bluuebunny/crossref_metadata_2025 huggingface dataset:
WBC content of platelet concentrates prepared by the buffy coat method using different processing procedures and storage solutions
Authors: De Wildt‐Eggen Janny , Schrijver Johanna G. , Bins Maarten
Published: March 2003

BACKGROUND: The number of WBCs in platelet concentrates (PCs) prepared by the buffy coat (BC) method with different storage solutions can result in low (5 × 106/unit) WBC levels by the use of careful centrifugation techniques without filtration. At present, most blood banks use filtration steps to meet these requirements. The difference in processing methods and suspension solutions prompted the investigation of the influence of the various procedures on the WBC and platelet content of PCs.

STUDY DESIGN AND METHODS: PCs from 5 BCs were harvested without or with inline filtration (AutoStop BC, Pall Corp.) in either plasma (PCs‐plasma) or platelet additive solution (PCs‐PAS‐2). After preparation, samples were taken for counting WBCs and platelets and for analyzing WBC subsets by flow cytometry using specific MoAbs. The WBCs were concentrated before analysis of the WBC subsets. Results less than 2.5 cells per μL were considered below the limit of accuracy of the subset analysis.

RESULTS: All filtered PCs met the AABB standard of 5 × 106 per unit and the European guidelines of 1 × 106 per unit. None of the nonfiltered PCs met the European guidelines, but all met the AABB guidelines. All filtered units gave residual WBC counts below the detection limit for subset analysis. Filtered PCs‐plasma gave significantly higher platelet counts than filtered PCs‐PAS‐2 or nonfiltered PCs (p<0.01, ANOVA).

CONCLUSION: Careful centrifugation of pooled BCs, with plasma or PAS‐2, can result in PCs with low WBC contamination levels. However, filtered PCs are superior, because of better WBC removal and higher platelet counts.
Survival and function of baboon RBCs released from clotted blood and washed before autologous transfusion
Authors: Valeri C. Robert , Ragno Gina , Pivacek Linda E. , Dennis Richard C. , Hechtman Herbert B. , Khuri Shukri F.
Published: March 2003

BACKGROUND: One alternative to an allogeneic transfusion is the salvaging of the patient's own shed blood. In this study, baboon blood was allowed to clot and the RBCs that were released from the clotted blood lysed with and without urokinase were washed before autologous transfusion.

STUDY DESIGN AND METHODS: Forty‐four studies were done in 13 baboons (Papio cynocephalus or Papio anubis) over a 3‐year period. In 24 studies, a 50‐mL volume of blood was collected without an anticoagulant and stored at 22°C for as long as 72 hours before washing and autologous transfusion. In 20 other studies, a 50‐mL volume of blood was collected without an anticoagulant and allowed to clot for 30 to 60 minutes. Urokinase, ranging from 2,500 to 10,000 units per mL, was added, and the blood was stored at 22°C for 24 hours before washing and autologous transfusion.

RESULTS: RBCs that were stored at 22°C without urokinase for 24 hours exhibited an in vitro recovery value of 45 percent, a 51Cr 24‐hour posttransfusion survival of 86 percent, and an index of therapeutic effectiveness of 39 percent. The 51Cr T50 value was normal at 14 days, and RBC oxygen‐transport function was slightly reduced. RBCs that were stored at 22°C for 24 hours with 10,000 units per mL of urokinase exhibited an in vitro recovery value of 89 percent, a 51Cr 24‐hour posttransfusion survival value of 86 percent, and an index of therapeutic effectiveness of 76 percent. The 51Cr T50 value was normal at 14 days, and the RBC oxygen‐transport function was only slightly reduced.

CONCLUSION: Autologous baboon RBCs isolated from clotted blood treated or not treated with urokinase and washed before transfusion have excellent survival and normal or only slightly reduced oxygen‐transport function.
Immunization of transgenic mice for production of MoAbs directed at polymorphic blood group antigens
Authors: Halverson Gregory R. , Chaudhuri Asok , Huang Tianjun , Yazdanbakhsh Karina , Reid Marion E.
Published: March 2003

BACKGROUND: Antibodies of human origin for blood typing are increasingly difficult to obtain, and, despite aggressive efforts, MoAbs with specificities to several blood group polymorphisms have eluded production. As an approach for the generation of MoAbs with defined specificities, the feasibility of immunizing mice that are transgenic for the target polymorphism, Fya/Fyb of the Duffy blood group system, was tested with a source of the antithetical antigen.

STUDY DESIGN AND METHODS: Nontransgenic mice were immunized with recombinant Fyb, and transgenic mice expressing human Fyb were immunized with recombinant Fya.

RESULTS: Immunization of the nontransgenic mice resulted in the production of MoAbs to the Duffy protein, but not to the Fya/Fyb blood group polymorphism. However, immunization of the transgenic mice resulted in production of the first example of murine Fya MoAb (MIMA‐19). This antibody is being used to screen for Fy(a–) blood donors and has been evaluated by many laboratories in an international workshop.

CONCLUSION: This approach provides an effective method for producing MoAbs with specificities to polymorphic epitopes. These MoAbs are needed in transfusion medicine to identify antigen‐negative donors and to alleviate the critical shortage of blood bank typing reagents, which currently are available only from human‐derived sources.
E variants found in Japanese and c antigenicity alteration without substitution in the second extracellular loop
Authors: Kashiwase Kouichi , Ishikawa Yoshihide , Hyodo Hironobu , Watanabe Yoshihisa , Ogawa Atsuko , Tsuneyama Hatsue , Toyoda Chizu , Uchikawa Makoto , Akaza Tatsuya , Omine Mitsuhiro , Juji Takeo
Published: March 2003

BACKGROUND: The molecular basis of E variants in the Japanese population is poorly understood. In this study, molecular analysis of E variants detected in Japanese by serologic methods was carried out.

STUDY DESIGN AND METHODS: E variants from healthy Japanese blood donors were screened by serologic analysis using E MoAbs. Fifteen E variant samples were divided into three types—EFM, EKH, and EKK—on the basis of patterns of reactivity with five distinct E antibodies. The entire coding region of the Rh cDNAs from the E variant samples was analyzed by sequencing.

RESULTS: Although the Rh cDNA sequences of the three types were different from each other, those of the EFM‐type variants (RHEFM) had a partial DNA exchange in exon 5 between the RHCE and RHD genes, generating an RHcE variant (Gln233Glu, Met238Val). The cDNA of EKH‐type variants (RHEKH) exhibited a point mutation (G461C) in exon 3 of the RHcE allele that resulted in an Arg154Thr substitution in the third external loop of the RhcE peptide. The EKK‐type variant (RHEKK) carried a hybrid gene structure characterized by replacement of exons 1‐3 (or 2‐3) of the RHCE gene with those of the RHD gene. The RHD gene of a person possessing an E variant of the EKK type was also a hybrid gene, D–cE(2‐3)–D or cE(1‐3)–D (RHDKK). The E variants of types EKH and EKK showed weak c antigenicity.

CONCLUSION: In serologic screening of 140,723 Japanese blood donors, 15 were found to possess E variants (0.011%). A new RHCE variant, RHEKH, was identified. On the basis of the variants found in this study, the c antigenicity seemed to be determined not only by Pro‐103 but also by the structure of the third extracellular loop or the amino acids contained in it.
Residual subset population analysis in WBC‐reduced blood components using real‐time PCR quantitation of specific mRNA
Authors: Pennington Joanne , Garner Stephen F. , Sutherland Janet , Williamson Lorna M.
Published: March 2003

BACKGROUND: Implementation of WBC reduction of the blood supply increases the importance of measurement of residual WBC subtypes responsible for immunologic and infectious complications of transfusion.

STUDY DESIGN AND METHODS: Real‐time RT‐PCR assays were developed to detect mRNA encoding lineage‐specific WBC markers. Primers and fluorescent probes were designed for CD45 (pan‐WBC), CD3 (T‐lymphocyte), CD19 (B‐lymphocyte), CD14 (monocyte), and CD66 (granulocyte), and the specificity was assessed by comparison with flow cytometric analysis of enriched cell populations. WBC subsets were examined in WBC‐reduced whole blood prepared with filters (WBF2, Pall; and RZ2000, Baxter) and in platelet concentrates prepared with other filters (Autostop, Pall; and PLX‐5, Baxter) and apheresis (COBE Spectra LRS, Gambro).

RESULTS: All real‐time RT‐PCR assays were linear over >5 log concentration range, allowing pre‐WBC‐reduction and post‐WBC‐reduction comparisons. Sensitivity limits ranged from 10 cells per mL (CD45) to 200 cells per mL (CD19). Assay specificity was confirmed by the close correlation of real‐time RT‐PCR and immunophenotyping results by flow cytometry. For all subsets, >3.8 log and >3.1 log reduction was obtained during WBC reduction of whole blood and platelets, respectively.

CONCLUSION: Real‐time RT‐PCR assays are suitable for analysis of subset removal during WBC reduction. There was no significant difference between the two whole‐blood filters or between platelet filtration and apheresis in the removal of any WBC subset.
Expansion of the Knops blood group system and subdivision of Sla
Authors: Moulds J.M. , Zimmerman P.A. , Doumbo O.K. , Diallo D.A. , Atkinson J.P. , Krych‐Goldberg M. , Hourcade D.E. , Moulds J.J.
Published: March 2003

BACKGROUND: Complement receptor type 1 (CR1), which bears the Knops (Kn [KN]) blood group antigens, is involved in the rosetting of Plasmodium falciparum‐infected RBCs with uninfected cells. As a first step in understanding this interaction, the molecular basis for the blood group antigens encoded by CR1 was investigated.

STUDY DESIGN AND METHODS: An antibody from a white donor who exhibited an apparent anti‐Sla was used for population studies of several racial groups. The donor's genomic DNA was sequenced to identify the Sla mutation and other mutations.

RESULTS: The donor with anti‐Sla typed as Sl(a+) with some sera and had the CR1 genotype AA at bp 4828 (R1601). However, she was homozygous for a new mutation (GG) at bp 4855 changing amino acid 1610 from S1610 to T1610 (S1610T). This mutation occurred in heterozygous form in eight white and one Asian donor. The site is only nine amino acids from the previously described Sla polymorphism and appears to produce a new conformational epitope.

CONCLUSION: The antigen formerly known as Sla can now be subdivided. A new terminology is proposed that recognizes both linear and conformational epitopes on the CR1 protein. At amino acid 1601, Sl 1 (Sla) is represented by R, Sl 2 (Vil) is represented by glycine, and Sl 3 requires both R1601 and S1610. Sl 4 and Sl 5 are hypothetical epitopes represented by S1610 and T1610, respectively.
Insights into the Holley– and Joseph– phenotypes
Authors: Rios Maria , Hue‐Roye Kim , Øyen Ragnhild , Miller Jeffrey , Reid Marion E.
Published: March 2003

BACKGROUND: The Dombrock blood group system consists of two antithetical antigens (Doa and Dob) and three high‐incidence antigens (Gregory [Gya], Holley [Hy], and Joseph [Joa]). Hy and Joa have an unusual phenotypic relationship. All Hy– RBCs are Jo(a–), but not all Jo(a–) RBCs are Hy–. The molecular background associated with Hy– and Jo(a–) phenotypes is reported.

STUDY DESIGN AND METHODS: DNA from 18 probands with Gy(a+w) Hy– Jo(a–) RBCs (Hy– phenotype) and from 13 probands with Gy(a+) Hy+w Jo(a–) RBCs (Jo[a–] phenotype) was tested.

RESULTS: Sequencing and PCR‐RFLP revealed 323 G>T (Gly108Val) and 378 T>C (silent mutation) changes on a DOB background (HY) associated with the Hy– samples. The sister of the original Hy– proband and the majority of samples had an additional mutation of 898 C>G (Leu300Val) (HY1); others had 898C (300Leu) (HY2). In the Jo(a–) phenotype, there is a 350 C>T (Thr117Ile) and a 378 C>T (silent mutation) change on a DOA background (JO).

CONCLUSION: The results provide an explanation for the variation in typing results in antibody producers. The ablation of Joa in the Hy– phenotype and the weakening of Hy in the Jo(a–) phenotype may be due to the close proximity of these antigens. The 898 C>G mutation, within the sequence motif for glycosylphosphatidylinositol linkage, may cause reduced efficiency of anchoring the protein to the RBC membrane, thereby weakening the expression of Gya and Dob.
Detection and quantitation of ABO RBC chimerism by a modified coil planet centrifuge method
Authors: Takahashi Junko , Seno Taiko , Nakade Toru , Yamashita Naoko , Tanaka Mitsunobu , Sako Masahiro , Yoshihara Takao , Hayashi Kunio , Tomiyama Yoshiaki , Hirayama Fumiya , Shibata Hirotoshi , Tani Yoshihiko
Published: March 2003

BACKGROUND : Differential agglutination procedures and flow cytometric analysis have been used for detecting and quantitating mixed cell populations. For more than 20 years in our laboratory, a differential agglutination method using the coil planet centrifuge and polyclonal anti‐A or anti‐B has been used. However, it is now difficult to obtain polyclonal antisera, and it is unknown whether MoAbs can take the place of polyclonal antisera in the coil planet centrifuge method.

STUDY DESIGN AND METHODS : Polyclonal antisera and MoAbs were filled into a coil first and then unsensitized packed RBCs from ABO variants, and from chimeras and patients after ABO‐incompatible HPC trans‐ plantation (HPCT) were loaded. After centrifugation, agglutinated and nonagglutinated RBCs were collected, hemolyzed, and subjected to colorimetric analysis for quantitation.

RESULTS : ABO chimerism was quantitatively estimated with detection as low as 0.1 percent. ABO variants showed different patterns of agglutination and nonagglutination. The reconstitution status of the erythroid lineage after ABO‐mismatched HPCT was also quantitatively evaluated.

CONCLUSION : A modified coil planet centrifuge method is established by which ABO chimerism could quantitatively be analyzed and ABO variants identified to the same degree of accuracy as the other differential methods and flow cytometry. The monitoring of ABO chimerism might also help the diagnosis of early relapse or rejection after ABO incompatible HPCT.
Racial and ethnic composition of volunteer cord blood donors: comparison with volunteer unrelated marrow donors
Authors: Ballen Karen K. , Hicks Julie , Dharan Bernie , Ambruso Daniel , Anderson Kenneth , Bianco Celso , Bemiller Lynn , Dickey William , Lottenberg Richard , O'Neill Mary , Popovsky Mark , Skerrett Donna , Sniecinski Irena , Wingard John R.
Published: March 2003

BACKGROUND : Umbilical cord blood is an alternative peripheral blood progenitor cell source for patients who need transplantation. A presumed advantage of cord blood is the ability to increase minority recruitment.

STUDY DESIGN AND METHODS : The racial composition of five member cord blood banks of the National Marrow Donor Program (NMDP) was compared, representing 9020 cord blood donors with NMDP marrow donors from comparable geographic areas, representing 417,676 donors. Cord blood and marrow donors self‐reported racial designations on questionnaires. Donor statistics were compared with baseline racial data of deliveries from participating hospitals for cord blood donors and with geographic census data for marrow donors.

RESULTS : The California, Florida, and Massachusetts cord blood banks recruited a lower percentage of minorities than the corresponding marrow donor centers. In New York and Colorado, minority recruitment was equivalent. In California, Florida, Massachusetts, and New York, the cord blood banks recruited a lower percentage of minorities than those delivering at the respective hospitals. The cord blood banks in California, Colorado, Florida, and Massachusetts recruited a lower percentage of minorities compared with delivery data than the corresponding marrow donor centers compared with census population (p < 0.001). In New York, the percentages were similar.

CONCLUSION : The problem of insufficient minority recruitment of cord blood has not yet been solved. Better strategies are needed to recruit minority donors.
Coagulant stability and sterility of thawed S/D‐treated plasma
Authors: Nifong Thomas P. , Light Jan , Wenk Robert E.
Published: March 2003

BACKGROUND : Units of frozen S/D‐treated plasma (SDP) must be transfused within 24 hours after thawing. To avoid waste, an attempt was made to determine how long SDP could be therapeutically effective after thawing and storing it at 20°C.

STUDY DESIGN AND METHODS : The microbiologic safety and the activity of labile coagulation factors were evaluated in units stored at 20°C of thawed SDP units and FFP within 24 hours of collection (FFP24). Five SDP and FFP24 samples of each ABO blood group were cultured and assayed for coagulation factors daily over 5 days. Assays included FV, FVII, FVIIa, FVIII, F IX, FXI, protein S, antiplasmin, fibrinogen, prothrombin times (PTs), and activated partial thromboplastin times (aPTTs).

RESULTS : None of the 80 bacterial cultures demonstrated growth under either aerobic or anaerobic conditions. FV, FVIII, F IX, FXI, fibrinogen, and the aPTT appeared to be stable in both thawed FFP24 and SDP. The PT increased slightly in thawed FFP24 and insignificantly in SDP. FVII decreased slightly in FFP24 but remained in the normal range, and FVIIa was low and constant. FVII was increased in SDP and FVIIa was markedly increased. Protein S decreased from initial normal values in FFP24 to very low values. Protein S was very low immediately after thawing in the SDP and continued to decline. Antiplasmin was normal and stable in thawed FFP24 but was low in SDP and remained constant after thawing.

CONCLUSION : Sterile SDP that is stored at 20°C provides sufficient coagulant activity of labile FV and FVIII to transfuse it for up to 5 days after thaw. Caution is warranted by decreases in Protein S and antiplasmin, clinical evidence of coagulopathy in some recipients of SDP, and a recent manufacturer's warning.
Screening for alloantibodies in the serum of patients receiving platelet transfusions: a comparison of the ELISA, lymphocytotoxicity, and the indirect immunofluorescence method
Authors: Levin Mark‐David , De Veld Jos C. , Van der Holt Bronno , Van't Veer Mars B.
Published: March 2003

BACKGROUND : For screening of alloimmunization in patients repeatedly receiving platelet transfusions, different tests are used, none of which is the standard. Here we describe a comparison of four tests most commonly used for detection of alloimmunization in a group of nonselected patients receiving platelet transfusions.

STUDY DESIGN AND METHODS : In 99 patients with hematologic malignancies who received platelet transfusions, 192 random serum samples were tested in the ELISA, the lymphocytotoxic test (LCT), the lymphocyte immunofluorescence test (LIFT), and the platelet immunofluorescence test (PIFT). Results of all tests were compared.

RESULTS : The results of all tests were significantly correlated with each other (p < 0.005). ELISA and LIFT were more often positive than LCT and PIFT. ELISA and LIFT showed the best correlation (chi‐square test = 63.7, p < 0.001).

CONCLUSION : ELISA, the least time‐consuming test, detects alloimmunization as often as LIFT and more often than LCT and PIFT.
Expression levels of H‐type α(1,2)‐fucosyltransferase gene and histo‐blood group ABO gene corresponding to hematopoietic cell differentiation
Authors: Hosoi Eiji , Hirose Masao , Hamano Shuichi
Published: March 2003

BACKGROUND
: The expression of ABO antigens on the surface of RBCs is regulated by
ABO gene‐encoded ABO transferase activity after the formation of the H antigen. The molecular mechanisms that control the expression of the ABO blood group antigens along with erythroid differentiation are one of the most important subjects of study in transfusion science.

STUDY DESIGN AND METHODS
: FUT1(H), ABO, and β
2
‐microglobulin mRNA were determined by semiquantitative RT‐PCR from 27 hematopoietic cultured cell lines showing various differentiation stages and cell lineages and normal PBMNCs. The expression level of each cell was analyzed with computer software (Image, NIH) and was shown as the ratio of ABO mRNA or H mRNA to β
2 ‐microglobulin mRNA. The H antigen was also determined by immunocytochemical methods with flow cytometry in some cell lines.

RESULTS : The highest expression of H mRNA was found in KOPM‐28 and HEL cell lines and a lower expression was found in the mature cells. In contrast, it was observed that H antigen expression began at the level of HEL and PL‐21 cells and increased with cell maturation. The highest expression of ABO mRNA was found in K‐562 and KOPM‐28 cell lines and it decreased along with cell maturation.

CONCLUSION
: Based on these results, it is concluded that the transcription of both
H
and
ABO genes starts early in immature peripheral blood progenitor cells but gradually decreases during cellular maturation and also that the H antigen maintains a high level of expression thereafter. These results may reflect the active synthesis of H and ABO antigens in normal hematopoietic peripheral blood progenitor cells.
Modulations of anti‐D affinity following promiscuous binding of the heavy chain with naïve light chains
Authors: St‐Amour Isabelle , Proulx Chantal , Lemieux Réal , Bazin Renée
Published: March 2003

BACKGROUND : It is generally accepted that the antibody heavy (H) chain is more important than the light (L) chain for determining antigen specificity. In the case of anti‐D, the predominant role of H chains in antigen binding is well recognized, but much less is known about the function of L chains. In this work, the contribution of L chains from non‐D‐immunized donors to the specificity and reactivity of anti‐Ds was studied with L‐chain shuffling.

STUDY DESIGN AND METHODS : A kappa L chain library was recombined with the H chain of the 43F10 anti‐D in a phagemid vector system (pComb3H, Scripps Institute). D‐specific F(ab) phages were selected by panning on RBCs. Soluble F(ab)s were prepared, and their reactivity was assessed by RBC agglutination. The nucleotide and amino acid sequences of the variable region of the L chains were analyzed.

RESULTS : The L chains of the six D‐specific 43F10 F(ab) clones studied used five different germline genes from three Vκ families and three different Jκ segments. The L chains were all cationic with isoelectric points ranging from 8.1 to 10.2.

CONCLUSION : The 43F10 anti‐D H chain could bind promiscuously to a diversity of L chains from non‐D‐immunized donors without losing the D‐antigen specificity. Relationships between the anti‐D affinity and the cationic charge of the L chain as well as with the presence of an arginine residue in the L‐chain complementarity‐determining region 1 were observed.
Increased Dispersion of Refractoriness in Patients with Atrial Fibrillation in the Early Postoperative Period after Coronary Artery Bypass Grafting
Authors: SOYLU MUSTAFA , DEMIR AHMET DURAN , ÖZDEMIR ÖZCAN , SOYLU ÖZER , TOPALOĞLU SERKAN , KUNT AYŞEGÜL , SASMAZ ALI , KORKMAZ ŞULE , TAŞDEMIR OĞUZ
Published: March 2003

Preoperative EP Characteristics of Post‐CABG AF. Introduction: Increased atrial effective refractory period (AERP) dispersion is well correlated with vulnerability to atrial fibrillation (AF). However, the preoperative electrophysiologic characteristics of atrial abnormalities that may play an important role in the development of AF postoperatively in patients with coronary artery bypass grafting (CABG) have not been investigated in detail.

Methods and Results: Fifty‐six consecutive patients who underwent CABG were enrolled in this study. Eighteen patients (14 men and 4 women; mean

age 57.7 ± 5.2 years

) with AF in the early postoperative period and 38 patients (28 men and 10 women; mean

age 56.3 ± 6.4 years

) without AF were compared with regard to preoperative clinical, echocardiographic, angiographic, and electrophysiologic parameters. Preoperative PA interval and AERP dispersion values were higher

(P < 0.05)

in patients who developed AF in the early postoperative period. PA interval (

P < 0.05

, odds ratio = 1.64, 95% confidence interval 1.17–2.30), AERP in the high right atrium (AERPHRA;

P < 0.05

, odds ratio = 0.94, 95% confidence interval 0.91–0.97), AERP in the right posterolateral atrium (AERPRPL;

P < 0.05

, odds ratio = 0.79, 95% confidence interval 0.63–0.98), AERP in the distal coronary sinus (AERPDCS;

P < 0.05

, odds ratio = 0.84, 95% confidence interval 0.74–1.02), and AERP dispersion (

P < 0.001

, odds ratio = 1.29, 95% confidence interval 1.12–1.47) were independently related to post‐CABG AF in univariate analysis. Increases in preoperative PA interval and AERP dispersion were found to be associated with a high risk for development of post‐CABG AF.

Conclusion: AERP dispersion is a suitable electrophysiologic indicator for atrial vulnerability. The presence of increased preoperative AERP dispersion and PA interval may indicate patients at high risk for development of AF in the early postoperative period after coronary artery bypass grafting.
Biventricular Implantable Cardioverter Defibrillator and Inappropriate Shocks
Authors: SRIVATHSAN KOMANDOOR , BAZZELL JANE L. , LEE RICHARD W.
Published: March 2003

Biventricular ICD and Inappropriate Shocks. A 53‐year‐old man with nonischemic cardiomyopathy underwent implantation of a biventricular implantable cardioverter defibrillator (ICD) for symptomatic ventricular tachycardia. He received five shocks while attempting to exercise, 48 hours after implantation. Interrogation of the device revealed double counting of ventricular sensed events by the left and right ventricular leads. Shortening the AV delay and AV nodal blockade (beta‐blocker) to promote ventricular pacing failed to prevent additional inappropriate ICD discharges. After detailed consideration of all options including AV nodal ablation, we chose to disconnect the left ventricular lead pending availability of newer devices with sensing functions limited to the right ventricular lead. Since then, the patient has not experienced any additional inappropriate discharges.
Percutaneous Mitral Valve Repair for Mitral Regurgitation
Authors: BLOCK PETER C.
Published: March 2003

Mitral regurgitation (MR) associated with, ischemic, and degenerative (prolapse) disease, contributes to left ventricular (LV) dysfunction due to remodeling, and LV dilation, resulting in worsening of MR. Mitral valve (MV) surgical repair has provided improvement in survival, LV function and symptoms, especially when performed early. Surgical repair is complex, due to diverse etiologies and has significant complications. The Society for Thoracic Surgery database shows that operative mortality for a 1st repair is 2% and for re‐do repair is 4 times that. Cardiopulmonary bypass and cardiac arrest are required. The attendant morbidity prolongs hospitalization and recovery. Alfieri simplified mitral repair using an edge‐to‐edge technique which subsequently has been shown to be effective for multiple etiologies of MR. The MV leaflers are typically brought together by a central suture producing a double orifice MV without stenosis. Umana reported that MR decreased from grade 3.6 +/−0.5 to

0.8 +/−0.4 (P < 0.0001)

and LV ejection fraction increased from 33 +/−13% to 45 +/−11%

(P = 0.0156)

. In 121 patients, Maisano reported freedom from re‐operation of 95 +/−4.8% with up to 6 year follow‐up. Oz developed a MV “grasper” that is directly placed via a left ventriculotomy and coapts both leaflets which are then fastened by a graduated spiral screw. An in‐vitro model using explanted human valves showed significant reduction in MR and in canine studies, animals followed by serial echo had persistent MV coaptation. At 12 weeks the device was endothelialized. These promising results have paved the way for a percutaneous or minimally invasive off pump mitral repair. Evalve has developed catheter‐based technology, which, by apposing the edges of a regurgitant MV, results in edge‐to‐edge repair. Release of the device is done after echo and fluoroscopic evaluation under normal loading conditions. If the desired effect is not produced the device can be repositioned or retrieved. Animal studies show excellent healing, with incorporation of the device into the leaflets at 6–10 weeks with persistent coaptation. Another percutaneous approach has been to utilize the proximity of the coronary sinus (CS) to the mitral annulus (MA). Placement of a self‐compressing device in the CS along the region of the posterior MA has, in canine models, reduced MR and addresses the issues of MA dilation and its contribution to MR. Ongoing studies are underway for both techniques. (J Interven Cardiol 2003;16:93–96)
The Soul of Knowledge
Authors: Allen Barry
Published: March 2003

Rewriting the Soul: Multiple Personality and the Sciences of Memory. By Ian Hacking.
Hayden White: The Form of the Content
Authors: Partner Nancy
Published: March 2003

Hayden White's perhaps richest and most profoundly argued book,The Content of the Form, touches many nerves in the American historicalprofession. The entirety of the book, from its premises through its most thoughtful exegeses of historical writing, insists that linguistic form is the primary carrier of content in historical writing, indeed, in historical knowledge. This insistence on a respectful and careful attention tothe formal usages of nonfiction prose, truth‐claiming language, goes well against the grain of American tastes. As de Tocqueville presciently and correctly predicted, when Americans take to literature in a serious way, they won't have much patience with precise matters of form.Hayden White's narrative theory has had uphill work to penetrate this pervasive indifference, especially among historians.

He has been joined in recent decades by Paul Ricoeur, whose Time andNarrative, beginning from different premises and a slightly different question, arrives at a sympathetic and complementary analysis of historical narrative. In spite of White's published hesitations about the political/philosophical tendencies of Ricoeur's work, I amconvinced that their books are mutually supporting and, in an important cultural sense, belong together.

Altogether, however, I do feel that the main import and justification of this presentessay must rest on my quite serious reading of Hayden White's best joke, a profound shaggy dog story about the historian monk of St. Gall.
Searle's Social Reality
Authors: Turner Stephen P.
Published: March 2003

Book reviewed in this article:

The Construction of Social Reality by John R. Searle
The Cage of Nature: Modernity's History in Japan
Authors: Thomas Julia Adeney
Published: March 2003

“The Cage of Nature” focuses on the concept of nature as a way to rethink Japanese and European versions of modernity and the historical tropes that distance “East” from “West.” This essay begins by comparing Japanese political philosopher Maruyama Masao and his contemporaries, Max Horkheimer and Theodor Adorno. Both sets of authors define modernity as the moment when humanity overcomes nature, but Maruyama longs for this triumph while Horkheimer and Adorno deplore its consequences. Maruyama insists that Japan has failed to attain the freedom promised by modernity because it remains in the thrall of nature defined in three ways: as Japan's deformed past, as the mark of Japan's tragic difference from “the West,”and as Japan's accursed sensuality, shackling it to uncritical bodily pleasures. In short, Maruyama sees Japan as trapped in the cage of nature.

My argument is that Maruyama's frustration arises from the trap set by modern historiography, which simultaneously traces the trajectory of modernity from servile Nature to freedom of Spirit and at the same time bases the identity of the non‐Western world on its closeness to nature. In other words, nature represents both the past and the East, an impossible dilemma for an Asian nationalist desirous of liberty. By revising our historical narratives to take into account the ways in which Western modernity continued to engage versions of nature, it becomes possible to reposition Japan and “the East” within modernity's history rather than treating them as the Other.
Between Discourse and Experience: Agency and Ideas in the French Pre‐Revolution
Authors: Smith Jay M.
Published: March 2003

Experience has recently reemerged as an important analytical category for historians of the Old Regime and the French Revolution. Reacting against the perceived excesses of discourse analysis, which made political language independent of any social determinants, certain post‐revisionists are now seeking to contextualize political language by relating it to the experience of those who use it. Political agency, in these analyses, is understood to be the effect of particular formative experiences. This article suggests that the search for an experiential antidote to discourse is misconceived because it perpetuates an untenable dichotomy between thought and reality. Access to the phenomenon of historical agency should be pursued not through experience or discourse but through the category of consciousness, since the make‐up of the subject’s consciousness determines how he/she engages the world and decides to attempt changing it. After a brief discussion of an important study that exemplifies both the allure and the functionality of the notion of experience, Timothy Tackett’s Becoming a Revolutionary, the article focuses on the evolving political consciousness of a man who became a revolutionary agitator in 1789, J.‐M.‐A. Servan. Analysis of his writings between 1770 and 1789 shows that the way in which his perspective was constructed, rather than the lessons of experience per se, determined the shape of his revolutionary intentions in 1789.
Innovation in Labor Contracts: On the Adoption of Profit Sharing inCanadian Labor Contracts
Authors: Azfar Omar
Published: March 2003

I present a model in which I show that labor contracts with wages indexed to prices have longer optimal contract lengths and therefore are more likely to adopt performance‐related pay. There is empirical support for these predictions in Canadian collective‐bargaining agreements. Contract durations are longer in indexed contracts. Performance‐related pay is more than twice as likely to be adopted and present in indexed contracts and more likely to be adopted in contracts with longer durations.
Testing for a Structural Change in U.S. Wage Determination
Authors: Budd John W. , Nho Yongjin
Published: March 2003

Previous tests for structural changes (slope changes) and shifts (intercept changes) in the Phillips curve and union wage determination specify the date of structural change a priori. This article tests for structural changes and shifts without specifying the change point ex ante. The results support the belief that structural changes occurred in the early 1980s. Contrary to some previous research, however, the results do not support a structural shift in the Phillips curve.
The Voting Propensity of Hong Kong Christians: Individual Disposition, Church Influence, and the China Factor
Authors: Chan Che‐po , Leung Beatrice
Published: March 2003

Considering China's history of unfavorable treatment of mainland Chinese Christians, the authors hypothesize that Christians in Hong Kong reflected their concern over the future protection of religious freedom during the 1995 Legislative Council election, the last election before the handover of the British colony to Chinese sovereignty. We have looked at the relative contributions of individual disposition, the China factor and church influence on the presence of Hong Kong Christians at the polling booth on election day. Our analysis found that Hong Kong Christians are subjected more to the influenceof the latter two factors. The influence of socio‐economic status is relatively unimportant in determining the voting propensity of Hong Kong Christians. While both Catholics and Protestants are influenced by general church teachings, this research found that Catholic voters, are more subject to their church's organizational mobilization than Protestant voters.
From Excommunication to Nullification: Testing and Extending Supply‐Side Theories of Religious Marketing with the Case of Catholic Marital Annulments
Authors: Wilde Melissa J.
Published: March 2003

Since the Second Vatican Council (1965), Catholic marital annulments have risen dramatically, especially in the United States. A comparison of American and international rates demonstrates that, consistent with supply‐side theories of religion, annulment rates have risen only in countries where the Church competes with other religious institutions. However, supply‐side theory cannot explain why the American rate is double that of other countries with competitive religious economies. Historical analysis suggests that the growing number, estrangement, organization, and mobilization of divorced American Catholics motivated the American Church to engage in more intense marketing of annulments. I therefore argue that another variable that incorporates these “qualities of the target market” should be considered in future analyses of religious marketing.
Doing Field Studies of Religious Movements: An Agenda
Authors: Pitchford Susan , Bader Christopher , Stark Rodney
Published: March 2003

Although the social scientific study of religion has seen the accumulation of numerous case studies, comparative work involving substantial numbers of cases is rare. In the absence of an accepted agenda for field research, field studies contain information relevant to the study at hand, but do not add systematically to a cumulative database. By contrast, field studies in anthropology may contain idiosyncratic information relevant to the author's interests, but an existing research agenda defines information researchers are expected to include, which has produced an expanding cross‐cultural database. In this paper, we propose elements of a research agenda for the study of religious movements, including information related to movements' organizational history and context, mobilization, organization, governance, and outcomes. While this preliminary agenda is subject to refinement by others, it provides a starting point for the accumulation of comparable cases, and a basis for the comparative study of religious movements.
American Church/State Jurisprudence from the Warren Court to the Rehnquist Court
Authors: Hammond Phillip E.
Published: March 2003

The Supreme Court under Chief Justice Earl Warren did much to expand the free exercise of religion and diminish government endorsement of it. The pace at which this occurred slowed under Chief Justice Burger and is directly challenged by the Court under Chief Justice William Rehnquist. This change is documented, followed by an analysis of what seems to animate Rehnquist.
Capital Structure and Corporate Control: The Effect of Antitakeover Statutes on Firm Leverage
Authors: Garvey Gerald T. , Hanka Gordon
Published: March 2003

We find that firms protected by “second generation” state antitakeover laws substantially reduce their use of debt, and that unprotected firms do the reverse. This result supports recent models in which the threat of hostile takeover motivates managers to take on debt they would otherwise avoid. An implication is that legal barriers to takeovers may increase corporate slack.
The Performance of Hedge Funds: Risk, Return, and Incentives
Authors: Ackermann Carl , McEnally Richard , Ravenscraft David
Published: March 2003

Hedge funds display several interesting characteristics that may influence performance, including: flexible investment strategies, strong managerial incentives, substantial managerial investment, sophisticated investors, and limited government oversight. Using a large sample of hedge fund data from 1988–1995, we find that hedge funds consistently outperform mutual funds, but not standard market indices. Hedge funds, however, are more volatile than both mutual funds and market indices. Incentive fees explain some of the higher performance, but not the increased total risk. The impact of six data‐conditioning biases is explored. We find evidence that positive and negative survival‐related biases offset each other.
A Test of the Relative Pricing Effects of Dividends and Earnings: Evidence from Simultaneous Announcements in Japan
Authors: Conroy Robert M. , Eades Kenneth M. , Harris Robert S.
Published: March 2003

We study the pricing effects of dividend and earnings announcements by taking advantage of the unique setting in Japan where managers simultaneously announce the current year's dividends and earnings as well as forecasts of next year's dividends and earnings. Defining surprises as deviations from analysts' forecasts, we find that share price reactions are significantly affected by earnings surprises, especially management forecasts of next year's earnings. The information content of dividends is marginal and is restricted to announcements of next year's dividends. Consistent with Modigliani and Miller's dividend irrelevance proposition, current dividend surprises have no material impact on stock prices in Japan.
Conflicts of Interest and Market Illiquidity in Bankruptcy Auctions: Theory and Tests
Authors: Strömberg Per
Published: March 2003

I develop and estimate a model of cash auction bankruptcy using data on 205 Swedish firms. The results challenge arguments that cash auctions, as compared to reorganizations, are immune to conflicts of interest between claimholders but lead to inefficient liquidations. I show that a sale of the assets back to incumbent management is a common bankruptcy outcome. Sale‐backs are more likely when they favor the bank at the expense of other creditors. On the other hand, inefficient liquidations are frequently avoided through sale‐backs when markets are illiquid, that is, when industry indebtedness is high and the firm has few nonspecific assets.
True Spreads and Equilibrium Prices
Authors: Ball Clifford A. , Chordia Tarun
Published: March 2003

Stocks and other financial assets are traded at prices that lie on a fixed grid determined by the minimum tick size. Observed prices and quoted spreads do not correspond to the equilibrium prices and true spreads that would exist in a market with no minimum tick size. Using Monte Carlo Markov Chain methods, this paper estimates the equilibrium prices and true spreads. For large stocks, most of the quoted spread is attributable to the rounding of prices and the adverse selection component is small. The true spread and the adverse selection component are greater for mid‐sized stocks.
Evaluating Mutual Fund Performance
Authors: Kothari S. P. , Warner Jerold B.
Published: March 2003

We study standard mutual fund performance measures, using simulated funds whose characteristics mimic actual funds. We find that performance measures used in previous mutual fund research have little ability to detect economically large magnitudes (e.g., three percent per year) of abnormal fund performance, particularly if a fund's style characteristics differ from those of the value‐weighted market portfolio. Power can be substantially improved, however, using event‐study procedures that analyze a fund's stock trades. These procedures are feasible using time‐series data sets on mutual fund portfolio holdings.
Equity Carve‐Outs and Managerial Discretion
Authors: Allen Jeffrey W. , McConnell John J.
Published: March 2003

This study proposes a managerial discretion hypothesis of equity carve‐outs in which managers value control over assets and are reluctant to carve out subsidiaries. Thus, managers undertake carve‐outs only when the firm is capital constrained. Consistent with this hypothesis, firms that carve out subsidiaries exhibit poor operating performance and high leverage prior to carve‐outs. Also consistent with this hypothesis, in carve‐outs wherein funds raised are used to pay down debt, the average excess stock return of + 6.63 percent is significantly greater than the average excess stock return of −0.01 percent for carve‐outs wherein funds are retained for investment purposes.
The Agroindustry: A Neglected Aspect of the Location Theory of Manufacturing
Authors: Hsu Song‐ken
Published: March 2003

The agroindustry, that is, the industry of processing of agricultural products, plays an important role in the economy of a developing country. However, the location theory of manufacturing, as developed to date, is not applicable to this type of manufacturing. This paper attempts to examine this neglected aspect of the location theory of manufacturing. The model is built on a framework that is adopted by most previous studies on production location, except that one of the inputs is of the von Thunen type, that is, produced over space and initially sold to consumers in the town. The location behavior of an agroindustrial firm is systematically analyzed. Moreover, and more importantly, a comparison of an agroindustrial firm with its non‐agroindustrial counterpart is presented, demonstrating clearly that in many respects, the location behaviors of these two categories of manufacturing are significant different.
An Empirical Analysis of Retailer Participation Decisions in a Downtown Parking Coupon Program
Authors: Lindsey C. Robin , West Douglas S.
Published: March 2003

Parking coupon programs help downtown shopping areas attract consumers away from suburban shopping centers. Here we conduct an empirical analysis of retailer participation in such a program. Consistent with expectations, participation was higher for stores in shopping centers than for street‐front retailers, for stores receiving subsidies for coupon purchase, and for stores selling comparison‐shopping goods than for stores selling goods bought on one‐stop, single‐purpose or multipurpose‐shopping trips. Participation also varied with numbers of competitors, chain membership, and store vintage. Apparently, participation is a local public good for downtown retailers and stores are inclined to free ride.
Cournot Retail Chains
Authors: Claycombe Richard J.
Published: March 2003

In this paper a model of spatial Cournot competition among retail firms is devised and used to assess the effect of a variety of structural factors on retail prices and profits. The model illustrates the spatial chain of interaction that firms must anticipate to reach equilibrium when organized in chains or as independents. It shows the sensitivity of price to the location of stores, the number of stores per location, and transportation cost.
On the Specification of Indirect Utility and Willingness to Pay for Discrete Residential Location Models
Authors: Jara‐Díaz Sergio R. , Martínez Francisco J.
Published: March 2003

In this paper we develop a framework to describe the individual choice of residential location using the microeconomics of discrete choices. The individual is seen as deciding frequency, duration, and location of a set of activities for each potential residential zone, knowing the distribution of goods and activities in space as well as transport costs and travel times. The conditional indirect utility function and its associated willingness to pay function for each zone are obtained, where the roles of accessibility, income, and neighborhood attributes emerge clearly. Zonal utility in discrete location choice models can be specified and interpreted using these functions.
The Neoclassical Economic Base Multiplier
Authors: McGregor Peter G. , McVittie Eric P. , Swales J. Kim , Ping Yin Ya
Published: March 2003

In this paper we derive an analytical expression for the regional neoclassical economic base marginal employment multiplier. The model that we adopt is a variant of the 1‐2‐3 general equilibrium model used in trade analysis. Its specific neoclassical characteristics are that laborsupply is a positive function of the real consumption wage and that factor and product demands are price sensitive. We calculate the employment multipliers associated with both a demand and supply stimulus to the basic sector. We demonstrate that it is possible for the marginal economic base multiplier to take any positive or negative value. However, the value of the marginalmultiplier is likely to approximate the value of the conventional average multiplier the closer production and utility functions are to Cobb‐Douglas specifications and the more elastic is the labor supply function.