bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intramuscular innervation of upper‐limb skeletal muscles
Authors: Lim Aymeric Y.T. , Pereira Barry P. , Kumar V. Prem , de Coninck Christine , Taki Christina , Baudet Jacques , Merle Michel 
Published: March 2004

AbstractWe studied 150 skeletal muscles from 8 upper limbs using the modified Sihler's staining technique. Based on the pattern of the intramuscular innervation and shape, the muscles were grouped into trapezoidal‐shaped (Class I), spindle‐shaped (Class II), and muscles that were combinations of these two classes (Class III). Such distinctions are clinically important for limb reconstruction procedures. Bipennate, spindle‐shaped muscles with the aponeurosis of the tendons of insertion extending proximally into the muscle belly and Class III muscles with multiple tendons of origin may be split for separate independent functional transfers. Muscle Nerve 29: 523–530, 2004
Multifocal slowing of nerve conduction in metachromatic leukodystrophy
Authors: Cameron Carol L. , Kang Peter B. , Burns Ted M. , Darras Basil T. , Jones H. Royden 
Published: March 2004

AbstractPolyneuropathy is invariably associated with the late‐infantile form of metachromatic leukodystrophy (MLD), and occurs frequently in the early juvenile, juvenile, and adult variants. Uniform slowing of nerve conduction velocity is the neurophysiologic hallmark of metachromatic leukodystrophy and other inherited demyelinating polyneuropathies. To evaluate the consistency of this principle, we reviewed nerve conduction studies in 9 children with late‐infantile or early‐juvenile metachromatic leukodystrophy. Each child had significant slowing of motor nerve conduction velocity (NCV). The compound muscle action potentials showed abnormal temporal dispersion in 3 of the 9 children, which is usually regarded as the hallmark of acquired demyelinating polyneuropathies. There are reports of multifocal slowing in other hereditary processes including X‐linked Charcot–Marie–Tooth disease, hereditary neuropathy with liability to pressure palsies, and adrenomyeloneuropathy. Although multifocal NCV slowing in a child with polyneuropathy is seen most commonly in acquired conditions, a hereditary process, including MLD, cannot always be excluded in this setting. Muscle Nerve 29: 531–536, 2004
Increased blood pressure can reduce fatigue of thenar muscles paralyzed after spinal cord injury
Authors: Butler Jane E. , Ribot‐Ciscar Edith , Zijdewind Inge , Thomas Christine K. 
Published: March 2004

AbstractThe aim of this study was to evaluate whether increases in blood pressure, and presumably muscle perfusion pressure, improve the endurance of thenar muscles paralyzed chronically by cervical spinal cord injury (SCI). Resting mean arterial pressure (MAP) was low in all eight subjects (64 ± 2 mmHg). Muscle fatigue (force decline) was produced on 2 days by intermittent supramaximal electrical stimulation of the median nerve at 20 Hz for 2 min. During one of the fatigue tests, a concurrent sustained voluntary contraction of the contralateral elbow flexors was used to increase resting MAP (by 22%, on average). Although this change in blood pressure resulted in no significant change in mean fatigue for the group, changes in MAP with exercise (median nerve stimulation with and without voluntary contraction) correlated with changes in thenar muscle fatigue in seven subjects. For every 10% increase in MAP, fatigue was reduced by ∼3%. The data suggest that low blood pressure after chronic cervical SCI and poor blood pressure control during exercise exacerbate the fatigability of paralyzed muscles. Muscle Nerve 29: 575–584, 2004
Carpal tunnel syndrome with normal nerve conduction studies
Authors: Witt John C. , Hentz Joseph G. , Stevens J. Clarke 
Published: March 2004

AbstractThe utility of electrodiagnostic testing in the evaluation of carpal tunnel syndrome (CTS) has been questioned. We studied patients who met the clinical criteria for CTS and compared patients who had normal nerve conduction studies (NCS) with patients who had abnormal NCS. We found that 25% of the CTS patients without confounding neurologic disorders had normal NCS with median palmar nerve stimulation. Patients with abnormal NCS were older and heavier and had more clinical features of CTS. NCS results could not be predicted accurately from clinical features by use of logistic regression models. This was especially true in clinically borderline cases. NCS did not predict the outcome of conservative management. We concluded that NCS provide independent information in the evaluation of suspected CTS, especially when fewer clinical criteria are present, but that NCS are not helpful in predicting the outcome of nonsurgical management. Muscle Nerve 29: 515–522, 2004
Attenuation of free radical production and paracrystalline inclusions by creatine supplementation in a patient with a novel cytochrome b mutation
Authors: Tarnopolsky Mark A. , Simon David K. , Roy Brian D. , Chorneyko Kathy , Lowther Stuart A. , Johns Donald R. , Sandhu Jagdeep K. , Li Yan , Sikorska Marianna 
Published: March 2004

AbstractMitochondrial cytopathies are associated with increased free radical generation and paracrystalline inclusions. Paracrystalline inclusions were serendipitously found in a young male athlete with a very high respiratory exchange ratio during steady‐state exercise; he also had an unusually low aerobic capacity. Direct sequencing of the mitochondrial DNA (mtDNA) coding regions revealed a novel missense mutation (G15497A) resulting in a glycine→serine conversion at a highly conserved site in the cytochrome b gene in the subject, his mother, and sister. Cybrids, prepared by fusion of the subject's platelets with either U87MG ρ° or SH‐SY5Y ρ° cells, generated higher basal levels of reactive oxygen species (ROS), had a lower adenosine triphosphate (ATP) content, and were more sensitive to oxygen and glucose deprivation and peroxynitrite generation compared to control cybrids with wild‐type mtDNA. Cell survival was significantly enhanced with 50 mmol/L creatine monohydrate (CM) administration. The subject was also treated with CM (10 g/d) for a period of 5 weeks and a repeat muscle biopsy showed no paracrystalline inclusions. The results suggest that the development of exercise‐induced paracrystalline inclusions may be influenced by the G15497A mtDNA mutation, and that CM mitigates against the pathological consequences of this mutation. Muscle Nerve 29: 537–547, 2004
Electrodiagnostic criteria for acute and chronic inflammatory demyelinating polyradiculoneuropathy
Authors: Van Den Bergh Peter Y. K. , Piéret Françoise 
Published: March 2004

AbstractElectrodiagnosis plays an important role in the early detection and characterization of inflammatory demyelinating polyradiculoneuropathies, because timely treatment reduces morbidity and disability. The challenge consists of defining electrodiagnostic criteria that are highly specific for primary demyelination but sufficiently sensitive to be useful in clinical practice. We compared 10 published sets of criteria in 53 patients with demyelinating Guillain–Barré syndrome (GBS) and 28 with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Specificity of criteria sets was tested in 40 patients with amyotrophic lateral sclerosis (ALS) and 32 with diabetic polyneuropathy (DPN). Sensitivity ranged from 24 to 83% (mean, 54.3%) in GBS and 39 to 89% (mean, 64.9%) in CIDP. With regard to ALS, specificity was 100% for nine sets but was 97% in one. In contrast, 3–66% of DPN patients fulfilled criteria in eight of ten sets. We propose a set of criteria with 72% and 75% sensitivity in our GBS and CIDP patient series, respectively, and 100% specificity with regard to ALS and DPN. Our data illustrate that most, but not all, patients can be electrodiagnostically ascertained. Muscle Nerve 29: 565–574, 2004
Numerical simulation of flow over delta wing with trailing‐edge jet at high angle of attack
Authors: Zhang Z. K. , Tang H. S. 
Published: March 2004

AbstractThe incompressible Reynolds‐averaged Navier–Stokes equations, together with a modified mixing length algebraic turbulence model, are solved to simulate the flow over a delta wing with trailing‐edge jets at high angles of attack. An artificial compressibility method and a Beam–Warming implicit approximate factorization scheme are employed to discretize the equations. The computed results indicate that trailing‐edge jets tend to not only decrease the pressure but also increase the velocity at the cores of the streamwise primary vortices. This moves the vortex breakdown locations aft and stabilizes the vortical flow. As a result, the jets lead to a decreased pressure on the upper wing surface and an increased pressure on the lower wing surface, thereby increasing the overall lift. Computations further show that as the exit area of the trailing‐edge jets is enlarged, or, as the jets are deflected downward, the above‐mentioned effects become more pronounced. Copyright © 2004 John Wiley & Sons, Ltd.
Role of radiotherapy in Ewing tumors
Authors: Dunst Juergen , Schuck Andreas 
Published: March 2004

AbstractBackgroundThe objective of this review article is to outline the role of radiotherapy in a curative multimodal treatment concept.ProcedureWe have analyzed the data from major multi‐institutional prospective trials in Ewing tumors for to evaluate the impact of radiotherapy on local control and survival.ResultsSurgery yields in general better local control and survival figures as compared to radiotherapy. The efficacy of radiotherapy as compared to surgery varies among the studies and seems to be dependent on patient selection and sequencing with chemotherapy. Combined local therapy (surgery plus post‐ or pre‐operative radiotherapy) has yielded excellent local control rates in patients with high‐risk lesions (e.g., pelvic tumors); although not proven by randomized studies, an impact on survival is likely. Indications for post‐operative radiotherapy are unradical or marginal resections and poor histological response. In patients with chest wall primaries, adjuvant hemithorax irradiation has reduced the relapse rate significantly. Pre‐operative irradiation offers theoretical advantages. Bilateral lung irradiation (as consolidation after chemotherapy) seems to improve prognosis in patients with metastases at diagnosis.ConclusionsPatients with high‐risk lesions probably benefit from combined local treatment (surgery plus radiotherapy). Improving local control after radiotherapy is a major issue for future studies, and sequencing with chemotherapy seems to be critical factor. The possible curative potential of radiotherapy in metastatic disease requires further investigation. © 2004 Wiley‐Liss, Inc.
Technical Aspects in Cerebrospinal Irradiation
Authors: Bernier Valérie 
Published: March 2004

AbstractBackgroundCraniospinal irradiation (CSI) is commonly used for medulloblastoma patients and some others; for example, those with ependymoma. It is a complex technique where accuracy of field placement and choice of irradiation source and energy can play a major role in determining success or failure.ProcedureA literature review of the techniques used and reported by treatment centers was undertaken.ResultsGreat variability was found in methods and practices. This is striking because many hospitals treat fewer than five patients per year.ConclusionStandardized techniques with strict central review for quality control before therapy is initiated should become the norm. Standardization is especially important when clinical trials are planned. Valid outcome data depend on CSI uniformity. © 2004 Wiley‐Liss, Inc.
Measuring the neuro‐cognitive side‐effects of irradiation in children with brain tumors
Authors: Grill Jacques , Kieffer Virginie , Kalifa Chantal 
Published: March 2004

AbstractBackgroundReduction of the treatment‐related side effects has become one of the main goals of the recent study protocols for brain tumor therapies. When the treatment burden is decreased in patients with good prognostic features, the potential increased risk of relapse has to be counterbalanced by a significantly improved cognitive outcome. This objective is always clearly stated but comprehensive data on the neuropsychological outcomes are seldom reported.Procedures and ResultsThe appropriate means to measure the long‐term morbidity need to be clarified. Health Status and Quality of Life (QOL) questionnaires can be easily administered but these questionnaires represent usually a composite evaluation where cognition is analyzed along with other items such as mood or pain. However, none of these questionnaires has ever been used to measure a difference in cognitive outcome when comparing two different therapeutic strategies in children. Complete neuropsychological evaluations are time consuming, need specialized psychologists and most of the tests have not been rigourously validated. In this respect, Wechsler scales are, however, robust and objective methods to evaluate intelligence. Several studies have been able to show meaningful differences in IQ scores between treatments in children with posterior fossa tumors, even with small numbers of patients.ConclusionsIn order to evaluate any refinement in the treatment of these patients, widely accepted evaluation tools are needed. Ideally, these methods will have to be sensitive, reproducible, and widely applicable. None of the available tools fullfil all of these criteria but their development should be a major endeavour in modern neuro‐oncology. © 2003 Wiley‐Liss, Inc.
Review of radiotherapy dose and volume for intracranial ependymoma
Authors: Taylor Roger E. 
Published: March 2004

AbstractBackgroundRadiotherapy (RT) is well established in the management of intracranial ependymoma (EP) and post‐operative RT is employed for the majority of patients. There are no randomised trials of RT in EP and evidence for dose and volume relies on retrospective single institution series, usually comprising a heterogeneous mix of relatively small numbers of patients recruited over several decades.ProcedureThe literature including RT dose and response data reported since the early 1990s was reviewed.ResultsFive‐year overall survival (OS) ranges from 40 to 79%. There is some evidence of a dose response relationship from <45 Gy to >50 Gy. In the majority of series outcome is related to WHO grade and extent of resection. There is no evidence of benefit for ‘prophylactic’ craniospinal RT (CSRT). In all series there is a significant risk of local recurrence, usually within the target volume. Early results of conformal RT have suggested that a margin for CTV of 1 cm around the post‐operative tumour bed and any residual GTV is feasible.ConclusionsThe main aims of future studies will be to maximise the number of patients achieving complete resection, and RT dose escalation. Hyperfractionated radiotherapy (HFRT) has been employed in some studies and results are awaited. The role of CSRT needs to be evaluated further for patients presenting with leptomeningeal metastases. Multi‐institutional and international studies are necessary to improve understanding of the clinical behaviour, biology and management of EP. © 2004 Wiley‐Liss, Inc.
Ewing sarcoma: Radiation dose and target volume
Authors: Donaldson Sarah S. 
Published: March 2004

AbstractBackgroundThe outcome of children and adolescents with Ewing sarcoma is impacted by many prognostic factors and often measured by estimates of: event‐free, relapse‐free, disease‐free, or overall survival. However, the preferred assessment following radiation therapy is local control.ProcedureA review of large group experiences over the past several decades was undertaken to assess the optimal radiation dose and volume for patients with localized, osseous Ewing sarcoma. New approaches and techniques to improve local control were also investigated.ResultsWith multidisciplinary therapy, 5‐year overall local control rates range from 58 to 93%. Following definitive irradiation, they are 53–86%. Recommended radiation therapy doses are 55.8–60.0 Gy. In the postoperative setting, gross disease requires 55.8 Gy; microscopic disease requires 45 Gy. Altered fractionation schemes have not improved local control. The appropriate irradiated volume is an involved field to the pretreatment tumor volume plus 2.0–2.5 cm margin, followed by a boost to the post‐induction chemotherapy tumor volume with margin. Good radiation quality control with central review improves local control. Use of an involved radiation field requires accuracy in defining tumor volume. Techniques to improve local control include risk‐adapted multidisciplinary therapy, intraoperative boost radiation, and high radiation doses as delivered by 3‐dimensional conformal radiation. Intensity modulated and proton beam radiotherapy may offer an advantage at special sites.ConclusionsInnovative uses of radiation in the multidisciplinary setting will continue to provide excellent local control, improved function, and quality of life for young patients with localized Ewing sarcoma of bone. © 2004 Wiley‐Liss, Inc.
Ewing sarcoma: The pediatrician's point of view
Authors: Marec‐Bérard Perrine , Philip Thierry 
Published: March 2004

AbstractBackgroundIntegrated multimodal care is needed for patients with Ewing sarcoma, which is the second most common primary bone malignancy in children and adolescence. Chemotherapy increases survival from less than 5% to 65–70% for patients with localized tumors and to 25–30% for those with metastases at diagnosis. Surgery is a major tool, whereas advances in imaging techniques have improved the indications for and the optimization of treatment. Radiotherapy remains useful, either alone or in addition to surgery, and new techniques (conformational RT and IMRT) will reduce short‐term toxic effects. Pediatric oncologists do not outweigh surgeons or radiation therapists, but they are the ones who coordinate the medical team, which also includes pathologists and imaging specialists.MethodsThe point of view of the pediatric oncologist was assessed as follows: the place of chemotherapy in Ewing tumor treatment, the place of radiotherapy in Ewing tumor treatment (including why avoid radiotherapy when technically possible in children), and how to proceed into the future? The place of surgery as local treatment for Ewing tumors was also evaluated.ResultsThese reviews show a dynamic and kaleidoscopic panorama of intense activity at the laboratory and clinical levels.ConclusionsThough good survival rates have been achieved, improvements using entirely new approaches are needed. © 2003 Wiley‐Liss, Inc.
Influence of Age Upon Ifosfamide‐Induced Nephrotoxicity
Authors: McCune Jeannine S. , Friedman Debra L. , Schuetze Scott , Blough David , Magbulos Madonna , Hawkins Douglas S. 
Published: March 2004

AbstractBackgroundIfosfamide‐induced nephrotoxicity is well recognized in children, although it has also been reported in adults. Whether ifosfamide nephrotoxicity is more common in children than in adults is not known.ProcedureMedical records of adults and children diagnosed with sarcoma whom received ifosfamide with a cumulative dose >20 g/m2 were evaluated. Twenty‐five children (≤18‐years of age) and 28 adults were identified.ResultsNational Cancer Institute Common Toxicity Criteria grade 3–4 ifosfamide‐induced nephrotoxicity was present in 24 and 17% of children and adults, respectively (P = 0.58). Cumulative ifosfamide doses were similar between the two populations, with the median (range) of 70.2 g/m2 (22.4–72) for children and 59 g/m2 (20.8–146) for adults (P = 0.25). Logistic regression analysis indicated that neither age or cumulative ifosfamide dose were associated with grade 3–4 ifosfamide‐induced nephrotoxicity (P = 0.36).ConclusionsChildren and adults receiving >20 g/m2 of ifosfamide have similar susceptibility to ifosfamide‐induced nephrotoxicity. Factors other than age and cumulative dose should be considered for understanding the inter‐individual variation in nephrotoxicity. © 2004 Wiley‐Liss, Inc.
Significance of serum immunoglobulin G for leukocytosis and prognosis in childhood B‐lineage acute lymphoblastic leukemia
Authors: Potapnev Michael P. , Belevtsev Michael V. , Bortkevich Ludmila G. , Grinev Vasily V. , Martsev Sergey P. , Kravchuk Zinaida I. , Migal Natalia V. , Aleinikova Olga V. 
Published: March 2004

AbstractBackgroundThis study was conducted to evaluate the significance of serum level of immunoglobulins (Igs) and particularly IgG for leukemic cell persistence in peripheral blood (PB) and prognosis for childhood acute lymphoblastic leukemia (ALL).ProcedureHuman sera were obtained from 68 children with primary B‐lineage ALL at diagnosis and 46 healthy children (control). Serum level of IgM, IgG, IgA, IgG1, IgG2, IgG3, IgG4, antitumor antibody, homogeneous IgG were quantified by turbidimetric or enzyme‐linked immunosorbent assays.ResultsThe mean values of serum IgM, IgG, IgA at diagnosis were not differed significantly in ALL patients and control children. The level of IgM and IgG1 inversely correlated with white blood cell (WBC) count in PB of patients. Normal range of serum IgG, separated by 25th and 75th percentiles of IgG variables, was associated in patients with decreased WBC count in PB but not in bone marrow (BM) versus patients with low concentration of IgG. Normal range of IgG also favors low frequency of homogeneous IgG and antitumor antibodies. Patients with high level of IgG, besides increased frequency of homogeneous IgG and antitumor antibodies, had worse 3‐year overall survival (OS) rate as compared to patients with normal level of IgG (58.8 vs. 91.2%, P = 0.014).ConclusionsThe normal level of serum IgG at diagnosis is a beneficial prognostic factor associated with lower rate of leukemic cell persistence in PB and better outcome of childhood B‐lineage ALL. © 2004 Wiley‐Liss, Inc.
Permanent consequences in Langerhans cell histiocytosis patients: A pilot study from the Histiocyte Society—Late Effects Study Group
Authors: Haupt Riccardo , Nanduri Vasanta , Calevo Maria Grazia , Bernstrand Cecilia , Braier Jorge L. , Broadbent Valerie , Rey Guadalupe , McClain Kenneth L. , Janka‐Schaub Gritta , Egeler R. Maarten 
Published: March 2004

AbstractBackgroundPermanent consequences (PC) are often described among subjects with Langerhans cell histiocytosis (LCH) but data on the real incidence are scarce. Within the Histiocyte Society (HS), and in order to design a definitive late effects study, a retrospective survey was organized to describe the prevalence of PC among long‐term survivors of LCH.MethodsNine institutions contributed with their LCH patients having a minimum follow‐up of 3 years. Information was collected on their disease‐history, and on type and date of onset of any PC. Because of the retrospective type of this study, it was accepted that each institution might have used different criteria to assess PC.ResultsOne hundred eighty‐two subjects were registered and in 95 (52%) at least 1 PC was reported. For some specific PC (e.g., anterior pituitary dysfunction) information was too scarce to provide reliable data. PC were more frequent among subjects with multisystem (MS) disease (71%), compared to those with single system (SS) disease (24%); P < 0.0001. The most frequently reported PC were diabetes insipidus (DI) (24%) orthopedic abnormalities (20%), hearing loss (13%), and neurological consequences (11.0%). Analysis of cumulative risk showed that some types of PC may become manifest more than 10 years from diagnosis.ConclusionsThis survey on selected cases of LCH survivors has confirmed that late sequels are frequent, and that they are even more common among those with MS LCH. Our findings highlight the need for long‐term and patient‐oriented follow‐up in children with LCH. © 2004 Wiley‐Liss, Inc.