Expression of Bcl-xL in ovarian carcinoma is associated with chemoresistance and recurrent disease.

Objective: The long-term survival of patients with epithelial ovarian cancer is limited by the emergence of tumor cells that are resistant to chemotherapy. We hypothesized that expression of Bcl-x(L), a homologue of Bcl-2 that confers protection from chemotherapy-induced apoptosis, may be predictive of patients' clinical response to treatment, and that treatment with chemotherapy may result in the selection of tumor cells that overexpress this protein.

Methods: We determined the expression of Bcl-x(L) in epithelial ovarian cancers from 28 patients at the time of initial staging laparotomy and in recurrent tumors in the same patients following treatment with platinum-based chemotherapy.

Lifetime and 12-month prevalence of psychiatric disorders in 8,169 male Vietnam War era veterans.

Objective: This study reports the prevalence of psychiatric disorders among a nationally distributed sample of Vietnam Era veterans assessed using standardized psychiatric interviewing methods.

Methods: In 1992, the National Institute of Mental Health Diagnostic Interview Schedule was administered by telephone to 8,169 middle-aged males who served in the military during the Vietnam era (1965-1975).

Results: Approximately 72% of respondents reported a lifetime history and 36% reported a 12-month history of at least one psychiatric disorder.

The identification of empirically derived cancer patient subgroups using psychosocial variables.

Objective: To determine if there are subgroups of cancer patients who differ on coping, psychological, and quality of life (QOL) measures, and to determine if these subgroups have a different course of distress and health following a cancer diagnosis.

Methods: Three hundred fifty-one individuals presenting to a multidisciplinary melanoma clinic completed a baseline questionnaire packet containing the Brief Symptom Inventory (BSI), the Medical Outcomes Survey Short-Form 36 (SF-36), Ways of Coping (WOC), State-Trait Anxiety Inventory (STAI), an informed consent form, and a demographic questionnaire. Participants subsequently completed measures at 2, 5, and 9 months after completion of their baseline assessment.

Genetic evidence for pre-recruitment as the mechanism of transcription activation by SoxS of Escherichia coli: the dominance of DNA binding mutations of SoxS.

SoxS, the direct transcriptional activator of the Escherichia coli superoxide (SoxRS) regulon, displays several unusual characteristics which suggest that it is unlikely to activate transcription by the ususal recruitment mechanism. Thus, agents that generate superoxide endogenously and thereby provoke the defense response elicit the de novo synthesis of SoxS, and with the SoxS binding site being highly degenerate, the number of SoxS binding sites per cell far exceeds the number of SoxS molecules per cell. To account for these distinctive features of the SoxRS system, we proposed "pre-recruitment" as the mechanism by which SoxS activates transcription of the regulon's genes.

High-risk surgically resected pediatric melanoma and adjuvant interferon therapy.

Background: Pediatric patients with high-risk surgically resected melanoma are at risk for relapse, yet little is known about these young patients and how they tolerate high-dose interferon therapy.

Procedure: We reviewed medical records of patients (< or =18 years) with high-risk melanoma referred to the University of Michigan Pediatric Hematology-Oncology service between January 1989 and July 2003.

Results: Fourteen patients were identified with high-risk resected melanoma.

Prospective quality-of-life assessment in patients receiving concurrent gemcitabine and radiotherapy as a bladder preservation strategy.

Objectives: To assess, in a Phase I study, whether bladder preservation with concurrent gemcitabine and radiotherapy (RT) influenced patient-reported quality of life (QOL) as determined by the Functional Assessment of Cancer Therapy-Bladder (FACT-BL).

Methods: Between January 1998 and March 2002, 24 patients with urothelial carcinoma of the bladder were enrolled, and 23 patients underwent transuretheral resection of bladder tumor, followed by twice-weekly gemcitabine with concurrent RT. The initial dose was 10 mg/m2 given twice weekly and increased as tolerated.

The role of radiation therapy after surgical resection of nonfunctional pituitary macroadenomas.

Objective: Radiotherapy after aggressive surgical resection of nonfunctional macroadenoma (NFA) of the pituitary remains controversial. Historically, immediate postoperative radiotherapy has been recommended to decrease risk of recurrence. With the availability of high-resolution imaging, most neurosurgeons now withhold radiation until recurrence.

Dysplasia in Barrett esophagus.

Background: Dysplasia in Barrett esophagus is a premalignant condition that is associated with an increased risk of developing esophageal adenocarcinoma. Unfortunately, clinical investigation aimed at prevention of progression to malignant disease has been hampered by the variable prevalence of dysplasia reported in the literature. The objective of the current study was to more accurately determine the prevalence of dysplasia among individuals with Barrett esophagus who would be available for enrollment in a chemoprevention trial.

Dosimetry around metallic ports in tissue expanders in patients receiving postmastectomy radiation therapy: an ex vivo evaluation.

Postmastectomy breast reconstruction can be accomplished utilizing tissue expanders and implants. However, in patients who require postoperative radiotherapy, the complication rate with tissue expander/implant reconstruction can exceed 50%. One potential cause of this high complication rate may be the metallic port in the tissue expander producing altered dosimetry in the region of the metallic device.

Proteolytic degradation of Escherichia coli transcription activators SoxS and MarA as the mechanism for reversing the induction of the superoxide (SoxRS) and multiple antibiotic resistance (Mar) regulons.

In Escherichia coli, the SoxRS regulon confers resistance to redox-cycling compounds, and the Mar regulon provides a defence against multiple antibiotics. The response regulators, SoxS and MarA, are synthesized de novo in response to their inducing signals and directly activate transcription of a common set of target genes. Although the mechanisms of transcription activation by SoxS and MarA have been well studied, little is known about how the systems are shut-off once the inducing stress has subsided, except that de novo synthesis of the regulators is known to cease almost immediately.

Supramolecular control of [2 + 2] photodimerization via hydrogen bonding.

The use of supramolecular catalysis to control the photoinduced dimerization of styrene, cinnamate, and stilbene chromophores is reported. The strategy employs the formation of a 2:1 supramolecular assembly in the presence of 5,5-dihexylbarbituric acid (DHB). A 3- to 10-fold increase in dimerization efficiency is observed in its presence, concomitant with accrued selectivity for the syn photodimers.

Clinicopathologic features of metastasis in nonsentinel lymph nodes of breast carcinoma patients.

Background: In breast carcinoma patients with a positive sentinel lymph node (SN), the value of complete axillary lymph node dissection has been questioned. Multiple published reports have attempted to identify clinicopathologic characteristics of the primary tumor and SN that are associated with an increased likelihood of positive nonsentinel lymph nodes (NSN). Because of differences in lymph node evaluation techniques and limited patient numbers in each study, the authors performed a meta-analysis to assess the regularity and relative strength of association between various characteristics and the risk of NSN metastasis.

Relationship of mammographic parenchymal patterns to breast cancer risk factors and smoking in Alaska Native women.

The purpose is to determine breast cancer risk factors and correlates of mammographic parenchymal patterns among Alaska Native women. A retrospective review was performed of mammograms and mammogram records among 528 sequential screening mammogram examinations performed in Anchorage, Alaska. Mammogram density was classified by American College of Radiology (Breast Imaging Reporting and Data System) density patterns 1-4 (fat-->dense) and by percent density.

Longitudinal stratification of gait economy in young boys and girls: the locomotion energy and growth study.

The purpose of this study was to determine if the relative ordering of locomotor oxygen consumption ( VO(2)) values remains stable as healthy children age. Beginning at age 6 and ending at age 10, VO(2) during level treadmill walking and running was quantified in 15 boys and 18 girls who were tested on an annual basis. Following 30 min of treadmill accommodation to each exercise mode, subjects walked and ran for 5 min at 1.

Dose escalation for localized prostate cancer: substantial benefit observed with 3D conformal therapy.

Purpose: To determine the effect of radiation dose escalation on biochemical and/or disease failure in patients with localized prostate cancer treated with three-dimensional conformal radiotherapy (3D-CRT).

Methods And Materials: Between May 1987 and December 2000, 1473 patients were assessed after treatment with 3D-CRT. The mean patient age was 70.

Cognitive-behavioral intervention for distress in patients with melanoma: comparison with standard medical care and impact on quality of life.

Background: Melanoma accounts for > 79% of skin cancer-related deaths, although it accounts for only 4% of skin cancer incidence. Given the potential for lethality, it is likely that patients with melanoma may experience significant emotional distress. The current study was designed to determine the effect of a cognitive-behavioral intervention on distress and health-related quality of life (HRQOL) in patients with melanoma who had medium-to-high distress.

Long-term results of three-dimensional conformal adjuvant and salvage radiotherapy after radical prostatectomy.

Objectives: To evaluate the efficacy and toxicity of three-dimensional conformal radiotherapy (3D-CRT) in the adjuvant and salvage setting after radical prostatectomy (RP).

Methods: From 1986 to 1997, 38 patients received adjuvant 3D-CRT, with a median time from RP to 3D-CRT of 2.8 months, and 57 patients were treated with salvage RT for a rising prostate-specific antigen with a median time to 3D-CRT of 27.

Use of a supportive care team for screening and preemptive intervention among multiple myeloma patients receiving stem cell transplantation.

Although peripheral blood stem-cell transplantation (PBSCT) has assumed a growing role in the treatment of multiple myeloma, very few studies have examined the functional and quality-of-life changes experienced by myeloma patients in the transplant setting. Multiple myeloma is characterized by a range of debilitating physical and psychosocial symptoms. However, supportive care needs for patients with this disease are often overlooked or managed only episodically.

Correlates of mammogram density in southwestern Native-American women.

Little is known about the breast cancer risk factors or mammogram characteristics among Native-American women. Southwestern Native-American women have a low risk of breast cancer and a high risk of diabetes. Our purpose was to determine the prevalence of known clinical risk factors for breast cancer and their association with mammogram density in a sample of Southwestern Native-American women undergoing breast cancer screening.

Bioterrorism-related inhalational anthrax in an elderly woman, Connecticut, 2001.

On November 20, 2001, inhalational anthrax was confirmed in an elderly woman from rural Connecticut. To determine her exposure source, we conducted an extensive epidemiologic, environmental, and laboratory investigation. Molecular subtyping showed that her isolate was indistinguishable from isolates associated with intentionally contaminated letters.

Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis.

Background: Immunosuppression is a consequence of allogeneic (homologous) blood transfusion (ABT) in humans and is associated with an increased risk in cancer recurrence rates after potentially curative surgery as well as an increase in the frequency of postoperative bacterial infections. Although a meta-analysis has been reported demonstrating the relationship between ABT and colon cancer recurrence, no meta-analysis has been reported demonstrating the relationship of ABT to postoperative bacterial infection.

Methods: Twenty peer-reviewed articles published from 1986 to 2000 were included in a meta-analysis.

Conservative management of Paget disease of the breast with radiotherapy: 10- and 15-year results.

Background: At 5-year follow-up, patients with Paget disease of the breast who were treated with breast-conserving surgery (BCS) and radiotherapy (RT) had excellent results. The current report provides 10- and 15-year rates of tumor control in the breast, as well as disease-free and overall survival rates following BCS and RT in a cohort of patients with Paget disease presenting without a palpable mass or mammographic density.

Methods: Through a collaborative review of patients treated with BCS and RT from seven institutions, 38 cases of Paget disease of the breast presenting without a palpable mass or mammographic density were identified.

The disclosure dilemma for gay men and lesbians: "coming out" at work.

This study examined disclosing sexual orientation at work for 220 gay men and 159 lesbians. Self-acceptance, the centrality of one's identity, how "out" one is to friends and family, employer policies, and perceived employer gay-supportiveness were associated with disclosure behaviors at work for gay/lesbian employees. Disclosing at work and working for an organization perceived to be more gay supportive was related to higher job satisfaction and lower job anxiety.

Prediction of the aerobic demand of walking in children.

Purpose: The purpose of this study was to develop a generalized equation to predict VO2 during level treadmill walking in young boys and girls.

Methods: On an annual basis from ages 6 to 10, 23 able-bodied children (14 girls, 9 boys) completed six 5-min walking bouts at speeds ranging from 40.2 to 107.