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Since 1789, when George Washington became the first president of the United States, forty-three men have held the nation's highest office. Four were killed by assassins, and serious attempts were made on the lives of eight others. Add to that list the names of Martin Luther King, Jr. and Malcolm X, and it is reasonable to conclude that political prominence in the United States entails grave risks. In \"Defining Danger\", James W. Clarke explores the cultural and psychological linkages that define assassinations and a new era of domestic terrorism in America. Clarke notes an upsurge in political violence beginning with the assassination of John F. Kennedy in 1963. Since then, there have been ten assassination attempts on nationally prominent political leaders. That is two more than the eight recorded in the previous 174 years of the nation's presidential history. New elements of domestic terror in American life were introduced in the 1990s by Timothy McVeigh, the \"Oklahoma City Bomber,\" Ted Kaczynski, the \"Unabomber,\" and Eric Rudolph, the abortion clinic bomber. These men were politically motivated; their crimes unprecedented. These events and the perpetrators behind them are the subjects of this book. The volume conveys two central themes. The first is that individual acts of violence directed toward America's democratically elected leaders represent a defining element of American politics. The second addresses how danger is defined, through an analysis of the motives and characteristics of twenty-one perpetrators responsible for these acts of political violence where shots were fired, or bombs detonated, and, in most instances, victims died. The importance and originality of this material have been acknowledged in presentations to and consultations with the U.S. Secret Service and some of the nation's top independent private investigators. It is written in an accessible and engaging style that will appeal to the informed general reader, as well as to professionals in a variety of fields - especially in the wake of recent events and the specter of future violence that, sadly, haunts us all.

Brain metastases from radioresistant histologies are perceived to be less responsive to WBRT compared to other histologies, and stereotactic radiosurgery (SRS) may provide better local control. The aim of this study was to examine the outcomes of patients with 1–4 brain metastasis from radioresistant histologies (renal cell carcinoma and melanoma) treated with SRS alone. Thirty-eight patients with 1–4 radioresistant brain metastases (66 lesions) were treated with SRS alone. The median age was 55 years. Fourteen and 24 patients had renal cell carcinoma (RCC) and melanoma brain metastases, respectively. Distribution of number of lesions was as follows: one lesion, 22 patients; 2 lesions, 8 patients; 3 lesions, 5 patients; and 4 lesions, 3 patients. Distribution of RTOG recursive partitioning analysis (RPA) classes was as follows: II, 37 patients and III, 1 patient. The median marginal dose was 20 Gy. The median follow-up was 6.1 months. The 3-, 6-, 9-, 12-, and 18-month local control (LC) rates were 87.9, 81.4, 67.9, 67.9, and 60.3%, respectively. The corresponding free-from-distant-brain failure (FFDBF) rates were 71.3, 58.1, 49.8, 40.2, and 27.6%. The corresponding progression-free survival (PFS) rates were 55.3, 41.9, 33, 23.3, and 13.3%. RCC histology was associated with better LC ( P  = 0.0055). Although SRS alone could yield reasonable LC in patients with 1–4 radioresistant brain metastases, the risk of distant brain failure was substantial. The approach of routine omission of WBRT outside of a trial setting should be used judiciously.

A 73-year-old female with malignant melanoma metastatic to her left frontal lobe status post-gross total resection of the metastasis, whole brain radiotherapy, and Gamma Knife-based stereotactic radiosurgery for local recurrence presented with an area of increasing enhancement on follow-up magnetic resonance imaging (MRI) and hypermetabolic lesions on 18-fluorodeoxyglucose positron emission tomography/computerized tomography ( 18 FDG PET/CT) of the brain suspicious for tumor recurrence. Surgical resection of the lesion was performed showing radiation necrosis with no evidence of tumor. The patient was alive 1 year after her second craniotomy. This case illustrates that despite being perceived as a radioresistant histology, complete local eradication of melanoma is possible with ablative dose regimens. Prolonged survival is possible in patients with limited metastatic melanoma if local tumor control is achieved.

Recent studies of lynching have focused on structural theories that have been tested with demographic, economic and electoral data without much explanatory success. This article suggests that lynching was largely a reflection of a facilitating subculture of violence within which these atrocities were situationally determined by cultural factors not reported in census and economic tabulations, or election returns. Lynching declined in the twentieth century, in part, as a result of segregation and disfranchisement policies, but mainly because state executioners replaced lynch mobs in carrying out the will of the white majority.

Glioblastoma is the most common malignant primary brain tumor. Despite recent advances, the overall prognosis remains poor with median survivals of approximately 1 year and 5-year survivals of less than 5%. Efforts at risk stratification have identified age and performance status as the most important prognostic features. It is well established that patients treated with postoperative radiation therapy have improved survival and functional capacity compared with unirradiated patients. Recent evidence suggests that the benefit of postoperative radiation persists even within the cohort aged 70 years or over. Some investigators have questioned whether the standard treatment schedule of 60 Gy delivered over a 6-week period is necessary for older patients with limited functional status. Alternative treatment schedules have been devised to reduce the inconvenience and morbidity of standard therapy. This review aims to evaluate the current state of knowledge on alternative radiotherapy schedules for elderly and poor-prognosis patients with glioblastoma.

High-grade gliomas are the most commonly diagnosed malignant brain tumor in adults. Prognosis can be estimated by examining risk factors, including histology, age and performance status. Postoperative radiation therapy is associated with improved survival and standard treatment includes external beam radiotherapy to a dose of 60 Gy in 30-33 fractions. Patients with poor prognostic features have a more limited benefit from radiotherapy. This article reviews the current state of knowledge on risk stratification and analyzes strategies that can be employed to better individualize treatment for poor-prognosis patients.

Sunday, 29 October 1994 was cool, partly cloudy, and almost warm when the sun was out, a pleasant autumn day in Washington. Clusters of sightseers strolled along Pennsylvania Avenue in front of the White House, others sat across the street in Lafayette Square, some of them paying concessionaires to have themselves photographed beside life-size images of President Bill Clinton and his wife. At approximately 2.55 p.m., a man in a long, bulky, tan trench coat stood next to the wrought-iron fence, gazing intently towards the White House. He had been standing there for nearly an hour when two young boys on a field trip ran to a spot near him, pointing excitedly towards a small group of men in dark suits strolling near the north portico of the White House. ‘That looks like Bill Clinton,’ one of them said. ‘Yeah it does,’ replied the other. At that moment, the man near the fence, pushed the boys aside, slipped a semiautomatic assault rifle from beneath his coat, extended its folding stock, and began firing at the person he mistakenly believed was President Clinton. Running back and forth along the fence as he fired, the shooter quickly emptied a clip of thirty rounds at his intended victim as bystanders scattered in panic, one of them leaving unattended an infant in a baby carriage. When he stopped to insert another thirty-round clip, a very courageous tourist, Michael Rokosky, tackled him from behind. As they struggled on the sidewalk, two other courageous bystanders joined Rokosky, subduing the attacker before uniformed Secret Service officers arrived. No one had been injured.Another bystander cooly recorded the whole event on videotape. As he was being handcuffed, Francisco Martin Duran spoke for the first time: ‘I wish you had shot me,’ were his only words. Meanwhile, President Clinton was watching a televised football game on the opposite side of the White House, unaware until he was informed moments later by his Secret Service detail of what had happened.The account is drawn from, White House Security Review Public Report: Francisco Martin Duran, http://www.fas.org/irp/agency/ustreas/usss/t1pubrpt.htm, p. 1. Hereafter cited as White House Security Report Website.

CNS germ cell tumors are rare primary brain malignancies. Germinomas comprise approximately two-thirds of CNS germ cell tumors. Owing to their radiosensitivity, radiotherapy has been used to treat patients with CNS germinomas, with favorable treatment outcomes. Historically, craniospinal irradiation has been used. Given the concerns over long-term toxicities associated with craniospinal irradiation, reduced volume radiotherapy with or without chemotherapy has been employed. Data on the use of different strategies in the treatment of CNS germinomas are emerging but a standard strategy has not been established. This article reviews the different strategies used in the management of CNS germinomas.

The standard treatment for medulloblastoma is surgery followed by adjuvant chemotherapy and external beam radiotherapy to the craniospinal axis and posterior fossa. However, in very young children, craniospinal irradiation has a more significant detrimental effect in terms of neurocognitive function and growth. This article reviews the different strategies used for very young patients with medulloblastoma.

The Man Farthest Down represents an early contribution to the study of comparative social systems. Its treatment of life in the East European shtetls is as moving as the analysis of ghetto life in America. In his new introduction to this edition, Drake illustrates the intellectual camaraderie shared between Park and Washington in their studies of race. Drake also details their individual observations, philosophies, and activities in both their academic and political lives.