Research Topics
Species | Roger PackerSummaryAffiliation: Children's National Medical Center Country: USA Publications
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Publications
Medulloblastoma and primitive neuroectodermal tumorsRoger J Packer
The George Washington University, Washington, DC, USA
Handb Clin Neurol 105:529-48. 2012..For further improvements,the recent impressive discoveries concerning molecular mechanisms of embryonal tumor origin, development,and growth will need to be translated into molecularly based, risk-adapted therapy...
Center for Neuroscience and Behavioral Medicine: an innovative administrative structure and possible paradigm for the futureRoger J Packer
Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, Washington, DC 20010, USA
Pediatr Neurol 44:1-9. 2011..The strengths, limitations, and challenges of this structure in terms of child neurology are reviewed. This administrative structure has been successful and may act as a model for other programs...
Medulloblastoma: present concepts of stratification into risk groupsRoger J Packer
Department of Neurology, Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, Washington, DC 20010, USA
Pediatr Neurosurg 39:60-7. 2003..Biologic markers, especially molecular genetic findings, have not yet been incorporated into risk classifications, but will likely add to the understanding of medulloblastoma and may significantly alter concepts of staging and treatment...
Long-term neurologic and neurosensory sequelae in adult survivors of a childhood brain tumor: childhood cancer survivor studyRoger J Packer
Department of Neurology, Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, Washington, DC, USA
J Clin Oncol 21:3255-61. 2003..To describe the neurologic and neurosensory deficits in children with brain tumors (BTs), compare incidence of these deficits with that of a sibling control group, and evaluate the factors associated with the development of these deficits...
Proceedings of the conference on the effects of radiotherapy on the brain and on behavior through the life spanRoger J Packer
Center for Neuroscience and Behavioral Medicine, Department of Neurology, Children's National Medical Center, Washington, DC 20010-2916, USA
Med Pediatr Oncol 41:448-9. 2003
Progress and challenges in childhood brain tumorsRoger J Packer
Center for Neuroscience and Behavioral Medicine, USA
J Neurooncol 75:239-42. 2005....
New insights into childhood ependymomasRoger J Packer
Division of Neurology, Children s National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA
Curr Neurol Neurosci Rep 5:107-9. 2005..Relapse-free survival rates vary significantly in contemporary series, and therapeutic approaches remain unsettled...
Phase 1 study of concurrent RMP-7 and carboplatin with radiotherapy for children with newly diagnosed brainstem gliomasRoger J Packer
Division of Neurology, Children s National Medical Center, Washington, DC 20010, USA
Cancer 104:1281-7. 2005..The goal of the current Phase I study was to determine the toxicity and feasibility of delivering RMP-7 and carboplatin for 5 successive days during radiotherapy...
A Phase I study of concurrent RMP-7 and carboplatin with radiation therapy for children with newly diagnosed brainstem gliomasRoger J Packer
Center for Neuroscience and Behavioral Medicine, Division of Neurology, Children s National Medical Center, Washington, DC 20010, USA
Cancer 104:1968-74. 2005..The objective of this Phase I study was to determine the toxicity and feasibility of delivering RMP-7 and carboplatin for 5 successive days during radiotherapy to children with newly diagnosed, diffuse, intrinsic brainstem gliomas...
Management of and prognosis with medulloblastoma: therapy at a crossroadsRoger J Packer
Division of Neurology, Children s National Medical Center, Washington, DC 20010, USA
Arch Neurol 65:1419-24. 2008..However, these biological advances have yet to be integrated into the treatment of medulloblastoma in children or adults...
Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastomaRoger J Packer
Division of Neurology, Children s National Medical Center, Washington, DC 20010, USA
J Clin Oncol 24:4202-8. 2006..To determine the event-free survival (EFS) and overall survival of children with average-risk medulloblastoma and treated with reduced-dose craniospinal radiotherapy (CSRT) and one of two postradiotherapy chemotherapies...
Central nervous system tumorsRoger J Packer
Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, Washington, DC 20010, USA
Pediatr Clin North Am 55:121-45, xi. 2008..Symptoms and signs depend on the growth rate of the tumor, its location in the central nervous system (CNS), and the age of the child. This article describes the presentation, diagnosis and management of these tumors...
Childhood brain tumors: accomplishments and ongoing challengesRoger J Packer
Division of Child Neurology, Center of Excellence for Neuroscience and Behavioral Medicine, Children s National Medical Center, Washington, DC 20010, USA
J Child Neurol 23:1122-7. 2008..Because of advances in our understanding of the biology underlying childhood brain tumors, treatments may change dramatically in the years ahead. Accordingly, survival rates may improve and long-term sequelae lessen...
Objective response of multiply recurrent low-grade gliomas to bevacizumab and irinotecanRoger J Packer
Division of Neurology, Children s National Medical Center, Washington, District of Columbia 20010, USA
Pediatr Blood Cancer 52:791-5. 2009..Bevacizumab, a humanized immunoglobulin, monoclonal antibody that inhibits the activity of vascular endothelial growth factor and irinotecan have been used with some success in adults with malignant gliomas...
Gene expression profiling to analyze embryonal tumors of the central nervous systemRoger J Packer
Department of Neurology, Children's National Medical Center, Washington, DC 20010, USA
Curr Neurol Neurosci Rep 3:117-9. 2003
Alternative treatments for childhood brain tumorsR J Packer
Department of Neurology, Children s National Medical Center, 111 Michigan Avenue N W, Washington, DC 20010, USA
Childs Nerv Syst 15:789-94. 1999..Such innovative treatments will be more widely employed in the years ahead and may improve outcome for children with brain tumors...
Treatment of progressive or recurrent pediatric malignant supratentorial brain tumors with herpes simplex virus thymidine kinase gene vector-producer cells followed by intravenous ganciclovir administrationR J Packer
Department of Neurology, Children s National Medical Center, Washington, DC 20010, USA
J Neurosurg 92:249-54. 2000..The goal of this Phase I study was to evaluate the safety of in vivo suicide gene therapy in 12 children with recurrent, malignant, supratentorial brain tumors...
Plexiform neurofibromas in NF1: toward biologic-based therapyR J Packer
Department of Neurology, Children s National Medical Center, George Washington University, Washington, DC 20010, USA
Neurology 58:1461-70. 2002..The ability to design more rational therapies for NF1-associated neurofibromas is heavily predicated on an improved understanding of the molecular and cellular biology of the cells involved in neurofibroma formation and growth...
Atypical teratoid/rhabdoid tumor of the central nervous system: report on workshopRoger J Packer
Department of Neurology, Children s National Medical Center, The George Washington University Medical Center, Washington, DC 20010, USA
J Pediatr Hematol Oncol 24:337-42. 2002..Therapeutic approached have included surgery, chemotherapy, and radiotherapy. Prospective clinical trials are needed for children with AT/RTs...
Intracranial germ cell tumorsR J Packer
Department of Neurology, Children s National Medical Center Cleveland Clinic Foundation, Cleveland, Ohio, USA
Oncologist 5:312-20. 2000..Radiation therapy alone will result in disease control in 40%-60% of patients. The addition of chemotherapy to radiation therapy may improve the rate of survival...
Treatment of children with medulloblastomas with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: A Children's Cancer Group StudyR J Packer
Departments of Neurology and Radiology, Children s National Medical Center, Washington, DC, USA
J Clin Oncol 17:2127-36. 1999..This study was undertaken to determine the feasibility and efficacy of treating children with nondisseminated medulloblastoma with reduced-dose craniospinal radiotherapy plus adjuvant chemotherapy...
Therapy for plexiform neurofibromas in children with neurofibromatosis 1: an overviewRoger J Packer
Department of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, The George Washington University, Washington, DC 20010, USA
J Child Neurol 17:638-41; discussion 646-51. 2002..The use of innovative neuroimaging techniques and other outcome measures may greatly improve the design of trials and evaluation of potential effective agents...
Chemotherapy: low-grade gliomas of the hypothalamus and thalamusR J Packer
Center for Neuroscience and Behavioral Medicine, Department of Neurology, Children s National Medical Center, Washington, DC, USA
Pediatr Neurosurg 32:259-63. 2000..The erratic natural history of diencephalic tumors confounds evaluation of efficacy of the regimen chosen...
Feasibility of metronomic maintenance chemotherapy following high-dose chemotherapy for malignant central nervous system tumorsL Mi Rim Choi
Division of Hematology and Oncology, Children s National Medical Center, Washington, District of Columbia, USA
Pediatr Blood Cancer 50:970-5. 2008..Metronomic chemotherapy has also been reported as a potential new treatment strategy in solid tumors, particularly in adults...
Outcome for children <4 years of age with malignant central nervous system tumors treated with high-dose chemotherapy and autologous stem cell rescueHalldora K Thorarinsdottir
Division of Hematology and Oncology, Children s National Medical Center, Washington, District of Columbia, USA
Pediatr Blood Cancer 48:278-84. 2007....
Phase II study of high-dose chemotherapy before radiation in children with newly diagnosed high-grade astrocytoma: final analysis of Children's Cancer Group Study 9933Tobey J Macdonald
Department of Hematology Oncology, Children s National Medical Center, Washington, DC 20010, USA
Cancer 104:2862-71. 2005..High-grade astrocytomas (HGA) carry a dismal prognosis and compose nearly 20% of all childhood brain tumors. The role of high-dose chemotherapy (HDCT) in the treatment of HGA remains unclear...
Proteomic profiling of cerebrospinal fluid identifies prostaglandin D2 synthase as a putative biomarker for pediatric medulloblastoma: A pediatric brain tumor consortium studyMeena U Rajagopal
Center for Genetic Medicine, Children s National Medical Center, Washington, DC, USA
Proteomics 11:935-43. 2011..In addition, our results demonstrate the feasibility of performing proteomic studies on CSF samples collected from patients at multiple institutions within the consortium setting...
Medulloblastoma in childhood: new biological advancesJohn R Crawford
Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, Washington DC 20010, USA
Lancet Neurol 6:1073-85. 2007..Greater understanding of the molecular biology of medulloblastoma is needed so that more children can be cured or have an improved quality of life...
Neurotoxicity of chemotherapeutic and biologic agents in children with cancerKevin C De Braganca
Division of Neurology, Children s National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA
Curr Neurol Neurosci Rep 8:114-22. 2008..The earlier recognition of these neurotoxicities could possibly alter the course of a treatment or facilitate interventions to improve quality of life...
Cerebrovascular abnormalities in a population of children with neurofibromatosis type 1Tena L Rosser
Department of Neurology, Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, The George Washington University, 111 Michigan Avenue NW, Washington, DC 20010, USA
Neurology 64:553-5. 2005..Of 316 patients with NF1 who underwent brain MRI, 8 (2.5%) children were reported to have an abnormality of the cerebrovascular system, including narrowed or ectatic vessels, vascular stenoses, aneurysm, and moyamoya...
Current treatment of medulloblastoma: recent advances and future challengesBrian R Rood
Division of Hematology Oncology, Center for Cancer Research, Children s National Medical Center, Washington, DC 20010, USA
Semin Oncol 31:666-75. 2004..Treatment for this disease has evolved a great deal over the preceding decades, but a great deal of work remains to be done to effect reliable cures while reducing long-term sequelae of therapy...
Neurocognitive dysfunction in children with neurofibromatosis type 1Tena L Rosser
Department of Neurology, Children s National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA
Curr Neurol Neurosci Rep 3:129-36. 2003..The development of NF1 animal models with learning and memory difficulties similar to those seen in humans demonstrates promising preliminary evidence that medical treatment of cognitive abnormalities may one day be possible...
Advances in the diagnosis, molecular genetics, and treatment of pediatric embryonal CNS tumorsTobey J Macdonald
Departments of Hematology Oncology, Children s Hospital National Medical Center, Washington, DC 20010, USA
Oncologist 8:174-86. 2003..In this review, recent advances in the diagnosis, molecular genetics, and treatment of the most common pediatric embryonal CNS tumors are discussed...
Isolated extracranial recurrence of anaplastic ependymomaMwe Mwe Chao
Children s National Medical Center, Division of Pediatric Oncology, Washington, District of Columbia 20010, USA
Pediatr Blood Cancer 56:317-8. 2011..The location of tumor recurrence proximate to the surgical site suggested surgical seeding. This case demonstrates an unusual site of recurrence of anaplastic ependymoma and highlights a previously underappreciated surgical complication...
The use of gene expression analysis to gain insights into signaling mechanisms of metastatic medulloblastomaArun Chopra
Department of Pediatrics, Children's National Medical Center, Washington, DC 20010, USA
Pediatr Neurosurg 39:68-74. 2003..We conclude that these genes may interact to promote prometastatic signaling in medulloblastoma...
Intracranial neoplasms in children with neurofibromatosis 1Tena Rosser
Department of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, The George Washington University, Washington, DC 20010, USA
J Child Neurol 17:630-7; discussion 646-51. 2002....
The cerebellar mutism syndrome and its relation to cerebellar cognitive function and the cerebellar cognitive affective disorderElizabeth M Wells
Division of Neurology, Brain Tumor Institute, Children s National Medical Center, The George Washington University School of Medicine and Health Sciences, Washington DC 20010, USA
Dev Disabil Res Rev 14:221-8. 2008..Future directions include more thorough neuropsychological characterization, functional and diffusion tensor imaging studies, and investigations into the underlying differences that may make some patients more vulnerable to CMS...
Central nervous system meningiomas in the first two decades of life: a clinicopathological analysis of 87 patientsElisabeth J Rushing
Department of Neuropathology, Armed Forces Institute of Pathology, Washington, DC 20306 6000, USA
J Neurosurg 103:489-95. 2005..The authors of this study sought to add to the limited available information regarding clinicopathological factors that influence outcome, disease progression, and survival in children with meningiomas...
Postoperative cerebellar mutism syndrome following treatment of medulloblastoma: neuroradiographic features and originElizabeth M Wells
Division of Neurology, Children s National Medical Center, Washington, DC 20010, USA
J Neurosurg Pediatr 5:329-34. 2010..The current study was undertaken to determine factors associated with development of CMS, a means to determine its severity or cause, and outcomes of patients with this syndrome...
Central nervous system tumorsRoger J Packer
Center for Neuroscience and Behavioral Medicine, Children s National Medical Center, 111 Michigan Avenue, Washington, DC 20010, USA
Hematol Oncol Clin North Am 24:87-108. 2010..Symptoms and signs depend on the growth rate of the tumor, its location in the central nervous system (CNS), and the age of the child. This article describes the presentation, diagnosis, and management of these tumors...
Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survivalJohn R Crawford
Department of Neurology, Children s National Medical Center, The George Washington University, Washington, DC, USA
J Neurooncol 95:259-69. 2009..While tumor grade and gross total resection rather than duration of symptoms correlated with survival in our series, greater than one-third of patients had reported symptoms greater than 6 months duration prior to diagnosis...
Neurofibromas in children with neurofibromatosis 1Tena Rosser
Department of Neurology and Pediatrics, Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, The George Washington University, Washington, DC 20010, USA
J Child Neurol 17:585-91; discussion 602-4, 646-51. 2002..The purpose of this review is to summarize the defining characteristics, incidence, clinical course, management options, and outcome of neurofibromas in children with neurofibromatosis 1...
Germinoma: unusual imaging and pathological characteristics. Report of two casesElisabeth J Rushing
Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306 6000, USA
J Neurosurg 104:143-8. 2006..The diagnosis of diffuse germinoma was confirmed, and the patient was treated with adjunctive chemotherapy. Although uncommon, germ cell tumors can present outside the midline and exhibit a multifocal growth pattern...
Study design and cohort characteristics of the Childhood Cancer Survivor Study: a multi-institutional collaborative projectLeslie L Robison
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
Med Pediatr Oncol 38:229-39. 2002..It serves as a resource for addressing important issues such as risk of second malignancies, endocrine and reproductive outcome, cardiopulmonary complications, and psychosocial implications, among this unique and ever-growing population...
Stroke as a late treatment effect of Hodgkin's Disease: a report from the Childhood Cancer Survivor StudyDaniel C Bowers
Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390 9063, USA
J Clin Oncol 23:6508-15. 2005..The objectives of this report are to examine the incidence of and risk factors for stroke among childhood Hodgkin's disease (HD) survivors...
Current approaches to CNS tumors in infants and very young childrenKatherine E Warren
Neuro Oncology Branch, National Cancer Institute, Bethesda, MD 20892, USA
Expert Rev Neurother 4:681-90. 2004..Achieving successful tumor control while optimizing quality of life for survivors is the major goal of recent research...
Neurocognitive deficits in children with neurofibromatosis type 1Roger J Packer
Curr Neurol Neurosci Rep 6:119-20. 2006
Neurocognitive sequelae of cancer treatmentRoger J Packer
Neurology 59:8-10. 2002
Phase I study of O6-benzylguanine and temozolomide administered daily for 5 days to pediatric patients with solid tumorsKatherine E Warren
National Cancer Institute Neuro Oncology Branch, Building 82, Room 219, 9030 Old Georgetown Rd, Bethesda, MD 20892 8200, USA
J Clin Oncol 23:7646-53. 2005....
Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors: Childhood Cancer Survivor StudyJames G Gurney
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
Cancer 97:663-73. 2003....
Psychological outcomes in long-term survivors of childhood brain cancer: a report from the childhood cancer survivor studyBrad J Zebrack
University of Southern California School of Social Work, 669 W 34th St, Los Angeles, CA 90089 0411, USA
J Clin Oncol 22:999-1006. 2004..To evaluate and compare psychological outcomes in long-term survivors of pediatric brain cancer and siblings of childhood cancer survivors, and to identify significant correlates of psychological distress...
Preradiation chemotherapy versus radiotherapy alone for nonmetastatic medulloblastomaRoger J Packer
Curr Neurol Neurosci Rep 4:127-8. 2004
Phase I and pharmacokinetic study of the oral farnesyltransferase inhibitor lonafarnib administered twice daily to pediatric patients with advanced central nervous system tumors using a modified continuous reassessment method: a Pediatric Brain Tumor ConsMark W Kieran
Dana Farber Cancer Institute and Children s Hospital Boston, Boston, MA 02115, USA
J Clin Oncol 25:3137-43. 2007..Primary objectives were to estimate the maximum-tolerated dose (MTD) and to describe the dose-limiting toxicities (DLTs) and pharmacokinetics of lonafarnib. Farnesylation inhibition of HDJ-2 in peripheral blood was also measured...
Radiation-induced neurocognitive decline: the risks and benefits of reducing the amount of whole-brain irradiationRoger J Packer
Curr Neurol Neurosci Rep 2:131-3. 2002
Phase I trial of single-dose temozolomide and continuous administration of o6-benzylguanine in children with brain tumors: a pediatric brain tumor consortium reportAlberto Broniscer
Department of Oncology, St Jude Children s Research Hospital, 332 North Lauderdale, Memphis, TN 38105, USA
Clin Cancer Res 13:6712-8. 2007..To estimate the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of escalating doses of temozolomide combined with O(6)-benzylguanine in patients < or =21 years with recurrent brain tumors...
The role of INI1 and the SWI/SNF complex in the development of rhabdoid tumors: meeting summary from the workshop on childhood atypical teratoid/rhabdoid tumorsJaclyn A Biegel
Department of Pediatrics, Children s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA
Cancer Res 62:323-8. 2002..Drs. Malcolm Smith, Jaclyn Biegel, and Roger Packer hosted the meeting. There were 22 participants from 14 institutions...
Phase II study of thalidomide and radiation in children with newly diagnosed brain stem gliomas and glioblastoma multiformeChristopher D Turner
Department of Pediatric Oncology, Dana Farber Cancer Institute, Boston, MA 02115, USA
J Neurooncol 82:95-101. 2007..In this small patient sample adding thalidomide to radiation did not improve TTP or TTD from historical controls, however, toxicity appeared to be increased...
New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor StudyJoseph P Neglia
Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA
J Natl Cancer Inst 98:1528-37. 2006..However, the details of the dose-response relationships, the expression of excess risk over time, and the modifying effects of other host and treatment factors have not been well defined...
Late-occurring stroke among long-term survivors of childhood leukemia and brain tumors: a report from the Childhood Cancer Survivor StudyDaniel C Bowers
Department of Pediatrics, The University of Texas Southwestern Medical School, Dallas, TX 75390 9063, USA
J Clin Oncol 24:5277-82. 2006..This report examines the incidence of and risk factors for strokes that occur in > or = 5-year survivors of childhood leukemia and brain tumors...
Progress in the treatment of childhood brain tumors: no room for complacencyJonathan L Finlay
Department of Hematology/Oncology, Children's Hospital, Los Angeles, California 90027, USA
Pediatr Hematol Oncol 24:79-84. 2007
Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children's Oncology GroupPatricia L Robertson
Department of Pediatrics, University of Michigan Health System, Ann Arbor, Michigan 48109 0203, USA
J Neurosurg 105:444-51. 2006..Most descriptions have been limited to small institutional series using a retrospective chart review methodology...
Phase I trial of pirfenidone in children with neurofibromatosis 1 and plexiform neurofibromasDusica Babovic-Vuksanovic
Department of Medical Genetics, Mayo College of Medicine, Rochester, MN, USA
Pediatr Neurol 36:293-300. 2007..The second dose level was the pharmacokinetically comparable dose and is being used in an ongoing phase II trial of pirfenidone for children with neurofibromatosis 1 and progressive plexiform neurofibroma...
Long-term outcomes of adult survivors of childhood cancerLeslie L Robison
Department of Pediatrics, University of Minnesota Medical School and Cancer Center, Minneapolis, USA
Cancer 104:2557-64. 2005..The ongoing evaluation of large and diverse cohorts of cancer survivors will aid in further identifying individuals who should be the target of innovative intervention strategies...
MedulloblastomaRoger J Packer
J Neurosurg 103:299-300; discussion 300-1. 2005
Final height and body mass index among adult survivors of childhood brain cancer: childhood cancer survivor studyJames G Gurney
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455, USA
J Clin Endocrinol Metab 88:4731-9. 2003..We did not find a corresponding elevated risk for obesity...
Endocrine outcome in children with medulloblastoma treated with 18 Gy of craniospinal radiation therapyWeizhen Xu
Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
Neuro Oncol 6:113-8. 2004..In contrast, within group 18 Gy, only 1 was hypothyroid (P = 0.006) and 1 had early puberty. We conclude that endocrine morbidity was significantly reduced with 18 Gy CSRT in young children with medulloblastoma...
Research Grants
- CHILDRENS NATIONAL MEDICAL CENTERRoger Packer; Fiscal Year: 2003....
- Pirfenidone in Children with PNs in NF1Roger Packer; Fiscal Year: 2006..Abstract Not Provided ..
- Neurological Sciences Academic Development at CNMCRoger Packer; Fiscal Year: 2007....
