Akt, a Serine/Threonine protein kinase, mediates growth factor^associated cell survival. Constitutive activation of Akt (phosphorylated Akt, P-Akt) has been observed in several human cancers, including lung cancer and may be associated with poor prognosis and chemotherapy and radiotherapy resistance. The clinical relevance of P-Akt in non^small cell lung cancer (NSCLC) is not well described. In the present study, we examined 82 surgically resected snapfrozen and paraffin-embedded stage I to IIIA NSCLC samples for P-Akt and Akt by Western blotting and for P-Akt by immunohistochemistry. P-Akt protein levels above the median, measured using reproducible semiquantitative band densitometry, correlated with a favorable outcome (P = 0.007). Multivariate analysis identified P-Akt as a significant independent favorable prognostic factor (P = 0.004). Although associated with a favorable prognosis, high P-Akt levels correlated with high tumor grade (P = 0.02). Adenocarcinomas were associated with low P-Akt levels (P = 0.039). Akt was not associated with either outcome or clinicopathologic variables. Cytoplasmic (CP-Akt) and nuclear (NP-Akt) P-Akt tumor cell staining was detected in 96% and 42% of cases, respectively. Both CP-Akt and NP-Akt correlated with well-differentiated tumors (P = 0.008 and 0.017, respectively). NP-Akt also correlated with nodal metastases (P = 0.022) and squamous histology (P = 0.037). These results suggest P-Akt expression is a favorable prognostic factor in NSCLC. Immunolocalization of P-Akt, however, may be relevant as NP-Akt was associated with nodal metastases, a known poor prognostic feature in this disease. P-Akt may be a potential novel therapeutic target for the management of NSCLC.

No abstract

No abstract

A single food allergy education session targeting school nurses increased the availability of epinephrine to children with food allergies, and this effect was sustained over 2 years. This study details a feasible model to increase the nationwide school availability of this lifesaving treatment. TO THE EDITOR:Food allergy is a serious disease that affects 5% of US children. 1 Approximately 18% to 23% of children with food allergies experience reactions in the school setting, which accounts for 28% of anaphylaxis fatalities. 2,3 One critical risk factor of death from anaphylaxis is delay in epinephrine administration. 4