perceptions of children and young people who have been abused about their experiences of victimization and subsequent interventions. The subject of the article is an adolescent boy who experienced extreme abuse by his mother's partner. The mother also suffered severe violence in the relationship, which the boy witnessed. The impact of the abuse has left this boy deeply disturbed and this has been confirmed in psychiatric assessments. The article is based on a research interview and presents this young person's descriptions of his experiences of abuse and his attempts to survive. The paper draws out the parallels between this boy's experiences as an abuse victim and those in a hostage situation. Copyright © 2001 John Wiley & Sons, Ltd.
The role of power and control in children's lives: an ecological analysis of pathways toward wellness, resilience and problems
Authors: Prilleltensky Isaac , Nelson Geoffrey , Peirson Leslea
Published: August 2002

The literature on powerlessness, empowerment and control tends to be adult‐centric and psycho‐centric. It is adult‐centric in that most studies deal with the experience of powerlessness in adults or interpret children's realities from an adult point of view. At the same time, the literature is quite psycho‐centric in that it focuses on the emotional and cognitive dimensions of powerlessness, to the relative neglect of social and political power. The purpose of this article is to redress these biases and elucidate the role of power and control in pathways toward health, resilience and problems in children's lives. We define wellness as a satisfactory state of affairs, brought about by the acquisition and development of material and psychological resources, participation and self‐determination, competence and self‐efficacy. Power and control are defined as opportunities afforded by social, community, and family environments to develop these three dimensions of health and wellness. We highlight basic research which describes pathways toward wellness, resilience, and problems in life, as well as applied research on promising interventions to improve children's health and wellness. This literature is interpreted in terms of our conceptual framework that links power/control and wellness through the three dimensions that we have proposed. Copyright © 2001 John Wiley & Sons, Ltd.
Self‐evaluation and social comparison amongst adolescents with learning difficulties
Authors: Crabtree Jason , Rutland Adam
Published: August 2002

Two studies are presented which examine self‐evaluation in adolescents with learning difficulties and how these adolescents strategically protect their self‐concept through the use of social comparison. Study one involved 145 adolescents with learning difficulties and the same number of non‐disabled adolescents aged between 11 to 16 years. All adolescents completed Harter's ‘Self Perception Profile for Children’ (SPPC). No significant overall differences were found between the self‐evaluations of the adolescents with learning difficulties and non‐disabled adolescents. In addition, adolescents with learning difficulties strategically devalued less favourable comparison dimensions and valued more positive comparison attributes. Study two utilized a four condition between‐groups design with a sample of 68 adolescents with learning difficulties. All participants completed the SPPC, but the availability of a social comparison group was systematically varied between conditions. The self‐evaluations made by adolescents changed significantly when the social comparison group made available was altered. The findings are discussed with regard to their theoretical implications and in terms of inclusion policies for adolescents with learning difficulties. Copyright © 2001 John Wiley & Sons, Ltd.
Monoamine oxidase A and B activities in embryonic chick hepatocytes: differential regulation by retinoic acid
Authors: Nicotra Antonietta , Falasca Laura , Senatori Ornella , Conti Devirgiliis Laura
Published: August 2002

Monoamine oxidases (MAOs) A and B are two isoenzymes involved in the degradation of many biological amines in the nervous system and in peripheral organs. In the present work hepatocytes isolated from 14‐day‐old chick embryos were used as a model system to determine whether retinoic acid (RA) is capable of modulating the activity of the two MAO forms. RA is a retinoid that, by binding with nuclear receptors, interferes with the expression of specific genes in many differentiation processes. Enzymic activity was measured with a radiochemical method using serotonin and β‐phenylethylamine as preferential substrates for MAO A and MAO B, respectively. The specific activity of the two forms was measured in hepatocytes cultured for 24, 48 and 72 h in the presence and the absence of serum. RA stimulated MAO B but not MAO A activity, in a dose‐ and time‐dependent way, and only in the presence of serum. Maximum stimulation (about 3.5‐fold) was obtained after treatment with 5 μM RA for 72 h. Kinetic analysis of MAO B activity showed an increase in Vmax in treated hepatocytes (5 μM RA for 72 h) with no change in Km. In conclusion, the present work shows that RA selectively elicits MAO B activity in cultured chick embryonic hepatocytes, this stimulation requires the presence of some factors present in the serum and is probably due to an increase in the number of enzyme molecules. Copyright © 2001 John Wiley & Sons, Ltd.
Effects of thymoquinone on antioxidant enzyme activities, lipid peroxidation and DT‐diaphorase in different tissues of mice: a possible mechanism of action
Authors: Mansour Mahmoud A. , Nagi Mahmoud N. , El‐Khatib Aiman S. , Al‐Bekairi Abdullah M.
Published: August 2002

The present investigation focused, firstly, on the effects of oral administration of thymoquinone (TQ) on antioxidant enzyme activities, lipid peroxidation and DT‐diaphorase activity in hepatic, cardiac and kidney tissues of normal mice. Superoxide dismutase (SOD; E.C:1.15.1.1), catalase (CAT; E.C:1.11.1.6), glutathione peroxidase (GSH‐Px; E.C:1.11.1.9), glutathione‐S‐transferase (GST; E.C:2.5.1.18), and DT‐diaphorase (E.C:1.6.99.2) enzyme activities in each tissue type were determined. Treatment of mice with the different doses of TQ (25, 50 and 100 mg kg−1 day−1 orally) for 5 successive days, produced significant reductions in hepatic SOD, CAT and GSH‐Px activities. In addition cardiac SOD activity was markedly inhibited with the higher doses of TQ, (namely 50 and 100 mg kg−1). Moreover, TQ (100 mg kg−1) significantly reduced hepatic and cardiac lipid peroxidation as compared with the respective control group. Conversely, TQ (50,100 mg kg−1) and TQ (100 mg kg−1) enhanced cardiac and renal DT‐diaphorase activity respectively. However, the selected doses of TQ neither produced any change in GST activity nor influenced reduced glutathione content in all tissues studied. TQ was tested, secondly, as a substrate for hepatic, cardiac and renal DT‐diaphorase of normal mice in the presence of NADPH. Kinetic parameters for the reduction of TQ to dihydrothymoquinone (DHTQ) indicated that DT‐diaphorase of different tissues can efficiently reduce TQ to DHTQ. Km and Vmax values revealed that hepatic DT‐diaphorase exhibited the higher values, while the lower values were associated with renal DT‐diaphorase. TQ and DHTQ were tested, thirdly, as specific scavengers for superoxide anion (generated biochemically) or as general scavengers for free radicals (generated photochemically). The results revealed that TQ and DHTQ acted not only as superoxide anion scavengers but also as general free radical scavengers. The IC50 for TQ and DHTQ in biochemical and photochemical assays were in the nanomolar and micromolar range respectively. Our data may explain at least partly the reported beneficial in vivo protective effects of TQ through the combined antioxidant properties of TQ and its metabolite DHTQ. Copyright © 2002 John Wiley & Sons, Ltd.
Successful percutaneous coronary intervention with stent implantation in anomalous right coronary arteries arising from the left sinus of valsalva: A report of two cases
Authors: Cohen Mauricio G. , Tolleson Thaddeus R. , Peter Robert H. , Harrison J. Kevin , Sketch Michael H.
Published: August 2002

Percutaneous coronary intervention (PCI) in an anomalous right coronary artery arising from the left sinus of valsalva can be technically challenging because of difficulty in selectively cannulating the vessel. We present two cases of successful stent implantation in an anomalous right coronary artery arising from the left sinus of valsalva. In both cases, we used an oversized 6 Fr Judkins left guiding catheter, which provided excellent angiographic visualization and guide support for stent delivery. Cathet Cardiovasc Intervent 2002;55:105–108. © 2002 Wiley‐Liss, Inc.
Carotid and cerebral angiography performed by cardiologists: Cerebrovascular complications
Authors: Fayed Akram M. , White Christopher J. , Ramee Stephen R. , Jenkins J. Stephen , Collins Tyrone J.
Published: August 2002

The management of extracranial carotid artery disease is primarily concerned with the prevention of acute stroke. In order to understand the current risks of carotid angiography performed by interventional cardiologists, we undertook a retrospective study to determine the neurologic complications in patients who underwent selective cerebral angiography. All patients undergoing studies that were limited to diagnostic aortic arch angiography and selective four‐vessel cerebral angiography in the cardiac catheterization laboratories during the past 6 years were included in this study. Hospital records were reviewed to determine any in‐hospital cerebrovascular complications following carotid angiography, ranging from transient ischemic attack to major disabling stroke or death. A total of 189 consecutive patients underwent 191 diagnostic studies limited to aortic arch and four‐vessel cerebral angiography in the cardiac catheterization laboratories between 1 January 1995 and 31 December 2000. Only one (0.52%) neurological complication, a minor stroke, occurred in our study population. There were no transient ischemic attacks, major strokes, or death. We have shown that experienced interventional cardiologists can perform diagnostic aortic arch and selective carotid and vertebral angiography in a cardiac catheterization laboratory with a very low complication rate. Because the risks of angiography add to those of revascularization of the carotid artery, the most highly skilled angiographer, regardless of primary specialty, should perform these studies. Cathet Cardiovasc Intervent 2002;55:277–280. © 2002 Wiley‐Liss, Inc.
Mini‐invasive strategy in acute coronary syndromes: Direct coronary stenting using 5 Fr guiding catheters and transradial approach
Authors: Hamon Martial , Sabatier Rémi , Zhao Quanming , Niculescu Rodica , Valette Benoît , Grollier Gilles
Published: August 2002

The purpose of this study was to assess the feasibility and safety of direct coronary stenting in acute coronary syndromes using 5 Fr guiding catheters by transradial approach. A series of 119 patients with an acute coronary syndrome (unstable angina, n = 55; acute myocardial infarction, n = 45; recent acute myocardial infarction, n = 19) explored by transradial approach and eligible for direct stenting were included. A large proportion of patients (52%) was treated during the procedure by platelet IIb/IIIa receptor blockade. Only Medtronic 5 Fr guiding catheters were used in this study. Direct coronary stenting was attempted in all 119 highly selected patients. Failure of direct stenting was observed in only five cases (3.9%) and the stent successfully retrieved in each case in the 5 Fr guiding catheter. In these five cases, balloon predilation was performed and then the stent implanted successfully. Different stents were used: ACS stent (54%), AVE stent (33%), Velocity stent (10%), Nir stent (3%), with diameter ranging from 2.5 to 4 mm. In four cases, the dilation was finally performed using 6 Fr guiding catheters because the backup of the 5 Fr catheter was considered to be too low (3%). No vascular access site complications occurred in this series of patients. We conclude that direct coronary stenting using transradial approach and 5 Fr guiding catheters yields excellent procedural success rate. In the setting of acute coronary syndromes requiring platelet IIb/IIIa receptor blockade or after failure of thrombolysis, this mini‐invasive strategy is very attractive because of the low risk of access site complications. Cathet Cardiovasc Intervent 2002;55:340–343. © 2002 Wiley‐Liss, Inc.
Lepirudin as a safe alternative for effective anticoagulation in patients with known heparin‐induced thrombocytopenia undergoing percutaneous coronary intervention: Case reports
Authors: Manfredi Joseph A. , Wall Rivers P. , Sane David C. , Braden Gregory A.
Published: August 2002

Heparin‐induced thrombocytopenia (HIT) is a well‐documented complication of heparin anticoagulation therapy. Heparin's frequent use in the cardiovascular population poses a significant challenge for managing patients with HIT in need of percutaneous coronary intervention (PCI). We describe four patients with HIT who successfully underwent PCI without thrombotic or hemorrhagic complications while on lepirudin. Cathet Cardiovasc Intervent 2001;52:468–472. © 2001 Wiley‐Liss, Inc.
Early clinical experience with the 6 French Angio‐Seal™ device: Immediate closure of femoral puncture sites after diagnostic and interventional coronary procedures
Authors: Eggebrecht Holger , Haude Michael , von Birgelen Clemens , Woertgen Uta , Schmermund Axel , Baumgart Dietrich , Kaiser Christoph , Naber Christoph K. , Kroeger Knut , Erbel Raimund
Published: August 2002

The objective of this study was to assess the early safety and efficacy of the novel 6 Fr Angio‐Seal device for routine clinical use after diagnostic cardiac catheterization and coronary angioplasty. In a prospective study, we used the 6 Fr Angio‐Seal™ device in 180 consecutive patients (131 male, 49 female, mean age 60.7 years) for closure of femoral arterial puncture sites immediately after diagnostic (n = 108) or interventional (n = 72) coronary procedures independent of the coagulation status. All patients were monitored for 24 hr after the procedure and followed for 30 days. The closure device was successfully deployed in 95.4% after diagnostic catheterization versus 98.6% after coronary angioplasty (P = 0.963). Immediate hemostasis was achieved in 91.5% versus 90.1% of the patients (P = 0.993). Major complications were observed 1.9% versus 2.8% of the patients (P = 0.885). During 30‐day follow‐up, no late events or complications were reported. The 6 Fr Angio‐Seal™ device is a safe and effective device that allows for immediate closure of femoral puncture sites after both diagnostic and interventional procedures with a low rate of major complications. Cathet Cardiovasc Intervent 2001;53:437–442. © 2001 Wiley‐Liss, Inc.
Direct coronary stenting: Effect on coronary blood flow, immediate and late clinical results
Authors: Capozzolo Claudia , Piscione Federico , De Luca Giuseppe , Cioppa Angelo , Mazzarotto Pietro , Leosco Dario , Golino Paolo , Indolfi Ciro , Chiariello Massimo
Published: August 2002

Direct stenting (DS) was attempted in 99 coronary lesions in 94 patients while standard stenting (SS) was attempted in 113 lesions in 103 patients matched for clinical characteristics, stenosis type, and location and stent type. The angiographic result was also evaluated according to TIMI frame count method (TFC) before and after procedure. A clinical follow‐up was performed 1 year after the procedure. Before the procedure, TIMI grade 3 flow was detected in 42 cases (42.4%), grade 2 in 40 cases (40.4%), grade 1 in 5 cases (5.1%), and grade 0 in 12 cases (12.1%) in the DS group; these data were similar in SS group. After the procedure, TIMI grade flow was 3 in 90 cases (92.8%) in DS group and in 87 (77.0%) in SS group (P < 0.005); grade 2 was observed in 7 case (7.2%) in DS group and in 25 (22.1%) in SS group (P < 0.005). Major adverse cardiac events during hospitalization and at follow‐up were similar in two groups. Radiation exposure time and procedure costs per lesion were significantly reduced in DS group compared to SS group (10.1 ± 8 min vs. 13.9 ± 4.7 min, P < 0.001; and 1901 ± 687 Euro vs. 2352 ± 743 Euro, P < 0.001, respectively). This study confirms that, in selected patients, direct stenting is a safe and successful procedure, allowing a significant reduction in radiation exposure time and procedural costs compared to standard stenting technique. The angiographic success is confirmed by the improvement in TFC in all cases. Cathet Cardiovasc Intervent 2001;53:464–473. © 2001 Wiley‐Liss, Inc.
Complete or incomplete percutaneous coronary revascularization in patients with unstable angina in stent era: Are early and one‐year results different?
Authors: Mariani Giuseppe , De Servi Stefano , Dellavalle Antonio , Repetto Sergio , Chierchia Sergio , D'Urbano Maurizio , Repetto Alessandra , Klersy Catherine
Published: August 2002

The aim of our study was to evaluate the impact of a strategy of incomplete revascularization by PTCA, with or without stent implantation, on clinical outcome of 208 consecutive patients (171 men) with unstable angina and multivessel coronary artery disease. Mean age of the group was 63.8 ± 10.3 years (range, 31–91). Complete and incomplete revascularization was achieved in 49 and 159 patients, respectively. A total of 226 stents were implanted in 172 patients (1.31 ± 0.65 stent per patient), equally distributed between the two groups. Left ventricular ejection fraction < 40% and total chronic coronary occlusions were significantly more frequent in patients with incomplete revascularization than in those with complete (P = 0.014 and 0.001, respectively). In‐hospital MACE occurred in 10% and 7.5% of patients with complete and incomplete revascularization, respectively (P = NS). By multivariate analysis, multiple stent implantation (OR, 5.44; 95% CI, 1.21–24.3), presence of thrombus in the treated lesion (OR, 6.3; 95% CI, 1.53–25.9), Braunwald class III (OR, 4.74; 95% CI, 1.08–20.8), and ad hoc PTCA (OR 4.51; 95% CI, 1.11–18.3) were significantly related to in‐hospital outcome. At 1‐year follow‐up, 11.3% and 11.5% of patients with complete and incomplete revascularization, respectively, had MACE. In all patients, diabetes (OR, 3.40; 95% CI, 1.09–10.58) and presence of thrombus in the treated lesion (OR, 3.48; 95% CI, 1.12–10.84) were significant predictors of 1‐year outcome by multivariate analysis. These results indicate that the strategy of incomplete revascularization in unstable angina patients with multivessel coronary disease does not expose them to a higher risk of death or other major ischemic events in comparison to those undergoing complete revascularization. Cathet Cardiovasc Intervent 2001;54:448–453. © 2001 Wiley‐Liss, Inc.
Biotransformation of flobufen enantiomers in ruminant hepatocytes and subcellular fractions
Authors: Skálová Lenka , Szotáková Barbora , Lamka Jiří , Král Radim , Vaňková Ilona , Baliharová Vendula , Wsól Vladimír
Published: August 2002

Flobufen (F), a new antiinflammatory drug, has one chiral and one prochiral center in its structure. Reduction of rac‐F, the principal biotransformation pathway, leads to the formation of four diastereoisomers of 4‐dihydroflobufen (DHF). F was chosen as a model substrate for interspecies comparison of activity, stereospecificity, and stereoselectivity of biotransformation enzymes in fallow bucks, red deer stags, and roe bucks in vitro. Formation of F metabolites was examined in hepatocyte suspension and in subcellular fractions of liver homogenate. (+)‐R‐F, (−)‐S‐F and rac‐F were used as substrates. After incubation of substrates, the amounts and ratios of DHF diastereoisomers and F enantiomers were assessed by HPLC, with (R,R)‐ULMO and terguride‐bonded columns. Considerable interspecies differences in stereoselectivity and stereospecificity of F reductases were found at the cellular and subcellular levels, although these ruminants are closely related. Chiral inversion of F enantiomers to their antipodes was detected in vitro in all ruminants tested, but individual species also differed in the direction and rate of this inversion. Chirality 13:760–764, 2001. © 2001 Wiley‐Liss, Inc.
Diene chirality and cotton effects of nonhomoannular cisoid conjugated dienes: Circular dichroism and crystal structure of a steroidal 19‐nor‐1(10),9(11)‐diene derived from westphalen's diol diacetate
Authors: Burgstahler Albert W. , Jahansouz Hossain , Véliz Eduardo A. , Takasugawa Fusao
Published: August 2002

Nonhomoannular cisoid conjugated dienes exhibit negative lowest‐energy π→π* Cotton effects when they have P diene chirality and positive CEs when they have M diene chirality. We investigated this relationship further with a variety of such dienes by MM2 conformational energy‐minimization calculations and by an X‐ray crystal structure of a steroidal 19‐nor‐1(10),9(11)‐diene. CEs are stronger when each double bond of the diene is endocyclic in a different ring and weaker when only one of the double bonds is endocyclic or when neither double bond is endocyclic. They are also stronger when axial allylic and homoallylic substituents with CH/π interactions are present that exert consignate chirality contributions. Chirality 14:180–186, 2002. © 2002 Wiley‐Liss, Inc.
Liquid chromatographic resolution of N‐acyl‐α‐amino acids as their anilide derivatives on a chiral stationary phase based on (S)‐leucine
Authors: Hyun Myung Ho , Lee Gil Soo , Han Sang Cheol , Cho Yoon Jae , Baik In Kyu
Published: August 2002

A chiral stationary phase (CSP 1) derived from N‐(3,5‐dinitrobenzoyl)leucine N‐phenyl N‐alkylamide was used for the liquid chromatographic resolution of anilide derivatives of N‐acyl‐α‐amino acids and the chromatographic resolution results were compared with those from four other commercial CSPs. The chromatographic resolution results showed that CSP 1 was most effective among five CSPs used in this study. The chiral recognition mechanism exerted by CSP 1 for the resolution of anilide derivatives of N‐acyl‐α‐amino acids is proposed to involve a face‐to‐face π–π interaction and two hydrogen bonding interactions between the CSP and the analytes from the chromatographic resolution behaviors of slightly modified anilide derivatives of N‐acyl‐α‐amino acids. The chiral recognition mechanism proposed is quite similar to that advanced previously for the resolution of N‐(3,5‐methoxybenzoyl)‐α‐amino acids on CSP 1, even though the interaction sites of the two types of analytes were totally different from each other. The apparent similarity of the two chiral recognition mechanisms was assumed to stem from the identical interaction modes of the two types of analytes with the CSP. In addition, the dependence of the enantioselectivity of anilide derivatives of N‐acyl‐α‐amino acids on the length of the alkyl tail of the N‐acyl group of analytes was rationalized to stem from the intercalation of the N‐acyl group of the (R)‐enantiomer of analytes between the tethers of the CSP. Chirality 14:503–508, 2002. © 2002 Wiley‐Liss, Inc.
Dissipation, resistance, and rational impedance matching for TEM and birdcage resonators
Authors: Tropp James
Published: August 2002

Using simple circuit parameters, mathematical expressions are given for the power dissipated by pure excitation of the principal mode of a Transverse ElectroMagnetic (TEM) or a birdcage resonator. From these, the Q, or quality factors are then derived for the TEM, and for the high and low pass birdcage. The drive point impedance is then expressed in terms of the Q and the element capacitance; and the synthesis of impedance matching networks by means of the Smith Chart is described, or in explicit detail for the discrete (or lumped) element TEM and the high pass birdcage, and in passing for the distributed TEM and the low pass birdcage. The limited applicability of a commonly used matching formula is noted. A complementary method of determining the drive point impedance by direct measurement is also given, along with corresponding Smith Chart calculations. All the proposed methodology is illustrated with respect to a pair of real world resonators—a discrete element TEM and a high pass birdcage—designed for proton imaging of the human head at 3.0 T. © 2002 Wiley Periodicals, Inc. Concepts in Magnetic Resonance (Magn Reson Engineering) 15: 177–188, 2002
Preradiation chemotherapy for pediatric patients with high‐grade glioma
Authors: Wolff Johannes E. A. , Gnekow Astrid K. , Kortmann Rolf‐Dieter , Pietsch Thorsten , Urban Christian , Graf Norbert , Kühl Joachim
Published: August 2002

BACKGROUND

To evaluate the feasibility and efficacy of intensive chemotherapy given prior to irradiation in pediatric patients with malignant glioma, the Society of Pediatric Oncology in Germany started a randomized trial in 1991. The high‐grade glioma strata had to be closed because of insufficient patient accrual. The follow‐up data from these patients are reported.

METHODS

Fifty‐two patients with World Health Organization (WHO) Grade 4 malignant glioma (n = 27 patients) or with WHO Grade 3 anaplastic astrocytoma (n = 25 patients) between the ages of 3 years and 17 years were available for analysis. The tumor locations were supratentorial in 42 patients, the cerebellum in 8 patients, and the spinal cord in 2 patients (the brainstem was excluded). Tumor surgeries were biopsy in 10 patients, partial resection in 5 patients, subtotal resection in 10 patients, and macroscopic total resection in 21 patients. Patients received either 54 grays of irradiation (n = 22 patients) followed by chemotherapy with lomustine, vincristine, and cisplatin (maintenance chemotherapy) or sandwich chemotherapy (n = 30 patients), which consisted of ifosfamide, etoposide, methotrexate, cisplatin, and cytosine arabinoside followed by irradiation.

RESULTS

The extent of resection was the most important prognostic factor. The median survival was 5.2 years for patients who underwent tumor resection of ≥ 90% compared with 1.3 years for patients who underwent less than complete resection (P < 0.0005). After undergoing macroscopic total resection, sandwich chemotherapy (n = 15 patients) resulted in better overall survival (median, 5.2 years) compared with the maintenance protocol (n = 16 patients; median survival, 1.9 years; P = 0.015). A Cox multivariate regression analysis showed better survival for female patients (P = 0.025), WHO Grade 3 disease (P = 0.016), tumor resection of ≥ 90% (P = 0.003), irradiation with ≥ 54 grays (P = 0.003), and sandwich chemotherapy (P = 0.006).

CONCLUSIONS

These data suggest that early, intensive chemotherapy increases survival rates in patients with malignant glioma who undergo complete resection. Cancer 2002;94:264–71. © 2002 American Cancer Society.
An ecologic study of dietary and solar ultraviolet‐B links to breast carcinoma mortality rates
Authors: Grant William B.
Published: August 2002

BACKGROUND

The role of diet in the etiology of breast carcinoma has been debated for decades. The ecologic approach generally finds that dietary fat is highly associated with breast carcinoma mortality, with fish intake and solar ultraviolet‐B (UV‐B) radiation, a source of vitamin D, inversely associated. Case–control and cohort studies generally find a variety of chemical, nonfat dietary, environmental, genetic, lifestyle, and reproductive factors to be important.

METHODS

An ecologic study was conducted using breast carcinoma mortality rates (1989–1996), dietary supply data, and latitude (an index of solar UV‐B radiation) from 35 countries.

RESULTS

The fraction of energy derived from animal products (risk) combined with that from vegetable products (risk reduction), followed by solar UV‐B radiation and, to a lesser extent, energy derived from alcohol (risk) and fish intake (risk reduction), were found to explain 80% of the variance of breast carcinoma mortality rates. Dietary fat contributed insignificantly in regressions involving the other factors.

CONCLUSIONS

It is hypothesized that animal products are associated with risk for breast carcinoma because they are associated with greater amounts of insulin‐like growth factor–1and lifetime doses of estrogen. Vegetable products contain several risk reduction components including antioxidants and phytoestrogens. The association with latitude is very likely because of solar UV‐B radiation and vitamin D. Alcohol modulates estrogen's effects on breasts. Fish intake is associated with risk reduction through vitamin D and n‐3 oils. These results are consistent with those of many case–control and cohort studies but should be assessed in well designed cohort studies. Cancer 2002;94:272–81. © 2002 American Cancer Society.
Expression of nucleotide excision repair genes and the risk for squamous cell carcinoma of the head and neck
Authors: Cheng Lie , Sturgis Erich M. , Eicher Susan A. , Spitz Margaret R. , Wei Qingyi
Published: August 2002

BACKGROUND

Phenotypic differences in the ability to repair genetic damage induced by tobacco carcinogens may reflect genetic differences in susceptibility to squamous cell carcinoma of the head and neck (SCCHN). The objective of this study was to assess the variation in baseline expression of five nucleotide excision repair genes between individuals with SCCHN and cancer free controls.

METHODS

The authors conducted a hospital‐based case–control study of 57 SCCHN patients and 105 cancer free controls. Using peripheral blood lymphocytes, a multiplex reverse transcriptase–polymerase chain reaction assay was used to quantitate in vitro the mRNA levels of five genes (ERCC1, XPB/ERCC3, XPG/ERCC5, CSB/ERCC6, and XPC) involved in the nucleotide excision repair pathway.

RESULTS

The levels of ERCC1, XPB/ERCC3, XPG/ERCC5, and CSB/ERCC6 transcripts were lower in cases than in controls (P =0.0001, 0.096, 0.001, and 0.0001, respectively). In multivariate logistic regression analysis (adjusting for age, gender, race, smoking status, and alcohol use), low expression of ERCC1, XPB/ERCC3, XPG/ERCC5, and CSB/ERCC6 was associated with a statistically significant increased risk for SCCHN (adjusted odds ratios [95% confidence intervals] 6.42 [2.63–15.69], 2.86 [1.39–5.90], 3.69 [1.73–7.90], and 2.46 [1.19–5.09], respectively).

CONCLUSIONS

Reduced expression of ERCC1, XPB/ERCC3, XPG/ERCC5, and CSB/ERCC6 is associated with a more than two‐fold increased risk of SCCHN. Cancer 2002;94:393–7. © 2002 American Cancer Society.
Combined chemotherapy and radiation therapy for head and neck malignancies
Authors: Nguyen Nam P. , Sallah Sabah , Karlsson Ulf , Antoine John E.
Published: August 2002

BACKGROUND

The standard of care for locally advanced head and neck carcinoma usually has been surgery followed by radiation therapy. Patient survival using this approach has been reported to be poor. The disfiguration resulting from surgery and the long‐term morbidity of postoperative radiation often results in considerable distress. Concurrent chemotherapy and radiation was introduced to improve outcome. Excellent local control and survival results often have been reported in Phase II and Phase III studies. The acute toxicity of combined chemotherapy and radiation is significant. However, organ preservation may improve quality of life. This review article summarizes the findings from published series of surgery, postoperative radiation, radiation therapy alone, and chemoradiation with regard to quality of life issues for patients with locally advanced head and neck carcinoma.

METHODS

A literature search was used to identify quality‐of‐life studies of postoperative radiation, radiation therapy alone, and chemoradiation in patients with locally advanced head and neck carcinoma. Factors affecting long‐term quality‐of‐life issues in each treatment modality were identified, compared, and evaluated.

RESULTS

Speech disorder, dysphagia, pain, and depression were found to be the common side effects affecting quality of life regardless of the treatment modality. Xerostomia is the major complication affecting patients undergoing radiation or chemoradiation.

CONCLUSIONS

Acute side effects of combined chemotherapy and radiation therapy usually were found to resolve after treatment. Long‐term morbidity is substantial because of xerostomia and severe dysphagia. However, preliminary studies suggest that because of organ preservation, patients may achieve a better quality of life after chemoradiation compared with the conventional use of surgery and postoperative radiation. Cancer 2002;94:1131–41. © 2002 American Cancer Society.

DOI 10.1002/cncr.10257
Breast carcinoma in women age 25 years or less
Authors: Kothari Ashutosh S. , Beechey‐Newman Nicolas , D'Arrigo Corrado , Hanby Andrew M. , Ryder Ken , Hamed Hisham , Fentiman Ian S.
Published: August 2002

BACKGROUND

Although several studies have examined breast carcinoma in young women aged ≤ 35 years at diagnosis, there are only occasional cases reported in very young women aged ≤ 25 years, and, to the authors' knowledge, no series are available. The presentation, tumor biology, behavior, and outcome of breast carcinoma in very young women are not known, and the rarity of breast malignancy within this age group could lead to diagnostic delays.

METHODS

The tumor characteristics and survival of 15 women aged ≤ 25 years at the time of diagnosis, have been reviewed and compared with women aged 26–35 years under the care of Guy's Hospital's Breast Unit during the same period of time. Where appropriate, the two groups were individually matched for tumor size (clinical measurement) and histologic grade.

RESULTS

Fifteen cases were examined, with a median follow‐up of 108 months and a median age of 24 years. The median duration of symptoms was 4 weeks, and the median tumor size was 20 mm. Two patients had ductal carcinoma in situ (DCIS) only, while the other 13 patients had invasive carcinomas, none of which were Grade I. A mastectomy was performed on 8 out of 15 patients (53%). Axillary nodal metastases were present in 4 out of 12 patients (33%). Of the 13 cases of invasive disease, 9 out of 13 patients (69%) experienced recurrence and died of breast carcinoma. Median disease free survival for patients with invasive disease was 86 months. There was no difference in overall survival between the patients aged ≤ 25 years and those aged 26–35, but taken together young women ≤ 35 had a worse prognosis than women between 36 and 65, due to a higher incidence of high grade and estrogen receptor negative tumors.

CONCLUSIONS

The current study suggests that among young women with breast carcinoma there is no difference in prognosis between the very young and the young. Despite two thirds of patients being node negative, the high mortality rate indicates a need for an optimal selection of adjuvant therapy among these cases. Cancer 2002;94:606–14. © 2002 American Cancer Society.

DOI 10.1002/cncr.10273
Thymidine phosphorylase and vascular endothelial growth factor in patients with Stage I lung adenocarcinoma
Authors: Kojima Hiroshi , Shijubo Noriharu , Abe Shosaku
Published: August 2002

BACKGROUND

Thymidine phosphorylase (TP) has chemotactic activity in endothelial cells in vitro and angiogenic activity in vivo. However, the clinical significance of TP and cooperative roles of TP with other angiogenic factors have remained unclear in nonsmall cell lung carcinoma (NSCLC).

METHODS

The authors stained for TP, vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) in 132 tumors from patients with Stage I NSCLC. They compared TP, VEGF, and bFGF expression levels with microvessel counts (MVCs), macrophage counts, mast cell counts, and clinical outcomes of patients with Stage I NSCLC.

RESULTS

In adenocarcinoma samples, only stromal cell‐TP expression and tumor cell‐VEGF expression were associated with MVCs and mast cell counts but not with macrophage counts. In squamous cell carcinoma samples, there were no significant associations of the expression of any examined angiogenic factors with MVCs, mast cell counts, or macrophage counts. More importantly, only among patients with Stage I adenocarcinoma of the lung did patients in the stromal cell‐TP positive tumor group and in the tumor cell‐VEGF positive tumor group have a significantly worse prognosis compared with patients in the stromal cell‐TP negative tumor group and in the tumor cell VEGF negative group, respectively. In addition, among patients with Stage I adenocarcinoma, patients in the stromal cell‐TP positive and tumor cell‐VEGF positive tumor group had a significantly worse prognosis among the four groups.

CONCLUSIONS

TP induction in tumoral stroma, but not in tumor cells, and tumor cell‐VEGF induction may promote angiogenesis cooperatively in adenocarcinoma of the lung. Stromal cell‐TP expression and tumor cell‐VEGF expression may be important prognostic factors in adenocarcinoma of the lung, and stromal cell‐TP expression may be a marker of active remodeling stroma in adenocarcinoma of the lung. Cancer 2002;94:1083–93. © 2002 American Cancer Society.

DOI 10.1002/cncr.10352
Expression of smooth muscle calponin in tumor vessels of human hepatocellular carcinoma and its possible association with prognosis
Authors: Sasaki Yo , Yamamura Hisako , Kawakami Yuriko , Yamada Terumasa , Hiratsuka Masahiro , Kameyama Masao , Ohigashi Hiroaki , Ishikawa Osamu , Imaoka Shingi , Ishiguro Shingo , Takahashi Katsuhito
Published: August 2002

BACKGROUND

Hepatocellular carcinoma (HCC) is a vascular‐rich tumor. The tumor vessels in HCC were demonstrated to have α‐smooth muscle actin positive smooth muscle cells (SMCs). However, it is unclear whether the SMCs in the wall of the tumor vessels are differentiated or undifferentiated. Basic calponin is an actin‐, tropomyosin‐, and calmodulin‐binding protein, and expression of the calponin gene in SMCs has been recognized as one of the late stage differentiation markers of SMCs. The authors investigated the differentiation state of SMCs in tumor vessels by immunohistochemical examination of calponin in patients with HCC, and whether it is associated with the patients' prognosis.

METHODS

Tumor and nontumor tissues were obtained from 75 patients with HCC who underwent radical hepatic resection. The differentiation state of the smooth muscle cells were evaluated based on the expression level of calponin, an actin‐binding protein, using immunohistochemistry and reverse transcription–polymerase chain reaction analysis. The disease free survival (DFS) rates were estimated according to the Kaplan–Meier method comparing groups of patients with calponin positive and negative tumor vessels. A multivariate analysis based on the Cox proportional hazards regression model was performed to estimate whether the expression of calponin is an independent prognostic factor.

RESULTS

In the 75 patients with HCC examined, 36 patients (48%) possessed calponin positive SMCs, and the remaining 39 (52%) did not. There were no significant differences in either clinical or pathologic factors between the two groups of patients. The 5‐ and 8‐year DFS rate of the patients with calponin positive vessels were 37% and 26%, respectively. These values were significantly higher (11% and 5%) than those of patients with calponin negative vessels. Gender, TNM classification, perioperative transfusion, and calponin expression were found to be independent prognostic factors for DFS.

CONCLUSIONS

Immunohistochemical examination of the calponin expression in the tumor vessels is a new and useful means to predict the prognosis of HCC patients after hepatic resection. Cancer 2002;94:1777–86. © 2002 American Cancer Society.

DOI 10.1002/cncr.10402
Increased mammography use and its impact on earlier breast cancer detection in Vermont, 1975–1999
Authors: Vacek Pamela M. , Geller Berta M. , Weaver Donald L. , Foster Roger S.
Published: August 2002

BACKGROUND

A trend toward earlier breast carcinoma detection in the United States has been attributed to screening mammography, although direct evidence linking this trend to the increased use of mammography in a general population is lacking. This study examined the effects of mammography on tumor size and axillary lymph node metastasis in Vermont over 25 years.

METHODS

Pathology and mammography data from 3499 Vermont women who were diagnosed with invasive breast carcinoma during 1975–1984, 1989–1990, and 1995–1999 were compared. Logistic regression analysis was used to estimate the effects of age, mammography use, and period on the odds of a tumor ≤ 2 cm and the odds of negative lymph nodes.

RESULTS

The proportion of breast tumors that were detected by screening mammography increased from 2% during 1974–1984 to 36% during 1995–1999 (P < 0.001), and these tumors were more likely to measure ≤ 2 cm than tumors that were detected by other methods. Among women age > 50 years, the odds ratio (OR) was 4.5, with a 95% confidence interval (95% CI) of 3.5–6.4. The effect was smaller in younger women (OR, 1.8; 95% CI, 1.1–3.0). Mammographic detection increased the odds of negative lymph nodes by a similar amount in both age groups, although women age > 50 years were more likely to have negative lymph nodes than younger women (OR, 1.3; 95% CI, 1.1–1.6). Tumor size and lymph node metastasis also were related to the number of mammograms and to the mammographic interval.

CONCLUSIONS

Most of the trend toward earlier detection in Vermont was due to mammography. Mammography had a lesser effect on tumor size among younger women, which may be related to less frequent screening, although its effect on lymph node metastasis was not age dependent. Women age < 50 years were more likely to have positive lymph nodes, independent of the method of detection or the frequency of mammography. Cancer 2002;94:2160–8. © 2002 American Cancer Society.

DOI 10.1002/cncr.10459