Virology Experts in the Boundary Zone Between Science, Policy and the Public: A Biographical Analysis

This article aims to open up the biographical black box of three experts working in the boundary zone between science, policy and public debate. A biographical-narrative approach is used to analyse the roles played by the virologists Albert Osterhaus, Roel Coutinho and Jaap Goudsmit in policy and public debate. These figures were among the few leading virologists visibly active in the Netherlands during the revival of infectious diseases in the 1980s. Osterhaus and Coutinho in particular are still the key figures today, as demonstrated during the outbreak of novel influenza A (H1N1). This article studies the various political and communicative challenges and dilemmas encountered by these three virologists, and discusses the way in which, strategically or not, they handled those challenges and dilemmas during the various stages of the field’s recent history. Important in this respect is their pursuit of a public role that is both effective and credible. We will conclude with a reflection on the H1N1 pandemic, and the historical and biographical ties between emerging governance arrangements and the experts involved in the development of such arrangements

Doctors of Amsterdam

Holland 's Golden Age of the arts was also a bright era for medical science. Public dissections in the anatomy theatre were a popular attraction, and visitors came from far and wide to view the wonderful anatomy collections of Frederik Ruysch. In the intervening 350 years, every aspect of medicine has changed. In Doctors of Amsterdam Annet Mooij describes the transformation of city infirmaries from shelters for indigent townspeople into centers of highly specialized medical care, of universities from seats of timeless general scholarship into institutions of science and specialization, and of medical research from improvised tests in private rooms into sophisticated experiments in hi-tech university laboratories. All this is set in the city of Amsterdam. Still, events in the Dutch capital cannot be seen in isolation from national and international developments, and these contextual factors receive ample attention. The result is a lively and informative picture of more than three centuries of medicine

Roddels, ruzie, achterklap. Veranderende omgangsvormen in de medische beroepsgroep

Snoop, scandal, slander Changing manners in the medical profession During the seventeenth and eighteenth century medical men were rather secret about their therapies, instruments and techniques. In their discourses they pictured their rivals as worthless, incompetent characters, unfit for the medical profession. This article states that this manner of conduct was connected with the relation between physician and patient, as physicians were highly dependent on their patients' patronage. The rivalry between all kinds of medical professionals originated from this situation in which the physician's conduct was directed by his patient's patronage rather than by his medical capability. This doctor-patient relation changed during the nineteenth century. The development of the hospital from a place to die to a place to get the best medical care accompanied this change. In the hospital, physicians started to work as partners instead of rivals, they developed their therapies and techniques together, whereas the patient lost his influence on the physician's behaviour

The Politics of War Trauma

History;geography;auxiliary discipline

Mifepristone effects on tumor somatostatin receptor expression in two patients with Cushing's syndrome due to ectopic adrenocorticotropin secretion

Context: Two patients presented with Cushing's syndrome due to ectopic ACTH secretion. Initial localization studies included computed tomography, magnetic resonance imaging, and octreoscans (111In-pentreotide scintigraphy), which were negative in both patients. They were treated with the glucocorticoid receptor antagonist mifepristone, with improvement in their clinical symptoms. Follow-up octreoscans after, respectively, 6 and 12 months showed the unequivocal presence of a bronchial carcinoid in both patients. Objective: The objective of the study was to correlate in vivo and in vitro findings in patients with ectopic ACTH-producing syndrome. Methods: We determined the expression of somatostatin and dopamine receptors by immunohistochemistry (patients 1 and 2), quantitative PCR, and in vitro culturing of tumor cells (patient 1 only). In Vitro Results: Both tumors were strongly positive for somatostatin receptor type 2 (sst2) on immunohistochemistry, whereas one of the tumors (patient 1) was also dopamine receptor subtype 2 (D 2) positive on both immunohistochemistry and quantitative PCR. Octreotide (a sst2preferring analog) and cabergoline (D2 agonist) both decreased the ACTH levels in the cultured tumor cells of patient 1. Conclusion:Wedescribe two patients with ACTH-producing bronchial carcinoids, inwhoma direct down-regulatory effect of glucocorticoid levels on tumoral sst2 receptor expression is suggested by a remarkable change in octreoscan status after successful mifepristone therapy. Further studies will have to demonstrate whether glucocorticoid lowering or antagonizing therapy may be used to improve the diagnostic accuracy of somatostatin receptor scintigraphy in patients with ectopic ACTH production of unknown primary origin. Copyrigh

Preoperative normalization of cortisol levels in cushing's disease after medical treatment: Consequences for somatostatin and dopamine receptor subtype expression and in vitro response to somatostatin analogs and dopamine agonists

Context: Corticotroph pituitary adenomas often highly express the dopamine 2 receptor (D2R) and somatostatin receptor subtype 5 (sst5). The sst2 expression is relatively low, likely resulting from downregulating effects of high cortisol levels. This may explain why the sst2-preferring somatostatin analog octreotide, compared with the multi-receptor-targeting somatostatin analog pasireotide, is generally ineffective in Cushing's disease. Objective: Our objective was to compare sst and D2R expression levels between adenomas from patients with elevated and normalized preoperative urinary free cortisol excretion. Patients and Design: Corticotroph adenoma tissue was examined from patients from group 1 (n = 22; elevated preoperative urinary free cortisol) and group 2 (n = 11;meanduration of preoperative normocortisolism 10 weeks). Somatotroph adenoma tissue from 10 acromegalic patients was examined to compare receptor expression profiles. Main Outcome Measures: We evaluated receptor mRNA and protein expression levels and effects of octreotide,p