bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expanding the traditional user versus non‐user dichotomy amongst ecstasy users
Authors: McMillan Brian , Sherlock Kellie , Conner Mark 
Published: February 2003

AbstractDifferences in the drug use characteristics and psychosocial variables in the use and non‐use of ecstasy within 845 16–25 year‐olds in the UK was examined. Based on levels of ecstasy use and intentions, two groups of non‐users (resistant and vulnerable), three groups of users (light, moderate and heavy) and an ex‐user group were identified. It was found that there is predictive utility in this way of expanding the widely employed ‘user versus non‐user’ dichotomy. Resistant non‐users were more likely to be younger, female, and were characterized by lower levels of use of four other drugs (amphetamine, cannabis, cocaine and LSD). Those ‘at risk’ of using ecstasy reported more frequent use of amphetamine, LSD, and cannabis than resistant non‐users. Heavy user groups reported using amphetamine, cocaine and LSD more frequently than all the other groups. Having ecstasy using friends increased the odds of being an ‘at risk’ non‐user or an ecstasy user. Normative influence also differentiated between the three user groups (light, moderate, and heavy). Beliefs about ecstasy use being immoral, ecstasy offers being difficult to resist, ecstasy use making one feel guilty and ecstasy being readily available differentiated between user and non‐user groups. These factors could usefully inform the content of health education materials designed to change ecstasy use. Copyright © 2003 John Wiley & Sons, Ltd.
Rhetorical representations of masculinities in South Africa: moving towards a material‐discursive understanding of men
Authors: Luyt Russell 
Published: February 2003

AbstractA material‐discursive perspective holds advantage in understanding male realities. It seeks to integrate dominant approaches that appear anaemic in their failure to capture the interplay between the material and discursive realms of human existence. Three dominant metaphorical themes in the rhetorical representation of South African masculinities are described in an attempt to illustrate the complexity of embodied masculine experience. In this sense the discussion seeks to reveal the dynamic nature of masculine debate and lived experience across differing contexts. It serves to underline the importance of adopting a material‐discursive perspective in understanding men, which recognizes that they do not exist as a homogeneous social group, and as such experience their masculinities in a variable and changing fashion. The theoretical amalgamation of social representations and rhetoric is argued to provide a useful analytical tool in an endeavour of this nature. It is suggested that the rhetorical approach problematizes an overly consensual view of social reality that social representations theory typically promotes. Copyright © 2003 John Wiley & Sons, Ltd.
Phase II trial of cyclophosphamide, vincristine, and dexamethasone in the treatment of androgen‐independent prostate carcinoma
Authors: Daliani Danai D. , Assikis Vasily , Tu Shi‐Ming , Papandreou Christos N. , Pagliaro Lance C. , Holtkamp Tammy , Wang Xumei , Thall Peter F. , Logothetis Christopher J. 
Published: February 2003

AbstractBACKGROUNDIn this Phase II study, the authors assessed the toxicity and anti‐tumor activity of a combination of oral cyclophosphamide, oral low‐dose dexamethasone, and intravenous vincristine (CVD) in patients with metastatic androgen‐independent prostate carcinoma (AI‐PCa).METHODSPatients with histologic proof of adenocarcinoma of the prostate progressing despite adequate hormonal therapy and adequate organ function were treated with oral cyclophosphamide, 250 mg/daily (Days 1–14); intravenous vincristine, 1 mg daily (Days 1, 8, 15); and oral dexamethasone, 0.75 mg twice a day (Days 1–14) in 28‐day cycles. Study endpoints were toxicity, rate of prostate specific antigen (PSA) decline > 50%, and/or measurable disease response.RESULTSFifty‐two (95%) of 55 registered patients were evaluable. The majority (65%) of patients had received prior chemotherapy. The median number of treatment cycles given was two (range, one–seven cycles). Twenty‐nine percent of the patients were found to have a > 50% decline in PSA level compared with baseline levels, and 25% of the patients with bidimensionally measurable soft‐tissue or visceral disease were found to have a partial response. The median progression‐free survival duration was 10 weeks, and the median overall survival duration was 10.6 months. There were no thromboembolic events, and hematologic and nonhematologic toxicity was minimal.CONCLUSIONSCVD was found to be an active and well‐tolerated regimen for AI‐PCa. The low toxicity profile makes CVD a useful treatment option for patients with significant comorbidities and high risk for treatment‐related toxicity, especially thromboembolic events and myelotoxicity. Cancer 2003;97:561–7. © 2003 American Cancer Society.DOI 10.1002/cncr.11078
Low expression of p27 indicates a poor prognosis in patients with high‐grade astrocytomas
Authors: Kirla Ruut M. , Haapasalo Hannu K. , Kalimo Hannu , Salminen Eeva K. 
Published: February 2003

AbstractBACKGROUNDTwo families of tumor suppressor genes, Cip/Kip (p21, p27, and 57) and INK4 (p15, p16, p18, and p19), regulate cell proliferation and neoplastic transformation. p27 exerts its suppressor effect through cyclin E‐dependent kinase (CDK2) by inhibiting the phosphorylation of pRb by CDK2, which, in turn, arrests cells in the G1‐phase. p21 has a similar effect in addition to participating in the p53 dependent CDK4‐mediated and CDK6‐mediated pathway. The authors studied the prognostic significance of p21 and p27 in patients with high‐grade astrocytomas who were treated with radiotherapy.METHODSThe expression of p27 and p21 was analyzed immunohistochemically in 52 glioblastomas and 25 anaplastic astrocytomas. All patients underwent surgery for the first time and were treated with adjuvant external radiotherapy.RESULTSThe p27 labeling index (LI) was < 30% in 36% of tumors, 30–50% in 25% of tumors, and > 50% in 39% of tumors. A significant difference in cumulative survival was observed between these groups (P = 0.0072; log‐rank test). The p21 LI was < 30% in 48% of tumors, 30–50% in 39% of tumors, and > 50% in 13% of tumors; these groups did not differ significantly in survival. In multivariate Cox analysis, p27 LI was an independent prognostic factor (P = 0.0008). The grade of malignancy and proliferation activity also were independent prognostic factors.CONCLUSIONSAlthough p27 and p21 are parallel cell‐cycle regulators, only p27 has independent prognostic value in patients with malignant astrocytomas. It appears that decreased levels of p21/p27 are associated with a poor prognosis and short survival. Cancer 2001;97:644–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11079
Impact of germline BRCA1 mutations and overexpression of p53 on prognosis and response to treatment following breast carcinoma
Authors: Goffin John R. , Chappuis Pierre O. , Bégin Louis R. , Wong Nora , Brunet Jean‐Sébastien , Hamel Nancy , Paradis Ann‐Josée , Boyd Jeff , Foulkes William D. 
Published: February 2003

AbstractBACKGROUNDOverexpression of p53 has been associated with poor survival following breast carcinoma. BRCA1 interacts biochemically with p53 and may also contribute to poor outcome when constitutionally mutated. The joint effect of both abnormalities has not been studied. The primary objective of this study was to assess the impact of germline BRCA1 mutations and p53 overexpression on survival after 10 years of follow‐up.METHODSA historical cohort of Ashkenazi Jewish women 65 years or younger with invasive breast carcinoma was tested for BRCA1 founder mutations. p53 overexpression was assessed by immunohistochemistry. Clinicopathologic information was obtained by chart review.RESULTSIn total, 278 women were analyzed. On univariate analysis, p53 overexpression (n = 63) was prognostic for worse overall survival (relative risk [RR] 2.6, P = 0.001) whereas BRCA1 germline mutations (n = 30) were of borderline significance (RR 1.9, P = 0.052). In the lymph node‐negative subpopulation, BRCA1 mutation status conferred a higher mortality on univariate (RR 5.6, P < 0.001) and multivariate (RR 3.5, P = 0.03) analyses. There was a trend in favor of a worse prognosis for women who carried a germline BRCA1 mutation and whose tumor overexpressed p53. When compared with noncarriers, BRCA1 mutation carriers had a worse overall survival if they did not receive adjuvant chemotherapy (RR 3.3, P= 0.01) or adjuvant hormonal therapy (RR 2.3, P = 0.02).CONCLUSIONSGermline BRCA1 mutations and p53 overexpression carry a negative prognosis that is not additive to known prognostic factors. Given the experimental sensitivity of BRCA1‐mutated cells to chemotherapy, the worse survival among BRCA1 mutation‐carrying lymph node‐negative breast carcinoma patients may be partly explained by the significantly lower proportion of lymph node‐negative patients who received adjuvant chemotherapy (P < 0.001). Cancer 2003;97:527–36. © 2003 American Cancer Society.DOI 10.1002/cncr.11080
A Phase II trial of docetaxel and estramustine in patients with refractory metastatic breast carcinoma
Authors: Tiersten Amy D. , Nelsen Caron , Talbot Susan , Vahdat Linda , Fine Robert , Troxel Andrea , Brafman Lois , Shriberg Laureen , Antman Karen , Petrylak Daniel P. 
Published: February 2003

AbstractBACKGROUNDThe similarity between the mechanism of action between docetaxel and estramustine generated the hypothesis of synergistic antimicrotubule effects and cytotoxicity when the two agents are combined. In addition, it has been demonstrated that estramustine binds P‐glycoprotein in vitro and, thus, may prevent the efflux of taxanes in tumors that over‐express P‐glycoprotein. To further evaluate the combinations clinical efficacy and safety, a trial was performed in heavily pretreated patients with metastatic breast carcinoma (MBC).METHODSThirty‐six patients with MBC were treated with estramustine 900 mg/m2 per day divided into 3 doses given on Days 1–3 and docetaxel 70 mg/m2 given by intravenous administration over 1 hour on Day 3 after the first dose of estramustine, every 21 days. Patients may have received any number of prior chemotherapy regimens for MBC.RESULTSNine partial responses were observed in 31 assessable patients, for an objective response rate of 29% (95% confidence interval, 14–48%). The median progression free survival was 4 months (range, 1–41 months), and the median overall survival was 17 months (range, 2–45 months). Severe toxicities (Grade 3 or 4) were neutropenia, hypophosphatemia, and thrombosis. Seventy‐five percent of patients experienced either an improvement or no change in quality of life.CONCLUSIONSThe combination of docetaxel and estramustine produced responses in heavily pretreated women with MBC while maintaining quality of life. Cancer 2003;97:537–44. © 2003 American Cancer Society.DOI 10.1002/cncr.11082
Survival of patients with metastatic breast carcinoma
Authors: Chang Jenny , Clark Gary M. , Allred D. Craig , Mohsin Syed , Chamness Gary , Elledge Richard M. 
Published: February 2003

AbstractBACKGROUNDWomen with metastatic breast carcinoma have a highly variable clinical course and outcome. Intrinsic genetic heterogeneity of the primary breast tumor may play a role in this variability and may explain it in part. Therefore, the authors tested the hypothesis that the characteristics of primary breast tumors are important determinants of prognosis and survival in patients with metastatic breast carcinoma.METHODSThe prognostic significance of the biology of the primary tumor for outcome in patients with metastatic breast disease was assessed in 346 patients with lymph node positive breast carcinoma who developed distant, recurrent disease. Traditional prognostic indicators (age, tumor size, number of involved lymph nodes, sites of recurrence, disease free interval [DFI], adjuvant treatments, estrogen receptor [ER] expression, progesterone receptor [PgR] expression, S‐phase fraction [SPF], and DNA ploidy), together with three newer biologic markers (c‐erbB‐2, p53, and bcl‐2) were assessed. Sites of recurrence were defined as nonvisceral (bone and locoregional lymph nodes) or visceral (lung, liver, brain, and other organs).RESULTSThe median duration of survival was 17.8 months (95% confidence interval, 15.2–21.5 months). Univariate analysis showed that age > 50 years, visceral disease, and shorter DFI were associated significantly with poor outcome (P < 0.05). In addition, the molecular phenotype of the primary breast tumor was significant, with primary tumors that showed ER negativity and PgR negativity, high SPF, aneuploidy, accumulation of p53 protein, and lower bcl‐2 expression, together with c‐erbB‐2 overexpression, all associated with a poorer clinical outcome (P < 0.05). In a multivariate analysis, older age, visceral disease, shorter DFI, PgR negativity, high SPF, and lower bcl‐2 expression were significant predictors of worse survival (P < 0.05).CONCLUSIONSIn addition to traditional risk factors, bcl‐2 negativity was associated significantly with a worse clinical outcome. Biologic features of primary tumors were correlated independently with outcome after first recurrence in patients with metastatic breast carcinoma and may be used as indicators of prognosis in the metastatic setting. Cancer 2003;97:545–53. © 2003 American Cancer Society.DOI 10.1002/cncr.11083
Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases
Authors: Wood Bradford J. , Abraham Jame , Hvizda Julia L. , Alexander H. Richard , Fojo Tito 
Published: February 2003

AbstractBACKGROUNDThe current study was performed to analyze the feasibility, safety, imaging appearance, and short‐term efficacy of image‐guided percutaneous radiofrequency ablation (RFA) of primary and metastatic adrenal neoplasms including adrenocortical carcinoma.METHODSThe procedure was performed using 36 treatment spheres on 15 adrenocortical carcinoma primary or metastatic tumors in eight patients over 27 months. Tumors ranged from 15 to 90 mm in greatest dimension with a mean of 43 mm. All patients had unresectable tumors or were poor candidates for surgery. Mean follow‐up was 10.3 months.RESULTSAll patients were discharged or were free of procedure‐related medical care 6–48 hours after the procedures without major complications. All treatments resulted in presumptive coagulation necrosis by imaging criteria, which manifested as loss of previous contrast enhancement in ablated tissue. Eight of 15 (53%) posttreatment thermal lesions lost enhancement and stopped growing on latest follow‐up computed tomographic scan. Three of 15 (20%) demonstrated interval growth and four did not change in size. Of these four lesions, two showed contrast enhancement. For smaller tumors with a mean greatest dimension less than or equal to 5 cm, 8 of 12 (67%) tumors were completely ablated, as defined by decreasing size and complete loss of contrast enhancement. Three of 15 (20 %) tumors and related thermal lesions were found to have disappeared nearly completely on imaging.CONCLUSIONSPercutaneous, image‐guided RFA is a safe and well tolerated procedure for the treatment of unresectable primary or metastatic adrenocortical carcinoma. The procedure is effective for the short‐term local control of small adrenal tumors, and is most effective for tumors less than 5 cm. The survival rate for patients with adrenocortical carcinoma improves when radical excision is performed in selected patients. Aggressive local disease control may potentially influence survival as well. However, further study is required to evaluate survival impact, document long‐term efficacy, and to determine if RFA can obviate repeated surgical intervention in specific clinical scenarios. Cancer 2003;97:554–60. Published 2003 by the American Cancer Society.DOI 10.1002/cncr.11084
Health‐related quality of life of cancer and noncancer patients in Medicare managed care
Authors: Baker Frank , Haffer Samuel C. , Denniston Maxine 
Published: February 2003

AbstractBACKGROUNDData from the Health Care Financing Administration's (HCFA) Medicare Health Outcomes Survey (MHOS) of patients enrolled in managed care services through Medicare were analyzed. The MHOS provided baseline estimates of quality of life of cancer survivors in comparison to a frequency age‐matched cohort of noncancer patients.METHODIn 1998, the MHOS was mailed to a random sample of 279,135 beneficiaries. Completed surveys were received from 167,096 respondents (60%). Some 22,747 respondents who had been diagnosed with cancer were frequency age matched to an equal number of noncancer patients.RESULTSCancer survivors had statistically significantly poorer scores than noncancer patients on all eight subscales as well as on the Physical Component and Mental Component summary measures of the Medical Outcomes Study Short Form‐36 (MOS SF‐36). Comparisons by type and number of cancers for which an individual was currently in treatment showed lowest quality of life for those in treatment for lung carcinoma, followed by those who were in treatment for more than one type of cancer.CONCLUSIONThe data suggest that cancer shows negative effects on health‐related quality of life that are not explainable by simple effects of age because frequency age‐matched cancer survivors had statistically significantly lower scores on all 10 scores of the MOS SF‐36. Effect sizes are evaluated to determine the clinical significance of these differences in health‐related quality of life. The MHOS offers useful data for planning and improving cancer policy and programs. Cancer 2003;97:674–81. Published 2003 by the American Cancer Society.DOI 10.1002/cncr.11085
Prognostic factors in neuroendocrine small cell cervical carcinoma
Authors: Chan John K. , Loizzi Vera , Burger Robert A. , Rutgers Joanne , Monk Bradley J. 
Published: February 2003

AbstractBACKGROUNDThe purpose of this study was to evaluate the clinical and pathologic factors associated with survival in patients with neuroendocrine (NE) cervical carcinoma.METHODSAll patients with NE cervical carcinoma diagnosed between 1979–2001 were identified from tumor registry databases at two hospitals. Data were collected from hospital charts, office records, and tumor registry files. The impact of clinical and pathologic risk factors on the survival of patients with small cell NE carcinoma of the cervix was evaluated using Kaplan–Meier life table analyses and log‐rank tests. The independent prognostic factors found to be predictive of survival in univariate analysis were evaluated using Cox regression. All tests were two‐tailed with P values < 0.05 considered significant.RESULTSThirty‐four patients (median age, 42 years) were diagnosed with neuroendocrine cervical carcinoma, which included 21 with International Federation of Gynecology and Obstetrics (FIGO) Stage I disease, 6 with FIGO Stage II disease, 5 with FIGO Stage III disease, and 2 with FIGO Stage IV disease. Seventeen patients underwent a radical and 6 patients underwent a simple hysterectomy. Fourteen women received adjuvant therapy with pelvic radiation and/or cisplatin‐based chemotherapy. Ten women received primary radiotherapy with (n = 5) or without (n = 4) chemotherapy and the remaining patient refused therapy. Women with early‐stage (Stage I‐IIA) disease had median survival rates of 31 months compared with 10 months in the advanced‐stage (Stage IIB‐IVB) group (P = 0.002). In univariate analysis, advanced stage (P = 0.002), tumor size >2 cm (P = 0.02), margin involvement (P = 0.016), pure versus a mixed histologic pattern (P = 0.04), margin status (P = 0.016), and smoking (P = 0.04) were considered poor prognostic factors. In multivariate analysis, smoking for early‐stage patients and stage of disease in the overall population remained as independent prognostic factors of survival.CONCLUSIONSSmoking and advanced stage are reported to be poor prognostic factors for survival in patients with NE small cell carcinoma of the cervix. Only those with early lesions amenable to extirpation are cured. The role of primary or postoperative radiation with or without chemotherapy is unclear and yields uniformly poor results, particularly in patients with advanced lesions. Clinical trials are needed. Cancer 2003;97:568–74. © 2003 American Cancer Society.DOI 10.1002/cncr.11086
Protease‐activated receptor (PAR)‐1 and PAR‐2 participate in the cell growth of alveolar capillary endothelium in primary lung adenocarcinomas
Authors: Jin Enjing , Fujiwara Masakazu , Pan Xin , Ghazizadeh Mohammad , Arai Satoru , Ohaki Yoshiharu , Kajiwara Keiko , Takemura Tamiko , Kawanami Oichi 
Published: February 2003

AbstractBACKGROUNDCell growth can be induced via elicitation of protease‐activated receptors (PAR) with serine proteases such as thrombin and trypsin.METHODSTo understand whether PAR are involved in tumor vessel formation in the neoplastic cell‐bearing alveolar walls, immunohistochemical and reverse transcriptase‐polymerase chain reaction analyses were performed using the lung tissues from 16 patients with primary lung adenocarinomas.RESULTSIn microdissected tumor alveolar walls, the expressions of PAR‐1 and PAR‐2 mRNA were increased by 10‐fold (P < 0.05) and 16‐fold (P < 0.01), respectively, as compared with normal alveolar walls. Confocal microscopy revealed that tumor capillary endothelial cells in alveolar walls lost thrombomodulin expression. Instead, the expression of PAR‐2 often became obvious at the normal border. Both PAR‐1 and PAR‐2 were expressed in the microvessel endothelial cells in tumors. Trypsin mRNA was expressed in 7 of the 16 cancer cell‐bearing tissue specimens in contrast to 1 of the 14 normal alveolar walls. Immunohistochemically, trypsin was positive in the neoplastic cells from 10 patients and in lung adenocarcinoma cell lines (A549, HLC‐1, LC‐2, and PC‐14). An in vitro assay showed a significant increase in idoxuridine (IdU) or bromodeoxyuridine uptake in human pulmonary artery endothelial cells and human umbilical cord vein endothelial cells after treatments with α‐thrombin or activating peptides; SFLLRN for PAR‐1 and SLIGKV for PAR‐2, respectively.CONCLUSIONSThus, proliferation of alveolar capillary endothelial cells is initialized in part by PAR activation with serum thrombin and neoplastic cell‐released trypsin. These results suggest a synergistic effect of PAR with vascular endothelial growth factor in alveolar angiogenesis. Cancer 2003;97:703–13. © 2003 American Cancer Society.DOI 10.1002/cncr.11087