Hemochromatosis and alcoholic liver disease

The close association of excessive alcohol consumption and clinical expression of hemochromatosis has been of widespread interest for many years. In most populations of northern European extraction, more than 90% of patients with overt hemochromatosis are homozygous for the C282Y mutation in the HFE gene. Nevertheless, the strong association of heavy alcohol intake with the clinical expression of hemochromatosis remains. We (individually or in association with colleagues from our laboratories) have performed three relevant studies in which this association was explored. In the first, performed in 1975 before the cloning of the HFE gene, the frequency of clinical symptoms and signs was compared in patients with classical hemochromatosis who consumed 100 g or more of alcohol per day versus in nondrinkers or moderate drinkers who consumed less than 100 g of alcohol per day. The results showed no difference between the two groups except for features of complications of alcoholism in the first group, especially jaundice, peripheral neuritis, and hepatic failure. Twenty-five percent of those with heavy alcohol consumption showed histologic features of alcoholic liver disease (including cirrhosis) together with heavy iron overload. It was concluded that these patients had the genetic disease complicated by alcoholic liver disease. In the second study (2002), 206 subjects with classical HFE-associated hemochromatosis in whom liver biopsy had been performed were evaluated to quantify the contribution of excess alcohol consumption to the development of cirrhosis in hemochromatosis. Cirrhosis was approximately nine times more likely to develop in subjects with hemochromatosis who consumed more than 60 g of alcohol per day than in those who drank less than this amount. In the third study (2002), 371 C282Y-homozygous relatives of patients with HFE-associated hemochromatosis were assessed. Eleven subjects had cirrhosis on liver biopsy and four of these drank 60 g or more of alcohol per day. The reason why heavy alcohol consumption accentuates the clinical expression of hemochromatosis is unclear. Increased dietary iron or increased iron absorption is unlikely. The most likely explanation would seem to be the added co-factor effect of iron and alcohol, both of which cause oxidative stress, hepatic stellate cell activation, and hepatic fibrogenesis. In addition, the cumulative effects of other forms of liver injury may result when iron and alcohol are present concurrently. Clearly, the addition of dietary iron in subjects homozygous for hemochromatosis would be unwise. (C) 2003 Elsevier Inc. All rights reserved.

Futures dreaming outside and on the margins of the western world

In this article, we challenge the hegemony of western science fiction, arguing that western science fiction is particular even as it claims universality. Its view remains based on ideas of the future as forward time. In contrast, in non-western science fiction the future is seen outside linear terms: as cyclical or spiral, or in terms of ancestors. In addition, western science fiction has focused on the good society as created by technological progress, while non-western science fiction and futures thinking has focused on the fantastic, on the spiritual, on the realization of eupsychia-the perfect self. However, most theorists assert that the non-west has no science fiction, ignoring Asian and Chinese science fiction history, and western science fiction continues to 'other' the non-west as well as those on the margins of the west (African-American woman, for example). Nonetheless, while most western science fiction remains trapped in binary opposites-alien/non-alien; masculine/feminine; insider/outsider-writers from the west's margins are creating texts that contradict tradition and modernity, seeking new ways to transcend difference. Given that the imagination of the future creates the reality of tomorrow, creating new science fictions is not just an issue of textual critique but of opening up possibilities for all our futures.

Students' conceptions of sport and sport education

This article explores a class of Grade 5 (age 9 and 10) children’s conceptions of sport during a season of sport education at Forest Gate Primary School. The purpose, following Kirk and Kinchin (this issue), is to examine the extent to which the potential transfer of learning between school and sport as a community of practice may be possible through sport education in school physical education. With reference to student interviews and drawings we report and discuss children’s conceptions of sport, their experiences of sport outside of the school, and their emerging conceptions of sport education in light of these prior understanding and experiences. We conclude that there was an evident level of compatibility between students’ experiences of sport education and their conceptions of sport more broadly.