The addition of paclitaxel to continuous infusion 5-fluorouracil is an active regimen for metastatic breast cancer

We investigated tissue staining for Bcl-2 and Bax proteins, which regulate apoptosis, as indicators of chemotherapeutic effect in patients with gastric cancer. In 23 patients with gastric carcinoma biopsy specimens were obtained endoscopically prior to chemotherapy and stained immunohistochemically with anti-Bcl-2 and anti-Bax antibodies. Patients then were treated with continuous infusion of 5-FU and cisplatin. No correlation was seen between chemotherapeutic effect and Bcl-2 or Bax alone. However, among the Bax-positive cases, the patients with Bcl-2-positive tumors were significantly more chemoresistant (p = 0.036) and had worse prognoses (p = 0.008) than Bcl-2-negative cases. Therefore, immunohistochemical staining for Bcl-2 protein may predict chemotherapeutic efficacy or guide specific therapeutic choices in treating Bax-positive tumors.     

Effect of Gene Dosage at High Amylose Loci on the Properties of the Amylopectin Fractions of the Starches

The effect of gene dosage at the amylose-extender (ae) locus of maize and the rigosus-a (r_a) locus of peas on the amylopectin fraction of endosperm and cotyledon starch were examined. Amylopectin fractions were isolated by gel filtration, butanol complexing and a combination of the two methods. In general, increasing doses of the recessive allele at either locus resulted in amylopectin fractions with iodine spectra with absorption maxima at higher wavelengths and greater absorptivity. Starches from endosperm of differing ae dosage but homozygous waxy were found to contain no amylose by gel filtration. By debranching with pullulanase, these starches were shown to have increasing average chain length with increasing ae dosage. Additional data suggested that increasing dosage at the ae locus (regardless of the genotype at the waxy locus) or the r_a locus resulted in amylopectin with increasing linearity. In addition, short chained amylose (approximately 100 glucose units) was observed in all ae genotypes in a homozygous Waxy background and all r_a genotypes.     

Industry Learns From a Turbine Spindle Failure

The chemical analysis of the material used for this forging met all requirements of the specification. Mechanical tests of the specimens taken from the outside and at mid-radius of the forging also met the specification requirements. Test specimens taken near the bore tended to have lower yield and tensile strengths and frequently had very low ductility. Some reduction of ductility is to be expected at the center of a heavy mass, but in this case the reduction was considered to be excessive. The fractures of some of the deep-seated specimens contained fisheyes. Tests of duplicate specimens that had been heated to a low temperature, 400°F, resulted in normal ductility. Fisheyes and low ductility, which may be considerably improved by a low temperature heat-treatment, are typical effects of large amounts of hydrogen in steel. Macroex-amination of the forging indicated that the main body contained approximately 5000 cracks. These cracks were generally oriented in radial planes with their maximum dimensions in the longitudinal direction. They occurred most frequently in zones of sulfur segregation in the main body of the forging. These cracks are believed to be flakes produced while the forging was cooling from a high temperature or while it was standing at room temperature after such cooling and prior to a tempering or stress-relieving heat treatment. Flakes are generally considered to be caused by thermal transformation stresses combined with severe reduction in ductility caused by the collection of gaseous hydrogen under high pressure within imperfections in the steel. No cracks were observed in the portions of the shaft extensions which were forged to relatively small diameters. Apparently cracks did not occur in these smaller sections because the transformation stresses were lower and possibly because more of the hydrogen could diffuse from these smaller sections than from the main body.Ultrasonic reflectoscope indications observed in examination of the failed spindle were very similar to those observed at the time the forging was made. It must be concluded, therefore, that the thermal cracks or flakes were present at the time the forging was first inspected and that the ultrasonic indications were from flakes rather than from inclusions.It is believed that the fatigue crack that developed at the fillet between the generator end shaft extension and the main body was not a factor in this failure. Assumption of the fatigue crack as the origin of failure would not lead to the symmetrical pattern of failure which was observed. Origin of the fatigue crack was identified as a thermal crack or flake that happened to occur in the fillet between the shaft extension and the main body. This fillet was the location of moderate. stress concentration, and the additional stress concentration owing to the flake resulted in development of the fatigue crack.Detailed examination of the fractured pieces indicated that failure began in the plane shown in Fig. 5 at or near the bore toward the turbine end of the main body. The assumption of this origin of failure leads to a consistent sequence of failure and explains the high degree of symmetry of the broken parts. It is believed that the large number of thermal cracks or flakes within the spindle was the primary cause of failure.Although this was a serious failure, much has been learned from it. It is now possible to interpret tests much more accurately, and it should be possible to avoid such accidents in the future. Changes in practice in the manufacture of such forgings should also avoid hydrogen solution and subsequent cracking.     

An agency-based representative payee program and improved community tenure of persons with mental illness

OBJECTIVE: Representative payee programs help severely mentally ill individuals manage money from their Social Security payments to cover expenses for necessities and to avoid homelessness and rehospitalization. This study examined a representative payee program operated by a community mental health center to determine the criteria used by clinicians and ease managers to refer clients to the program and to learn whether participation in the program was associated with reductions in hospitalization. METHODS: The retrospective study included 56 individuals with severe mental illness who were enrolled in the representative payee program at Community Counseling Centers of Chicago for one year and who also had received services from the agency for at least one year before enrollment. Criteria used to refer clients to the representative payee program were determined through chart reviews. Data on state hospitalizations before and after enrollment were available for the entire sample; additional data on Medicaid-funded private hospitalizations were available for a subset of 33 clients. RESULTS: The most common criteria for enrollment in the representative payee program were comorbid substance abuse or dependence (49 percent), a history of homelessness (33 percent), and frequent hospitalizations (32 percent). During the year of participation in the representative payee program, the mean number of days spent in state hospitals decreased markedly compared with the year before enrollment, from 68 days to seven days. A similar reduction was noted in the number of days spent in state and private hospitals, from 97 days to 15 days. CONCLUSIONS: Findings from this pre- and postintervention retrospective study are tentative in the absence of a more rigorous design. However, the results suggest that the representative payee program is quite effective in reducing hospital stays.     

An outbreak of non-sexually transmitted gonococcal conjunctivitis in Central Australia and the Kimberley region

From 13 February to 27 June 1997, 447 cases of gonococcal conjunctivitis were identified by Communicable Disease and Public Health Centres and Community Clinics in the Northern Territory, Western Australia and South Australia. The outbreak involved Aboriginal communities predominantly in Central Australia and the Kimberley region in Western Australia. This was the first outbreak recorded in the Kimberley region. It is not yet known whether the Kimberley cases were part of the larger Central Australian outbreak or whether they represented a separate and unrelated outbreak. Environmental factors associated with this outbreak were similar to those seen in previous outbreaks. Control measures were based on early recognition and treatment of index cases and identifying and treating contacts. Until sexually transmitted Neisseria gonorrhoeae is controlled in communities gonococcal conjunctivitis is likely to appear again. The role of oropharyngeal carriage of N. gonorrhoeae needs to be evaluated further.     

Characteristics of persons with mental illness in a representative payee program

This study compared the characteristics of 56 clients with severe mental illness in a community mental health agency's representative payeeship program with those of 54 clients who did not participate in the program. Based on data from a two-year period, participants in the representative payee program were characterized by disability or financial distress, indicated by a diagnosis of schizophrenia, homelessness, lack of rent money, and lack of financial skills; long-term dependence on income from Social Security and services provided by the mental health system, evidenced by receipt of Supplemental Security Income and frequent hospitalizations; and lack of financial independence, as reflected by inability to earn income from employment and lack of financial support from family.     

Development of a Money Mismanagement Measure and cross-validation due to suspected range restriction

A measure of the tendency to mismanage money was developed in an evaluation of a representative payee program for individuals with serious mental illnesses. A conceptual model was composed to guide item development, and items were tested, revised, added, and rejected in three waves of data collection. Rasch analyses were used to examine measurement properties. The resulting Money Mismanagement Measure (M3) consisted of 28 items with a Rasch person reliability at .72. Restriction of range was likely responsible for the low Rasch reliability. Validity analyses supported the construct validity of the M3. Subsequently, a cross-validation study was conducted on an untreated sample not as susceptible to range restriction. The M3 produced a Rasch person reliability = .85 with good validity. The M3 fills a gap that can facilitate research in the understudied area of money mismanagement.