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To discuss the long-term view of treating and following pediatric, adolescent, and young adult patients with acute lymphoblastic leukemia (ALL) — with review of what can be done to prevent, monitor for, and treat complications of therapy. Pediatric, adolescent, and young adult oncology patients, including those with ALL, are living longer with higher overall survival rates as treatments and supportive care for these patients continue to improve. These patients are burdened by the risk of significant health and quality of life consequences as a result of their treatment.. For these patients, the late effects of treatment can be life-threatening, such as secondary cancers or cardiotoxicity, or life-altering with respect to quality of life. The goal of this paper is to review the current literature, research, and surveillance guidelines regarding the late effects of ALL therapy, to outline what can be done to mitigate the toxic effects of oncology treatment, and to extend life expectancy and improve quality of life for our patients. We review risk factors and interventions available to prevent and treat cardiovascular disease, secondary malignancies, endocrine complications (obesity, osteoporosis, infertility, and premature menopause), cognitive effects, and effects on functioning and mortality.

Immunotherapeutic strategies targeting B-cell acute lymphoblastic leukemia (B-ALL) effectively induce remission; however, disease recurrence remains a challenge. Due to the potential for antigen loss, antigen diminution, lineage switch or development of a secondary or treatment-related malignancy, the phenotype and manifestation of subsequent leukemia may be elusive. We report on two patients with multiply relapsed/refractory B-ALL who, following chimeric antigen receptor T-cell therapy, developed myeloid malignancies. In the first case, a myeloid sarcoma developed in a patient with a history of myelodysplastic syndrome. In the second case, two distinct events occurred. The first event represented a donor-derived myelodysplastic syndrome with monosomy 7 in a patient with a prior hematopoietic stem cell transplantation. This patient went on to present with lineage switch of her original B-ALL to ambiguous lineage T/myeloid acute leukemia. With the rapidly evolving field of novel immunotherapeutic strategies, evaluation of relapse and/or subsequent neoplasms is becoming increasingly more complex. By virtue of these uniquely complex cases, we provide a framework for the evaluation of relapse or evolution of a subsequent malignancy following antigen-targeted immunotherapy.

Purpose: Genetic and preclinical studies have implicated FGFR signaling in the pathogenesis of adenoid cystic carcinoma (ACC). Dovitinib, a suppressor of FGFR activity, may be active in ACC. Experimental Design: In a two-stage phase II study, 35 patients with progressive ACC were treated with dovitinib 500 mg orally for 5 of 7 days continuously. The primary endpoints were objective response rate and change in tumor growth rate. Progression-free survival, overall survival, metabolic response, biomarker, and quality of life were secondary endpoints. Results: Of 34 evaluable patients, 2 (6%) had a partial response and 22 (65%) had stable disease >4 months. Median PFS was 8.2 months and OS was 20.6 months. The slope of the overall TGR fell from 1.95 to 0.63 on treatment (P < 0.001). Toxicity was moderate; 63% of patients developed grade 3–4 toxicity, 94% required dose modifications, and 21% stopped treatment early. An early metabolic response based on 18FDG-PET scans was seen in 3 of 15 patients but did not correlate with RECIST response. MYB gene translocation was observed and significantly correlated with overexpression of MYB but did not correlate with FGFR1 phosphorylation or clinical response to dovitinib. Conclusions: Dovitinib produced few objective responses in patients with ACC but did suppress the TGR with a PFS that compares favorably with those reported with other targeted agents. Future studies of more potent and selective FGFR inhibitors in biomarker-selected patients will be required to determine whether FGFR signaling is a valid therapeutic target in ACC. Clin Cancer Res; 23(15); 4138–45. ©2017 AACR.

BACKGROUND: Based on the encouraging activity and manageable safety profile observed in a phase 1 study, the ECHELON-2 trial was initiated to compare the efficacy and safety of brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone (A+CHP) versus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) for the treatment of CD30-positive peripheral T-cell lymphomas.METHODS: ECHELON-2 is a double-blind, double-dummy, randomised, placebo-controlled, active-comparator phase 3 study. Eligible adults from 132 sites in 17 countries with previously untreated CD30-positive peripheral T-cell lymphomas (targeting 75% with systemic anaplastic large cell lymphoma) were randomly assigned 1:1 to receive either A+CHP or CHOP for six or eight 21-day cycles. Randomisation was stratified by histological subtype according to local pathology assessment and by international prognostic index score. All patients received cyclophosphamide 750 mg/m2 and doxorubicin 50 mg/m2 on day 1 of each cycle intravenously and prednisone 100 mg once daily on days 1 to 5 of each cycle orally, followed by either brentuximab vedotin 1·8 mg/kg and a placebo form of vincristine intravenously (A+CHP group) or vincristine 1·4 mg/m2 and a placebo form of brentuximab vedotin intravenously (CHOP group) on day 1 of each cycle. The primary endpoint, progression-free survival according to blinded independent central review, was analysed by intent-to-treat. This trial is registered with ClinicalTrials.gov, number NCT01777152.FINDINGS: Between Jan 24, 2013, and Nov 7, 2016, 601 patients assessed for eligibility, of whom 452 patients were enrolled and 226 were randomly assigned to both the A+CHP group and the CHOP group. Median progression-free survival was 48·2 months (95% CI 35·2-not evaluable) in the A+CHP group and 20·8 months (12·7-47·6) in the CHOP group (hazard ratio 0·71 [95% CI 0·54-0·93], p=0·0110). Adverse events, including incidence and severity of febrile neutropenia (41 [18%] patients in the A+CHP group and 33 [15%] in the CHOP group) and peripheral neuropathy (117 [52%] in the A+CHP group and 124 [55%] in the CHOP group), were similar between groups. Fatal adverse events occurred in seven (3%) patients in the A+CHP group and nine (4%) in the CHOP group.INTERPRETATION: Front-line treatment with A+CHP is superior to CHOP for patients with CD30-positive peripheral T-cell lymphomas as shown by a significant improvement in progression-free survival and overall survival with a manageable safety profile.FUNDING: Seattle Genetics Inc, Millennium Pharmaceuticals Inc, a wholly owned subsidiary of Takeda Pharmacuetical Company Limited, and National Institutes of Health National Cancer Institute Cancer Center.

Adolescent and Young Adult (AYA) Oncology is a relatively new field encompassing research in the unique pathophysiology, clinical care, and psychosocial issues facing patients between the ages of 15 and 40 with cancer. About 100,000 of the approximately 1.5 million people diagnosed annually with cancer in the USA are in this age range. This chapter will review notable new developments in the care of adolescents and young adults with acute lymphoblastic leukemia (ALL) within the last 3 years. The preponderance of data favors the treatment of AYA ALL patients with pediatric-inspired treatment regimens due to better relapse-free and overall survival. Minimal residual disease (MRD) measurement is emerging as an important prognostic factor and can serve as a new measure of efficacy of the addition of novel therapies to the treatment of patients with new diagnoses. There have been several treatment advances ranging from new cytotoxic agents for ALL to new antibody-based therapy to novel immune therapies such as CAR-T cells. The care of AYA ALL patients is improving as the unique issues for this patient population are addressed.

Display Omitted Solution processed multicolor OLEDs.Efficient energy transfer.Fast response OLEDs.Porphyrin interlayers.Reduced electron injection barrier. In this work we present an all solution processing scheme for the fabrication of the three primary colors, (R-G-B), emitting organic light-emitting diodes (OLEDs) via efficient color tuning of a blue organic semiconducting (OSC) thin film, in particular the poly9,9-di-(2'-ethylhexyl)fluorenyl-2,7-diyl (PF), in which different color fluorescent emitters are dispersed to define the final emitting color and thus to simplify the different color device fabrication. The transmission speed of the fabricated OLEDs was also examined for possible application in interactive telecommunications. To increase the response speed of the different color devices we altered both the device geometry and the electron injection efficiency. To this end we increased the emissive layer thickness and decreased the device emissive area and we also performed engineering of the cathode interfaces through the incorporation of solution processed porphyrin interlayers in order to lower the electron injection barrier height. The final devices exhibited improved operational characteristics and, consequently, modulation speeds.

The present study is aimed at investigating the solid state reduction of a representative series of Keggin and Dawson polyoxometalate (POM) films in contact with a metallic (aluminum) electrode and at introducing them as highly efficient cathode interlayers in organic optoelectronics. We show that, upon reduction, up to four electrons are transferred from the metallic electrode to the POM clusters of the Keggin series dependent on addenda substitution, whereas a six electron reduction was observed in the case of the Dawson type clusters. The high degree of their reduction by Al was found to be of vital importance in obtaining effective electron transport through the cathode interface. A large improvement in the operational characteristics of organic light emitting devices and organic photovoltaics based on a wide range of different organic semiconducting materials and incorporating reduced POM/Al cathode interfaces was achieved as a result of the large decrease of the electron injection/extraction barrier, the enhanced electron transport and the reduced recombination losses in our reduced POM modified devices.

Polyoxometalate (POM) layers have been used to realize efficient and long-term stable single-junction polymer photovoltaic devices with diverse configuration and donor : acceptor combination in the photoactive blend and polymer tandem cells through functioning as effective hole extraction layers and, also, as recombination layers in the interconnecting unit of the tandem cell. Their unique properties, such as their extremely high work function (WF) of 6.0–6.2 eV, their high degree of crystallinity without any post annealing requirements and, especially, the position of their lowest unoccupied molecular orbital (LUMO), were used to control the characteristics of optoelectronic devices. It was found that POMs having a deep LUMO level lying below the highest occupied molecular orbital (HOMO) of the donor polymer are highly beneficial for device operation due to the interfacial p-doping of the latter. We demonstrated conventional and reverse structure single-junction cells reaching an efficiency of 7.9% in the latter case and a tandem cell with an efficiency of 9.9% using an all solution processed inverted structure, where a POM layer simultaneously offers enhanced hole extraction in the sub-cells and minimal losses in the recombination unit. The specific properties of four POM materials and their role as functional layers in those different types of polymer photovoltaic devices are discussed.

Oncology nurses are uniquely positioned to offer fertility preservation counseling and education for cancer patients of reproductive age, yet there is a dearth of research that focuses on current practice and perceptions of nursing role. In 2013, the American Society of Clinical Oncology extended the duties of fertility preservation counseling among patients of reproductive age undergoing cancer treatment to include registered nurses and other allied health professionals as active partners in the counseling and education process. This study used a cross-sectional descriptive survey to assess current practices, role perceptions, and barriers to fertility preservation counseling among registered nurses working in an academic care setting with outpatient and inpatient services. There were significant gaps in current practices and perceptions of roles regarding fertility preservation counseling. Many nurses expressed the perception that fertility preservation counseling was important, but it was outside the scope of their practice to perform this education. This preliminary work defined need for an interdisciplinary fertility preservation team, communication surrounding educational practice norms, and designated oncofertility navigator.

Transition metal oxides.Under-stoichiometric tungsten oxides.Organic photodetectors.Anode interfaces. We demonstrate a transition metal oxide based hole extraction layer approach to improve the efficiency, dark current and time stability of organic photodetectors (OPDs). A significant increase in device efficiency and over two orders of magnitude lower dark current at a bias voltage of -0.5V were obtained in OPDs based on the poly(3-hexylthiophene) (P3HT) and 6,6]-phenyl-C71 butyric acid methyl ester (PC71BM) bulk heterojunctions (BHJ). This was achieved by introducing an under-stoichiometric tungsten oxide layer, after optimizing its thickness to 10nm, at the anode/organic layer interface instead of the commonly used poly(styrenesulfonate)-doped poly(ethylenedioxythiophene) (PEDOT:PSS). The increased efficiency and lower dark current were attributed to the formation of a favorable interfacial dipole and the reduction in the device series resistance, when PEDOT:PSS was replaced by these metal oxide layers.

We report a patient with history of Hodgkin lymphoma. Six months after treatment, 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography and/or computed tomography ([18F] FDG PET/CT) scan showed abnormal uptake in right axillary lymph nodes concerning for recurrence. In addition, PET/CT showed a new hypermetabolic skin lesion overlying the right scapula. Clinical evaluation was consistent with shingles, and the patient was treated with valacyclovir. Subsequent PET/CT scan was normal with no evidence of lymphoma. Although there have been reported cases of abnormal FDG in nodes or in skin due to herpes zoster, our case is unique in the literature in that the PET/CT demonstrates abnormalities involving both the skin and associated lymph nodes. The possibility of false positive uptake, not because of recurrent malignancy, must always be considered when abnormal FDG uptake is noted in the follow-up of oncology patients. Careful review of the scan and correlation with clinical findings can avoid false positive interpretation and facilitate patient management.

Vapor-deposited molybdenum oxide films are used as low resistance anode interfacial layers in applications such as organic light emitting diodes (OLEDs) and organic photovoltaics (OPVs). A versatile method for the vapor deposition of molybdenum oxide layers is presented, which offers the control of the oxygen stoichiometry of the deposited films and their doping with hydrogen. The possibility of tuning the electronic structure of the deposited molybdenum oxides is also investigated by controlling oxygen deficiency and hydrogenation (the incorporation of hydrogen within the molybdenum oxide's lattice). To take advantage of the altered electronic properties of the non-stoichiometric Mo oxides, we embedded them as anode interfacial layers in organic optoelectronic devices. Large improvement in the operational characteristics of both electroluminescent devices and bulk heterojunction solar cells was achieved and correlated with the oxygen deficiency and the hydrogen content of the Mo oxides.

Cerebrovascular reserve capacity (CVRC) is a hemodynamic parameter indicating the brain’s capacity to overcome ischemia. Transcranial Doppler (TCD) is a useful device to measure CVRC, with high availability and low cost. The aim of the study is to investigate asymptomatic patients with affected CVRC, who could benefit from CEA. One hundred and forty five consecutive patients (60 symptomatic and 65 asymptomatic), with internal carotid artery (ICA) stenosis >70 % and 20 healthy individuals without internal carotid stenosis underwent TCD-inhalation CO2 tests in order to measure the CVRC in both hemispheres of each patient. CVRC between asymptomatic and symptomatic patients were significantly different in the 95 % confidence interval (CI) as well as the mean CVRC value in contralateral carotid artery. The correlation between CVRC in the carotid artery with stenosis and the existence of symptoms is significant at the 0.01 level. Additionally, symptoms and CVRC of the contralateral carotid artery are also significant at the 0.05 level and CVRC values in asymptomatic patients and the control group at the 0.01 level. None of the covariant factors, except the age, are significantly correlated with CRVC. CVRC could be an early mark-index to evaluate the risk of stroke in this group of patients and to design their therapeutic approach.

Primary varicose veins of the upper extremity constitute a rare pathological entity with a few references in the literature, in contrast to those of the lower extremity. The diagnostic approach is necessary in order to eliminate the case of secondary varicose veins, whereas the therapy is similar to those of the lower extremity. We present the case of a 37 year-old male with primary varicose veins of the upper extremity, at the distribution of basilic vein. Keywords: Basilic Vein; Primary Varicose Veins; Secondary Varicose Veins; Vascular Ultrasound

Here, we report on the dual functionality of tungsten oxide for application as an efficient electron and hole injection/transport layer in organic light-emitting diodes (OLEDs). We demonstrate hybrid polymer light-emitting diodes (Hy-PLEDs), based on a polyfluorene copolymer, by inserting a very thin layer of a partially reduced tungsten oxide, WO2.5, at the polymer/Al cathode interface to serve as an electron injection and transport layer. Significantly improved current densities, luminances, and luminous efficiencies were achieved, primarily as a result of improved electron injection at the interface with Al and transport to the lowest unoccupied molecular orbital (LUMO) of the polymer, with a corresponding lowering of the device driving voltage. Using a combination of optical absorption, ultraviolet spectoscopy, X-ray photoelectron spectroscopy, and photovoltaic open circuit voltage measurements, we demonstrate that partial reduction of the WO3 to WO2.5 results in the appearance of new gap states just below the conduction band edge in the previously forbidden gap. The new gap states are proposed to act as a reservoir of donor electrons for enhanced injection and transport to the polymer LUMO and decrease the effective cathode workfunction. Moreover, when a thin tungsten oxide film in its fully oxidized state (WO3) is inserted at the ITO anode/polymer interface, further improvement in device characteristics was achieved. Since both fully oxidized and partially reduced tungsten oxide layers can be deposited in the same chamber with well controlled morphology, this work paves the way for the facile fabrication of efficient and stable Hy-OLEDs with excellent reproducibility.

Introduction Asparaginase is incorporated into many multi-agent chemotherapy regimens used in the treatment of acute lymphoblastic leukemia (ALL). Asparaginase depletes proteins including stores of factors in the coagulation cascade and proteins regulating it, including antithrombin III (AT) and fibrinogen. This results in an increased risk of both bleeding and thrombosis. The rate of thrombosis following administration of asparaginase ranges from 5% to 35%, depending on treatment protocol and study design. While recommendations exist for the repletion of coagulation factors with cryoprecipitate and fresh frozen plasma (FFP), there are no current consensus recommendations for the replacement of AT in patients receiving asparaginase. This study aims to assess if administration of AT replacement products decreased the risk of thrombosis in ALL, lymphoblastic lymphoma, and NK/T-cell lymphoma patients with asparaginase-induced deficiency. Secondarily, this study investigated the risk of hemorrhage, budgetary impact of AT replacement products, and survival in this patient population. Methods This retrospective study evaluated patients 18 years of age or older who received L-asparaginase, pegaspargase, or asparaginase Erwinia chrysanthemi between January 2011 and June 2018 for ALL, lymphoblastic lymphoma, or NK/T-cell lymphoma. At our institution, a change in practice occurred in 2014 which led to the monitoring and supplementation of AT in this patient population. AT levels were monitored in patients post asparaginase therapy and supplementation was provided when levels were below 60%. Patients receiving anticoagulation treatment prior to the start of asparaginase therapy were excluded from the study. Data were analyzed using Chi-squared and T-tests were used to assess for significance between the groups. Results Forty-six patients were analyzed in total; the mean age was 36 years of age and the most common diagnoses were B-cell ALL and T-cell ALL; 26 patients did not receive AT monitoring while 20 patients were monitored and received AT repletion (Table 1). There was a statistically significant difference in the development of thrombi between the groups with only 2 patients (10%) in the treatment group developing a thrombus compared to 10 patients (38%) in the non-treatment group (p=0.029) (Table 2). Two patients in the non-treatment group developed a sinus venous thrombus. It should be noted, a patient in each group developed multiple thrombi (Table 3). Overall, no patients experienced a clinically significant bleeding event that required clinical intervention. Overall survival was similar between groups with death from any cause occurring in 5 patients (25%) in the treatment group and 8 patients (31%) in the non-treatment group (p=0.67) (Table 2). The average cost of AT replacement for patients receiving supplementation was $78,370. Conclusion The monitoring and supplementation of AT in ALL, lymphoblastic lymphoma, and NK/T-cell lymphoma patients was associated with a significant decrease in the occurrence of clinically significant thrombi. Patients in both groups did not experience bleeding events and the overall survival rate was similar between groups. While the average cost of AT repletion was considerable, the cost associated with a thrombus is arguably more substantial when taking into account intensive care admissions, diagnostic exams, and anticoagulation medications. Therefore, the result of this study suggests utilization of monitoring AT activity and its supplementation in patients receiving asparaginase therapy. Disclosures No relevant conflicts of interest to declare.

All-inorganic self-arranged molecular transition metal oxide hyperstructures based on polyoxometalate molecules (POMs) are fabricated and tested as electronically tunable components in emerging electronic devices. POM hyperstructures reveal great potential as charging nodes of tunable charging level for molecular memories and as enhancers of interfacial electron/hole injection for photovoltaic stacks. STM, UPS, UV-vis spectroscopy and AFM measurements show that this functionality stems from the films' ability to structurally tune their HOMO-LUMO levels and electron localization length at room temperature. By adapting POM nanocluster size in solution, self-doping and current modulation of four orders of magnitude is monitored on a single nanocluster on SiO2 at voltages as low as 3 Volt. Structurally driven insulator-to-semi-metal transitions and size-dependent current regulation through single electron tunneling are demonstrated and examined with respect to the stereochemical and electronic structure of the molecular entities. This extends the value of self-assembly as a tool for correlation length and electronic properties tuning and demonstrate POM hyperstructures' plausibility for on-chip molecular electronics operative at room temperature.

Molecular storage elements consisting of a stack of a proton conducting layer (PCL) and a proton trapping layer (PTL) are investigated in view of their perspective application to non-volatile proton memories. Experimental studies are conducted on PCL and PTL materials made of poly(methyl methacrylate) (PMMA) with embedded molecules of 12-tungstophosphoric acid (HPW) and 2-aminoanthracene (AA), respectively. Particular emphasis is placed on the thermal processing parameters (temperature and duration) used in material preparation and their optimization for circumventing undesirable phenomena, for the device stability and performance, like reactions between HPW and PMMA and inter-mixing of the PCL and PTL. Transient current measurements performed on metal–insulator–semiconductor devices containing an HPW/PMMA layer allowed the determination of both the concentration and mobility of the protons within this layer. Comparison of the extracted proton concentration (ca. 3.8 × 10 17 protons/cm 3 ) under full polarization conditions with the HPW concentration determined by UV spectroscopy indicates that only 2 protons per ∼1000 HPW molecules are mobile and contribute to the current. Finally, the material features of a generic PCL/PTL stacked structure affecting the operation of a molecular proton memory device are examined from a theoretical point of view. Results indicate that the write characteristics of this type of memory such as the magnitude of the memory window and the write speed depend on the thickness, the proton mobility and the proton concentration of the PCL, while the write voltage is mainly determined by the thickness of the PTL. In light of these analyses, it appears that memory windows as large as 2.8 V might be obtained for a 1 ms/3 V write operation regime even in the case of PCL and PTL thicknesses as high as 175 nm. These observations suggest that a PTL/PCL storage element may be well suited in future low-cost, low-power, and non-volatile single-organic transistor memory applications.

A series of recently synthesized partially fluorinated methacrylate homopolymers and copolymers with varying fluorination degree were evaluated as coupling layers in polymeric optical waveguides. These materials show very low absorption (and high transparency) over a wide wavelength range (in the visible and near infrared region) and their refractive index can be tuned in the range of 1.43-1.49 (at 400nm), mainly by varying the fluorination degree. Simulations of the fundamental transverse electric (TE"0) mode in three layer planar waveguide structures with a poly(methyl methacrylate) (PMMA) cladding layer showed that its intensity and profile can be appropriately controlled by varying the width and thickness of the coupling layer as well as tuning the refractive index difference between the coupling and the cladding layer.

The one-bit memory-cell structure of choice for use in digital integrated circuit (IC) applications would be a single field-effect-transistor (FET) that includes a binary information storage element and acts as a memory-cell addressing switch. The storage element can be placed in two readily discernible physical states that modulate the transistor’s channel conductivity enabling data to be read electrically by sensing the current level of the transistor. The data sensing mode of memory transistors renders them robust against read-current distortions to the storage mechanism; an important advantage over their two-terminal counterparts. In the case of organic memory transistors, various combinations of storage elements, in the form of charged electrets or ferroelectric-like gate dielectrics, and organic semiconductor channels have been actively investigated for emerging large-area lowperformance logic circuit applications on flexible substrates. Regarding inorganic Si-based ICs, the polysilicon floating-gate (FG) storage element has been the dominant technology for the implementation of extremely durable nonvolatile memory transistors (currently referred to as FG flash transistors) for the past three decades. With the increasing challenge of scaling flash memory, various storage elements based on novel gate materials and physical storage principles have been proposed as modified flash cells. Significant development efforts have been devoted to storage elements exploiting: (a) the trapping of electrons and/or holes in nitride gate dielectrics or in isolated nanocrystals embedded in FET gate dielectrics (referred as nano-floating gate memory, NFGM); (b) the ferroelectric polarization of gate dielectrics (ferroelectric memory FET, FEMFET); and (c) the motion of protons within the gate dielectrics (proton memory). Apart from the benefits of using a modified flash memory architecture and of being radiation-tolerant, the proton memories also have the advantage, over FEMFETs and NFGMs, of being able to be programmed at much lower voltages, thus offering an attractive alternative for ultradense low-voltage, non-volatile data storage. While promising device results have been obtained, the conventional methods of forming protonmemories still face critical issues towards the development of commercial products. For example, all

We describe a patient in remission from acute lymphoblastic leukemia who developed a painless common peroneal neuropathy. Magnetic resonance imaging (MRI) revealed nerve thickening and enhancement, while a positron emission tomography (PET) scan demonstrated increased fluorodeoxyglucose uptake in a large segment of the neurovascular bundle, suggesting peripheral nerve infiltration. Both findings resolved following treatment with chemotherapy that crossed the blood-nerve barrier. In selected patients presenting with peripheral neuropathy, MRI and PET scan can be helpful in the diagnosis of peripheral nerve infiltration.

Evangelia Sarantopoulou, Zoe Kollia*, Margarita Chatzichristidi**, Antonios Douvas**, Panagiotis Argitis**, Spomenka Kobe*** , Alkiviadis-Constantinos Cefalas*. National Hellenic Research Foundation, TPCI,48 Vas. Constantinou Aven. Athens 11635 Greece email: ccefalas@eie.gr Institute of Microelectronics, NCSR Demokritos, 15310 Agia Paraskevi, Greece Jožef Stefan Institute,Department of Nanostructured Materials, Jamova 39, SI-1000 Ljubljana, Slovenia

Specification of laser ablating parameters is important to fabricate biomolecule microarrays with enhanced sensitivity and speed. Optimum fabricated conditions occur when thin surface layers of biocompatible fluoropolymers, (poly(2,2,2-trifluoroethyl methacrylate),, were ablated with nano-scale spatial resolution using laser at 157 nm. The surface ablation efficiency, morphology, molecular dissociation within the polymer volume and other effects, such as the formation of nano-columns depend on the exposing conditions and the laser beam spot size. The efficiency of surface ablation for PTFEMA and Teflon AF was greatly reduced for laser beam dimensions below 10 and 50 μm respectively and for large beam spot sizes, > 50 μm, the ablative rate was 0.5 and 0.8 nm at 1 mJ/cm2 laser fluence respectively.

Surface relief gratings (SRG) and self-organized nano-structures induced by laser light at 157 nm on the fluoropolymer poly(2,2,2trifluoroethyl methacrylate) (PTFEMA), films were obtained under well-controlled light exposure conditions. Regular and semi-regular spaced self-organized grating-like structures were created on polymeric films for � 7.5‐100 mJ/cm 2 laser energy fluence. For lower laser fluence, the surface morphology of light exposed/non-exposed areas exhibited irregular-like structure morphologies, while polymer surface irradiation with energyfluencehigherthan150 mJ/cm 2 causesprogressivelyfadingoutof theregularpatterns.Underthespecificexperimentalconditions, theSRG and self-organization patterning have their origin in the development of a surface thermal instability (Rayleigh’s instability), which is resolved itself into regular patterns on the surface of the fluoropolymer film. The thermal instability is due to the explosive polymer surface photodissociation at 157 nm and the build up of longitudinal and periodic surface stress, which eventually create the SRG and the self-assembled structures on the polymer. # 2007 Elsevier B.V. All rights reserved.

Longer follow-up studies available to date on the phakectomy technique combined with a planned shallow anterior vitrectomy for the removal of congenital or juvenile cataract reveal the method to be justified. The morbidity of multiple reoperations for residual after-cataract membrane has been significantly reduced (6 of 163 eyes or 3.6%). Only two retinal detachments (1.2%) have occurred; both were successfully attached. The visual status has been improved both quantitatively (visual acuity) and most importantly qualitatively (brighter images, wider field of view, and enhanced vision under poorly lighted conditions). No eyes have been made worse.

A sensing scheme based on mobile protons generated by radiation, including ionizing radiation (IonR), in organic gate dielectrics is investigated for the development of metal–insulator–semiconductor (MIS)-type dosimeters. Application of an electric field to the gate dielectric moves the protons and thereby alters the flat band voltage (VFB) of the MIS device. The shift in the VFB is proportional to the IonR-generated protons and, therefore, to the IonR total dose. Triphenylsulfonium nonaflate (TPSNF) photoacid generator (PAG)-containing poly(methyl methacrylate) (PMMA) polymeric films was selected as radiation-sensitive gate dielectrics. The effects of UV (249 nm) and gamma (Co-60) irradiations on the high-frequency capacitance versus the gate voltage (C–VG) curves of the MIS devices were investigated for different total dose values. Systematic improvements in sensitivity can be accomplished by increasing the concentration of the TPSNF molecules embedded in the polymeric matrix.

We report the case of a primary nasopharyngeal interdigitating dendritic cell tumor (IDDCT). A 25-year old male presented with bilateral decreased hearing, double vision, and ataxia. Flexible nasopharyngoscopy reviewed a large mass obstructing and filling the entire nasopharynx. MRI and PET-CT confirmed the presence of the primary tumor and demonstrated bilateral cervical lymphadenopathy. Biopsy of the nasopharynx revealed a hematolymphoid neoplasm with dendritic cell differentiation, most consistent with an IDDCT. The lesion was unresectable. The patient was treated with definitive radiotherapy to 66 Gy to the primary tumor and 50 Gy to the bilateral cervical lymphatics using an IMRT technique. A complete response was achieved and the patient remains disease free at the primary site 23 months after completion of radiotherapy.

e17092 Background: ACCs frequently acquire a chromosome (6:9) translocation that leads to overexpression of the MYB oncogene with autocrine activation of the fibroblast growth factor receptor (FGFR...

e17721 Background: In 2008, over 130,000 people in the US under age 45 were diagnosed with cancer. Due to increased survival rates, treatment-related infertility is a growing concern among patients...

The authors report the case of a neonate presenting with a distended abdomen and shock from factor IX (F.IX) deficiency and intrahepatic bleeding. After resuscitation and treatment with recombinant F.IX through a central venous line, he developed superior vena cava, upper extremity, and intracerebral venous thrombosis resulting in superior vena cava syndrome and intrathalamic hemorrhage. He was treated with F.IX to achieve near-normal F.IX activity levels and with low-dose unfractionated heparin with clinical improvement. F.IX replacement on a subsequent admission was again complicated by upper venous system thrombosis and improved with low-dose heparin. The case illustrates an unusual presentation of hemophilia, life-threatening thrombotic complications associated with factor replacement, and a strategy for anticoagulant management in the setting of hemophilic bleeding.

This work presents results on protein detection through a monolithically integrated silicon optoelectronic transducer. Also, we demonstrate the enabling technologies for developing high probe density optical biochips that can be read out without the need of external optical components. Experimental results are presented that demonstrate sensitive protein detection using biotin and protein coated chips as well as probe patterning using biocompatible photoresist.

In this work we study the utilization of molecular transition metal oxides known as polyoxometalates (POMs), in particular the Keggin structure anions of the formula PW12O40 3−, as active nodes for potential switching and/or fast writing memory applications. The active molecules are being integrated in hybrid Metal-Insulator/POM molecules-Semiconductor capacitors, which serve as prototypes allowing investigation of critical performance characteristics towards the design of more sophisticated devices. The charging ability as well as the electronic structure of the molecular layer is probed by means of electrical characterization, namely, capacitance-voltage and current-voltage measurements, as well as transient capacitance measurements, C (t), under step voltage polarization. It is argued that the transient current peaks observed are manifestations of dynamic carrier exchange between the gate electrode and specific molecular levels, while the transient C (t) curves under conditions of molecular charging can supply information for the rate of change of the charge that is being trapped and de-trapped within the molecular layer. Structural characterization via surface and cross sectional scanning electron microscopy as well as atomic force microscopy, spectroscopic ellipsometry, UV and Fourier-transform IR spectroscopies, UPS, and XPS contribute to the extraction of accurate electronic structure characteristics and open the path for the design of new devices with on-demand tuning of their interfacial properties via the controlled preparation of the POM layer.

Reduced molybdenum peroxides with varying degrees of reduction were synthesized following a modified sol–gel peroxo method and the respective films were employed as anode interfacial layers in organic optoelectronics applications, such as organic light emitting diodes (OLEDs) and organic photovoltaics (OPVs). The degree of reduction was controlled through both the synthesis route and the thermal treatment protocol of the obtained films. The films were thoroughly investigated with a variety of spectroscopic, diffraction, and electron microscopy methods (UV-Vis, FT-IR, XPS, UPS, Raman, XRD, SEM, and TEM). These films were found to be considerably sub-stoichiometric with a relatively high content of hydrogen. When they were used as anode interfacial layers in OLED and OPV devices, high efficiencies and adequate temporal stability were achieved. The enhanced hole injection/extraction properties of the reduced molybdenum peroxide films were attributed to the improved charge transport facilitated through the gap states present in these materials.

CBA mice injected intravenously with CBA anti-A/J spleen cell antiserum, and challenged subcutaneously 24 hr later with A/J-derived sarcoma 1 (Sa 1) develop progressive tumors. “Normal” CBA mice (i.e., injected with normal CBA serum or noninjected) reject the allograft within 20 days. Spleen cells taken from mice 20–35 days after the injection of antiserum and Sa 1 challenge can specifically transfer the ability to enhance tumor growth when injected into 200 rad irradiated recipients. Spleen cells taken 8 days after antiserum and Sa 1 challenge cannot transfer suppression. The induction of suppressor cells requires both antiserum treatment and Sa 1 challenge. Serum from suppressed mice, and from control mice that are rejecting their tumors, can also transfer suppression but only when taken 20–35 days after treatment. The suppressor cells function most effectively when transferred at the time of tumor challenge, however, they also inhibit the rejection of Sa 1 when mixed with nylon-wool purified sensitized T cells. Suppressor cells are both nylon-wool nonadherent and adherent. Further purification of the column-enriched cells using antiimmunoglobulin or anti-Thy 1.2, plus complement, suggests that both T and B cells can suppress. The mixed lymphocyte response (MLR) of spleen cells from mice challenged only with Sa 1 is inhibited 8 days after challenge. A secondary response is obtained at 20–27 days. In contrast, the MLR from antiserum and Sa 1-treated mice 8 days after challenge resembles a secondary response. By 20–27 days mice with progressive tumors have only a primary-like response. In the present experimental situation, mitomycin-treated spleen cells from antiserum and Sa 1-treated mice cannot significantly inhibit the MLR of normal cells.

The induction of tuberculin-type delayed hypersensitivity, as measured by skin test, can be specifically inhibited by administration of antibody during sensitization. The cellular mechanisms involved in this tolerance were investigated in CAP 1 mice, using chicken conalbumin as antigen. Tolerance was prevented when mice were treated with Cyclophosphamide 2 days before sensitization and suppression. However, it was not affected by splenectomy 7 or 21 days before sensitization. This tolerance could be transferred to normal CAF 1 mice with spleen cells, but not with thymocytes, when taken from donor mice 21 to 28 days after sensitization and tolerance induction. Production of these cells in the donors required both antibody and antigen. The cells responsible for the transfer were B cells, as shown by their sensitivity to rabbit anti-mouse-immunoglobulin serum and complement. In addition to B cells, serum from tolerant mice also could transfer suppression at 21 to 28 days. We conclude that sensitizing mice, and treating them with specific immunosuppressive antiserum, induces the recipients to make suppressor B cells and suppressive humoral factors, which are involved in arresting the induction of tuberculin-type delayed hypersensitivity.

Fourteen patients with severe pregnancy-induced hypertension and low lecithin/sphingomyelin (L/S) ratios were treated with 5 mg of dexamethasone phosphate intramuscularly every 12 hours for four doses to induce fetal pulmonary maturity. A comparison was made of the average gestational age, mean L/S ratio, method of delivery, Apgar scores, mean birth weight, and incidence of respiratory distress syndrome in these patients and in 16 patients with similar demographic backgrounds and clinical presentations who did not receive corticosteroid therapy. There was no significant difference between the two groups except that the time of treatment (or nontreatment) to delivery was longer in the steroid group. There were two cases of neonatal respiratory distress syndrome in the treatment group, and one of these infants died. In the control group, there were two neonatal deaths among four cases of respiratory distress syndrome. There was no clinical evidence of intraventricular hemorrhage in any neonate nor was there aggravation of hypertension in the parturient patients. The administration of corticosteroids to induce fetal pulmonary maturity in patients with severe pregnancy-induced hypertension who are carefully selected and monitored does not appear to be contraindicated.

Meperidine and its principle metabolite, normeperidine, were given intravenously to four non-human primates prior to cesarean delivery in an equivalent dose for human parturients. The status of the infants regarding neonatal depression was assessed at delivery. Repeated blood samples from both the mother and the neonate were obtained over a period of 4 days. The levels of meperidine and normeperidine were analyzed. The results showed that the metabolism of meperidine and normeperidine in the non-human primate was essentially the same as that observed in the human parturient. In addition, normeperidine appeared to be more toxic than meperidine to the neonate. Finally, there does not appear to be an evidence for neonatal metabolism of meperidine to normeperidine.

Among 1,318 live born infants delivered in our institution during a 120-day period, 1,025 (77.8%) were monitored electronically. Of the 1,025 monitored infants, 89 were of low birth weight (≤1,800 gm) and were admitted to the neonatal intensive care unit. Twenty-seven (30%) of these had abnormal fetal heart rate tracings. The remaining 62 (70%) had normal fetal heart rate tracings. Of the 27 low-birth weight neonates with an abnormal fetal heart rate tracing, 24 (89%) were asphyxiated, whereas of those 62 low-birth weight infants with a normal fetal heart rate tracing, only nine (14%) had asphyxia (p

This paper discusses vitrectomy instrumentation design requirements, a description of the Roto-Extractor (DOUVAS 1975) results and analysis of 100 consecutive Roto-Extractor cases.

Cystoid blebs occasionally develop inad­ vertently in the postoperative cataract inci­ sion that is well covered by a conjunctival flap. This has been more frequently observed with the use of buried 8-0 virgin silk su­ tures. Most of these blebs cicatrize within a few months. A small percentage persist, and often result in continued postoperative filtra­ tion and hypotony that may or may not en­ danger macular function. Other cystoid blebs involving the cataract wound may prove to be nonfiltering and represent an extraocular thin-walled extension of the anterior chamber. The intraocular pressure is found to be within the acceptable limits of normal. Both the filtering and the non-filtering thinwalled cystoid wound represents a potential source of infection to the eye and a contrain­ dication to the fitting of an aphakic contact lens. To date, surgical correction of the persis­ tent cystoid wound, either for the correction of hypotony or to restore the structural in­ tegrity of the eye so as to permit the use of an aphakic contact lens, has necessitated a reopening of the wound and the anterior chamber in the course of the operative wound repair.

WITH THE discovery of new antibiotic substances the treatment of ocular diseases has changed considerably during recent years. One of the new broad bacterial spectrum antibiotics is terramycin. 1 This antibiotic will be compared with previously reported substances to determine its role in ophthalmology. 2 Terramycin is an amphoteric compound whose empirical formula is believed to be C 22 H 22-24 N 2 O 9 · 2H 2 O. 3 The chemical and physical properties of terramycin have been studied, 4 as well as its antimicrobial action 5 and pharmacodynamics. 6 Numerous articles on the clinical effectiveness of terramycin in a wide variety of infections have appeared in the literature. 7 At the time of this writing no published reports are available on the effectiveness of terramycin in the treatment of ocular infections. Terramycin hydrochloride, powdered and in a special ophthalmic borate buffer, and 0.1 per cent terramycin hydrochloride in

Continuous aspiration serves to prevent the accumulation of fluids in the internal canthal area during the course of intraocular surgery. The prevention of this fluid accumulation is necessary in order to prevent the flow of irrigating fluids directed onto the eye from accumulating in the internal canthal area to such an extent that fluid bathing the skin can possibly re-enter an opened eye. This is always a possible avenue for infection because of the likely presence of contaminating skin bacteria. Excessive fluid accumulation also serves to obscure visualization of fine tissue details in some instances. In the course of surgery, transient copious irrigation is desirable insomuch as it permits point cauterization of incisional bleeders which are more readily visualized in the presence of an irrigating stream. The Scheie cautery has proved most effective for point cauterization in the presence of liquids because it is possible to regulate the current and

Antenatal diagnosis and appropriate management of pheochromocytoma complicating pregnancy offers a reduction in mortality for both mother and fetus. We have presented the successful management of such a case, emphasizing the close collaboration between obstetricians, pediatricians, anesthesiologists, surgeons, and internists that is mandatory for a successful outcome.