bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures
Authors: Kiemeneij Ferdinand , Vajifdar Bhavesh U. , Eccleshall Simon C. , Laarman GertJan , Slagboom Ton , Wieken Ron van der
Published: February 2003

Radial artery spasm is a frequent complication of the transradial approach for coronary angiography and angioplasty. Recently, we have been able to quantify spasm using the automatic pullback device. The objective of this study was to assess the efficacy of an intra‐arterial vasodilating cocktail in reducing the incidence and severity of radial artery spasm. A hundred patients undergoing coronary procedures via the radial artery were divided into two groups of 50 each. Patients in group A received intra‐arterial cocktail (5 mg of verapamil plus 200 μg nitroglycerine in 10 ml of normal saline), while patients in group B did not receive any vasodilating drug. The pullback device was used for sheath removal at the end of the procedure. Seven (14%) patients in group A experienced pain (i.e., pain score of III–V) during automatic sheath removal, as compared to 17 (34%) in group B (P = 0.019). The mean pain score was significantly lower in group A than in group B (1.7 ± 0.94 vs. 2.08 ± 1.07; P = 0.03). The maximal pullback force (MPF) was also significantly lower for group A (0.53 ± 0.52 kg; range, 0.10–3.03 kg) as compared to group B (0.76 ± 0.45 kg; range, 0.24–1.99 kg; P = 0.013). Only 4 (8%) patients in group A had an MPF value greater than 1.0 kg, suggesting the presence of significant radial artery spasm, as opposed to 11 (22%) in group B (P = 0.029). Administration of an intra‐arterial vasodilating cocktail prior to sheath insertion reduces the occurrence and severity of radial artery spasm. Cathet Cardiovasc Intervent 2003;58:281–284. © 2003 Wiley‐Liss, Inc.
Treatment of recurrent stroke and pulmonary thromboembolism with percutaneous closure of a patent foramen ovale and placement of inferior vena cava filter
Authors: Donti Andrea , Giardini Alessandro , Formigari Roberto , Bronzetti Gabriele , Prandstraller Daniela , Bonvicini Marco , Picchio Fernando M.
Published: February 2003

The association between recurrent episodes of pulmonary embolism, stroke, and congenital anomalies of the clotting system features a condition of increased risk of recurrences despite anticoagulant therapy. We report the successful management of this association with percutaneous closure of the foramen ovale and placement of an inferior caval vein filter. Cathet Cardiovasc Intervent 2003;58:413–415. © 2003 Wiley‐Liss, Inc.
New balloon‐thermography catheter for in vivo temperature measurements in human coronary atherosclerotic plaques: A novel approach for thermography?
Authors: Stefanadis Christodoulos , Toutouzas Konstantinos , Vavuranakis Manolis , Tsiamis Eleftherios , Vaina Sophia , Toutouzas Pavlos
Published: February 2003

Although ex vivo studies showed marked thermal heterogeneity in atheromatic plaques, in in vivo human studies trivial temperature variations are recorded due to the cooling effect of blood flow. We investigated a new balloon‐thermogaphy catheter for temperature measurements during coronary flow interruption. A thermistor probe is positioned at the distal segment of the catheter. At the opposite site of the thermistor, a balloon is placed. By inflation of the balloon, coronary flow is interrupted. Ten patients with effort angina were studied. Coronary flow velocity was continuously recorded. Temperature was recorded at the proximal vessel wall and at the lesion before, during, and after complete interruption of blood flow by inflation of the balloon. ΔTp was assigned as the difference between the background temperature and the maximal temperature during and after balloon inflation. ΔTl was assigned as the difference between the atherosclerotic plaque and the proximal vessel wall. The procedure was not complicated. ΔTp during and after balloon inflation was 0.01 ± 0.01°C and −0.003 ± −0.01°C (P < 0.001), respectively. ΔTl was 0.07 ± 0.04°C at baseline, 0.17 ± 0.06°C (59.3% ± 11.8% increase) during, and 0.07 ± 0.05°C after flow interruption (P < 0.001). ΔTl was greater than ΔTp during and after impairment of flow (P < 0.001). In vivo atherosclerotic plaque temperature recording seems to be feasible with this new balloon‐thermography catheter. This device may introduce a new approach for the detection of thermal heterogeneity in plaques by addressing the issue of cooling effect of blood flow. Cathet Cardiovasc Intervent 2003;58:344‐350. © 2003 Wiley‐Liss, Inc.
Fluoroscopic image quality in the film and filmless eras: A standardized comparison performed in coronary interventional facilities
Authors: Laskey Warren , Wondrow Merrill , Chambers Charles
Published: February 2003

One hundred and one coronary interventional systems (45 primarily film‐based predigital systems, labeled group 1; and 56 filmless digital systems, labeled group 2) were examined over a 5‐year period using a standardized imaging phantom. Fluoroscopic image intensifier input dose, high‐contrast spatial resolution, low‐contrast sensitivity, and static and dynamic low‐contrast resolution were assessed under several conditions simulating patient body habitus. The distribution of spatial resolutions in group 2 facilities favored higher line pair resolution over group 1 (P = 0.01). Contrast sensitivity (smallest‐diameter hole visualized) was consistently and significantly enhanced with the use of digital imaging under both medium (P = 0.001) and large (P = 0.002) patient habitus simulations. Low‐contrast video resolution (number of wires seen) under static (P = 0.007) and dynamic (P = 0.002) conditions was also improved in the digital facilities. However, image intensifer input dose was similar in both groups (group 1 median dose, 23 mR/min; group 2 median dose, 26 mR/min; P = NS). Fluoroscopic spatial resolution in digital filmless laboratories was significantly improved when compared to predigital, film‐based laboratories. Low‐contrast sensitivity and low‐ contrast video resolution under both static and dynamic conditions were also significantly improved in the digital laboratories. Notably, the input dose of radiation required to produce these improved fluoroscopic images was similar between groups. Cathet Cardiovasc Intervent 2003;58:383–390. © 2003 Wiley‐Liss, Inc.
3‐D in vitro model of early skeletal muscle development
Authors: Cheema U. , Yang S.‐Y. , Mudera V. , Goldspink G.G. , Brown R.A.
Published: February 2003

An understanding of the mechanical and mechano‐molecular responses that occur during the differentiation of mouse c2c12 myoblasts in 3‐D culture is critical for understanding growth, which is important for progress towards producing a tissue‐engineered muscle construct. We have established the main differences in force generation between skeletal myoblasts, dermal fibroblasts, and smooth muscle cells in a 3‐D culture model in which cells contract a collagen gel construct. This model was developed to provide a reproducible 3‐D muscle organoid in which differences in force generation could be measured, as the skeletal myoblasts fused to form myotubes within a collagen gel. Maintenance of the 3‐D culture under sustained uni‐axial tension, was found to promote fusion of myoblasts to form aligned multi‐nucleate myotubes. Gene expression of both Insulin Like Growth Factor (IGF‐1 Ea) and an isoform of IGF‐1 Ea, Mechano‐growth factor (IGF‐1 Eb, also termed MGF), was monitored in this differentiating collagen construct over the time course of fusion and maturation (0–7 days). This identified a transient surge in both IGF‐1 Ea and MGF expression on day 3 of the developing construct. This peak of IGF‐1 Ea and MGF expression, just prior to differentiation, was consistent with the idea that IGF‐1 Ea stimulates differentiation through a Myogenin pathway [Florini et al., 1991: Mol. Endocrinol. 5:718–724]. MGF gene expression was increased 77‐fold on day 3, compared to a 36‐fold increase with IGF‐1 Ea on day 3. This indicates an important role for MGF in either differentiation or, more likely, a response to mechanical or tensional cues. Cell Motil. Cytoskeleton 54:226–236, 2003. © 2003 Wiley‐Liss, Inc.
Clinical outcome and survival after palliative surgery for spinal metastases
Authors: Hirabayashi Hiroki , Ebara Sohei , Kinoshita Tetsuya , Yuzawa Yohei , Nakamura Isao , Takahashi Jun , Kamimura Mikio , Ohtsuka Kuniyoshi , Takaoka Kunio
Published: February 2003

BACKGROUND

The authors sought to identify treatment‐related factors that influenced survival after surgical treatment for metastatic spinal tumors and to evaluate the relationship between survival and postoperative ambulation time as a factor related to quality of life.

METHODS

The medical records of 81 patients with metastatic spinal tumors who underwent palliative surgery at the study institution were assessed. Univariate analysis for factors influencing survival used the Kaplan–Meier log rank statistic and multivariate analysis used the Cox proportional hazards model. The Spearman correlation test was used to analyze the relationship between postoperative ambulation and survival time.

RESULTS

The patients had a median age of 59.9 years and a median survival of 10.6 months after surgery. For patients, postoperative ambulatory median survival was 16.5 months and median ambulation time was 13.8 months. By univariate analysis, anatomic site of the primary tumor, postoperative ambulation, and combined adjuvant therapy (chemotherapy plus radiotherapy) were associated with prolonged survival (P < 0.05). Multivariate analysis identified primary site and postoperative ambulatory function as independent predictors of prolonged survival (P < 0.0001). Significant correlations were found between ambulation time and survival time of patients who were able to walk after surgery (P < 0.0001), even in patients with liver (P < 0.05) or lung carcinoma (P < 0.05).

CONCLUSIONS

The anatomic site of primary carcinoma and postoperative ambulation were associated with longer survival after palliative surgery for metastatic spinal tumor. When ambulation is attained after surgery, it can be preserved until late in remaining life even when the primary tumor is unfavorable. Palliative surgery for spinal metastasis can improve the quality and quantity of life. Cancer 2003;97:476–84. © 2003 American Cancer Society.

DOI 10.1002/cncr.11039
Ciprofloxacin prophylaxis in patients with acute leukemia and granulocytopenia in an area with a high prevalence of ciprofloxacin‐resistant Escherichia coli
Authors: Gomez Lucia , Garau Javier , Estrada Cristina , Marquez Montserrat , Dalmau David , Xercavins Mariona , Martí Josep Maria , Estany Cristina
Published: February 2003

BACKGROUND

Infection remains the major cause of morbidity and mortality in patients with neutropenia, and the beneficial effects of oral prophylaxis remain controversial.

METHODS

From 1993 to December 1999, the authors analyzed the clinical and microbiologic outcomes of 144 episodes of febrile neutropenia among adult patients with acute leukemia.

RESULTS

Forty‐three consecutive episodes occurred among patients who were on ciprofloxacin prophylaxis during 1993–1996 (ciprofloxacin group), and 101 subsequent episodes occurred among patients who were not exposed to ciprofloxacin prophylaxis (control group). There were no differences in clinical presentation, antibiotic treatment received for the episode, or a worse outcome between groups. The rate of bacteremia was similar (12 of 43 patients [28%] vs. 26 of 101 patients [26%], respectively). There was a trend toward a higher rate of Gram positive bacteremia in the control group (12 of 101 patients [12%] vs. 2 of 43 patients [5%]) and a higher rate of Gram negative bacteremia in the ciprofloxacin group (11 of 43 patients [26%] vs. 15 of 101 patients [15%]). Resistance to fluoroquinolones was greater in Escherichia coli blood isolates from patients in the ciprofloxacin group (7 of 8 patients vs. 2 of 9 patients; P = 0.02).

CONCLUSIONS

The current results suggest that fluoroquinolone prophylaxis for patients with febrile neutropenia may be abandoned safely in areas with a high prevalence of ciprofloxacin‐resistant enterobacteria. Cancer 2003;97:419–24. © 2003 American Cancer Society.

DOI 10.1002/cncr.11044
Cancer in Fanconi anemia, 1927–2001
Authors: Alter Blanche P.
Published: February 2003

BACKGROUND

Fanconi anemia (FA) is an autosomal recessive disease associated with an abnormal response to DNA damage. Although FA is well known for the association of aplastic anemia and characteristic birth defects, leukemia and solid tumors also occur at a high rate in this group of patients. A review of all reported cases is informative with regard to the specific types of cancer, the ages at which they occur, and the cumulative probability of their development.

METHODS

Medline and bibliographies of publications were searched for articles containing “Fanconi's anemia” or “aplastic anemia” and all cases of FA from 1927 through 2001 were included in the database. Cancer cases were identified within these reports. Descriptive statistical analyses were performed using Stata7 software.

RESULTS

One thousand three hundred cases of FA were identified. Nine percent had leukemia (primarily acute myeloid leukemia), 7% had myelodysplastic syndrome, 5% had solid tumors, and 3% had liver tumors. Patients with cancer were older than the cancer‐free patients at the time of diagnosis of FA. The median age for cancer (including leukemia) was 16, compared with 68 in the general population. The most frequent solid tumors were aerodigestive and gynecological carcinomas. In approximately 25% of patients with cancer, the malignancy preceded the diagnosis of FA.

CONCLUSIONS

If the competing risks of aplastic anemia and leukemia could be removed, the estimated cumulative probability of development of a solid tumor in FA patients is 76% by the age of 45 years. Carcinogenic pathways and cancer prevention, surveillance, and treatment can be studied to advantage in this genetic model of human cancer. Cancer 2003;97:425–40. Published 2003 by the American Cancer Society.

DOI 10.1002/cncr.11046
Docetaxel, cisplatin, and 5‐fluorouracil‐based induction chemotherapy in patients with locally advanced squamous cell carcinoma of the head and neck
Authors: Haddad Robert , Colevas A. Dimitrios , Tishler Roy , Busse Paul , Goguen Laura , Sullivan Christopher , Norris Charles M. , Lake‐Willcutt Bernadette , Case Mary Ann , Costello Rosemary , Posner Marshall
Published: February 2003

BACKGROUND

The authors conducted a series of four Phase I–II trials of high‐dose and intermediate‐dose docetaxel, cisplatin, and 5‐fluorouracil (TPF)‐based induction chemotherapy for patients with advanced squamous cell carcinoma of the head and neck (SCCHN). The chemotherapy regimens and response rates for each trial were published previously. In the current analysis, the authors report the data on long‐term survival, patterns of failure, and morbidity among the patients who were treated at their institution.

METHODS

A total of 101 patients with previously untreated, locally advanced, curable SCCHN were entered onto the studies. Overall, 68 patients (67%) had N2–N3 disease, and 86 patients (85%) had Stage IV disease. Patients were treated with combinations of TPF with or without leucovorin. Cycles were repeated every 21–28 days for a total of 3 cycles followed by hyperfractionated radiotherapy.

RESULTS

After a median follow‐up of 49 months, 65 patients (64%) remain alive with no evidence of disease (NED), and 3 patients remain alive with disease, for an overall survival rate of 67% (68 patients). Twenty‐six patients had locoregional recurrences (LRR), and 5 patients had both LRR and distant metastasis (DM). Only five patients had DM as the sole site of failure. Four patients underwent salvage surgery at the primary site and remain alive with NED. Excluding 17 patients with nasopharyngeal carcinoma, of 84 patients, 55 patients remain alive with NED (65%). Notably, 43 of 84 patients (51%) had oropharyngeal primary tumors, and 30 of those patients remain alive with NED (70%). Significant morbidity was low, with two treatment‐related deaths. All but two of the surviving patients are able to swallow and had their feeding tubes removed.

CONCLUSIONS

These data suggest that docetaxel adds incrementally to the efficacy of cisplatin and fluorouracil. Local‐regional failures continue to be the major impediment to cure in these patients. Given the increase in local‐regional dose intensity with chemoradiation, sequential treatment plans that integrate induction chemotherapy and chemoradiotherapy seem to be the logical next step. Cancer 2003;97:412–8. © 2003 American Cancer Society.

DOI 10.1002/cncr.11063
Health related quality of life in prostate carcinoma patients
Authors: Efficace Fabio , Bottomley Andrew , van Andel George
Published: February 2003

BACKGROUND

Health related quality of life (HRQOL) is increasingly reported as an important endpoint in cancer clinical trials. However, evidence suggests that HRQOL reporting is often inadequate. Given this, the authors undertook a systematic review to evaluate HRQOL assessment methodology and reported outcomes of randomized controlled clinical trials (RCTs) with prostate carcinoma patients.

METHODS

A comprehensive search of the literature from 1980 to 2001, mainly on the following databases, was undertaken: MedLine, Cancerlit, and the Cochrane Controlled Trials Register. Studies were identified according to a predefined coding scheme, including HRQOL measure, cultural validity, compliance data reported and the clinical significance of the results.

RESULTS

Twenty‐five RCTs were identified, involving 8015 patients primarily with metastatic cancer. Bicalutamide was the medical treatment against which most treatment comparisons were made. Limitations identified included the fact that only 44% of the studies gave a rationale for selecting a specific HRQOL measure, 64% of the studies failed to report information about the administration of the HRQOL measure, and 56% failed to report compliance at baseline. The measure most often used was the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire—Care 30 (EORTC QLQ‐C30), although some studies used non‐validated HRQOL tools.

CONCLUSIONS

The current study revealed a lack of a uniform approach to HRQOL assessment and several methodologic limitations. It is possible that such methodologic limitations have influenced trial findings for HRQOL outcomes. Cancer 2003;97:377–88. © 2003 American Cancer Society.

DOI 10.1002/cncr.11065
Racial differences in the outcome of patients with colorectal carcinoma
Authors: Govindarajan Rangaswamy , Shah Rajesh V. , Erkman Linda G. , Hutchins Laura F.
Published: February 2003

BACKGROUND

African‐American (AA) patients with colorectal carcinoma have a worse prognosis compared with Caucasians. To analyze the causes of this disparity in survival, a retrospective study of patients with colorectal carcinoma was undertaken. The impact of treatments received and the role of socioeconomic factors such as income, education, and poverty levels were studied.

METHODS

A retrospective analysis of patients with colorectal carcinoma at a single institution was conducted. The overall survival of AA and Caucasians, stage at presentation, treatment received, and socioeconomic factors were analyzed using the institutional tumor registry and 1990 census data.

RESULTS

The overall survival of AA patients was worse compared with Caucasians, both due to all causes (P < 0.001) and cancer‐related deaths (P < 0.001). The relative risk of death due to all causes was 1.4 (95% confidence interval [CI] 1.2–1.8) for AA, 4.3 for patients with Stage IV disease (95% CI 3.2–5.7), and 2.3 for patients not undergoing surgery (95% CI 1.7–3.1). After multivariate adjustment for gender, site, socioeconomic factors, and therapeutic modalities, the relative risks for death were 1.5 (95% CI 1.2) for AA, 1.4 (95% CI 1.1–1.7) for patients 60 years of age or older, and 4.2 (95% CI 3.4–5.2) for Stage IV disease. The survival difference between AA and Caucasians was not influenced by income, poverty level, and education. African Americans were treated less frequently with chemotherapy and radiation therapy compared with their Caucasian counterparts.

CONCLUSIONS

African American patients with colorectal carcinoma have a poorer prognosis compared with Caucasians. This discrepancy may be due to decreased utilization of chemotherapy and radiation therapy. Socioeconomic factors and lack of access to health care do not entirely explain the worse prognosis of AA. These factors should be identified and dealt with to improve the health care of AA patients with various malignant disorders. Cancer 2003;97:493–8. © 2003 American Cancer Society.

DOI 10.1002/cncr.11067
Fourteen‐gauge needle core biopsy of mammographically evident radial scars
Authors: Cawson Jennifer N. , Malara Frank , Kavanagh Anne , Hill Prue , Balasubramanium Gnani , Henderson Michael
Published: February 2003

BACKGROUND

Radial scars are benign lesions that may mimic breast carcinoma on mammography and usually are managed by excision biopsy. The authors report their experience with stereotactic needle core biopsy (SNCB) in sampling these lesions.

METHODS

A prospective study examined a consecutive series of 75 mammographically detected radial scars from a population‐based screening program. In patients who were sampled by SNCB followed by surgical biopsy, the histologic findings of core biopsy and the gold standard of excision biopsy were compared.

RESULTS

Sixty‐three patients were sampled by core biopsy: SNCB was used in 55 patients (87.0%), and ultrasound‐guided needle core biopsy (UNCB) was used in 8 patients (13%). One patient who underwent SNCB did not undergo a follow‐up excision biopsy. Radial scars were diagnosed preoperatively by core biopsy in 51 of 62 patients who underwent excision (82%; 95% confidence interval [95%CI], 70–91%). The sensitivity for SNCB was 85% (95%CI, 73–94%), and the sensitivity for UNCB was 63% (95%CI, 24–91%). Of 54 patients who underwent SNCB and excision, 4 patients had coexistent ductal carcinoma in situ (DCIS) at the time they underwent surgical excision: SNCB identified DCIS in 1 patient and identified atypical ductal hyperplasia (ADH) in 3 patients. In the entire group of 75 radial scars, 5 scars were associated with DCIS (7%), and there were no invasive carcinomas. ADH was present in association with 42 of 74 radial scars that were excised surgically (57%). Twenty‐nine of those radial scars were sampled preoperatively by SNCB. ADH was found in 21 patients (72%; 95CI, 53–87%).

CONCLUSIONS

The sensitivity of SNCB in the identification of radial scars was 85%. In four patients with associated DCIS, SNCB revealed either ADH or DCIS, both of which required excision. These findings suggest that patients with SNCB‐proven radial scars among a screened population can be managed safely by mammographic follow‐up, provided there is no associated DCIS, ADH, or lobular carcinoma in situ. Spiculated abnormalities with discordant SNCB results require surgical biopsy. Cancer 2003;97:345–51. © 2003 American Cancer Society.

DOI 10.1002/cncr.11070
Clinical significance of vascular endothelial growth factor C and vascular endothelial growth factor receptor 3 in patients with nonsmall cell lung carcinoma
Authors: Arinaga Mitsuyuki , Noguchi Tsuyoshi , Takeno Shinsuke , Chujo Masao , Miura Takashi , Uchida Yuzo
Published: February 2003

BACKGROUND

Vascular endothelial growth factor C (VEGF‐C) plays an important role in lymphangiogenesis and activates VEGF receptor 3 (VEGFR‐3). By contrast, lymphatic spread is an important prognostic factor in patients with nonsmall cell lung carcinoma (NSCLC). The objective of the current study was to determine whether the expression of VEGF‐C and VEGFR‐3 correlates with clinicopathologic factors and prognosis in patients with primary NSCLC.

METHODS

The authors conducted a retrospective review of 180 consecutive patients who underwent complete resection for NSCLC and who did not receive any chemotherapy or radiotherapy prior to surgery. Immunohistochemical staining for VEGF‐C and VEGFR‐3 was performed. The clinicopathologic implications of VEGF‐C and VEGFR‐3 expression were analyzed statistically.

RESULTS

Of 180 patients with NSCLC, 137 patients (76.1%) were positive for VEGF‐C, and 40 patients (22.2%) were positive for VEGFR‐3. VEGF‐C expression was observed frequently in patients with adenocarcinoma (P = 0.026). For VEGFR‐3 expression, significant correlations were demonstrated with age (P = 0.02), gender (P = 0.008), and histologic differentiation in patients with squamous cell carcinoma (P = 0.03). Patients who had positive staining for VEGF‐C showed significantly less favorable survival rates compared with patients who had negative staining for VEGF‐C (P = 0.003). The survival rates of patients who had positive staining for VEGFR‐3 also were significantly lower compared with patients who had negative staining for VEGFR‐3 (P < 0.001). Patients who had positive staining for both VEGF‐C and VEGFR‐3 exhibited the most unfavorable prognoses. Univariate analysis revealed the following prognostic factors: gender (P = 0.03), tumor status (T1,T2 vs. T3; P < 0.01), lymph node status (negative vs. positive; P < 0.01), tumor size (≤ 35 mm vs. > 35 mm; P < 0.01), disease stage (Stage I vs. Stages II and III; P < 0.01), VEGF‐C expression (negative vs. positive; P < 0.01), VEGFR‐3 expression (negative vs. positive; P < 0.01) and combined VEGF‐C and/or VEGFR‐3 expression (both positive vs. VEGF‐C or VEGFR‐3 positive; P < 0.01). Multivariate analysis demonstrated that VEGFR‐3 expression was the only independent negative prognostic factor (P < 0.01).

CONCLUSIONS

VEGF‐C and VEGFR‐3 expression may be indicative of survival rates for patients with NSCLC. Cancer 2003;97:457–64. © 2003 American Cancer Society.

DOI 10.1002/cncr.11073
A prognostic model and staging for metastatic uveal melanoma
Authors: Eskelin Sebastian , Pyrhönen Seppo , Hahka‐Kemppinen Marjo , Tuomaala Seppo , Kivelä Tero
Published: February 2003

BACKGROUND

To identify factors that independently contribute to overall survival in Stage IVB uveal melanoma and to subcategorize by prognosis.

METHODS

Data of 91 consecutive patients who died of metastatic uveal melanoma in 1985–2000 were analyzed by Kaplan–Meier and Cox regression analysis. Main covariates were participation in annual review, symptoms, Karnofsky index, metastatic burden, liver function tests, and age. Time on chemotherapy was modeled as a confounder. A working formulation for staging patients according to predicted survival was designed.

RESULTS

Of the 91 patients, 85% underwent annual liver imaging and function tests, 63% were asymptomatic, and 73% received chemotherapy. The median survival period was 8.4 months (95% confidence interval [CI], 6.3–11.8). Karnofsky index, largest dimension of the largest metastasis, metastatic burden, serum transaminase, lactate dehydrogenase, and alkaline phosphatase (AP) levels, and time on chemotherapy were strongly (P < 0.001) associated with survival. Symptoms (P = 0.031) and regular review (P = 0.081) were weakly associated with survival. Karnofsky index (P = 0.013), the largest dimension of the largest metastasis (P = 0.003), and serum AP level (P = 0.042) retained independent significance, adjusting for time on chemotherapy. Predicted median survival calculated for relevant covariate combinations was divided into three periods (≥12 months vs. 6–11 months vs. < 6 months). Observed median survival for Stage IVBa was 14.9 months (95% CI, 11.7–21.3), for Stage IVBb 8.9 months (95% CI, 2.7–13.7), and for Stage IVBc 2.0 months (95% CI, 1.0–3.7).

CONCLUSION

The model and working formulation for categorization can be tested as an aid in patient counseling and as a tool in design and analysis of clinical trials. Cancer 2003;97:465–75. © 2003 American Cancer Society.

DOI 10.1002/cncr.11113
Kava: a Java dialect with a uniform object model for lightweight classes
Authors: Bacon David F.
Published: February 2003

Object‐oriented programming languages have always distinguished between ‘primitive’ and ‘user‐defined’ data types, and in the case of languages like C++ and Java the primitives are not even treated as objects, further fragmenting the programming model. The distinction is especially problematic when a particular programming community requires primitive‐level support for a new data type, as for complex, intervals, fixed‐point numbers, and so on.

We present Kava, a design for a backward‐compatible version of Java that solves the problem of programmable lightweight objects in a much more aggressive and uniform manner than previous proposals. In Kava, there are no primitive types; instead, object‐oriented programming is provided down to the level of single bits, and types such as int can be explicitly programmed within the language. While the language maintains a uniform object reference semantics, efficiency is obtained by making heavy use ofunboxingandsemantic expansion.

We describe Kava as a dialect of the Java language, show how it can be used to define various primitive types, describe how it can be translated into Java, and compare it to other approaches to lightweight objects. Copyright © 2003 John Wiley & Sons, Ltd.
Integration and application of TAU in parallel Java environments
Authors: Shende Sameer , Malony Allen D.
Published: February 2003

Parallel Java environments present challenging problems for performance tools because of Java's rich language system and its multi‐level execution platform combined with the integration of native‐code application libraries and parallel run‐time software. In addition to the desire to provide robust performance measurement and analysis capabilities for the Java language itself, the coupling of different software execution contexts under a uniform performance model needs careful consideration of how events of interest are observed and how cross‐context parallel execution information is linked. This paper relates our experience in extending the TAU (Tuning and Analysis Utilities) performance system to a parallel Java environment based on mpiJava. We describe the complexities of the instrumentation model used, how performance measurements are made, and the overhead incurred. A parallel Java application simulating the game of Life is used to show the performance system's capabilities. Copyright © 2003 John Wiley & Sons, Ltd.
Automatic translation of Fortran to JVM bytecode
Authors: Seymour Keith , Dongarra Jack
Published: February 2003

This paper reports on the design of a Fortran‐to‐Java translator whose target language is the instruction set of the Java Virtual Machine. The goal of the translator is to generate Java implementations of legacy Fortran numerical codes in a consistent and reliable fashion. The benefits of directly generating bytecode are twofold. First, compared with generating Java source code, it provides a much more straightforward and efficient mechanism for translating Fortran GOTO statements. Second, it provides a framework for pursuing various compiler optimizations, which could be beneficial not only to our project, but to the Java community as a whole. Copyright © 2003 John Wiley & Sons, Ltd.
Supporting multidimensional arrays in Java
Authors: Moreira José E. , Midkiff Samuel P. , Gupta Manish
Published: February 2003

The lack of direct support for multidimensional arrays in JavaTM has been recognized as a major deficiency in the language's applicability to numerical computing. It has been shown that, when augmented with multidimensional arrays, Java can achieve very high‐performance for numerical computing through the use of compiler techniques and efficient implementations of aggregate array operations. Three approaches have been discussed in the literature for extending Java with support for multidimensional arrays: class libraries that implement these structures; extending the Java language with new syntactic constructs for multidimensional arrays that are directly translated to bytecode; and relying on the Java Virtual Machine to recognize those arrays of arrays that are being used to simulate multidimensional arrays. This paper presents a balanced presentation of the pros and cons of each technique in the areas of functionality, language and virtual machine impact, implementation effort, and effect on performance. We show that the best choice depends on the relative importance attached to the different metrics, and thereby provide a common ground for a rational discussion and comparison of the techniques. Copyright © 2003 John Wiley & Sons, Ltd.
A dynamic bandwidth resource allocation based on neural networks in euroskyway multimedia satellite system
Authors: Camarda P. , Castellano M. , Piscitelli G. , Striccoli D. , Tomasicchio G.
Published: February 2003

Advanced traffic management based on the dynamic resource assignment allows a broadband satellite system such as euroskyway (ESW) to dynamically assign the resources of connections. The mechanisms of the dynamic assignment exploit variations of burstiness exhibited by real time and non‐real time variable bit rate traffic sources to perform an optimized resource redistribution. The efficiency of the dynamic bandwidth allocation capability (DBAC) depends on the accuracy of the traffic source description; inaccurate assessment of the arrival process will cause an overhead and a degraded utilisation of system resources.

In this paper a flexible traffic burstiness predictor for dynamic bandwidth resource allocation based on neural network is presented. The approach is able to perform an online estimation of expected resource requests implementing traffic resource assignment by using a sub‐symbolic adaptive representation of the traffic source. The achieved results prove that the flexible approach is more effective than the ones based on fixed schemes designed using analytical traffic source description when applied on the satellite terminal ESW system component. Copyright © 2003 John Wiley & Sons, Ltd.
Packet scheduling for QoS support in IEEE 802.16 broadband wireless access systems
Authors: Wongthavarawat Kitti , Ganz Aura
Published: February 2003

In this paper we introduce a scheduling algorithm and admission control policy for IEEE 802.16 broadband wireless access standard. The proposed solution which is practical and compatible to the IEEE 802.16 standard, provides QoS support to different traffic classes. To the best of our knowledge this is the first such algorithm. The simulation studies show that the proposed solution includes QoS support for all types of traffic classes as defined by the standard. We have shown the relationship between traffic characteristics and its QoS requirements and the network performance. Copyright © 2003 John Wiley & Sons, Ltd.
Application of pseudo‐particle fast multipole and tree methods to surface charge method
Authors: Hamada Shoji , Takuma Tadasu
Published: February 2003

This paper describes triangular surface charge methods (SCM) using fast multipole method (FMM) or tree method (TM) coupled with pseudo‐particle method for calculating three‐dimensional electric fields. FMM and TM enable us to calculate an N × N matrix and vector product of interacting N bodies by O(N) or O(N log N) times of operations and the same order of memories based on divide‐and‐conquer algorithm. Application of these techniques to the SCM allows us to utilize a million surface elements on an ordinary personal computer system with 1‐GB main memory. The calculated results of a benchmark test and two examples, that is, straight and spiral chains of dielectric spheres in a homogeneous field, show the validity and usefulness of the developed SCMs. © 2003 Wiley Periodicals, Inc. Electr Eng Jpn, 143(2): 11–21, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.10099
Analysis of output voltage ripple caused by ESR of a smoothing capacitor for a low‐voltage high‐current buck converter
Authors: Hyakutake Hiroki , Harada Koosuke
Published: February 2003

This paper presents the analytical results of output voltage ripple for a buck converter with synchronous rectifier. In the conventional analysis of the output voltage ripple, it is assumed that the inductor current ripple is equal to the ripple current of the smoothing capacitor and that the equivalent series resistance (ESR) of the smoothing capacitor is sufficiently small or sufficiently large. However, if the load impedance is not much larger than the impedance of the smoothing capacitor including ESR, this assumption is not correct. In this paper, we consider the cases that the inductor current ripple is not always equal to the ripple current of the smoothing capacitor and that there are no restrictions on ESR. From the analytical results, it is shown that the output voltage ripple has four modes which are determined by the relation of load resistance, the capacitance, the ESR, the switching cycle, and the duty ratio. As a result of analysis, we show the lower limit of the ripple rate of the output voltage. The analytical results are confirmed by simulations and experiments. © 2003 Wiley Periodicals, Inc. Electr Eng Jpn, 143(2): 59–66, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.10133
An MPPT control scheme for a PV system utilizing limit cycle operation and its system design
Authors: Kitano Tatsuya , Matsui Mikihiko , Xu De‐Hong
Published: February 2003

This paper proposes a new simple maximum power point tracking (MPPT) control scheme for a PV system without using conventional “mountain climbing” optimum operating point searching technique. Although no information is needed on PV array, the generated output power is maximized by utilizing limit cycle phenomena occurring on the equilibrium/nonequilibrium boundary of system power flow. A parameter design procedure to determine operating period based on a theoretical model is presented. It has been found that the operating period of limit cycle is kept constant depending on the circuit and control parameters irrespective of the insolation conditions of PV array. Availability of the proposed new MPPT control scheme has been shown by simulation and experimental results. © 2003 Wiley Periodicals, Inc. Electr Eng Jpn, 143(2): 67–75, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.10134
A study of geoelectric potential change caused by rail leak current observed at Ohtawa, Gifu, Japan
Authors: Tanbo Toshiya , Sakai Hideo , Nagao Toshiyasu
Published: February 2003

Observations of geoelectric potential have been conducted since 1997 at Ohtawa (Kamioka town, Gifu prefecture) for the purpose of testing the VAN method (short‐term earthquake prediction), as collaborative research of Toyama University and RIKEN‐IFREQ.

The data from Ohtawa station are obtained in excellent condition for geoelectric potential study because of small artificial electric noises. A relatively strong change of geoelectric potential is observed. This is clearly correlated with the timetable of Tateyama railway. That is, the geoelectric potential change is caused by the leakage current from DC train of Tateyama railway. The current travels a distance of more than 16 km.

The geoelectric potential changes caused by the leak current of Tateyama railway may be useful to study the electrical resistivity of the soil and its time variation around the area. Time variation of the largest amplitude of the rail leak current has been analyzed since April 1998 to obtain the variation of apparent resistivity.

So far, there has not been sensible correlation for apparent resistivity variation and an inert seismic activity. In contrast, it is remarkable that the resistance changes gently in a cycle of 1 year. The gentle variation of resistivity is thought to be caused by an annual or seasonal phenomenon. The leakage of the current from DC train is a powerful tool to monitor temporal variation of resistivity structure around the area. © 2003 Wiley Periodicals, Inc. Electr Eng Jpn, 143(2): 1–10, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.10142
Characterisation of Moringa stenopetala seed oil variety “Marigat” from island Kokwa
Authors: Lalas Stavros , Tsaknis John , Sflomos Konstantinos
Published: February 2003

The oil from Moringa stenopetala seeds variety Marigat from the island Kokwa was extracted using 3 different procedures including cold press (CP), extraction with n‐hexane and extraction with a mixture of chloroform:methanol (1:1) (CM). The yield of oil was 35.7% (CP) to 44.9% (CM). The density, refractive index, colour, smoke point, viscosity, acidity, saponification value, iodine value, fatty acid methyl esters, sterols, tocopherols (by high‐performance liquid chromatography), peroxide value, E at 232 nm and the susceptibility to oxidation measured by the Rancimat method were determined.

The oil was found to contain high levels of unsaturated fatty acids, especially oleic (up to 76.40%). The dominant saturated acids were behenic (up to 6.01%) and palmitic (up to 6.21%). The oil was also found to contain high levels of β‐sitosterol (up to 52.19%%of total sterols), stigmasterol (up to 16.53% of total sterols) and campesterol (up to 14.26% of total sterols). α‐, β‐ and δ‐tocopherols were detected up to levels of 98.00, 44.50 and 82.41 mg/kg of oil, respectively. The reduction of the induction period (at 120 °C) of M. stenopetala seed oil ranged from 29.4% to 54.7% after degumming. The M. stenopetala seed oil showed high stability to oxidative rancidity. The results of all the above determinations were compared with those of a commercial virgin olive oil and Moringa oleifera seed oil.
Directed sequential synthesis of conjugated linoleic acid isomers from Δ7, 9 to Δ12, 14
Authors: Destaillats Frédéric , Angers Paul
Published: February 2003

Position and configuration isomers of conjugated linoleic acid (CLA), from 7, 9‐ through 12, 14‐C18:2, were synthesized by directed sequential isomerizations of a mixture of rumenic (cis‐9, trans‐11 C18:2) and trans‐10, cis‐12 C18:2 acids. Indeed, the synthesized conjugated fatty acids cover the range of unsaturated systems as found in milk fat CLA. The two‐step sequence consisted in initial sigmatropic rearrangement of cis/trans CLA isomers at 200 °C for 13 h under inert atmosphere (Helium, He), followed by selenium‐catalyzed geometrical isomerization of double bonds at 120 °C for 20 h under He. Product analysis was achieved by gas‐liquid chromatography using a 120 m polar capillary column coated with 70% cyanoalkylpolysiloxane equivalent polymer. Migration of conjugated systems was geometrically controlled as follows: the cis‐Cn, trans‐Cn+2 double bond system was rearranged through a pericyclic [1, 5] sigmatropic mechanism into a trans‐Cn‐1, cis‐Cn+1 unsaturated system, while the trans‐Cn, cis‐Cn+2 double bond system was rearranged through a similar pericyclic mechanism into a cis‐Cn+1, trans‐Cn+3 unsaturated system. Selenium‐catalyzed geometrical isomerization under mild conditions then allowed cis/trans double bond configuration transitions, resulting in the formation of all cis, all trans, cis‐trans and trans‐cis isomers. A sequential combination of the two reactions resulted in a facile controlled synthesis of CLA isomers, useful for the chromatographic identification of milk fat CLA, as well as for the preparation of CLA standard mixture.
Asymmetric Sharpless epoxidation of 13S‐hydroxy‐ 9Z, 11E‐octadecadienoic acid (13S‐HODE)
Authors: Nor Omar Muhammad , Moynihan Humphrey A. , Hamilton Richard J.
Published: February 2003

The asymmetric Sharpless epoxidation of methyl 13S‐hydroxy‐9Z, 11E‐octadeca‐dienoate (13S‐HODE, 1) with tert‐butyl hydroperoxide (TBHP) catalysed by titanium tetraisopropoxide {Ti(iOPr)4} in the presence of L(+)‐diisopropyl tartrate (L‐DIPT) gave methyl 13S‐hydroxy‐11S, 12S‐epoxy‐9Z‐octadecenoate 2 (erythro isomer) in 84% diastereomeric excess (de). The epoxidation of 1 with TBHP catalysed by Ti(iOPr)4 in the presence of D(‐)‐DIPT yielded methyl 13S‐hydroxy‐11RR12R‐epoxy‐9Z‐octadecenoate (threo isomer) 3 in 76% de.
Determination of monoglycerides, diglycerides, triglycerides and glycerol in fats by means of gel permeation chromatography [C‐VI 5b(02)]
Authors: Schoenfelder Wolfgang
Published: February 2003

The “Joint Committee for the Analysis of Fats, Oils, Fatty Products, Related Products and Raw Materials (GAFett)” has developed the following method for the determination of the content of monoglycerides, diglycerides, triglycerides and glycerol in fats and fat derivatives. It is intended to include this method in Section C, Chapter VI of the German Standard Methods.
Elimination of polycyclic aromatic hydrocarbons by bleaching of olive pomace oil
Authors: León‐Camacho Manuel , Viera‐Alcaide Isabel , Ruiz‐Méndez M. Victoria
Published: February 2003

A detailed study of the efficacy of the bleaching process for elimination of polycyclic aromatic hydrocarbons in Spanish olive pomace oils has been carried out. For this purpose active carbon with bleaching earth was used as absorbent. The amount of benzo‐(α)‐pyrene was determined by reversed‐phase high‐performance liquid chromatography with a Fluorimetric detector. The use of exhausted filter‐cakes in countercurrent processes with a cake formed of active carbon and bleaching earth is very efficient for reducing the initial content of benzo‐(α)‐pyrene before the addition of fresh adsorbent, thus reducing the amounts of carbon and earth required.
Investigating the needs of carers in the area of eating disorders: development of the Carers' Needs Assessment Measure (CaNAM)
Authors: Haigh Rachel , Treasure Janet
Published: February 2003

Objective:

To develop an instrument that can be used to assess the needs of carers of people with an eating disorder and to perform a pilot test of this measure.

Method:

A focus group was held with 12 carers of people with anorexia nervosa (AN). A self‐report questionnaire, the Carers' Needs Assessment Measure (CaNAM), was developed from discussions of the focus group. A pilot test of the CaNAM was carried out with a sample of 28 carers of people with AN.

Results:

Carers of people with AN showed high levels of unmet needs in the domains of ‘Information about eating disorders’, ‘Support from other people/organizations’ and ‘Information received from general practitioners’.

Discussion:

Carers of people with AN show high levels of unmet needs. The dominant need was for practical and emotional help in dealing with the eating disorder. A revised version of the CaNAM is currently being tested with a larger sample of carers. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.
Decisional balance in anorexia nervosa: capitalizing on ambivalence
Authors: Cockell Sarah J. , Geller Josie , Linden Wolfgang
Published: February 2003

Previous research has shown that unlike two‐factor solutions found in other populations, the Decisional Balance (DB) scale for anorexia nervosa consists of three factors: Benefits (Pros), Burdens (Cons), and Functional Avoidance.

Objective

The purpose of this study was to examine the psychometric properties of the DB scale for anorexia nervosa and to investigate relationships between DB scores and pre‐action stages of change.

Method

Eighty women with anorexia nervosa were recruited from consecutive referrals to an eating disorder clinic. Participants completed the DB scale, as well as measures to assess validity.

Results

The DB scale demonstrated good convergent and discriminant validity. Furthermore, relative to individuals in precontemplation, individuals in contemplation reported more disadvantages of anorexia nervosa (i.e. higher Burdens) and more insight regarding how anorexia nervosa provides a means to avoid (i.e. higher Functional Avoidance). Benefits of anorexia nervosa did not change between pre‐action stages.

Discussion

The clinical implications for enhancing readiness to change are addressed. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.
Come to me, my melancholic baby!
Authors: Weiss Kenneth
Published: February 2003

Some famous textbook cases of evolution aren't unambiguously true. Does it matter?