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The role of chemotherapy in the treatment of high-grade gliomas in children is unclear. Early reports were suggestive of improved outcome in children with high-grade glioma with the addition of chemotherapy after surgery and radiation therapy. Subsequent studies did not show similar favorable contribution of chemotherapy to the outcome of these children. Further efforts to identify active chemotherapy agents in children include use of agents that have shown efficacy in adult patients with high-grade glioma and agents that have shown promise in mice bearing human xenografts of brain tumors. A Pediatric Oncology Group (POG 9431) trial tested the activity of two such agents, procarbazine and topotecan in newly diagnosed patients with high-grade glioma who had measurable disease after diagnostic surgery. Neither agent showed efficacy within the confines of the statistical design of the study. This study showed that children with high-grade glioma have an innate resistance to alkylating agents based on mismatch repair deficiency and high levels of alkyguanine transferase (AGT). Future trials should consider strategies to overcome the resistance mechanisms in children with high-grade glioma. [ABSTRACT FROM AUTHOR]

This paper explores perspectives about certain individual and social characteristics that may contribute to school shootings by students. It begins with perspectives on individual/environment fit, arguing first that persons marginalized by their caregivers during their upbringing, and by their peers, are lacking in the social interactions that help develop ethical behavior. Our argument contends that lacking such interactions may result in the failure to develop a sound moral philosophy. Further, we argue that when such persons enter the highly competitive environment found in some suburban and rural schools, some will be continually and consistently marginalized, finding their means of self-expression and sense of significance subdued. Their need for self-expression and a sense of significance as persons will surface, but without the benefit of a moral philosophy to guide that expression, this may result in deviant means of expression, such as violence— even extraordinary violence. We do not attempt to identify a list of specific traits of school shooters, which might lead to the development of a profile of school shooters. Rather, we are concerned with the characteristics of the environment in which shootings might occur, and how students not fully prepared for that environment might react. Thus, this paper is an overview of how seeds of the neglect of the basic needs of personhood, when sown early in life, and nurtured by peers, might come to fruition in the fertile field of the competitive school environment. [ABSTRACT FROM AUTHOR]