Friday, April 10, 2009
Any Suggestions for My New User-Friendly Name?
Ever since I left Hawaii for the mainland U.S. I have had to assist and reassure Americans who find my Okinawan name intimidating. Brian Zenkichi Tamanaha is impossible to say, after all. (Blame my immigrant grandfather for this tongue-twisting name, which was his, except for the "Brian" part.) I'm sympathetic to their predicament, of course, as I have no idea how to pronounce many Polish, Russian, Serbian, Lebanese, Turkish, Indonesian, and so forth, names. They might officially be citizens, but their names sure aint American. That is a major inconvenience of our "melting pot" society.
The obvious answer is 'Brian Tam'. It's easy for us gringos and also pays homage to Summer Glau in Serenity and Firefly.
OMG. And, of course, it's Texas.
To all you Texans who might object: Yes, I lived in TX for several years and recognize that there are many wonderful people to be found there. But, the legislature ... I suppose we can be glad that Molly Ivins did not live to see this, at least.
If it makes you feel any better, Professor T., here's a True Texas story:
When I was about to move from Emory (Atlanta) to Rice (Houston), I went to Houston to find a house. My first day in TX, I was cursed by a 'native' for being a "Mother-F-ing Yankee" - based on my Georgia plates.
Whence it comes.
Oh, shoot me for my stubborn stupidity in following the link - and for reading the first few comments, where I ran into this:
"I can tell you that many immigrants do not have standard names."
And, welcome home, George and Laura!
Well, if we are really going to make suggestions, here are a few:
1) In 'Merica outside of TX, try Brian Man
2) Inside the Republic, try Lyle Man
The key is to make both the pronunciation [pronusayshun] and the spelling as easy as possible.
I suggest Brian Taman. It's not particularly American, but it's easy to pronounce and it has the added benefit that it sounds like "The Man".
Okay, Brian, you're from Hawaii. I assume you were born there so that you are a natural born U.S. citizen. Coincidentally our new president was born in Hawaii (despite challenges from the "usual suspects," including the late Edgar Bergen's scion at this Blog) and he has foreign sounding names, including (unlike you) his first name. And he did not come up with a new user-friendly name to make his mark on America. So perhaps you might emulate him. I assume you are or soon will be 35 years of age. As for your first name, that's the name of my second son, which differs from my ethnicity. Perhaps when we named him I was a bit dyslexic. Brian, you have a Brain, a heart and a sense of humor. Add a little audacity and hope and the lei of the land may some day rest on your shoulders. In closing, as I think of Groucho Marx singing "hello, I must be going," I need only say aloha.
OMG. And, of course, it's Texas.
Stow the snotty regionalism. Immigration authorities at Staten Island, NY regularly anglicized foreign names of immigrants for decades. Some of my Irish ancestors were the beneficiaries of this "assistance."
There is rarely anything new under the sun.
Thanks for the helpful suggestions, everyone.
So far I like "Taman" (AKA "The Man"), and just plain "T" (people can't mess that one up). ("James Bond" is tempting, but it would elicit too many humiliating laughs.)
I'll wait until the end of the day to make my decision. There might a winning late entry.
Reminds me of a joke told back during the new deal. A guy petitions a court to change his name. The judge asks, "What is your name?" The man answers, "Franklin Delano Stink, Your Honor." The judge says, "Oh! Of course you can change your name. What would you like to change it to?" The man replies, "Joe Stink."
I lived in Texas and please remember there is the late Molly Ivins Texas too folks.
Brian Zenkichi Tamanaha:
You're the "user". You get to use what's 'friendly' to you.
-- Arn-eh Lnagostimo.
Before the competition closes, let's get serious:
Brian Zen Amana,
Brian Kichi Naha,
or (drum roll)
Shag from Hawaii (franchise fee waived).
First: One week in Colorado Springs
Second: Two weeks in Colorado Springs
Third: Permanent comment rights on all of Brian's posts on this Blog or the knapsack of your choice
Change it to
Geronimo Zenkichi Tamanaha
Geronimo is an historically original American name that invokes an image of a heroic strong warrior that was always true to his American people.
I think you should change your name to Mark Tee. Then we could call you “M.T.”, in honor of the contents of Rep. Betty Brown’s head.
Alternative: Generalissimo Brian Zenkichi Tamanaha, because everyone likes to say “Generalissimo”.
I don't find your last name difficult in the least, though I take your point. My wife's name is Hamamoto -- again, a lot of syllables, but nothing that can't be handled by the sounding-it-out skill we all learned early on. My name, on the other hand, is the real problem. No one in my life has pronounced it correctly. And though I've been with my wife for over 10 years, my father in law recently spelled my name "Kawol."
Ironically, someone in my family changed the spelling of my name from "Koal" to "Kowal" to preserve the pronunciation ("CO-wall", not "cowl" as in "scowl"). But the end result was to render both the spelling and pronunciation more difficult. (Incidentally, the original spelling is German, but the changed spelling is Polish, the equivalent of "Smith".)
Thus, while I'm usually a big "melting pot" proponent, I'd say just stick it out.
I've been there. Thankfully, only my first and middle names were Americanized and my family name was transliterated properly. (My daughter has it.) I was surprised that Mrs. Brown knew such a long word as "transliterated".
Bart DePalma said:
Stow the snotty regionalism. Immigration authorities at Staten Island, NY regularly anglicized foreign names of immigrants for decades."
True, but most of us have moved beyond such arrogance and condescension.
By that logic, it would be impossible to condemn a country still practicing slavery because it was once practiced in New England.
with all due respect to you, brian, in honor of the person who started all of this, i believe every single one of us should petition the state of texas to have our names all changed to "rep. betty brown". this way, she will never have trouble dealing with a name, will probably have no trouble remembering a name, and will fight like all hell to ensure that the name is eligible to vote.
My only point is that ignorant xenophobia is hardly limited to Texas. We have gone through these cycles repeatedly in this land of immigrants when the prior waves of immigrants give the next wave of immigrants a hard time about their funny sounding names not being American enough.
This would have been a much more humorous article if the know nothing legislator was herself named Dutkiewicz instead of Brown.
My ancestry came from Sweden and I have rarely found people with my maiden last name who are not related.
We *broke* the pronunciation to accommodate this weakness in American adaptability. I say we, but I mean my mother who somehow managed to take on a name and sneer at it simultaneously. It was her way. She held the failure to adapt to be a lesser sin that the expectation of adaptation.
The result was an ugly phonetic pronunciation. People had no problem with hearing and spelling it, but they all sneered as it was harsh.
I say keep your name, add a sound file that supplies an appropriate and fun rhythm to it, and contribute to our cultural decor.
PS: I seriously considered changing my last name to Jones, so I'll understand if you think my idea bad.
"Brian T. Amana"
What could be more American than a major appliance brand name?
Betty's bio says the ranch she owns has been in her family for four entire generations. I wonder where Frau Brown's family lived before that?
I propose we all change our surnames to one of the following: White, Yellow, Brown, Black.
Or better yet, let's go the Cambodia route. I anoint Brian Tamanaha "Brother No. 1," at least until we can arrange ourselves in a strict hierarchy of who is most valuable and important. Of course, Brian may remain Brother No. 1 thereafter, but we'll just have to see.
And obviously by Cambodia I was referring to the Khmer Rouge.
I'm also surprised no one has suggested "Qui Tam," yet.
The most important part of your name is it is yours, intact, a gift from your family.
Politics in TX can be somewhat hyperbolic, nevertheless, though I would recommend against changing your name simply to accommodate the grandiose visions of a state legislator.
However, I visited the university website for a lawschool in Newtown PA where there is a photo of a person who resembles B.Tamanaha. If that person were to wear a cowboy hat and speak laconically, without being too verbose, and had to supply a middle name, I would suggest "Enid". It is the name of a town across the border from TX, in OK. You could explain your grandfather was a hog farmer in Enid, and that is how you got the moniker.
Your own middle name, a brief search of Okinawa websites reveals, has substantial etymologic meaning. Perhaps you could have its existence declared a State Secret protected by the uninformed executive theory of the balance of powers.
A lot of good suggestions folks.
It was a hard decision, but I picked "Brother No. 1." Henceforth that's me.
Thanks all. I'll make it legal as soon as I can.
Brother No. 1
I'm sorry to arrive late. Great post (and, everyone, great thread). This all reminds me of a story, apparently true, of man who had no middle name when he was drafted into the U.S. Army during WWII. The Army found that unacceptable, so it took his answer to its persistent question literally -- the Army made him, officially, Wilbur None Geronimo.
Thanks, Hank G. I don't take B too seriously, particularly when he confuses snotty derogation of a specific state with snotty 'regionalism.'
I would like to be Sister No. 1, but I fear my two older sisters would object.
We too are discussing this at our blog. I made the following comment regarding my "difficult" Asian name.
Whenever I have to say my name over the phone to identify myself to a customer service agent of a utilities company or a catalog, I begin spelling it even before I say it. After my first name is duly noted, I say my last name and qualify it with "as in Peter, Paul and Mary." There is invariably a relieved chortle on the other side of the phone of the "that was easy!" variety. So I fully understand where Ms Brown is coming from. I just don't believe that things always have to be "easy." Also, Ms Brown gives herself away with this statement: "do you think that it would behoove you and your citizens to adopt a name that we could deal with more readily here?” As I pointed out, the people in question are not "your citizens." Being Americans, they are "her" citizens too.
On the other hand, clearly understanding that people only have so much time to spend to get my name correctly in public places, I often just say "Paul" or "Mrs. Paul" to save time and aggravation. Just a few weeks ago, at a sandwich shop which takes the name of customers with their orders, I gave my name as "Paul." Soon afterwards, three "Pauls" were called out (all men) causing a bit of confusion requiring matching every order with the right "Paul." When my turn came, the man at the counter, whose first name was also Paul, muttered, "The Pauls are taking over the world, it seems." Sometimes, calling myself Ruchira helps to simplify things.
As a Japanese-American (JA), your support for this sitting politician's veiled immigrant-bashing platform offends me. While JAs expect Media's insults to their dignitas by providing a forum, your joining the Media exposes you as either deceptive or stupid. I expose you consequently below:
1)Sitting politician Brown acted on the matter of confused renderings of Chinese government names, which confusion evidently produced multiple IDs for a single person; even you should comprehend the implication of, say, a Chinese rendering "Bin Wong" on birth certificate as "Bill Wong" on DL and "William Wong" on voter ID; so the Media , as expected, and you didn't even comprehend Brown's matter.
2) Brown represents a TX conservative district with about 0 "Asians"; you and the Media, by expanding an inconsequential and insignificant matter, have provided Brown a commodious and opportune re-election matter in her racist, conservative district with 0 "Asians".
3) You and the Media, by providing this obscure woman a national forum, have degraded "Asians" by depicting them to the majority as infirm pathetic victims. As the US declines into the worst depression since a global war, what kind of ethnic minorities do you estimate to be most probable of being assailed by hostile majority; minorities perceived as robust, independent, invincible or those perceived as infirm, violable, dependent?
The story about Betty Brown's comments appears to be more than a bit overblown. A video of the exchange can be seen here.
As Bart says, Rep. Brown didn't want people to change their names -- just the way the name is spelled (!). That's just so different from having to change your name, as Bart will no doubt explain.
Because spelling in English is so non-idiosyncratic, you know, so we would never have a problem spelling a last name like Mapledurham (pronounced "mum").
Oh, by the way, the name my ancestors saddled us with cannot be pronounced by Americans on sight -- and, thanks to the number of spaces on the forms at Ellis Island, neither can it be pronounced, or even recognized, by folks still resident in the ancestral homeland. Thanks, everybody.
I think American life and letters would be improved more by a phonetic spelling convention than by a constitutional convention (apologies to Sandy). And I say, leave the homosexuals alone and eliminate homonyms. They're nothing but trouble.
As a retired attorney who had to search title in eastern states, please do not choose Johnson, Jones, Smith, Brown, etc. Actually, your name (as with most Japanese names) is easily pronounced in English. It may have one too many syllables, that's all. "Qui Tam" sounds good. Back in my military intelligence days we had a training character called "Fnu Lnu", and I had a friend with the middle name "Nmn".
mesothelioma Mesotheliomais a form of cancer that is almost always caused by exposure to Asbestos In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart the pericardium (a sac that surrounds the heart or tunica vaginalis.
Most people who develop
mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing Mesothelioma Unlike lung cancer, there is no association between mesothelioma and smoking but smoking greatly increases risk of other asbestos induced cancer.Compensation via
Asbestos funds or lawsuits is an important issue in
mesothelioma The symptoms of
mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis, which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural
mesotheliomaSymptoms of peritoneal
mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal
mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by
mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
chest wall pain
pleural effusion, or fluid surrounding the lung
shortness of breath
fatigue or anemia
wheezing, hoarseness, or cough
blood in the sputum (fluid) coughed up hemoptysis
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
ascites, or an abnormal buildup of fluid in the abdomen
a mass in the abdomen
problems with bowel function
In severe cases of the disease, the following signs and symptoms may be present:
blood clots in the veins, which may cause thrombophlebitis
disseminated intravascular coagulation a disorder causing severe bleeding in many body organs
jaundice, or yellowing of the eyes and skin
low blood sugar level
pulmonary emboli, or blood clots in the arteries of the lungs
mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs
mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for
mesothelioma A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of
mesothelioma A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude
mesothelioma it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of
mesothelioma A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
There is no universally agreed protocol for screening people who have been exposed to
asbestosScreening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for
mesotheliomaThe level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening. Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate is approximately one per 1,000,000. The highest incidence is found in Britain, Australia and Belgium: 30 per 1,000,000 per year. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[ Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.
is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven.
has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
The combination of smoking and
asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer bronchial carcinoma). The Kent brand of cigarettes used
mesothelioma in its filters for the first few years of production in the 1950s and some cases of
. have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 may act as a cofactor in the development of mesothelioma.
Asbestos was known in antiquity, but it wasn't mined and widely used commercially until the late 1800s. Its use greatly increased during World War II Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with
. exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of
. exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for
mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with
asbestos wear personal protective equipment to lower their risk of exposure. Recent findings have shown that a mineral called erionite has been known to cause genetically pre-dispositioned individuals to have malignant mesothelioma rates much higher than those not pre-dispositioned genetically. A study in Cappadocia, Turkey has shown that 3 villiages in Turkey have death rates of 51% attributed to erionite related
asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.
The documented presence of
asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to
asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure.
asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
Family members and others living with
asbestos workers have an increased risk of developing
mesothelioma and possibly other asbestos related diseases. This risk may be the result of exposure to
asbestos dust brought home on the clothing and hair of
asbestos workers. To reduce the chance of exposing family members to asbestosMany building materials used in both public and domestic premises prior to the banning of
asbestos may contain
asbestos Those performing renovation works or activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue
asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to
mesothelioma radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel.
Radiation Therapy when given alone with curative intent has never been shown to improve survival from
mesothelioma The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy is the only treatment for
mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy) in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery. This trial was the first to report a survival advantage from chemotherapy in malignant pleural
mesothelioma showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the combination pemetrexed group in patients who received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.
Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.
In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer.
mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by at the Washington Cancer Institute. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.
What is the mesothelium?
The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs to glide easily against adjacent structures.
The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The
mesothelioma tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women.
What is mesothelioma?
mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs.
cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
How common is mesothelioma?
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.
What are the risk factors for mesothelioma?
Working with asbestos is the major risk factor for mesothelioma. A history of . exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. . has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.
Who is at increased risk for developing mesothelioma?
asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
The risk o f asbestosrelated disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.
There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to
asbestos dust brought home on the clothing and hair of
asbestos workers. To reduce the chance of exposing family members to
asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
What are the symptoms of mesothelioma?
Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to
asbestos Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by
mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.
A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the
cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the
cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
Treatment for mesothelioma depends on the location of the
cancerthe stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.
Surgery is a common treatment for
mesotheliomaThe doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural
mesotheliomaa lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.
Stereo Tactic Radiation Therapy also called radiotherapy, involves the use of high-energy rays to kill
cancercells and shrink tumors Radiation therapy affects the
cancercells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the
cancercells are found (internal radiation therapy).
Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat
mesotheliomaare given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).
To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation Therapy and surgery may also be helpful in relieving symptoms.
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Any risk that can be quantified can potentially be insured. Specific kinds of risk that may give rise to claims are known as "perils". An insurance policy will set out in detail which perils are covered by the policy and which are not. Below are (non-exhaustive) lists of the many different types of insurance that exist. A single policy may cover risks in one or more of the categories set out below. For example, auto insurance would typically cover both property risk (covering the risk of theft or damage to the car) and liability risk (covering legal claims from causing an accident). A homeowners insurance policy in the U.S. typically includes property insurance covering damage to the home and the owner's belongings, liability insurance covering certain legal claims against the owner, and even a small amount of coverage for medical expenses of guests who are injured on the owner's property.
Business insurance can be any kind of insurance that protects businesses against risks. Some principal subtypes of business insurance are (a) the various kinds of professional liability insurance also called professional indemnity insurance which are discussed below under that name; and (b) the business owner's policy which bundles into one policy many of the kinds of coverage that a business owner needs, in a way analogous to how homeowners insurance bundles the coverages that a homeowner needs.
Vehicle insuranceAuto insurance protects you against financial loss if you have an accident. It is a contract between you and the insurance company. You agree to pay the premium and the insurance company agrees to pay your losses as defined in your policy. Auto insurance provides property, liability and medical coverage:
Property coverage pays for damage to or theft of your car.
Liability coverage pays for your legal responsibility to others for bodily injury or property damage.
Medical coverage pays for the cost of treating injuries, rehabilitation and sometimes lost wages and funeral expenses.
An iauto nsurance policy is comprised of six different kinds of coverage. Most countries require you to buy some, but not all, of these coverages. If you're financing a car, your lender may also have requirements. Most auto policies are for six months to a year.
In the United States, your insurance company should notify you by mail when it’s time to renew the policy and to pay your premium.
Home insuranceHome insurance provides compensation for damage or destruction of a home from disasters. In some geographical areas, the standard insurance excludes certain types of disasters, such as flood and earthquakes, that require additional coverage. Maintenance-related problems are the homeowners' responsibility. The policy may include inventory, or this can be bought as a separate policy, especially for people who rent housing. In some countries, insurers offer a package which may include liability and legal responsibility for injuries and property damage caused by members of the household, including pets.
Health insurance and Dental iinsurance
Health insurance policies by the National Health Service in the United Kingdom or other publicly-funded health programs will cover the cost of medical treatments. Dental insurance like medical insurance is coverage for individuals to protect them against dental costs. In the U.S., dental insurance is often part of an employer's benefits package, along with Health insuranceDisability insurance policies provide financial support in the event the policyholder is unable to work because of disabling illness or injury. It provides monthly support to help pay such obligations as mortgages and credit cards.
Disability overhead insurance allows business owners to cover the overhead expenses of their business while they are unable to work.
Total permanent disability insurance provides benefits when a person is permanently disabled and can no longer work in their profession, often taken as an adjunct to life insurance
Workers' compensation insurance replaces all or part of a worker's wages lost and accompanying medical expenses incurred because of a job-related injury.
Casualty insurance insures against accidents, not necessarily tied to any specific property.
Casualty insuranceCrime insurance is a form of casualty insurance that covers the policyholder against losses arising from the criminal acts of third parties. For example, a company can obtain crime insurance to cover losses arising from theft or embezzlement.
Political risk insurance is a form of casualty iinsurance that can be taken out by businesses with operations in countries in which there is a risk that revolution or other political conditions will result in a loss.
Life insuranceLife insurance provides a monetary benefit to a decedent's family or other designated beneficiary, and may specifically provide for income to an insured person's family, burial funeral and other final expenses. Life insurance policies often allow the option of having the proceeds paid to the beneficiary either in a lump sum cash payment or an annuity.
Annuities provide a stream of payments and are generally classified as insurance because they are issued by insurance companies and regulated as insurance and require the same kinds of actuarial and investment management expertise that life insurance requires. Annuities and pensions that pay a benefit for life are sometimes regarded as insurance against the possibility that a retiree will outlive his or her financial resources. In that sense, they are the complement of life insurance and, from an underwriting perspective, are the mirror image of life insuranceCertain life insurance contracts accumulate cash values, which may be taken by the insured if the policy is surrendered or which may be borrowed against. Some policies, such as annuities and endowment policies are financial instruments to accumulate or liquidate wealth when it is needed.
In many countries, such as the U.S. and the UK, the tax law provides that the interest on this cash value is not taxable under certain circumstances. This leads to widespread use of life insurance as a tax-efficient method of saving as well as protection in the event of early death.
In U.S., the tax on interest income on life insurance policies and annuities is generally deferred. However, in some cases the benefit derived from tax deferral may be offset by a low return. This depends upon the insuring company, the type of policy and other variables (mortality, market return, etc.). Moreover, other income tax saving vehicles may be better alternatives for value accumulation. A combination of low-cost term life insurance and a higher-return tax-efficient retirement account may achieve better investment return.
Property insurance provides protection against risks to property, such as fire, theft or weather damage. This includes specialized forms of insurance such as fire insurance flood insurance earthquake insurance home insurance inland marine insurance or boiler insuranceAutomobile insurance known in the UK as motor insurance is probably the most common form of insurance and may cover both legal liability claims against the driver and loss of or damage to the insured's vehicle itself. Throughout the United States an auto insurance policy is required to legally operate a motor vehicle on public roads. In some jurisdictions, bodily injury compensation for automobile accident victims has been changed to a no-fault system, which reduces or eliminates the ability to sue for compensation but provides automatic eligibility for benefits. Credit card companies insure against damage on rented cars.
Driving School insurance provides cover for any authorized driver whilst undergoing tuition, cover also unlike other motor policies provides cover for instructor liability where both the pupil and driving instructor are equally liable in the event of a claim.
Aviation insurance insures against hull, spares, deductibles, hull wear and liability risks.
Boiler insurance (also known as boiler and machinery iinsurance or equipment breakdown insurance insures against accidental physical damage to equipment or machinery.
Builder's risk insurance insures against the risk of physical loss or damage to property during construction. Builder's risk insurance is typically written on an "all risk" basis covering damage due to any cause (including the negligence of the insured) not otherwise expressly excluded.
Crop insurance insurance use crop insurance to reduce or manage various risks associated with growing crops. Such risks include crop loss or damage caused by weather, hail, drought, frost damage, insects, or disease, for instance."
Earthquake insurance is a form of property insurance that pays the policyholder in the event of an earthquake that causes damage to the property. Most ordinary homeowners insurance policies do not cover earthquake damage. Most earthquake insurance policies feature a high deductible. Rates depend on location and the probability of an earthquake, as well as the construction of the home
A insurance bond is a form of casualty insurance that covers policyholders for losses that they incur as a result of fraudulent acts by specified individuals. It usually insures a business for losses caused by the dishonest acts of its employees.
Flood insurance protects against property loss due to flooding. Many insurers in the U.S. do not provide flood insurance in some portions of the country. In response to this, the federal government created the National Flood insurance Program which serves as the insurer of last resort.
Home insurance or homeowners' insurance Property insurance
Landlord insurance is specifically designed for people who own properties which they rent out. Most house insurance cover in the U.K will not be valid if the property is rented out therefore landlords must take out this specialist form of home insurance
Marine insurance and marine cargo insurance cover the loss or damage of ships at sea or on inland waterways, and of the cargo that may be on them. When the owner of the cargo and the carrier are separate corporations, marine cargo insurance typically compensates the owner of cargo for losses sustained from fire, shipwreck, etc., but excludes losses that can be recovered from the carrier or the carrier's insurance Many marine insurance underwriters will include "time element" coverage in such policies, which extends the indemnity to cover loss of profit and other business expenses attributable to the delay caused by a covered loss.
Surety bond insurance is a three party insurance guaranteeing the performance of the principal.
Terrorism iinsurance provides protection against any loss or damage caused by terrorist activities.
Volcano insurance is an insurance that covers volcano damage in Hawaii.
Windstorm insurance is an insurance covering the damage that can be caused by hurricanes and tropical cyclones.
Liability insuranceLiability insurance is a very broad superset that covers legal claims against the insured. Many types of insurance include an aspect of liability coverage. For example, a homeowner's insurance policy will normally include liability coverage which protects the insured in the event of a claim brought by someone who slips and falls on the property; automobile insurance also includes an aspect of liability insurance that indemnifies against the harm that a crashing car can cause to others' lives, health, or property. The protection offered by a liability insurance policy is twofold: a legal defense in the event of a lawsuit commenced against the policyholder and indemnification (payment on behalf of the insured) with respect to a settlement or court verdict. Liability policies typically cover only the negligence of the insured, and will not apply to results of wilful or intentional acts by the insured.
Directors and officers liability insurance protects an organization (usually a corporation) from costs associated with litigation resulting from mistakes made by directors and officers for which they are liable. In the industry, it is usually called for short.
Environmental liability insurance protects the insured from bodily injury, property damage and cleanup costs as a result of the dispersal, release or escape of pollutants.
Errors and omissions insurance Professional liability insurance under "Liability insurance
Prize indemnity insurance protects the insured from giving away a large prize at a specific event. Examples would include offering prizes to contestants who can make a half-court shot at a basketball game, or a hole-in-one at a golf tournament.
Professional liability insurance also called professional indemnity insurance protects insured professionals such as architectural corporation and medical practice against potential negligence claims made by their patients/clients. Professional liability insurance may take on different names depending on the profession. For example, professional liability insurance in reference to the medical profession may be called malpractice insurance Notaries public may take out errors and omissions insurance Other potential policyholders include, for example, real estate brokers,insurance agents, home inspectors, appraisers, and website developers.
Instead of everyone getting worked up over this, why not try to understand the question a little better? I mean, I know it's more fun to make fun of people, but isn't it more responsible (and more adult) to try and understand the problem at hand, and try to solve it in a reasonable way?
To my understanding, Chinese names are written as a collection of pictographs. In the US, this is not a commonly understood form. Thus, when a person with a name only represented as a pictograph goes to vote, the person checking them in can't.
One solution for fixing this is to teach everyone in the US to read and speak Chinese. Or to teach everyone checking in voters to read and speak Chinese. What are the downsides to this? How hard is Chinese to understand? How much time is necessary for an average person born and raised in China to be able to read the newspaper?
A second solution is to write the Chinese name using an alphabet more standard in the US (one which most people in the US can reasonably be expected to understand), such as the English alphabet. Reading the Texas legislator's comments, it appears that this is already being done, but there's inconsistency in how names are written. For example, a certain pictogram can be written as Zen, Xen, or Shen. If a voter signs in as "Zen" but the official voter roll reads "Shen", does that mean this is a different person?
So, to correct this new problem, a standardized method of converting Chinese pictographs into phonetic English-character text would help. The legistlator's question of "what is wrong with this?", when looked at as an honest question of "Can we do this? What are the problems incurred? How do they balance with other problems? How would we even create such a standard - or does one exist?" is a totally reasonable question.
How exactly does one pronounce mesothelioma?
And speaking of which, how did that spambot get past the word verification gate that I have to get past now? Maybe if the CAPTCHA used Hawaiian names, spambots couldn't figure them out.
But seriously, the fact that somebody has raised the race card means that a good third of America will never be able to think straight about the legitimate aspect of the question. The answer to which can be found in the names of half the movie stars, and rock stars on the planet.
Change your name to something catchy.
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