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e14184 Background: The Neutrophil to lymphocyte ratio (NLR), a marker of systemic inflammatory response, is associated with prognosis in various cancers. The aim of this study is to evaluate the association of pre-operative NLR with oncologic outcomes in patients with appendiceal carcinomatosis. Methods: Clinico-pathological data were obtained from a prospectively maintained database of patients with appendiceal carcinomatosis who underwent cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemoperfusion (HIPEC) between 2001 and 2010. Pre-operative absolute neutrophil and lymphocyte counts were used to compute NLR, with elevated NLR defined a priori as >5. Logistic regression modeling and Kaplan-Meier analyses were performed on the available data. Results: 195 patients, with a median age of 54.5 years, underwent CRS and HIPEC. The median follow up time was 1.96 years. There were 41 patients (21%) who had elevated NLR preoperatively. Factors associated with overall survival (OS) were grade (p=0.01), simplified peritoneal cancer index (SPCI) (p=0.013), and age (p=0.02). In patients who did not undergo splenectomy at the time of CRS, elevated NLR, lymph node involvement, SPCI, age and pre-operative albumin were statistically significant predictors of OS on multivariable analysis. None of these factors were significant in patients who underwent splenectomy at the time of CRS. The 5-year overall survival was 57% vs. 31% in patients with NLR5 respectively (p5 (p=0.001). Strikingly, the 5-year OS in patients with NLR5 with or without splenectomy 37.5% vs. 23%, respectively (p=0.0001). Conclusions: In patients with appendiceal carcinomatosis, pre-operative NLR is a potential systemic inflammatory marker that independently predicts oncologic outcomes. The impact of NLR appears to be influenced by the performance of splenectomy at the time of CRS. Further studies will be required to prospectively validate this systemic inflammatory marker and its interaction with splenectomy.

The pre-existing anti-poxvirus immunity in cancer patients presents a hurdle to successful poxvirus-mediated oncolytic virotherapy. To overcome this hurdle, we have explored strategies of immunosuppression (IS) or/and immune evasion (IE) for successful delivery of an oncolytic vaccinia virus to tumor models in mice pre-vaccinated with a poxvirus. These include transient IS using a cocktail of three immunosuppressive drugs (IS drugs) (tacrolimus, mycophenolate mofetil and methylprednisolone sodium succinate) that have been used in organ transplant, carrier cells as a means of IE, or the combined strategy. The three drug cocktail, which targeted multiple components of innate and adaptive immunity, displayed no enhancing effects on viral infection in tumor tissue in the pre-immunized host. Using B cell knockout mice, we confirmed that B cells and the neutralizing antibodies, the later of which were not targeted by the drug cocktail, played a significant role in preventing poxvirus infection. Cancer cells as carrier cells alone were not effective to deliver the virus to tumor. Instead, the application of both IS drugs and carrier cells worked synergistically to promote the delivery to, viral infection, replication and spread inside the tumor mass and thus enhanced the efficacy of oncolytic virotherapy in an ovarian carcinomatosis model. The administraton of these IS drugs led to facilitated development of tumor-associated macrophages (TAMs) into immunosuppressive M2 phenotype (IL-10hi/IL-12low) in the tumor microenvironment. These results revealed a novel mechanism for induction of the immunosuppressive tumor microenvironment by the IS drugs, and demonstrated in principle that it is feasible to treat pre-vaccinated cancer patients with an oncolytic poxvirus when combined with both IS and IE strategies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1498.

Unlike most of the other metaphysical poets Traherne wrote no secular poetry. His subject matter is wholly religious and basically he has one main theme: man has been created to enjoy the world, which, like himself, has been made by God. His enjoyment and gratitude to his Maker make him a partaker in God’s divinity and complete God’s joy in his Creation: … all the business of Religion on GODS part is Bounty, Gratitude on ours, and … this Gratitude is the sphere of all Vertue and Felicity. (CE, 284)1

Wordsworth’s reputation during his lifetime reached its peak during the 1830s. It owed little to what we call The Prelude, which was published posthumously. Parts of this poem were, however, written as early as 1798 and a more or less full version, which was known to his friends, was complete by 1805. When Coleridge heard Wordsworth recite it in 1807 he was moved to praise it in blank verse. He included this eulogy in Sybilline Leaves in 1817 and referred to Wordsworth’s poem in Biographia Literaria in the same year. Much that Coleridge said and believed about Wordsworth arose from his knowledge of this poem. He believed that Wordsworth was not only a great poet but should write the great philosophical poem that English still lacked. The Prelude (this title was never given to it by the poet himself) was for Wordsworth a prelude to this great philosophical work, proving to himself his fitness for the task. When at last it was published, it afforded the key to the rest of his life’s work, and many later writers believe it was the crown of his poetic achievement. However that may be, Wordsworth himself thought highly enough of the poem to work over it for the rest of his life. Here, then, we shall examine two passages from The Prelude, using the 1805 text that Coleridge heard and admired in 1807.

Unlike Donne, Herbert has one theme only and it runs through all his writings: Christianity and Christian experience. Inevitably much of his vocabulary is taken from religious sources, principally the Bible, but also the Liturgy and other medieval and Renaissance works and devotional writings, not excluding religious lyrics and the illuminated Books of Hours. Two well-known and popular books were the Biblia Pauperum and the Speculum humanae salvationis, both of which were illustrated.1 Herbert uses these not so much for vocabulary as for the inter-relating of images and symbols, and thus enriches the significance of many biblical allusions. References to the Bible and biblical stories of the Old and New Testaments are common. Often Herbert simply uses the names of biblical characters, clearly expecting his readers to be familiar with the context and significance of the names. An example is in the first stanza of ‘Decay’: Sweet were the dayes, when thou didst lodge with Lot, Struggle with Jacob, sit with Gideon, Advise with Abraham, when thy power could not Encounter Moses strong complaints and mone: Thy words were then, Let me alone. (11.1–5)

The language of Vaughan’s religious poems is probably more varied and eclectic than that of the other metaphysical poets. Direction and meaning may often seem unclear and diffuse. It is not surprising, therefore, that critics disagree about the nature, intentions and quality of his poetry.

Two aspects of Donne’s language have often been commented on and both are part of his rhetoric: his unusual handling of metre and his images. These last are thought to characterize any poetry that is termed ‘metaphysical’. Donne’s subject matter is inseparable from the language in which it is written and the different facets of the language themselves are intertwined in such ways that it is hard to isolate any one of them for examination. However, for the purposes of analysis and description it is necessary to try.

(1973). Epistolary conventions in the Clift family correspondence. English Studies: Vol. 54, No. 2, pp. 129-140.

In ‘The Female Vagrant’, written between 1791 and 1792, Wordsworth had found the subject matter that he wanted but he had still to find the medium in which to convey it. This he developed in a group of poems, all in some form of ballad measure and mostly written during the prolific year 1798. The language Wordsworth used for all these ballads is basically similar and marks a clear break from that which he used earlier and also, to some extent, that which he used later. It was influenced very greatly by the ballads of Percy’s Reliques and the broadsheet ballads of the time.1 In it, Wordsworth set himself severe limitations. He deliberately worked within a very restricted language, in both vocabulary and sentence structure, abandoning everything that had hitherto been associated with poetry, except rhyme and metre. There are difficulties in coming to terms with this language. Wordsworth uses both diction and syntax in such a new and bold manner that it sometimes hovers on the borders of collapse into the ludicrous even today. Nevertheless, its success in terms of what Wordsworth was trying to do is quite astonishing. Frequently it strikes readers who come fresh to it, with inbuilt assumptions of what to expect from poetry, as clumsy and banal.

Whilst writing the poems examined in the last chapter, Wordsworth was composing other, shorter poems, often of a more lyrical kind, in strict ballad measure: that is four-lined stanzas of alternating four and three stresses, usually rhyming abab. These include ‘We Are Seven’, ‘Anecdote for Fathers’, the pair of poems, ‘Expostulation and Reply’ and ‘The Tables Turned’, and the groups known as the ‘Matthew’ and the ‘Lucy’ poems. On a first reading, the language seems little different from that of the experimental-type narrative ballads. On closer inspection, one finds that it is slightly less restricted, at least in vocabulary, and the distribution of syntactical features is different. The use of figurative language seems much the same and on the surface, perhaps, there appear to be fewer figures of speech or a slighter use of the same ones: simile, apostrophe and exclamation chiefly. Yet it is in this area that the greatest difference in the language occurs.

Wordsworth’s blank verse can be roughly divided into three types: narrative, descriptive and what may be called contemplative or reflective. No poem is written entirely in one mode and some contain all three. This division is rather different from what we shall find in Coleridge, whose blank verse is basically reflective, although it contains elements of description and even a small amount of narrative. All the poems to be examined were written in fairly close sequence, and one hesitates, therefore, to postulate a progression but there does appear to be some development. Certain features are common to all the blank verse but others vary according to the type, and the variation becomes more distinct in the later poems, ‘Michael’ showing the greatest differentiation among its various parts. The poems which are most accessible to linguistic analysis are, once again, those in Lyrical Ballads. Representative poems are ‘Tintern Abbey’ (July 1798), mainly reflective; ‘The Old Cumberland Beggar’ (1800), mainly descriptive; and ‘Michael’ (1800), which is generally considered to be narrative. ‘The Brothers’ (also 1800) must also be taken into account, although here the narrative is in the form of dialogue.

The most obvious way in which the sentence structure of Wordsworth’s blank verse differs from that of the ballad-type poems and the poems in ballad measure is in sentence length and consequently the complexity of the syntax. The differences are partly the result of the metrical forms. The short stanzas of the ballads prescribed limits to clause and sentence length. Blank verse more readily allows for run-on lines and longer statements. However, even in his blank verse the language of Wordsworth’s experimentation in the ballads has left its mark in the shorter sentences interspersed among the longer ones.1