bluuebunny/crossref_metadata_2025 huggingface dataset:
A humanized adaptive baseline information technology (HABIT) algorithm for a building management system
Authors: Wong L T , Mui K W , Fong N K
Published: October 2006

A building management system (BMS) established to control the system of building services would not incorporate records of occupants’ views nor integrate real-time occupants’ response for any system fine tuning to satisfy individual demands in a dynamic manner. This study proposes a humanized adaptive baseline information technology (HABIT) algorithm to enable such fine tuning according to the occupants’ feedback to optimize the acceptance of the indoor environment. Apart from solving the complaints from occupants, the proposed algorithm also integrates the collective real-time feedback from end-users with a balance of the imposed design conditions to determine the optimum operation condition of the system. In the study, the temperature set point of an air-conditioning system in certain Hong Kong offices was used as an illustrative example to demonstrate the operation of the algorithm. Survey results on occupants’ views and indoor environmental conditions of the offices were used to determine the input parameters of the algorithm. With the proposed algorithm, HABIT could be used for updating the design set point of the existing BMS.

Practical application: This study provides a new notion of humanized adaptive baseline information technology (HABIT) for air-conditioned spaces of a single temperature set point. The occupants’ views and indoor environmental conditions of the offices are used as input parameters of the algorithm in determining the optimum temperature set point for maximizing the occupants’ satisfaction. The algorithm could be built into existing building management systems (BMS) for determining the air temperature set point of a centralized air conditioning system.
The application of particle tracking velocimetry as a velocity measurement technique
Authors: Campbell D P
Published: October 2006

Within building drainage, waste and ventilation (DWV) systems, airflow measurement within and across the cross-section of the stack is problematic due to the multiphase and unsteady nature of the flow. This paper investigates the suitability for measurement of mixed-phase fluid flow in building (DWV) systems utilizing a particle tracking velocimetry (PTV) flow measurement technique. PTV is a non-intrusive optical flow measurement technique that supplies an instantaneous sample of velocity throughout a 2D plane in the flow field. The results of the PTV investigation can then be utilized for comparison with the results of previous investigations.

Practical application: Development of a remote sensing technique capable of discriminating between phases in DWV stack systems would benefit researchers and code bodies by allowing more robust and comprehensive models to be developed. These models could be used in sensitivity tests for code changes.
The logic of small samples in interview-based qualitative research
Authors: Crouch Mira , McKenzie Heather
Published: October 2006

In a qualitative framework, research based on interviews often seeks to penetrate social life beyond appearance and manifest meanings. This requires the researcher to be immersed in the research field, to establish continuing, fruitful relationships with respondents and through theoretical contemplation to address the research problem in depth. Therefore a small number of cases (less than 20, say) will facilitate the researcher’s close association with the respondents, and enhance the validity of fine-grained, in-depth inquiry in naturalistic settings. Epistemologically prior to these considerations, however, is the explanatory status of such research. From a realist standpoint, here concept formation through induction and analysis aims to clarify the nature of some specific situations in the social world, to discover what features there are in them and to account, however partially, for those features being as they are. Since such a research project scrutinizes the dynamic qualities of a situation (rather than elucidating the proportionate relationships among its constituents), the issue of sample size - as well as representativeness - has little bearing on the project’s basic logic. This article presents this argument in detail, with an example drawn from a study of persons with a past history of cancer diagnosis and treatment.
Medium as a basic concept of sociology: contributions from systems theory
Authors: Tosini Domenico
Published: October 2006

The main purpose of this article is to present the fundamental concepts of a theory of social systems, with special reference to the concepts of medium and form, and their application in sociology. By challenging the indifference and opposition shown by most contemporary sociologists to the ontological and theoretical questions of social theory (e.g. in the case of micro-sociologists’ aversion to Parsons), systems theory has, from the beginning, represented an attempt at an analysis focusing on the fundamental concepts (and on their coherent relations) of a general theory of society. Ignoring the elaboration of these concepts may be tantamount to reducing sociology to countless collections of facts of a limited informative value. Indeed, only an adequate conceptual framework will suffice. Certain recent developments in systems theory offer useful tools. Some of these developments are illustrated in this article, which marshals a network of concepts, each dealing with specific aspects relating to sociological analysis.
La sociologie de Max Scheler
Authors: Frère Bruno
Published: October 2006

This article has a double goal. First, it aims to rediscover a little-used sociological system (Max Scheler’s). Second, it aims to propose a thematic analysis of solidary economy (third-sector) actors’ justifications with a specific action regime (also not much discussed). These attempts merge very fast because this retrospective becomes the limits of this very (particular?) regime. It formalizes the search for social bonds in the third-sector engagement. The latter could be understood as a search for philia - in the vocabulary of the regimes of action sociology - or a sympathy search - in the vocabulary of Max Scheler. This search for social bonds appears as a strong opposition to the “capitalist mindset (kapitalistische Geist)”.
Effects of mycophenolate mofetil on transplant coronary artery disease and survival following cardiac transplantation
Authors: Mamelok RD
Published: October 2006

Cardiac allograft vasculopathy is a leading cause of death in patients undergoing cardiac transplantation. This disease of coronary arteries in characterized by diffuse intimal thickening and narrowing of the vessel lumen. Mycophenolate mofetil (MMF) is a prodrug that is efficiently metabolized to mycophenolic acid (MPA) and which is an effective suppressor of T and B lymphocyte proliferation. MMF also leads to inhibition of lymphocyte adhesion and migration, smooth muscle proliferation. these mechanisms lead to decreased cellular rejection and in a controlled clinical trial MMF, compared to azathioprine, has been demonstrated to improve patient survival, in part by diminishing deaths due to cardiovascular causes. MMF has also been demonstrated to reduce titres of anti-vimentin antibodies, which have been shown to be a marker for increased risk of coronary vascular disease. Data from intravascular ultrasound, angiography and autopsies suggest that MMF by diminish the development of cardiac allograft vasculopathy, which may explain the improvement in survival observed after MMF therapy.
Nonlinear Finite Element Simulation of Shape Adaptive Structures with SMA Strip Actuator
Authors: Roh Jin-Ho , Han Jae-Hung , Lee In
Published: October 2006

In this research, the thermomechanical responses of shape memory alloy (SMA) actuators and their applications in the shape adaptive structures combining strip SMA actuators are investigated. The numerical algorithm of the three-dimensional (3-D) SMA thermomechanical constitutive equations based on Lagoudas model is developed to analyze the unique characteristics of a SMA strip. The Green–Lagrange strain-displacement relationships are adopted to consider the large displacements, large strains, and material nonlinearity. For the numerical results presented in this article, the ABAQUS finite element program has been utilized with an appropriate user supplied subroutine (UMAT) written by FORTRAN for modeling a SMA strip and host elastic structure elements. In this model of a SMA strip, the shape memory effect is restricted to one-way applications. Numerical results show that an SMA strip actuator can generate enough recovery force to deform the host structure and sustain the deformed shape subjected to large external load, simultaneously. But, there are some difficulties found in designing reversible shape adaptive structures with this actuator, even if the SMA strip is coupled to an elastic structure which compels the SMA to recover the initial condition.
Consumer Opinions about Genetically Engineered Salmon and Information Effect on Opinions
Authors: Qin Wei , Brown J. Lynne
Published: October 2006

American consumers remain uninformed about genetically engineered (GE) foods, raising the prospect of their rejection based on outrage rather than risk. The Food and Drug Administration (FDA) is considering introduction of GE salmon into the food supply, an animal application likely to raise consumer concerns. As the first step in designing balanced information to help consumers reach informed opinions about GE salmon, we held eleven focus group discussions to compare the effect of limited (six groups) and detailed (five groups) information on the participants’ formulated consequences of this GE application. The results suggested that an effective communication piece about a specific GE application should contain basic and specific, including process- and product-related, information to help the recipient formulate consequences, and hence, opinions. It should also incorporate multiple viewpoints on certain and uncertain consequences to increase perceptions of source trustworthiness and help consumers reach informed opinions.
Pelvic ring injuries
Authors: Cooper Julian
Published: October 2006

Pelvic ring injuries exhibit a wide spectrum of severity; at times devastating with potentially serious immediate and long-term consequences. The anatomical and mechanistic basis of the injured pelvis is described. The non-operative and surgical management of pelvic ring disruption in the acute and definitive care settings is discussed. As emphasized here, basic principles, the mechanism of injury and pattern of instability help guide management.
Traces of feminist art
Authors: Johnson Clare
Published: October 2006

This article discusses the relationship between Eleanor Antin’s Carving: A Traditional Sculpture (1973) and Elizabeth Manchester’s All My Dresses With All My Shoes (2002) in terms of the differently structured temporalities of making and viewing through which the concept of femininity materializes in each work. Diachronic understandings of post-feminism, as a concept emptied of a former moment of political consciousness, are contested through my readings of artworks that call forth a complexity of tenses. The article argues that the connections and tensions between the two works, which are generationally distinct in terms of the political and cultural climate of their production, require a critical apparatus that suggests the simultaneity of differently valued temporal experiences. The notion of temporal play is further explored in relation to Vanessa Beecroft’s performance and film works VB29 (1997) and VB35 (1998). Here the traces of earlier feminist strategy, in which femininity is cast in relation to loss, are reconfigured in the failure to achieve the stasis of the photographic moment.
The Revival of the Propaganda State
Authors: Snow Nancy , Taylor Philip M.
Published: October 2006

Events since 11 September 2001 have brought to light debates about the revival of public diplomacy and the role of propaganda in domestic and global communications. This article analyzes American strategies to manipulate information and to ‘manage’ the media against the backdrop of the ongoing war on terrorism and of the conflict in Iraq. It explores the problematic tension between democratic ideals and principles toward openness alongside government and military needs of operational security and to secure public support in a ‘war’ that has been declared on global terrorism. This ongoing tension requires a genuine movement toward more open media and advocacy on the part of global citizens, including the strengthening of independent and non-corporate media, in order to challenge prevailing media that are subject to government and military influence. In a democracy, when things go wrong at home, it becomes much more difficult to project a positive image abroad. The impact of these trends in undermining the messages of public diplomacy overseas helps to explain both the success of US propaganda at home and its failure abroad.
Military Accord, Media Discord
Authors: Dardis Frank E.
Published: October 2006

Although the UK and US were staunch allies before and during the Iraq War, differing sociopolitical milieus existed within the countries regarding support for the war. This cross-national content analysis compared stories on antiwar protest by leading newspapers in each country to determine if the differing sociopolitical environments were reflected in each nation's press coverage. Results indicate that the US press invoked the ‘protest paradigm’ to a greater extent than its UK counterpart by being more likely to implement marginalization techniques in its coverage of protesters. Additionally, a greater number of marginalization techniques were associated with negative overall story tone toward the protesters within US coverage when compared to UK coverage. These results underscore the importance of cross-national research in examining the generality of contemporary mass media theory.
International News Agencies and the War Debate of 2003
Authors: Horvit Beverly
Published: October 2006

A stratified random sample of articles about the debate from 29 January 2003, to 18 February 2003, leading up to the US–Iraq conflict was selected from six news agencies – AP, Agence France Presse, Reuters, Xinhua, ITAR-TASS and Inter Press Service. US official sources were cited most frequently by all agencies except IPS and ITAR-TASS, which showed a nationalistic bias in its sourcing. Neither the western news agencies nor Xinhua's sourcing patterns were nationalistic, and their coverage was more balanced than IPS and ITAR-TASS. However, the non-western news agencies presented significantly more non-western viewpoints in their coverage of the pre-war debate.
International Diplomacy and the Prelude to the 2003 Invasion of Iraq
Authors: Alozie Emmanuel C.
Published: October 2006

Using framing as a theoretical and methodological framework, this study presents an analysis of the interpretation that the sub-Saharan African press put upon events prior to the 2003 Americanled military invasion of Iraq. It was found that the press opposed policies and efforts intended to initiate military action. This opposition was based on the contention that a westernled attack on Iraq, without an international consensus, would produce great political, economic and social upheaval in the Middle East, which might destabilize and have a negative impact upon African states.
Arab Satellite Television and Crisis Reporting
Authors: Zayani Mohamed , Ayish Muhammad I.
Published: October 2006

The question as to what dictates the choices of various media outlets and what guides the professional practices of journalists when reporting on international military crises is particularly pertinent when considering Arab media, who have been claiming a space in the global media scene by virtue of their intense and often controversial coverage of wars and crises in the postSeptember 11 era. This article is concerned with the coverage of the war against Iraq. It examines how Arab media reported the fall of Baghdad and the collapse of the regime of Saddam Hussein. The study focuses on how three pan-Arab satellite news channels that have been at the forefront of the coverage of the war against Iraq – Al Jazeera, Al Arabiya and Abu Dhabi Channel–handled the news from a narrative and visual perspective.
Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma
Authors: Derendorf H. , Nave R. , Drollmann A. , Cerasoli F. , Wurst W.
Published: October 2006

The pharmacokinetic and pharmacodynamic effects of inhaled corticosteroids (ICS) have shaped the efficacy and safety of these agents in the treatment of asthma.

Important pharmacokinetic and pharmacodynamic characteristics that can enhance the efficacy of ICS include small particle size, high glucocorticoid-receptor-binding affinity, long pulmonary residence time and lipid conjugation. These characteristics can increase or prolong the anti-inflammatory effects of an ICS. Important pharmacokinetic characteristics that can enhance the safety of ICS include on-site activation in the lung, low oropharyngeal exposure, negligible oral bioavailability, high protein-binding and rapid systemic clearance.

The degree of oropharyngeal exposure is relevant to local side-effects, such as oropharyngeal candidiasis, dysphonia and coughing. Pharmacokinetic properties that influence the degree of systemic exposure are relevant to the pharmacodynamic effect of ICS-induced hypothalamic–pituitary–adrenal axis suppression and cortisol suppression, an indicator of potential long-term systemic side-effects, such as reduced growth velocity and bone density, fractures, and skin bruising and thinning.

Therefore, significant differences in the pharmacokinetic and pharmacodynamic characteristics of the currently available inhaled corticosteroids warrant careful consideration when used in clinical practice as they may result in differences in efficacy and local and systemic safety profiles.
Hepatocellular Carcinoma and Non-Hodgkin's Lymphoma: The Roles of HIV, Hepatitis C Infection, and Alcohol Abuse
Authors: McGinnis Kathleen A. , Fultz Shawn L. , Skanderson Melissa , Conigliaro Joseph , Bryant Kendall , Justice Amy C.
Published: October 2006

Purpose

To explore the relationship of HIV, hepatitis C (HCV), and alcohol abuse/dependence to risk for hepatocellular carcinoma and non-Hodgkin's lymphoma (NHL).

Patients and Methods

Male veterans (n = 14,018) with a first HIV diagnosis in the Veterans Affairs Healthcare System from October 1997 to September 2004; and 28,036 age-, race-, sex-, and location-matched HIV-negative veterans were identified. We examined the incidence of hepatocellular carcinoma and NHL and presence of HCV and alcohol abuse/dependence using International Classification of Diseases, ninth revision (ICD-9-CM) codes. HIV-positive to HIV-negative incident rate ratios (IRRs) and 95% CIs for the occurrence of hepatocellular carcinoma and NHL were calculated using Poisson regression models.

Results

HIV-positive veterans were at greater risk for hepatocellular carcinoma than HIV-negative veterans (IRR = 1.68; 95% CI, 1.02 to 2.77). After adjusting for HCV infection and alcohol abuse/dependence, HIV status was not independently associated with hepatocellular cancer (IRR = 0.96; 95% CI, 0.56 to 1.63). HIV-positive veterans had 9.71 times (95% CI, 6.99 to 13.49) greater risk of NHL than HIV-negative veterans. After adjusting for HCV and alcohol abuse/dependence, the IRR for NHL comparing HIV-positive with HIV-negative veterans is similar (IRR = 10.03, 95% CI, 7.19 to 13.97).

Conclusion

HIV-positive veterans have a higher relative incidence of hepatocellular carcinoma and NHL than HIV-negative veterans. For hepatocellular carcinoma, this association appears to be largely explained by the higher prevalence of HCV and alcohol abuse/dependence. Efforts to decrease hepatocellular carcinoma among persons with HIV should focus primarily on detecting and treating HCV and reducing heavy alcohol use.
Liver Histology and Surgical Outcomes After Preoperative Chemotherapy With Fluorouracil Plus Oxaliplatin in Colorectal Cancer Liver Metastases
Authors: Aloia Thomas , Sebagh Mylène , Plasse Marylène , Karam Vincent , Lévi Francis , Giacchetti Sylvie , Azoulay Daniel , Bismuth Henri , Castaing Denis , Adam René
Published: October 2006

Purpose

Preoperative chemotherapy for colorectal liver metastases (CLM) can produce histologic changes in the nontumor-bearing liver (NTBL) that may impact on surgical outcomes.

Patients and Methods

From a cohort of 303 patients treated for CLM with liver resection, 92 patients (75 received preoperative chemotherapy: group C+; and 17 were chemotherapy naïve: group C−) were randomly selected for detailed pathologic analysis. Preoperative chemotherapy consisted of fluorouracil (FU)/leucovorin alone (23 patients, the majority chronomodulated) or in combination with oxaliplatin (52 patients, all chronomodulated). To determine associations between study factors, clinical and operative variables were compared with pathology data and surgical outcomes.

Results

Although clinical and operative factors were similarly distributed, C+ patients, compared with C− patients, were more likely to receive intraoperative RBC transfusions (mean units: 1.9 v 0.5, respectively; P = .03) and to have vascular abnormalities in the NTBL (52% v 18%, respectively; P = .01). Presence of the most severe forms of vascular alterations was closely associated with RBC transfusion requirements (P = .04). In contrast, moderate to severe steatosis was similarly distributed (C− group, 12%; C+ group, 13%). Although perioperative mortality and morbidity rates were similar in all groups, more than 12 courses of chemotherapy, compared with ≤ 12 courses, predisposed patients to reoperation (11% v 0%, respectively; P = .04) and to longer hospitalization (15 v 11 days, respectively; P = .02).

Conclusion

The main hepatic lesion induced by preoperative FU/oxaliplatin chemotherapy in patients with CLM is vascular and not steatosis. Detailed pathologic analysis determined that the most severe vascular lesions are associated with increased intraoperative transfusions. The risk for other postoperative complications is related to the duration of preoperative chemotherapy administration.
Randomized Phase II Study of Bortezomib Alone and Bortezomib in Combination With Docetaxel in Previously Treated Advanced Non–Small-Cell Lung Cancer
Authors: Fanucchi Michael P. , Fossella Frank V. , Belt Robert , Natale Ronald , Fidias Panos , Carbone David P. , Govindan Ramaswamy , Raez Luis E. , Robert Francisco , Ribeiro Maria , Akerley Wallace , Kelly Karen , Limentani Steven A. , Crawford Jeffrey , Reimers Hans-Joachim , Axelrod Rita , Kashala Oscar , Sheng Shihong , Schiller Joan H.
Published: October 2006

Purpose

To evaluate the efficacy and toxicity of bortezomib ± docetaxel as second-line therapy in patients with relapsed or refractory advanced non–small-cell lung cancer (NSCLC).

Patients and Methods

Patients were randomly assigned to bortezomib 1.5 mg/m2(arm A) or bortezomib 1.3 mg/m2plus docetaxel 75 mg/m2(arm B). A treatment cycle of 21 days comprised four bortezomib doses on days 1, 4, 8, and 11, plus, in arm B, docetaxel on day 1. Patients could receive unlimited cycles. The primary end point was response rate.

Results

A total of 155 patients were treated, 75 in arm A and 80 in arm B. Baseline characteristics were comparable. Investigator-assessed response rates were 8% in arm A and 9% in arm B. Disease control rates were 29% in arm A and 54% in arm B. Median time to progression was 1.5 months in arm A and 4.0 months in arm B. One-year survival was 39% and 33%, and median survival was 7.4 and 7.8 months in arms A and B, respectively. Adverse effect profiles were as expected in both arms, with no significant additivity. The most common grade ≥ 3 adverse events were neutropenia, fatigue, and dyspnea (4% and 53%, 19% and 26%, and 17% and 14% of patients in arms A and B, respectively).

Conclusion

Bortezomib has modest single-agent activity in patients with relapsed or refractory advanced NSCLC using this schedule, with minor enhancement in combination with docetaxel. Additional investigation of bortezomib in NSCLC is warranted in combination with other drugs known to be active, or using different schedules.
Customized Oligonucleotide Microarray Gene Expression–Based Classification of Neuroblastoma Patients Outperforms Current Clinical Risk Stratification
Authors: Oberthuer André , Berthold Frank , Warnat Patrick , Hero Barbara , Kahlert Yvonne , Spitz Rüdiger , Ernestus Karen , König Rainer , Haas Stefan , Eils Roland , Schwab Manfred , Brors Benedikt , Westermann Frank , Fischer Matthias
Published: October 2006

Purpose

To develop a gene expression–based classifier for neuroblastoma patients that reliably predicts courses of the disease.

Patients and Methods

Two hundred fifty-one neuroblastoma specimens were analyzed using a customized oligonucleotide microarray comprising 10,163 probes for transcripts with differential expression in clinical subgroups of the disease. Subsequently, the prediction analysis for microarrays (PAM) was applied to a first set of patients with maximally divergent clinical courses (n = 77). The classification accuracy was estimated by a complete 10-times-repeated 10-fold cross validation, and a 144-gene predictor was constructed from this set. This classifier's predictive power was evaluated in an independent second set (n = 174) by comparing results of the gene expression–based classification with those of risk stratification systems of current trials from Germany, Japan, and the United States.

Results

The first set of patients was accurately predicted by PAM (cross-validated accuracy, 99%). Within the second set, the PAM classifier significantly separated cohorts with distinct courses (3-year event-free survival [EFS] 0.86 ± 0.03 [favorable; n = 115] v 0.52 ± 0.07 [unfavorable; n = 59] and 3-year overall survival 0.99 ± 0.01 v 0.84 ± 0.05; both P < .0001) and separated risk groups of current neuroblastoma trials into subgroups with divergent outcome (NB2004: low-risk 3-year EFS 0.86 ± 0.04 v 0.25 ± 0.15, P < .0001; intermediate-risk 1.00 v 0.57 ± 0.19, P = .018; high-risk 0.81 ± 0.10 v 0.56 ± 0.08, P = .06). In a multivariate Cox regression model, the PAM predictor classified patients of the second set more accurately than risk stratification of current trials from Germany, Japan, and the United States (P < .001; hazard ratio, 4.756 [95% CI, 2.544 to 8.893]).

Conclusion

Integration of gene expression–based class prediction of neuroblastoma patients may improve risk estimation of current neuroblastoma trials.
Prognostic Significance of Tumor Necrosis Factor–Related Apoptosis-Inducing Ligand and Its Receptors in Adjuvantly Treated Stage III Colon Cancer Patients
Authors: van Geelen Caroline M. , Westra Jantine L. , de Vries Elisabeth G. , Boersma-van Ek Wytske , Zwart Nynke , Hollema Harry , Boezen H. Marike , Mulder Nanno H. , Plukker John T. , de Jong Steven , Kleibeuker Jan H. , Koornstra Jan J.
Published: October 2006

Purpose

In preclinical models, there is synergism between chemotherapy and recombinant human tumor necrosis factor (TNF) –related apoptosis-inducing ligand (TRAIL) on apoptosis induction in tumor cells. Therefore, the prognostic relevance was analyzed of the expression of TRAIL and its death receptors DR4 and DR5 on disease-free survival and overall survival in stage III colon cancer patients treated with adjuvant chemotherapy.

Methods

Tissue microarrays were constructed of primary tumor tissue from 376 stage III colon cancer patients treated in a randomized adjuvant chemotherapy study (fluorouracil/levamisole v fluorouracil/levamisole/leucovorin) and stained immunohistochemically for TRAIL, DR4, and DR5. Log-rank tests and Cox proportional hazard analysis, with adjustment for treatment arm, sex, age, N stage, microsatellite instability status, and p53 mutation status, were performed.

Results

The majority of tumors showed high expression of TRAIL (83%), DR4 (92%), and DR5 (87%). Median follow-up was 43 months. High DR4 expression was associated with worse disease-free survival (odds ratio [OR] = 2.19; 95% CI, 1.06 to 4.53; P = .03), worse overall survival (OR = 2.22; 95% CI,1.03 to 4.81; P = .04) and shorter time to recurrence (P = .02) compared with those with low DR4 expression. TRAIL or DR5 expression had no prognostic value.

Conclusion

High DR4 expression is associated with worse disease-free and overall survival in stage III adjuvant-treated colon cancer patients. Evaluation of DR4 expression in stage III colon cancer patients may identify a subset requiring more aggressive adjuvant treatment.
Phase I Study of Adoptive T-Cell Therapy Using Antigen-Specific CD8+ T Cells for the Treatment of Patients With Metastatic Melanoma
Authors: Mackensen Andreas , Meidenbauer Norbert , Vogl Sandra , Laumer Monika , Berger Jana , Andreesen Reinhard
Published: October 2006

Purpose

The adoptive transfer of in vitro generated tumor antigen-specific cytotoxic T lymphocytes (CTL) provides a promising approach to the immunotherapy of cancer. A phase I study was conducted to test the feasibility, safety, and survival of adoptively transferred Melan-A–specific CTL lines in melanoma patients.

Patients and Methods

Eleven HLA-A2+ patients with metastatic melanoma received at least three intravenous infusions of Melan-A–specific CTL at 2-week intervals. CTL were generated by four rounds of in vitro stimulation of purified CD8+ peripheral blood lymphocytes with autologous dendritic cells pulsed with an HLA-A2 binding Melan-A peptide. Each T-cell infusion was accompanied by a 6-day course of low-dose interleukin-2.

Results

A total of 52 T-cell infusions were administered, averaging 2.1 × 108 Melan-A–specific CTL per infusion. Clinical adverse effects were mild and consisted of chills and low-grade fever in seven of 11 patients. Clinical and immunologic responses revealed an antitumor response in three of 11 patients (one complete regression, one partial regression, one mixed response), an elevated frequency of circulating Melan-A tetramer+ T cells up to 2 weeks in all the patients with a maximal frequency of 2% of total CD8+ T cells, an increase in eosinophils to up to 50% in seven of 11 patients, and a selective loss of Melan-A expression in lymph node metastases in two evaluated patients after T-cell transfer.

Conclusion

Our data indicate that the adoptive transfer of antigen-specific T cells in melanoma patients can induce clinical tumor-specific immune responses without major adverse effects.
Locoregional Control of Clinically Diagnosed Multifocal or Multicentric Breast Cancer After Neoadjuvant Chemotherapy and Locoregional Therapy
Authors: Oh Julia L. , Dryden Mark J. , Woodward Wendy A. , Yu Tse-Kuan , Tereffe Welela , Strom Eric A. , Perkins George H. , Middleton Lavinia , Hunt Kelly K. , Giordano Sharon H. , Oswald Mary Jane , Domain Delora , Buchholz Thomas A.
Published: October 2006

Purpose

The purpose was to assess whether patients with clinical multifocal or multicentric (MFMC) breast cancer determined by mammogram, ultrasound, or physical examination have inferior outcome compared with patients with clinical unicentric lesions.

Patients and Methods

We retrospectively analyzed 706 consecutive patients with stages I-III breast cancer treated at the M.D. Anderson Cancer Center (Houston, TX) from 1976 to 2003 who received neoadjuvant anthracycline-based chemotherapy followed by breast conservation therapy (BCT), mastectomy alone, or mastectomy plus postmastectomy radiation therapy.

Results

The mean follow-up was 66 months. At presentation, 97 of 706 patients had clinically MFMC disease (13.7%). The 5-year rate of locoregional failure was 10% for unicentric disease compared with 7% for MFMC disease (P = .78). Subset analyses of patients by treatment groups confirmed no statistical difference in locoregional control regardless of the type of locoregional treatment. Among patients with multifocal disease treated with BCT, there were no in-breast recurrences and one supraclavicular recurrence. Five-year disease-free survival and overall survival was equivalent between patients with MFMC and unicentric breast cancers.

Conclusion

Patients with clinical MFMC breast cancer at the time of diagnosis treated with neoadjuvant chemotherapy followed by locoregional therapy have similar 5-year rates of locoregional control, disease-free survival, and overall survival as those with unicentric disease. Clinically detected MFMC disease did not predict for inferior outcome.
The Association Between Cigarette Smoking During Pregnancy and Maternal Behavior During the Neonatal Period
Authors: Schuetze Pamela , Eiden Rina D. , Dombkowski Laura
Published: October 2006

This study examined the association between maternal smoking during pregnancy and maternal behavior during mother‐infant interactions during the neonatal period. Participants included 84 mother‐infant dyads (43 cigarette‐exposed and 41 nonexposed) who were recruited after birth and assessed at 2 to 4 weeks of infant age. Results indicated that mothers who smoked during pregnancy had higher levels of maternal insensitivity (MI) and lower levels of maternal warmth (MW) during interactions with their infant even after controlling for demographics and pregnancy alcohol use. Maternal anxiety and hostility mediated the association between smoking and MI and maternal anger mediated the association between smoking and reduced MW. In addition, there was an interaction between infant gender and maternal smoking for MW with smokers displaying less warmth to boys during interactions.
Rational Imitation in 12‐Month‐Old Infants Christiane Schwier, Catharine van Maanen, Malinda Carpenter
Authors: Tomasello Michael
Published: October 2006

Gergely, Bekkering, and Király (2002) demonstrated that 14‐month‐old infants engage in “rational imitation.” To investigate the development and flexibility of this skill, we tested 12‐month‐olds on a different but analogous task. Infants watched as an adult made a toy animal use a particular action to get to an endpoint. In 1 condition there was a barrier that prevented a more straightforward action and so gave the actor no choice but to use the demonstrated action. In the other condition there was no barrier, so the actor had a free choice to use the demonstrated action or not. Twelve‐month‐olds showed the same pattern of results as in Gergely and colleagues' study: They copied the particular action demonstrated more often when the adult freely chose to use the action than when she was forced to use it. Twelve‐month‐olds, too, thus show an understanding of others' intentions as rational choices and can use this understanding in cultural learning contexts.
Two separate molecular systems, Dachsous/Fat and Starry night/Frizzled,act independently to confer planar cell polarity
Authors: Casal José , Lawrence Peter A. , Struhl Gary
Published: October 2006

Planar polarity is a fundamental property of epithelia in animals and plants. In Drosophila it depends on at least two sets of genes: one set, the Ds system, encodes the cadherins Dachsous (Ds) and Fat (Ft), as well as the Golgi protein Four-jointed. The other set, the Stan system, encodes Starry night (Stan or Flamingo) and Frizzled. The prevailing view is that the Ds system acts via the Stan system to orient cells. However, using the Drosophila abdomen, we find instead that the two systems operate independently: each confers and propagates polarity, and can do so in the absence of the other. We ask how the Ds system acts; we find that either Ds or Ft is required in cells that send information and we show that both Ds and Ft are required in the responding cells. We consider how polarity may be propagated by Ds-Ft heterodimers acting as bridges between cells.
Cell-cycle-dependent dynamics of nuclear pores: pore-free islands and lamins
Authors: Maeshima Kazuhiro , Yahata Kazuhide , Sasaki Yoko , Nakatomi Reiko , Tachibana Taro , Hashikawa Tsutomu , Imamoto Fumio , Imamoto Naoko
Published: October 2006

Nuclear pores are sophisticated gateways on the nuclear envelope that control macromolecular transport between the cytoplasm and nucleoplasm. So far the structural and functional aspects of nuclear pores have been extensively studied, but their distribution and density, which might reflect nuclear organization and function, remain unknown. Here, we report the cell-cycle-dependent dynamics of nuclear pores. Large distinct subdomains lacking nuclear pores are present on the nuclear surface of HeLaS3 cells in early cell-cycle stages. Such `pore-free islands' gradually become dispersed in G1-S phase. Surprisingly, the islands are enriched with inner nuclear membrane proteins lamin A/C and emerin, but exclude lamin B. Lamin-A/C-enriched pore-free islands were also observed in human normal diploid fibroblasts and several cell lines, showing the generality of this phenomenon. Knockdown and ectopic expression analyses demonstrated that lamin A/C, but not emerin, plays an essential structural and regulatory role in the nuclear pore distribution and the formation of pore-free islands. These data thus provide strong evidence that the dynamics of nuclear pores are regulated by the reorganization of inner nuclear structures.
Prolonged intubation vs. tracheotomy: Complications, practical and psychological considerations
Authors: Astrachan David I. , Kirchner J. Cameron , Goodwin W. Jarrard
Published: October 2006

The charts of 52 adult patients who underwent tracheotomy (49 after intubation) were reviewed to identify early complications of both endotracheal intubation and tracheotomy. The complication rate of endotracheal intubation was 57%, and of tracheotomy, 14%. None of the complications of tracheotomy was serious.

Sixty critical‐care nurses were surveyed about their attitudes regarding prolonged endotracheal intubation and tracheotomy. A large majority preferred tracheotomy for patients who require airway support, for several reasons. First, they felt that tracheotomy patients were more comfortable and, therefore, required less sedation and restraint. Second, the patients could communicate more effectively. Third, airway care was simplified. Ninety‐two percent of nurses stated that they would prefer a tracheotomy for themselves or a loved one if more than 10 days of ventilatory support were required.

We conclude that tracheotomy can be performed safely in this group of patients, and that it offers significant practical and psychological benefits compared to prolonged endotracheal intubation.
Reflux as an etiological factor of carcinoma of the laryngopharynx
Authors: Ward Paul H. , Hanson David G.
Published: October 2006

This study examined charts and 16‐mm pictures or videotapes of 138 patients with carcinoma of the larynx treated during the last 10 years. Among these patients, 19 were nonsmokers and nondrinkers or only light social drinkers with moderate to severe gastroesophageal reflux (GER). Serial cinephotographs are presented with follow‐up of up to 10 years. The common presence of GER in these nonsmoking, nondrinking patients and the probable role of this chronic irritative disorder as a causative agent in carcinoma of the laryngopharynx are discussed.
Nerve transfer versus teflon® injection for vocal cord paralysis: A comparison
Authors: Crumley Roger L. , Izdebski Krzysztof , Mcmicken Berry
Published: October 2006

Teflon® injection for unilateral vocal cord paralysis frequently produces an improved yet breathy voice. Ansa hypoglossi‐recurrent laryngeal nerve anastomosis has been performed in five patients. In the four patients discussed in this paper, excellent phonatory quality has been achieved. Electroacoustic analysis indicates that this technique may produce normal phonatory function in paralyzed larynges.

There have been no serious side effects or complications in our first five patients. Denervation of the sternothyroid muscle, which results from sectioning its nerve in preparation for suture to the RLN, appears to further improve the voice by medially positioning the vocal cord. Gelfoam® paste is injected at the time of nerve transfer to rehabilitate the voice during the 2 months required for nerve regeneration.

For younger patients, or those with professional use of their voices, this technique offers superior speech results when compared with Teflon® injection.
Preoperative chemotherapy in advanced resectable head and neck cancer: Final report of the southwest oncology group
Authors: Schuller David E. , Stem David W. , Metch Barbara , Mattox Douglas , Mccracken Joseph D.
Published: October 2006

In 1980, the Southwest Oncology Group instituted a multi‐institutional, prospective, randomized phase III trial to evaluate whether inductive chemotherapy improved survival in patients with advanced stage resectable squamous cell carcinoma of the head and neck. From a group of 158 eligible patients, 76 were randomized to conventional treatment (surgery and postoperative radiotherapy), and 82 were assigned to experimental treatment (induction chemotherapy, surgery, postoperative radiotherapy). Median follow‐up for living patients was approximately 5 years. These analyses include chemotherapy responses and toxicities, surgical complications, radiotherapy toxicities, patient compliance, survival time, and patterns of treatment failure. Overall chemotherapy response was 0.70 (0.19 CR, 0.51 PR). The median survival time for conventional treatment was longer than the time for patients receiving preoperative chemotherapy, although the survival time differences were not statistically significant. This final analysis demonstrates no benefit in survival using preoperative chemotherapy for advanced stage, resectable head and neck squamous cell carcinoma.
Surgical management of recurrent nasopharyngeal carcinoma after radiation failure at the primary site
Authors: Fee Willard E. , Gilmer Patricia A. , Gopffinet Don R.
Published: October 2006

Nine patients have undergone transpalatal resection of recurrent nasopharynx cancer 10 to 56 months following a full course of external beam, irradiation. Seven patients were treated for cure, and two were treated palliatively because of nasal airway obstruction, recurrent epistaxis, and severe headaches. Of the patients treated for cure, five are living free of disease 6 to 48 months (mean, 22.2 months) after their surgery. Disease recurred in two patients at 5 and 7 months. Both underwent secondary procedures and are alive with disease at 25 months and 11 months, respectively. The mean hospital stay was 8.7 days (range, 2 to 30 days) for all patients. The average time to swallowing was 2 days (range, 1 to 3 days). Six patients required resection of their soft palate and a soft palate obturator; two patients had intact functioning soft palates without velopharyngeal insufficiency.

Of the two patients treated for palliation, one patient died 1 year postoperatively and, although she received some benefit from the resection (diminished headaches), in retrospect, surgery was not worthwhile. The second patient is alive 3 years following her resection and remained symptom‐free for 2 years.
In search of missing links in otology. I. development of a collagen‐based biomaterial
Authors: Goycoolea Marcos V. , Muchow David C. , Scholz Matt T. , Sirvio Larry M. , Stypulkowski Paul H.
Published: October 2006

Experiments leading to the development and use of a biomaterial based on reconstituted collagen for use in tympanoplasty are presented. A stable, even membrane with optimal strength and an organized matrix of collagen protein strands has been obtained. Biocompatibility was documented by subcutaneous implantation, cytotoxicity with agar overlay, cell contact, and cell‐growth inhibition studies. Experimental grafting in chinchillas with perforated tympanic membranes demonstrated that the collagen membrane performed well in all cases. Histopathological studies in chinchillas showed that the collagen membrane compared favorably with fascia grafts. Of significance is that: 1. The membrane has a matrix of microperforations that enhance tissue ingrowth, allow stable anchoring, and permit aeration of the middle ear cavity. 2. The membranes obtained are not exposed to aldehyde cross‐linking; therefore, tissue reaction due to aldehydes is avoided.
Efficacy of feedback training in long‐standing facial nerve paresis
Authors: Ross Brenda , Nedzelski Julian M. , McLean J. Arline
Published: October 2006

An efficacious treatment has not been available to patients with aberrant regeneration of the facial nerve as a result of Bell's palsy or after acoustic neuroma excision. This prospective controlled trial examines the efficacy of electromyographic feedback versus mirror feedback as treatment strategies for patients suffering from long‐standing (18 months minimum) facial nerve paresis. Twenty‐five patients were randomly assigned to electromyography with mirror feedback or mirror feedback alone. Seven rural patients who did not undergo treatment served as controls. At 0,6, and 12 months, facial motor function was objectively quantified by linear measurement of facial movement, visual assessment of voluntary movement, and electrical measurement of facial nerve response to maximal stimulation. Statistically significant improvements were noted in both electromyography and mirror‐feedback groups with respect to symmetry of voluntary movement (P < .03) and linear measurement of facial expression (P < .01). The positive results of this controlled trial demonstrate that feedback training in combination with a structured home rehabilitation program is a clinically efficacious treatment for patients with facial nerve paresis.
Detection of intraoperative laser injury to the facial nerve by electromyographic monitoring of facial muscles
Authors: Wiegand David A. , Mertz Pamela S. , Latz Barbara
Published: October 2006

Injury to the facial nerve is a significant risk during resection of cerebellopontine angle tumors. To minimize the risk of facial nerve injury, intraoperative electromyographic monitoring of facial musculature is frequently used. However, the reliability of such monitoring systems for detection of thermal nerve injury resulting from the use of carbon dioxide lasers has not been systematically evaluated. We determined the sensitivity of a computerized electromyographic monitor for detection of laser facial nerve injury in an anesthetized rat model. The mandibular and buccal branches of the facial nerve were isolated in 12 rats. A carbon dioxide laser was used to create controlled sites of thermal injury to both nerves over a 3‐hour period. When a laser injury was created distal to previous injury sites, electromyographic discharge was noted in 72% to 82% of injuries. Laser injury proximal to previous injury sites was detected with 33% efficiency. These detection rates did not change significantly over a 3‐hour period. This preliminary data suggests that electromyographic monitoring of facial musculature allows detection of facial nerve injury caused by carbon dioxide lasers.
Uvulopalatopharyngoplasty: Evaluation of postoperative complications, sequelae, and results
Authors: Zohar Yuval , Finkelstein Yehuda , Talmi Yoav P. , Bar‐Ilan Yakov
Published: October 2006

A study of 71 patients with obstructive sleep apnea syndrome was performed to evaluate the effectiveness, complications, and late sequelae of uvulo‐palatopharyngoplasty. Postoperative immediate complications were of minor importance. In 96% of the patients, the snoring was improved; it was completely resolved in 48%. The postoperative apnea index remained pathologic in all patients who underwent postoperative polysomnography, although mild improvement was noted. Seventy‐four percent of our patients felt a subjective postoperative improvement which was not always confirmed by the polysomno‐graphic examination. A record of improvement was obtained in 64% of the operated patients. Our results establish the beneficial effect of uvulopalatopharyn‐goplasty, which is the recommended surgical procedure for obstructive sleep apnea syndrome.