bluuebunny/crossref_metadata_2025 huggingface dataset:
Representing Australia
Authors: Farquharson Karen , Marjoribanks Timothy
Published: April 2006

Sport and representations of sport in the media are key sites for political and social struggles around race and nation. In order to explore how meanings of race are constructed in a sporting context, we undertook a discourse analysis of Australian print media coverage of two incidents of alleged racial vilification in sport. In one, Australian cricketer Darren Lehmann was suspended for racially vilifying the Sri Lankan team. In the other, Pakistani cricketer Rashid Latif was accused of racially vilifying an Australian cricketer. Our research suggests the following: first, there was strong condemnation of racial vilification; second, despite this, print media representations reflect a white versus black divide in world cricket; third, a Lehmann as victim/reverse racism theme emerged. We conclude that race is being mobilized as a potent but contested symbol of both inclusion and exclusion within Australia.
Beyond the ‘digital divide’
Authors: Willis Suzanne , Tranter Bruce
Published: April 2006

The increasing potential of the Internet to widen access to information and enhance communication capacity has brought opposing arguments about the social consequences of Internet use. Advocates of the ‘digital divide’ thesis argue that the Internet advantages privileged groups while further marginalizing disadvantaged social categories. Critics of the thesis see the expansion of the Internet as enabling and egalitarian, promoting social inclusion and facilitating democratic participation. In order to assess which view is more plausible, we examine the social barriers to Internet use in Australia over a five-year period, using multivariate analyses of national survey data. The notion of a ‘digital divide’ is too simplistic to capture the complexity of social barriers to Internet use. Although the Internet has become more accessible to all social categories, and further technological diffusion should widen this accessibility, household income, age, education and occupational class location remain as key dimensions of differential Internet use.
Family, work and health
Authors: Hewitt Belinda , Baxter Janeen , Western Mark
Published: April 2006

We investigate multiple-burden and multiple-attachment hypotheses for the association among marriage, parenthood, employment and health for Australian men and women. Using longitudinal data from the Australian panel survey, ‘Negotiating the Lifecourse’, we find that men and women employed full time report better health than those employed part time or not employed. Previously married women report worse health than married women, but there is no association between marital status and health for men. We also find that men with preschool children in the household report worse health than men with older children, whereas women with preschool children report better health than women with older children. In addition for women we find evidence of a role-burden where combining full-time employment and children has a negative impact on health, but combining children with part-time or no employment has a beneficial health effect. There are no health effects of combining roles for men.
Social resources, class habitus and friendship ties in urban China
Authors: Zang Xiaowei
Published: April 2006

This article draws insights from social resource theory and class habitus theory to study friendship choices in urban China. Data are from two surveys conducted in two Chinese cities in 2000 and 2001 respectively. Data analysis shows that cross-status friendships are negatively related to both cadre status and professional status in urban China. However, in-group association is more closely related to instrumentality than to cultural distinction. These findings suggest new interpretations of the effect of social resources and cultural distinction on friendship formation in urban China.
Julien Benda’s Anti-Passionate Europe
Authors: Müller Jan-Werner
Published: April 2006

In the early 1930s, Julien Benda provided one of the most uncompromising visions for a united Europe. In line with his rationalist universalism, Benda sought a continent that was cleansed of passion and particularism, and called on European intellectuals to act as a rationalist vanguard in constructing such a Europe. However, Benda fatefully wavered between polity-building strategies of reshaping and redirection. For the most part, Benda seemed to demand nothing less than a comprehensive reshaping of the moral and political psychology of European citizens. However, his universalism faltered frequently, and he conceived of Europe rather as a large nation, in which the ‘passion for reason’ would come to dominate other passions. Such ambiguities - and failures to draw a clear line between normative ideals and the pragmatics of polity-building - persist in many present debates on European unification.
Europeanism and Americanism in the Age of Globalization
Authors: Rensmann Lars
Published: April 2006

The article examines Hannah Arendt’s analysis of ‘pan-nationalist Europeanism’ and anti-Americanism which may serve inherently problematic identity-generating functions for the European project. For Arendt, this specific form of Europeanism is often intimately linked to mobilizations of widely spread fears of global sociocultural and economic modernization, which is frequently perceived as ‘Americanization’. In addition, however, those fears may reflect self-referential politics of ‘Americanism’ abroad and also originate in ‘objective’ structural international imbalances. According to Arendt, then, Americanism on one side and Europeanism on the other side of the Atlantic should be challenged as two ideologies facing, fighting and, above all, resembling each other as all seemingly opposed ideologies. In light of the current transatlantic cleavages, it is argued with Arendt that it is in the EU’s best interest to avoid binary, culturalized legitimizations of Europeanism and (anti-)Americanism. Instead, it is the eminent political task to positively resignify the EU as a new, truly post-national project and polity in its own right. Adapting and expanding Arendt’s framework, conceptual and normative implications for a self-reflexive, unique and future-oriented EU political identity and response to globalization are indicated and discussed.
Habeas Corpus?
Authors: Janssens David
Published: April 2006

This article examines and assesses Pierre Manent’s critique of the European political project and his concomitant endorsement of the nation-state. It first presents Manent’s basic arguments against the European Union, focusing on his Aristotelian understanding of political forms and his notion of the body politic. Subsequently, it argues that Manent’s position, in part due to its Aristotelian underpinnings, is deeply problematic, in that it disregards the contingency and the element of representation that are necessarily inherent in the foundation of every body politic. As a result, Manent’s critique tends to downplay the contingency of the nation-state and to overplay the contingency of the European Union.
The European Union Democratic Deficit
Authors: Bowman Jonathan
Published: April 2006

I outline the current debate over the European Union democratic deficit in terms of differing methodological approaches towards the realization of freedom and basic rights to political participation. Federalists opt for a model of freedom as noninterference and autonomous self-determination by proposing to tie basic rights in the EU to a univocal form of European-wide popular sovereignty. Although skeptics argue that the EU lacks the fundamental basis for such European-wide democratic self-determination, they ultimately defend a similar view of freedom as noninterference with their appeal to the collective will of the member states. Democratic revisionists instead point to the novel democratic potential of institutions in the EU such as the Open Method of Coordination for mediating overlapping sovereignties. I conclude using the example of basic rights to effective participation for immigrants and minorities to illustrate the strengths of the revisionist view over views that appeal to the principle of subsidiarity.
Melatonin suppresses macrophage cyclooxygenase-2 and inducible nitric oxide synthase expression by inhibiting p52 acetylation and binding
Authors: Deng Wu-Guo , Tang Shao-Tzu , Tseng Hui-Ping , Wu Kenneth K.
Published: April 2006

Melatonin has been shown to be produced by nonpineal cells and possess anti-inflammatory actions in animal models. In the present study, we tested the hypothesis that melatonin suppresses the expression of proinflammatory genes such as cyclooxygenase-2 (COX2) and inducible nitric oxide synthase (INOS) by a common transcriptional mechanism. Melatonin but not tryptophan or serotonin inhibited lipopolysaccharide (LPS)–induced COX-2 and iNOS protein levels and promoter activities in RAW 264.7 cells in a time- and concentration-dependent manner. LPS or LPS plus interferon-γ (IFNγ) increased binding of all 5 isoforms of NF-κB to COX-2 and iNOS promoters. Melatonin selectively inhibited p52 binding without affecting p100 expression, p52 generation from p100, or p52 nuclear translocation. p52 acetylation was enhanced by LPS, which was abrogated by melatonin. Melatonin inhibited p300 histone acetyltransferase (HAT) activity and abrogated p300-augmented COX-2 and iNOS expression. HAT inhibitors suppressed LPS-induced p52 binding and acetylation to an extent similar to melatonin, and melatonin did not potentiate the effect of HAT inhibitors. These results suggest that melatonin inhibits COX-2 and iNOS transcriptional activation by inhibiting p300 HAT activity, thereby suppressing p52 acetylation, binding, and transactivation.
The p67 laminin receptor identifies human erythroid progenitor and precursor cells and is functionally important for their bone marrow lodgment
Authors: Bonig Halvard , Chang Kai-Hsin , Nakamoto Betty , Papayannopoulou Thalia
Published: April 2006

The laminins are a group of extracellular matrix proteins with constitutive expression in all tissues, including bone marrow stroma. A functional role for the nonintegrin laminin receptor p67 has been described for cancer metastasis and lymphocyte trafficking. Expression of p67 was also reported for other subsets of mature leukocytes and for malignant hematopoietic or nonhematopoietic cells. We explored p67 expression on normal hematopoietic progenitor cells (HPCs) and its putative role in bone marrow retention of transplanted HPCs. We found p67 expression on a subset of primary human CD34+ cells coexpressing erythroid markers. Of importance, p67 recognizes early erythroid progenitors, since sorted p67+ cells were significantly enriched for burst-forming units–erythroid (BFU-Es) and depleted of colony-forming units–granulocyte/macrophage (CFU-GMs). Blockade of p67 binding of donor cells, using antifunctional antibody, reduced bone marrow homing of BFU-Es. These studies identify p67 as a novel phenotypic marker for erythroid HPCs of functional importance for lineage-specific homing/retention among adult transplanted HPCs.
Patients with quinine-induced immune thrombocytopenia have both “drug-dependent” and “drug-specific” antibodies
Authors: Bougie Daniel W. , Wilker Peter R. , Aster Richard H.
Published: April 2006

Immune thrombocytopenia induced by quinine and many other drugs is caused by antibodies that bind to platelet membrane glycoproteins (GPs) only when the sensitizing drug is present in soluble form. In this disorder, drug promotes antibody binding to its target without linking covalently to either of the reacting macro-molecules by a mechanism that has not yet been defined. How drug provides the stimulus for production of such antibodies is also unknown. We studied 7 patients who experienced severe thrombocytopenia after ingestion of quinine. As expected, drug-dependent, platelet-reactive antibodies specific for GPIIb/IIIa or GPIb/IX were identified in each case. Unexpectedly, each of 6 patients with GPIIb/IIIa-specific antibodies was found to have a second antibody specific for drug alone that was not platelet reactive. Despite recognizing different targets, the 2 types of antibody were identical in requiring quinine or desmethoxy-quinine (cinchonidine) for reactivity and in failing to react with other structural analogues of quinine. On the basis of these findings and previous observations, a model is proposed to explain drug-dependent binding of antibodies to cellular targets. In addition to having implications for pathogenesis, drug-specific antibodies may provide a surrogate measure of drug sensitivity in patients with drug-induced immune cytopenia.
The Steap proteins are metalloreductases
Authors: Ohgami Robert S. , Campagna Dean R. , McDonald Alice , Fleming Mark D.
Published: April 2006

Iron and copper are essential for all organisms, assuming critical roles as cofactors in many enzymes. In eukaryotes, the transmembrane transport of these elements is a highly regulated process facilitated by the single electron reduction of each metal. Previously, we identified a mammalian ferrireductase, Steap3, critical for erythroid iron homeostasis. Now, through homology, expression, and functional studies, we characterize all 4 members of this protein family and demonstrate that 3 of them, Steap2, Steap3, and Steap4, are not only ferrireductases but also cupric reductases that stimulate cellular uptake of both iron and copper in vitro. Finally, the pattern of tissue expression and subcellular localization of these proteins suggest they are physiologically relevant cupric reductases and ferrireductases in vivo.
Lenalidomide therapy in myelofibrosis with myeloid metaplasia
Authors: Tefferi Ayalew , Cortes Jorge , Verstovsek Srdan , Mesa Ruben A. , Thomas Deborah , Lasho Terra L. , Hogan William J. , Litzow Mark R. , Allred Jacob B. , Jones Dan , Byrne Catriona , Zeldis Jerome B. , Ketterling Rhett P. , McClure Rebecca F. , Giles Francis , Kantarjian Hagop M.
Published: April 2006

We present results of 2 similarly designed but separate phase 2 studies involving single-agent lenalidomide (CC-5013, Revlimid) in a total of 68 patients with symptomatic myelofibrosis with myeloid metaplasia (MMM). Protocol treatment consisted of oral lenalidomide at 10 mg/d (5 mg/d if baseline platelet count < 100 × 109/L) for 3 to 4 months with a plan to continue treatment for either 3 or 24 additional months, in case of response. Overall response rates were 22% for anemia, 33% for splenomegaly, and 50% for thrombocytopenia. Response in anemia was deemed impressive in 8 patients whose hemoglobin level normalized from a baseline of either transfusion dependency or hemoglobin level lower than 100 g/L. Additional treatment effects in these patients included resolution of leukoerythroblastosis (4 patients), a decrease in medullary fibrosis and angiogenesis (2 patients), and del(5)(q13q33) cytogenetic remission accompanied by a reduction in JAK2V617F mutation burden (1 patient). Grade 3 or 4 adverse events included neutropenia (31%) and thrombocytopenia (19%). We conclude that lenalidomide engenders an intriguing treatment activity in a subset of patients with MMM that includes an unprecedented effect on peripheral blood and bone marrow abnormalities.
Are the “Life‐Support” Courses Updated? An Evaluation of Their Literature Base
Authors: Hack Jason B. , Wilkinson Heather L.
Published: April 2006

Background:
As a condition of employment, many physicians practicing in the United States are mandated to remain current in their certification of some or all of the life‐support courses. These courses reputedly set the standard of care by establishing nationally recognized paradigms of resuscitation. These courses' textbooks are revised and re‐released at regular intervals.

Objectives:
To determine whether the source data for these texts are vigorously updated with each revision and whether there is an obvious literature‐based impetus to release a new version.

Methods:
A comparison was made of the years of the references contained within the three most recent textbook editions of the advanced cardiac life support (ACLS), advanced trauma life support, basic life support, and pediatric advanced life support courses. The years of the references were tallied for each text, and these tallies were compared both within and between the courses. Data were divided into three groups: group 1, references published before the previous versions' release; group 2, references published after previous versions' release; group 3, references dated within three years of the texts' release.

Results:
There appears to be a large amount of overlap of group 1 data throughout most of the course texts; the number of references in group 2 and 3 varies greatly between and within these courses.

Conclusions:
With one exception (ACLS in 2003), the life‐support courses appear to be based on similar reference sets for the last 7 to 11 years. There may be a reason other than an availability of a critical mass of new information that prompts the release of a new edition of these life‐support courses.
Predictors of On‐call Specialist Response Times in California Emergency Departments
Authors: Mohanty Sarita A. , Washington Donna L. , Lambe Susan , Fink Arlene , Asch Steven M.
Published: April 2006

Objectives:
To assess waiting times in emergency departments (EDs) for on‐call specialist response and how these might vary by facility or neighborhood characteristics. Limited availability of on‐call specialists is thought to contribute to ED overcrowding.

Methods:
Direct observational data from a random sample of 1,798 patients visiting 30 California EDs during a six‐month period provided specialist waiting times. The authors used multivariate logistic regression and survival analysis to analyze predictors of time to on‐call specialists' telephone response.

Results:
Eighty‐six percent of on‐call specialists who were paged responded by telephone within 30 minutes. Ten percent of specialists did not respond at all. After controlling for the annual percentage of nonurgent ED patients at each facility, near closure status, and hospital ownership status, for every $10,000 increase in hospital zip code income, the odds of on‐call specialist response within 30 minutes increased by 123% (adjusted odds ratio = 2.23; 95% confidence interval = 1.24 to 4.02; p = 0.01).

Conclusions:
Although the majority of on‐call specialists met the federal recommendation of a 30‐minute response, those in poor neighborhoods were less likely to do so. One in ten on‐call specialists did not respond at all. State and federal policies should focus on making more funding available for on‐call specialist panels in poor areas.
Child Witnesses and Victims in Homes with Adult Intimate Partner Violence
Authors: Ernst Amy A. , Weiss Steven J. , Enright‐Smith Shannon
Published: April 2006

Objectives:
To determine demographics of children in homes to which police are called for intimate‐partner violence (IPV) and to compare the relative risk of perpetrator versus victim for those who, as children, witnessed or were victims of IPV and sexual assault.

Methods:
Data from Resources, Inc. Victim Assistance Unit yearly intake statistics for 2004 were accessed. In this city with a population of approximately 500,000 people, police will call for an on‐site advocate intervention (a trained social worker) at their own discretion for the adult or child victims of IPV and for children witnessing IPV. The social worker collects data on victims, perpetrators of IPV, and child witnesses or victims at all police calls for IPV. Comparisons were made by using chi‐square, relative risks (RRs), and 95% confidence intervals (95% CI).

Results:
Police and advocates visited 2,038 homes for IPV calls; 2,617 children were in these homes. Of these children, 1,904 (76%) witnessed IPV, and 698 (27%) were victims themselves. Adult victims (31%) and perpetrators (41%) had high rates of having witnessed IPV when they were children. Perpetrators were more likely than victims to have witnessed IPV as a child (RR, 1.56; 95% CI = 1.37 to 1.78) and to have been a victim of IPV as a child (RR, 1.71; 95% CI = 1.49 to 1.96).

Conclusions:
In this study population, 76% of IPV households include children, and one third of these children also are victims of IPV. Perpetrators often were victims and witnesses of IPV when they were children. This suggests that a history of childhood IPV is common for perpetrators of IPV. Development of and research on interventions for child witnesses or victims of IPV is needed.
Does Functional Decline Prompt Emergency Department Visits and Admission in Older Patients?
Authors: Wilber Scott T. , Blanda Michelle , Gerson Lowell W.
Published: April 2006

Background:
Older patients may visit the emergency department (ED) when their illness affects their function.

Objectives:
To quantify the function of older ED patients, to assess whether functional decline (FD) had occurred, and to determine whether function contributes to the ED visit and hospital admission.

Methods:
The authors performed an institutional review board–approved, prospective, cross‐sectional study in a community teaching hospital ED. Eligible patients were older than 74 years of age, with an illness at least 48 hours old. Patients from a nursing facility and those without a proxy who were unable or unwilling to complete the questions were excluded. The Older Americans Resources and Services Questionnaire, which tests seven instrumental activities of daily living (IADL) and seven physical ADLs (PADL), was used. Data are presented as means or proportions with 95% confidence intervals (95% CI), and comparisons as 95% CI for the difference between proportions.

Results:
The authors enrolled 90 patients (mean age, 81.6 yr [SD ± 4.9], 40% male). Dependence in at least one IADL was reported by 68% (95% CI = 57% to 77%), and in at least one PADL by 61% (95% CI = 50% to 71%). Functional decline was reported by 74% (95% CI = 64% to 83%). Two thirds of those with IADL decline and three quarters of those with PADL decline said that this contributed to their ED visit. Seventy‐seven percent with, and 63% without, IADL decline were admitted (14% difference, 95% CI =−6.1% to 33%). Seventy‐nine percent with and 61% without PADL decline were admitted (18% difference, 95% CI =−1.4% to 38%).

Conclusions:
Functional decline is common in older ED patients and contributes to ED visits in older patients; its role in admission is unclear.
National Study on Emergency Department Visits for Transient Ischemic Attack, 1992–2001
Authors: Edlow Jonathan A. , Kim Sunghye , Pelletier Andrea J. , Camargo Carlos A.
Published: April 2006

Objectives:
To describe the epidemiology of U.S. emergency department (ED) visits for transient ischemic attack (TIA) and to measure rates of antiplatelet medication use, neuroimaging, and hospitalization during a ten‐year time period.

Methods:
The authors obtained data from the 1992–2001 National Hospital Ambulatory Medical Care Survey. TIA cases were identified by having ICD‐9 code 435.

Results:
From 1992 to 2001, there were 769 cases, representing 2,969,000 ED visits for TIA. The population rate of 1.1 ED visits per 1,000 U.S. population (95% CI = 0.92 to 1.30) was stable over time. TIA was diagnosed in 0.3% of all ED visits. Physicians administered aspirin and other antiplatelet agents to a small percentage of patients, and 42% of TIA patients (95% CI = 29% to 55%) received no medications at all in the ED. Too few data points existed to measure a statistically valid trend over time. Physicians performed computed tomography scanning in 56% (95% CI = 45% to 66%) of cases and performed magnetic resonance imaging (MRI) in < 5% of cases, and there was a trend toward increased imaging over time. Admission rates did not increase during the ten‐year period, with 54% (95% CI = 42% to 67%) admitted. Regional differences were noted, however, with the highest admission rate found in the Northeast (68%).

Conclusions:
Between 1992 and 2001, the population rate of ED visits for TIA was stable, as were admission rates (54%). Antiplatelet medications appear to be underutilized and to be discordant with published guidelines. Neuroimaging increased significantly. These findings may reflect the limited evidence base for the guidelines, educational deficits, or other barriers to guideline implementation.
Laser‐assisted Anesthesia Reduces the Pain of Venous Cannulation in Children and Adults: A Randomized Controlled Trial
Authors: Singer Adam J. , Weeks Robert , Regev Ran
Published: April 2006

Objectives:
Application of topical anesthetics before intravenous (IV) cannulation is effective yet limited by delayed transdermal absorption. The authors evaluated a handheld laser device to enhance topical anesthetic absorption by ablating the stratum corneum, the major barrier to drug absorption through the skin. The hypothesis was that laser‐assisted anesthesia would reduce the pain of IV cannulation in emergency department (ED) patients.

Methods:
This was a blinded, randomized, controlled trial. ED patients aged 1 year and older requiring nonemergent IV cannulation were included. Patients were randomized to pretreatment of the skin with laser or sham laser, and standardized venous cannulation was performed on the dorsum of the patients' hands or antecubital fossa. In the experimental group, the area over the target vein was pretreated with a lightweight, portable Er:YAG unit, with a fluence of 3.5 J/cm2, a pulse width of 600 microseconds, and a spot diameter of 6 mm. Lidocaine 4% cream was applied to the area immediately after laser application. Five minutes later, the cream was wiped off and a trained nurse inserted an IV catheter. In the control group, a sham laser and lidocaine were used. Pain of laser application and IV cannulation was recorded on age‐appropriate pain scales; presence of infection or abnormal pigmentation was determined at one week. Pain of cannulation was compared using parametric and nonparametric tests.

Results:
Sixty‐one patients were randomized to laser (30) and sham (31) pretreatment. Mean (± SD) age was 27 (± 21) years, 49% were female, and one half were children younger than 18 years. The mean pain of IV cannulation was significantly less (mean difference, 28.3 mm; 95% confidence interval = 17.9 to 38.7) in patients pretreated with the laser (10.0 mm; 95% confidence interval = 4.4 to 15.6) than with sham laser (38.3 mm; 95% confidence interval = 29.3 to 42.2). The difference in children was also significant. Application of the laser was painless in most patients. No patient developed infection or abnormal pigmentation.

Conclusions:
Pretreatment of the skin with a laser device followed by a five‐minute topical lidocaine 4% application reduces the pain of IV cannulation in ED adult and pediatric patients.
The Effect of a Commercially Available Burn‐cooling Blanket on Core Body Temperatures in Volunteers
Authors: Singer Adam J. , Freidman Brenda , Modi Prachi , Soroff Harry H.
Published: April 2006

Background:
Cooling of burns is one of the oldest therapies, yet there are concerns that excessive cooling may result in hypothermia.

Objectives:
To determine the effects of surface cooling with a commercially available cooling blanket on the core temperatures of volunteers and to test the ability of the cooling blanket to reduce water evaporation from plastic containers. The null hypothesis was that rectal temperatures would not be reduced by surface cooling and that the cooling blanket would reduce evaporative water loss.

Methods:
This was a prospective, noncomparative, interventional study. Ten healthy adult volunteers were recruited. Subjects were completely unclothed, and their entire body (excluding the head) was circumferentially wrapped with a commercially available gel‐soaked cooling blanket at room temperature. A rectal temperature probe was inserted, and continuous monitoring of vital signs was performed during a 30‐minute period. In addition, six plastic containers were filled with 50 mL of room‐temperature water, half of which were covered with the cooling blanket. The amount of water remaining within the containers was measured at hourly intervals over four hours.

Results:
The subjects' mean age was 38 years; 50% were female. There were no significant changes in core body temperatures over time in any of the study subjects. Mean (95% confidence intervals [CI]) core temperatures at the beginning and at the end of the study period were 37.2°C (95% CI = 37.0°C to 37.4°C) and 37.3°C (95% CI = 37.1°C to 37.5°C), respectively. Water evaporation in the blanket‐covered containers was less than in the uncovered containers.

Conclusions:
The authors conclude that covering healthy volunteers with a room temperature burn‐cooling blanket for 30 minutes does not result in hypothermia and that the cooling blanket reduces evaporative water loss.
Chemoembolization for Liver Metastases from Medullary Thyroid Carcinoma
Authors: Fromigué J. , De Baere T. , Baudin E. , Dromain C. , Leboulleux S. , Schlumberger M.
Published: April 2006

Background: Medullary thyroid carcinoma (MTC) is a well-differentiated neuroendocrine tumor. Distant metastases are the main cause of cancer-related death. Systemic chemotherapy produces only rare tumor responses. Somatostatin analogs and other available modalities are poorly effective to control symptoms.

Aims: The aim of our study was to evaluate the impact of liver transarterial chemoembolization (TACE) in MTC patients with predominant and progressive liver metastases.

Patients and Methods: Twelve MTC patients underwent 18 TACE courses (mean, 1.5; range, 1–2). Response evaluation criteria in solid tumors were used to evaluate tumor responses. Symptomatic responses were defined by more than a 25% decrease of symptoms intensity.

Results: Partial radiological tumor response was obtained in five patients (42%) with a median duration of 17 months (mean, 19; range, 15–28 months), stabilization in five (42%) with a median duration of 24 months (mean, 24; range, 4–39 months), and progression in the remaining two (16%). The five partial tumor responses were observed in the nine patients with less than 30% liver involvement. Clinical response was observed in two of the five patients with diarrhea. Carcinoembryonic antigen did not appear to be a useful marker in this setting. Significant grade 3–4 toxicity was observed in one patient who had a major tumor necrosis after TACE.

Conclusion: TACE should be considered for treating MTC patients with progressive and predominant liver metastasis, and preferably at an early stage during the course of metastatic disease.
Urine Steroid Hormone Profile Analysis in Cytochrome P450 Oxidoreductase Deficiency: Implication for the Backdoor Pathway to Dihydrotestosterone
Authors: Homma Keiko , Hasegawa Tomonobu , Nagai Toshiro , Adachi Masanori , Horikawa Reiko , Fujiwara Ikuma , Tajima Toshihiro , Takeda Ryoujun , Fukami Maki , Ogata Tsutomu
Published: April 2006

Context: Although the “backdoor” pathway to dihydrotestosterone has been postulated in the fetal-to-early-infantile period of patients with cytochrome P450 oxidoreductase deficiency (PORD), clinical data in support of this pathway remain limited.

Objective: The objective of this study was to obtain clinical evidence for the presence of the backdoor pathway in PORD.

Setting: This was a collaboration study between laboratories and hospitals.

Subjects: Twenty-two Japanese patients with molecularly confirmed PORD and 1763 control subjects participated in this study.

Intervention: Urine steroid profile analysis was performed by gas chromatography/mass spectrometry. In five patients and 776 control subjects, urine samples were obtained before 12 months of age.

Main Outcome Measure: The main outcome measure was identification of a urine steroid(s) indicating the backdoor pathway.

Results: In the PORD patients, pregnanediol, pregnanetriolone, and pregnanetriol were obviously elevated, and the urine steroid ratios reflecting CYP17A1 and CYP21A2 activities were decreased throughout the examined ages. Furthermore, etiocholanolone and 11-hydroxyandrosterone, which should originate almost exclusively from androstenedione in the conventional “frontdoor” pathway, were grossly normal or somewhat decreased since early infancy, whereas androsterone, which can be derived not only from androstenedione and dihydrotestosterone in the conventional frontdoor pathway but also from 5α-pregnane-3α,17α-diol-20-one in the backdoor pathway, was increased during early infancy and remained grossly normal thereafter. Thus, the androsterone to etiocholanolone ratio was increased during early infancy and remained grossly normal thereafter. 5α-Pregnane-3α,17α-diol-20-one was elevated throughout the examined ages.

Conclusions: The increased androsterone excretion during early infancy, as compared with the etiocholanolone and 11-hydroxyandrosterone excretions in the same period, suggests the presence of the backdoor pathway in PORD.
Intimal Estrogen Receptor (ER)β, But Not ERα Expression, Is Correlated with Coronary Calcification and Atherosclerosis in Pre- and Postmenopausal Women
Authors: Christian Rose C. , Liu Peter Y. , Harrington Sean , Ruan Ming , Miller Virginia M. , Fitzpatrick Lorraine A.
Published: April 2006

Background: Controversy exists over the association of estrogen and cardiovascular disease. Estrogen receptors (ERs) α and β are expressed in the endothelial cells and vascular smooth muscle cells (VSMCs) of many arteries, but the relative importance of ERα or ERβ in mediating the vascular response to estrogens is not well defined, particularly in humans. We have shown previously that postmenopausal women receiving hormone therapy (HT) had lower mean coronary artery calcium, plaque area, and calcium-to-plaque ratio compared with untreated women. In this study, we examined coronary artery ERα and ERβ expression in pre- and postmenopausal women as a function of plaque area, calcium area, calcium-to-plaque ratio, and estrogen status.

Methods: Coronary arteries were obtained at autopsy from a total of 55 women: nine premenopausal women, 13 postmenopausal women on HT and 33 untreated postmenopausal women (non-HT). Coronary calcification was quantified by contact microradiography, and atherosclerotic plaque area was measured histologically. Coronary artery cross-sections were immunostained for ERα and ERβ, and the amount of receptors was estimated semiquantitatively in each arterial wall layer (intima, adventitia, and media). Double immunofluorescence was used to colocalize ERα and ERβ with smooth muscle actin, a marker of VSMCs.

Results: ERβ and ERα were expressed in all artery wall layers, but most avidly in the media (P = 0.001), and colocalized with VSMCs. ERβ expression exceeded ERα expression in all wall layers (P < 0.001) and was adjacent to areas of calcium deposition. ERβ expression in the intimal layer correlated with calcium content, plaque area, and calcium-to-plaque ratio (all P < 0.01) and tended to be greater in non-HT than in HT women (P = 0.06). ERα expression did not vary significantly among groups, nor did it correlate with calcium content, plaque area or calcium-to-plaque ratio. Expression of ERα but not ERβ declined with age (P < 0.01) in HT women only. Age had no effect on ERα or ERβ expression in non-HT or premenopausal women.

Conclusions: ERβ is the predominant ER in human coronary arteries and correlates with coronary calcification, a marker of severe atherosclerosis. Increased ERβ expression is linked to advanced atherosclerosis and calcification independent of age or hormone status. Future pharmacogenetic studies that target this receptor are needed to confirm causality.
Metabolic Factors Associated with Benign Prostatic Hyperplasia
Authors: Parsons J. Kellogg , Carter H. Ballentine , Partin Alan W. , Windham B. Gwen , Metter E. Jeffrey , Ferrucci Luigi , Landis Patricia , Platz Elizabeth A.
Published: April 2006

Context: Benign prostatic hyperplasia poses a significant public health problem, but its etiology remains unclear. Obesity and associated abnormalities in glucose homeostasis may play a role in benign prostatic hyperplasia development by influencing prostate growth.

Objective: The objective of this study was to determine whether obesity, fasting plasma glucose concentration, and diabetes are associated with radiologically determined prostate enlargement, an objective measure of benign prostatic hyperplasia.

Design: This study was a cross-sectional analysis with robust variance estimates to account for multiple measures over time in the same individuals.

Setting: This prospective cohort study was composed of community volunteers.

Patients: Patients studied were 422 adult men enrolled in The Baltimore Longitudinal Study of Aging.

Main Outcome Measurements: Total prostate volume as determined by pelvic magnetic resonance imaging was measured.

Results: Among 422 participants, 91 (21.6%) had prostate enlargement (defined as total prostate volume ≥ 40 cc) at first visit. Compared with men of normal weight [body mass index (BMI) < 25 kg/m2], the age-adjusted odds ratio (OR) for prostate enlargement for overweight men (BMI, 25–29.9 kg/m2) was 1.41 (95% CI, 0.84–2.37), for obese men (BMI, 30–34 kg/m2) was 1.27 (95% CI, 0.68–2.39), and for severely obese men (BMI ≥ 35 kg/m2) was 3.52 (95% CI, 1.45–8.56) (P = 0.01). Men with elevated fasting glucose (>110 mg/dl) were more likely to have an enlarged prostate than men with normal fasting glucose (≤110 mg/dl) (OR, 2.98; 95% CI, 1.70–5.23), as were men with a diagnosis of diabetes (OR, 2.25; 95% CI, 1.23–4.11).

Conclusions: Obesity, elevated fasting plasma glucose, and diabetes are risk factors for benign prostatic hyperplasia.
Telling in Time (III): Chronology, Estrangement, and Stories of Literary History
Authors: Sternberg Meir
Published: April 2006

Trumpeted as the artistic hallmark, central to Russian Formalism, and persistent ever since, estrangement yet remains an ill-defined term. We have nothing like a comprehensive approach to it, equipped to specify its workings by kind, medium, art form, discourse level, historical context. Narrative, Shklovsky's own forte, would appear the paradigm case, as the most inclusive genre and the most akin to art's and life's temporal movement. I accordingly revisit “making strange,” with its branches and afterlives, from the viewpoint of narrative theory and history—especially in relation to my account of narrative dynamics, in this “Telling in Time” series and elsewhere. Above all, given Shklovsky's perceptual emphasis, does his master effect constitute the genre's universal, overlapping and/or rivaling the dynamics of prospection (“suspense”), retrospection (“curiosity”), and, especially, recognition (“surprise”)? Or is it only a pretender to the title, a fortiori to literature's and art's supreme value and motive power?

The answer hinges on the equation, current since Formalism, of perceptual estrangement with temporal disarrangement: artistic sjuzhet is disordered, hence defamiliarized, fabula, à la Tristram Shandy. Itself a variant of the anti-chronologism that has always dominated narrative study—as early as in medias res—this formula proves untenable in all its versions and reversions. But the inquiry into it, and them, is nonetheless instructive. The versions consist in two silent Formalist logics of making strange: one absolute and universalist, the other more relativized to history, both originating in Shklovsky's own ambivalence, or thoughtlessness, and still going strong. The reversions include the underground pushing of the idea to some extremein (Post)Structuralist narratology—Genette's anti-perceptual, mind-less formalism, Barthes's drive against all sequentiality (actional, textual, historical) in the name of “writerly” license—as well as open follow-ups, in cognitivist and literary-empirical circles, for example.

Through these lineages, inter alia, the argument develops a set of key issues and counterproposals. Thus the shifts of estrangement, as a value, between top and low priority; its affective, or experiential, constants and variables; its relation to narrativity, their respective limits included; its correlation of narrative's unmatched time repertoire with the temporalities of history, via survival tactics and more strategic dishabituating resources; the models that capture, or emplot, its birth-death-revival (hi)stories; its transfer from the life of art to the art of living; and, most fundamental, its endless form/function interplay in both synchrony and diachrony, under the Proteus Principle.
Distortion and Theatricality: Estrangement in Diderot and Shklovsky
Authors: Smoliarova Tatiana
Published: April 2006

The article investigates some textual coincidences between Denis Diderot's major works on art and theater and the Formalist manifesto “Art as Device” by Victor Shklovsky. Acknowledging the accidental nature of these coincidences, I try to determine the common philosophical origins of the metaphors that aesthetics “lived by” in mid-eighteenth-century France and in Russia at the beginning of the twentieth century. What kind of cultural crisis engenders the cult of difficulty and retardation? How is this aesthetics connected to the idea of freedom? In order to answer these questions, we trace the key notion of Shklovsky's theory, the automatization of perception, back to its “personified version”—l'homme-automate of Diderot. The modernity of both these authors consists in their special concern with the deliberate distancing of artistic representation from the reality represented. Studying the phenomenon of the delinearization of human perception from the semiotic viewpoint, the article discusses visual counterparts of literary estrangement, such as anamorphic structures in painting and the art of pantomime in the theater.
The Politics of Estrangement: Tracking Shklovsky's Device through Literary and Policing Practices
Authors: Vatulescu Cristina
Published: April 2006

Critics have frequently accused Russian Formalism of supporting an apolitical separation of art from life. As a central Formalist term, estrangement (ostranenie) often bore the brunt of this accusation. Taking issue with this critique, this essay focuses on the entangled relationship between the aesthetics and politics of estrangement and argues that an attentive look at the history of estrangement reveals its deep involvement with revolutionary and police state politics. This essay traces estrangement's conflicted development through Victor Shklovsky's oeuvre and beyond, in the work of Nicolae Steinhardt and Joseph Brodsky, and also in secret police interrogation and reeducation practices and in CIA manuals.

In Sentimental Journey, Shklovsky wrote that during the civil war, life itself was made strange and became art. Shklovsky's memoirs shed light on the effects of this revolutionary estrangement on the self. Furthermore, the memoirs reenacted this unsettling estrangement by incorporating elements of official Soviet genres, such as the trial deposition, the interrogation autobiography, and the letter to the government. As Shklovsky suggests, the effects of revolutionary estrangement on the self were certainly not limited to the therapeutic value of refreshing perception that is commonly ascribed to artistic estrangement. Indeed, estrangement of the self was a key device in secret police interrogation and reeducation practices; as such, it was instrumental in the politicized fashioning of the subject during Soviet times. In their confrontations with this police state brand of estrangement, writers like Joseph Brodsky and Nicolae Steinhardt further probed its methods and then appropriated its lessons for their own ends, developing self-estrangement as a new art of survival.
My Leader, Myself? Pictorial Estrangement and Aesopian Language in the Late Work of Kazimir Malevich
Authors: Katsnelson Anna Wexler
Published: April 2006

In the late 1920s, the Russian avant-garde artist Kazimir Malevich embarked on a new direction in art that eighty years later continues to perplex the art historical establishment: the artist formerly known for the radical abstraction of The Black Square returned to figuration. My analysis attempts to unpack this about-face and address the many questions that surround it. How does Malevich's late work relate to the regime of Socialist Realism? Was his return to figuration a conversion, an aesthetic rethinking, or a calculated move? I argue that this return was designed to navigate the restrictions of the new aesthetic episteme and carve out a third way, ostensibly compliant but in fact containing kernels of subversiveness. This third way, I suggest, consisted of a peculiar painterly poetics of estrangement and Aesopian language. While scholarship has offered insights into the literary aspect of these phenomena, very little has been written on their pictorial incarnation. Focusing on Malevich's late paintings of Russian peasants and his 1933 Self-Portrait, I try to trace the complex art historical moment of the late 1920s and early 1930s and map out the representational possibilities of the two literary concepts.
Lyn Hejinian and Russian Estrangement
Authors: Edmond Jacob
Published: April 2006

This essay shows how the Language poet Lyn Hejinian came to relate her experiences of Russia and her poetics of the “person” to Victor Shklovsky's concept of estrangement (ostranenie). I argue that in The Guard (1984), Oxota (1991), Leningrad (1991), and in other writings about Russia, Hejinian came to conflate poetic estrangement with the estranging effect of Russia itself and, in so doing, developed her poetics of the person, which linked the material text of poetic estrangement with the social poetics of everyday life. Everyday life in Russia seemed to take on the very qualities that she associated with estrangement: the dissolution of defined objects and essential selfhood and their replacement with the dynamic experience that Hejinian defined as “personhood.” At the same time, Hejinian found in this dynamic personhood a means to oppose essentialist national identities, so that Russian estrangement also became central to her utopian vision of bridging the Cold War divide between Russia and the United States.
Matrix metalloproteases from chondrocytes generate an antiangiogenic 16 kDa prolactin
Authors: Macotela Yazmín , Aguilar Manuel B. , Guzmán-Morales Jessica , Rivera José C. , Zermeño Consuelo , López-Barrera Fernando , Nava Gabriel , Lavalle Carlos , de la Escalera Gonzalo Martínez , Clapp Carmen
Published: April 2006

The 16 kDa N-terminal fragment of prolactin (16K-prolactin) is a potent antiangiogenic factor. Here, we demonstrate that matrix metalloproteases (MMPs) produced and secreted by chondrocytes generate biologically functional 16K-prolactin from full-length prolactin. When incubated with human prolactin at neutral pH, chondrocyte extracts and conditioned medium, as well as chondrocytes in culture, cleaved the Ser155-Leu156 peptide bond in prolactin, yielding - upon reduction of intramolecular disulfide bonds - a 16 kDa N-terminal fragment. This 16K-prolactin inhibited basic fibroblast growth factor (FGF)-induced endothelial cell proliferation in vitro. The Ser155-Leu156 site is highly conserved, and both human and rat prolactin were cleaved at this site by chondrocytes from either species. Conversion of prolactin to 16K-prolactin by chondrocyte lysates was completely abolished by the MMP inhibitors EDTA, GM6001 or 1,10-phenanthroline. Purified MMP-1, MMP-2, MMP-3, MMP-8, MMP-9 and MMP-13 cleaved human prolactin at Gln157, one residue downstream from the chondrocyte protease cleavage site, with the following relative potency: MMP-8>MMP-13 >MMP-3>MMP-1=MMP-2>MMP-9. Finally, chondrocytes expressed prolactin mRNA (as revealed by RT-PCR) and they contained and released antiangiogenic N-terminal 16 kDa prolactin (detected by western blot and endothelial cell proliferation). These results suggest that several matrix metalloproteases in cartilage generate antiangiogenic 16K-prolactin from systemically derived or locally produced prolactin.