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Objective The aim of this study was to analyze the expression, biological role and clinical relevance of cancer stem cell markers in high-grade serous carcinoma (HGSC). Methods mRNA expression by qRT-PCR of NANOG, OCT4, SOX2, SOX4, SOX9, LIN28A and LIN28B was analyzed in 134 HGSC specimens (84 effusions, 50 surgical specimens). Nanog, OCT3/4, SOX2 and SOX9 protein expression by immunohistochemistry was analyzed in 52 HGSC effusions. Nanog protein expression in exosomes from 80 HGSC effusions was studied by Western Blotting. OVCAR3 cells underwent CRISPR/Cas9 Nanog knockout (KO), and the effect of Nanog KO on migration, invasion, proliferation and proteolytic activity was analyzed in OVCAR3 and OVCAR8 cells. Results OCT4 mRNA was overexpressed in effusions compared to solid specimens (p = 0.046), whereas SOX9 was overexpressed in the ovarian tumors compared to effusions and solid metastases (p = 0.003). Higher SOX2 and SOX9 expression was associated with primary (intrinsic) chemoresistance (p = 0.009 and p = 0.02, respectively). Higher SOX9 levels were associated with shorter overall survival in univariate (p = 0.04) and multivariate (p = 0.049) analysis. OCT3/4, SOX2 and SOX9 proteins were found in HGSC cells, whereas Nanog was detected only in exosomes. Higher SOX2 protein expression was associated with shorter overall survival in univariate analysis (p = 0.049). OVCAR cells exposed to OVCAR3 NANOG KO exosomes had reduced migration, invasion and MMP9 activity. Conclusions SOX2 and SOX9 mRNA levels in HGSC effusions may be markers of clinically aggressive disease. Nanog is secreted in HGSC exosomes in effusions and modulates tumor-promoting cellular processes in vitro.

Tonsillectomy/adenoidectomy is one of the most frequently performed operations in the United States. It is therefore likely that pediatric ENG surgeons will encounter autistic and developmentally delayed children in routine practice. Autistic children differ from normal children in that they exhibit severe deficits in language and social functioning; abnormal reaction to stimuli such as light, sound, touch, and pain; attachments to particular unusual objects and rigidly stereotyped routines. They are often mentally retarded. With the increasing importance of managed care and continuous quality improvement, knowledge of how to manage the operative course of such children is crucial for the practising surgeon. Based on research and clinical knowledge of these children, certain psychosocial and medical interventions are presented which may improve the operative course of this population. Using the parent as a consultant; decreasing separation from familiar caretakers, objects, and routines; pre-operative role-playing; tailoring anesthetic induction; and using post-operative distractors are suggested techniques.

This investigation attempts to clarify 3- and 4-year-old children's perceptions of ghosts and their relation to the hypothesis of the “floating ghost” as an early infantile remembrance. It appears to confirm the notion that young children's representation of ghosts results from an admixture of learned conscious ideas regarding ghosts and an ill-defined part which is based upon primitive unconscious ideas about the unknown stranger and the mysterious images of earlier nightly visits from mother and father.

Two related research problems are investigated. First, an empirical approach to classifying developmental disorder is presented. This approach induces types of developmental disorder defined in terms of functional criteria. The classifications derived are then used to validate the classificatory scheme and the set of play and language indicators. This second analysis demonstrates that both the classificatory scheme and the play/language indicators are correlated as hypothesized. In particular, linguistic capacity and peer play performance are the most important discriminators of developmental disorder. The clinical implications of the data analytic approach and the findings are also discussed.

A semistructured telephone interview designed to elicit data concerning the history of the treasured object and the history of attachment to other objects after age 2 was conducted with mothers of 54 developmentally disordered patients (21 mentally retarded, 33 pervasive developmental disordered). Results indicated a dramatically reduced frequency of treasured objects use among this population that is independent of both diagnosis and IQ. The proportion of developmentally disordered children who ever (after age 2) form an object attachment is also significantly reduced and does vary with both diagnosis and IQ. The type of object to which an attachment is formed differs according to diagnosis.

General psychiatrists' interest in childhood has been stimulated by the genetic aspect of dynamic psychiatry. The prospective developmental approach of child psychiatrists has been molded by developmental psychological theory, epidemiological approaches, and clinical experience with children who exhibit symptoms of psychopathology. The authors review follow-up data on children diagnosed as having attention deficit disorder, pervasive developmental disorder, autism, and conduct disorders. They also discuss the results of studies of subjects who, as children, were diagnosed as being hyperactive or neurotic, or who experienced language delay.

Child psychiatrists have recently been asked to provide consultation and liaison to neonatal intensive care units in order to assist in providing humane care for all those who are distressed by the events that commonly unfold in intensive care units and to help deal with the special neurologic and emotional problems of the high-risk infant and his caretaking environment. Discussed are the role of the psychiatrist, the complexities of the NICU setting, initiating liaison, parental and staff reactions to the NICU experience, staff communication with parents, and psychiatric intervention for parents and staff.

Thirty-six children ages 30 to 63 months diagnosed as autistic or as having Atypical Pervasive Developmental Disorder, Developmental Language Disorder, and Mental Retardation were videotaped with their mothers using a modification of the strange situation and coding devised by Ainsworth et al. (1978). Autistic and atypical children's manifested attachment behavior is not significantly different from the attachment behavior normal children display at a younger age. A majority (64%) of the developmentally disordered children manifest some behavior change upon separation, whereas almost half (44%) display negative mood change. Quality of attachment did not correlate with diagnosis, developmental quotients, mood change, or behavior change on separation in all the developmentally disordered group. Affective display on separation tended to correlate with security of attachment, although this did not reach statistical significance.

A study that explored children's understanding of the body and illness was conducted with 23 thalassemic outpatients and 27 healthy controls. The findings were supportive of a developmental progression in children's understanding that is reflective of their underlying cognitive maturity. Behavioral compliance was related to psychiatric adjustment. There was a trend toward poorer psychiatric adjustment in children with impaired understanding of their illness. These findings hold implications for both educational and psychiatric intervention with this group. Optimal health care of chronically ill children requires knowledge of the developmental course and interplay of children's cognition and their familial and personal adjustment.

An array of six photographs of the same woman was used to assess the ability of 18 autistic, 14 nonautistic mentally retarded, and 18 normal preschool subjects to use affect - and activity -related concepts in the solution of cognitive tasks. The Total Performance Level of the autistic and mentally retarded subjects did not differ significantly. Autistic subjects performed imitation, directed action, and description tasks less well in the affect mode. The findings are consistent with other studies, suggesting an impairment in the expression of emotion in autism.

The primary role of the psychiatrist in a neonatal intensive care unit (NICU) is to assist in providing humane care for those in distress —the infants, the parents, and the staff. The issues that face NICU psychiatrists and the unique characteristics of these groups of individuals with whom they interact are presented.

To effectively communicate in a pediatric setting, the liaison psychiatrist must be aware of those elements that make successful communication possible. By paying close attention to the criticisms leveled at psychiatrists by pediatricians, to the pediatricians expectations of the consultant, to parental expectations, and to the discordant perceptions of diagnostic terms by parents and professionals, the liaison psychiatrist can then function as a catalyst who facilitates the understanding and treatment of illness.

• A chemiluminescent material (Cyalume) was injected into the lacrimal excretory passages of eight normal monkeys (16 eyes). Patency was established by almost instantaneous observation of a yellowish-green glow in the nose and pharynx. No toxic effects of the chemical were noted in any of the monkeys.

Although an average rate of noncompliance of 54% has been reported in conjunction with other pediatric therapies, noncompliance has not previously been associated with infant home monitoring. We studied 24 consecutive infants placed on home apnea monitors because of near-miss sudden infant death (SIDS) episodes, subsequent siblings of SIDS victims, and apneic preterm infants at The New York Hospital-Cornell Medical Center. In 8 cases(33%) noncompliance was noted. The monitor was prematurely terminated in 5 cases, and was continued in use in 3 cases despite medical advice to the contrary. A semi-structured interview was administered to the parents of all 24 monitored infants. Discriminant analysis was performed to determine what variables were connected with noncompliance in this population. Socioeconomic status, severity of preceding illness, or diagnosis were not predictors of noncompliance. Noncompliance in home monitoring programs may be more significant than previously recognized. Clearer guidelines for both the use of the monitor and the physician's responsibility when noncompliance is an issue need to be established. Pediatric and psychiatric collaboration is crucial in order to deliver optimal care to these vulnerable infants and their families.

Perceptions of diagnostic terms were investigated in a study of 30 mothers of developmentally deviant preschoolers, 24 psychiatrists, 24 pediatricians, and 15 therapeutic nursery school educators. Statistical analysis of ranking by severity revealed little concordance between mothers and professionals and among the three groups of professionals. Results indicated that the mothers tended to discard or reinterpret diagnostic terms to permit themselves to maintain hope. Professional awareness of the potential for miscommunication with parents is urged.

There has been a recent increase in the number of neonatal intensive care units. The literature suggests that premature innfants are poorly parented more frequently than full term infants. It is known that low birth weight and seriously ill infants have a higher incidence of abuse and failure-to-thrive than those born at full term. In order to provide optimal care for parents of high risk infants an attempt was made to assess what these parents perceived their needs to be. They were offered an opportunity to be a part of a parent group and/or speak to a professional on an individual basis. Sixty-one parents of infants from age 1-18 months were evaluated using a brief semi-structured interview. Results indicated that 62% of parents interviewed wanted the intervention program. A discriminant analysis was performed to determine what variables correlated with the parents desire to engage in the intervention program. Higher socio-economic status (SES) and greater severity of illness were directly correlated with parents wanting an intervention. Younger maternal age and lower SES were correlated with not wanting the intervention program. Programs designed to meet the needs of these parents should be part of the comprehensive care prescription. Other programs must be designed to reach the low SES young mother.