A long-lasting, complete hematologic and cytogenetic remission of chronic myelogenous leukemia after treatment with busulfan alone

A 44-year-old man suffering from cytogenetically and molecularly proven Philadelphia translocation-positive chronic myelogenous leukemia in chronic phase was treated with busulfan for 18 months and studied during a follow-up period of 13 years. Hematologically and cytogenetically, he attained a continuing complete remission, although at one point (9.5 years) at least, after attaining complete remission molecular analysis indicated the presence of minimal residual disease

Case management in primary palliative care is associated more strongly with organisational than with patient characteristics: results from a cross-sectional prospective study

Background: Case managers have been introduced in Dutch primary palliative care; these are nurses with expertise in palliative care who offer support to patients and informal carers in addition to the care provided by the general practitioner and home care nurses. This study aims to describe support and investigate what characteristics of patients and the organizational setting are related to the number of contacts and to the number of times topics are discussed between the case manager and patients and/or informal carers. Methods: Prospective study following cancer patients (n = 662) receiving support from a palliative care case manager in Dutch primary care, using registration forms filled out by the case manager after contact with the patient and/or informal carer. In backward linear regression, the association was studied between patient or organizational characteristics and the number of contacts and the number of times conversation topics were discussed. Results: Organizational characteristics add more to explained variability in data than patient characteristics. Case managers provide support in a flexible manner with regard to the number, mode, persons present, and duration of contacts. Support covered all domains of palliative care, with most attention given to physical complaints, life expectancy and psychological aspects. Conclusions: Support offered by the case managers is prompted by characteristics of the organization for which they work. This is contradictory to the idea of patient centered care highly valued in palliative care

Evidence for CO depletion in the inner regions of gas-rich protoplanetary disks

We investigate the physical properties and spatial distribution of Carbon Monoxide (CO) gas in the disks around the Herbig Ae/Be stars HD 97048 and HD 100546. Using high-spectral-resolution 4.588-4.715 $\mu$m spectra containing fundamental CO emission taken with CRIRES on the VLT, we probe the circumstellar gas and model the kinematics of the emission lines. By using spectro-astrometry on the spatially resolved targets, we constrain the physical size of the emitting regions in the disks. We resolve, spectrally and spatially, the emission of the $^{13}$CO v(1-0) vibrational band and the $^{12}$CO $v=1-0, v=2-1, v=3-2$ and $v=4-3$ vibrational bands in both targets, as well as the $^{12}$CO $v=5-4$ band in HD 100546. Modeling of the CO emission with a homogeneous disk in Keplerian motion, yields a best fit with an inner and outer radius of the CO emitting region of 11 and $\geq$ 100 AU for HD 97048. HD 100546 is not fit well with our model, but we derive a lower limit on the inner radius of 8 AU. The fact that gaseous [OI] emission was previously detected in both targets at significantly smaller radii suggests that CO may be effectively destroyed at small radii in the surface layers of these disksComment: v2: Letter format has been changed to Paper format; Change in the focus of the paper towards CO depletion; Major changes in text; Change of title. Submitted to A&A, 14/10/2008. Accepted by A&A, 17/04/200

The anatomy of an unusual edge-on protoplanetary disk: I. Dust settling in a cold disk

Interstellar matter and star formatio

HIV-tuberculosis-associated immune reconstitution inflammatory syndrome is characterized by Toll-like receptor and inflammasome signalling

Patients with HIV-associated tuberculosis (TB) initiating antiretroviral therapy (ART) may develop immune reconstitution inflammatory syndrome (TB-IRIS). No biomarkers for TB-IRIS have been identified and the underlying mechanisms are unclear. Here we perform transcriptomic profiling of the blood samples of patients with HIV-associated TB. We identify differentially abundant transcripts as early as week 0.5 post ART initiation that predict downstream activation of proinflammatory cytokines in patients who progress to TB-IRIS. At the characteristic time of TB-IRIS onset (week 2), the signature is characterized by over-representation of innate immune mediators including TLR signalling and TREM-1 activation of the inflammasome. In keeping with the transcriptional data, concentrations of plasma cytokines and caspase-1/5 are elevated in TB-IRIS. Inhibition of MyD88 adaptor and group 1 caspases reduces secretion of cytokines including IL-1 in TB-IRIS patients. These data provide insight on the pathogenesis of TB-IRIS and may assist the development of specific therapies

High-resolution Br γ spectro-interferometry of the transitional Herbig Ae/Be star HD 100546: a Keplerian gaseous disc inside the inner rim

We present spatially and spectrally resolved Br γ emission around the planet-hosting, transitional Herbig Ae/Be star HD 100546. Aiming to gain insight into the physical origin of the line in possible relation to accretion processes, we carried out Br γ spectro-interferometry using AMBER/VLTI from three different baselines achieving spatial and spectral resolutions of 2–4 mas and 12 000. The Br γ visibility is larger than that of the continuum for all baselines. Differential phases reveal a shift between the photocentre of the Br γ line – displaced ∼0.6 mas (0.06 au at 100 pc) NE from the star – and that of the K-band continuum emission – displaced ∼0.3 mas NE from the star. The photocentres of the redshifted and blueshifted components of the Br γ line are located NW and SE from the photocentre of the peak line emission, respectively. Moreover, the photocentre of the fastest velocity bins within the spectral line tends to be closer to that of the peak emission than the photocentre of the slowest velocity bins. Our results are consistent with a Br γ-emitting region inside the dust inner rim ( ≲ 0.25 au) and extending very close to the central star, with a Keplerian, disc-like structure rotating counter-clockwise, and most probably flared (∼25°). Even though the main contribution to the Br γ line does not come from gas magnetically channelled on to the star, accretion on to HD 100546 could be magnetospheric, implying a mass accretion rate of a few 10−7 M⊙ yr−1. This value indicates that the observed gas has to be replenished on time-scales of a few months to years, perhaps by planet-induced flows from the outer to the inner disc as has been reported for similar systems

Probing protoplanetary disk evolution in the Chamaeleon II region

Context. Characterizing the evolution of protoplanetary disks is necessary to improve our understanding of planet formation. Constraints on both dust and gas are needed to determine the dominant disk dissipation mechanisms. Aims. We aim to compare the disk dust masses in the Chamaeleon II (Cha II) star-forming region with other regions with ages between 1 and 10Myr. Methods. We use ALMA band 6 observations (1.3 mm) to survey 29 protoplanetary disks in Cha II. Dust mass estimates are derived from the continuum data. Results. Out of our initial sample of 29 disks, we detect 22 sources in the continuum, 10 in 12CO, 3 in 13CO, and none in C18O (J=2-1). Additionally, we detect two companion candidates in the continuum and 12CO emission. Most disk dust masses are lower than 10Mearth, assuming thermal emission from optically thin dust. We compare consistent estimations of the distributions of the disk dust mass and the disk-to-stellar mass ratios in Cha II with six other low mass and isolated star-forming regions in the age range of 1-10Myr: Upper Sco, CrA, IC 348, Cha I, Lupus, and Taurus. When comparing the dust-to-stellar mass ratio, we find that the masses of disks in Cha II are statistically different from those in Upper Sco and Taurus, and we confirm that disks in Upper Sco, the oldest region of the sample, are statistically less massive than in all other regions. Performing a second statistical test of the dust mass distributions from similar mass bins, we find no statistical differences between these regions and Cha II. Conclusions. We interpret these trends, most simply, as a sign of decline in the disk dust masses with time or dust evolution. Different global initial conditions in star-forming regions may also play a role, but their impact on the properties of a disk population is difficult to isolate in star-forming regions lacking nearby massive stars.Comment: Accepted for publication in A&