The Bermuda offshore market in transition

In summary, the Bermuda insurance industry is undergoing a major upheaval, with the ultimate outcome being presently unclear. However, offshore markets have been at the forefront of innovation in international insurance for the past decade, and this innovation is likely to continue. The successful companies of the future will take full advantage of the regulatory and accounting freedoms offered in Bermuda, the Cayman Islands, and other Caribbean locations. In the end, the offshore captive industry could well be transformed into an offshore specialty insurance market. The players will be fewer, but the business volume may be larger than ever.     

Family history of alcoholism, youthful antisocial behavior and problem drinking among DWI offenders

This study assessed the impact of family history of alcoholism and antisocial behavior on problem drinking among male first-time DWI offenders. A sample of 123 men in DWI classes were assessed on demographic factors, antisocial behavior and family history of alcoholism. Also, measures of current and past drinking problems were assessed, including scales of perceived ability to control consumption, degree of physical dependence, occurrence of alcohol-related problems and preoccupation with alcohol. The results indicated that while family history of alcohol and antisocial behavior were not significantly related to quantity/frequency of alcohol consumption or alcohol-related problems, family history was related to drink duration. Main effects of family history and antisocial behavior were found for preoccupation with alcohol and physical dependence. There was a significant interaction with respect to perceived ability to control drinking. Results are discussed with regard to the implication that family history of alcoholism and antisocial behavior may influence the development of important precursors to alcoholism.     

Rapid,simple identification of individual osteoblastic cells and their specific products by cell blotting assay

Biochemical and molecular biological studies of osteoblastic cell function and hormonal regulation are frequently confounded by the inherent cellular heterogeneity and phenotypic instability of existing in vitro and in vivo model systems. A new technique (derived from Western blotting or antibody-based detection of protein molecules bound to nitrocellulose paper) is described for identification of individual cells which synthesize osteoblast-specific gene products (bone Gla-protein, type I collagen, and alkaline phosphatase) or produce cAMP in response to parathyroid hormone (PTH) or isoproterenol. Dispersed primary neonatal rat calvariae or osteogenic sarcoma cells were “plated” on Immobilon-P (a hydrophobic transfer membrane with very high protein-binding capacity) for 30 minutes to several hours, followed by agonist treatment, formalin fixation, hematoxylin staining, and immunostaining with a battery of antibodies specific for osteoblastic products. Individual cells and their secretory zones were visualized by light microscopy and counted. Treatment with PTH with or without isoproterenol resulted in increases in the percentages of osteoblastic cells elaborating cAMP, as well as the intensity of immunostaining, but had no effects on MCF-7 cells, a nonosteoblastic breast carcinoma control line. The percentage of cells within each primary osteoblastic cell population isolated or rat osteogenic sarcoma cell clone (G2 or C12) that elaborated bone-specific proteins or that generated cAMP in response to PTH varied with time and the individual cellular preparation, reconfirming the cellular heterogeneity of these systems. This method, in conjunction with techniques such as in vitro hybridization, should prove useful in characterizing discrete osteoblastic bone cell subpopulations and in clarifying mechanisms of hormonal regulation by local and systemic agents.     

New imaging techniques in prostate cancer

Correct staging of prostate cancer at initial diagnosis, as well as accurate staging and tumor localization with biochemical recurrence, remains generally inaccurate with current imaging techniques. Newer modalities are being investigated to accurately identify patients with prostate cancer at different stages of disease. Identification of locally recurrent disease or distant metastasis at the time of biochemical failure after local therapy will help guide treatment options and avoid potentially toxic salvage therapies in patients who will not benefit. A review of prostate cancer imaging literature over the past 12 months was performed to identify emerging imaging modalities that may be beneficial in the management of prostate cancer. Enhanced transrectal ultrasonography modalities, including ultrasound contrast agents, color and power Doppler, and elastrography, have demonstrated incremental benefit when combined with standard grayscale ultrasonography to accurately target and diagnose prostate cancer. Endorectal MRI, with contrast enhancement and spectroscopic imaging, shows promise in the initial staging of prostate cancer prior to local therapy. The use of positron-emission tomography scan for prostate cancer remains to be defined, but may help delineate the site of recurrence with biochemical failure after local therapy. Several new imaging modalities show promise for the evaluation of the patient with prostate cancer. Enhanced ultrasonography techniques may prove to be more accurate in diagnosing prostate cancer over standard gray-scale ultrasonography. Accumulating evidence supports the use of endorectal MRI and spectroscopy to help treatment planning with either surgical or radiotherapeutic approaches. Although intriguing, the available data for positron-emission tomography in prostate cancer remains too shallow to advocate routine use.     

Toward a VA women’s health research agenda: Setting evidence-based priorities to improve the health and health care of women veterans

The expansion of women in the military is reshaping the veteran population, with women now constituting the fastest growing segment of eligible VA health care users. In recognition of the changing demographics and special health care needs of women, the VA Office of Research & Development recently sponsored the first national VA Women’s Health Research Agenda-setting conference to map research priorities to the needs of women veterans and position VA as a national leader in Women’s Health Research. This paper summarizes the process and outcomes of this effort, outlining VA’s research priorities for biomedical, clinical, rehabilitation, and health services research.     

Children's ice hockey injuries.

OBJECTIVE--To determine the rate, type, and severity of injuries to child hockey players as well as assessing coaches', parents', and players' attitudes and knowledge of hockey. DESIGN--A prospective observation of a population's injuries using injury-reporting forms and surveys. SETTING--A community-organized hockey program in Minnesota. PARTICIPANTS: One hundred fifty boys, aged 9 through 15 years, who played ice hockey during the 1990-1991 winter season. MEASUREMENTS AND MAIN RESULTS--Injuries were reported by multiple observers, including coaches, managers, and trained independent observers at the time an injury occurred; coaches, parents, and players were surveyed regarding hockey injuries, knowledge, and attitudes. One in three players experienced an injury during the season. The most common injuries were contusions. Six of 100 players experienced injuries severe enough to require cessation of physical activities for 8 to 25 days or longer. Weight differences of 53 kg and height differences of 55 cm were reported between Bantam-aged players (13 through 15 years), and body contact, including legal checks, accounted for 86% of injuries during games. Illegal checks and violations were associated with 66% of injuries during games, yet only four penalties (14%) were assessed. In addition, one in three games in which an injury resulted was described as hostile and 15% of the injuries were considered intentional. CONCLUSIONS--Eliminating violence and body checking for prepubertal boys while emphasizing rule enforcement and good sportsmanship are recommended.     

Semipermeable Hollow Fiber Membranes in Hepatocyte Bioreactors: A Prerequisite for a Successful Bioartificial Liver?

Abstract: Recent studies have shown that liver support systems based on viable hepatocytes can prolong life in animal models of acute liver failure. Now the time has come to elucidate the design characteristics that are essential to construct an efficient bioreactor. The gold standard remains the intact liver. Despite the very high cell density in this organ, individual cell perfusion is guaranteed resulting in low diffusional gradients which are essential for optimal mass transfer. These conditions are not met in bioreactors based on hollow fiber membranes. Moreover, the semipermeable membranes can foul and act as a diffusional barrier between the hepatocytes and the blood or plasma of the recipient. We devised a novel bioreactor for use as a bioartificial liver that does not include hollow fiber membranes for blood or plasma perfusion. The device is based on an integral oxygenator and a nonwoven polyester matrix material for hepatocyte culture as small aggregates. The efficacy of this original design was tested in rats with liver ischemia. Preliminary results show statistically significantly improved survival; life was prolonged 100% compared to the control experiments.