Risk model for severe anemia requiring red blood cell transfusion after cytotoxic conventional chemotherapy regimens. The Elypse 1 Study Group.

PURPOSE: Cancer patients frequently experience anemia as a consequence of myelosuppressive therapy or bone marrow invasion. PATIENTS AND METHODS: A risk model for chemotherapy-induced severe anemia requiring RBC transfusions (SARRT) within 31 days after the administration of chemotherapy was delineated in the cohort of cancer patients treated with chemotherapy in the Department of Medicine of Centre Léon Bérard in 1996 (CLB-1996). The risk model was tested on a series of 797 patients treated in 1997 (CLB-1997) and on 295 patients included in a multicenter prospective series (ELYPSE 1). RESULTS: One hundred seven of the 1,051 patients of the CLB-1996 cohort (10%) experienced SARRT. In univariate analysis, only female sex, performance status greater than 1, hemoglobin level less than 12 g/dL before chemotherapy on day 1 (d1), and d1 lymphocyte count < or = 700/microL significantly correlated with the risk of SARRT. Using logistic regression, d1 hemoglobin level less than 12 g/dL (odds ratio [OR] = 14.0; 95% confidence interval [CI], 7 to 30), performance status greater than 1 (OR = 2.2; 95% CI, 1.4 to 3.5), and d1 lymphocyte count < or = 700/microL (OR = 1.7; 95% CI, 1. 1 to 2.6) were identified as independent risk factors for SARRT. These three factors were given arbitrary risk coefficients of 3, 1, and 1 respectively, and a risk score for each individual patient was obtained by adding the coefficients. The calculated probability of RBC transfusions was 30% for patients with a score > or = 4, and 11%, 4%, and 1% in patients with a score of 2 or 3, 1, and 0 respectively. This model was then tested and validated in the CLB-1997 and ELYPSE 1 series. CONCLUSION: This risk index could be useful to identify patients at high risk for chemotherapy-induced SARRT who might be appropriate candidates for prophylactic erythropoietin treatment.

Selection of internal standards for analysis of silicate rocks and limestones by laser ablation inductively coupled plasma atomic emission spectrometry (LA-ICP-AES).

Included (Si, Ca) and added (Li, B) internal standards (IS) have been used comparatively in LA-ICP-AES of silicates and limestones to improve both precision and accuracy. A Q-switched Nd:YAG laser (355 nm, 10 Hz, 10 mJ per shot) has been applied for ablation. Samples have been prepared by fusion with Li(2)B(4)O(7) and measured using a Perkin-Elmer Optima 3000 ICP system. Both types of IS have given a relative standard deviation (RSD) less than 2-1%, which improved the repeatability by a factor of 2-10 and calibration graphs have been linear over the whole concentration range.

Comparison of some analytical performance characteristics in inductively coupled plasma spectrometry of platinum group metals and gold.

The limits of detection, precision and matrix effects in the inductively coupled plasma spectrometry of platinum group metals (PGMs) and gold were measured and evaluated for four ICP-AES and one ICP-MS instrument. The sample matrix was a cationic surfactant used for the PGMs and gold preconcentration on a modified silica gel (C18). A sorption of ion associates of PGMs and gold chlorocomplexes with the cation of onium salt N(1-carbaethoxypentadecyl)-trimethyl ammonium bromide was considered. The calibration curves, limits of detection and matrix effects were evaluated in the presence of 0.003 mol dm(-3) of onium salt (1.3 mg cm(-3)) and 0.1 mol dm(-3) HCl. The values of limits of detection (3 sigma(bl)) of PGMs for all axial ICP instruments were mostly below 10 ng cm(-3). Lateral observation on dual view ICP instrument yielded only 3 times higher detection limits in comparison to the axial mode of the same spectrometer and the detection limits for ICP-MS instrument were on the levels of units or tens of pg cm(-3). These limits of detection did not significantly differ from values obtained with pure solutions. Matrix effects in the presence of onium salt did not exceed 12% depression in the analytical signals. Besides the coefficients of correlation, the uncertainties on centroids of concentrations were calculated for calibration graphs obtained by linear regression.

Observations on the determination of osmium by inductively-coupled plasma atomic emission spectroscopy.

Osmium tetroxide gives rise to very characteristic atomic emission properties. In acidic samples it gives much higher sensitivity than that given by the lower oxidation states (IV, III, II). However, in alkaline medium (pH 10.5) its atomic emission sharply decreases, and the sensitivity is the same as that for the other oxidation states. It has been shown that there is a direct relation between these characteristics of OsO(4) solutions and pH. With increasing pH the intensity of its atomic emission decreases, the electrode potential of its solutions drops sharply and the molecular absorption of radiation at 193 nm undergoes a hyperchromic and bathochromic shift. The volatility of OsO(4) has also been studied, and found to be minimum at around pH 9.5. This favours its determination at this pH.

[Ovarian cancer: anatomo-clinical classifications]. / Cancers de l'ovaire: les classifications anatomo cliniques.

There are important barriers in the correct evaluation of the anatomic involvement of malignant ovarian tumors. Nevertheless, it seems advisable to rationalise the criteria of involvement. The authors relate the past classifications of Heyman, Helsel, Munnel, Davis, Gellé, Rutledge and Burns. The most widely accepted present-day classifications are the TNM system of the UICC and above all that of the FIGO. It seems that an attempt at unification between the two systems is recommendable. However, all classifications are arbitrary in nature because of the very diversity of carcinoma of the ovary.

Determination of chromium in whole blood by DRC-ICP-MS: spectral and non-spectral interferences.

Quantification of chromium in whole blood has been performed by ICP-quadrupole MS. The spectrometer was equipped with a dynamic reaction cell (DRC) with ammonia as reaction gas. The rejection parameter q (RPq) of the DRC and the flow rate of ammonia (NH3) were optimized and set at 0.7 and 0.6 mL min(-1), respectively. Blood was diluted 1:51 (v/v) with an aqueous solution containing 0.1 mg L(-1) NH4OH, 0.1 g L(-1) EDTA, 5 mg L(-1) n-butanol, and 0.1 per thousand Triton X100. Non-spectral matrix effects observed when using the DRC were confirmed by use of vanadium. External calibration with blank and standard solutions prepared in purified water led to biased results for quality control samples. Standard addition calibration was therefore used and its validity verified. By comparing the slopes and calculating residues, it was proved that the plot obtained with standard additions and the plot obtained from blood samples of different concentrations were aligned down to 0.05 microg L(-1) after dilution.

Sub-urethral tape treatment of female urinary incontinence--morbidity assessment of the trans-obturator route and a new tape (I-STOP): a multi-centre experiment involving 604 cases.

PURPOSE: To make an assessment of the morbidity related to using the trans-obturator route (TOT); findings after one year for the 140 first cases and preliminary results of short term morbidity after 604 implants. PATIENTS AND METHOD: This retrospective, multi-centre study involves the 604 first procedures with a 1-3 month follow-up. The mean patient age was 57 years. 92% of the patients underwent an isolated urinary incontinence cure and 8% had associated surgery. 47.3% of the cases had pure stress urinary incontinence and 52.7% had mixed incontinence. A 12-month minimum follow-up period was applied to the first 140 cases operated between September 2002 and January 2003. Patient assessment was made by a clinical examination in the first three months and their satisfaction rate expressed after 1 year. RESULTS: Operative complications were very few: 0.5% vesical perforations, 0.3% vaginal perforations, no urethral wounds, 0.8% 200-300 ml haemorrhages, two perineal haematomas (0.33%). The post-operative period was marked by: 1.5% transient retentions, 2.3% transient pain, 2.5% urinary infections, 1.3% transient dysuria. The 1-3 month follow-up of 572 patients shows a 5.2% rate of de novo symptoms. Patient assessment of 131 subjects after one year revealed an encouraging satisfaction rate of 85.5% with a 1.5% rate of de novo dysuria and urgency. To date there have been no serious or specific complications attributable to the surgical route adopted. The morbidity is not affected by associated surgery. CONCLUSION: The trans-obturator route combines low morbidity with a low rate of de novo symptoms on a large series. These results will have to be corroborated by further studies.

Depth profiling of tin-coated glass by laser ablation inductively coupled plasma emission spectrometry with acoustic signal measurement.

A pulsed, frequency-quadrupled Nd:YAG laser (266 nm, 10 Hz) coupled to an inductively coupled plasma atomic emission spectrometer (ICP-AES) was employed for depth profiling by ablation of a pyrolytically deposited Sn layer (300 nm) on float glass. The procedure consisted of performing individual ablation cycles (layer-by-layer). A raster with stroke distance of either 50 microm or 200 microm (the raster density) was used as an ablation pattern. The ablation was stopped after each cycle and the peak area of the resulting transient optical signal of the ICP discharge was plotted against the cycle number. The ablation rate of 90 to 20 nm per cycle at a low-energy pulse (6 mJ to 1 mJ) was determined by profilometry. A beam masking was employed to attenuate the laser shot energy and to eliminate the peripheral irregularity of the beam profile. Almost uniform removal of the square area (1 mm x 1 mm) of the coating by ablation was achieved by combining the fitted raster density, beam masking, focusing and beam energy. Different ablation processes were distinguished in cases of the tin coating and the uncoated glass surface. While the coating was mainly evaporated, the uncoated glass surface exhibited a crumbling associated with production of glass powder. This was confirmed by electron microscopy observations. The measured acoustic signal followed the behavior of the emission intensity of the Sn line and was supposed to be proportional to the amount of Sn vapors. The emission intensity depth profile of the Sn coating with graded structure was obtained, which qualitatively corresponded with the depth profile measured by secondary ion mass spectrometry.

Optimization of HPLC-ICP-AES for the determination of arsenic species.

High performance liquid chromatography coupled to ICP-AES detection provides a rapid, reliable and sensitive method for arsenic speciation. The separation of As(III), As(V), DMA and MMA was achieved with ion exchange chromatography coupled to an axially-viewed sequential ICP-AES. After optimization of the chromatographic parameters (pH and concentration of the mobile phase), a careful study of the interface was conducted. Five nebulizers associated to three spray chambers were tested. Response of the ICP to each arsenic species was strongly affected by the selection of the nebulizer and spray chamber, however similar responses were obtained for each arsenic species. Best signal-to-noise ratios were obtained by using a microconcentric nebulizer and a cyclone spray chamber and did not affect the chromatographic resolution. Detection limits better than 10 microg L(-1) were obtained for As(III), DMA, MMA and 20 microg L(-1) for As(V), which is a significant improvement over previously published results.

[Scarred uterus: management]. / L'utérus cicatriciel: conduite à tenir.

Uterine rupture was seen in a total of 1.1 per cent of 10,012 pregnancies involving scarred uteri. Rupture frequency during pregnancy was estimated as 0.4 per cent, although this is doubtless an underestimate due to the occasionally asymptomatic nature of the condition. Maternal mortality was nil. Fetal mortality related to uterine rupture was also nil, but psychomotor backwardness was seen in one case of uterine rupture after completion of 30 weeks of pregnancy. These results and those of the literature show that maternal and fetal risks linked to uterine rupture are significant during pregnancy and very small during confinement. The indications for systematic prophylactic cesarean section are discussed. An increased frequency of uterine tests could decrease the overall rate of cesarean sections without danger to mother or baby.

[Outcome of pregnancies with an intrauterine devices and their management]. / Devenir des grossesses sur stérilet et conduite à tenir.

The authors report a study of 157 cases of pregnancy occurring with an intrauterine device (IUD) in place. Particular attentions was paid to developments in patients who had accepted pregnancy (n : 67). The frequency of gravidic complications was much higher when the IUD was in place, and two septic abortions were seen between the fourth and sixth months of pregnancy. The authors put forward a new method of echo-guided removal of the device.

Evaluation of several pneumatic micronebulizers with different designs for use in ICP-AES and ICP-MS. Future directions for further improvement.

This paper reports characterization of the behavior of five pneumatic micronebulizers based on slightly different designs in inductively coupled plasma atomic-emission spectrometry and mass spectrometry (ICP-AES and ICP-MS). Two nebulizers were used as reference nebulizers, a high-efficiency nebulizer (HEN) and a micromist (MM). They were compared with a commercially available PFA (tetrafluoroethylene-perfluoroalkyl vinyl ether copolymer) nebulizer and with two new prototypes called the polymeric pneumatic concentric nebulizer (PMN) and the high-solids micronebulizer (HSM). The dimensions of the nebulizers, the gas back-pressure, and the free liquid uptake rates were measured. The study also included tertiary aerosol drop-size distributions, analyte transport rate, and analytical figures of merit, i.e. sensitivities and limits of detection, both in ICP-AES and ICP-MS. Recoveries for two food solid reference materials were also determined. Overall, the results indicated that the PFA and the HEN nebulizers provided the best results. These two nebulizers delivered a higher mass of analyte to the plasma and showed better sensitivies giving lower limits of detection than the PMN, HSM and MM. The results revealed that the liquid prefilming effect occurring before aerosol production in the PFA nebulizer promoted more efficient interaction of liquid and gas, thus affording good results even though gas back-pressure values could be maintained below 3 bar. In contrast, the HEN had to be operated at about 7 bar under the same conditions. Nebulizer design did not have a relevant effect on the recovery, which confirmed that the spray chamber plays an important role in terms of non-spectroscopic interferences.

Self-absorption effects in radially and axially viewed inductively coupled plasma-atomic emission spectrometry--the key role of the operating conditions.

Self-absorption effects leading to curvatures of the upper part of calibration graphs were investigated in multichannel detection ICP-AES. A dual view Optima 3000 ICP system was used to enable the simultaneous determination of 38 lines for both radial and axial viewing. Resonance and non-resonance lines were selected for both atomic and ionic lines. The concentrations of 22 standards were in the range 0.1-100 mg L(-1) and two sets of operating conditions, namely power and carrier gas flow rate, were used to evaluate their influence. It was found that these two conditions, and in particular the carrier gas flow rate, play a major role in self-absorption effects. Except for strongly absorbing lines, it was possible, under suitable conditions, to reduce or to suppress differences between self-absorption effects in radial and axial viewing, enabling extension of the range of linearity of axial viewing to higher concentrations. A diagnostic tool, based on emission line ratios, is proposed for detection of self-absorption. A calibration procedure is given for strongly absorbing lines affected by self-absorption even when operating conditions were optimized.

Calibration graphs for Ti, Ta and Nb in sintered tungsten carbide by infrared laser ablation inductively coupled plasma atomic emission spectrometry.

Infrared laser ablation (IR-LA) has been studied as a sample introduction technique for the analysis of sintered cobalt-cemented tungsten carbide materials by inductively coupled plasma atomic emission spectrometry (ICP-AES). Fractionation of cobalt was observed. Linearity of calibration plots was verified at least up to 15% Ti, 8% Ta, and 3% Nb. Above 1% (m/m) Ti, Ta, and Nb, the repeatability of results was better than 3% R.S.D. The relative uncertainty at the centroid of the calibration line was in the range from +/- 3% to +/- 4% for Ti, Ta, and Nb with internal standardization by tungsten and up to +/- 5% without internal standardization. The limits of detection were 0.004% Ti, 0.001% Ta, and 0.004% Nb. Elimination of the cemented hardmetal dissolution procedure is the main advantage of this method.

Bulk analysis by IR laser ablation inductively coupled plasma atomic emission spectrometry.

Two laser ablation systems dedicated to bulk analysis were evaluated for steel and PVC samples, using inductively coupled plasma atomic emission spectrometry detection. These systems were characterized by the use of a Nd:YAG laser operating at 1064 nm, the absence of observation device and a large laser spot size. The 1064 nm wavelength was selected to avoid the use of frequency-multiplying optics, and to be less critical to the sampling position. Calibration graphs and limits of detection are given for both types of materials. LODs were in the range 3-120 microg/g for steel, and in the range 0.07-15 microg/g for PVC. In the case of steel samples, similar calibration graph slopes were obtained between polished and unpolished samples.

Preconcentration of selenium compounds on a porous graphitic carbon column in view of HPLC-ICP-AES speciation analysis.

The retention of organic selenium compounds on a porous graphitic carbon stationary phase was investigated. Different acids were studied as mobile phases to elute selenocystamine, selenoethionine, selenomethionine and selenocystine. Detection was achieved using inductively coupled plasma-atomic emission spectrometry to provide selenium-specific and sensitive detection. The separation of the four species was carried out using methanoic acid. An important on-column preconcentration was obtained when solutes were injected in nitric acid or trifluoroacetic acid (TFA) media. The large injection volume employed (2,500 micro L) allowed us to reach low relative detection limits (2-6 micro g/L). The method, employing TFA as injection solvent and methanoic acid as the eluent was found to be robust with respect to different matrices spiked with selenocompounds.

Saturation in laser excited atomic fluorescence spectrometry: experimental verification.

The use of lasers to saturate an energy level of an atomic or molecular species is becoming almost commonplace. In this paper measurements of fluorescence signal vs laser power are reported. When a log-log plot of these data departs from the slope of unity saturation is invoked, but when the curve does not roll over B(F max) (fluorescence radiance) is lost. The shapes of the experimental log B(F) vs log E(nu) curves are investigated and also their absolute values with respect to theory.

Calibration graphs for steels by IR laser ablation inductively coupled plasma atomic emission spectrometry.

Infrared laser ablation (IRLA) was studied as a sample-introduction technique for the analysis of steels by inductively coupled plasma atomic emission spectrometry (ICP-AES). A comparison of two IRLA-ICP-AES systems based on Q-switched nanosecond Nd: YAG lasers was performed. The beam of the LINA-Spark atomizer (LSA Sarl, Cully, Switzerland) based on the Surelite 1-20 laser (Continuum, USA) was moved along a circle. A Perkin-Elmer Optima 3000 DV ICP system was used both with lateral and axial viewing modes. A laboratory-made ablation system based on the Brilliant laser (Quantel) was coupled to a Jobin-Yvon 170 Ultrace ICP (lateral viewing, polychromator part employed). A sample was rotated along a circle during ablation. Linearity of calibration plots was verified at least up to 19% Cr and 12% Ni without internal standardization for both LA-ICP-AES systems. Other elements examined were Mo up to 3%, Mn up 1.5%, Si up to 1.7%, and Cu up to 0.15%. The reproducibility was in the range 5-1 %RSD for a mass percentage 0.5-20% of steel constituents. The relative uncertainty of the centroids of the calibration lines was in the range from +/- 4% to +/- 12% for Cr, Ni, Mn, Mo, and Si, and from +/- 8% to +/- 19% for Cu. The lowest determinable quantities were calculated for calibration dependencies. Performances of both the IR-LA-ICP-AES were comparable.