How to interpret high levels of distress when using the Distress Thermometer in the long-term follow-up clinic? A study with Acute Lymphoblastic Leukemia survivors.

OBJECTIVES: Recent guidelines recommend to assess emotional distress in pediatric oncology during treatment and in after care. One tool used to do this is the distress thermometer (DT), a simple tool which has almost exclusively been studied in its screening abilities. Given its increased used as a measure of distress per se, it is necessary to document its concurrent validity. The goal of this study was to identify clinical domains (eg, depression, anxiety) and individual symptoms associated with pediatric cancer survivors' rating on the DT. PARTICIPANTS: To do so we used data collected from 84 young (≤18 years old), and 120 older (>18 years old) survivors who were treated for pediatric leukemia. METHODS: Participants responded to self-report questionnaires as part of a research visit. RESULTS: Results from stepwise regressions show that in the younger group, high scores on the thermometer were associated with higher negative affectivity only. In adults, high scores were associated with higher anxiety, higher negative affectivity, and lower positive affectivity. When exploring associations with individual items, we found that the main emotional tone reflected by the thermometer score was anxiety. CONCLUSIONS: Interpreting ratings on the thermometer should probably focus on anxiety in childhood cancer survivors. This widely used tool also does not measure the same domains in young versus older survivors, so that age groups should be considered separately in future work.

Adverse neuropsychological effects associated with cumulative doses of corticosteroids to treat childhood acute lymphoblastic leukemia: A literature review.

Corticosteroids (CS) are an essential component of childhood acute lymphoblastic leukemia treatments (cALL). Although there is evidence that daily doses of CS can have neuropsychological effects, few studies have investigated the role of cumulative doses of CS in short- and long-term neuropsychological effects in cALL. The aims of this review were to identify the measures used for documenting adverse neuropsychological effects (ANEs) of CS treatment and to study the association between cumulative doses of CS and the presence of ANEs. Twenty-two articles met the inclusion criteria. A variety of measures were used to evaluate outcomes in the domains of emotion, behaviour, neurocognition, and fatigue/sleep. The results suggest that we cannot conclude in favour of an association between the cumulative dosage of CS and ANEs. Yet, several factors including the heterogeneity of measures used to evaluate outcomes and reporting biases may limit the scope of the results. We offer several recommendations that could help improve the future published evidence on ANEs in relation to CS treatment in cALL.

Porous media investigation before and after hydrochloric acid injection on a pre-salt carbonate coquinas sample.

Porous space characterization of carbonate rocks is an important aid in petroleum exploration from carbonate reservoir. In this study, X-ray microtomography technique was applied to evaluate total porosity of a coquina sample extracted from pre-salt reservoir, in Brazil, before and after acid injection. Two image processing program were used in order to assess performance. The results showed that microtomography has potential to compute porosity of coquina samples and provides information about rock porous network.

Distribution of SPARC during neovascularisation of degenerative aortic stenosis.

OBJECTIVE: To examine the hypothesis that degenerative aortic stenosis (AS) is associated with the development of blood vessels and the expression of the secreted protein, acidic and rich in cysteine/osteonectin (SPARC), a matricellular protein that is involved in ossification, the modulation of angiogenesis and the production of metalloproteinases. METHODS: 30 surgically excised AS valves and 20 normal aortic valves were studied. RESULTS: Blood vessels were detected in the aortic valves from patients with degenerative AS, whereas normal valves were avascular structures. Blood vessels in AS valves expressed endothelial nitric oxide synthase, CD34 and von Willebrand factor (vWF). Blood vessels were located in three distinct regions: near calcified nodules, under the leaflet border and in rich cellular areas forming cell islands. Blood vessels were predominantly present in early and intermediate grades of calcification. Cell islands were densely populated by CD45-positive cells where endothelial cells (CD34+, vWF+) forming cord-like structures were present. Immunoblotting detected SPARC only in AS valves and immunohistological analysis located SPARC in mature blood vessels. The proportion of blood vessels positive for SPARC was higher in valves with a lower grade of calcification. In cell islands, SPARC was distributed to mature blood vessels and to macrophages, where it co-located with matrix metalloproteinase-9, whereas no expression was detected in endothelial cells forming cord-like structures. CONCLUSION: The localisation of SPARC to mature blood vessels and its predominant expression in AS valves with a lower calcification grade suggest that the spatial and temporal distribution of this matricellular protein is tightly controlled to participate in the neovascularisation of AS valves.

Expression of bone-regulatory proteins in human valve allografts.

OBJECTIVE: To test the hypothesis that valve allograft (VA) calcification results from an ossification process in which bone-regulatory proteins are expressed. METHODS: 15 VA that were explanted at the time of surgery for dysfunction were studied. VA were analysed and compared with normal aortic valves (n = 20). RESULTS: All the VA (5 aortic, 10 pulmonary) exhibited heavy calcification and important fibrosis. Immunohistochemistry studies showed that the bone-specific transcription factor Cbfa-1 was expressed by stromal cells. Bone alkaline phosphatase was expressed in calcified regions. Immunostaining for alpha smooth muscle (alpha-SM) actin was increased in VA compared with normal valves and in 6 of the 15 valves formed cellular clusters close to the calcified nodules. In VA osteopontin and osteonectin were expressed by stromal cells, whereas osteocalcin was closely associated with the calcified regions. Furthermore, analysis of the bone-regulatory proteins that control bone resorption showed that receptor activator of nuclear factor kappaB ligand (RANKL), receptor activator of nuclear factor kappaB (RANK) and osteoprotegerin (OPG) were differentially expressed in calcified VA and normal valves. Normal valve leaflets expressed OPG, whereas OPG expression was absent or faint in calcified VA. RANKL and RANK were not detected in normal valves, whereas calcified VA expressed RANKL and RANK. CONCLUSION: These data suggest that calcification of VA results from an ossification process, which relies on tight control of bone-regulatory protein expression. The expression pattern of the RANKL/RANK/OPG system suggests that it may have a regulatory role not only in osteoclastogenesis but also in the calcification of human VA.

Treadmill walking in incomplete spinal-cord-injured subjects: 1. Adaptation to changes in speed.

UNLABELLED: Walking in spinal-cord-injured (SCI) subjects is usually achieved at a lower speed than in normal subjects. STUDY DESIGN/METHODS: Time and distance parameters, angular displacements of lower limbs and electromyographic (EMG) activity were measured for seven normal and seven SCI subjects at several walking speeds. Analyses of variance were used for comparing groups and speeds. OBJECTIVES: First, to measure the adaptability of SCI subjects' walking pattern to different speeds (0.1-1.0 m/s), and to compare it to that of normal subjects. Second, to characterize SCI subjects' walking pattern as compared to that of normal subjects at a matched treadmill speed (0.3 m/s). SETTING: University-Based Human Gait Laboratory, Montreal, Canada. RESULTS: SCI subjects' pattern adapted to a limited range of speeds. Longer cycle duration, flexed knee at foot contact, increased hip joint flexion at foot contact and during swing, and altered coordination of hip and knee joints were found for the SCI group. At all speeds, duration of muscle activity was longer in the SCI group and the increase in amplitude of soleus EMG activity at higher speeds was not specific to push-off. The importance of matching the walking speed of SCI and normal subjects in order to differentiate the features that are a consequence of SCI subjects' reduced walking speed rather than a direct consequence of the injury is demonstrated. CONCLUSIONS: All SCI subjects could adapt to a narrow range of speeds and only three could reach the maximal tested speed. This limited maximal speed seems to be a consequence of SCI subjects having reached their limit in increasing stride length and not being able to increase stride frequency further. This limitation in increasing stride frequency is likely because of the altered neural drive. SPONSORSHIP: Neuroscience Network of the Canadian Centre of Excellence.

Treadmill walking in incomplete spinal-cord-injured subjects: 2. Factors limiting the maximal speed.

STUDY DESIGN/METHODS: Five SCI subjects referred to the laboratory and a convenience sample of five normal volunteer individuals was selected. Stride length and frequency were measured at different walking speeds under three different conditions: preferred, highest possible and lowest possible stepping frequencies. OBJECTIVE: To determine which factors are limiting the maximal walking speed in spinal-cord-injured (SCI) individuals. SETTING: University-Based Human Gait Laboratory, Montreal, Canada. RESULTS: It is shown that maximal stride frequency was the predominant limiting factor of the maximal treadmill-walking speed in SCI subjects. These results were explained in the light of the forced hybrid mass-spring pendulum model. At all speeds, SCI subjects spent longer time in stance, swing and double support phases. The relative time spent in single support is greater at higher walking speed and the difficulty to reduce double support time is a limiting factor. CONCLUSIONS: A better understanding of the factors limiting the maximal speed in SCI subjects should help developing rehabilitation interventions oriented towards increasing the control and the capacity of walking. Rehabilitation strategies should put the emphasis on improving the capacity to produce rapid alternate rhythmical stepping movements of the lower limbs. SPONSORSHIP: Neuroscience Network of the Canadian Centre of Excellence.

Nanofabrication: conventional and nonconventional methods.

Nanofabrication is playing an ever increasing role in science and technology on the nanometer scale and will soon allow us to build systems of the same complexity as found in nature. Conventional methods that emerged from microelectronics are now used for the fabrication of structures for integrated circuits, microelectro-mechanical systems, microoptics and microanalytical devices. Nonconventional or alternative approaches have changed the way we pattern very fine structures and have brought about a new appreciation of simple and low-cost techniques. We present an overview of some of these methods, paying particular attention to those which enable large-scale production of lithographic patterns. We preface the review with a brief primer on lithography and pattern transfer concepts. After reviewing the various patterning techniques, we discuss some recent application issues in the fields of microelectronics, optoelectronics, magnetism as well as in biology and biochemistry.

Walking after spinal cord injury: evaluation, treatment, and functional recovery.

OBJECTIVE: To present some recent developments and concepts emerging from both animal and human studies aimed at enhancing recovery of walking after spinal cord injury (SCI). DATA SOURCES: Researchers in the field of restoration of walking after SCI, as well as references extracted from searches in the Medline computerized database. STUDY SELECTION: Studies that reported outcome measures of walking for spinal cord injured persons with an incomplete motor function loss or cats with either a complete or incomplete spinal section. DATA EXTRACTION: Data were extracted and validity was assessed by the authors. DATA SYNTHESIS: This review shows that a multitude of interventions--mechanical, electrical, or pharmacologic--can increase the walking abilities of persons with SCI who have incomplete motor function loss. CONCLUSIONS: A comprehensive evaluation of walking behavior requires tasks involving the different control variables. This comprehensive evaluation can be used to characterize the process of recovery of walking as well as the effectiveness of various treatments.

Effects of drugs on walking after spinal cord injury.

Clonidine, a noradrenergic agonist, and cyproheptadine, a serotonergic antagonist, have each been associated with improved walking in SCI subjects. Baclofen, a GABA agonist, is frequently prescribed for spasticity but its effects on walking have not been well quantified. The objective of this study was to compare the effects of clonidine, cyproheptadine and baclofen on walking in SCI subjects with incomplete injuries. A motorized treadmill was used and harness support provided when necessary. A repeated single-subject design was employed for the twelve subjects. The greatest effects were found in more severely disabled subjects. Cyproheptadine was associated with greatly reduced need for assistance, increases in maximum treadmill speed (MTS) and reduced clonus. Clonidine was associated with increases in MTS and a generally more upright posture. Baclofen was associated with minor changes in walking. In many cases of drug effects, MTS increases and other changes were retained following washout of drugs. The significance and implications of the drug effects and the retention of effects during washout periods are discussed. It is concluded that clonidine and cyproheptadine have different effects but both appear useful for severely disabled SCI subjects. The effects of baclofen on walking after spinal cord injury remains unclear.

A treadmill apparatus and harness support for evaluation and rehabilitation of gait.

This report describes a treadmill apparatus for the evaluation and rehabilitation of gait in disabled persons. The apparatus incorporates a body weight support system as well as mechanisms to change certain conditions: treadmill belt speed, upward-downward and lateral slopes, and provision of obstacles. The apparatus enables elements of a treadmill walking pattern to be visible in persons for whom gait evaluation or rehabilitation may not otherwise be possible. It also allows for exploration of factors that limit the adaptability of gait in person after disease or injury by changing the mechanical demand of the locomotor task.

Idiotype and anti-anti-idiotype antibodies to Neisseria gonorrhoeae lipooligosaccharides with bactericidal activity but no cross-reactivity with red blood cell antigens.

A panel of murine mAb against three different epitopes of Neisseria gonorrhoeae lipooligosaccharides (LOS) was developed. Only one of these, 3G5, displays bactericidal activity against all in vitro serum-resistant strains of N. gonorrhoeae. Evidence suggests that sialylation, which could occur in vivo, modifies some LOS epitopes in such a way that the strains become resistant to bactericidal activity and are no longer recognized by specific antibodies. The epitope recognized by our bactericidal mAb is not affected by sialylation as shown by immunoblot analysis. We also provided evidence that the 3G5 epitope is different from RBC precursor Ag, since our mAb did not induce RBC agglutination. Since LOS induce an immune response in a T cell-independent fashion and are highly toxic, they cannot be used for immunization. Use of anti-idiotypic antibodies (aId) could be a way to bypass these difficulties. Therefore, in the present study, aId were produced in rabbits and rendered idiotype-specific by appropriate adsorption. These aId specifically bind to the relevant Id but not to LOS, and inhibit only the binding of anti-LOS mAb (3G5) to LOS preparations from N. gonorrhoeae in a dose-response fashion. The specificity of our aId for the binding site of anti-LOS mAb is suggested by the binding inhibition of affinity-purified aId to Id by LOS. In addition, the capacity of aId to inhibit bactericidal activity of this anti-LOS mAb and the idiotypic cross-reactivity between rat and mouse anti-LOS antibodies support this point. Finally, the elicitation of anti-LOS activity with bactericidal activity upon immunization of naive mice with aId confirms the internal image properties of the aId. These data suggest that a bactericidal mAb suitable for immunoprotection was obtained, and the production of aId opens the door for development of a vaccine.

Quadriceps femoris muscle activity in patellofemoral pain syndrome.

To elucidate and attempt to dissociate the two mechanisms, neuromuscular and mechanical, underlying patellofemoral pain syndrome, 18 subjects, divided into two groups based on a diagnosis of patellofemoral pain syndrome and the knee Q angle, were studied. The control group was asymptomatic and exhibited a normal Q angle (mean, 8.25 degrees), whereas the other group, diagnosed as patellofemoral pain syndrome patients, reported knee pain and had an above-normal Q angle (mean, 21.05 degrees). All subjects were tested for isometric maximum knee extension at 90 degrees, 30 degrees, and 15 degrees of knee flexion while they were seated in a special restraining chair. During testing, surface electromyography at the oblique and long fibers of the vastus medialis, and at the vastus lateralis were recorded along with the knee moment of force. The integrated electromyographic signals associated with the peak torque for all of the vastus muscles, along with the vastus medialis obliquus:vastus lateralis and vastus medialis longus:vastus lateralis activity ratios showed no significant differences between groups nor between the three angles, suggesting that all vasti measured were consistently active throughout the studied range of motion. This suggests that the neural drive was not affected in the patellofemoral pain syndrome patients. However, when the five patients showing the largest Q angles were isolated, they revealed a significantly smaller vastus medialis obliquus:vastus lateralis ratio when compared to the other group. The same ratio was also significantly smaller at 15 degrees compared to 90 degrees.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of molecular structure in a series of merocyanines on the in vitro cytotoxicity for adenocarcinoma cells.

Preliminary results have shown that merocyanines were cytotoxic for human adenocarcinoma cells in vitro. We report the synthesis of a series of new merocyanines and the structure-effect relationship as cytotoxic agents on human adenocarcinoma cells in vitro. Some of these new derivatives were found very cytotoxic for tumor cells in vitro, whereas their systemic toxicity in vivo was very low.