bluuebunny/crossref_metadata_2025_split huggingface dataset:
The management of ductal carcinoma in situ in North America and Europe
Authors: Ceilley Elizabeth , Jagsi Reshma , Goldberg Saveli , Kachnic Lisa , Powell Simon , Taghian Alphonse 
Published: September 2004

AbstractBACKGROUNDThe goal of the current study was to understand and document contemporary treatment approaches in the management of ductal carcinoma in situ (DCIS).METHODSAn original questionnaire was designed to assess radiation oncologists' management of breast carcinoma, including 26 questions specifically addressing DCIS. A postal survey was conducted of members of the American and European Societies of Therapeutic Radiology and Oncology. The results of 702 responses from North America were compared with 435 responses from Europe, to determine treatment recommendations and variability by type of institution and geographic region.RESULTSThere were strong correlations between the grade of DCIS and/or the margin status and the use of radiotherapy (RT; P < 0.0001). For Grade 3 DCIS, RT was recommended regardless of the margin status. Opinions were split in the treatment of low‐grade DCIS with 10‐mm margins. North American respondents were more likely to recommend RT for low‐grade DCIS than their European counterparts (P < 0.0001). Within the United States, there were significant regional variations in physician recommendations for tamoxifen (P < 0.001), but not in the tendency to recommend RT. North American academic physicians were less likely to recommend RT for favorable DCIS than nonacademic physicians (P < 0.01).CONCLUSIONSThere were marked differences in physician opinions regarding the management of DCIS, with significant international differences in patterns of care. The survey quantified and highlighted areas of agreement and controversy regarding the use of RT and tamoxifen in the management of DCIS. It provided support for large international trials to evaluate the optimal management of DCIS in the areas identified as most controversial. Cancer 2004. © 2004 American Cancer Society.
Unexpectedly frequent hepatitis B reactivation by chemoradiation in postgastrectomy patients
Authors: Cheng Jason Chia‐Hsien , Liu Mei‐Ching , Tsai Stella Y. , Fang Wei‐Tse , Jer‐Min Jian James , Sung Juei‐Low 
Published: September 2004

AbstractBACKGROUNDPostgastrectomy patients undergoing chemoradiation risk chemoradiation‐induced liver disease (CRILD). The objectives of this study were to investigate dosimetric implications and assess biologic susceptibility to CRILD in these patients.METHODSSixty‐two patients with Stage IB–IV gastric/gastroesophageal adenocarcinoma without metastases underwent radical total/subtotal gastrectomy; regional lymph node dissection; and postoperative, adjuvant, concomitant chemoradiotherapy (CCRT). Among these, 8 patients developed CRILD (defined as Grade 3–4 liver toxicity), and 11 patients were chronic hepatitis B virus (HBV) carriers (HBV+). Chemotherapy consisted of 1 cycle of etoposide, leucovorin, and 5‐fluorouracil (ELF); followed by 5 weekly high doses of 5‐fluorouracil (2000–2600 mg/m2) and leucovorin concurrent with radiotherapy (median dose, 45 grays [Gy] to the tumor bed/regional lymphatics); followed by 3 cycles of ELF separated by a 21‐day interval. Patients were followed for ≥ 4 months after CCRT. Patient‐related and dosimetric factors were correlated with CRILD.RESULTSHBV+ status was the only independent factor associated with CRILD. HBV+ patients had a higher CRILD incidence (6 of 11 patients vs. 2 of 51 patients; P < 0.001). HBV‐negative patients with CRILD were recipients of a higher mean liver dose (MLD) (23.8 Gy vs. 15.2 Gy; P = 0.009) and a higher volume fraction of liver that received > 30 Gy (36.5% vs. 19.7%; P = 0.009) compared with noncarriers without CRILD, but no MLD difference was found between HBV+ patients with or without CRILD. Moreover, in four of six carriers with CRILD, HBV infection was reactivated during CRILD. Two of the toxicities were fatal.CONCLUSIONSHBV carriers had a higher incidence of CRILD after postgastrectomy CCRT, probably related to HBV reactivation. Dosimetric parameters modulated the risk of CRILD in noncarriers, but not in carriers. These factors deserve attention in CRILD/HBV+ patients, and the underlying pathogenesis warrants investigation. Cancer 2004. © 2004 American Cancer Society.
Bacteremia caused by Achromobacter and Alcaligenes species in 46 patients with cancer (1989–2003)
Authors: Aisenberg Gabriel , Rolston Kenneth V. , Safdar Amar 
Published: September 2004

AbstractBACKGROUNDAchromobacter and Alcaligenes are emerging infectious gram‐negative bacterial species that can affect immunosuppressed patients. The authors sought to determine the incidence and characteristics of bloodstream infections caused by these organisms in patients with underlying malignancies.METHODSAll consecutive episodes of hematogenous Achromobacter and Alcaligenes infections recorded from December 26, 1989, to July 27, 2003, were studied retrospectively.RESULTSFifty‐two episodes occurred in 46 patients; 31 patients (67%) had hematologic malignancies, and 24 (52%) experienced neutropenia (< 500 cells/μL). Diabetes mellitus was present in 12 patients (26%), and high‐dose corticosteroids were administered to 12 patients (26%). Seventeen of the 52 infectious episodes (33%) were nosocomial in origin, and 10 patients (22%) had sepsis syndrome. Achromobacter xylosoxidans was the most common cause of infection (47 of 52 episodes [94%]), followed by Ach. denitrificans (2 of 52 episodes [4%]) and Alcaligenes faecalis (1 of 52 episodes [2%]). Twenty‐seven episodes (52%) were polymicrobial, and 3 patients (7%) had concurrent fungemia. Infected intravascular catheters were present in 13 of 52 cases (25%), pneumonia was encountered in 6 of 52 cases (12%), and urinary tract infections were present in 5 of 52 cases (10%). Most isolates exhibited in vitro susceptibility to carbapenems, antipseudomonal penicillins, and trimethoprim‐sulfamethoxazole. Resistance to ciprofloxacin, levofloxacin, aminoglycosides, and monobactam was common. Seven deaths (15%) were attributable to Achromobacter species. Incidence rates for sepsis syndrome, multiorgan dysfunction (Acute Physiology and Chronic Health Evaluation [APACHE] II score > 16), and use of mechanical ventilation and pressor support were significantly higher in patients who died (P < 0.001). Logistic regression analysis revealed that sepsis syndrome and high APACHE II scores were predictors of increased 30‐day mortality.CONCLUSIONSMost infections caused by this group of nonfermentative gram‐negative bacteria were attributable to Ach. xylosoxidans, and only one‐third were acquired during hospitalization. The presence of sepsis syndrome has evolved as an independent predictor of poor outcome in patients with high‐risk malignancies accompanied by Achromobacter bloodstream infections. Cancer 2004. © 2004 American Cancer Society.
Parent proxy–reported health‐related quality of life and fatigue in pediatric patients diagnosed with brain tumors and acute lymphoblastic leukemia
Authors: Meeske Kathleen , Katz Ernest R. , Palmer Stephanie N. , Burwinkle Tasha , Varni James W. 
Published: September 2004

AbstractBACKGROUNDPediatric patients with brain tumors (BT) are often excluded from health‐related quality of life (HRQOL) studies even though they experience more severe disease and treatment‐related sequelae than children with other types of cancer. Parent proxy assessments of HRQOL allow for greater inclusion of children who are developmentally immature, physically ill, or cognitively impaired.METHODSParents of children ages 2–18 years who were diagnosed at Childrens Hospital Los Angeles and Children's Hospital San Diego with BT (n = 86) or acute lymphoblastic leukemia (ALL; n = 170) evaluated their children's HRQOL over the previous week using the parent‐proxy versions of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 Generic Core scales, the PedsQL™ 3.0 Acute Cancer Module, and the PedsQL™ Multidimensional Fatigue scales. Multiple regression analyses were used to determine the independent effect of the child's diagnosis on HRQOL. Separate analyses were conducted for patients receiving treatment, patients who had not received treatment for < 12 months, and patients who had not received treatment for ≥ 12 months.RESULTSPatients with BT exhibited more problems than patients with ALL in the physical, social, psychosocial, school, cognitive, and fatigue domains of HRQOL. The Core Physical Health, Core Psychosocial Health, and Fatigue Total scores for patients with BT demonstrated peak improvements for children who had not received treatment for < 12 months and sharp declines for children who had not received treatment for ≥ 12 months. The Core Physical Health and Fatigue Total scores for patients with ALL were highest (better HRQOL) for those who had not received treatment for ≥ 12 months.CONCLUSIONSPediatric patients and survivors of BT experienced more fatigue and HRQOL problems than patients with ALL, and HRQOL differed by treatment status. Cancer 2004. © 2004 American Cancer Society.
Lymphoepithelial carcinoma versus large cell undifferentiated carcinoma of the major salivary glands
Authors: Wang Cheng‐Ping , Chang Yih‐Leong , Ko Jenq‐Yuh , Lou Pei‐Jen , Yeh Chun‐Fong , Sheen Tzung‐Shiahn 
Published: September 2004

AbstractBACKGROUNDUndifferentiated carcinomas of the major salivary glands are rare malignant neoplasms of the head and neck region, and patients with these lesions have a poor prognosis. Patients with lymphoepithelial carcinoma (LEC), a specific subtype of undifferentiated carcinoma, however, have a better prognosis, and LEC seems to differ from large cell undifferentiated carcinoma (LCUC) clinically.METHODSSixteen patients with LEC and 12 patients with LCUC were retrieved from the records of 295 patients who had malignancies of the major salivary glands. A retrospective study on clinical manifestations, treatments, long‐term outcomes, and an association with Epstein–Barr virus (EBV) by EBV‐encoded small RNA‐1 in situ hybridization was conducted to identify their differences.RESULTSThe median patient age was 44.5 years in the LEC group and 56 years in the LCUC group. At the time of presentation, patients with LCUC had a history of rapid‐growing tumor and more advanced locoregional disease (Stage IV in 75% of patients with LCUC compared with 13% of patients with LEC). All 16 patients with LEC underwent curative surgery and radiotherapy, and their 5‐year survival rate was 85.6%. In the LCUC group, only 7 patients were eligible to undergo radical surgery and receive radiotherapy, and their 2‐year survival rate was only 36%. Age > 50 years was associated with a significantly worse prognosis for patients with LCUC. Neck metastasis and tumor size > 6 cm tended to be poor prognostic factors. Tumors were positive for harboring the EBV genome in all 16 LEC samples but in none of the LCUC samples.CONCLUSIONSThe clinicopathologic features of LEC and LCUC of the major salivary glands were different. LEC was associated with EBV, and patients with LEC had a much better prognosis compared with the prognosis for patients with LCUC. Therefore, LEC should be put in an independent group and should not be included in the same category as undifferentiated carcinomas of the salivary gland. Cancer 2004. © 2004 American Cancer Society.
Contralateral prophylactic mastectomy
Authors: Goldflam Katja , Hunt Kelly K. , Gershenwald Jeffrey E. , Singletary S. Eva , Mirza Nadeem , Kuerer Henry M. , Babiera Gildy V. , Ames Frederick C. , Ross Merrick I. , Feig Barry W. , Sahin Aysegul A. , Arun Banu , Meric‐Bernstam Funda 
Published: September 2004

AbstractBACKGROUNDWomen with unilateral breast carcinoma are at increased risk for developing contralateral breast carcinoma (CBC). The authors sought to identify predictors of malignant or moderate to high‐risk histologic findings in contralateral prophylactic mastectomy (CPM) specimens, and to determine the efficacy of CPM.METHODSThe authors performed a retrospective review of 239 patients with unilateral early‐stage breast carcinoma who underwent CPM. The number of CBCs expected if the contralateral breast had been left intact was calculated based on CBC rates observed in the Surveillance, Epidemiology, and End Results (SEER) database and on life‐table analysis by family history.RESULTSIn the current study, 11 patients (4.6%) had occult contralateral malignancies (4 invasive carcinomas and 7 ductal carcinomas in situ) and 44 (18.4%) patients had moderate to high‐risk pathology (8 lobular carcinoma in situ, 11 atypical lobular hyperplasia, 25 atypical ductal hyperplasia). At 1846 patient‐years of follow‐up, only 1 patient (0.4%) developed a new CBC compared with 11 expected cancers based on SEER data. One CBC was observed among 140 patients with a family history of breast carcinoma, compared with 16 expected cancers based on life‐table analysis adjusted for adjuvant therapy. The determinants of significant findings at CPM were invasive lobular histology, estrogen and progesterone receptor positivity, additional ipsilateral moderate to high‐risk pathology, and age > 40 years at cancer diagnosis.CONCLUSIONSCPM was associated with a low risk of subsequent development of breast carcinoma. Evaluation of histologic findings in the ipsilateral breast may help to predict the likelihood of significant disease in the contralateral breast and assist in risk stratification. Cancer 2004. © 2004 American Cancer Society.
Can we afford to add chemotherapy to radiotherapy for glioblastoma multiforme? Cost‐identification analysis of concomitant and adjuvant treatment with temozolomide until patient death
Authors: Wasserfallen Jean‐Blaise , Ostermann Sandrine , Pica Alessia , Mirimanoff René‐Olivier , Leyvraz Serge , Villemure Jean‐Guy , Stupp Roger 
Published: September 2004

AbstractBACKGROUNDAdding temozolomide (TMZ) to standard radiotherapy as a first‐line therapy for glioma may increase costs to a disproportionate degree compared with the resulting survival benefits.METHODSForty‐six consecutive patients (28 males and 18 females; median age, 52 years; age range, 24–70 years) received concomitant TMZ with radiotherapy for 6 weeks followed by adjuvant TMZ for 6 cycles, and they were followed until disease recurrence and then until death. The authors assessed the costs associated with the four phases of treatment from a hospital‐centered perspective.RESULTSTreatment was discontinued early in 3 patients, 9 patients, and 15 patients during concomitant TMZ, before adjuvant TMZ, and during adjuvant TMZ, respectively. Karnofsky index values varied between 85% (at the beginning of treatment) and 76% (at the end of treatment). The nature of care after disease recurrence was diverse. Overall survival ranged from 1.4 months to 64.3 months (median, 15.8 months) and was better if surgical debulking could be carried out before treatment. Global costs amounted to €39,092 ± €21,948 (concomitant TMZ, €14,539 ± €4998; adjuvant TMZ, €13,651 ± €4320; follow‐up, €6363 ± €6917; and recurrence, €12,344 ± €18,327), with 53% of these costs being related to the acquisition of TMZ; this represented an eightfold increase in cost compared with radiotherapy alone.CONCLUSIONSTMZ may be an effective but costly adjuvant outpatient therapy for patients with glioblastoma multiforme. Definite cost‐effectiveness/utility must be assessed in a randomized Phase III trial. Cancer 2004. © 2004 American Cancer Society.
Distinct migratory behavior of early‐ and late‐born neurons derived from the cortical ventricular zone
Authors: Hatanaka Yumiko , Hisanaga Shin‐Ichi , Heizmann Claus W. , Murakami Fujio 
Published: September 2004

AbstractTime‐lapse studies indicate that ventricular zone (VZ)‐derived cells show two migratory modes in the cerebral cortex at different stages of mammalian embryogenesis: somal translocation and locomotion. We carried out a systematic analysis to examine whether the migratory behavior of cortical neurons derived from the cortical VZ is stage‐dependent. We labeled VZ cells of mouse embryos with green fluorescent protein (gfp) ‐encoding plasmids by in utero electroporation and evaluated the labeled cells after appropriate survival periods. After electroporation at either embryonic day (E) 12.5 or E15.5, GFP+ VZ cells were initially spindle‐shaped and radially oriented. After leaving the VZ, they transformed into round or horizontally oriented fusiform neurons with many short processes. They then seemed to gradually change into radially oriented bipolar cells as they moved upward. Whereas the earliest emigrants from the VZ labeled at E12.5 (early‐born neurons) reached the top of the cortical plate (CP) after these changes, VZ cells labeled at E15.5 (late‐born neurons) further migrated along the length of radial fibers to reach the top of the CP. A dominant negative form of the gene for cyclin‐dependent kinase 5 (Cdk5DN) was then introduced into VZ cells. Transfection of E12.5 VZ with cdk5dn did not disrupt the migration of the early‐born neurons. However, this caused a failure in migration of the late‐born neurons, although they transformed into bipolar shapes in the intermediate zone. Thus, there appear to be at least two distinct migratory phases of cortical neurons: one common to the early‐ and late‐born neurons, and the other specific to late‐born neurons and Cdk5‐dependent. J. Comp. Neurol. 479:1–14, 2004. © 2004 Wiley‐Liss, Inc.
Quantitative analysis of synaptic distribution along thalamocortical axons in adult mouse barrels
Authors: White Edward L. , Weinfeld Elizabeth , Lev Dmitri L. 
Published: September 2004

AbstractQuantitative data on thalamocortical synapses in adult mouse barrels have been obtained largely by using lesion‐nduced degeneration to label thalamic afferents. By the time degenerating axons can be identified with the electron microscope, they have broken up into many separate pieces, making it impossible to assess the distribution of synapses along unbroken lengths of afferent. Here, this deficiency is rectified by examining intact lengths of axon labeled by the injection of biotinylated dextran amine into ipsilateral thalamus. Serial thin section reconstructions were analyzed to determine the numbers of synapses per axon length made with dendritic spines vs. shafts and the locations of synapses with respect to axonal varicosities. Results for seven axonal segments from six mice showed an average of 0.2 synapses/μm; 80% were made with spines and 20% with dendritic shafts. Just over two‐thirds of axonal varicosities formed one synapse; most of the remainder formed two and rarely three, whereas 8% formed none. Although most synapses occurred at varicosities (88%), more than 12% were made at cylindrically shaped regions of the reconstructed axonal segments. These results serve as a caveat for the use of light microscopy to quantify synapses, wherein the usual approach is to equate one varicosity with one synapse. For thalamocortical afferents to mouse barrels, equating one varicosity with one synapse would prove to be incorrect more than 30% of the time and would exclude the roughly 12% of synaptic connections made at cylindrical regions of thalamocortical afferents. J. Comp. Neurol. 479:56–69, 2004. © 2004 Wiley‐Liss, Inc.
Neurogranin is expressed by principal cells but not interneurons in the rodent and monkey neocortex and hippocampus
Authors: Singec Ilyas , Knoth Rolf , Ditter Margarethe , Volk Benedikt , Frotscher Michael 
Published: September 2004

AbstractAs a substrate of protein kinase C (PKC), neurogranin (NG) is involved in the regulation of calcium signaling and activity‐dependent plasticity. Recently, we have shown that, in the rodent cerebellum, NG is exclusively expressed by γ‐aminobutyric acidergic Golgi cells, whereas, in the monkey cerebellum, brush cells were the only neuronal population expressing NG (Singec et al. [2003] J. Comp. Neurol. 459:278–289). In the present study, we analyzed the neocortical and hippocampal expression patterns of NG in adult mouse (C57Bl/6), rat (Wistar), and monkey (Cercopithecus aetiops). By using immunocytochemistry and nonradioactive in situ hybridization, we demonstrate strong NG expression by principal cells in different neocortical layers and in the hippocampus by granule cells of the dentate gyrus and pyramidal neurons of CA1–CA3. In contrast, double‐labeling experiments in rodents revealed that neocortical and hippocampal interneurons expressing glutamate decarboxylase 67 (GAD67) were consistently devoid of NG. In addition, by using antibodies against parvalbumin, calbindin, and calretinin, we could demonstrate the absence of NG in interneurons of monkey frontal cortex and hippocampus. Together these findings corroborate the idea of different calcium signaling pathways in excitatory and inhibitory cells that may contribute to different modes of synaptic plasticity in these neurons. J. Comp. Neurol. 479:30–42, 2004. © 2004 Wiley‐Liss, Inc.
Up‐regulation of activated macrophages in response to degeneration in the taste system: Effects of dietary sodium restriction
Authors: McCluskey Lynnette Phillips 
Published: September 2004

AbstractDietary sodium restriction combined with unilateral chorda tympani nerve section leads to a rapid and specific decrease in neurophysiological taste responses to sodium in the contralateral, intact chorda tympani (Hill and Phillips [1994] J. Neurosci. 14:2904–2910). Previous work demonstrated that dietary sodium restriction may induce these early functional deficits by inhibiting immune activity after denervation (Phillips and Hill [1996] Am. J. Physiol. 271:R857–R862). However, little is known about the leukocyte response to denervation of taste buds in fungiform papillae. In the current study, it was hypothesized that T cells and macrophages are increased in the tongue after unilateral denervation in control‐fed but not sodium‐restricted animals. Adult, specified pathogen‐free rats received unilateral chorda tympani nerve section or sham section followed by dietary sodium restriction or maintenance on control diet. At day 1, 2, 5, 7, or 50 postsectioning, immunostaining was used to detect the percentage of staining for activated macrophages, the number of αβ T cells, and the number of δγ epithelial T cells in the tongue. The number of lingual T cells did not significantly differ between treatment groups following denervation. However, there was a dramatic bilateral increase in ED1+ staining for activated macrophages in control‐fed rats that peaked at day 2 postsectioning. In contrast, sodium‐restricted rats did not show an increase in activated macrophages above baseline at any time postsectioning. Further analysis of extralingual macrophages indicated that the deficit in immune activity in sodium‐restricted rats is localized to the tongue and is not widespread. A model for immune modulation of taste receptor cell function is proposed based on these novel findings. J. Comp. Neurol. 479:43–55, 2004. © 2004 Wiley‐Liss, Inc.