Radiation-dependent demyelination in normal appearing white matter in glioma patients, determined using quantitative magnetic resonance imaging.

Background and purpose: A brain tumour, especially a glioma, is a rare disease; it is challenging to treat and the prognosis is often poor. Routine care includes surgery and concomitant chemoradiotherapy (CRT). Diagnostic work-up and treatment effects are typically evaluated using magnetic resonance imaging (MRI). Quantitative MRI (qMRI), unlike conventional MRI, has the advantage of providing tissue-specific relaxation rates and proton density. The purpose is to detect changes in normal appearing white matter (NAWM) in brain tumour patients after CRT using qMRI. Materials & methods: NAWM was analysed in 10 patients, in 83 MR examinations performed before and after surgery and after CRT. Relaxation rates R1 and R2, the proton density (PD) and the concentration of myelin (cMy) were calculated from the qMRI scans and analysed in correlation to radiation dose and time after treatment. Results: A significant decrease in cMy between pre-treatment imaging and first follow-up and an increase in PD were observed. For low doses (less than 30 Gy) PD and cMy returned to baseline (=pre-operative status), while for high doses (>30 Gy) the change increased during the full extent of the follow-up period. No difference could be established for R1. For R2 an increase was observed during the first year, which then gradually returned to baseline. For R2, stronger effects were seen as a consequence of higher absorbed doses. Conclusion: In the long-term follow-up for glioma patients, qMRI is a powerful tool for detecting small changes, such as a decrease of myelin concentration, in NAWM after CRT.

APR-246 Enhances Colorectal Cancer Sensitivity to Radiotherapy.

p53 mutation is common and highly related to radiotherapy resistance in rectal cancer. APR-246, as a small molecule, can restore the tumor-suppressor function to mutant p53. As there is currently no existing study on combining APR-246 with radiation in rectal cancer, our objective was to investigate whether APR-246 could enhance the sensitivity of colorectal cancer cells, regardless of their p53 status, to radiation treatment. The combination treatment had synergistic effects on HCT116p53-R248W/- (p53Mut) cells, followed by HCT116p53+/+ [wild-type p53 (p53WT)] cells, and exhibited an additive effect on HCT116p53-/- (p53Null) cells through inhibiting proliferation, enhancing reactive oxygen species, and apoptosis. The results were confirmed in zebrafish xenografts. Mechanistically, p53Mut and p53WT cells shared more activated pathways and differentially expressed genes following the combination treatment, compared with p53Null cells, although the combination treatment regulated individual pathways in the different cell lines. APR-246 mediated radiosensitization effects through p53-dependent and -independent ways. The results may provide evidence for a clinical trial of the combination in patients with rectal cancer.

Teaching children with attention deficit hyperactivity disorder in remedial classes.

This article is based on data collected in the interdisciplinary project 'basic skills, social interaction and training of the working memory'. The trend in today's schools is to work for inclusion of all children based on the Convention on the Rights of the Child. The focus of this study is teachers' and parents' views on the education of children with attention deficit hyperactivity disorder and similar symptoms. The aim is to increase teachers' and parents' knowledge of the school context for this group of children. A questionnaire was developed and distributed to all teachers and parents involved in the project and data were compiled and reported in running text. Twenty-one teachers and school staff, and 41 parents (one dropped out) were involved. The results showed that problems in the classroom sometimes exceeded the genuine tasks of the school, and too much time was spent on reproving pupils' unacceptable behaviours.

Self-concept in children with attention deficits.

This study focuses on the BASTA project (basic skills, social interaction and training of the working memory), which studied children with attention deficits and hyperactive behaviour attending remedial classes in regular schools. The project is interdisciplinary, with research teams from both social science and medicine. Our study is both qualitative and quantitative with a socio-cultural approach, and focuses on the pupil's social interaction, self-concept and the classroom climate. This article reports on the results of the study on self-concept. Our supposition was that the pupil's self-concept should change when they improved their skills in reading, writing and mathematics, but this was not the case. The results showed the dominating pattern to be that the differences between data from the BASTA project and comparison data from a similar study on academic self-concept, social self-concept, personal self-concept and global self-concept are small to nonexistent. Our results indicate that the children studied report higher degrees of self-concept than were warranted and that entering remedial classes was often linked to previous academic failures, social failures or both.

Ethical issues when interviewing children in remedial classes.

This study concerns the ethical issues related to interviews with children. In a substudy of the Basic Skills, Social Interaction and Training of the Working Memory (BASTA) project, 10 children between 10 and 12 years of age were interviewed. Interviews involving children have to address many more ethical issues than interviews with adults. Children constitute an overexposed group because they are under age and because they stand in a dependent relationship with adults. One ethical dilemma for the researcher in interviews with children might be the conflict between professional secrecy and the obligation to report, as stated in the Swedish Social Services Act. According to this Act and to ethical research principles, researchers are bound to maintain professional secrecy.