Family and Illness Predictors of Outcome in Pediatric Brain Tumors

Investigated the prediction of cognitive and behavioral outcomesin 63 children with heterogenous brain tumors. Hierarchicalmultiple regression analyses were used to determine how family-relatedvariables added to the prediction of children's outcome overand above illness measures. The best predictors of children'sbehavior problems and adaptive behavior were family and demographicvariables, whereas the best predictors of achievement were illnessand demographic variables. A combination of family and illnessvariables, however, was the best predictor of intellectual functioning.In addition to identifying specific predictors of cognitiveand behavioral outcome in children with brain tumors, theseresults lend initial support for the inclusion of contextualfactors such as family stress, maternal coping, number of parentsin the home, and family SES measures in studies of how diseasefactors affect outcomes in pediatric brain tumor patients.     

Structural and mutational analysis of the xeroderma pigmentosum group D (XPD) gene

Individuals affected by the autosomal recessive disease xerodermapigmentosum (XP) are acutely sensitive to sunlight and predisposedto skin cancer on exposed areas. Cells cultured from XP patientsare both UV sensitive and defective in the nucleotide excisionrepair of damaged DNA. These cellular phenotypes are amenableto experimental strategies employing complementation, an approachpreviously used to demonstrate the correction of XP-D phenotypesfollowing the introduction of the XPD (ERCC2) gene. In the presentstudy, we have characterized the genomic organization of theXPD (ERCC2) gene and found it to be comprised of 23 exons. Thesedata were helpful in evaluating the functional integrity ofalleles in two XP-D cell lines. In cell line GM436 a C     

Long-term maintenance of hematopoietic stem cells does not require contact with embryo-derived stromal cells in cocultures

We recently established that two midgestation-derived stromal clones--UG26-1B6, urogenital ridge-derived, and EL08-1D2, embryonic liver-derived--support the maintenance of murine adult bone marrow and human cord blood hematopoietic repopulating stem cells (HSCs). In this study, we investigate whether direct HSC-stroma contact is required for this stem cell maintenance. Adult bone marrow ckit+ Ly-6C- side population (K6-SP) cells and stromal cells were cocultured under contact or noncontact conditions. These experiments showed that HSCs were maintained for at least 4 weeks in culture and that direct contact between HSCs and stromal cells was not required. To find out which factors might be involved in HSC maintenance, we compared the gene expression profile of EL08-1D2 and UG26-1B6 with four HSC-nonsupportive clones. We found that EL08-1D2 and UG26-1B6 both expressed 21 genes at a higher level, including the putative secreted factors fibroblast growth factor-7, insulin-like growth factor-binding proteins 3 and 4, pleiotrophin, pentaxin-related, and thrombospondin 2, whereas 11 genes, including GPX-3 and HSP27, were expressed at a lower level. In summary, we show for the first time long-term maintenance of adult bone marrow HSCs in stroma noncontact cultures and identify some secreted molecules that may be involved in this support.     

Student's perceptions of a virtual PBL experience.

OBJECTIVE: Our purpose is to present findings regarding student attitudes towards a virtual PBL program used to standardize their pediatric clinical experience. DESCRIPTION: With funding provided by the Fund for the Improvement of Post-Secondary Education, we developed Project LIVE (Learning through Interactive Video Education), a CD-ROM/Web hybrid program that uses digital video cases to conduct "virtual" problem-based learning groups with students doing a clinical rotation in a remote setting. Cases were progressively disclosed by videos of patient/physician encounters on a CD-ROM. Groups of five students and a faculty facilitator collaborated, teaching each other within the discussion section of the program. We conducted a multifaceted evaluation of Project LIVE to study the impact of case modality or distance on student learning and attitudes. We placed students in one of three groups (1) a face-to-face group with a paper case (FFT), (2) a face-to-face group with a video case (FFV), and (3) a virtual group (VG) with the digital video case. We then studied student attitudes about the three teaching formats. Over a six-month period three education specialists, who were not a part of the development team, conducted eight focus groups lasting one hour to assess student attitudes about Project LIVE. No one from the project team was present during these groups, and an independent evaluator analyzed the notes taken by each focus group leader. DISCUSSION: Trends across the groups included the following: (1) Authenticity (video)-Students reported that the authenticity of the case was a critical feature and that, "seeing (videos) made learning more memorable." Virtual and FFV groups reported more confidence in their ability to recognize abnormal findings in their patients. "You can't expect to teach clinical exam skills with a piece of paper." (2) Use of time-Students from all groups believed the cases were a good use of their time and improved their ability to solve clinical problems. They said it gave them an opportunity to "get away from just doing and focus on learning." However, the virtual groups complained of the lack of "a barometer for how much is too much" time. Some students reported spending an average of eight to ten hours per case over the period of a week. (In contrast, face-to-face groups met for three hours.) (3) Modeling clinical reasoning-Students believed the cases were valuable in structuring their knowledge, conceptualizing how to handle difficult situations, distinguishing abnormal from normal physical examination findings, and collaborating with their peers and their mentor to develop critical thinking. "It forced us to be logical" and ". how to think through the process-it mimics the real setting." (4) Technical support-The responsiveness of the Project LIVE staff was essential in assisting students in troubleshooting problems. (5) Distance component-Students preferred to work through the cases in face-to-face groups but agreed that the virtual experience is "good if you are in the middle of nowhere." This program was enjoyed by students and gave us an approach to standardizing experiences across multiple clinical sites.     

Synthèse de polysiloxanes téléchéliques, 2. Synthèse de diamines aromatiques

Telechelic aromatic diamines ( 11 ) containing an oligo- or polysiloxane chain were prepared in a 4-step synthesis. In the first step 1-allyloxy-4-nitrobenzene ( 6 ) was synthesized and subsequently hydrosilylated with chlorodimethylsilane. In the third step the product ( 7 ) was hydrolyzed or condensed with α-hydro-β-hydroxyoligo- or polydimethylsiloxane ( 9a or 9b ). In the last step the nitro groups were reduced into amino groups. The steps were controlled by means of ¹H and ²⁹Si NMR spectroscopy.     

Treatment Options in Severe Psychotic Depression

In our sample of 15 hospitalized patients with severe psychotic depression, six responded to therapy with tricyclic antidepressants combined with neuroleptics. Of the nine nonresponders, eight showed an excellent clinical response to electroconvulsive therapy (ECT). The clinical outcome after 6 months of treatment was similar in both groups. We recommend that protracted, complicated trials of pharmacotherapy be reevaluated in psychotic depression. A prospective comparative study of ECT and pharmacotherapy is needed to define the optimal treatment for psychotic depression.     

Prevalence and distribution of gingivitis and dental caries in children aged 6–12 years in Brisbane primary schools

A study of caries experience and gingivitis prevalence in 6-, 9- and 12-yr-old children attending primary schools in Brisbane was undertaken in November/December 1983. Children from high socioeconomic level (SEL) schools exhibited lower dmft and DMFT scores at all ages. At age 6 yr the proportion of children with caries-free primary dentitions was for high SEL Schools 70%, for middle SEL schools 52% and for low SEL Schools 23%. At 12 yr DMFT scores were 1.8 (high), 2.1 (middle) and 3.3 (low). Similar differences in gingivitis prevalence occurred, children from high SEL schools displaying a much lower proportion of bleeding sites than those from middle and low SEL schools. For selection of children at "high risk" to gingival disease for intensive prevention programmes, an increased emphasis on probing techniques is indicated to achieve diagnostic consistency.