Multidisciplinary Service Utilization Pattern by Advanced Head and Neck Cancer Patients: A Single Institution Study

Purpose. To analyze the patterns and associations of adjunctive service visits by head and neck cancer patients receiving primary, concurrent chemoradiation therapy. Methods. Retrospective chart review of patients receiving adjunctive support during a uniform chemoradiation regimen for stages III-IV head and neck squamous cell carcinoma. Univariate and multivariate models for each outcome were obtained from simple and multivariate linear regression analyses. Results. Fifty-two consecutive patients were assessed. Female gender, single marital status, and nonprivate insurance were factors associated with an increased number of social work visits. In a multivariate analysis, female gender and marital status were related to increased social work services. Female gender and stage IV disease were significant for increased nursing visits. In a multivariate analysis for nursing visits, living greater than 20 miles between home and hospital was a negative predictive factor. Conclusion. Treatment of advanced stage head and neck cancer with concurrent chemoradiation warrants a multidisciplinary approach. Female gender, single marital status, and stage IV disease were correlated with increased utilization of social work and nursing services. Distance over 20 miles from the center was a negative factor. This information may help guide the treatment team to allocate resources for the comprehensive care of patients

Involvement of circular intermediates in the transfer of T-DNA from Agrobacterium tumefaciens to plant cells

Co-cultivation of Agrobacterium tumefaciens with plant cells leads to the induction of circular copies of the T-DNA segment of the large tumour-inducing (Ti) plasmid in the bacterial cells. These circular molecules are presumably intermediates in DNA transfer from the A. tumefaciens genome to the plant cells. In support of this suggestion, the junction of the T-DNA circles occurs precisely in the 25-base pair terminal sequence involved in T-DNA transfer