bluuebunny/crossref_metadata_2025 huggingface dataset:
A case of matrix-producing carcinoma of the breast
Authors: Hirose Toshiyuki , Honda Junko , Bando Yoshimi , Sasa Mitsunori , Hirose Yukiko , Nagao Taeko , Tangoku Akira
Published: June 2008

Background

Matrix-producing carcinoma (MPC) of the breast is one variant type of metaplastic carcinoma. The cellular origin of MPC remains unclear. It has been suggested the tumor cells in MPC have the combined characteristics of both epithelial cells and mesenchymal cells. Several reports suggested that the tumor cells in MPC might originate from the myoepithelial cells, but others suggested the origin was basal-like cells.

Case presentation

The patient was a 42-year-old Japanese female. A tumor of about 2 cm in diameter was noted in the right breast. CT revealed the circumference of the tumor to have a ring-like structure, and fine needle aspiration cytology indicated suspicion for malignancy. Breast-conserving surgery was performed. Histopathological studies showed carcinoma cells, having cuboidal to oval-shaped nucleus, were proliferating in cord-like and sheet-like structures in the periphery. In the central areas of the tumor, myxoedematous area was observed with cartilaginous matrix and necrosis. The diagnosis was a matrix-producing carcinoma. Immunohistochemical findings showed the tumor cells had the characteristics of both epithelial cells and mesenchymal cells, while being negative for estrogen receptor, progesterone receptor, Her2, myoepithelial cell markers and basal cell markers.

Conclusion

The findings for our present patient and many of the other MPC patients reported in the published literature indicate that this breast cancer has the properties of both epithelial cells and mesenchymal cells. In addition, there is a possibility that matrix-producing tumor cells of our present patient may have a feature of undifferentiated cells.
Viable chimaeric viruses confirm the biological importance of sequence specific maize streak virus movement protein and coat protein interactions
Authors: van der Walt Eric , Palmer Kenneth E , Martin Darren P , Rybicki Edward P
Published: June 2008

Background

A variety of interactions between up to three different movement proteins (MPs), the coat protein (CP) and genomic DNA mediate the inter- and intra-cellular movement of geminiviruses in the genus Begomovirus. Although movement of viruses in the genus Mastrevirus is less well characterized, direct interactions between a single MP and the CP of these viruses is also clearly involved in both intra- and intercellular trafficking of virus genomic DNA. However, it is currently unknown how specific these MP-CP interactions are, nor how disruption of these interactions might impact on virus viability.

Results

Using chimaeric genomes of two strains of Maize streak virus (MSV) we adopted a genetic approach to investigate the gross biological effects of interfering with interactions between virus MP and CP homologues derived from genetically distinct MSV isolates. MP and CP genes were reciprocally exchanged, individually and in pairs, between maize (MSV-Kom)- and Setaria sp. (MSV-Set)-adapted isolates sharing 78% genome-wide sequence identity. All chimaeras were infectious in Zea mays c.v. Jubilee and were characterized in terms of symptomatology and infection efficiency. Compared with their parental viruses, all the chimaeras were attenuated in symptom severity, infection efficiency, and the rate at which symptoms appeared. The exchange of individual MP and CP genes resulted in lower infection efficiency and reduced symptom severity in comparison with exchanges of matched MP-CP pairs.

Conclusion

Specific interactions between the mastrevirus MP and CP genes themselves and/or their expression products are important determinants of infection efficiency, rate of symptom development and symptom severity.
Sodium polystyrene sulfonate (Kayexalate) aspiration
Authors: Gonzalez-Cuyar Luis F , Cresswell Nathaniel B , Burke Allen P
Published: June 2008

In this short report we illustrate a case of extensive sodium polystyrene sulfonate (SPS) aspiration as an immediate cause of death in a terminally ill patient. SPS is a cation exchange resin utilized to decrease potassium levels in patients with renal failure. When administered rectally in conjunction with sorbitol, colonic necrosis and perforation have been documented. On the other hand, oral administration can be complicated by aspiration, especially in very ill or debilitated patients. In our current report, histological examination of a patient who aspirated SPS shows multiple polygonal to amorphous basophilic crystalline particles deposited intraalveolarly. The purpose of our report is to familiarize pathologists with the histologic features of this rare iatrogenic complication of therapy for hyperkalemia.
Spatial analysis of BSE cases in the Netherlands
Authors: Heres Lourens , Brus Dick J , Hagenaars Thomas J
Published: June 2008

Background

In many of the European countries affected by Bovine Spongiform Encephalopathy (BSE), case clustering patterns have been observed. Most of these patterns have been interpreted in terms of heterogeneities in exposure of cattle to the BSE agent. Here we investigate whether spatial clustering is present in the Dutch BSE case data.

Results

We have found three spatial case clusters in the Dutch BSE epidemic. The clusters are geographically distinct and each cluster appears in a different birth cohort. When testing all birth cohorts together, only one significant cluster was detected. The fact that we found stronger spatial clustering when using a cohort-based analysis, is consistent with the evidence that most BSE infections occur in animals less than 12 or 18 months old.

Conclusion

Significant spatial case clustering is present in the Dutch BSE epidemic. The spatial clusters of BSE cases are most likely due to time-dependent heterogeneities in exposure related to feed production.
Bacteroides fragilis aortic arch pseudoaneurysm: case report with review
Authors: Lee Hsin-Ling , Liu Kung-Hung , Yang Yu-Jen , Kan Chung-Dann
Published: June 2008

We present a case of 58-year-old woman with underlying diabetes mellitus, hepatitis C virus-related liver cirrhosis, and total hysterectomy for uterine myoma 11 moths ago, who was diagnosed ruptured aortic arch mycotic pseudoaneurysm after a certain period of survey for her unknown fever cause. After emergent surgery with prosthetic graft interposition, all her blood cultures and tissue cultures revealed pathogen with Bacteroides fragilis. Although mycotic aneurysms have been well described in literatures, an aneurysm infected solely with Bacteroides fragilis is unusual, with only eight similar cases in the literature. Here we reported the only female case with her specific clinical and management course and summarized all reported cases of mycotic aneurysm caused by Bacteroides fragilis to clarify their conditions and treatments, alert the difficulty in diagnosis, and importance of highly suspicious.
Cingulate NMDA NR2B receptors contribute to morphine-induced analgesic tolerance
Authors: Ko Shanelle W , Wu Long-Jun , Shum Fanny , Quan Jessica , Zhuo Min
Published: June 2008

Morphine is widely used to treat chronic pain, however its utility is hindered by the development of tolerance to its analgesic effects. While N-methyl-D-aspartate (NMDA) receptors are known to play roles in morphine tolerance and dependence, less is known about the roles of individual NMDA receptor subtypes. In this study, Ro 256981, an antagonist of the NMDA receptor subunit NR2B, was used to reduce the expression of analgesic tolerance to morphine. The mechanisms altered with chronic drug use share similarities with those underlying the establishment of long-tem potentiation (LTP) and behavioral memory. Since NMDA NR2B receptors in the anterior cingulate cortex (ACC) play roles in the establishment of LTP and fear memory, we explored their role in changes that occur in this region after chronic morphine. Both systemic and intra-ACC inhibition of NR2B in morphine-tolerant animals inhibited the expression of analgesic tolerance. Electrophysiological recordings revealed a significant increase in the NR2B component of NMDA receptor mediated excitatory postsynaptic currents (EPSCs), at both synaptic and extra-synaptic sites. However, there was no change in alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor mediated EPSCs. This study suggests that selective inhibition of NMDA NR2B receptors may prove useful in combating the development of analgesic tolerance to morphine and proposes a novel role for the ACC in opioid tolerance and morphine induced changes in synaptic plasticity.
Transcriptional regulation of long-term memory in the marine snail Aplysia
Authors: Lee Yong-Seok , Bailey Craig H , Kandel Eric R , Kaang Bong-Kiun
Published: June 2008

Whereas the induction of short-term memory involves only covalent modifications of constitutively expressed preexisting proteins, the formation of long-term memory requires gene expression, new RNA, and new protein synthesis. On the cellular level, transcriptional regulation is thought to be the starting point for a series of molecular steps necessary for both the initiation and maintenance of long-term synaptic facilitation (LTF). The core molecular features of transcriptional regulation involved in the long-term process are evolutionally conserved in Aplysia, Drosophila, and mouse, and indicate that gene regulation by the c yclic AMP r esponse e lement b inding protein (CREB) acting in conjunction with different combinations of transcriptional factors is critical for the expression of many forms of long-term memory. In the marine snail Aplysia, the molecular mechanisms that underlie the storage of long-term memory have been extensively studied in the monosynaptic connections between identified sensory neuron and motor neurons of the gill-withdrawal reflex. One tail shock or one pulse of serotonin (5-HT), a modulatory transmitter released by tail shocks, produces a transient facilitation mediated by the cAMP-dependent protein kinase leading to covalent modifications in the sensory neurons that results in an enhancement of transmitter release and a strengthening of synaptic connections lasting minutes. By contrast, repeated pulses of 5-hydroxytryptamine (5-HT) induce a transcription- and translation-dependent long-term facilitation (LTF) lasting more than 24 h and trigger the activation of a family of transcription factors in the presynaptic sensory neurons including ApCREB1, ApCREB2 and ApC/EBP. In addition, we have recently identified novel transcription factors that modulate the expression of ApC/EBP and also are critically involved in LTF. In this review, we examine the roles of these transcription factors during consolidation of LTF induced by different stimulation paradigms.
Torsion of an intrahydrocelic sac in a child: A case report
Authors: Christianakis Efstratios , Paschalidis Nikolaos , Filippou Georgios , Chorti Maria , Andromanakos Nikolaos , Pitiakoudis Michael , Rizos Spiros , Filippou Dimitrios
Published: June 2008

We report the case of a 3-yr-old boy who presented an acute right hydrocele. A rapid scrotal swelling under tension developed the first hours and the child complained for discomfort especially during palpation of the scrotum. Three days later, surgical exploration revealed an incomplete torsion of a communicated and pedunculated peritoneal sac arising from the tunica vaginalis testis.

The present case report represents the eleventh report of torsion of processus vaginalis saccular protrusion in the literature, being unique due to painless hematocele.
The CD44+/CD24-phenotype is enriched in basal-like breast tumors
Authors: Honeth Gabriella , Bendahl Pär-Ola , Ringnér Markus , Saal Lao H , Gruvberger-Saal Sofia K , Lövgren Kristina , Grabau Dorthe , Fernö Mårten , Borg Åke , Hegardt Cecilia
Published: June 2008

Introduction

Human breast tumors are heterogeneous and consist of phenotypically diverse cells. Breast cancer cells with a CD44+/CD24- phenotype have been suggested to have tumor-initiating properties with stem cell-like and invasive features, although it is unclear whether their presence within a tumor has clinical implications. There is also a large heterogeneity between tumors, illustrated by reproducible stratification into various subtypes based on gene expression profiles or histopathological features. We have explored the prevalence of cells with different CD44/CD24 phenotypes within breast cancer subtypes.

Methods

Double-staining immunohistochemistry was used to quantify CD44 and CD24 expression in 240 human breast tumors for which information on other tumor markers and clinical characteristics was available. Gene expression data were also accessible for a cohort of the material.

Results

A considerable heterogeneity in CD44 and CD24 expression was seen both between and within tumors. A complete lack of both proteins was evident in 35% of the tumors, while 13% contained cells of more than one of the CD44+/CD24-, CD44-/CD24+ and CD44+/CD24+ phenotypes. CD44+/CD24- cells were detected in 31% of the tumors, ranging in proportion from only a few to close to 100% of tumor cells. The CD44+/CD24- phenotype was most common in the basal-like subgroup – characterized as negative for the estrogen and progesterone receptors as well as for HER2, and as positive for cytokeratin 5/14 and/or epidermal growth factor receptor, and particularly common in BRCA1 hereditary tumors, of which 94% contained CD44+/CD24- cells. The CD44+/CD24- phenotype was surprisingly scarce in HER2+ tumors, which had a predominantly CD24+ status. A CD44+/CD24- gene expression signature was generated, which included CD44 and α6-integrin (CD49f) among the top-ranked overexpressed genes.

Conclusion

We demonstrate an association between basal-like and particularly BRCA1 hereditary breast cancer and the presence of CD44+/CD24- cells. Not all basal-like tumors and very few HER2+ tumors, however, contain CD44+/CD24- cells, emphasizing that a putative tumorigenic ability may not be confined to cells of this phenotype and that other breast cancer stem cell markers remain to be identified.
Development of a triage protocol for patients presenting with gastrointestinal hemorrhage: a prospective cohort study
Authors: Das Aneesa M , Sood Namita , Hodgin Katherine , Chang Lydia , Carson Shannon S
Published: June 2008

Introduction

Many patients presenting with acute gastrointestinal hemorrhage (GIH) are admitted to the intensive care unit (ICU) for monitoring. A simple triage protocol based upon validated risk factors could decrease ICU utilization.

Methods

Records of 188 patients admitted with GIH from the emergency department (ED) were reviewed for BLEED criteria (visualized red blood, systolic blood pressure below 100 mm Hg, elevated prothrombin time [PT], erratic mental status, and unstable comorbid disease) and complication within the first 24 hours of admission. Variables associated with early complication were reassessed in 132 patients prospectively enrolled as a validation cohort. A triage model was developed using significant predictors.

Results

We studied 188 patients in the development set and 132 in the validation set. Red blood (relative risk [RR] 4.53, 95% confidence interval [CI] 2.04, 10.07) and elevated PT (RR 3.27, 95% CI 1.53, 7.01) were significantly associated with complication in the development set. In the validation cohort, the combination of red blood or unstable comorbidity had a sensitivity of 0.73, a specificity of 0.55, a positive predictive value of 0.24, and a negative predictive value of 0.91 for complication within 24 hours. In simulation studies, a triage model using these variables could reduce ICU admissions without increasing the number of complications.

Conclusion

Patients presenting to the ED with GIH who have no evidence of ongoing bleeding or unstable comorbidities are at low risk for complication during hospital admission. A triage model based on these variables should be tested prospectively to optimize critical care resource utilization in this common condition.
Quantification of lean and fat tissue repletion following critical illness: a case report
Authors: Reid Clare L , Murgatroyd Peter R , Wright Antony , Menon David K
Published: June 2008

Introduction

Muscle wasting is a recognised feature of critical illness and has obvious implications for patient rehabilitation and recovery. Whilst many clinicians believe lean tissue repletion to be a slow process following critical illness, and a probable explanation for poor functional recovery of patients many months after resolution of the illness, we have found no studies quantifying body composition changes during patient recovery.

Methods

A combination of assessment techniques were used to monitor changes in body composition (that is, fat, water, protein and mineral), following intensive care unit (ICU) discharge, in a 38-year-old female recovering from extrapontine myelinolysis. Assessments were made at discharge from the ICU and then again 1 month, 3 months, 6 months and 12 months later. Functional recovery (respiratory muscle and hand-grip strength) and quality of life (36-item Short-form Health Survey) were assessed at these same timepoints.

Results

Twelve months after discharge from the ICU, and despite an extensive rehabilitation programme and improvements in respiratory muscle and hand-grip muscle strength, our patient was unable to return to full-time employment and continued to complain of fatigue. She had successfully regained weight and was back to her pre-illness body weight. Body composition measurements showed that an incredible 73% of the weight gained was due to an increase in body fat.

Conclusion

It is difficult to extrapolate the results of a single case to the wider ICU population, not least because the present patient sustained a significant neurological injury, but our data are the first to support the long-held belief that patient weight gain following critical illness is largely attributable to a gain in fat mass. The magnitude of body composition changes in the present patient are startling and support the need for longitudinal body composition data in a wider ICU population.
Multicenter Validation Study of the Sentinel Lymph Node Concept in Cervical Cancer: AGO Study Group
Authors: Altgassen Christopher , Hertel Hermann , Brandstädt Antje , Köhler Christhardt , Dürst Matthias , Schneider Achim
Published: June 2008

Purpose

Single-institution case series have demonstrated the feasibility of the sentinel concept in cervical cancer. However, the diagnostic accuracy remains to be validated. We evaluated detection rate and diagnostic accuracy to predict the histopathologic pelvic nodal status in patients with cervical cancer of all stages.

Patients and Methods

In a hypothesis-based, prospective, multicenter cohort study, patients underwent lymph node detection after labeling with technetium, patent blue, or both. After systematic pelvic and, if indicated, para-aortic node dissection, all lymph nodes were histopathologically examined. Detection rate, sensitivity, and negative predictive value (NPV) were calculated.

Results

According to the protocol, 590 patients were eligible. Detection rate of pelvic sentinel nodes was 88.6% (95% CI, 85.8% to 91.1%) and was significantly higher for the combination of technetium and patent blue (93.5%; 95% CI, 90.3% to 96.0%). Of 106 patients with pelvic lymph node metastases, 82 had pelvic sentinel node metastases. The overall sensitivity was 77.4% (95% CI, 68.2% to 85.0%), which was lower than 90%, the predefined noninferiority margin (P < .001). Sensitivity in women with tumors ≤ 20 mm (90.9%), with bilateral detection (87.2%), or with both substances applied (80.3%) was higher compared with the total population. The overall NPV was 94.3% (95% CI, 91.6% to 96.4%) and was higher in patients with tumors ≤ 20 mm (99.1%; 95% CI, 96.6% to 100%) compared with patients with tumors more than 20 mm (88.5%; 95% CI, 82.9% to 92.8%; P < .001).

Conclusion

In our cohort (all stages), sensitivity of the sentinel concept was low. However, patients with tumor diameter ≤ 20 mm may profit from this concept.
Patients With Acute Myeloid Leukemia and RAS Mutations Benefit Most From Postremission High-Dose Cytarabine: A Cancer and Leukemia Group B Study
Authors: Neubauer Andreas , Maharry Kati , Mrózek Krzysztof , Thiede Christian , Marcucci Guido , Paschka Peter , Mayer Robert J. , Larson Richard A. , Liu Edison T. , Bloomfield Clara D.
Published: June 2008

Purpose

RAS mutations occur in 12% to 27% of patients with acute myeloid leukemia (AML) and enhance sensitivity to cytarabine in vitro. We examined whether RAS mutations impact response to cytarabine in vivo.

Patients and Methods

One hundred eighty-five patients with AML achieving complete remission on Cancer and Leukemia Group B study 8525 and randomly assigned to one of three doses of cytarabine postremission were screened for RAS mutations. We assessed the impact of cytarabine dose on cumulative incidence of relapse (CIR) of patients with (mutRAS) and without (wild-type; wtRAS) RAS mutations.

Results

Thirty-four patients (18%) had RAS mutations. With 12.9 years median follow-up, the 10-year CIR was similar for mutRAS and wtRAS patients (65% v 73%; P = .31). However, mutRAS patients receiving high-dose cytarabine consolidation (HDAC; 3 g/m2 every 12 hours on days 1, 3, and 5 or 400 mg/m2/d × 5 days) had the lowest 10-year CIR, 45%, compared with 68% for wtRAS patients receiving HDAC and 80% and 100%, respectively, for wtRAS and mutRAS patients receiving low-dose cytarabine (LDAC; 100 mg/m2/d × 5 days; overall comparison, P < .001). Multivariable analysis revealed an interaction of cytarabine dose and RAS status (P = .06). After adjusting for this interaction and cytogenetics (core binding factor [CBF] AML v non-CBF AML), wtRAS patients receiving HDAC had lower relapse risk than wtRAS patients receiving LDAC (hazard ratio [HR] = 0.67; P = .04); however, mutRAS patients receiving HDAC had greater reduction in relapse risk (HR = 0.28; P = .002) compared with mutRAS patients treated with LDAC.

Conclusion

AML patients carrying mutRAS benefit from higher cytarabine doses more than wtRAS patients. This seems to be the first example of an activating oncogene mutation favorably modifying response to higher drug doses in AML.
Factors Associated With Severe Late Toxicity After Concurrent Chemoradiation for Locally Advanced Head and Neck Cancer: An RTOG Analysis
Authors: Machtay Mitchell , Moughan Jennifer , Trotti Andrew , Garden Adam S. , Weber Randal S. , Cooper Jay S. , Forastiere Arlene , Ang K. Kian
Published: June 2008

Purpose

Concurrent chemoradiotherapy (CCRT) for squamous cell carcinoma of the head and neck (SCCHN) increases both local tumor control and toxicity. This study evaluates clinical factors that are associated with and might predict severe late toxicity after CCRT.

Methods

Patients were analyzed from a subset of three previously reported Radiation Therapy Oncology Group (RTOG) trials of CCRT for locally advanced SCCHN (RTOG 91-11, 97-03, and 99-14). Severe late toxicity was defined in this secondary analysis as chronic grade 3 to 4 pharyngeal/laryngeal toxicity (RTOG/European Organisation for the Research and Treatment of Cancer late toxicity scoring system) and/or requirement for a feeding tube ≥ 2 years after registration and/or potential treatment-related death (eg, pneumonia) within 3 years. Case-control analysis was performed, with a multivariable logistic regression model that included pretreatment and treatment potential factors.

Results

A total of 230 patients were assessable for this analysis: 99 patients with severe late toxicities and 131 controls; thus, 43% of assessable patients had a severe late toxicity. On multivariable analysis, significant variables correlated with the development of severe late toxicity were older age (odds ratio 1.05 per year; P = .001); advanced T stage (odds ratio, 3.07; P = .0036); larynx/hypopharynx primary site (odds ratio, 4.17; P = .0041); and neck dissection after CRT (odds ratio, 2.39; P = .018).

Conclusion

Severe late toxicity after CCRT is common. Older age, advanced T-stage, and larynx/hypopharynx primary site were strong independent risk factors. Neck dissection after CCRT was associated with an increased risk of these complications.
Osteonecrosis in Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Authors: Kadan-Lottick Nina S. , Dinu Irina , Wasilewski-Masker Karen , Kaste Sue , Meacham Lillian R. , Mahajan Anita , Stovall Marilyn , Yasui Yutaka , Robison Leslie L. , Sklar Charles A.
Published: June 2008

Purpose

Osteonecrosis (ON) is a potentially serious complication of therapy in survivors of childhood cancer. Our goals were to describe the incidence of ON and identify patient and treatment characteristics associated with elevated risk.

Patients and Methods

The rate of self-reported ON was determined for 9,261 patients enrolled onto the Childhood Cancer Survivor Study, a cohort of 5-year survivors of childhood cancer diagnosed from 1970 to 1986, and compared with the rate in a random sample of 2,872 siblings of survivors. Survivors with positive responses were reinterviewed to confirm the diagnosis.

Results

Fifty-two cancer survivors reported ON in 78 joints, yielding 20-year cumulative incidence of 0.43% and a rate ratio (RR) of 6.2 (95% CI, 2.3 to 17.2) compared with siblings, adjusted for age and sex; 44% developed ON in a previous radiation field. The RR was greatest among survivors of stem-cell transplantation for acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), and chronic myelogenous leukemia (RR = 26.9, 66.5, and 93.1, respectively). Nontransplantation patients with ALL (RR = 6.5; 95% CI, 2.2 to 19.4), AML (RR = 11.2; 95% CI, 2.1 to 61.2), and bone sarcoma (RR = 7.3; 95% CI, 2.0 to 26.2) were at higher risk for ON. Older age at diagnosis, shorter elapsed time, older treatment era, exposure to dexamethasone (± prednisone), and gonadal and nongonadal radiation were independently associated with ON.

Conclusion

ON among long-term survivors of childhood cancer is rare. However, compared with siblings, childhood cancer survivors have a significantly increased relative rate of ON, particularly those who were older at diagnosis and who received dexamethasone or radiation therapy. Future studies are needed to better delineate our findings, particularly the increased risk after gonadal radiation.
Wilms’ Tumor 1 Gene Mutations Independently Predict Poor Outcome in Adults With Cytogenetically Normal Acute Myeloid Leukemia: A Cancer and Leukemia Group B Study
Authors: Paschka Peter , Marcucci Guido , Ruppert Amy S. , Whitman Susan P. , Mrózek Krzysztof , Maharry Kati , Langer Christian , Baldus Claudia D. , Zhao Weiqiang , Powell Bayard L. , Baer Maria R. , Carroll Andrew J. , Caligiuri Michael A. , Kolitz Jonathan E. , Larson Richard A. , Bloomfield Clara D.
Published: June 2008

Purpose

To analyze the prognostic impact of Wilms’ tumor 1 (WT1) gene mutations in cytogenetically normal acute myeloid leukemia (CN-AML).

Patients and Methods

We studied 196 adults younger than 60 years with newly diagnosed primary CN-AML, who were treated similarly on Cancer and Leukemia Group B (CALGB) protocols 9621 and 19808, for WT1 mutations in exons 7 and 9. The patients also were assessed for the presence of FLT3 internal tandem duplications (FLT3-ITD), FLT3 tyrosine kinase domain mutations (FLT3-TKD), MLL partial tandem duplications (MLL-PTD), NPM1 and CEBPA mutations, and for the expression levels of ERG and BAALC.

Results

Twenty-one patients (10.7%) harbored WT1 mutations. Complete remission rates were not significantly different between patients with WT1 mutations and those with unmutated WT1 (P = .36; 76% v 84%). Patients with WT1 mutations had worse disease-free survival (DFS; P < .001; 3-year rates, 13% v 50%) and overall survival (OS; P < .001; 3-year rates, 10% v 56%) than patients with unmutated WT1. In multivariable analyses, WT1 mutations independently predicted worse DFS (P = .009; hazard ratio [HR] = 2.7) when controlling for CEBPA mutational status, ERG expression level, and FLT3-ITD/NPM1 molecular-risk group (ie, FLT3-ITDnegative/NPM1mutated as low risk v FLT3-ITDpositive and/or NPM1wild-type as high risk). WT1 mutations also independently predicted worse OS (P < .001; HR = 3.2) when controlling for CEBPA mutational status, FLT3-ITD/NPM1 molecular-risk group, and white blood cell count.

Conclusion

We report the first evidence that WT1 mutations independently predict extremely poor outcome in intensively treated, younger patients with CN-AML. Future trials should include testing for WT1 mutations as part of molecularly based risk assessment and risk-adapted treatment stratification of patients with CN-AML.
Phase II Trial Evaluating the Clinical and Biologic Effects of Bevacizumab in Unresectable Hepatocellular Carcinoma
Authors: Siegel Abby B. , Cohen Emil I. , Ocean Allyson , Lehrer Deborah , Goldenberg Alec , Knox Jennifer J. , Chen Helen , Clark-Garvey Sean , Weinberg Alan , Mandeli John , Christos Paul , Mazumdar Madhu , Popa Elizabeta , Brown Robert S. , Rafii Shahin , Schwartz Jonathan D.
Published: June 2008

Purpose

To determine the clinical and biologic effects of bevacizumab, an anti–vascular endothelial growth factor (VEGF) monoclonal antibody, in unresectable hepatocellular carcinoma (HCC).

Patients and Methods

Adults with organ-confined HCC, Eastern Cooperative Oncology Group performance status of 0 to 2, and compensated liver disease were eligible. Patients received bevacizumab 5 mg/kg (n = 12) or 10 mg/kg (n = 34) every 2 weeks until disease progression or treatment-limiting toxicity. The primary objective was to determine whether bevacizumab improved the 6-month progression-free survival (PFS) rate from 40% to 60%. Secondary end points included determining the effects of bevacizumab on arterial enhancement and on plasma cytokine levels and the capacity of patients' plasma to support angiogenesis via an in vitro assay.

Results

The study included 46 patients, of whom six had objective responses (13%; 95% CI, 3% to 23%), and 65% were progression free at 6 months. Median PFS time was 6.9 months (95% CI, 6.5 to 9.1 months); overall survival rate was 53% at 1 year, 28% at 2 years, and 23% at 3 years. Grade 3 to 4 adverse events included hypertension (15%) and thrombosis (6%, including 4% with arterial thrombosis). Grade 3 or higher hemorrhage occurred in 11% of patients, including one fatal variceal bleed. Bevacizumab was associated with significant reductions in tumor enhancement by dynamic contrast-enhanced magnetic resonance imaging and reductions in circulating VEGF-A and stromal-derived factor-1 levels. Functional angiogenic activity was associated with VEGF-A levels in patient plasma.

Conclusion

We observed significant clinical and biologic activity for bevacizumab in nonmetastatic HCC and achieved the primary study end point. Serious bleeding complications occurred in 11% of patients. Further evaluation is warranted in carefully selected patients.
Benjamin Franklin and the Limits of Secular Civil Society
Authors: Glazener Nancy
Published: June 2008

Assessments of Benjamin Franklin have often been implicit assessments of civil society, whose double character of facilitating market transactions and promoting more expansive forms of public reflection have fueled competing accounts of Franklin. This essay explores Franklin's reliance on the conception of self-interest as a way of managing conflicting beliefs about the world. Taking Franklin as an influential early proponent of “interest-thinking”—the view that a self automatically or naturally possesses interests that fit an economic model, even if the interests are not solely economic in nature—the essay examines the failure of interest-thinking to capture the most important features of conviction or belief (religious or not). To the extent that secular civil society relies on interest-thinking to manage conflicting beliefs, secularism as we know it may be limited and compromised.

Franklin's writings offer a particular, wryly humorous way of wearing interests that is important to understand, however. The historical emergence of an interest-bearing self was facilitated, especially in America, by the fact that the doctrine of self-interest circulated not only (maybe even not primarily) as an abstract theory of the human but in satirical, self-ironic writings such as Franklin's. Franklin's satires of religious hypocrisy and public posing were an important way in which the interest-bearing self was absorbed into American public culture.
Consuming George Thompson
Authors: Stewart David M.
Published: June 2008

Misgivings about consumption as a biological metaphor reflect the extent to which our turn to the body in literary and cultural studies too often reduces it to abstractions of text and theory. This limits treating literature whose bodily appeal seems obvious, even when the appetites it served are obscured by history and our own taste for cultural politics. One is antebellum sensational literature, which in various forms has been used to examine the “bad attitudes” (racism, nativism, misogyny) of its main audience: large numbers of male workers who migrated to U.S. cities in the period. This essay revisits consumption as a metaphor that joins reading and eating, arguing that the attitudes of working men require a more faithful materiality than our qualms about the term's biologism permit. Sensational reading was a response, this essay argues, to coercive disciplinary rhetoric that pervaded the culture of antebellum reform, directly targeting bodies to re-form their conduct. In a parody of Benjamin Franklin, My Life; or, The Adventures of Geo. Thompson (1854), pornographer and sensationalist George Thompson attributes his large size to his being “somewhat of a gourmand,” with appetites that defied constraints placed upon them increasingly, in the period, by reading. Best known as the author of innumerable cheap, lurid crime novels, Thompson likens his fat to pleasure obtained from such literature and from bodily styles it helped to produce when men closed their books and enacted forms of display that aspired as much to grace and intimacy as vulgarity and intimidation.
The Unsentimental Woman Preacher of Uncle Tom's Cabin
Authors: Coleman Dawn
Published: June 2008

Challenging the critical commonplace that Uncle Tom's Cabin is, in effect, a sentimental sermon, this essay takes the novel's relationship to preaching, one of the most culturally authoritative forms of speech in antebellum America, as itself an object of analysis. It shows that Stowe, eager to preach yet uneasy about violating gender norms, created a narrator whose sermonic interventions move steadily from the culturally feminine to the culturally masculine—from sentimentality to a dark and angry theological vision that pushed the boundaries of acceptable religious speech. Stowe's qualms about this bold appropriation of religious discourse appear most strikingly in the afterword to the novel as it ran in the National Era, an overlooked alternate ending that undercuts the novel's closing jeremiad. This essay also demonstrates how thoroughly Uncle Tom's Cabin critiques and silences male preachers—both proslavery and antislavery—and how liberally it puts sermons into the mouths of numerous “lowly” characters, strategies by which Stowe transfers the power to preach from the ordained clergy to ordinary people who speak their convictions across the lines of gender, class, and race. The novel's diverse challenges to antebellum preaching defied social and religious hierarchies with a brio that implicitly called for broader democratic empowerment. The radicalism of the novel's sermonizing becomes especially clear when juxtaposed with that of the fiery, ultra-liberal Theodore Parker, antebellum America's leading antislavery preacher.
Toward a Definition of Caribbean American Regionalism: Contesting Anglo-America's Caribbean Designs in Mary Seacole and Sui Sin Far
Authors: Goudie Sean X.
Published: June 2008

This essay brings into dialogue discrete conversations in Caribbean studies, international political economy (IPE), and hemispheric American studies. Contextualizing these fields through the trope of hospitality, a figure of particular significance in Caribbean-U.S. relations, the author charts a field of writing he terms Caribbean American Regionalism, which is not bound necessarily to the geographic or ideological commitments of U.S. regionalist traditions even as it acknowledges and extends from innovative scholarship about them. The essay focuses on the role of women's voices in such a regionalist, Caribbean American imaginary, specifically Jamaican Creole healer and boarding-house operator Mary Seacole and the Eurasian writer Sui Sin Far. Although from distinct epochs and locations, Seacole and Sui Sin Far—as migrant laboring women of color in the Caribbean American region—are affected by, and their texts keenly respond to, developments in Caribbean-U.S. relations during the last half of the nineteenth century. This is particularly so in light of the dependence of corporations like the Panama Railroad Company and United Fruit Company on commodities produced by, and on the commodifying the bodies of, laboring West Indian women in hospitality industries. Seacole and Sui Sin Far, by marking (in)hospitable relations in the Caribbean American region in sites of hospitality where they reside and work—the Jamaican creole boarding-house and tourist hotel, respectively—expose the (in)hospitality of industry and the industry of (in)hospitality sponsoring nineteenth-century U. S. expansionism.
Within and without Raced Nations: Intratextuality, Martin Delany, and Blake; or the Huts of America
Authors: Chiles Katy
Published: June 2008

Martin Delany's Blake; or the Huts of America, a serialized novel about a black West Indian who plans a hemispheric slave rebellion, theorizes the nineteenth-century nation-state. While scholars have drawn connections between seriality and the establishment of nation-states, Blake complicates notions of transparent relationships among the parts and wholes of periodicals and national collectives. The complex serial publication of Blake performs the logic of what Martin Delany called elsewhere the “nation within the nation.” The conversation among various texts within texts—what I call a type of intratextuality—renders the nineteenth-century problem of raced nations within nations analogous to the problematic of Blake's textual existence. Blake's serial printing in the Weekly Anglo-African, which ran concurrently with advertisements for another version of Blake, provides a way to think about “texts within texts” that demonstrates the tensions that arise when individuals or entities exist both inside and outside various national or textual totalities. The novel's serialization also enacts a type of history that compresses different periods into the briefer time of the novel's plot and disrupts Benedict Anderson's axiomatic theories of how seriality helps imagine the nation. Delany's changing views on Haiti and black emigration plans—published alongside Blake in the Weekly Anglo-African—produce a serial palimpsest of Delany's dynamic politics. In addition, the novel depicts a malleability of racial formation that it simultaneously critiques and authorizes. Ultimately, the novel's intratextuality inflects Blake's depiction of a disjointed nation-state and reworks common understandings of periodicity and nation formation.
Distrusting: Marianne Moore on Feeling and War in the 1940s
Authors: Miller Cristanne
Published: June 2008

Marianne Moore's war poems of the 1940s, and in particular “In Distrust of Merits,” have frequently been read as a compendium of didactic, clichéd, pious, overstated public pronouncements brought on by the immediate urgency of the war, “show[ing] too much the pressure of news.” Work with Moore's drafts, notebooks, and uncollected poems, however, makes it clear that the genesis of these poems is broad and deep, not a matter of impulsive response to headlines. In them Moore uses an emotional register to construct a simultaneously political and spiritual exploration of the ethics of individual response to the issues of freedom and community raised by international genocide and world war. This essay reads “In Distrust of Merits” as a courageous and complex but not altogether successful poem dealing with tough questions about war, ethics, and trust. Moreover, it reads “The Mind Is an Enchanting Thing” as a companion poem to “In Distrust of Merits,” which deals with another side of the question of what can keep humanity human.
In the “Training Center of the Skillful Servants of Mankind”: Carlos Bulosan's Professional Filipinos in an Age of Benevolent Supremacy
Authors: Tolentino Cynthia
Published: June 2008

This essay examines Carlos Bulosan's autobiography America Is in the Heart (1943) as it engages Henry Luce's influential editorial “The American Century” (1941). To begin, it studies how Luce envisioned the mobile, American-style education of a professional class as the distinguishing feature of the postwar era. Luce's emphasis on postwar professionals as celebrated citizens of a U.S. trained professional class created the conditions of possibility for Bulosan to paradoxically construct Filipinos and Filipino Americans as experts on processes of Americanization. Departing from dominant readings of America Is in the Heart as setting the limits by which Filipinos are excluded by discourses of race in the U.S. national polity, this essay argues that Luce's definition of U.S. expertise as patriotic work resonated deeply with Filipino American writers, including Bulosan, in their attempts to position themselves as included subjects. The article examines the ways Bulosan revises Luce's arguments in order to study the implications of benevolent assimilation, the colonial policy of tutelage for Filipinos. Although the notion of a model minority discourse is conventionally understood as the result of 1965 immigration policy and a reaction to the intensification of black civil rights and protest movements, the concluding sections of the essay suggest that Bulosan provides a glimpse of the emergence of a model minority discourse as it takes shape in the shadow of black pathologization, the transformation of the U.S.-Philippines colonial relationship, and U.S. immigration narratives during World War II.
Management Strategies for Premenstrual Syndrome/Premenstrual Dysphoric Disorder
Authors: Jarvis Courtney I , Lynch Ann M , Morin Anna K
Published: June 2008

Objective:

To evaluate the current nonpharmacologic and pharmacologic treatment options for symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

Data Sources:

Literature was obtained through searches of MEDLINE Ovid (1950–March week 3, 2008) and EMBASE Drugs and Pharmacology (all years), as well as a bibliographic review of articles identified by the searches. Key terms included premenstrual syndrome, premenstrual dysphoric disorder, PMS, PMDD, and treatment.

Study Selection/Data Extraction:

All pertinent clinical trials, retrospective studies, and case reports in human subjects published in the English language were identified and evaluated for the safety and efficacy of pharmacologic and nonpharmacologic treatments of PMS/PMDD. Data from these studies and information from review articles were included in this review.

Data Synthesis:

Selective serotonin-reuptake inhibitors (SSRIs) have been proven safe and effective for the treatment of PMDD and are recommended as first-line agents when pharmacotherapy is warranted. Currently fluoxetine, controlled-release paroxetine, and sertraline are the only Food and Drug Administration-approved agents (or this indication. Suppression of ovulation using hormonal therapies is an alternative approach to treating PMDD when SSRIs or second-line psychotropic agents are ineffective; however, adverse effects limit their use. Anxiolytics, spironolactone, and nonsteroidal antiinflammatory drugs can be used as supportive care to relieve symptoms. Despite lack of specific evidence, lifestyle modifications and exercise are first-line recommendations for all women with PMS/PMDD and may be all that is needed to treat mild-to-moderate symptoms. Herbal and vitamin supplementation and complementary and alternative medicine have been evaluated for use in PMS/PMDD and have produced unclear or conflicting results. More controlled clinical trials are needed to determine their safety and efficacy and potential for drug interactions.

Conclusions:

Healthcare providers need to be aware of the symptoms of PMS and PMDD and the treatment options available. Treatment selection should be based on Individual patient symptoms, concomitant medical history, and need for contraception.
Increase in counselling communication skills after basic and advanced microskills training
Authors: Kuntze Jeroen , van der Molen Henk T. , Born Marise P.
Published: June 2008

Background Mastering counselling communication skills is one of the requirements that lead to the diploma of a registered European psychologist. The microcounseling method proves to be effective in training these skills.

Aim Research into the effectiveness of the microcounseling method often reports overall effect sizes only. The aim of this study was to investigate the adequate use of separate counselling communication skills (seven basic skills: minimal encouragements; asking questions; paraphrasing; reflection of feeling; concreteness; summarizing; and situation clarification and five advanced skills: advanced accurate empathy; confrontation; positive relabelling; examples of one's own; and directness) after respectively a basic and an advanced training in these skills.

Sample Participants were 583 first year or second year bachelor students in psychology who took the counselling communication skills progress test (CSPT). The participants are divided in a group of freshmen, who had not received any training in counselling communication skills; first year students, who had received a training in basic skills; second year students who had followed a training in advanced skills and a control group.

Method A between‐subject design, a within‐subject design and a pre‐test–post‐test‐control group design were used to examine the scores on these skills.

Results Seven basic skills and four advanced skills had large effect sizes. One advanced skill had a moderate effect size.

Conclusio The microcounseling method is very effective on the level of separate microskills. However, students perform better on the basic skills than on the advanced skills. More training seems to be needed in the latter to achieve the same level of mastery.
Improving self‐regulated learning of preschool children: Evaluation of training for kindergarten teachers
Authors: Perels Franziska , Merget‐Kullmann Miriam , Wende Milena , Schmitz Bernhard , Buchbinder Carla
Published: June 2008

Background In the context of lifelong learning, self‐regulated learning is an important competence. Children between 4 and 6 years of age are at a crucial step in their life to develop self‐regulatory competence. That is why their kindergarten teachers play an important role as instructors as well as role models.

Aim This study tested the effects of self‐regulation training for kindergarten teachers concerning their own self‐regulation and methods to foster self‐regulation in children at preschool age whom they were teaching.

Sample In this study, 35 German kindergarten teachers and 97 children participated. All adult participants were graduated kindergarten teachers.

Method The kindergarten teachers were tested with a questionnaire 2 weeks before and after the training. At the same time, the preschoolers were interviewed. A waiting control group design was applied.

Results and conclusions The results obtained by means of analyses of variance show that the self‐regulation of the kindergarten teachers as well as the self‐regulated learning of preschoolers whose kindergarten teachers took part in the training improved significantly. The results indicate that it is possible to improve self‐regulated learning of preschool children by a training programme for kindergarten teachers.