bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of sildenafil citrate in treatment of erectile dysfunction after radical retropubic prostatectomy
Authors: OGURA KEIJI , ICHIOKA KENTARO , TERADA NAOKI , YOSHIMURA KOJI , TERAI AKITO , ARAI YOICHI
Published: February 2004

Background: Sildenafil citrate was introduced as a treatment for erectile dysfunction in April 1998 in the United States and has been available since March 1999 in Japan. In this article, we assess the efficacy of sildenafil in the treatment of erectile dysfunction in Japanese men after radical retropubic prostatectomy for localized prostate cancer.

Methods: Of 106 men who underwent radical retropubic prostatectomy between January 1994 and March 2000, 43 were prescribed sildenafil at their request after radical retropubic prostatectomy. Medication was initiated at 25 mg, and if this was ineffective, the dose was increased to 50 mg. Of the patients, 18 underwent bilateral and 21 unilateral nerve sparing (NS) procedures, while in 4 patients, a non‐NS procedure was performed. These patients were interviewed using a questionnaire about  their  response  to  sildenafil  and  using  the  5‐item  International  Index  of  Erectile  Function (IIEF‐5) questionnaire.

Results: Thirty‐three of the 43 patients were eligible for evaluation of the efficacy of sildenafil and 27 completed the IIEF‐5 questionnaires. Sildenafil at 50 mg had a better effect on sexual function than 25 mg in most Japanese patients. Of the 16 patients who underwent bilateral NS procedures, 10 (62.5%) had improved ability for intercourse and 3 (18.8%) had improved erections. Of the 13 patients who underwent unilateral NS procedures, 7 (53.8%) had improved ability for intercourse and 4 (30.8%) had improved erections. None of the 4 patients who underwent non‐NS procedures had a positive response. Of 24 patients with positive response to sildenafil, 3 (12.5%) did not have to take sildenafil after receiving it because they did not require it for intercourse. Mean IIEF‐5 score increased from 4.3 to 11.4 (P < 0.0001). Patient age, time since surgery, PSA and pathological stage did not have statistically significant effects on outcome. The most commonly cited adverse effect was headache (21%).

Conclusion: Sildenafil is equally effective for erectile dysfunction in Japanese patients who have undergone bilateral and unilateral NS procedures, and aids recovery of natural erectile function after radical retropubic prostatectomy. However, non‐NS procedure patients had no response to sildenafil. This study suggested that sildenafil is well tolerated and should be initially used for treatment of Japanese men with erectile dysfunction after radical retropubic prostatectomy.
Peritoneal carcinomatosis in refractory seminoma
Authors: ABE TAKASHIGE , SHINOHARA NOBUO , HARABAYASHI TOHRU , TSUCHIYA KUNIHIKO , SUZUKI SHIN , ITOH TOMOO , SEKI TOSHIMORI , TOGASHI MASAKI , NONOMURA KATSUYA , KOYANAGI TOMOHIKO
Published: February 2004

Abstract Intraperitoneal metastasis from a testicular germ cell tumor is very rare. We report a case in a 33‐year‐old man who was referred to Hokkaido University Hospital, Hokkaido, Japan, for further therapy for refractory seminoma. Physical examination revealed abdominal distension as a result of ascites, and cytology of the ascites showed seminoma cells. Although the ascites completely disappeared after treatment with a novel regimen of irinotecan‐based chemotherapy, the patient had a recurrence of ascites and died of progressive disease 5 months after the start of the therapy.
Torsion of an epididymal cyst
Authors: YILMAZ ERDAL , BATISLAM ERTAN , BOZDOGAN ONDER , BAŞAR HALİL , BAŞAR M MURAD
Published: February 2004

Abstract Torsion of an epididymal cyst is a very rare condition. We present a case of torsion of an epididymal cyst in a 13‐year‐old boy. The patient presented with acute scrotal pain. Scrotal ultrasonography showed a 38 × 35 × 30 mm fluid‐filled mass within the caput of the left epididymis. Histologically, the cells of the epididymal duct were necrotic. To our knowledge, this is the second case report in the literature.
Comparison of Gas‐less laparoscopy‐assisted surgery, hand‐assisted laparoscopic surgery and pure laparoscopic surgery for radical nephrectomy
Authors: HAYAKAWA KUNIHIRO , AOYAGI TEIICHIRO , OHASHI MASAKAZU , HATA MAKOTO
Published: February 2004

Background: We report our experience with Gas‐less laparoscopy‐assisted surgery (Gas‐less LAS), hand‐assisted laparoscopic surgery (HALS) and pure laparoscopic surgery (LS) for renal carcinoma and compare the characteristics and usefulness of these methods.

Methods: Seventeen, 14 and 16 patients were subjected to Gas‐less LAS, HALS and LS, respectively. The study started with Gas‐less LAS and then gradually shifted to HALS and LS. We evaluated the operative and postoperative parameters for each group. The learning curve effect was evaluated based on data from the first 10 cases of each group, which were operated on by the same surgeon and operation team.

Results: The learning curve of operation times in the LS group demonstrated that the operation time for this procedure is acceptable even in early‐stage cases. Differences in mean operative time between the three surgical groups, excluding the conversion cases, were not statistically significant; however, there was a significant difference in blood loss volume between the groups (P ≤ 0.001). Operation time tended to be shorter in Gas‐less LAS and the frequency of parental analgesia administration tended to be reduced in the LS group when compared to the other two groups. Of the total 47 patients treated, two cases were converted to open surgery. The major postoperative complication was one case of brain infarction in the HALS group. One patient in the LS group developed a lung metastasis 11 months after the operation.

Conclusion: As minimally invasive operative techniques, these three methods do not differ significantly in terms of surgical outcome; however, LS tended to be slightly superior in terms of postoperative pain control and cosmetic appearance.
Sensitization of human renal cell carcinoma cell lines to TRAIL‐induced apoptosis by anthracyclines
Authors: WU XIU‐XIAN , OGAWA OSAMU , KAKEHI YOSHIYUKI
Published: February 2004

Background: Tumor necrosis factor‐related apoptosis‐inducing ligand (TRAIL) is a new member of the tumor necrosis factor family. The present study investigated whether anthracyclines enhance TRAIL‐induced apoptosis and cytotoxicity in renal cell carcinoma (RCC) cells.

Methods: Cytotoxicity was measured using the microtiter assay. Apoptosis was monitored using DNA ladder analysis. Caspase activity was determined using a quantitative colorimetric assay.

Results: Treatment of ACHN and Caki‐1 human RCC lines with TRAIL, in combination with subtoxic concentrations of epirubicin (EPI) or pirarubicin (THP), enhanced induction of apoptosis and cytotoxicity. Sequential treatment with EPI followed by TRAIL induced significantly more cytotoxicity than the inverse treatment. The combined cytotoxicity of TRAIL and EPI was significantly inhibited by the TRAIL‐neutralizing fusion protein DR5:Fc, although EPI did not affect the mRNA expression of DR4, DR5, DcR1 or DcR2. The combination treatment with TRAIL and EPI activated caspase‐6 and ‐3, which were downstream molecules of the death receptor. Furthermore, the combined cytotoxicity of TRAIL and EPI was almost completely inhibited by Z‐VAD‐FMK, and partly inhibited by Ac‐DMQD‐CHO.

Conclusion: These findings indicate that anthracyclines sensitize RCC cells to TRAIL‐induced apoptosis and cytotoxicity through activation of caspases, suggesting that TRAIL, in combination with anthracyclines, has a therapeutic potential in the treatment of RCC.
High‐dose rate iridium‐192 brachytherapy and external beam radiation therapy for prostate cancer with or without androgen ablation
Authors: CHIANG PO HUI , FANG FU MIN , JONG WANG CHONG , YU TSAN JUNG , CHUANG YAO CHI , WANG HUNG JEN
Published: February 2004

Aim: To report the results of our feasibility study incorporating iridium‐192 high‐dose‐rate (HDR) afterloading brachytherapy and external beam radiation therapy (EBRT) for the treatment of prostate carcinoma and to assess the role of androgen ablation in conjunction with this treatment option.

Methods: From July 2000 to June 2002, 42 patients with clinically localized or locally extensive prostate carcinoma were treated with HDR iridium‐192 brachytherapy and EBRT with or without androgen ablation. The median follow up was 16.5 months.

Results: The technique of HDR brachytherapy and EBRT proved to be feasible with acceptable morbidities. Continuous prostate‐specific antigen (PSA) reduction was noted in all patients and no PSA failure was noted during follow up. Within 1 year, the decline of PSA nadir values less than 1 ng/mL was faster in patients with the addition of androgen blockade (P = 0.001). However, within 1 year, PSA nadir values less than 1.0 ng/mL can be achieved in all patients whose initial PSA is less than 20 ng/mL, with or without hormone blockade.

Conclusions: The need for hormonal therapy in favorable‐risk brachytherapy patients (PSA < 20 ng/mL) might be less than the need for intermediate‐ or high‐risk patients. The use of hormonal therapy in intermediate‐risk patients (PSA ≥ 20 ng/mL) treated with HDR brachytherapy and pelvic EBRT is appealing, considering the favorable results. High dose rate brachytherapy appears to be an effective treatment for clinically localized and locally extensive prostate cancer, with minimal morbidity.
Anaphylaxis following administration of intravenous methylprednisolone sodium succinate in a renal transplant recipient
Authors: SAITO RYOICHI , MOROI SEIJI , OKUNO HIROSHI , OGAWA OSAMU
Published: February 2004

Abstract Methylprednisolone sodium succinate (MPS) is widely used in the management of renal transplantation. Of interest is the rare occurrence of anaphylaxis and anaphylactoid reaction to MPS. We report on a patient who developed anaphylaxis following the intravenous administration of MPS during a renal transplant operation. Intracutaneous testing was carried out with MPS and a strong positive reaction was observed. Histamine and tryptase concentrations were high after the anaphylactic reaction. Including the present case, there have been 13 reports of anaphylactic or anaphylactoid reactions to MPS, occurring in renal transplant recipients. Clinicians should be aware of the potential risk of MPS administration. If transplant patients undergo skin testing against MPS prior to transplant, they may benefit from an alternative medication with other corticosteroids. To use MPS without severe adverse reactions, lower administration rates and dosages are very important.
The Writer's Refusal and Law's Malady
Authors: Hanafin Patrick
Published: February 2004

In this piece I want to (re)pose the relation of writing to law and politics, by interrogating the sense of a writing which is simultaneously an unwriting or undoing of legal and political discourse through Maurice Blanchot's involvement in the movement against the French colonial war in Algeria and, in particular, his framing of the Declaration of the Right to Insubordination in the Algerian War in 1960. The piece analyses how the sense of the event of the Declaration continues to call us to acknowledge a ‘disastrous responsibility’ to a non‐community beyond the time of law and politics.
Estopped by Grand Playsaunce: Flann O'Brien's Post‐colonial Lore
Authors: Brooker Joseph
Published: February 2004

This article seeks to extend our understanding of the Irish writer Flann O'Brien (Myles na gCopaleen, Brian O'Nolan) by reading him from a Law and Literature perspective. I suggest that O'Nolan's painstaking and picky mind, with its attention to linguistic nuance, was logically drawn to the languages of law. In this he confirmed the character that he showed as a civil servant of the cautious, book‐keeping Irish Free State. The Free State, like other post‐colonial entities, was marked at once by a rhetoric of rupture from the colonial dispensation and by a degree of legal and political continuity. I suggest that O'Nolan's writing works away at both these aspects of the state, alternating between critical and utopian perspectives.

After establishing an initial context, I undertake a close reading of O'Nolan's parodies of actual legal procedure, focusing on questions of language and censorship. I then consider his critical work on the issue of Irish sovereignty, placing this in its post‐colonial historical context. Finally I describe O'Nolan's treatment of Eamon de Valera's 1937 Constitution. I propose that his attention to textual detail prefigures in comic form the substantial rereadings of the Constitution that have been made in the last half‐century.
‘Tell All the Truth, but Tell it Slant’: A Poetics of Truth and Reconciliation
Authors: Gearey Adam
Published: February 2004

There is a voice that tries to speak the truth. This essay will suggest that the discourse on the South African Truth and Reconciliation Commission [TRC] has perhaps ignored this most invisible of things, and has looked for the truth of the Commission everywhere except where it might be found, if indeed it can be found at all. To the extent that it is possible to oppose the truth of the voice to another truth, it may be useful to make use of a notion of poetics; even a sublime poetics.
Then and Now: The Natural/Positivist Nexus at War: Auden's ‘September 1, 1939’
Authors: Williams Melanie L.
Published: February 2004

This article returns to a little examined moment in the history of jurisprudence. A moment fleetingly considered, it has been ascribed, nevertheless, an iconic status in that history,2 and it is meet to return to it now, at the war‐shadowed dawn of the twenty‐first century to consider how the juxtaposition of war with the positivist‐Natural Law debate compares with the outbreak of an earlier war. The consideration of poetry alongside philosophy and jurisprudence permits reflection upon the history of ideas permeating many strands of thought and allows tentative conclusions to be drawn concerning implications for ‘local’ theory — especially ‘Anglo‐American’ debate and the influence of discrete aspects of theory as they impinge one upon the other. The history also holds lessons for the very notion of theory itself — in the need to consider the ‘tensile’ properties of legal and political theory, any putative interactions between the formerly separate worlds of the analytic and normative, the ‘natural’ and ‘positive’— particularly tested in the contingent event.
The Jurisprudence of Travel Literature: Despotism, Excess, and the Common Law
Authors: Haldar Piyel
Published: February 2004

This article is an attempt to gauge the influence of Orientalism upon western ideals of judgment. More specifically, it focuses on descriptions of despotism in early travel literature as a measure of what the emerging rationality of western legality was attempting to disavow.
Literature in the Dock: The Trials of Oscar Wilde
Authors: Kaplan Morris B.
Published: February 2004

This essay uses the recently published expanded record of the Queensberry libel trial to revisit the relationship between the ‘literary’ and ‘sexual’ dimensions of the Wilde scandal. The defence was guided by an integrated conception of the links between the two that shaped both the public responses and the legal proceedings, including the criminal prosecution. The conflict between moral literalism and aesthetic indeterminacy not only informed the legal determination of sexual guilt but also was inflected by social class in ways that contributed to the construction of male homosexuality and of the ‘literary’.
A Fragment on Cnutism with Brief Divagations on the Philosophy of the Near Miss
Authors: Goodrich Peter
Published: February 2004

This fragment is taken, mid‐sentence as it were, from a longer discourse. It is plucked in process from a discussion of friendship for ideas. It is part of a longer journey through the annals of amity. The fragment also examines a fragment, a gloss on a text, a marginal comment, a handwritten note, which is taken to constitute the modern origin of Cnutism.
Dominions: Law, Literature, and the Right to Death
Authors: Fitzpatrick Peter
Published: February 2004

The ‘curious right’ attending modernity and revealed in Blanchot's ‘Literature And the Right to Death’ could be readily reduced to that sovereign right to take life which ultimately subordinates law. Yet, so the argument runs, with that same curious right law surpasses sovereignty. And it does so by way of its similarity to literature. What will uncover that surpassing by law, and by literature, will be a pervasive concern with death as the horizon of the law.
Beyond Otonomy, or Beyond the Law of Law's Ear
Authors: Chryssostalis Julia H.
Published: February 2004

Can the relationship between law and literature be thought in terms of conversation? Can the law still ‘hear’ the voice of a writing that has come before it, yet outside the frame of the ‘hearing’ and the rules of ‘standing’? And when literature speaks, what does it say? Perhaps what the law has always known …
Public–Private Partnerships: Organisational Hybrids as Channels for Local Mobilisation and Participation?1
Authors: Andersen Ole Johan
Published: February 2004

The article focuses on new forms of governance involving partnerships between public and private actors. As several scholars have noticed, organisational hybrids at the intersection of the public and private sectors play an important part in the implementation of collective action. Local economic development in particular has provided a fertile ground for building coalitions across traditional divisions, and encouraging partnerships. This applies to Norway as well as to other liberal Western democracies.

Obviously, the formation of partnerships reflects efforts to design more efficient and flexible instruments for founding new firms and for supporting local entrepreneurs. The article, however, raises the question of whether these arrangements may entail a far more expanded role and domain, opening up new channels for participation and mobilisation. By expanding their agenda and integrating new segments of the local community, public–private partnerships appear to be an innovation in local democracy.

Analytically, the article utilises elements of regime theory. Although the partnerships studied hardly constitute stable coalitions dominating local politics, they nevertheless illustrate how the building of coalitions including both private and public actors is crucial to coping with the problems and challenges of local restructuring and revitalisation. Case studies carried out in Norwegian municipalities provide the main empirical source. The article does, however, build on experience from other European countries.
Compliance and Conflict Management in the European Union: Nordic Exceptionalism
Authors: Sverdrup Ulf
Published: February 2004

Why and to what extent do states differ in their implementation of international norms? Furthermore, why and to what extent do states differ in their mode of resolving conflicts regarding non‐implementation of international norms? In this article the empirical focus is on implementation of Community legislation by the member states of the European Union (EU) and the European Free Trade Association (EFTA). The analysis shows that over time there has been an overall reduction in the deficit in transposition, but the number of conflicts regarding non‐implementation has increased in the same period. While states converge on transposition, they diverge regarding their mode of handling conflicts related to non‐implementation. In general, the larger member states more frequently use court rulings to settle such conflicts. By contrast, the smaller states, and in particular the Nordic states, pursue a more consensus‐seeking approach, with limited use of courts. These observations indicate that domestic traditions and styles of decision making are more important for explaining variation than the enforcement capacity of the European institutions, and the extent of participation and power in decision making at the European level.
Shifting Dimensions of Citizen Control1
Authors: Bergman Torbjörn , Strøm Kaare
Published: February 2004

European politics is still dominated by representative and parliamentary national systems of policy making. These systems can be seen as chains of political delegation from citizens through parliamentarians and executive office holders to civil servants. In these chains, a major trend for the past thirty years, and more strongly during the second half of that period, is a strengthening of agents’ accountability to the principals. But, simultaneously, citizens’ ability to exercise accountability through parliamentary democracy is eroding because of a decline in political party cohesion. Concurrently, constraints external to both the constitutional chain and political parties are growing stronger.

The changes along these three dimensions lead to a situation in which democratic principals commonly decide more about less. Thus, while reforms have strengthened the constitutional parliamentary chain of governance, there is also an ongoing de‐parliamentarisation of modern politics. The main motivation for this special issue is to investigate this general phenomenon through a set of focused case studies of the Nordic (here known as ‘Scandinavian’) countries. These analyses show important differences in how these trends have been manifest. In one country, Finland, the parliamentary chain has actually grown in strength and importance in the last decade.
Developments in Danish Parliamentary Democracy: Accountability, Parties and External Constraints
Authors: Damgaard Erik
Published: February 2004

Danish parliamentary developments since the Second World War include the consolidation of minority rule, a reduction in the power of established political parties, and more external constraints on parliamentary actors. They also involve a number of more specific changes to the various steps of delegation and accountability. The evidence tends to support the thesis of a paradox in the development of parliamentary democracy. On the one hand, changes in the constitutional chain of delegation and accountability have, on the whole, favoured the principals (voters, parliament, ministers) compared with their agents (parliament, ministers, civil servants). On the other hand, the established parties have declined somewhat and there are more external constraints than there used to be. This implies that the power of democratic principals has increased within narrower limits of action. In such a situation, the principals can be said to ‘decide more about less’ because of the stronger national and (not least) international constraints. However, the emergence of a partially new system of governance cannot unequivocally be called better or worse than the traditional Danish system of democratic governance.
Combating deceptive advertisements and labelling on food products – an exploratory study on the perceptions of teachers
Authors: Lai Yeung Wai‐ling Theresa
Published: February 2004

People are becoming more health conscious nowadays, but most of them are not able to adopt a lifestyle with adequate physical exercise and a healthier eating pattern. Many attempt to compensate by taking ‘health foods’. Despite the recent economic recession, the functional food market is expanding rapidly in Asian countries. Recent statistics indicate a huge increase in weight loss and functional food product advertising expenditure in Hong Kong and other Asian countries. In a large scale survey conducted by the Hong Kong Consumer Council on advertisements, it was found that 85% of the medicines, health food and therapies sampled contain questionable claims and misleading messages, which was the second most problematic category of the survey. In addition, young people do not understand much about modern food processing, in particular with regard to low energy and functional foods, and they know very little about modern food marketing strategies. The situation is potentially detrimental to consumer welfare, especially to the younger generation. This study was conducted to reflect critically on implications of the issue on the health and well‐being of young people in Hong Kong. Attempts are made to explore directions for designing relevant and effective education programmes to empower young people's abilities in understanding food advertising strategies and making informed decisions on food choice. This paper begins with a critical review of the current situation with regard to Hong Kong. Then, the results of an interview survey and a questionnaire survey on pre‐service and in‐service teachers’ perception towards misleading food advertising and labelling are reported. The situations at schools are defined and problems faced by teachers in providing relevant consumer education programmes to students are identified. Finally, some prospective foci for further investigation of this important issue, with a view to developing students’ critical skills in evaluating claims offered in food advertisements, will be considered.
Dimensional analysis of schoolchildren's food label comprehension: a pilot study
Authors: Stuart Stephen A. , Schröder Monika , Hughes Alan , Bower John
Published: February 2004

This article discusses some weaknesses in current research into young consumers’ abilities to comprehend and successfully manipulate food label information and describes the development of a research project through to an analysis of the pilot phase. The research programme identifies a method  of  measuring  the  effectiveness  of  state  education in enabling the next generation of consumers to make informed food choices through the provision of appropriate tools and skills, both of which are necessary to fully understand a label's informational elements within a marketing context. The article also discusses the appropriateness of a quantitative questionnaire to measure the abilities and skills of individuals through the identification of some key comprehension dimensions required by modern food consumers. Finally, the article questions the appropriateness of the context in which information is provided to food consumers. Through a continuing programme of research, it is envisaged that a more appropriate context for certain elements important in the choice of a diet that is relevant to an individual's lifestyle may be proposed.
Making patient medication safer for all: an action research approach
Authors: Gould Nicholas
Published: February 2004

Complexity  in  medication  arrangements  can  lead  to  risks for older people and their carers. These risks need to be managed through a system without any single hierarchical command and control structure. The paper describes the processes by which an action research project created a network organization for the safer consumption of medication in the community. Service redesign outcomes are recorded. The applicability of the approach to other complex products‐in‐use is noted.
The golden age of protein: an initial teacher training perspective on the biological role of proteins in our everyday lives
Authors: Lakin Liz
Published: February 2004

We make use of proteins in all aspects of our daily lives from biological washing powders to soft‐centred sweets, yet their fundamental role in our diet is often misunderstood. This paper draws on the findings of a three‐phase research project into Initial Teacher Trainee's perception of food and eating, where students demonstrated several similar misconceptions about the food they eat and in particular, the role of proteins. More than 50% of the students thought that protein was a primary source of energy and were confused about the relationship between proteins, amino acids and nitrogen, and the role of DNA in synthesizing proteins. These misconceptions were often translated into practice in the diet the students consumed and the messages they passed on, with confidence, to their pupils. In addition to the misconceptions, teaching approaches used by the students were highly mechanistic, with little reference being given to the relationship between food and the circumstances in which it is eaten. The relationship between dietary intake and lifestyle is explored in secondary schools within Food Technology lessons. However, it is often too late to rectify the deeply entrenched misconceptions, attitudes and eating habits that school children have developed in their primary years. This paper makes the recommendation that we should reconsider how nutrition education is delivered in schools, especially at a primary level: emphasizing the need to relate teaching and learning to everyday experiences. The paper concludes by suggesting possible strategies by which this may be achieved, with proteins featuring centre‐stage.
Will consumers accept irradiated food products?
Authors: Nayga Rodolfo M. , Poghosyan Arsen , Nichols John P.
Published: February 2004

This study examines consumers’ willingness to pay for irradiated beef products. About 58% of the respondents are willing to pay a premium for irradiated beef. An ordered probit with sample selection model was estimated. Standard errors of the marginal effects of the ordered probit model were estimated using the bootstrap method. Our findings suggest that females and those who think that improper handling contributes to food poisoning are more likely to pay a premium of 50 cents per pound for irradiated beef than others. Those who trust the irradiation technology are also more likely to pay a premium of between 5 and 25 cents per pound for irradiated beef. Supply chain implications are discussed.
Consumer use of the internet for health information: a survey of primary care patients
Authors: Dolan Gina , Iredale Rachel , Williams Robert , Ameen Jamal
Published: February 2004

An increasing number of patients use the internet to obtain information about health. Although some information is available about how health professionals use the internet, little is known about how patients utilize this information. Some patients may actively seek information to assume more responsibility for their health. However, others may feel obliged to do so because of failing confidence in health care provision. Health professionals have the potential to assist patients to make sense of health information from the internet; however, they may not necessarily welcome this role. This study aims to evaluate patients’ use of such information in a primary care setting. The sample consisted of adult patients (n = 851) from two general practice populations at different levels of the socio‐economic spectrum in South Wales (UK). Patients were surveyed by questionnaire about the health information they use, including the internet. The majority of patients preferred to use their general practitioner as the main source of health information. The internet was jointly the second preferred source for information about an illness (6%). Just over half (51%) of patients in this study had access to the internet, of which about half use it to access health information. Just under a quarter (24%, n = 55) of health internet users had discussed information accessed from the internet during a subsequent consultation with a health professional. Of these, three‐quarters felt more prepared and able to participate in decision‐making about treatments. This study provides a greater understanding of how patients are making use of health‐related information from the internet. These findings can be used to help prepare health care professionals for dealing appropriately with internet‐informed patients.
Consumer education between ‘consumership’ and citizenship: experiences from studies of young people
Authors: Benn Jette
Published: February 2004

The aim of consumer education has been mainly to teach and educate students to act as informed, rational and prudent consumers. This perception of consumption as reasoned behaviour or action is inadequate in the late modern society, where consumerism is first and foremost characterized by globalization, cultural change and the liberation of the individual. The results of a research study involving Danish pupils aged 12–19 years present a picture of consumption connected both to material and non‐material aspects of life. Consumption as such has a significant impact on and meaning for the individual: it becomes a means by which human beings communicate and interact. Consumption is part of children's and young people's education and socialization, and plays a role in the development of identity and self‐image. Institutional consumer enlightenment and the education of students in school stand in contrast to informal consumer  socialization  and  the  education  of  individuals. The aim of formal consumer education may be described as ‘educating for critical consumer awareness and action competence’. However consumer education finds itself in the dilemma between ‘consumership’ and ‘citizenship’. This pilot study is aimed at understanding consumer socialization in order to improve formal consumer education and to reflect on how empowerment becomes part of consumer education.
Influences of question wording on levels of support for genetically modified organisms
Authors: Kolodinsky Jane , DeSisto Thomas Patrick , Narsana Rashmi
Published: February 2004

This paper examines the influences of question wording on consumers’ levels of support for genetically modified organisms (GMOs) in food products. Pairs of questions, offering varied amounts of information on the benefits and risks of GMOs, are posed to consumers in a specific geographic area (Vermont, USA) to ascertain the factors that impact on levels of support for this technology. A multivariate analysis is conducted to examine how knowledge, attitudes, and behavioural intentions affect changes in levels of support. The findings suggest that consumers’ levels of support do vary based on question wording. It is further found that knowledge and behavioural intentions play a consistently significant role in influencing change in support for GMOs. Implications for both consumer advocacy groups and industry groups are discussed.
The Use of Strontium Isotope Analysis to Investigate Tiwanaku Migration and Mortuary Ritual in Bolivia and Peru
Authors: Knudson K. J. , Price T. D. , Buikstra J. E. , Blom D. E.
Published: February 2004

Strontium isotope analysis is applied in South America for the first time in order to investigate residential mobility and mortuary ritual from ad 500 to 1000. While Tiwanaku‐style artefacts are spread throughout Bolivia, southern Peru and northern Chile during this time, the nature of Tiwanaku influence in the region is much debated. Human skeletal remains from the site of Tiwanaku and the proposed Tiwanaku colony of Chen Chen have been analysed to test the hypothesis that Tiwanaku colonies, populated with inhabitants from Tiwanaku, existed in Peru. Strontium isotope analysis supports this hypothesis by demonstrating that non‐local individuals are present at both sites.
How Did Mississippians Prepare Maize? The Application of Compound‐Specific Carbon Isotope Analysis to Absorbed Pottery Residues From Several Mississippi Valley Sites
Authors: Reber E. A. , Evershed R. P.
Published: February 2004

A newly developed compound‐specific stable carbon isotope technique allows the detection of maize in absorbed organic pottery residues. This method was applied to absorbed organic residues from a variety of Mississippi Valley potsherds, and successfully identified maize components. Maize was cooked in sampled vessels less often than expected, but otherwise fitted expected patterns of maize use derived from stable carbon isotope analysis of human bone from the region. Absorbed organic pottery residue analysis is useful in determining pottery use, particularly in concert with other analytical methods.
Identifying Chemical Activity Residues on Prehistoric House Floors: A Methodology And Rationale For Multi‐Elemental Characterization of a Mild Acid Extract of Anthropogenic Sediments
Authors: Middleton W. D.
Published: February 2004

Archaeologists have employed sediment chemistry in site prospection for nearly a century. For example, phosphorus is a good indicator of human occupation, because it is a generic indicator of human activity. Recently, multi‐element studies of sediments have successfully identified specific activity areas by analysing other elements in addition to phosphorus. To reach its full potential, however, sediment chemistry must be undertaken with an understanding of how these residues are formed and of the chemical indicators that can be used to identify specific activities. Methodologies that optimize the extraction of specific residues must be employed. Not to do so is a naïve application of the technique.
Investigating Activity Patterns In Prehispanic Plazas: Weak Acid‐Extraction ICP–AES Analysis of Anthrosols at Classic Period El Coyote, Northwestern Honduras
Authors: Wells E. C.
Published: February 2004

Weak acid‐extraction ICP–AES analysis was performed to obtain multi‐elemental characterizations of anthropogenic sediments from plaza spaces that no longer contain artefacts and adjacent trash deposits at the prehispanic site of El Coyote in northwestern Honduras. Multivariate quantitative assessments of the anthrosol chemical data, along with associated inventories of midden materials, are examined to derive signatures for activity areas and refuse dumps that can be linked across portions of the site. The findings of this study permit the reconstruction of activity patterns in the site's main plaza and in its environs. This has important implications for understanding the relationship among ritual practice, craft production and political economy during the Late and Terminal Classic periods, c. ad 600–1000.
Post‐Depositional Elemental Alterations in Pottery: Neutron Activation Analyses of Surface and Core Samples*
Authors: Schwedt A. , Mommsen H. , Zacharias N.
Published: February 2004

From 38 sherds with ‘corroded’ surfaces, two samples per sherd were examined using Neutron Activation Analysis, one from the surface and one from the core of each sherd, in order to analyse post‐depositional alterations of minor and trace elements. The most striking effect was that a leaching of Ca could be found at the surface. Another group of elements that is severely affected are the alkali metals, with Cs and Rb showing the strongest changes. A third conspicuous group of elements are the Rare Earth Elements. Finally, the effect of such alterations on a statistical data evaluation to classify pottery according to provenance is investigated.
Bitumen in Early Ceramic Art: Bitumen‐Painted Ceramics From Late Neolithic Tell Sabi Abyad (Syria)*
Authors: Connan J. , Nieuwenhuyse O. P. , Van As A. , Jacobs L.
Published: February 2004

The paper presents the results of a chemical analysis of black pigment used to decorate pottery from Late Neolithic Tell Sabi Abyad, northern Syria (c. 6100 cal bc). The pigment appears to be bitumen. A comparison with known reference samples from modern locations of bituminous sources in the Near East suggests that the bitumen used to paint ceramics at Tell Sabi Abyad came from at least two different source areas in northern Iraq. The bitumen‐painted ceramics at Tell Sabi Abyad represent the earliest evidence attested so far of bitumen used as a pigment for pottery decoration.
Vietnamese (15th Century) Blue‐And‐White, Tam Thai and Lustre Porcelains/Stonewares: Glaze Composition and Decoration Techniques*
Authors: Colomban PH. , Sagon G. , Huy L. Q. , Liem N. Q. , Mazerolles L.
Published: February 2004

EDS, X‐ray fluorescence, Raman spectroscopy, thermal expansion–shrinkage measurement and scanning electron microscopy were applied to determine the elemental components, structural phases and glazing temperatures of the transparent glazes, blue underglaze and overglaze tam thai (including gold‐like lustre) decorations from the 15th‐century Vietnamese porcelains/stonewares found at the Chu Ðâu–My Xa kiln site and in the Cù Lao Chàm (Hôi An) cargo. The ancient technology for colouring the glazes is discussed. The various blue tones in the underglazed décor result from cobalt‐containing manganese ore, with the intentional addition of iron oxide. The overglaze copper‐green and the gold‐like lustre were obtained by dispersing copper in lead‐based glass. The red colour was made using hematite dispersed in lead‐rich flux.
Potassium–Calcium Glass: New Data and Experiments*
Authors: Stern W. B. , Gerber Y.
Published: February 2004

The chemical composition of potassium–calcium ‘wood‐ash’ glass reflects the elemental pattern of the involved non‐volatile base materials in quartz sand, wood ash and possibly potash. The essential elemental ratio K2O/CaO of wood ash varies between 0.2 and 0.8, and depends on the habitat and geological substratum of the wood rather than on the tree species; ratios between 1.0 and 3.0 in wood‐ash glass are only possible when potash is added as a third base material. Melting temperatures of wood‐ash glass sensu stricto, termed K–Ca‐2, produced with the two raw materials quartz sand and wood ash, are between 1250°C and 1400°C, while those of three‐component‐glasses, termed K–Ca‐3, are between 900°C and 1250°C, according to the amount of added potash. Experimentally produced glass displays different hues, from colourless to brown, olive‐green and pink, according to the chemical composition of the wood ash. Elevated MnO concentrations between 0.5 and 3 wt% may originate from wood ash and are hence not necessarily an indicator of colour‐inhibiting additives. Phosphate stemming from wood ash is an essential discriminator between wood‐ash glass and potash–lime glass. Because wood ash contains only minor amounts of sodium, wood‐ash glass with equal concentrations of potassium and sodium is a hybrid glass type, where besides quartz sand, wood ash, possibly potash and also soda‐rich cullet have been applied for glass production.
The Preservation of Invertebrates in 16th‐Century Cesspits at St Saviourgate, York*
Authors: McCobb L. M. E. , Briggs D. E. G. , Hall A. R. , Kenward H. K.
Published: February 2004

The taphonomy of invertebrates from 16th‐century cesspits at St Saviourgate, York, was investigated. Earthworms, fly larvae and puparia are preserved through replication in calcium phosphate, a process facilitated by acidic cesspit pore water and by the presence of abundant organic matter, bones and shells. Features preserved by mineralization include muscles, blood vessels and setae. Non‐mineralized invertebrate remains include puparia and beetles. Py–GC/MS (flash pyrolysis–gas chromatography/mass spectrometry) revealed a very high level of preservation of structural biomolecules, with all the protein and chitin markers that are evident in the living forms still being detectable in the divalent remains.
Identification of the Kna/Knb polymorphism and a method for Knops genotyping
Authors: Moulds J.M. , Thomas B.J. , Doumbo O. , Diallo D.A. , Lyke K.E. , Plowe C.V. , Rowe J.A. , Birmingham D.J.
Published: February 2004

BACKGROUND: DNA mutations resulting in the McCoy and Swain‐Langley polymorphisms have been identified on complement receptor 1 (CR1)—a ligand for rosetting of Plasmodium falciparum‐infected RBCs. The molecular identification of the Kna/Knb polymorphism was sought to develop a genotyping method for use in the study of the Knops blood group and malaria.

STUDY DESIGN AND METHODS: CR1 deletion constructs were used in inhibition studies of anti‐Kna. PCR amplification of Exon 29 was followed by DNA sequencing. A PCR‐RFLP was developed with NdeI, BsmI, and MfeI for the detection of Kna/Knb, McCa/McCb, and Sl1/Sl2, respectively. Knops phenotypes were determined with standard serologic techniques.

RESULTS: A total of 310 Malian persons were phenotyped for Kna with 200 (64%) Kn(a+) and 110 (36%) Kn(a–). Many of the Kn(a–) exhibited the Knops‐null phenotype, that is, Helgeson. The Kna/b DNA polymorphism was identified as a V1561M mutation with allele frequencies of Kna (V1561) 0.9 and Knb (M1561) 0.1.

CONCLUSION: The high frequency (18%) of Knb in West African persons suggests that it is not solely a Caucasian trait. Furthermore, because of the high incidence of heterozygosity as well as amorphs, accurate Knops typing of donors of African descent is best accomplished by a combination of molecular and serologic techniques.
Alteration of amino acid residues at the L‐chain N‐terminus and in complementarity‐determining region 3 increases affinity of a recombinant F(ab) for the human N blood group antigen
Authors: Song Shuh‐Chyuny , Czerwinski Marcin , Wojczyk Boguslaw S. , Spitalnik Steven L.
Published: February 2004

BACKGROUND: To examine the fine specificity of glycopeptide‐specific antibodies, this study focused on the human MN blood group system. F(ab) phage display methods were previously used to construct an F(ab) family in which the H‐chain Fd fragment was held constant whereas the L chains were “shuffled.” This yielded two related F(ab), N92 and NNA7, with low and high affinity for N, respectively. Although their L‐chain sequences are very similar, sharing 92 percent amino acid identity, there are intriguing differences at the N‐terminus and in complementarity‐determining region 3 (CDR3) at positions 89, 91, 92, and 96.

STUDY DESIGN AND METHODS: Site‐directed mutagenesis, ELISA, and hemagglutination were used to examine the contributions of these variations to antibody affinity.

RESULTS: Studies with the N92‐S91G and NNA7‐G91S mutants demonstrated that the Gly at position 91 was critically important for ensuring high affinity. Indeed, the affinity of N92‐S91G was almost as high as N92TM, in which all four CDR3 residues were changed to match NNA7. N‐terminal L‐chain differences were surprisingly important in determining affinity. For example, when the N‐terminus of N92 was changed to match that of NNA7, affinity increased approximately 30‐fold.

CONCLUSION: Specific residues at the L‐chain N‐terminus and in CDR3 significantly affected F(ab) affinity for N. Future structural studies of these F(ab), alone and complexed with this glycopeptide antigen, will provide further insights into these phenomena.
Severe deficiency of VWF‐cleaving protease (ADAMTS13) activity defines a distinct population of thrombotic microangiopathy patients
Authors: Raife Thomas , Atkinson Bonnie , Montgomery Robert , Vesely Sara , Friedman Kenneth
Published: February 2004

BACKGROUND: Severe deficiency of ADAMTS13 activity is a biologic risk factor for thrombotic microangiopathy (TMA). It was hypothesized that severe ADAMTS13 deficiency is associated with a distinct TMA subpopulation.

STUDY DESIGN AND METHODS: ADAMTS13 activity before treatment was determined retrospectively in 107 adult TMA patients treated with plasma exchange. Patients were not clinically categorized, but divided between severely deficient (n = 50) and nonseverely deficient (n = 57) ADAMTS13 activity. Laboratory and clinical factors before treatment were compared between the groups.

RESULTS: Median PLT counts were 44,000 per µL in nonseverely deficient ADAMTS13 patients and 13,000 per µL in severely deficient ADAMTS13 patients (p < 0.001). Median serum creatinine levels were 2.7 mg per dL in nonseverely deficient patients and 1.2 mg per dL in severely deficient patients (p < 0.001). In surviving patients, median plasma exchange procedures were 9 in nonseverely deficient patients and 14.5 in severely deficient patients (p < 0.01). Rates of relapse following remission were 4 of 47 in nonseverely deficient patients and 16 of 46 in severely deficient patients (p < 0.01). Among analyzed factors only mortality rates were not significantly different.

CONCLUSION: In a heterogeneous population of TMA patients treated with plasma exchange, ADAMTS13 activity defined two subpopulations with distinct clinical and laboratory features. These results suggest that TMA with severe ADAMTS13 deficiency is a distinct pathologic process.