bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of CD40‐dependent B‐cell proliferation in B lymphocytes isolated from patients with persistent polyclonal B‐cell lymphocytosis
Authors: Loembé Marguerite Massinga , Lamoureux Josée , Deslauriers Noella , Darveau André , Delage Robert 
Published: March 2003

Persistent B‐cell lymphocytosis (PPBL) is a haematological disorder diagnosed primarily in adult female smokers that is characterized by a polyclonal increase in peripheral blood B lymphocytes and a moderate elevation of serum IgM. B lymphocyte‐associated cellular abnormalities, such as the occurrence of multi‐lobed nuclei, increased bcl2/Ig gene rearrangements and the identification of an extra long‐arm chromosome (i3)(q10) in the B‐cell population, indicate that PPBL could be part of a multi‐step process leading to the emergence of a malignant B lymphoproliferation. However, the resulting impact on cellular functional properties remains to be elucidated. Our goal was to address that aspect via the study of B‐cell activity following stimulation through CD40, a key molecule of the tumour necrosis factor receptor superfamily involved in B lymphocyte development. In contrast to normal B cells, PPBL B lymphocytes were unable to respond to the proliferative signal delivered in vitro by CD40, indicating a defect in the CD40 activation pathway. Polymerase chain reaction amplification and sequencing of the receptor as well as FACScan analysis of patient B lymphocytes dismissed the possibility of a defect in either CD40 structure or expression. Moreover, Western blot analysis of tyrosine phosphorylation, an early event in the CD40‐signalling cascade, was similar in patients and controls, leading to the conclusion that the defect affecting B lymphocytes in PPBL patients is probably located downstream of that signalling cascade.
Ex vivo expansion of umbilical cord blood (UCB) CD34+ cells alters the expression and function of α4β1 and α5β1 integrins
Authors: Ramírez Manuel , Segovia José Carlos , Benet Isana , Arbona Cristina , Güenechea Guillermo , Blaya Carolina , García‐Conde Javier , Bueren Juan A. , Prosper Felipe 
Published: March 2003

We have investigated the influence of ex vivo expansion of human CD34+ cord blood cells on the expression and function of adhesion molecules involved in the homing and engraftment of haematopoietic progenitors. Ex vivo expansion of umbilical cord blood CD34+ cells for 6 d in the presence of interleukin 3 (IL‐3), IL‐6 and stem cell factor (SCF) or IL‐11, SCF and Flt‐3L resulted in increased expression of α4, α5, β1, αΜM and β2 integrins. However, a significant decrease in the adhesion of progenitor cells to fibronectin was observed after the ex vivo culture (adhesion of granulocyte‐macrophage colony‐forming units (CFU‐GM) was 22 ± 4% in fresh cells versus 5 ± 2% and 2 ± 2% in each combination of cytokines). Incubation with the β1 integrin‐activating antibody TS2/16 restored adhesion to fibronectin. Transplantation of ex vivo expanded umbilical cord blood CD34+ cells was associated with an early delayed engraftment in non‐obese diabetic/severe combined immunodeficient (NOD/SCID) mice. Incubation of cells with the monoclonal antibody TS2/16 before transplantation almost completely abrogated NOD/SCID repopulating ability of both fresh and expanded CD34+ cells. The seeding efficiency of fresh and expanded CD34+ cells was similar, but markedly reduced after incubation with the TS2/16 monoclonal antibody. Our results show that functional activation of β1 integrins could overcome the decreased very late antigen (VLA)‐4‐ and VLA‐5‐mediated adhesion observed after ex vivo expansion of haematopoietic progenitors. However, in vivo, these effects induced an almost complete abrogation of the homing and repopulating ability of CD34+ UCB cells.
Prospective study of the incidence and outcome of intra-abdominal hypertension and the abdominal compartment syndrome
Authors: Hong J J , Cohn S M , Perez J M , Dolich M O , Brown M , McKenney M G 
Published: March 2003

Abstract

Background
Intra-abdominal hypertension has been recognized as a source of morbidity and mortality in the traumatized patient following laparotomy. Multiple organ dysfunction attributable to intra-abdominal hypertension has been called the abdominal compartment syndrome. The epidemiology and characteristics of these processes remain poorly defined.

Methods
Intra-abdominal pressure was measured prospectively in all patients admitted to a trauma intensive care unit over 9 months. Data were gathered on all patients with intra-abdominal hypertension.

Results
Some 706 patients were evaluated. Fifteen (2 per cent) of 706 patients had intra-abdominal hypertension. Six of the 15 patients with intra-abdominal hypertension had abdominal compartment syndrome. Half of the patients with abdominal compartment syndrome died, as did two of the remaining nine patients with intra-abdominal hypertension. Patients with abdominal compartment syndrome had a mean intra-abdominal pressure of 42 mmHg compared with 26 mmHg in patients with intra-abdominal hypertension only (P &lt; 0·05).

Conclusion
The incidence of intra-abdominal hypertension and abdominal compartment syndrome was 2 and 1 per cent respectively. Intra-abdominal hypertension did not necessarily lead to abdominal compartment syndrome, and often resolved without clinical sequelae. Abdominal compartment syndrome did not occur in the absence of earlier laparotomy. Abdominal compartment syndrome was associated with a marked increase in intra-abdominal pressure (above 40 mmHg).
Surgical technique and outcome of gasless video endoscopic transanal rectal tumour excision
Authors: Nakagoe T , Ishikawa H , Sawai T , Tsuji T , Tanaka K , Ayabe H 
Published: March 2003

Abstract

Background
Transanal endoscopic microsurgery (TEM) is unpopular because of its high cost and most surgeons' unfamiliarity with microscopic surgery. This report describes an experience with a modification of TEM, gasless video endoscopic transanal rectal tumour excision (gasless VTEM), which incorporates a standard laparoscopic video camera and requires no carbon dioxide insufflation system.

Methods
One hundred and one patients with 105 rectal tumours underwent gasless VTEM between 1993 and 2000.

Results
Histological examination revealed 18 adenomas, 75 carcinomas (Tis, 47; T1, 23; T2, five), 11 carcinoid tumours and one lymphoma. The median height above the dentate line and maximum tumour diameter was 5·0 (range 2–14) cm and 2·0 (range 0·4–8·0) cm respectively. The peritoneal cavity was opened intraoperatively in two patients. The median operating time was 53 (range 15–202) min. Bleeding, suture dehiscence and transient incontinence developed after operation in four patients. There was no operative death. Median hospital stay was 5 (range 1–21) days. Eleven patients with T1/T2 staging underwent subsequent radical resection. The median duration of follow-up was 52·3 months. One patient with a carcinoma developed a recurrence.

Conclusion
Gasless VTEM is a feasible, safe and minimally invasive procedure for the treatment of selected rectal adenomas and early carcinomas. The suggested modifications may make the procedure more widely available.
Long-term results of surgery for early gastric cancer
Authors: Popiela T , Kulig J , Kolodziejczyk P , Sierzega M 
Published: March 2003

Abstract

Background
Gastrectomy for early gastric cancer is widely accepted as an adequate therapeutic method. Recent developments of less invasive procedures require the identification of patients who will benefit from such an approach.

Methods
A retrospective study was undertaken of 238 patients with early gastric cancer who underwent gastrectomy from 1977 to 1999. Clinicopathological data relating to survival were evaluated.

Results
Analysis of 33 node-positive patients (14 per cent) revealed a tumour diameter greater than 20 mm (P = 0·011), depressed macroscopic type (P &lt; 0·05), diffuse histological type (P &lt; 0·001), poor tumour differentiation (P &lt; 0·001) and infiltration of the submucosal layer (P &lt; 0·002) as factors associated with lymph node metastasis. Multivariate analysis found diffuse histological type to be an independent risk factor. The overall 5-year survival rate was 87 per cent, and was significantly better in patients who underwent radical lymphadenectomy than in those who had regional lymph node dissection (92 versus 78 per cent; P &lt; 0·01). Similarly, patients younger than 65 years had a more favourable 5-year survival rate (90 per cent) than older ones (77 per cent). Multivariate analysis with the Cox proportional hazards model confirmed patient age and type of lymphadenectomy as independent prognostic factors.

Conclusion
The findings suggest that extended lymph node dissection may be beneficial for some patients with early gastric cancer, although randomized clinical trials are needed to evaluate this observation further.
Findings on the impact of treatment for childhood acute lymphoblastic leukaemia on family relationships
Authors: McGrath Pam 
Published: March 2003

ABSTRACTPaediatric acute lymphoblastic leukaemia (ALL) has provided a landmark in cancer therapy as the first disseminated and otherwise lethal malignancy to be curable in the majority of patients. Although the success rate is high, this benefit is achieved through a long, invasive and very arduous treatment process. The experience of undergoing such intensive treatments affects not only the child, but the entire family. To date, however, psychosocial research is only beginning to describe the depth and breadth of the impact on families of this experience. This paper presents findings from a recent qualitative study of families coping with the initial stage (induction remission) of treatment for childhood ALL. The findings indicate that the experience is so profoundly disturbing and disruptive that it challenges the families' sense of normalcy and stability. These findings provide evidence of significant hardship and stress, with the consequent indication of the need for social work support. Above all, such families need to hear the comforting message from social workers that what they are experiencing is normal under the circumstances. Along with practical assistance, they need reassurance about the intensity of feelings they will experience and an affirmation of the difficulty of the challenges they face.
Strategies for survival: users' experience of child welfare in three welfare regimes
Authors: Hetherington Rachael , Piquardt Rolf 
Published: March 2003

ABSTRACTThis paper draws on research into child welfare services in France, Germany and England which compares the subjective experience of mothers who have been in contact with family support and child protection agencies in the three countries. The mothers' stories suggest that successful help‐achieving strategies differ according to the nature of the child welfare regime, and that behaviour which is effective in getting a good response in one country may work less well elsewhere. The stories of two mothers in each of the countries have been chosen to demonstrate how the structures of different social welfare regimes affect the efforts of welfare users to get the help they need.
‘Contact Irregular’: a qualitative analysis of the impact of visiting patterns of natural parents on foster placements
Authors: Browne Deborah , Moloney Ann 
Published: March 2003

ABSTRACTOver the years there has been much debate about the effect of parental visiting on children in foster care. While some contend that it is essential to maintain attachment bonds to the birth family, others argue that contact undermines the new relationship with the foster family. By studying descriptions of visiting patterns of 113 foster placements this study attempts to examine how parental access affects the foster child. A qualitative analysis of the written accounts offered by social workers yielded four distinct visiting patterns: Regular and Frequent, Regular but Infrequent, Infrequent, and No Access. The nature of the analysis also allowed for a redefinition of placement outcome into three categories: Successful placements, Ambiguous placements and Crisis placements. Because the categories that emerged from the qualitative analysis were mutually exclusive it was possible to examine, using chi square, whether there was a quantitative relationship between the variables ‘Placement status’ and ‘Visiting patterns’. Analysis of the categorical data showed a statistically significant relationship between visiting patterns and placement outcome. This relationship, however, was not based on how visiting related to Successful or Crisis placements. Instead it was evident that those placements categorized as Ambiguous were far more likely to report Infrequent visiting patterns. Case examples offer an opportunity to examine possible reasons for this relationship. The paper also describes qualitative accounts of how children reacted to the visits. The unique approach to defining placement status in this study may help explain the conflicting findings on this topic over recent years.
Communication about parental illness with children who have learning disabilities and behavioural problems: three case studies
Authors: Barnes J , Kroll L , Lee J , Jones A , Stein A 
Published: March 2003

SummaryParental illness can have a profound impact on family relationships and children's behaviour. The amount and nature of communication between parents and children about the illness can play an important role, both positively and negatively, in mediating the outcomes. When children have a disability, families can be reluctant to communicate with them about family difficulties. They are often concerned about the impact that parental unavailability may have on their child's life. This paper reports on three families in which the mother was diagnosed with breast cancer and one child in the family had a disability. The extent and specific characteristics of their communication about the maternal illness with their children, behavioural changes in the children, explanations of communication strategies and attributions of behavioural changes are described. Family coping strategies are examined with reference to Lazarus's process model of stress and coping and the use of either problem‐focused or emotion‐focused strategies. Implications for possible clinical interventions are proposed. In particular it is suggested that families be offered consultation about: what children might understand ways in which to communicate effectively and strategies for coping with the long‐term implications of serious parental illness.
Six month follow‐up: the crucial test of multidisciplinary developmental assessment
Authors: Glaun D E , Cole K E , Reddihough D S 
Published: March 2003

SummaryParticipation of parents in the developmental assessment process is thought to be beneficial in promoting understanding of their child's disability, and improving consensus between parents and professionals about appropriate intervention programmes. If costly multidisciplinary assessments are to be justified, it is necessary to establish long‐term benefits for the child. This highlights a need for research identifying how families use services after diagnostic assessment and what they understand to be important for their child. Poor parent–professional agreement about diagnosis may be a factor contributing to low compliance with recommendations. The major purpose of the current study was to follow‐up families 6 months after developmental assessment, in order to investigate use of recommended intervention services. In addition, mothers’ opinions about diagnostic findings, recommendations and early intervention services were examined. Subjects were 40 pre‐school children who presented for developmental assessment, and their mothers. The majority were diagnosed with developmental problems in multiple domains. Results indicated that most mothers recalled and agreed with their child's diagnosis, but underestimated the severity of developmental delay. Families had not accessed the range of multidisciplinary intervention programmes recommended, given the complexity of their children's disabilities. Speech therapy was considered the service of highest priority by mothers, and was the treatment most frequently received. Mothers recognized a need for more therapeutic interventions for their child. An unexpected finding was the high prevalence of families who organized nonprescribed therapies. Possible explanations of the findings and implications for service delivery are discussed.
The development of a community child and family mental health service
Authors: Day C , Davis H , Hind R 
Published: March 2003

SummaryThe Community Child and Family Service is a primary care and community‐based child mental health service working in a socio‐economically disadvantaged area of inner London. This paper outlines the strategic framework and value base from which the service has developed. The clinical projects set up by the service in general practice, community and education settings are described, as are the training and supervision programmes that have been undertaken. The framework for evaluating the clinical and economic outcomes of the projects is outlined. There has been a positive response from purchasers, providers and clients to the introduction of this Service. The relationship between community‐ and hospital‐based child mental health services is discussed, as is the future direction of the Service.
Co‐existence of lysosomal storage diseases in a consanguineous family
Authors: Guy R , Forsyth J M , Cooper A , Morton R E 
Published: March 2003

SummaryLysosomal storage diseases are rare and coexistence of more than one in a family can present a diagnostic challenge as illustrated by this study. The index case born to consanguineous Asian parents presented with developmental delay. Investigations led to an incidental finding of Fabry disease. After numerous additional investigations over a year, a second diagnosis of aspartylglucosaminuria (AGU) was made. A family history of renal disease and developmental delay was disclosed. The sister and first cousin of the index case were diagnosed as homozygous for AGU, but do not have Fabry disease. The younger brother has since been diagnosed with both Fabry disease and AGU. Another cousin has learning difficulties and fits, but is heterozygous for AGU, and possibly has another uncharacterised autosomal recessive disorder. In a family with consanguinity when the clinical picture in an individual is not fully explained by the presence of one rare metabolic disease, it is essential to investigate further for the presence of others.
Acknowledging the extra care parents give their disabled children
Authors: Roberts K , Lawton D 
Published: March 2003

SummaryAround 150 000 families in the UK care for a severely disabled child under the age of 16. Many of these families receive assistance from the Family Fund Trust, which provides grants and information relating to the care of a severely disabled child. The aim of this study was to identify patterns of extra care needs among severely disabled children known to the Trust. Extra care needs are requirements for care not experienced by similarly aged non‐disabled children. The research comprised analysis of 40 000 records from the Trust database and qualitative exploration of the extra care needs of disabled children with parents and Trust staff. Although all children require parenting, the care parents give disabled children generally exceeds that given to a non‐disabled child. Quantitative analysis showed that the majority of children in the sample required extra assistance or supervision with multiple areas of daily life. With each of five activities (washing, dressing, meal times, during the night and keeping occupied), >70% of children needed extra help and, on average, each child needed extra help or supervision in six areas of daily life. Cluster analysis indicated distinctive combinations of extra care needs. Qualitative material indicated variety in extra care tasks undertaken (physical help, supervision, guidance) and causal factors (physical limitations, cognitive difficulties, behavioural problems). The findings confirm that severely disabled children have considerable extra care needs in many areas of daily life. Parents want professionals to recognize and offer explicit acknowledgement of the extra care they give their disabled children.
Technology‐dependent children in the community: definitions, numbers and costs1
Authors: Glendinning C , Kirk S , Guiffrida A , Lawton D 
Published: March 2003

Summary Objectives To assess available data on the numbers of technology‐dependent children living at home in the UK and estimate the costs of caring for them.Design Data were obtained from all known secondary sources, including surveys of children with specific conditions known to specialist paediatric departments and the database of applicants to the Family Fund Trust. The costs of all services received by three hypothetical exemplar ‘case study’ children were calculated.Results All existing sources of data have some shortcomings. Taking these shortcomings into account, it is estimated that there may be up to 6000 technology‐dependent children living at home. They appear to be disproportionately young and may be distributed unevenly between different regions of the UK. The total service costs of caring for each child will vary according to the types of technologies involved and local patterns of services, but may be as high as £150 000 a year.Conclusions Because of the very high costs of services, routine information on the numbers of technology‐dependent children discharged home is urgently needed. This should include details of the duration of technology dependence and the local area to which the child is discharged. New opportunities for joint service planning and purchasing should improve the co‐ordination of services for these children.
Measuring everyday visual discrimination in visually impaired children with the Sonksen Picture Guide to visual function
Authors: Vervloed M P J , Ormel E A , Schiphorst S A M 
Published: March 2003

SummaryThe Sonksen Picture Guide to Visual Function (SPGVF) assesses a person's ability to discriminate pictures of everyday objects. Sonksen added the SPGVF to tests of visual acuity, because real objects, miniatures, and pictures are the main learning medium for young children. In earlier studies correlations have been found between visual acuity and responses to the SPGVF. However, to date no studies have used visually impaired children. In the study reported here, the associations between performance on the SPGVF task, visual acuity and contrast sensitivity were investigated. Participants were 17 visually impaired and 29 children without disabilities, 4–6 years of age. The results showed that visual acuity was more important for picture recognition than contrast sensitivity. Contrast thresholds < 3.33% implied that not all SPGVF‐pictures could be recognized. The visually impaired children in the current study showed shorter mean identification distances than the normally sighted children in the original Sonksen and Macrae study.