bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroblastoma in adolescents and adults: The Memorial Sloan‐Kettering experience
Authors: Kushner Brian H. , Kramer Kim , LaQuaglia Michael P. , Modak Shakeel , Cheung Nai‐Kong V. 
Published: October 2003

AbstractBackgroundWe reviewed the utility of different treatment modalities in a large series of adolescents/adults with neuroblastoma (NB).ProcedureThe 30 adolescents/adults (median age, 19 years) had stage 2B (n = 1), 3 (n = 2), or 4 (n = 27) NB. Treatments included conventional and myeloablative therapy; local radiotherapy (RT); immunotherapy with anti‐GD2 3F8 monoclonal antibody ± granulocyte–macrophage colony‐stimulating factor (GM‐CSF); and 3F8 alternating with low‐dose oral etoposide.ResultsSeven patients are in first (n = 4) or second (n = 3) complete/very good partial remission (CR/VGPR) at 9+ to 181+ (median, 45+) months. Among 13 newly diagnosed or minimally prior‐treated patients, no major responses were seen in 4/4 treated with N4/N5 chemotherapy, but 6/9 treated with the higher dose N6/N7 regimens and surgery had major responses, and immunotherapy produced CR in BM in three patients. Among 17 patients referred because of resistant NB, favorable responses occurred in 6/12 treated with high‐dose cyclophosphamide‐based salvage therapy, including one patient who is in CR 170+ months after myeloablative consolidation and five patients who achieved CR/VGPR after 3F8/GM‐CSF (n = 4) or 3F8/oral etoposide (n = 1). With a median follow‐up of 32+ months post‐RT, no local relapses occurred in 10/10 patients who received hyperfractionated 21 Gy RT to prevent regrowth of soft tissue masses that had been resected.ConclusionsHigh‐dose chemotherapy and surgery can achieve a minimal disease state in >50% of newly diagnosed older NB patients. In that setting, local RT, and the use of agents with recently confirmed anti‐NB activity, including anti‐GD2 antibodies, and cis‐retinoic acid, may improve the poor prognosis of these patients reported to date. Med Pediatr Oncol 2003;41:508–515. © 2003 Wiley‐Liss, Inc.
Malawi pilot study of Burkitt lymphoma treatment
Authors: Hesseling Peter B. , Broadhead Robin , Molyneux Elizabeth , Borgstein Eric , Schneider Johann W. , Louw Mercia , Mansvelt Erna P.G. , Wessels Glynn 
Published: October 2003

AbstractBackgroundBurkitt lymphoma (BL) accounts for 50% of childhood cancer in Malawi. Lack of resources precludes the use of new successful treatment approaches such as the LMB 89 group B protocol, which cures >80% of children with stage III BL with high dose chemotherapy and matching supportive care. Our objective was to achieve a good cure rate in Murphy stage I–III BL with manageable toxicity in Malawi at a drug cost of <1,000 US dollars per patient.ProcedureThe intensity and toxicity of the LMB 89 group B protocol was reduced and adapted to Malawi realities. All stages received the same treatment. Children with suspected BL in the period July 1997–November 1999 were subjected to abdominal ultrasound, a tumor biopsy and/or fine needle aspirate (FNA) and bone marrow (BM), cerebrospinal fluid (CSF), and peripheral blood examination. HIV seropositive children were excluded. Endpoints are projected event free survival (EFS) at minimum 1 year, blood and gastro‐intestinal tract toxicity, and risk for and severity of infections.ResultsForty‐four children were eligible for treatment and analysis. Their median age was 7.2 years, M:F ratio 1.4:1 with 10 stage I, 5 stage II, and 29 stage III patients. Projected Kaplan–Meier EFS for all was 57% (CI 41–73) at 1 year with 90% EFS in stage I and 52% EFS in stage III. The survival curve remained stable at 500 days. Toxicity and delays in appropriate supportive care contributed to ten deaths during treatment. Local recurrent tumor caused five and CNS recurrence one death. Two children died from progressive disease. The incidence of severe (grade 3 and/or 4) hematologic toxicity varied from 13% to 36%, gastro‐intestinal toxicity (GIT) from 2% to 17%, and infections from 7% to 41% per chemotherapy module.ConclusionsIt is possible to administer less intense and less costly multiagent chemotherapy to children with BL in a developing society with acceptable EFS rates. Adequate supportive care of the at‐times associated severe toxicity must be made available to better the results. Med Pediatr Oncol 2003;41:532–540. © 2003 Wiley‐Liss, Inc.
Epigenetic changes in the DAP‐kinase CpG island in pediatric lymphoma
Authors: Shiramizu Bruce , Mick Paul 
Published: October 2003

AbstractBackgroundHypermethylation of CpG islands in the promoter region of death‐associated protein kinase (DAP‐kinase) coupled with the loss of γ‐interferon‐induced apoptosis have been reported in B‐cell malignancies suggesting a role in pathogenesis or prognosis. Along with B‐cell malignancies, pediatric lymphomas also include T‐cell non‐Hodgkin lymphoma (NHL), anaplastic large cell lymphoma, and Hodgkin disease, each with unique prognoses. The purpose of this study was to elucidate epigenetic changes in the DAP‐kinase promoter region of pediatric cases to determine associations with aberrant hypermethylation.ProceduresThirty‐nine cases of different lymphoid pathology [10 Burkitt lymphoma, 1 B‐cell NHL; 7 T‐cell lymphoblastic lymphoma; 4 anaplastic large cell lymphoma (LCL); 2 B‐cell LCL; 14 nodular sclerosing Hodgkin disease (NSHD); and 1 B‐cell acute lymphoblastic leukemia (ALL)] had methylation‐specific polymerase chain reaction performed on bisulfite‐treated DNA, which distinguishes the methylation status of the promoter region, and DAP‐kinase mRNA expression assays performed on available specimens.ResultsIn normal lymphocytes, the CpG islands in the promoter region were unmethylated, as were the T‐cell lymphoblastic lymphoma and anaplastic LCL. In contrast, 100% of the Burkitt lymphoma (10/10) and B‐cell ALL (1/1) were hypermethylated. Of the specimens with mRNA available, 7/8 Burkitt lymphoma had no DAP‐kinase mRNA expression compared to normal expression in 3/3 and 4/4 T‐cell lymphoblastic lymphoma and NSHD, respectively.ConclusionsIn these pediatric lymphoid tumors, hypermethylation of the DAP‐kinase promoter region with associated loss of DAP‐kinase gene expression was associated with B‐cell malignancies and thus may be important in the development and/or provide a prognostic tool in B‐ cell lymphomas. Med Pediatr Oncol 2003;41:527–531. © 2003 Wiley‐Liss, Inc.
Langerhans cell histiocytosis patients have HLA Cw7 and DR4 types associated with specific clinical presentations and no increased frequency in polymorphisms of the tumor necrosis factor alpha promoter
Authors: McClain Kenneth L. , Laud Purnima , Wu Wen‐Shu , Pollack Marilyn S. 
Published: October 2003

AbstractBackgroundCurrent theory on the etiology of Langerhans cell histiocytosis (LCH), formerly Histiocytosis‐X, is that abnormality(ies) of the immune system are responsible for dysregulation of Langerhans cells (LC) in patients' lesions. Among the known abnormalities in LCH patients are increased amounts of tumor necrosis factor alpha (TNF‐α) and other cytokines in the lesions.ProcedureWe investigated the human leukocyte antigen (HLA) phenotypes of 29 patients and 37 healthy family members to determine if any haplotypes segregate with the presence or locations of the disease. The lymphocyte subsets for 22 patients and 11 family members were also determined.ResultsPatients with single bone, multiple bone, or multi‐system LCH had different relative proportions of HLA types. Patients presenting with single bone disease had an especially high frequency of the DR4 type. In this patient group, every Caucasian patient had either Cw7 or DR4. Lymphopenia was documented in patients who had been off therapy as well as those who only had surgical curetage of their lesions. Family members also had low numbers of T lymphocytes. There were fewer mutations of the TNF‐α promoter in patients than in the general population.ConclusionsAlthough there is an increased percentage of LCH patients with DR4 and/or Cw7 there was also an increased prevalence of this antigen as well as lymphopenia among unaffected family members. Additional genetic and/or environmental factors are necessary to explain this association. TNF‐α promoter mutations are not responsible for the increased production of this cytokine. Med Pediatr Oncol 2003;41:502–507. © 2003 Wiley‐Liss, Inc.
Prevalence and correlations of anal incontinence and constipation in Taiwanese women
Authors: Chen Gin‐Den , Hu Suh‐Woan , Chen Yi‐Ching , Lin Tzu‐Li , Lin Long‐Yau 
Published: October 2003

AbstractAnal incontinence and constipation are not only physically and psychologically disabling symptoms but also a significant social and public health problem. The epidemiology of anal incontinence and constipation from community‐bases remains largely unknown, especially in Asian women. This study is a continuation of a previous survey taken on the epidemiology of urinary incontinence and overactive bladder in Taiwanese women by using a second questionnaire (correlation coefficient for symptoms, r=0.87; P<0.05). We evaluated the prevalence and potential risk factors associated with anal incontinence and constipation in the general population. Of the 1,584 (2.92%) women sampled, 1,253 (79.1%) were successfully interviewed at home. The prevalence of fecal incontinence and flatus incontinence was 35 (2.8%) and 107 (8.6%), respectively. There were 306 (24.5%) participants who reported constipation. However, according to the current medical criteria for constipation, the prevalence of constipation was only 2.7%. The prevalence of anal incontinence did not increase after the age of 65 years (9.7%, including 3.5% of elderly women with fecal incontinence and 6.2% of elderly women with flatus incontinence). The prevalence of constipation significantly increased in the women aged 65 years and over (self‐reported prevalence: 32.4%, fitted in medical criteria for constipation: 8.3%). Our results demonstrated that constipation shares some of the same risk factors, namely, symptoms of uterovaginal prolapse, prior gynecologic surgery, and overactive bladder that predispose women to the occurrence of anal incontinence. The questionnaire needs a higher discriminatory capacity, and a longitudinal study should be conducted to clarify this conflict further. Neurourol. Urodynam. 22:664–669, 2003. © 2003 Wiley‐Liss, Inc.
Bladder–anal reflex
Authors: Basinski Cindy , Fuller Elizabeth , Brizendine Edward J. , Benson J. Thomas 
Published: October 2003

AbstractAimsThe purposes of this study were to evaluate the bladder–anal reflex (BAR) latency in asymptomatic women and determine the pathway of the reflex using selective anesthesia and neuromuscular block.MethodsUrinary incontinence, voiding dysfunction, and pelvic organ prolapse are common problems in women. Evaluation of pelvic nerve function often augments the clinical assessment of these women. Urethral–anal and clitoral–anal reflex testing have been reported as methodologies to assess patients with neurogenic disorders. A bladder–anal reflex is also obtainable but has not been reported previously in the literature. Twenty‐two subjects and two patients were recruited for evaluation of the BAR.ResultsThis study has allowed us to estimate reference ranges for BAR latency and threshold. We defined the upper limit of these reference ranges as two standard deviations above their respective means. For the BAR latency, the upper limit of the reference range is 91 msec. Any latency value above this limit should be considered abnormal. The upper limit for the BAR threshold reference range is 37.7 mA. Lower thresholds are not thought to be clinically meaningful due to the presence of several low sensory thresholds in this asymptomatic normal population.ConclusionsThe BAR was obtainable in asymptomatic women and compatible with known anatomy and innervation of the lower urinary tract. Neurourol. Urodynam. 22:683–686, 2003. © 2003 Wiley‐Liss, Inc.
Compliance with a pelvic muscle exercise program as a causal predictor of urinary stress incontinence amongst Chinese women
Authors: Siu L.S. , Chang A.M. , Yip S.K. , Chang A.M.Z. 
Published: October 2003

AbstractAimTo determine the importance and contribution of compliance in a pelvic muscle exercise program as a factor in reducing the severity of urinary stress incontinence amongst Chinese women.MethodsTwo hundred fourteen women presenting with urinary stress incontinence who agreed to undertake a program of pelvic muscle exercises were recruited into the study. Incontinence (wetting episodes), pelvic muscle strength, exercises compliance, correctness of pelvic muscle exercise technique, duration of stress incontinence, and previous history of pelvic surgery were recorded on four occasions: baseline (first clinic session) and second to fourth clinic sessions. Demographic data were also collected at baseline. Stepwise multiple regression analyses were used to determine the relative importance of compliance to exercise regime in predicting the severity of incontinence. Path analysis was used to provide a summary description of the influence of compliance on the outcomes over the four visits.ResultsThe pelvic muscle training program appears to be able to reduce the overall urinary incontinence episodes by 85.2% and achieved a 73.1% increase in pelvic muscle strength. Although the number of wetting episodes in any visit are causally linked to that recorded in previous visit, those who were more compliant had a greater reduction. Age, mode of delivery, menopausal status, history of pelvic surgery, and duration of incontinence did not appear to contribute significantly to predicting incontinence.ConclusionCompliance with pelvic muscle exercises significantly contributed to a reduction in urinary stress incontinence. Neurourol. Urodynam. 22:659–663, 2003. © 2003 Wiley‐Liss, Inc.
Dissociation between electrical and mechanical bulbocavernosus reflexes
Authors: Amarenco Gerard , Ismael Samer Sheikh , Bayle Beatrice , Kerdraon Jacques 
Published: October 2003

AbstractAimsTo record reflex motor responses, elicited by mechanical stimulation of the penis or clitoris, in each bulbocavernosus muscles and to compare left and right reflex pathways in normal subjects, then to compare electrical and mechanical responses in various neurological diseases.MethodsTwo groups of patients were studied: 22 patients without neurological disease considered as normal subjects; and 25 patients with neurological disease (three multiple sclerosis, six spina bifida, nine conus medullaris syndrome, three peripheral neuropathies, two lumbosacral lesions, one multisystem atrophy, and one syringomyelia). Electrical bulbocavernosus reflex (EBCR) was evoked by orthodromic stimulation of the dorsal nerve of the penis at the penile base or the clitoris. Mechanical bulbocavernosus reflex (MBCR) was elicited with an electromechanical hammer, tapping directly on the clitoris zone or on the ventral part of glans penis. For EBCR and MBCR, bulbocavernosus muscle contractions were successively recorded in the left and in the right side with a needle inserted under visual guidance.ResultsMean left mechanical latency was 31.7 msec (SD = 4.5) and right one 31.6 msec (SD = 3.8). The reproducibility of the responses was excellent (P < 0.0001). ). The mean difference between left and right latencies was 2 msec (SD = 1.2). In the neurological group, 22 EBCR (six right, nine left, seven bilateral) and 19 MBCR (eight right, nine left, two bilateral) were considered abnormal. The mean reflex latencies in patients with neurological lesions (lower motor neuron lesions) were statistically longer (P < 0.0001) than in normal subjects. Exact concordance (side of lesion) between MBCR and EBCR was observed in 15/25 cases (60%), poor concordance (presence of a sacral reflex alteration) in 3/25 (12%) cases, and in 7/25 (28%) cases there was a significant difference between the two techniques.ConclusionsMBCR may provide a good alternative for electrical stimulation and can be used to evaluate urinary disorders when a neurological etiology is suspected. However, the presence of false negatives with MBCR suggest that it may be more useful as a screening test. Neurourol. Urodynam. 22:676–680, 2003. © 2003 Wiley‐Liss, Inc.
Urinary bladder hyperreflexia: A rat animal model
Authors: Shaker Hassan , Mourad Mohammed Sherif , Elbialy Mohammed Hatem , Elhilali Mostafa 
Published: October 2003

AbstractIn this work, we are presenting a rat animal model for bladder hyperreflexia after suprasacral spinal cord transection. Our aim was to standardize an animal model that can be useful in studying this condition. After standardizing the animal model in a pilot study, 26 female Sprague–Dawley rats were subjected to spinal cord transection at the level of T10 vertebra. Four animals were subjected to cystometrogram (CMG) 24 hr after spinalization and six rats 3 weeks post‐spinalization. These CMGs were compared to that of six normal controls. The detailed description of the model presented in this manuscript, is the final result after several modifications. All the animals consistently developed hyperreflexia after an initial period of spinal shock phase. Expressed volume of urine continued to decrease until it reached a plateau after peaking at 1‐week post‐spinalization. The attrition rate reached 27.3% after several improvements in the animal model and was mostly from self‐inflicted injuries. Post‐operative complications included hypothermia, decubitus ulcers, hematuria, urinary tract infection in addition to the unexplained death of two animals. In conclusion, we believe that this animal model closely resembles the clinical condition of hyperreflexia and follows similar course. The relative low cost of this animal model and the easy maintenance makes it a valuable tool to study such a condition. Neurourol. Urodynam. 22:693–698, 2003. © 2003 Wiley‐Liss, Inc.
Observations on the function of the female urethra: I: Relation between maximum urethral closure pressure at rest and urethral hypermobility
Authors: Schick Erik , Tessier Jocelyne , Bertrand Pierre E. , Dupont Charles , Jolivet‐Tremblay Martine 
Published: October 2003

AbstractAimsTo study the relation between maximum urethral closure pressure at rest and urethral hypermobility in female patients.Patients and MethodsWe selected 255 patients aged 20 years and older, with a stable bladder on multichannel urodynamics, without known neurological pathology, and without a history of pelvic or anti‐incontinence surgery. A resting urethral pressure profile and the degree of urethral hypermobility were registered. Two‐tailed analyses of variance (ANOVA) with Fisher's post‐hoc tests were used to detect any statistically significant difference (P < 0.05) in urethral closure pressure between groups with varying degrees of urethral hypermobility.ResultsMean age was 45.6 ± 12.7 (range 20–77) years. Mean maximum urethral closure pressure for the entire group was 62.7 ± 29 (range 10–150) cm of water. A statistically significant inverse relationship was found between age and maximum urethral closure pressure (r = 0.489, P < 0.0001) when both analyzed as continuous variables, and with age categorized in 10‐year increments (P < 0.0001). When comparing mean urethral closure pressure in each group examined for urethral hypermobility, a statistically significant difference was noted when grades I, II, and III were compared to grade 0 hypermobility. No significant difference was observed when grades I, II, and III were compared to each other. Even if statistically non‐significant, there exists an inverse relationship between the degree of urethral hypermobility and the maximum urethral closure pressure: a higher hypermobility is associated with a lesser urethral closure pressure.ConclusionsUrethral closure pressure falls significantly when urethral hypermobility is present. This decrease is not related to patient's age or parity. Our observations demonstrate an inverse relation between urethral closure pressure and the degree of cysto‐urethrocele. As hypermobility increases, closure pressure decreases, even if this decrease does not reach the level of statistical significance. Neurourol. Urodynam. 22:643–647, 2003. © 2003 Wiley‐Liss, Inc.
Preconditioning protects the guinea‐pig urinary bladder against ischaemic conditions in vitro
Authors: Lorenzi Bruno , McMurray Gordon , Jarvis Gavin , Brading Alison F. 
Published: October 2003

AbstractAimsTo investigate the ability of ischaemic preconditioning (IPC) to protect guinea‐pig detrusor from damage caused by a subsequent more prolonged exposure to ischaemic conditions.Materials and MethodsSmooth muscle strips were mounted for tension recording in small organ baths continuously superfused with Krebs' solution at 37°C. Ischaemia was mimicked by removing oxygen and glucose from the superfusing solution. Contractile responses to electrical field stimulation (EFS) and carbachol were monitored. Three regimes of preconditioning were examined: 15, 10, and 5 min of ischaemic conditions followed by 15, 10, and 5 min of normal conditions, respectively.ResultsWithout preconditioning, nerve‐mediated responses were significantly and proportionally reduced by periods of ischaemic conditions lasting for 45, 60, and 90 min, but recovered fully after exposure to ischaemic conditions for 30 min. The recovery of the responses to EFS was significantly improved in preconditioned strips when the period of ischaemic conditions was 45 or 60 min. However, no significant differences were seen with preconditioning when the period of ischaemic conditions was 90 min. The recovery of responses to carbachol was much greater than for the responses to EFS, and no significant differences were found between control and preconditioned strips.ConclusionsIt is suggested that in vivo short periods of transient ischaemia may be able to protect the guinea‐pig bladder from the impairment associated with longer periods of ischaemia and reperfusion, which might happen in obstructed micturition. Our results also indicate that the phenomenon affects mainly the intrinsic nerves, which are more susceptible to ischaemic damage than the smooth muscle. Neurourol. Urodynam. 22:687–692, 2003. © 2003 Wiley‐Liss, Inc.
Development of a dynamometer for measuring the isometric force of the pelvic floor musculature
Authors: Dumoulin Chantale , Bourbonnais D. , Lemieux M.‐C. 
Published: October 2003

AbstractAimsThe aim of this study was to design and develop a dynamometer providing a direct measurement of pelvic floor muscle (PFM) strength.Materials and MethodsTwo pairs of strain gauges were mounted on the moveable branch of a dynamometric speculum allowing measurements at different vaginal apertures. Linearity, repeatability, independence of the site of application of the resultant force to the lower branch of the speculum and hysteresis were tested by means of in vitro calibration studies.ResultsThe linearity proved excellent over a range of 0–15 N with regression coefficients close to unity between imposed loads and voltage outputs. The slopes and intercepts of the regression lines were not significantly different between repeated sessions, indicating the high reliability of these in vitro measurements. The slopes and intercepts of the calibrations, using the same repertoire of loads imposed at three locations on the moving branch of the dynamometer, were not significantly different, confirming that the force measurement is independent of the site of the force application. Hysteresis was considered to be minimal.ConclusionsThis study demonstrates that the dynamometer provides reliable measurements. The new device thus appears to have conceptual and measuring advantages over conventional methods and seems to be a very promising instrument for measuring pelvic floor strength. Neurourol. Urodynam. 22:648–653, 2003. © 2003 Wiley‐Liss, Inc.