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Secondary prevention of atherosclerosis, especially before the onset of symptoms, appears desirable and could be possible with a serum marker detecting atherosclerosis. Circulating, shedded forms of adhesion molecules may serve as such because their expression is upregulated in atherosclerotic plaques. In 52 patients with peripheral arterial vascular disease (Fontaine class IIa, 7 patients; class IIb, 29 patients; and class III, 16 patients), the extent of atherosclerosis was evaluated on the basis of angiograms of a large portion of the arterial system. The area diseased by atherosclerosis was determined by the percentage of vessel wall irregularities of the following calculated segments: aorta (distal from the kidney arteries), common iliac artery, external iliac artery, common femoral artery, lateral circumflex femoral artery, and popliteal artery. The maximal surface area that could exhibit atherosclerotic changes was 250 cm2. The serum concentration of circulating vascular cell adhesion molecule-1 (VCAM-1) correlated with the extent of atherosclerosis (r = .8, P < .001). In contrast, circulating intercellular adhesion molecule-1, E-selectin, P-selectin, and thrombomodulin (as markers for endothelial cell damage) did not correlate with the extent of atherosclerosis. Furthermore, circulating VCAM-1 could be used to indicate stages of atherosclerosis with a high degree of statistical significance. The potential bias of factors such as age, diabetes mellitus, hypercholesterolemia, arterial hypertension, renal failure, and history of myocardial infarction on the correlation of circulating VCAM-1 with the extent of atherosclerosis could be excluded by multivariate analysis. These findings suggest an important role of VCAM-1 in atherosclerosis and may serve as the basis for further evaluation of circulating VCAM-1 as a potential serum marker for atherosclerosis.

Increased oxidative stress generated by hyperglycaemia, hyperlipidaemia or the presence of advanced glycation endproducts (AGEs) or both is regarded as an important mediator of late diabetic complications [1]. A clear relation between the quality of glycaemic control and the presence of free radicals has been shown thereby relating the appearance of oxidative stress to the underlying metabolic disorder rather than to the complication itself [2]. The presence of oxygen free radicals and the simultaneous decline of antioxidative defence mechanisms observed in diabetic patients could therefore promote the development of late diabetic complications [1, 3±5].Oxidative stress has been proposed as a major cause of diabetic nephropathy [6±9]. Animal models implicate that oxidative stress accompanying the early onset of diabetes increases the kidney's susceptibility to develop diabetic nephropathy [10]. One possible mechanism for this is the activation of the oxidative stress sensitive transcription factor NF-kB [6, 11±13]. Translocation of activated NF-kB into the nucleus results in gene expression of NF-kB controlled Diabetologia (1999) 42: 222±232 Peripheral blood mononuclear cells isolated from patients with diabetic nephropathy show increased activation of the oxidative-stress sensitive transcription factor NF-kB

Marbles as building stones as well as in their natural environments show complex weathering phenomena. The most important damage scenario is based on the highly anisotropic thermal expansion coefficient a of calcite, i.e. extreme expansion parallel and contraction normal to the crystallographic c-axis. Therefore, the rock fabric and especially the latticepreferred orientation (texture) of calcite and/or dolomite as the predominant mineral phases in marbles have a significant influence on the mechanical weathering. The textures of marbles from five different locations vary from a more or less perfect prolate to moderate oblate shape of the [006] pole figure tensor. Accordingly, the texture-derived bulk thermal dilatation anisotropy covers a broad range from -0.048 to 0.680. The modelled thermal dilatations correlate with those obtained from experimental measurements. The difference in magnitude is basically explained by the microcrack fabrics which was not considered in the computations. All samples show a deterioration due to thermal treatment regardless of the strength of texture. The directional dependence of (a) the total magnitude of the thermal dilatation coefficient and (b) of the residual strain is highest in marbles with a strong texture, whereas the Carrara marble with a weak texture exhibits a uniform crack formation. The progressive loss of cohesion along grain boundaries due to dilatancy may serve as an example for the initial stage of physical weathering.

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The tragedies of the past decade have led to an identity crisis among humanitarians. Respecting traditional principles of neutrality and impartiality and operating procedures based on consent has created as many problems as it has solved. A debate is raging between “classicists,” who believe that humanitarian action can be insulated from politics, and various “political humanitarians,” who are attempting to use politics to improve relief and delivery in war zones This essay examines the pros and cons of impartial versus political humanitarianism and differing approaches across a spectrum of actors, including the classicists, led by the International Committee of the Red Cross, who believe that humanitarian action can and should be completely insulated from politics; the “minimalists,” who “aim to do no harm” in delivering relief; the “maximalists,” who have a more ambitious agenda of employing humanitarian action as part of a comprehensive strategy to transform conflict; and the “solidarists,” exemplified by Médecins Sans Frontières (Doctors without Borders), who choose sides and abandon neutrality and impartiality as well as reject consent as a prerequisite for intervention. The essay argues that there is no longer any need to ask whether politics and humanitarian action intersect. The real question is how this intersection can be managed to ensure more humanized politics and more effective humanitarian action.

Seismic anisotropy is often neglected in seismic studies of the earth's crust. Since anisotropy is a common property of many typically deep crustal rocks, its potential contribution to solving questions of the deep crust is evaluated. The anisotropic seismic velocities obtained from laboratory measurements can be verified by computations based on the elastic constants and on numerical data pertaining to the texture of rock-forming minerals. For typical lower crustal rocks the influence of layering is significantly less important than the influence of rock texture. Surprisingly, most natural lower crustal rocks show a hexagonal type of anisotropy. Maximum anisotropy is observed for rocks with a high content of aligned mica. It seems possible to distinguish between layered intrusives and metasediments on the basis of in situ measurements of anisotropy, which can thus be used to validate different scenarios of crustal evolution.

Economic sanctions have become a popular multilateral and bilateral enforcement measure in the 1990s. Their efficacy is doubtful along with their moral superiority over military force. Substantial suffering by vulnerable groups in Iraq, former Yugoslavia, and Haiti has led to a `bust' for this foreign policy tool. Sanctions can be designed to be more effective and less inhumane than they are at present, but much more research is required about their precise impact on civilians and on targeted regimes. Early post-Cold War euphoria is giving way to more realistic and subtle assessments of the pluses and minuses of economic and military coercion.