247 research outputs found

    The Social and Cultural Context of Coping with Sickle Cell Disease: I. A Review of Biomedical and Psychosocial Issues

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    Sickle cell disease (SCD) is widely conceived in the United States as a group of blood disorders that principally affect African Americans. Although pain is its principal feature, strokes, lung problems, sepsis, anxiety, depression, impaired social functioning, and maladjustment at work are frequent concomitants. This article selectively reviews biomedical and psychosocial aspects of SCD related to pain assessment, medical treatment, genetic counseling, education, and employment. The strongest support exists for claims of social deficits among adolescents and depression and work-related problems among adults. The social context of SCD, including issues related to socioeconomic status (SES), urbanicity, ethnicity, cultural values, and racial stigmatization, are important to include in empirical assessments and theoretical analyses of the effects of SCD on children and their families. The adverse psychosocial functioning often described as an effect of SCD might indeed be a consequence of these factors acting alone or in concert with the strains of SCD.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67048/2/10.1177_0095798499025003002.pd

    MMTV-Wnt1 and -ΔN89β-Catenin Induce Canonical Signaling in Distinct Progenitors and Differentially Activate Hedgehog Signaling within Mammary Tumors

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    Canonical Wnt/β-catenin signaling regulates stem/progenitor cells and, when perturbed, induces many human cancers. A significant proportion of human breast cancer is associated with loss of secreted Wnt antagonists and mice expressing MMTV-Wnt1 and MMTV-ΔN89β-catenin develop mammary adenocarcinomas. Many studies have assumed these mouse models of breast cancer to be equivalent. Here we show that MMTV-Wnt1 and MMTV-ΔN89β-catenin transgenes induce tumors with different phenotypes. Using axin2/conductin reporter genes we show that MMTV-Wnt1 and MMTV-ΔN89β-catenin activate canonical Wnt signaling within distinct cell-types. ΔN89β-catenin activated signaling within a luminal subpopulation scattered along ducts that exhibited a K18+ER−PR−CD24highCD49flow profile and progenitor properties. In contrast, MMTV-Wnt1 induced canonical signaling in K14+ basal cells with CD24/CD49f profiles characteristic of two distinct stem/progenitor cell-types. MMTV-Wnt1 produced additional profound effects on multiple cell-types that correlated with focal activation of the Hedgehog pathway. We document that large melanocytic nevi are a hitherto unreported hallmark of early hyperplastic Wnt1 glands. These nevi formed along the primary mammary ducts and were associated with Hedgehog pathway activity within a subset of melanocytes and surrounding stroma. Hh pathway activity also occurred within tumor-associated stromal and K14+/p63+ subpopulations in a manner correlated with Wnt1 tumor onset. These data show MMTV-Wnt1 and MMTV-ΔN89β-catenin induce canonical signaling in distinct progenitors and that Hedgehog pathway activation is linked to melanocytic nevi and mammary tumor onset arising from excess Wnt1 ligand. They further suggest that Hedgehog pathway activation maybe a critical component and useful indicator of breast tumors arising from unopposed Wnt1 ligand
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