NASA Scientific and Technical Aerospace Reports

20040111658 Henry Ford Health System, Detroit, MI
Population Based Assessment of MHC Class I Antigens Down Regulation as Markers of Increased Risk for
Development and Progression of Breast Cancer From Benign Breast Lesions
Worsham, Maria J.; Jan. 2004; 54 pp.; In English; Original contains color illustrations
Contract(s)/Grant(s): DAMD17-00-1-0288
Report No.(s): AD-A425768; No Copyright; Avail: CASI; A04, Hardcopy
Despite advances in chemotherapy and radiation therapies, advanced breast cancer still carries a high mortality rate. The
need for effective therapies is urgent. The overall aim of this research proposal is to recognize early markers of disease and
their interaction with other epidemiological risk factors that can serve as risk indicators for subsequent development of breast
cancer from precancerous lesions, and as prognostic markers for progression from primary to metastatic disease. The major
histocompatibility complex (MHC) class I molecules are found on the cell membrane of all cells in the body and are involved
in intercellular communications and in complex interactions with the immune system. Cancer cells with reduced or aberrant
MHC molecules have been shown to evade immune surveillance and become selected for cancer progression and spread of
disease to distant sites of the body. About half of all breast cancers have complete loss of reduced level of MHC class I
molecules and this finding has been associated with increased tumor invasiveness and more aggressive cancers with poorer
outcome. The outlined studies are expected to better define the clinical significance of abnormal MHC class I molecules in
precancerous and invasive breast lesions as markers of immunological events that could affect survival, selection, and
outgrowth of precancerous cells, and their subsequent progression to breast cancer. These MHC losses could also mark more
aggressive tumors and thus contribute to selection of appropriate treatments in individual cases.
DTIC
Antigens; Cancer; Lesions; Mammary Glands; Markers; Populations; Risk
20040111659 George Washington Univ., Washington, DC
TRICARE: Transformation of the Military Health Care System - Demystifying Military Medicine and the Mission
Impossible
Zeliff, Barbara H.; May 23, 2004; 76 pp.; In English
Report No.(s): AD-A425769; No Copyright; Avail: CASI; A05, Hardcopy
The Department of Defense’s military health care system, entitled TRICARE, brings together the direct health care
resources of the Department of Defense and supplements this capability through the use of managed care support services
contracts and purchased care. This blended system is charged with providing a comprehensive health benefit to approximately
8.9 million beneficiaries, including active duty and retired uniformed services members, their families, and survivors, while
also providing medical support to military operations. The defense health program differs in so many ways from other
employer-sponsored health plans that the label itself seems inappropriate at times, as this discretionary budget program
resembles more of an entitlement than a benefit. In the late 1980’s and early 1990’s, faced with escalating health care costs,
a transition to managed care seemed like an understandable and natural response to what was then a national belief that market
forces could improve health care quality and lower costs. The concept of managed competition proliferated as managed care
took hold in the USA and became the cornerstone of many private and public health plans, including the Federal Employee
Health Benefit Plan (FEHBP). FEHBP has received bipartisan recognition as one of the government’s more successful
undertakings and a model for federal health insurance purchasing, as health care reform proposals frequently focus on
expanding the FEHBP. Comparable in size to TRICARE, the FEHBP currently covers nine million active and retired federal
employees and their dependents, and is the nation’s largest employer-sponsored health insurance plan. Not surprisingly, some
have argued the logical result would have been for the military to adopt the FEHBP as their purchased care model.
DTIC
Health; Medical Services; Military Operations
20040111660 General Hospital Corp., Boston, MA
Center for Innovative Minimally Invasive Therapy
Parrish, John A.; Oct. 2003; 149 pp.; In English
Contract(s)/Grant(s): DAMD17-02-2-0006
Report No.(s): AD-A425770; No Copyright; Avail: CASI; A07, Hardcopy
The Center for Integration of Medicine and Innovative Technology (CIMIT), is a consortium of nonprofit Massachusettsbased
institutions led by Massachusetts General Hospital and includes Brigham and Women’s Hospital, Massachusetts
Institute of Technology and Draper Laboratory. The primary aim of the Center is to develop technologies that will advance
the capability of modem medicine to diagnose and treat patients using minimally invasive and less costly approaches. CIMIT
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