Medicine and Health Sciences Commons^™

New Findings, Classification And Long-Term Follow-Up Study Based On Mri Characterization Of Brainstem Encephalitis Induced By Enterovirus 71, Hongwu Zeng, Feiqiu Wen, Wenxian Huang, Yungen Gan, Weibin Zeng, Ranran Chen, Yanxia He, Yonker Wang, Zaiyi Liu, Changhong Liang, Kelvin K. L. Wong

Radiology Faculty Publications

Background To report the diversity of MRI features of brainstem encephalitis (BE) induced by Enterovirus 71. This is supported by implementation and testing of our new classification scheme in order to improve the diagnostic level on this specific disease.

Methods Neuroimaging of 91 pediatric patients who got EV71 related BE were hospitalized between March, 2010 to October, 2012, were analyzed retrospectively. All patients underwent pre- and post-contrast MRI scan. Thereafter, 31 patients were randomly called back for follow-up MRI study during December 2013 to August 2014. The MRI signal patterns of BE primary lesion were analyzed and classified according to …

P70s6k1 (S6k1)-Mediated Phosphorylation Regulates Phosphatidylinositol 4-Phosphate 5-Kinase Type I Γ Degradation And Cell Invasion, Naser Jafari, Qiaodan Zheng, Liqing Li, Wei Li, Lei Qi, Jianyong Xiao, Tianyan Gao, Cai Huang

Markey Cancer Center Faculty Publications

Phosphatidylinositol 4-phosphate 5-kinase type I γ (PIPKIγ90) ubiquitination and subsequent degradation regulate focal adhesion assembly, cell migration, and invasion. However, it is unknown how upstream signals control PIPKIγ90 ubiquitination or degradation. Here we show that p70S6K1 (S6K1), a downstream target of mechanistic target of rapamycin (mTOR), phosphorylates PIPKIγ90 at Thr-553 and Ser-555 and that S6K1-mediated PIPKIγ90 phosphorylation is essential for cell migration and invasion. Moreover, PIPKIγ90 phosphorylation is required for the development of focal adhesions and invadopodia, key machineries for cell migration and invasion. Surprisingly, substitution of Thr-553 and Ser-555 …

Age-Related Effect Of Viral-Induced Wheezing In Severe Prematurity, Geovanny F. Perez, Amisha Jain, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E. Rodriguez-Martinez, Mary C. Rose, Dinesh Pillai, Gustavo Nino

Pediatrics Faculty Publications

Abstract: Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (> 37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (< 32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the …

Plant Expression Of Cocaine Hydrolase-Fc Fusion Protein For Treatment Of Cocaine Abuse, Guojun Wang, Ting Zhang, Haifeng Huang, Shurong Hou, Xiabin Chen, Fang Zheng, Chang-Guo Zhan

Molecular Modeling and Biopharmaceutical Center Faculty Publications

BACKGROUND: A recently reported cocaine hydrolase (CocH3) fused with fragment crystallizable (Fc) region of human immunoglobulin G1, denoted as CocH3-Fc, is known as a promising therapeutic candidate for the treatment of cocaine overdose and addiction. A challenge for practical therapeutic use of this enzyme exists in the large-scale protein production and, therefore, it is interesting to identify a low-cost and feasible, sustainable source of CocH3-Fc production.

RESULTS: CocH3-Fc was transiently expressed in plant Nicotiana benthamiana leaves. The plant-expressed protein, denoted as pCocH3-Fc, was as active as that expressed in mammalian cells both in vitro and in vivo. However, compared to …

Pleckstrin Homology (Ph) Domain Leucine-Rich Repeat Protein Phosphatase Controls Cell Polarity By Negatively Regulating The Activity Of Atypical Protein Kinase C, Xiaopeng Xiong, Xin Li, Yang-An Wen, Tianyan Gao

Markey Cancer Center Faculty Publications

The proper establishment of epithelial polarity allows cells to sense and respond to signals that arise from the microenvironment in a spatiotemporally controlled manner. Atypical PKCs (aPKCs) are implicated as key regulators of epithelial polarity. However, the molecular mechanism underlying the negative regulation of aPKCs remains largely unknown. In this study, we demonstrated that PH domain leucine-rich repeat protein phosphatase (PHLPP), a novel family of Ser/Thr protein phosphatases, plays an important role in regulating epithelial polarity by controlling the phosphorylation of both aPKC isoforms. Altered expression of PHLPP1 or PHLPP2 disrupted polarization of Caco2 cells grown in 3D cell cultures …

Compact Heat Exchanger For Veno-Venous Perfusion-Induced Systemic Hyperthermia Systems, Dongfang Wang, Joseph B. Zwischenberger

Surgery Faculty Patents

A compact heat exchanger for vena-venous perfusion-induced hyperthermia includes an integral pneumatic pump and a hollow tubule heat exchange array. A vena-venous perfusion-induced hyperthermia system incorporating the compact heat exchanger is described. The heat exchanger provides a compact, efficient design allowing a lesser heat exchanging surface area and lesser required pumping power compared to conventional systems. In turn, the system provides a shorter blood circuit compared to conventional systems, allowing maintaining a lower blood temperature than such conventional systems while supplying sufficiently heated blood to patient visceral organs to provide a therapeutic effect, such as in supplementing chemotherapy drugs.

Comparing Performance Of Non-Tree-Based And Tree-Based Association Mapping Methods, Katherine L. Thompson, David W. Fardo

Statistics Faculty Publications

A central goal in the biomedical and biological sciences is to link variation in quantitative traits to locations along the genome (single nucleotide polymorphisms). Sequencing technology has rapidly advanced in recent decades, along with the statistical methodology to analyze genetic data. Two classes of association mapping methods exist: those that account for the evolutionary relatedness among individuals, and those that ignore the evolutionary relationships among individuals. While the former methods more fully use implicit information in the data, the latter methods are more flexible in the types of data they can handle. This study presents a comparison of the 2 …

5-Fluorouracil Upregulates Cell Surface B7-H1 (Pd-L1) Expression In Gastrointestinal Cancers, Lauren Van Der Kraak, Gaurav Goel, Krishnaveni Ramanan, Christof Kaltenmeier, Lin Zhang, Daniel P. Normolle, Gordon J. Freeman, Daolin Tang, Katie S. Nason, Jon M. Davison, James D. Luketich, Rajeev Dhupar, Michael T. Lotze

Markey Cancer Center Faculty Publications

Background: Resistance to chemotherapy is a major obstacle in the effective treatment of cancer patients. B7-homolog 1, also known as programmed death ligand-1 (PD-L1), is an immunoregulatory protein that is overexpressed in several human cancers. Interaction of B7-H1 with programmed death 1 (PD-1) prevents T-cell activation and proliferation, sequestering the T-cell receptor from the cell membrane, inducing T-cell apoptosis, thereby leading to cancer immunoresistance. B7-H1 upregulation contributes to chemoresistance in several types of cancer, but little is known with respect to changes associated with 5-fluorouracil (5-FU) or gastrointestinal cancers.

Methods: HCT 116 p53^+/+, HCT 116 p53^−/− colorectal …

Structures Of Mithramycin Analogues Bound To Dna And Implications For Targeting Transcription Factor Fli1, Caixia Hou, Stevi Weidenbach, Kristin E. Cano, Zhonghua Wang, Prithiba Mitra, Dmitri N. Ivanov, Jürgen Rohr, Oleg V. Tsodikov

Pharmaceutical Sciences Faculty Publications

Transcription factors have been considered undruggable, but this paradigm has been recently challenged. DNA binding natural product mithramycin (MTM) is a potent antagonist of oncogenic transcription factor EWS–FLI1. Structural details of MTM recognition of DNA, including the FLI1 binding sequence GGA(A/T), are needed to understand how MTM interferes with EWS–FLI1. We report a crystal structure of an MTM analogue MTM SA–Trp bound to a DNA oligomer containing a site GGCC, and two structures of a novel analogue MTM SA–Phe in complex with DNA. MTM SA–Phe is bound to sites AGGG and GGGT on one DNA, and to AGGG and GGGA(T) …

Spyb, A Small Heme-Binding Protein, Affects The Composition Of The Cell Wall In Streptococcus Pyogenes, Rebecca J. Edgar, Jing Chen, Sashi Kant, Elena Rechkina, Jeffrey S. Rush, Lennart S. Forsberg, Bernhard Jaehrig, Parastoo Azadi, Veronika Tchesnokova, Evgeni V. Sokurenko, Haining Zhu, Konstantin V. Korotkov, Vijay Pancholi, Natalia Korotkova

Molecular and Cellular Biochemistry Faculty Publications

Streptococcus pyogenes (Group A Streptococcus or GAS) is a hemolytic human pathogen associated with a wide variety of infections ranging from minor skin and throat infections to life-threatening invasive diseases. The cell wall of GAS consists of peptidoglycan sacculus decorated with a carbohydrate comprising a polyrhamnose backbone with immunodominant N-acetylglucosamine side-chains. All GAS genomes contain the spyBA operon, which encodes a 35-amino-acid membrane protein SpyB, and a membrane-bound C3-like ADP-ribosyltransferase SpyA. In this study, we addressed the function of SpyB in GAS. Phenotypic analysis of a spyB deletion mutant revealed increased bacterial aggregation, and reduced sensitivity to β-lactams of the …

Do Scapular Kinematics Alter During The Performance Of The Scapular Assistance Test And Scapular Retraction Test: A Pilot Study, W. Ben Kibler, Thomas J. Cunningham, Natalie L. Myers, Timothy L. Uhl

Physical Therapy Faculty Publications

Objective: To describe to what degree and in what plane biomechanical alterations occur during the performance of the Scapular Retraction test (SRT) and Scapular Assistance Test (SAT).

Design: Laboratory Pilot Study

Participants: Eight symptomatic and 7 asymptomatic subjects were instrumented with electromagnetic sensors.

Main Outcome Measures: The SRT and SAT were performed with the scapula stabilized and unstabilized. The scapular kinematic variables of posterior tilt, internal rotation, upward rotation, protraction, and elevation were measured during both tests.

Results: Descriptive analysis of scapular kinematics suggested that posterior tilt was primarily increased during both clinical tests in both groups. Both groups decreased …

Methods For Diagnosing And Treating Alzheimer's Disease (Ad) Using The Molecules That Stabilize Intracellular Calcium (Ca2+) Release, Philip W. Landfield, John C. Gant, Eric M. Blalock, Kuey-Chu Chen, Olivier Thibault, Nada M. Porter

Pharmacology and Nutritional Sciences Faculty Patents

The subject technology relates, in part, to a method of treating Alzheimer's Disease (AD), early-stage AD, elevated risk of AD, mild cognitive impairment (MCI), or other forms of age-related cognitive decline in a subject in need thereof by administering to the subject a molecule that promotes calcium-release stabilization in ryanodine receptors (RyRs) and/or inosital triphosphate receptors (InsP3Rs) in brain cells. Diagnostic methods using calcium-release stabilizing immunophilins, junctophilins or calmodulin are also disclosed.

Methods Of Inhibiting Alu Rna And Therapeutic Uses Thereof, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Patents

The presently-disclosed subject matter includes methods of identifying an Alu RNA inhibitor, and methods and compositions for inhibiting Alu RNA. Methods and compositions can be used for the treatment of geographic atrophy and other conditions of interest.

Social Determinants Of Health, Center For Business And Economic Research, Gatton College Of Business And Economics, University Of Kentucky

CBER Infographic Posters

What is health? How do we measure the health of a society? Is it merely the clinical outputs of each individual patient or are these numbers impacted by environmental and social factors such as access to healthcare facilities? The answer is yes. Research surrounding health and social services shows a correlation between health outcomes and the environment, calling this junction the Social Determinants of Health (Bradley, et al., 2011; Bradley, et al., 2016; Woolf, et al., 2015). This includes a combination of factors that impact the health of an individual such as: access to food, income, education, physical activity, and …

Sphingosine 1-Phosphate Activation Of Egfr As A Novel Target For Meningitic Escherichia Coli Penetration Of The Blood-Brain Barrier, Xiangru Wang, Ravi Maruvada, Andrew J. Morris, Jun O. Liu, Michael J. Wolfgang, Dong Jae Baek, Robert Bittman, Kwang Sik Kim

Internal Medicine Faculty Publications

Central nervous system (CNS) infection continues to be an important cause of mortality and morbidity, necessitating new approaches for investigating its pathogenesis, prevention and therapy. Escherichia coli is the most common Gram-negative bacillary organism causing meningitis, which develops following penetration of the blood–brain barrier (BBB). By chemical library screening, we identified epidermal growth factor receptor (EGFR) as a contributor to E. coli invasion of the BBB in vitro. Here, we obtained the direct evidence that CNS-infecting E. coli exploited sphingosine 1-phosphate (S1P) for EGFR activation in penetration of the BBB in vitro and in vivo. We …

Using Electronic Health Record Data To Improve Community Health Assessment, Brian E. Dixon, Jian "Frank" Zou, Karen F. Comer, Marc Rosenman, Jennifer L. Craig, P Gibson

Frontiers in Public Health Services and Systems Research

Background: Community health assessments assist health departments in identifying health needs as well as disparities, and they enable linking of needs with available interventions. Electronic health record (EHR) systems possess growing volumes of clinical and administrative data, making them a valuable source of data for ongoing community health assessment.

Purpose: To produce population health indicators using data from EHR systems that could be combined and visually displayed alongside social determinants data, and to provide data sets at geographic levels smaller than a county.

Methods: Data from multiple EHR systems used by major health systems covering >90% of the population in …

A Conceptual Framework For The Study Of Hospital Interaction And Investment In Public Health Systems, Danielle M. Varda, Lisa Vanraemdonck, Gregory Tung, Rachel A. Hogg, Adam Atherly

Frontiers in Public Health Services and Systems Research

Background: Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) and IRS requirements that nonprofit hospitals conduct community health needs assessments and develop implementation plans to guide greater investment in their respective communities. This has led to questions of which factors influence hospital interaction and investment in PH systems.

Purpose: This paper presents a comprehensive framework, informed by a literature review and expert panel that introduces hypothesized factors related to these outcomes.

Methods: To develop a conceptual framework that identifies hypothesized indicators of increased hospital interaction and investment in PH systems, we …

Visualizing Complex Adaptive Systems: A Case Study Of The Missouri Maternal, Infant, And Early Childhood Home Visiting Program, Julie M. Kapp, Sara Schlemper, Riyad Haq, Sofia Campos Vidal Pires, Eduardo J. Simoes

Frontiers in Public Health Services and Systems Research

Background: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program was created by the 2010 Patient Protection and Affordable Care Act. MIECHV provides comprehensive services to at-risk families through evidence-based home visiting programs.

Purpose: The following question is addressed: Does the Missouri MIECHV system meet the definition of a complex adaptive system (CAS)?

Methods: A systematic review was conducted of documents related to MIECHV programs (federal, state, and local levels), and to affiliated programs with a home visiting and early childhood (aged birth to 5 years) scope. The organizations’ fit was identified for the scope of early childhood home …

Rna-Seq Of Borrelia Burgdorferi In Multiple Phases Of Growth Reveals Insights Into The Dynamics Of Gene Expression, Transcriptome Architecture, And Noncoding Rnas, William K. Arnold, Christina R. Savage, Catherine A. Brissette, Janakiram Seshu, Jonathan Livny, Brian Stevenson

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Borrelia burgdorferi, the agent of Lyme disease, differentially expresses numerous genes and proteins as it cycles between mammalian hosts and tick vectors. Insights on regulatory mechanisms have been provided by earlier studies that examined B. burgdorferi gene expression patterns during cultivation. However, prior studies examined bacteria at only a single time point of cultivation, providing only a snapshot of what is likely a dynamic transcriptional program driving B. burgdorferi adaptations to changes during culture growth phases. To address that concern, we performed RNA sequencing (RNA-Seq) analysis of B. burgdorferi cultures at early-exponential, mid-exponential, and early-stationary phases …

Defining And Targeting Health Disparities In Chronic Obstructive Pulmonary Disease, Roy A. Pleasants, Isaretta L. Riley, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

The global burden of chronic obstructive pulmonary disease (COPD) continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES) due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF) exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and …

Tgf-Β Signaling: New Insights Into Aortic Aneurysms, Sean E. Thatcher

Pharmacology and Nutritional Sciences Faculty Publications

No abstract provided.

The Utility Of Perioperative Transesophageal Echocardiography After Left Ventricular Assist Device Implant: A Case Report, Andrew Parks, Bennet George, Alexis Shafii, Mikel Smith, Maya Guglin

The VAD Journal

Immediate post-operative evaluation of patients who have received a left ventricular assist device (LVAD) can be a daunting task. We present a case of a 51-year-old female who developed ventricular tachycardia soon after returning from the operating theatre and describe the role transesophageal echocardiogram played in helping prompt urgent and definitive treatment.

Adverse Events In Continuous-Flow Lvad Recipients: Gastrointestinal Bleeding Is Still Notable?, Marija Petrovic, Sriram Nathan, Rajko Radovancevic, Indranee Rajapreyar, Kevin J. Dasher, Mehmet H. Akay, Bindu Akkanti, Pranav Loyalka, Biswajit Kar, Igor D. Gregoric

The VAD Journal

Background: The etiology and risk factors associated with gastrointestinal bleeding (GIB) in patients with continuous-flow left ventricular assist devices (CF-LVADs) are currently unknown. Therefore, we sought to assess the risk factors for GIB in these patients.

Design and Methods: This was a retrospective, non-randomized, non-controlled study at a single center. Between 2012 and 2014, 65 men and 6 women (mean age = 55 ± 12 years) underwent CF-LVAD implantation at our institution. Overall, 23.9% of patients (17/71) had at least one GIB episode. Endoscopy confirmed GIB in 13/17. Arteriovenous malformation was the major GIB source in 8/13 (61%). …

Fever Of Unknown Origin In Patient After Left Ventricular Assist Device Implantation, Eugenia Raichlin, Sara Varnado, John Y. Um, Michael J. Moulton, Ronald Zolty Dr

The VAD Journal

Mechanical circulatory support (MCS) is a lifesaving procedure in patients with refractory cardiogenic shock. Despite improvement in surgical techniques, ICU care and restored hemodynamics, some patients on MCS remain severely debilitated due to multiple medical problems, including infections, respiratory failure, de-conditioning and nutritional deficits.

Here we present a case of a patient with persistent high degree fever, devastating muscle weakness, and elevated lactate dehydrogenase (LDH) level, who dramatically responded to treatment with vitamin B 12.

Epigenetics Of Lipid Phenotypes, Sergi Sayols-Baixeras, Marguerite R. Irvin, Donna K. Arnett, Roberto Elosua, Stella W. Aslibekyan

Epidemiology and Environmental Health Faculty Publications

Dyslipidemia is a well-established risk factor for cardiovascular disease, the main cause of death worldwide. Blood lipid profiles are patterned by both genetic and environmental factors. In recent years, epigenetics has emerged as a paradigm that unifies these influences. In this review, we have summarized the latest evidence implicating epigenetic mechanisms—DNA methylation, histone modification, and regulation by RNAs—in lipid homeostasis. Key findings have emerged in a number of novel epigenetic loci located in biologically plausible genes (eg, CPT1A, ABCG1, SREBF1, and others), as well as microRNA-33a/b. Evidence from animal and cell culture models suggests a complex interplay …

Applying Community-Based Participatory Research Partnership Principles To Public Health Practice-Based Research Networks, Nancy L. Winterbauer, Betty Bekemeier, Lisa Vanraemdonck, Anna Goodman Hoover

Preventive Medicine and Environmental Health Faculty Publications

With real-world relevance and translatability as important goals, applied methodological approaches have arisen along the participatory continuum that value context and empower stakeholders to partner actively with academics throughout the research process. Community-based participatory research (CBPR) provides the gold standard for equitable, partnered research in traditional communities. Practice-based research networks (PBRNs) also have developed, coalescing communities of practice and of academics to identify, study, and answer practice-relevant questions. To optimize PBRN potential for expanding scientific knowledge, while bridging divides across knowledge production, dissemination, and implementation, we elucidate how PBRN partnerships can be strengthened by applying CBPR principles to build and …

Physicochemical Properties Of Engineered Nanomaterials That Influence Their Nervous System Distribution And Effects, Robert A. Yokel

Pharmaceutical Sciences Faculty Publications

This critical review examines in vitro and in vivo evidence for the influence of engineered nanomaterial (ENM) physicochemical properties on their distribution into, and effects on, the nervous system. Nervous system applications of ENMs; exposure routes and potential for uptake; the nervous system and its barriers to ENM uptake; and the mechanisms of uptake into the nervous system and overcoming those barriers are summarized. The findings of English-language publications of studies that included at least two variations of an ENM physicochemical property and reported results of their pharmacokinetic and/or pharmacodynamic interaction with the nervous system that differed as a function …

An Arginine Finger Regulates The Sequential Action Of Asymmetrical Hexameric Atpase In The Double-Stranded Dna Translocation Motor, Zhengyi Zhao, Gian Marco De-Donatis, Chad T. Schwartz, Huaming Fang, Jingyuan Li, Peixuan Guo

Pharmaceutical Sciences Faculty Publications

Biological motors are ubiquitous in living systems. Currently, how the motor components coordinate the unidirectional motion is elusive in most cases. Here, we report that the sequential action of the ATPase ring in the DNA packaging motor of bacteriophage ϕ29 is regulated by an arginine finger that extends from one ATPase subunit to the adjacent unit to promote noncovalent dimer formation. Mutation of the arginine finger resulted in the interruption of ATPase oligomerization, ATP binding/hydrolysis, and DNA translocation. Dimer formation reappeared when arginine mutants were mixed with other ATPase subunits that can offer the arginine to promote their interaction. Ultracentrifugation …

Improving A Dental School's Clinic Operations Using Lean Process Improvement, Fonda G. Robinson, Larry L. Cunningham, Sharon P. Turner, John E. Lindroth, Deborah Ray, Talib Khan, Audrey Yates

Oral Health Practice Faculty Publications

The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to …

Using Low-Dose Radiation To Potentiate The Effect Of Induction Chemotherapy In Head And Neck Cancer: Results Of A Prospective Phase 2 Trial, Susanne M. Arnold, Mahesh Kudrimoti, Emily V. Dressler, John F. Gleason, Natalie L. Silver, William F. Regine, Joseph Valentino

Internal Medicine Faculty Publications

Purpose: Low-dose fractionated radiation therapy (LDFRT) induces effective cell killing through hyperradiation sensitivity and potentiates effects of chemotherapy. We report our second investigation of LDFRT as a potentiator of the chemotherapeutic effect of induction carboplatin and paclitaxel in locally advanced squamous cell cancer of the head and neck (SCCHN).

Experimental Design: Two cycles of induction therapy were given every 21 days: paclitaxel (75 mg/m²) on days 1, 8, and 15; carboplatin (area under the curve 6) day 1; and LDFRT 50 cGy fractions (2 each on days 1, 2, 8, and 15). Objectives included primary site complete response …