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Subject: Cancer Cell - Antiangiogenic Therapy Elicits Malignant Progression of Tumors to Increased Local Invasion and Distant Metastasis
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  <LI><A=20
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href=3D"http://www.cell.com/cancer-cell/abstract/S1535-6108(09)00029-4">A=
ccelerated=20
  Metastasis after Short-Term Treatment with a Pot...</A></LI></UL>
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  <LI id=3DmlktLink_1 class=3DmlktLink><A=20
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  resistance by evasion of antiangiogenic targeting of VE...</A>
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        <DIV style=3D"PADDING-LEFT: 5px; FLOAT: right"><A=20
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        =
onmouseover=3D"javascript:this.src=3D'/images/btn_xclose_hov.gif';"=20
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onmouseout=3D"javascript:this.src=3D'/images/btn_xclose.gif';"=20
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signaling in=20
        late-stage pancreatic islet tumors</STRONG><BR><I>Cancer =
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        299-309</I><BR>Oriol Casanovas, Daniel J. Hicklin, Gabriele =
Bergers and=20
        Douglas Hanahan<BR><BR><STRONG>Summary</STRONG><BR>
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VEGF=20
        receptors R1 and R2 were used to probe their roles in =
controlling=20
        angiogenesis in a mouse model of pancreatic islet =
carcinogenesis.=20
        Inhibition of VEGFR2 but not VEGFR1 markedly disrupted =
angiogenic=20
        switching, persistent angiogenesis, and initial tumor growth. In =

        late-stage tumors, phenotypic resistance to VEGFR2 blockade =
emerged, as=20
        tumors regrew during treatment after an initial period of growth =

        suppression. This resistance to VEGF blockade involves =
reactivation of=20
        tumor angiogenesis, independent of VEGF and associated with=20
        hypoxia-mediated induction of other proangiogenic factors, =
including=20
        members of the FGF family. These other proangiogenic signals are =

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  =
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src=3D"http://www.cell.com/images/btn_xclose.gif"></A></DIV><STRONG>Antia=
ngiogenic=20
        therapy: preclinical premise and promise</STRONG><BR><I>Trends =
in=20
        Molecular Medicine</I><I>, Volume 6, Issue 5</I><I>, 1 May =
2000</I>,=20
        <I>Pages 188-189</I><BR>Juergen Moll, Giulio F Draetta and =
Arturo P=20
        Galvani<BR><BR><A=20
        =
href=3D"http://www.cell.com/trends/molecular-medicine/fulltext/S1357-4310=
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        Text</A> | <A=20
        =
href=3D"http://download.cell.com/trends/molecular-medicine/pdf/PIIS135743=
1000016725.pdf">PDF=20
        (50 kb)</A></TD></TR></TBODY></TABLE></DIV></LI>
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  =
href=3D"http://www.cell.com/cancer-cell/abstract/S1535-6108(04)00305-8">K=
inetics=20
  of vascular normalization by VEGFR2 blockade govern...</A>
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        <DIV style=3D"PADDING-LEFT: 5px; FLOAT: right"><A=20
        onclick=3DInfoBubble.hide()><IMG=20
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onmouseover=3D"javascript:this.src=3D'/images/btn_xclose_hov.gif';"=20
        title=3DClose =
onmouseout=3D"javascript:this.src=3D'/images/btn_xclose.gif';"=20
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        =
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ics=20
        of vascular normalization by VEGFR2 blockade governs brain tumor =

        response to radiation</STRONG><BR><I>Cancer Cell</I><I>, Volume =
6, Issue=20
        6</I><I>, 1 December 2004</I>, <I>Pages 553-563</I><BR>Frank =
Winkler,=20
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Igor=20
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di=20
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        Jain<BR><BR><STRONG>Summary</STRONG><BR>
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clinical=20
        trial with a VEGF-specific antibody suggests that antiangiogenic =
therapy=20
        must be combined with cytotoxic therapy for the treatment of =
solid=20
        tumors. However, there are no guidelines for optimal scheduling =
of these=20
        therapies. Here we show that VEGFR2 blockade creates a <IMG =
border=3D0=20
        =
src=3D"http://www.cell.com/images/glyphs/u201c.gif">normalization=20
        window<IMG border=3D0=20
        src=3D"http://www.cell.com/images/glyphs/u201d.gif"><IMG =
border=3D0=20
        src=3D"http://www.cell.com/images/glyphs/u2014.gif">a period =
during which=20
        combined radiation therapy gives the best outcome. This window =
is=20
        characterized by an increase in tumor oxygenation, which is =
known to=20
        enhance radiation response. During the normalization window, but =
not=20
        before or after it, VEGFR2 blockade increases pericyte coverage =
of brain=20
        tumor vessels via upregulation of Ang1 and degrades their =
pathologically=20
        thick basement membrane via MMP =
activation.</DIV></DIV><BR><BR><A=20
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href=3D"http://www.cell.com/cancer-cell/abstract/S1535-6108(04)00305-8">S=
ummary</A>=20
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ull=20
        Text</A> | <A=20
        =
href=3D"http://download.cell.com/cancer-cell/pdf/PIIS1535610804003058.pdf=
">PDF=20
        (680 kb)</A></TD></TR></TBODY></TABLE></DIV>
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<P><STRONG>Marta P=C3=A0ez-Ribes</STRONG><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
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Allen</STRONG><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
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href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fn1"><SUP>6</SUP></A>,<IMG=20
border=3D0 =
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Hudock</STRONG><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
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href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
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rge_figure=3Dtrue#aff5"><SUP>5</SUP></A>,<IMG=20
border=3D0 =
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href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
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border=3D0 =
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Bergers</STRONG><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#aff3"><SUP>3</SUP></A>,<IMG=20
border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u00a0.gif"><STRONG>Douglas=20
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href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#aff2"><SUP>2</SUP></A><SUP>,<IMG=20
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href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
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src=3D"http://www.cell.com/images/REemail.gif"></SUP></A><B><IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">and<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif"></B><STRONG>Oriol=20
Casanovas</STRONG><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#aff1"><SUP>1</SUP></A><SUP>,<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u00a0.gif"></SUP><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#cor2"=20
name=3Dbcor2><SUP><IMG alt=3D"Go To Corresponding Author"=20
src=3D"http://www.cell.com/images/REcor.gif"></SUP></A><SUP>,<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif"></SUP><IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif"><A=20
href=3D"mailto:ocasanovas@iconcologia.net"><SUP><IMG=20
src=3D"http://www.cell.com/images/REemail.gif"></SUP></A></P>
<P class=3Darticle_affiliation><A name=3Daff1><SUP>1</SUP> Translational =
Research=20
Laboratory, Catalan Institute of Oncology, IDIBELL, 08907 L'Hospitalet =
de=20
Llobregat, Spain</A><BR><A name=3Daff2><SUP>2</SUP> Department of =
Biochemistry=20
&amp; Biophysics, Diabetes Center, and Helen Diller Family Comprehensive =
Cancer=20
Center, University of California, San Francisco, San Francisco, CA =
94143,=20
USA</A><BR><A name=3Daff3><SUP>3</SUP> Department of Neurosurgery and =
Helen Diller=20
Family Comprehensive Cancer Center, University of California, San =
Francisco, San=20
Francisco, CA 94143, USA</A><BR><A name=3Daff4><SUP>4</SUP> Department =
of=20
Biochemistry, Osaka Medical Center for Cancer and Cardiovascular =
Diseases, Osaka=20
537-8511, Japan</A><BR><A name=3Daff5><SUP>5</SUP> Departament de =
Ci=C3=A8ncies=20
Fisiol=C3=B2giques II, Universitat de Barcelona, IDIBELL, 08907 =
L'Hospitalet de=20
Llobregat, Spain</A><BR></P><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bcor1"=20
name=3Dcor1><SUP><IMG=20
src=3D"http://www.cell.com/images/REcor.gif"></SUP></A>Corresponding=20
author<BR><BR><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bcor2"=20
name=3Dcor2><SUP><IMG=20
src=3D"http://www.cell.com/images/REcor.gif"></SUP></A>Corresponding=20
author<BR><BR><A=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bfn1"=20
name=3Dfn1></A><SUP>6</SUP> These authors contributed equally to this =
work<BR><BR>
<P></P></DIV>
<DIV class=3Dsummary =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd"><A=20
name=3DSummary>
<H3>Summary</H3></A>Multiple angiogenesis inhibitors have been =
therapeutically=20
validated in preclinical cancer models, and several in clinical trials. =
Here we=20
report that angiogenesis inhibitors targeting the VEGF pathway =
demonstrate=20
antitumor effects in mouse models of pancreatic neuroendocrine carcinoma =
and=20
glioblastoma but concomitantly elicit tumor adaptation and progression =
to stages=20
of greater malignancy, with heightened invasiveness and in some cases =
increased=20
lymphatic and distant metastasis. Increased invasiveness is also seen by =
genetic=20
ablation of the <I>Vegf-A</I> gene in both models, substantiating the =
results of=20
the pharmacological inhibitors. The realization that potent angiogenesis =

inhibition can alter the natural history of tumors by increasing =
invasion and=20
metastasis warrants clinical investigation, as the prospect has =
important=20
implications for the development of enduring antiangiogenic =
therapies.</DIV><BR=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd"><A name=3Dsec1>
<H3>SIGNIFICANCE</H3></A>
<P class=3Dja50-ce-para=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd"><B>Angiogenesis =
inhibitors=20
targeting the VEGF signaling pathway have proven to be efficacious in=20
preclinical cancer models and in clinical trials. While antitumoral =
effects and=20
survival benefit are often evident, relapse to progressive tumor growth=20
typically ensues, reflecting multiple mechanisms of adaptation to =
antiangiogenic=20
therapies. Our findings further implicate angiogenesis inhibition as a =
driving=20
force in tumor progression to stages of greater malignancy, reflected in =

heightened invasion into surrounding tissue and in some cases increased=20
lymphatic and distant metastasis. Thus, antiangiogenic therapy that =
effectively=20
inhibits neovascularization and produces antitumor effects and survival =
benefit=20
can additionally alter the phenotype of tumors by increasing invasion =
and=20
metastasis. This realization motivates clinical studies to confirm and=20
potentially target this insidious consequence of antiangiogenic=20
therapies.</B></P><BR><A name=3Dsec2>
<H3>Introduction</H3></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Judah=20
Folkman's long-standing vision of angiogenesis as a therapeutic target =
(<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib15"=20
name=3Dback-bib15>Folkman, 1971</A>) has been increasingly validated in =
both=20
traditional transplant tumor models and genetically engineered mouse =
models of=20
cancer, beginning in the mid-1990s and continuing to the present (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib33"=20
name=3Dback-bib33>Parangi et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 1996</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib38"=20
name=3Dback-bib38>Shaked et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>). The =
<IMG=20
border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u201c.gif">angiogenic =
switch<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u201d.gif"> during =
tumor=20
progression (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib19"=20
name=3Dback-bib19>Hanahan and Folkman, 1996</A>) is increasingly =
recognized as=20
constituting a rate-limiting secondary event in tumorigenesis (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib20"=20
name=3Dback-bib20>Hanahan and Weinberg, 2000</A>) that can be =
effectively targeted=20
as a successful therapeutic approach to treat cancer; clinically, proof =
of=20
concept has begun with the recent regulatory approvals of three =
antiangiogenic=20
therapies targeting the VEGF/VEGFR2 pathway in certain types of cancer =
(<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib16"=20
name=3Dback-bib16>Folkman, 2007</A>,<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib17"=20
name=3Dback-bib17>Folkman and Ingber, 1992</A>,<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib23"=20
name=3Dback-bib23>Kerbel, 2000</A>). Notably, like most systemic =
therapies, these=20
drugs have not produced enduring efficacy in terms of either tumor =
shrinkage or=20
dormancy (stable disease) or long-term survival; rather, the common =
result is=20
delayed time to progression following a period of clinical benefit, =
which is=20
suggestive of an emergent resistance to the antiangiogenic therapy (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib4"=20
name=3Dback-bib4>Bergers and Hanahan, 2008</A>,<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib24"=20
name=3Dback-bib24>Kerbel et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2001</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib28"=20
name=3Dback-bib28>Miller et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>).</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Recently,=20
experimental evidence has been developed in support of this proposition: =
VEGF=20
receptor inhibition in a mouse model of pancreatic islet cancer reveals =
an=20
initial response with vascular dropout and tumor stasis, but tumors then =
adapt=20
and begin regrowing via a process referred to as <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u201c.gif">evasive =
resistance,<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u201d.gif"> based on =
the=20
observed upregulation of alternative proangiogenic signals that include=20
functional involvement of fibroblast growth factor (FGF) ligands (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib9"=20
name=3Dback-bib9>Casanovas et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>). =
Additionally,=20
it was noted that the relapsing tumors appear to be more invasive. Other =
studies=20
have also associated increased invasiveness with impaired angiogenesis =
in the=20
context of genetic ablation of the hypoxia response and/or the =
VEGF/VEGFR=20
pathways (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib7"=20
name=3Dback-bib7>Blouw et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2007</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib11"=20
name=3Dback-bib11>Du et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib34"=20
name=3Dback-bib34>Pennacchietti et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., =
2003</A>).</P><BR><A=20
name=3Dsec3>
<H3>Results</H3></A><A name=3Dsec3.1>
<H4>Increased Invasiveness in Response to a Specific VEGFR2 =
Inhibitor</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">To further=20
extend our previous study of resistance to abrogation of<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">VEGF signaling with =
a=20
function-blocking antibody against VEGFR2 (DC101) in the RIP1-Tag2 model =
of=20
pancreatic neuroendocrine cancer (PNET) (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib9"=20
name=3Dback-bib9>Casanovas et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>), we =
sought to=20
focus on the initial onset of malignant progression to invasive islet =
carcinoma.=20
Tumor-bearing immunocompromised RIP1-Tag2 mice treated with DC101 for a=20
relatively brief period of 1 week had reduced tumor vasculature and =
volume=20
compared to control age-matched untreated animals, as described =
previously (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig1"=20
name=3Dback-fig1>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">1</A>A and data not =
shown; <A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib9"=20
name=3Dback-bib9>Casanovas et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>). =
Nevertheless,=20
histological analysis showed a significantly more invasive phenotype =
after 1=20
week of treatment, an effect that was exacerbated when therapy was =
maintained=20
for 4 continuous weeks. These more aggressive tumors had wide fronts of=20
invasion, which prominently intermingled with the surrounding acinar =
tissue,=20
whereas the majority of control tumors were predominantly encapsulated =
or=20
microinvasive (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig1"=20
name=3Dback-fig1>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">1</A>A, top panels). =
This=20
aggravated invasive phenotype was readily revealed by fluorescent =
immunostaining=20
for a marker of cancer cells, the SV40 T antigen oncoprotein (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig1"=20
name=3Dback-fig1>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">1</A>A, middle =
panels).=20
Congruently, immunostaining for the tumor collagenous capsule with =
anti-collagen=20
type I antibody revealed the anti-VEGFR2-treated tumors to have a much =
thinner=20
capsule, with areas of breakage or its complete absence (data not =
shown).</P>
<DIV id=3Dfig1 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr1.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr1&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">1</DIV>Increased =
Invasive=20
Phenotype after Anti-VEGFR2 Therapy<BR>Histological analysis and =
quantification=20
of tumor invasion in anti-VEGFR2 antibody (DC101)-treated or control=20
immunocompromised tumor-bearing RIP1-Tag2 animals are presented.<BR>(A)=20
Histological images of tumors from control, 1-week, and 4-week treatment =
arms=20
are shown in hematoxylin and eosin staining (H&amp;E; top row), =
indicating=20
prominent invasive fronts in the treated animals (black arrowheads);=20
high-magnification images of immunofluorescence staining for SV40 T =
antigen=20
(middle row), where T indicates tumor and Ac indicates surrounding =
acinar=20
tissue; and immunodetection of the vasculature with anti-CD31 antibody =
(bottom=20
row), where a central view of the tumor parenchyma is shown.<BR>(B)=20
Quantification of tumor invasiveness represented as the percentage of=20
encapsulated islet tumors (IT), microinvasive carcinomas (IC1), and =
fully=20
invasive carcinomas (IC2) for the three different treatments. Both =
anti-VEGFR2=20
treatments show a statistically significant decrease in the percentage =
of IT and=20
a significant increase in IC2 tumors (<SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01 by =

Kruskal-Wallis test).<BR>(C) Quantification of tumor invasiveness in =
animals=20
treated for only 1 week with anti-VEGFR2 antibody and then maintained =
without=20
therapy for 1, 2, or 3 more weeks. Percentage of IT (white bars), IC1 =
(gray=20
bars), and IC2 (black bars) is shown per treatment and time point. All =
treatment=20
groups showed statistical differences by Mann-Whitney test (p &lt; 0.01) =
when=20
compared to the control group at the point when treatment was started.=20
Age-matched treated versus control statistical analysis is shown for =
each time=20
point. Note that no animals in the control group survived to the 16 week =
time=20
point. <SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.05, =
<SUP><IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01 by =

Mann-Whitney test.<BR>Error bars indicate <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00b1.gif"> SD.</DIV></DIV>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">In order=20
to quantify the degree of invasion, the frequency of<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">invasive lesions was =
scored in=20
short-term (1 week) and long-term (4 weeks) VEGFR2-blocking =
antibody-treated=20
RIP1-Tag2 animals using a three-grade nomenclature of noninvasive =
encapsulated=20
islet tumors (IT), microinvasive carcinomas (IC1), and widely invasive=20
carcinomas (IC2) as described previously (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib26"=20
name=3Dback-bib26>Lopez and Hanahan, 2002</A>). While control untreated =
animals=20
showed a 6% incidence of highly invasive tumors (IC2), treatment with=20
anti-VEGFR2 antibody for 1 week increased the IC2 tumor incidence to =
54%, and=20
furthermore, treatment for 4 continuous weeks with this antibody led to =
an=20
incidence of 62.5% (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig1"=20
name=3Dback-fig1>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">1</A>B). Thus, the =
event of=20
increased tumor invasiveness was already evident and significant =
following 1=20
week of antiangiogenic treatment, and the effect persisted and increased =
during=20
longer-term continuous treatment for 4 weeks. Notably, in some tumors =
from=20
long-term anti-VEGFR2-treated animals, tumor cells could be observed =
invading=20
not only into the surrounding acinar tissue but also into the =
vasculature (see=20
<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#app2"=20
name=3Dback-app2>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">S1 </A>available =
online); such=20
<IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u201c.gif">vasoinvasion<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u201d.gif"> has been =
used as an=20
indicator of poor prognosis in some human tumor types (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib32"=20
name=3Dback-bib32>Offerhaus et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 1991</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib40"=20
name=3Dback-bib40>Waggoner, 2003</A>).</P><BR><A name=3Dsec3.2>
<H4>Persistence of the Invasive Phenotype after Cessation of Anti-VEGFR2 =

Treatment</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">We next=20
sought to investigate the reversibility of this heightened invasive =
phenotype in=20
the presence of angiogenesis inhibition by<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">assessing its =
persistence when=20
the angiogenic blockade was lifted. Thus, 1-week anti-VEGFR2-treated =
animals=20
were then maintained for an additional 1, 2, or 3 weeks without =
treatment, and=20
tumor invasiveness was determined at each time point. Again, the =
proportion of=20
invasive tumors was increased after 1-week treatment, and strikingly,=20
invasiveness remained augmented after termination of therapy, with a =
10-fold=20
higher incidence of widely invasive carcinomas persisting 1, 2, and =
3<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u00a0.gif">weeks =
after cessation=20
of treatment (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig1"=20
name=3Dback-fig1>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">1</A>C). It is =
noteworthy that=20
the treated animals survived until 16 weeks of age due to the beneficial =
effect=20
of the 1-week therapy (which produced stable disease for that period), =
whereas=20
control untreated animals survived only until 15 weeks of age (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#app2"=20
name=3Dback-app2>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">S2 </A>). Thus, in =
order to=20
rule out the possibility that this increased invasion was due to an =
increased=20
life span of the animals and not to the inferred drug-related effect, we =
also=20
performed an age-matched comparison of the tumor invasion incidence in =
treated=20
animals versus controls at each defined time point. Again, all =
anti-VEGFR2=20
treatment groups<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">also exhibited =
statistically=20
significant differences when compared to their respective age-matched =
control=20
groups (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig1"=20
name=3Dback-fig1>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">1</A>C).</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Thus, the=20
augmentation of tumor invasiveness is a rapidly occurring event that =
develops=20
within 1 week of initiating anti-VEGFR2 therapy, producing a condition =
of=20
increased malignancy that persists even when the treatment is=20
terminated.</P><BR><A name=3Dsec3.3>
<H4>Increased Invasiveness in Tumors Carrying a Genetic Deletion of=20
<I>Vegf-A</I></H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">To=20
substantiate the hypothesis that this augmented invasive and malignant =
phenotype=20
is a result of impairing the VEGF/VEGFR2 proangiogenic signaling =
pathway, we=20
asked whether a genetic disruption of this pathway would produce a =
similar=20
adaptive response. To do so, we analyzed RIP1-Tag2 mice carrying<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">a tumor =
cell-specific deletion=20
of the <I>Vegf-A</I> gene, by means of<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">the Cre-loxP system. =
We have=20
previously shown that RIP1-Tag2/Cre;<I>Vegf-A</I><SUP>fl/fl</SUP> mice =
(<IMG=20
border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO)=20
exhibit a dramatic suppression of angiogenesis and impairment of tumor=20
development and growth (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib22"=20
name=3Dback-bib22>Inoue et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2002</A>). =
Detailed=20
histological observation of the borders of <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO =
lesions=20
revealed the tumors to be much more irregular and invasive, encroaching =
into=20
adjacent exocrine tissue, as compared to tumors in=20
RIP1-Tag2/Cre;<I>Vegf-A</I><SUP>+/+</SUP> mice (<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT), a =
result=20
that was further confirmed by positive immunostaining for insulin, a =
marker of=20
these islet <IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">=20
cell tumors (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig2"=20
name=3Dback-fig2>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">2</A>A). Consistent =
with=20
previous observations (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib22"=20
name=3Dback-bib22>Inoue et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2002</A>), <IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO =
lesions had=20
remarkably fewer blood vessels compared with their <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT =
counterparts,=20
and their invasive fronts had a microvessel density similar to that of =
normal=20
exocrine tissue, suggestive of a possible invasive co-option of the =
neighboring=20
normal vasculature in the exocrine pancreas (<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig2"=20
name=3Dback-fig2>Figures 2</A>A and 2B). When tumor invasiveness was<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">quantified in both =
genotypes,=20
encapsulated tumors and both grades of invasive lesions were observed in =
the=20
control <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT =
mice, whereas,=20
remarkably, no noninvasive tumors were observed in the <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO mice =
(<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig2"=20
name=3Dback-fig2>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">2</A>C). Instead, =
all tumors=20
were invasive to varying degrees, even in the smaller lesions. Taken =
together,=20
these results recapitulate the effect of the anti-VEGFR2 blocking =
antibody and=20
thus confirm the specificity of the heightened invasiveness caused by =
the=20
specific disruption of the VEGF/VEGFR signaling axis.</P>
<DIV id=3Dfig2 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr2.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr2&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">2</DIV>Increased =
Tumor=20
Invasion after Tumor-Specific <I>Vegf-A</I> Gene Deletion<BR>(A) Top =
row:=20
H&amp;E staining of lesions in RIP1-Tag2/Cre;<I>Vegf-A</I><SUP>+/+</SUP> =
(<IMG=20
border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT;=20
left) and RIP1-Tag2/Cre;<I>Vegf-A</I><SUP>fl/fl</SUP> (<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO; =
middle) mice.=20
Middle row: insulin immunostaining reveals the tumor cells in serial =
sections to=20
the H&amp;E images shown in the top row. Bottom row: CD31 vessel =
staining (red)=20
and DAPI nuclear staining (blue) of tumors in a <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT =
mouse and a=20
<IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO=20
mouse. Images at right show a higher magnification of images in the =
middle=20
column.<BR>(B) Microvessel area (MVA) at the invasive front was =
equivalent to=20
that of exocrine tissue in <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO =
tumors. MVA of=20
six tumors from four <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT and =
<IMG=20
border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO=20
animals was determined in the tumor <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u201c.gif">border<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u201d.gif"> as the band-like =
region 50=20
<IMG border=3D0 src=3D"http://www.cell.com/images/glyphs/u03bc.gif">m =
inside the=20
tumor perimeter (gray bars), the surrounding exocrine tissue (<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u201c.gif">Exo<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u201d.gif">; white bars), and =
the tumor=20
<IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u201c.gif">core<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u201d.gif"> (black =
bars). MVA=20
values were standardized to those of exocrine tissue distant from the =
tumors in=20
each section. <SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; =
0.05.<BR>(C)=20
Quantification of invasiveness represented by the frequency of each =
tumor grade=20
in 27 tumors from 5 <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO mice =
(gray=20
bars) versus 75 tumors from 5 <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT mice =
(black=20
bars) at 13 weeks of age. <SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.05, =
<SUP><IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01 by =

Mann-Whitney test.<BR>Error bars indicate <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00b1.gif"> =
SD.</DIV></DIV><BR><A=20
name=3Dsec3.4>
<H4>Increased Metastasis in Response to VEGFR2 Blockade</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">To further=20
determine the consequences of this augmented invasiveness, we next =
sought to=20
determine whether anti-VEGFR2 antiangiogenic therapy was associated with =
a=20
higher incidence of tumor dissemination and metastasis formation in=20
immunocompetent RIP1-Tag2 mice. Recognizing the rapid time course to =
end-stage=20
disease in this model, we started the treatment when solid tumors begin =
to=20
appear (at 10 weeks of age) and continued it for 10 days. The treatment =
was then=20
discontinued, and the animals were maintained until 16 weeks of age, =
when they=20
were sacrificed along with age-matched untreated control animals. Gross=20
morphology of surgically removed pancreata revealed that =
anti-VEGFR2-treated=20
animals more frequently contained enlarged and hemorrhagic =
peripancreatic lymph=20
nodes (LNs). The presence of tumor metastases in these lymph nodes was=20
determined by hematoxylin and eosin (H&amp;E) staining and corroborated =
by=20
immunohistochemical staining for the tumor-specific SV40 T antigen =
oncoprotein=20
(<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig3"=20
name=3Dback-fig3>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">3</A>A). =
Quantification of the=20
incidence of macroscopic LN metastasis in both treatment groups revealed =
that=20
the incidence of LN metastasis was 4-fold higher in treated animals than =
in=20
controls, with a relative risk of 4.3 [1.5<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">12.4] (95% =
confidence=20
interval) (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig3"=20
name=3Dback-fig3>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">3</A>B).</P>
<DIV id=3Dfig3 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr3.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr3&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">3</DIV>Increased =
Incidence of=20
Lymph Node and Liver Metastasis in Anti-VEGFR2-Treated =
Animals<BR>Histological=20
analysis of lymph node (LN) and liver metastasis (Met) in RIP1-Tag2 =
animals=20
treated with anti-VEGFR2 for 10 days starting at 10 weeks of age and =
then left=20
untreated until 16 weeks of age.<BR>(A) LN and Met observed by =
histological=20
H&amp;E staining of tissue sections from anti-VEGFR2-treated animals =
appear as=20
enlarged hemorrhaging LNs infiltrated with tumor cells and a small tumor =
nodule=20
in the liver parenchyma (left panels). Immunohistochemical staining for =
the=20
tumor marker SV40 T antigen (brown) reveals the presence of tumor cells=20
infiltrated into a LN or in the midst of the liver parenchyma (right=20
panels).<BR>(B) Top: quantification of the incidence of animals with =
microscopic=20
liver micrometastasis and macroscopic LN metastasis in the control (gray =
bars)=20
and anti-VEGFR2-treated (black bars) treatment arms. Bottom: contingency =
table=20
relating the number and percentage of animals in each =
treatment/metastasis case.=20
Treated animals show a statistically significant increase in the =
incidence of=20
liver micrometastasis and LN metastasis by the chi-square test =
(<SUP><IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p =
&lt; 0.05;=20
<SUP><IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p =
&lt;=20
0.01).<BR>(C) Quantification of the number of microscopic liver =
metastasis in=20
the anti-VEGFR2 treated (black bars) and control (gray bars) treatment =
arms.=20
Treated animals show a statistically significant increase in the number =
of liver=20
micrometastases per animal by the Mann-Whitney test (<SUP><IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.05). =
Error bars=20
indicate <IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u00b1.gif">=20
SEM.</DIV></DIV>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">We next=20
investigated the possible occurrence of distant metastasis, focusing on =
the=20
liver, which is a prevalent site for human pancreatic metastases. =
Microscopic=20
liver metastases were detected by H&amp;E staining and further confirmed =
by=20
tumor-specific immunostaining for the T antigen oncoprotein, revealing=20
microscopic tumor nodules in the liver parenchyma (<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig3"=20
name=3Dback-fig3>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">3</A>A). In this =
case, the=20
incidence of animals with liver micrometastases was also 2-fold higher =
in the=20
treated animals than in controls, with a relative risk of 2.0 [1.1<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">3.7] (95% confidence =
interval)=20
(<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig3"=20
name=3Dback-fig3>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">3</A>B). =
Furthermore, the=20
average number of metastatic lesions in the liver was also significantly =

increased (2.7-fold) in the treated animals compared to controls (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig3"=20
name=3Dback-fig3>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">3</A>C). We infer =
that death=20
due to primary tumor burden precluded the development of macrometastatic =

lesions.</P><BR><A name=3Dsec3.5>
<H4>A Multitargeted Antiangiogenic Kinase Inhibitor also Induces =
Increased=20
Invasiveness</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">We further=20
sought to determine whether these surprising adaptive responses occurred =
in the=20
context of treatment with other angiogenesis inhibitors. We chose to =
investigate=20
a more potent inhibitor of tumor angiogenesis, sunitinib (Sutent, Pfizer =
Inc.),=20
which effectively inhibits both VEGFR and PDGFR signaling, a combination =
that we=20
previously demonstrated to have potent efficacy and added benefit over =
singular=20
inhibition of VEGFR, by targeting both endothelial cells and their =
supporting=20
pericytes (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib5"=20
name=3Dback-bib5>Bergers et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib35"=20
name=3Dback-bib35>Pietras and Hanahan, 2005</A>). Consistent with these =
results,=20
continuous sunitinib treatment of tumor-bearing RIP1-Tag2 mice was =
markedly=20
efficacious, producing a significant survival benefit (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig4"=20
name=3Dback-fig4>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">4</A>A) and a 65% =
decrease in=20
tumor burden after 5 weeks of treatment when compared to age-matched =
control=20
animals (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig4"=20
name=3Dback-fig4>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">4</A>B). =
Histological analysis=20
of animals treated for 5 weeks starting at 10 weeks of age showed potent =

inhibition of angiogenesis and disruption of the preexisting tumor =
vasculature,=20
with concomitant exacerbated invasive and more aggressive tumor =
phenotype (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>A). Fluorescent =

immunostaining for T antigen further revealed widespread tumor =
infiltration,=20
with apparent dissemination of tumor cell clusters far from the primary =
tumor=20
masses (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>A; <A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#app2"=20
name=3Dback-app2>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">S3 </A>). =
Quantification of=20
this increased invasiveness demonstrated that sunitinib treatment for 5 =
weeks=20
more than doubled the incidence of highly invasive tumors (IC2) compared =
to=20
control animals (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>B). Notably, =
the tumors=20
in sunitinib-treated mice, while graded as IC2, were often remarkable =
for the=20
aggressive character of their invasiveness to a degree of malignancy =
rarely seen=20
in untreated tumors (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#app2"=20
name=3Dback-app2>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">S3 </A>).</P>
<DIV id=3Dfig4 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr4.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr4&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">4</DIV>Increased =
Life Span and=20
Tumor Reduction in Sunitinib-Treated RIP1-Tag2 Animals<BR>(A) =
Kaplan-Meier=20
survival curves in tumor-bearing RIP1-Tag2 mice (12 weeks) treated =
continuously=20
with vehicle control or sunitinib starting at 12 weeks. While =
vehicle-treated=20
mice showed a median life span of 15.2 weeks, mice receiving continuous=20
sunitinib treatment demonstrated a survival benefit of 7<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">additional weeks.=20
(Kaplan-Meier statistic: p &lt; 0.01.)<BR>(B) Total tumor burden =
analysis in=20
5-week treatment trials with sunitinib or vehicle control starting at 10 =
weeks=20
of age. Gray bar shows tumor burden of vehicle-treated RIP1-Tag2 =
animals, and=20
black bar shows the statistically significant tumor volume reduction of=20
efficacious sunitinib therapy. Each treatment cohort involved a minimum =
of ten=20
animals per group. <SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01 by =

Mann-Whitney test. Error bars indicate <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00b1.gif"> SEM.</DIV></DIV>
<DIV id=3Dfig5 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr5.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr5&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</DIV>Increased =
Tumor=20
Invasion Evoked by Treatment with a Multitargeted Angiogenic Kinase=20
Inhibitor<BR>Histological analysis and quantification of tumor invasion =
in=20
RIP1-Tag2 mice treated for 5 weeks with sunitinib compared to control=20
vehicle-treated mice are shown.<BR>(A) Top row: H&amp;E staining of =
control- and=20
sunitinib-treated tumors showing the invasive front extensively =
intercalating=20
into the surrounding tissue (dashed white line), producing isolated =
islands of=20
normal exocrine tissue inside treated tumors (white arrow). Middle row:=20
immunofluorescence staining for SV40 T antigen showing the widely =
invasive=20
phenotype in treated tumors, with several fronts invading into the =
surrounding=20
tissue. Bottom row: visualization of blood vessels by intravenous =
perfusion of=20
FITC-conjugated tomato lectin (green), revealing the effect of the=20
antiangiogenic treatment on the tumor vasculature.<BR>(B) Quantification =
of the=20
percentage of IT, IC1, and IC2 tumors in vehicle- versus =
sunitinib-treated=20
animals. Sunitinib treatment shows statistically significant decrease in =
IT and=20
increase in the highly invasive grade of tumor (IC2) by Mann-Whitney =
test=20
(<SUP><IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p=20
&lt; 0.01; <SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01). =
Error bars=20
indicate <IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u00b1.gif">=20
SD.<BR>(C) Left panels: histological analysis by H&amp;E staining of =
tissue=20
sections of lymph node and liver metastasis from sunitinib-treated =
animals.=20
Right panels: confirmation of metastasis is shown by immunofluorescence =
staining=20
for the tumor marker T antigen (red). The images give evidence of tumor =
cells=20
infiltrated into the lymph node or the liver parenchyma.<BR>(D) Top:=20
quantification of the proportion of animals with liver and lymph node =
(LN)=20
micrometastasis in<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">the vehicle-treated =
(gray=20
bars) and sunitinib-treated (black bars) arms. Bottom: contingency table =
listing=20
the number and percentage of animals in each treatment/metastasis case. =
Treated=20
animals show a 3.5-fold increase in the incidence of liver =
micrometastasis by=20
the chi-square test (<SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; =
0.05).<BR>(E)=20
Quantification of the number of liver micrometastases in the =
vehicle-treated=20
(gray bars) and sunitinib-treated (black bars) arms. The number of liver =

micrometastases was 3.7-fold increased in the sunitinib-treated group, =
which=20
showed a clear but not statistically significant trend compared to =
control=20
animals. Error bars indicate <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00b1.gif"> =
SEM.</DIV></DIV><BR><A=20
name=3Dsec3.6>
<H4>Increased Metastasis in Sunitinib-Treated PNET Tumors</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">To further=20
investigate the adaptive response to potent angiogenesis inhibition with =

sunitinib, peripancreatic LNs were assessed for the presence of =
metastatic=20
lesions by H&amp;E and by T antigen immunostaining of tissue sections =
from=20
treated animals (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>C). =
Quantitative analysis=20
revealed a similar incidence of animals with LN metastasis in the=20
sunitinib-treated versus control vehicle-treated groups (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>D). In contrast =
to the=20
lack of effect on lymphatic metastasis in sunitinib-treated mice, =
hematogenous=20
dissemination was prevalent and arguably more aggressive. H&amp;E =
staining=20
confirmed by immunostaining for the T antigen oncoprotein consistently =
showed=20
more abundant and larger liver micrometastases in the sunitinib-treated =
animals=20
than in controls (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>C, bottom row). =
The=20
incidence of liver micrometastases was significantly increased by =
3.5-fold in=20
treated animals (<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03c7.gif"><SUP>2</SUP>, p &lt; =
0.05),=20
with a relative risk of 3.5 (95% confidence interval 0.8<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">14.3) (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>D). When =
quantified, the=20
number of liver micrometastases per animal was also increased by =
3.7-fold in the=20
sunitinib-treated animal group, which showed a clear but not statistical =

significant tendency when compared with control animals (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig5"=20
name=3Dback-fig5>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">5</A>E). Thus, =
pancreatic=20
islet tumors treated with a multitargeted kinase inhibitor also adapt by =

increasing their metastatic phenotype.</P><BR><A name=3Dsec3.7>
<H4>VEGF Inhibitors also Evoke Increased Invasiveness in Orthotopic=20
Glioblastoma</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">These=20
provocative observations in a mouse model of PNET raised the question of =

generality to other tumor types. As a first step, we asked whether this =
adaptive=20
response of heightened malignancy in response to genetic or =
pharmacological=20
angiogenesis inhibition occurred in a second tumor type, glioblastoma =
multiforme=20
(GBM), by utilizing an orthotopic mouse model of genetically engineered=20
transformed mouse astrocytes (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib6"=20
name=3Dback-bib6>Blouw et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib11"=20
name=3Dback-bib11>Du et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>) =
characterized=20
by development of aggressive and locally invasive glioblastomas that =
phenocopy=20
the major characteristics of human glioblastomas (<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib3"=20
name=3Dback-bib3>Berger and Wilson, 1999</A>). Thus, the effects of a=20
VEGFR-selective kinase inhibitor (SU10944, Pfizer Inc.) or the =
multitarget VEGFR=20
kinase inhibitor sunitinib were assessed along with GBM cells =
genetically=20
deficient in <I>Vegf-A</I> gene expression (<I>VEGF</I>-KO GBMs) (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib6"=20
name=3Dback-bib6>Blouw et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>). In =
all three=20
situations in which VEGF activity was either pharmacologically or =
genetically=20
impaired, the tumor vasculature appeared thinner when compared to that =
of=20
control tumors (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig6"=20
name=3Dback-fig6>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">6</A>A). The =
<I>VEGF</I>-KO=20
GBMs produced a survival advantage, consistent with our previous report =
(<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib6"=20
name=3Dback-bib6>Blouw et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>), =
whereas the=20
kinase inhibitors produced minimal (SU10944) or modest (sunitinib) =
effects on=20
tumor growth and animal survival (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig6"=20
name=3Dback-fig6>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">6</A>B), consistent =
with a=20
clinical study wherein a VEGFR kinase inhibitor transiently normalized =
the tumor=20
vessels and reduced side effects such as edema but had little impact on =
GBM=20
growth or patient survival (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib1"=20
name=3Dback-bib1>Batchelor et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2007</A>). The =
most=20
notable consequence of all three conditions of impaired VEGFR signaling =
in our=20
mouse model was alterations in the invasive phenotype of the GBM, in the =
form of=20
a more highly invasive and qualitatively distinct tumor phenotype, with =
tumor=20
cells dispersed throughout the brain in close proximity to resident =
normal blood=20
vessels (perivascular tumor invasion), which contrasted with the less =
prominent=20
single-cell infiltrative pattern that was typical in the control GBM =
tumors (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig6"=20
name=3Dback-fig6>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">6</A>A). The =
relative=20
prevalence of the perivascular invasive mode was assessed by counting =
the=20
invading tumor cells in proximity to vessels and by grading the extent =
of=20
perivascular invasion (which accounts for both single vascular-proximal =
tumor=20
cells as well as focal clumps of tumor cells clustered around vessels). =
In all=20
three cases, a significant increase in perivascular tumor cell invasion =
was=20
observed, but the invasive effects were less pronounced in the case of =
both=20
chemical VEGFR inhibitors (SU10944 and sunitinib) than in <I>VEGF</I>-KO =
GBM (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig6"=20
name=3Dback-fig6>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">6</A>C). The =
differing degrees=20
of invasion could be explained by the fact that <I>VEGF</I>-KO GBM cells =
were=20
forced to grow from the time of their inoculation without a cancer =
cell-supplied=20
source of VEGF, whereas WT GBM tumors were subjected to VEGF blockade =
only after=20
having formed and grown to a substantive degree.</P>
<DIV id=3Dfig6 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr6.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr6&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">6</DIV>Effects of=20
VEGFR-Selective Kinase Inhibitors on an Orthotopic Mouse Model of =
Glioblastoma=20
Multiforme<BR>(A) Top row: immunohistological analysis of glioblastoma=20
multiforme (GBM) with fluorescent SV40 T antigen staining (red) on whole =
brain=20
sections counterstained with DAPI (blue). Control wild-type (WT) GBMs =
appear=20
less invasive than WT GBMs treated with SU10944 or sunitinib, or =
<I>VEGF</I>-KO=20
GBMs (purple arrowheads). Bottom row: high-magnification images of =
fluorescent=20
detection of tumor cells (anti-T antigen antibody; red) and the perfused =

vasculature (FITC-lectin, green). WT GBM cells infiltrate as single =
cells into=20
the brain parenchyma without associating with blood vessels (white =
arrowheads)=20
or invade alongside blood vessels in the brain (perivascular invasion; =
yellow=20
arrowheads). GBMs treated with either SU10944 or sunitinib as well as=20
<I>VEGF</I>-KO GBMs are more invasive and predominantly migrate along =
blood=20
vessels (yellow arrowheads).<BR>(B) Kaplan-Meier survival curves of WT=20
GBM-bearing mice untreated or treated with a relatively selective VEGFR=20
inhibitor (SU10944) or a multitargeted VEGFR inhibitor (sunitinib) =
starting 3=20
days after inoculation. The effects on survival observed with SU10944 =
and=20
sunitinib treatment were minimal or modest, respectively, and were not=20
statistically significant.<BR>(C) Top: grading of perivascular invasion =
was=20
performed on a scale from 1 to 4, where 1 indicates minimal distant =
spread of=20
tumor cells and 4 indicates substantial and marked distant spread; this=20
parameter indicated a significant increase in perivascular invasion in =
response=20
to both pharmacological treatments and in the <I>VEGF</I>-KO GBMs =
(<SUP><IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01). =
Bottom:=20
quantification of perivascular invasive mode by immunohistochemical =
analysis on=20
tumor sections. Perivascular invasive cells, counted as the number of =
cells in=20
the tumor periphery tightly associated with vessels, were significantly=20
increased by both antiangiogenic small-molecule treatments and the =
genetic=20
ablation of <I>VEGF</I>-KO GBM cells (<SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01). =
Error bars=20
indicate <IMG border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u00b1.gif">=20
SD.</DIV></DIV>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Thus,=20
genetically or pharmacologically impaired VEGF signaling in an =
orthotopic model=20
of GBM also evokes a more invasive and aggressive phenotype, distinct in =
form=20
and yet analogous in essence to that observed in pancreatic =
neuroendocrine=20
tumors subjected to similar genetic or pharmacological VEGF =
blockade.</P><BR><A=20
name=3Dsec3.8>
<H4>Hypoxia Is Implicated in the Adaptive Response</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">To gain=20
insight into one possible molecular mechanism for the increased invasion =
and=20
subsequent dissemination, we sought to determine whether hypoxia =
developed in=20
the treated tumors concomitant with invasion. While in control untreated =

animals, most of the tumors showed little or no hypoxia as revealed by=20
pimonidazole adduct staining, both <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO =
RIP1-Tag2=20
animals and animals treated with anti-VEGFR2 antibody or sunitinib =
displayed=20
multiple tumors with distinct regions of intense hypoxia (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig7"=20
name=3Dback-fig7>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">7</A>A). Moreover, =
when the=20
incidence of hypoxic pimonidazole-positive tumors was quantified, both=20
anti-VEGFR2 and sunitinib treatments showed a significant increase in =
hypoxic=20
tumors (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig7"=20
name=3Dback-fig7>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">7</A>B). =
Furthermore, intense=20
hypoxia was evident in the disseminated liver micrometastases of the=20
sunitinib-treated animals together with lack of vascularity inside the=20
metastatic lesions, while in control animals, the micrometastases were=20
vascularized and showed no hypoxia (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig7"=20
name=3Dback-fig7>Figures 7</A>Ag<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">7Ai). Thus, the =
hyperinvasive=20
and metastatic lesions that develop in the PNET model treated with a =
potent=20
angiogenesis inhibitor exhibit marked hypoxia, suggestive of a role for =
the=20
hypoxia response system in their manifestation.</P>
<DIV id=3Dfig7 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr7.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr7&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">7</DIV>Antiangiogenic=
=20
Treatment also Provokes Hypoxia in Tumors and Liver =
Micrometastases<BR>(A)=20
Hypoxia in islet tumors was detected by immunofluorescence staining of=20
pimonidazole adducts in sections of pancreas (Aa<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">Af) or liver (Ag<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">Ai) from control =
untreated=20
animals (Aa and Ag), animals receiving short-term (Ab) or long-term (Ac) =

anti-VEGFR2 treatment, <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-WT (Ad) =
and <IMG=20
border=3D0 =
src=3D"http://www.cell.com/images/glyphs/u03b2.gif">-<I>VEGF</I>-KO (Ae) =

islet tumors, and sunitinib-treated animals (Af, Ah, and Ai). (Aa)<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">(Ag) show =
pimonidazole=20
immunodetection (green) with blood vessel CD31 staining (red); (Ah) =
shows=20
pimonidazole immunodetection (green) and T antigen oncoprotein (red); =
(Ai) shows=20
blood vessel MECA32 staining (green) and T antigen oncoprotein (red). =
All images=20
show nuclei counterstained with DAPI (blue).<BR>(B) Quantitation of the=20
incidence of hypoxic tumors was performed in long-term =
anti-VEGFR2-treated and=20
sunitinib-treated animals and plotted as the percentage of =
pimonidazole-positive=20
tumors per animal compared to control animals. <SUP><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"><IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2217.gif"></SUP>p &lt; 0.01 by =

Mann-Whitney test. Error bars indicate <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00b1.gif"> =
SEM.</DIV></DIV><BR><BR><A=20
name=3Dsec4>
<H3>Discussion</H3></A>
<P class=3Dja50-ce-para=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Proinvasive =
consequences of=20
antiangiogenic therapy had been described previously as a collateral to =
the=20
antitumor response in glioblastoma multiforme and were attributed to =
vessel=20
co-option by cancer cells, but with uncertain significance for =
therapeutic=20
efficacy (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib25"=20
name=3Dback-bib25>Kunkel et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2001</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib37"=20
name=3Dback-bib37>Rubenstein et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2000</A>). =
Recently,=20
heightened invasion has been further implicated as a response to =
antiangiogenic=20
therapy in another model of orthotopic GBM (<A class=3Dja50-ce-cross-ref =

href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib45"=20
name=3Dback-bib45>Gomez-Manzano et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>), =
consistent=20
with these previous studies and our observations. More recently, we =
reported=20
that abrogation of VEGF signaling with a function-blocking antibody =
against=20
VEGFR2 elicits, after a period of transitory response, a bimodal =
resistance=20
reaction with evident revascularization and increased invasiveness; =
while the=20
revascularization was demonstrably important in the development of =
resistance=20
(<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib9"=20
name=3Dback-bib9>Casanovas et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>), the=20
significance of the heightened invasiveness was unclear. Here we =
demonstrate in=20
two distinct engineered mouse models of cancer (PNET and GBM) that=20
therapeutically efficacious antiangiogenic therapy can elicit an=20
adaptive-evasive response involving an augmented invasive phenotype and, =
in some=20
cases, increased dissemination and the emergence of distant metastasis =
(<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#fig8"=20
name=3Dback-fig8>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">8</A>).</P>
<DIV id=3Dfig8 class=3D"ja50-figure large-figure"=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DIV class=3Darticle_figure><IMG=20
src=3D"http://download.cell.com/images/journalimages/1535-6108/PIIS153561=
0809000348.gr8.lrg.jpg">
<DIV class=3Darticle_figure_versions><A=20
href=3D"http://www.cell.com/cancer-cell/image/S1535-6108(09)00034-8?image=
Id=3Dgr8&amp;imageType=3DhiRes"=20
target=3D_blank>Display high quality version of this =
figure</A></DIV></DIV>
<DIV class=3Dja50-ce-caption>
<DIV class=3Dja50-ce-label>Figure<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">8</DIV>Adaptive-Evasi=
ve=20
Responses by Tumors to<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">Antiangiogenic=20
Therapies<BR>Schematic summary of adaptive responses to VEGF/VEGFR =
inhibitors=20
(and likely other angiogenesis inhibitors) that elicit <IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u201c.gif">evasive =
resistance.<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u201d.gif"> Tumors =
respond to=20
VEGF/VEGFR pathway inhibition with tumor stasis or regression and a loss =
of=20
blood vessels, but mechanisms of evasive resistance to the =
antiangiogenic=20
treatment are then induced that can variously enable revascularization =
via=20
alternative proangiogenic signals, increased local invasiveness, and/or =
enhanced=20
distant metastasis.</DIV></DIV>
<P class=3Dja50-ce-para=20
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Interestingly, PNET =
development=20
in the context of genetic ablation of the <I>Vegf-A</I> gene produced =
small=20
pancreatic lesions with increased invasiveness but without evident =
metastasis=20
(data not shown), in contrast to the case of VEGF pathway inhibition. We =
suspect=20
that the metastasis response is somehow enabled by the initial presence =
of an=20
angiogenic vasculature in established solid tumors containing =
hyperproliferative=20
cancer cells that, when disrupted, fosters metastatic dissemination. In=20
contrast, the small avascular lesions populated by <I>VEGF</I>-KO cancer =
cells=20
may have failed to acquire other necessary capabilities for productive=20
dissemination. Regardless, the preclinical trials in the PNET model=20
unambiguously demonstrate the enhancement of invasion and metastasis =
consequent=20
to pharmacological angiogenesis inhibition.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">In the=20
PNET model, the multitargeted inhibitor sunitinib consistently =
demonstrated=20
significantly better efficacy than the VEGFR2-specific antibody, in =
regard to=20
both tumor shrinkage and augmented survival benefit. But in turn, =
sunitinib=20
evidently elicited a more highly invasive adaptation, with some of the =
most=20
aggressively invasive tumors observed heretofore in this model. Thus, =
the more=20
effective the VEGF/angiogenesis inhibition, the more pronounced the =
adaptive=20
progression to heightened and altered invasiveness. Interestingly, while =
both=20
angiogenesis inhibitors enhanced liver metastasis, sunitinib did not =
increase=20
lymphatic metastasis, in contrast to the anti-VEGFR2 antibody. This =
difference=20
could be due to the differential specificity of inhibition by the two =
drugs:=20
sunitinib potently blocks not only VEGFR2 and the PDGFRs but also =
lymphatic=20
vessel-related VEGFR3 (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib13"=20
name=3Dback-bib13>Faivre et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2007</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib36"=20
name=3Dback-bib36>Roskoski, 2007</A>). An attractive hypothesis is that =
the=20
specific blockade of VEGFR3 signaling by sunitinib serves to alter the =
structure=20
or permeability of lymphatic vessels or lymph nodes, thereby impeding =
formation=20
of LN metastasis.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">An=20
intriguing paradox involving these results is raised by previous reports =
in=20
other model systems, in which VEGF-driven angiogenesis was found to =
positively=20
correlate with increased tumor invasiveness (<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib39"=20
name=3Dback-bib39>Skobe et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 1997</A>) or =
metastasis=20
(<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib41"=20
name=3Dback-bib41>Warren et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 1995</A>). In =
contrast,=20
our results as well as those presented in the accompanying study by <A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib12"=20
name=3Dback-bib12>Ebos et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2009</A> in =
this issue of=20
<I>Cancer Cell</I> support the opposite conclusion, raising the =
possibility that=20
both induction and suppression of tumor angiogenesis can exert=20
proinvasive/prometastatic effects. We envision that the two effects, =
while=20
related, may have distinct physiological bases. For example, tumors that =
express=20
very high levels of VEGF (as in Skobe et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al. and Warren =
et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al.) may produce a =
tumor=20
vasculature with excessive sprouting, poor pericyte coverage, and =
collectively=20
impaired vascular integrity. Notably, <A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib43"=20
name=3Dback-bib43>Xian et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2006</A> =
demonstrated=20
that vessels with poor pericyte coverage are prone to increased =
metastasis and=20
that overexpression of VEGF can drive intense angiogenesis with low =
pericyte=20
coverage and a hyperpermeable vasculature, which can be more permissive =
for=20
tumor cell intravasation and dissemination. On the other hand, =
antiangiogenic=20
therapy demonstrably disturbs the tumor vasculature and in some cases =
(e.g.,=20
with sunitinib) also disrupts pericyte coverage, and may in addition be=20
indirectly affecting the tumor cells by inducing a more invasive =
phenotype in=20
response to hypoxia, leading to increased intravasation and metastatic=20
dissemination.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">How might=20
tumors become more invasive during antiangiogenic therapy? One =
possibility is=20
that tumors may elevate the activity of a preexisting invasion program =
that was=20
not previously the driving force of expansive tumor growth, given the =
capability=20
for angiogenesis. Alternatively, some tumors may switch on an invasive =
growth=20
program distinct from that arising spontaneously during unperturbed =
tumor=20
development and progression, as is evidently the case for GBMs, in which =

antiangiogenic therapy induced a phenotypic change from single-cell =
infiltration=20
to migration of cell clusters along normal blood vessels. These =
observations=20
suggest that the invasive growth program induced in response to therapy =
may be=20
qualitatively different than the pathway used in normal tumor =
progression.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">In this=20
regard, genetic studies have implicated the hypoxia/HIF-1<IMG border=3D0 =

src=3D"http://www.cell.com/images/glyphs/u03b1.gif"> pathway as an =
instigator of=20
invasion and metastasis (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib11"=20
name=3Dback-bib11>Du et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib34"=20
name=3Dback-bib34>Pennacchietti et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>). =
Interestingly=20
in the GBM model, hypoxia via consequent HIF-1 activation induced =
angiogenesis=20
and more infiltrative tumor cell behavior, while inhibition of HIF-1 and =

consequent failure to respond to hypoxia led to a blockade of =
angiogenesis and=20
an exacerbated proinvasive phenotype. Due to the degree of invasion and =
the=20
close proximity of invading tumor cells to blood vessels, these tumors =
are less=20
hypoxic (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib6"=20
name=3Dback-bib6>Blouw et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib11"=20
name=3Dback-bib11>Du et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>), =
despite the=20
implication that hypoxia in the primary tumor drove their switch to a=20
hyperinvasive condition. In concordance with the GBM results, we =
document herein=20
the concomitant triggering of hypoxia with increased invasion in =
response to=20
antiangiogenic therapy in the PNET model. While the concurrent =
initiation of=20
hypoxia and invasion could be a circumstantial coincidence, a body of =
published=20
evidence linking hypoxia and invasion (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib8"=20
name=3Dback-bib8>Cairns et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2001</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib34"=20
name=3Dback-bib34>Pennacchietti et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib44"=20
name=3Dback-bib44>Young and Hill, 1990</A>) suggests that the hypoxia =
response=20
system could be involved in regulating invasion in this tumor type as =
well.=20
Additionally, other therapy-induced mechanisms could contribute to the=20
phenotypic progression of malignancy, such as activation or upregulation =
of=20
extracellular proteases (e.g., matrix metalloproteinases and =
cathepsins), latent=20
signaling circuits (e.g., c-Met), or triggering of =
epithelial-to-mesenchymal=20
transition programs, each of which can demonstrably lead to more =
invasive and/or=20
metastatic phenotypes and has been linked to the hypoxia response in =
particular=20
model systems (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib21"=20
name=3Dback-bib21>Higgins et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2007</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib29"=20
name=3Dback-bib29>Munoz-Najar et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2006</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib34"=20
name=3Dback-bib34>Pennacchietti et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>). The =
possible=20
contributions of the hypoxia response system and other factors to =
adaptation and=20
emergent resistance to angiogenesis inhibitors remain to be determined =
and are=20
an important topic for future research.</P><A name=3Dsec4.1>
<H4>Translational Considerations</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">It must be=20
emphasized that the three VEGF pathway inhibitors currently approved for =
certain=20
cancer types (variously including colorectal, renal, breast, and=20
hepatocellular), and likely others (both new drugs and new indications) =
to=20
follow, are markedly altering the standard of care for these cancers. =
Despite=20
their transitory efficacy, angiogenesis inhibitors present important =
therapeutic=20
options that constitute improvements in terms of both clinical benefit =
and=20
reduced toxicity compared to conventional agents used to treat these =
diseases.=20
Recognizing both their benefits and their limitations, a pertinent =
question at=20
hand is that of the broader applicability of our findings to =
antiangiogenic=20
therapies aimed at other organ-specific cancers, and in particular their =

extrapolation to the outcomes of antiangiogenic therapies in cancer =
patients.=20
Notably, in the accompanying paper by <A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib12"=20
name=3Dback-bib12>Ebos et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2009</A>, one =
of these=20
approved angiogenesis inhibitors, sunitinib, is shown to facilitate =
metastatic=20
dissemination of both human breast cancer cells and syngeneic melanoma =
in mice=20
following either orthotopic or intravenous inoculation; a second =
approved drug,=20
sorafenib, evidently has similar effects. Even brief week-long =
antiangiogenic=20
treatment elicited increased metastasis, much as we observed following a =
similar=20
week-long treatment with the anti-VEGFR2 antibody in the PNET model.=20
Collectively, the two studies document increased invasion and/or =
metastasis in=20
four distinct mouse models of organ-specific cancer and begin to =
establish a=20
mechanistic pattern of increased invasion and metastasis as an adaptive =
response=20
to antiangiogenic therapy, one that seems likely to be operative in =
certain=20
human tumors.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">In regard=20
to the relevance of our findings in mouse models of neuroendocrine =
tumors and=20
glioblastoma to antiangiogenic therapies for the cognate human cancers, =
there=20
are currently insufficient data about the responses of human pancreatic=20
neuroendocrine tumors due to both their rarity and the limited number of =

patients that have been treated in clinical trials with angiogenesis =
inhibitors.=20
In the case of glioblastoma, there is growing experience with =
antiangiogenic=20
therapies, specifically the VEGF ligand-trapping antibody bevacizumab =
(<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib14"=20
name=3Dback-bib14>Fischer et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib30"=20
name=3Dback-bib30>Narayana et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2009</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib31"=20
name=3Dback-bib31>Norden et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>) and =
the=20
VEGFR1/2/3 kinase inhibitor AZD2171 (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib1"=20
name=3Dback-bib1>Batchelor et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2007</A>). In =
both cases,=20
there seems to be a proinvasive adaptation to antiangiogenic therapy, as =

suggested by magnetic resonance imaging in a subset of GBM patients that =

developed multifocal recurrence of tumors during the course of therapy =
with=20
anti-VEGF (bevacizumab) (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib14"=20
name=3Dback-bib14>Fischer et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib30"=20
name=3Dback-bib30>Narayana et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2009</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib31"=20
name=3Dback-bib31>Norden et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>) or =
AZD2171 (<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib1"=20
name=3Dback-bib1>Batchelor et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2007</A>). Much =
as in the=20
mouse GBM model, we infer that the human glioblastoma cells could be =
co-opting=20
blood vessels by invading along them into the surrounding normal brain =
tissue,=20
thereby achieving vascular/nutrient/oxygen sufficiency while =
consequently=20
promoting an invasive dispersion phenotype (perivascular tumor =
invasion). Thus,=20
there is reason to predict clinical relevance of our collective=20
observations.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">How then=20
could the improvement of survival in many clinical trials in spite of =
increased=20
invasiveness and metastasis be explained? The increased progression-free =

survival (PFS) could likely reflect the impairment of primary tumor =
growth,=20
which, while initially efficacious, is short lived, with the onset of =
multiple=20
forms of evasive resistance that would inevitably produce a return to=20
progressive disease. This tumor relapse would compromise this initial =
benefit=20
such that the prolongation of PFS and even overall survival (OS) would =
not be=20
particularly robust, as is the case in many clinical trials. For =
example, recent=20
results from two randomized clinical trials with bevacizumab and taxanes =
for the=20
treatment of metastatic breast cancer (the E2100 study and the AVADO =
study)=20
demonstrated small benefits in PFS but not an OS benefit, and our =
results=20
provide a possible explanation for this disconnect.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Indeed,=20
this undesirable therapy-triggered change in the natural history of the =
treated=20
tumors is convergent with emerging examples involving other targeted=20
therapy-driven changes, such as the case of trastuzumab (Herceptin) =
therapy in=20
HER2-positive breast cancer patients. Although effective in its =
antitumor and=20
prosurvival effects (13 months increased life span), trastuzumab therapy =
changes=20
the course of disease progression in these patients to one with a =
markedly=20
increased incidence of brain metastasis (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib2"=20
name=3Dback-bib2>Bendell et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib10"=20
name=3Dback-bib10>Clayton et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2004</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib27"=20
name=3Dback-bib27>Miller et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib42"=20
name=3Dback-bib42>Weil et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>), =
which is=20
otherwise rare in untreated patients. The companion study by <A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib12"=20
name=3Dback-bib12>Ebos et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2009</A> =
documents=20
increased metastasis in multiple organs, including the brain, in =
response to the=20
angiogenesis inhibitor sunitinib in a mouse model of breast cancer, =
illustrating=20
that convergence.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Another=20
clinically relevant question raised by our results is whether =
concomitant=20
chemotherapy in some tumor types (e.g., in all currently approved =
indications=20
for bevacizumab) could alter or even abrogate this increased malignant=20
phenotype. Both preclinical and clinical trials investigating the =
effects of=20
standard-of-care and more recent (e.g., metronomic) chemotherapy =
regimens on=20
proinvasive and prometastatic responses to antiangiogenic therapies are=20
warranted.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Certainly,=20
the characteristics and consequences of the exacerbated =
invasive-metastatic=20
phenotype that develops in response to treatment with angiogenesis =
inhibitors=20
motivate critical assessment in the clinical setting. Moreover, further=20
preclinical studies are warranted to elucidate the mechanisms of this=20
adaptive-evasive resistance, so as to design and test the potential of=20
mechanism-based combination therapies aimed at impeding this insidious=20
consequence of singular antiangiogenic therapy.</P><BR><BR><A =
name=3Dsec5>
<H3>Experimental Procedures</H3></A><A name=3Dsec5.1>
<H4>Animal Models</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">RIP1-Tag2=20
(<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib18"=20
name=3Dback-bib18>Hanahan, 1985</A>), immunocompromised =
RIP1-Tag2;<I>Rag1</I>-KO=20
(<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib9"=20
name=3Dback-bib9>Casanovas et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>), and=20
RIP1-Tag2/Cre;<I>Vegf-A</I><SUP>fl/fl</SUP> mice (<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib22"=20
name=3Dback-bib22>Inoue et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2002</A>) have =
been=20
described previously. The orthotopic mouse GBM models utilizing =
intracranial=20
injection of transformed mouse astrocytes of wild-type or =
<I>Vegf-A</I>-loxP=20
mice have also been described previously (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib6"=20
name=3Dback-bib6>Blouw et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2003</A>,<A=20
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib11"=20
name=3Dback-bib11>Du et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2008</A>). =
Animal=20
housing, handling, and all procedures involving mice were approved by =
the=20
University of California, San Francisco (UCSF), Catalan Institute of =
Oncology,=20
and Osaka Medical Center for Cancer and Cardiovascular Diseases =
institutional=20
committees that approve and oversee research involving vertebrate =
animals, and=20
all experiments were performed according to each country's guidelines =
governing=20
animal care in the USA, Spain, and Japan, respectively.</P><BR><A =
name=3Dsec5.2>
<H4>Therapeutic Trials</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">RIP1-Tag2=20
mice were treated starting at 10 or 12 weeks of age as indicated, and=20
immunocompromised RIP1-Tag2;<I>Rag1</I>-KO mice were used for long-term =
DC101=20
treatment to avoid immune reaction against the therapeutic antibody. The =

following antiangiogenic regimens were used: (1) 1 mg/mouse twice per =
week of=20
anti-VEGFR2 blocking antibody (DC101) purified from a hybridoma culture=20
(American Type Culture Collection) and its control purified rat IgG =
(Jackson=20
ImmunoResearch) as described previously (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib9"=20
name=3Dback-bib9>Casanovas et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2005</A>) =
administered=20
intraperitoneally (i.p.). (2) 40 mg/kg/day sunitinib L-malate (Sutent, =
Pfizer=20
Inc.) and its control carboxymethylcellulose vehicle formulation, =
administered=20
daily by oral gavage for 5 weeks. Tumor volume in the RIP1-Tag2 animals =
was=20
measured as described previously (<A class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib22"=20
name=3Dback-bib22>Inoue et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2002</A>). For=20
therapeutic trials in the GBM model, FVB/N <I>Rag1</I>-KO mice were =
injected=20
intracranially with 25,000 cells and treated with 150 mg/kg/day SU10944 =
or 40=20
mg/kg/day sunitinib L-malate administered by oral gavage starting 3 days =
after=20
inoculation until moribund (average 13.5 days in both groups).</P><BR><A =

name=3Dsec5.3>
<H4>Histopathological Analyses</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Pancreata=20
and livers were either OCT embedded and frozen or fixed in buffered =
formalin and=20
embedded in paraffin. Antibodies used for specific tissue immunostaining =

included rat monoclonal anti-mouse CD31 (clone MEC13.3, 1:50, BD =
Pharmingen),=20
rabbit polyclonal serum anti-large T antigen (1:10,000, prepared in the =
Hanahan=20
laboratory), polyclonal guinea pig anti-insulin (A0564, DAKO), and rat=20
anti-MECA32 (550563, BD Pharmingen). For immunohistochemistry, the =
EnVision=20
system of labeled polymer-HRP anti-rabbit IgG (DakoCytomation) was used =
as a=20
secondary antibody. For immunofluorescence detection, Alexa Fluor 488 =
goat=20
anti-rat IgG and Alexa Fluor 546<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">goat anti-rabbit IgG =
secondary=20
antibodies were used at a dilution of 1:200. For nuclear =
counterstaining, tissue=20
sections were either mounted with Vectashield with DAPI (Vector =
Laboratories) or=20
stained with TO-PRO-3 iodide used at a 1:1000 dilution and then mounted =
with=20
Vectashield without DAPI.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Systemic=20
perfusion of fluoresceinated lectin to visualize the functional blood=20
vasculature was performed as described previously (<A =
class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib22"=20
name=3Dback-bib22>Inoue et<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">al., 2002</A>). =
Briefly, 0.1=20
mg of fluorescein-labeled tomato lectin (Vector Laboratories) was =
injected=20
intravenously in a total volume of 0.1 ml and allowed to circulate for =
5<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u2013.gif">10 min, =
followed by=20
heart perfusion with neutral buffered formalin and tissue sample =
preparation for=20
OCT-embedded frozen sectioning.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">For=20
microvessel area (MVA) quantification, the ratio of CD31-stained area to =
total=20
area was calculated in ten randomly chosen circular spots (50 <IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u03bc.gif">m diameter) using =
Lumina=20
Vision image analysis software (Mitani Corporation). The MVA of the =
region was=20
expressed as the average ratio of these ten spots.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Hypoxia=20
detection was performed 1 hr after i.p. injection of 60 mg/kg =
pimonidazole using=20
a Hypoxyprobe Plus kit (Natural Pharmacia International Inc.) following =
the=20
manufacturer's instructions.</P><BR><A name=3Dsec5.4>
<H4>Invasion and Metastasis Analysis</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">Invasion=20
grading in the RIP1-Tag2 model was performed as described previously (<A =

class=3Dja50-ce-cross-ref=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#bib26"=20
name=3Dback-bib26>Lopez and Hanahan, 2002</A>) from five H&amp;E-stained =
sections=20
per animal from a minimum of five mice per treatment group. The =
incidence of=20
LN/liver metastasis was determined by scoring for presence or absence in =
each=20
animal and counting the number of liver micrometastases in five sections =
per=20
animal from a minimum of ten animals per treatment group. In the GBM =
model,=20
perivascular invasion was quantified by counting the number of invasive=20
cells/clusters associated with a vessel at the tumor edge (20<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00d7.gif"> field) in =
double-stained=20
frozen sections with large T antigen and CD31 from 3<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">10 sections per =
2<IMG border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u2013.gif">4 different tumor =
samples per=20
group. Perivascular invasion grading of tumors was determined by =
staining tumor=20
cells with an antibody for SV40 large T antigen on whole-brain sections, =
and=20
5<IMG border=3D0 src=3D"http://www.cell.com/images/glyphs/u2013.gif">8 =
tumors from=20
each group were graded from 1 to 4, where 1 indicates minimal distant =
spread of=20
tumor cells and 4 indicates substantial and marked distant =
spread.</P><BR><A=20
name=3Dsec5.5>
<H4>Statistical Analysis</H4></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">All=20
results were evaluated using the SPSS statistical software package. Due =
to the=20
small sample size in each analysis and the fact that not all of the data =
were=20
normally distributed, nonparametric statistical tests were used in each =
case=20
(Kruskal-Wallis, Mann-Whitney, or chi-square test).</P><BR><BR>
<DIV id=3Dacknowledgment class=3Dja50-ce-acknowledgment><A =
name=3DAcknowledgments>
<H3>Acknowledgments</H3></A>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">The=20
authors would like to acknowledge J.G. Christensen of Pfizer for advice =
and=20
encouragement; Pfizer for generous gifts of SU10944 and sunitinib; =
and<IMG=20
border=3D0 src=3D"http://www.cell.com/images/glyphs/u00a0.gif">X. =
Hernando=20
(Casanovas laboratory), C. Guinto and E. Drori (Hanahan laboratory), and =
K. Lu=20
and B. Kaplan (Bergers laboratory) for excellent technical support. This =
work=20
was funded by research grants SAF2006-00590, SAF2007-60955, =
RTICC-RD2006-0092,=20
and SGR727 from MICINN and AGAUR (Spain); grants from the US National =
Cancer=20
Institute to G.B. and D.H.; a grant from the William K. Bowes, Jr. =
Foundation to=20
D.H.; and a Grant-in-Aid for Scientific Research from the Japan Society =
for the=20
Promotion of Science to M.I. D.H. is a American Cancer Society Research=20
Professor, O.C. is a Ramon y Cajal fellow of the Spanish Ministry of =
Education,=20
G.B. holds the Neill H. and Linda S. Brownstein Chair in Brain Tumor =
Research at=20
UCSF, and M.P.-R. is a recipient of an IDIBELL fellowship.</P>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">D.H.=20
serves on a strategic advisory panel for oncology at Pfizer =
Inc.</P></DIV>
<DIV class=3Dja50-ce-appendices><A name=3Dapp2><BR>
<H4>Supplemental Data</H4>
<P class=3Dja50-ce-para =
xmlns:cja=3D"http://www.elsevier.com/xml/cja/dtd">
<DL>
  <DT><A onclick=3D"javascript:trackMMCDownload(this.href,'pdf');"=20
  =
href=3D"http://download.cell.com/cancer-cell/mmcs/journals/1535-6108/PIIS=
1535610809000348.mmc1.pdf">Document=20
  S1. Three Figures (PDF 406 kb)</A>
  <DD></DD></DL>
<P></P></DIV><A name=3DReferences =
xmlns=3D"http://www.w3.org/1999/xhtml">
<H3>References</H3></A>
<DIV class=3Dja50-ce-bibliography-sec =
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class=3Dja50-sb-title>J. Clin. Invest.</SPAN> <SPAN=20
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=3DSearch&amp;term=3DJ. Clin. =
Invest.[ta]+AND+116[vol]+AND+642[page]&amp;doptcmdl=3DAbstract">PubMed</A=
></SPAN></P>
<P id=3Dbib44 class=3Dja50-ce-bib-reference><A class=3Dback-link=20
href=3D"http://www.cell.com/cancer-cell/fulltext/S1535-6108(09)00034-8?la=
rge_figure=3Dtrue#back-bib44">Young=20
and Hill, 1990</A> <SPAN class=3Dja50-sb-reference><SPAN=20
class=3Dja50-sb-contribution><SPAN class=3Dja50-sb-authors>Young,<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">S.D., and Hill,<IMG =
border=3D0=20
src=3D"http://www.cell.com/images/glyphs/u00a0.gif">R.P.</SPAN> <SPAN=20
class=3Dja50-sb-date>(1990). </SPAN><SPAN class=3Dja50-sb-title>Effects =
of=20
reoxygenation on cells from hypoxic regions of solid tumors: anticancer =
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sensitivity and metastatic potential</SPAN>. </SPAN><SPAN=20
class=3Dja50-sb-issue><SPAN class=3Dja50-sb-title>J. Natl. Cancer =
Inst.</SPAN> <SPAN=20
class=3Dja50-sb-volume-nr><I>82</I>,</SPAN> </SPAN><SPAN=20
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name=3Dpublication-info>
<H3>Publication Information</H3></A><BR>Received: July 20, =
2008<BR>Revised:=20
October 27, 2008<BR>Accepted: January 27, 2009<BR>Published: March 2, =
2009
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#fulltext_body #expander {
	BACKGROUND: url(../../images/right_bg_ft.gif) repeat-y right top
}
BODY.home {
	BACKGROUND: url(../../images/left_bg.gif) repeat-y left top
}
BODY.toc {
	BACKGROUND: url(../../images/left_bg.gif) repeat-y left top
}
BODY.archive {
	BACKGROUND: url(../../images/left_bg.gif) repeat-y left top
}
BODY.wide #expander {
	BACKGROUND: none transparent scroll repeat 0% 0%
}
* HTML #expander {
	HEIGHT: 0px
}
A {
	COLOR: #000
}
P {
	MARGIN: 0.8em 0px
}
.alignright {
	TEXT-ALIGN: right; MARGIN: 0px 10px 10px 0px
}
.small {
	FONT-SIZE: 0.8em
}
.hide {
	DISPLAY: none
}
#header {
	BORDER-BOTTOM: #fff 4px solid; MIN-HEIGHT: 8.75em; WIDTH: 100%; =
BACKGROUND: #005587
}
* HTML #header {
	HEIGHT: 8.75em
}
#header H1 {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; FLOAT: left; PADDING-TOP: 0px
}
#header H1 IMG {
	MARGIN: 15px 0px 0px 15px
}
#header_middle {
	PADDING-LEFT: 245px; PADDING-TOP: 12px
}
#cover_images {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 80px; PADDING-RIGHT: 0px; =
PADDING-TOP: 0px
}
#cover_images A {
	MARGIN-RIGHT: 5px
}
#cover_images A IMG {
	BORDER-BOTTOM: #fff 2px solid; BORDER-LEFT: #fff 2px solid; WIDTH: =
72px; HEIGHT: 95px; BORDER-TOP: #fff 2px solid; BORDER-RIGHT: #fff 2px =
solid
}
#cover_images A:hover IMG {
	BORDER-BOTTOM: #aaa 2px solid; BORDER-LEFT: #aaa 2px solid; BORDER-TOP: =
#aaa 2px solid; BORDER-RIGHT: #aaa 2px solid
}
#console {
	TEXT-ALIGN: center; WIDTH: 228px; FLOAT: right; HEIGHT: 71px; COLOR: =
#fff; FONT-SIZE: 0.8em
}
#console P {
	TEXT-ALIGN: right; PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 8px; COLOR: #005587; FONT-SIZE: 0.8em; PADDING-TOP: 4px
}
#console A {
	COLOR: #005587
}
#console UL {
	LIST-STYLE-TYPE: none; MARGIN: 10px 1em 10px 0px
}
#console UL LI {
	DISPLAY: inline
}
#console UL LI A {
	TEXT-ALIGN: right; LINE-HEIGHT: 1.2em; WHITE-SPACE: nowrap; COLOR: =
#fff; MARGIN-LEFT: 1px; FONT-SIZE: 1.1em; FONT-WEIGHT: bold; =
MARGIN-RIGHT: 3px
}
#console FORM#searchBox {
	TEXT-ALIGN: left; PADDING-BOTTOM: 5px; MARGIN: 4px 10px 0px 0px; =
PADDING-LEFT: 8px; WIDTH: 208px; PADDING-RIGHT: 2px; BACKGROUND: =
url(../../images/search_bg.gif) #005587 no-repeat left top; FLOAT: =
right; HEIGHT: 59px; FONT-SIZE: 1.2em; PADDING-TOP: 7px
}
#console FORM INPUT {
	BORDER-BOTTOM: #6f9ebd 1px solid; BORDER-LEFT: #6f9ebd 1px solid; =
WIDTH: 131px; BORDER-TOP: #6f9ebd 1px solid; BORDER-RIGHT: #6f9ebd 1px =
solid
}
#console FORM INPUT.radio {
	BORDER-BOTTOM-STYLE: none !important; PADDING-BOTTOM: 0px; =
BORDER-RIGHT-STYLE: none !important; MARGIN: 0px; PADDING-LEFT: 0px; =
WIDTH: auto !important; PADDING-RIGHT: 0px; BORDER-TOP-STYLE: none =
!important; BORDER-LEFT-STYLE: none !important; PADDING-TOP: 0px
}
INPUT.button {
	BORDER-BOTTOM: 0px; BORDER-LEFT: 0px; PADDING-BOTTOM: 2px; LINE-HEIGHT: =
1em; PADDING-LEFT: 0px; PADDING-RIGHT: 0px; FONT-FAMILY: =
arial,helvetica,"Lucida Grande", Tahoma,verdana,sans-serif; BACKGROUND: =
#4b7837; COLOR: #fff; FONT-SIZE: 1em; BORDER-TOP: 0px; FONT-WEIGHT: =
bold; BORDER-RIGHT: 0px; PADDING-TOP: 2px
}
A.button {
	BORDER-BOTTOM: 0px; BORDER-LEFT: 0px; PADDING-BOTTOM: 2px; LINE-HEIGHT: =
1em; PADDING-LEFT: 0px; PADDING-RIGHT: 0px; FONT-FAMILY: =
arial,helvetica,"Lucida Grande", Tahoma,verdana,sans-serif; BACKGROUND: =
#4b7837; COLOR: #fff; FONT-SIZE: 1em; BORDER-TOP: 0px; FONT-WEIGHT: =
bold; BORDER-RIGHT: 0px; PADDING-TOP: 2px
}
A.button {
	PADDING-BOTTOM: 4px !important; PADDING-LEFT: 37px !important; WIDTH: =
4em !important; PADDING-RIGHT: 37px !important; DISPLAY: block =
!important; FONT-SIZE: 0.96em; TEXT-DECORATION: none; PADDING-TOP: 4px =
!important
}
A.button:hover {
	BACKGROUND: #005587
}
INPUT.button:hover {
	BACKGROUND: #005587
}
P A.button {
	MARGIN: 0px auto
}
P.buttons INPUT.button {
	PADDING-BOTTOM: 2px; PADDING-LEFT: 4px; PADDING-RIGHT: 4px; =
PADDING-TOP: 2px
}
#console FORM INPUT.button {
	FONT-SIZE: 0.85em
}
#console FORM INPUT.button {
	WIDTH: 55px !important
}
#console FORM LABEL {
	COLOR: #125685; MARGIN-LEFT: 4px; FONT-SIZE: 0.9em
}
#global_nav {
	POSITION: relative; BACKGROUND: #e4ddc5; HEIGHT: 1.5em; CLEAR: both
}
#global_nav UL {
	Z-INDEX: 999999; POSITION: relative; PADDING-BOTTOM: 0px; =
LIST-STYLE-TYPE: none; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; PADDING-TOP: 0px
}
#global_nav UL LI {
	POSITION: relative; PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: =
0px; PADDING-RIGHT: 0px; DISPLAY: block; FLOAT: left; PADDING-TOP: 0px
}
#global_nav UL LI.expander A {
	BACKGROUND-IMAGE: url(../../images/arrow.png); BACKGROUND-COLOR: =
#e4ddc5; PADDING-RIGHT: 18px; BACKGROUND-REPEAT: no-repeat; =
BACKGROUND-POSITION: right 0.5em
}
* HTML #global_nav UL LI.expander A {
	BACKGROUND-IMAGE: url(../../images/arrow.gif)
}
#global_nav UL LI A {
	PADDING-BOTTOM: 0px; LINE-HEIGHT: 1.68em; MARGIN: 0px; PADDING-LEFT: =
4px; PADDING-RIGHT: 4px; DISPLAY: block; BACKGROUND: #e4ddc5; FLOAT: =
left; COLOR: #0f5988; FONT-SIZE: 0.9em; FONT-WEIGHT: bold; BORDER-RIGHT: =
#fff 5px solid; TEXT-DECORATION: none; PADDING-TOP: 0px
}
#global_nav UL LI A:hover {
	BACKGROUND-COLOR: #c1baa7
}
#global_nav UL LI.on A {
	BACKGROUND-COLOR: #c1baa7
}
#global_nav UL.sub A:hover {
	TEXT-DECORATION: underline !important
}
#global_nav UL.sub {
	Z-INDEX: 9999; POSITION: absolute !important; PADDING-BOTTOM: 5px =
!important; MARGIN: 0px; PADDING-LEFT: 0px !important; WIDTH: 150px; =
PADDING-RIGHT: 0px !important; DISPLAY: none; BACKGROUND: #c1b8a6; =
HEIGHT: 100% !important; BORDER-TOP: #fff 5px solid; TOP: 22px; RIGHT: =
5px; PADDING-TOP: 5px !important
}
#global_nav UL.wide {
	WIDTH: 285px !important
}
#global_nav UL.sub LI {
	Z-INDEX: 9999; MARGIN: 0px; DISPLAY: block !important; FLOAT: none =
!important
}
#global_nav UL.sub LI A {
	Z-INDEX: 9999; BORDER-BOTTOM-STYLE: none !important; PADDING-BOTTOM: =
1px; BORDER-RIGHT-STYLE: none !important; MARGIN: 0px; PADDING-LEFT: =
5px; WIDTH: 140px; PADDING-RIGHT: 5px; DISPLAY: block !important; =
BORDER-TOP-STYLE: none !important; BACKGROUND: #c1b8a6; FLOAT: none =
!important; COLOR: #494440; FONT-SIZE: 11px !important; =
BORDER-LEFT-STYLE: none !important; FONT-WEIGHT: normal; PADDING-TOP: =
0px
}
#global_nav TABLE {
	WIDTH: 285px; BACKGROUND: #c1b8a6
}
#global_nav TD {
	Z-INDEX: 9999; FONT-SIZE: 11px
}
#global_nav TD UL LI A {
	LINE-HEIGHT: 14px; WIDTH: 125px !important
}
#global_nav LI.off:hover UL.sub {
	Z-INDEX: 6000; DISPLAY: block !important
}
#global_nav LI.over UL.sub {
	Z-INDEX: 6000; DISPLAY: block !important
}
#global_nav UL LI:hover UL {
	DISPLAY: block
}
#main_banner {
	TEXT-ALIGN: center; BACKGROUND: #e7e3c8; HEIGHT: 90px; CLEAR: both
}
#footer_ad {
	TEXT-ALIGN: center; BACKGROUND: #e7e3c8; HEIGHT: 90px; CLEAR: both
}
#footer_ad {
	Z-INDEX: 1; WIDTH: 100%; BACKGROUND: #efefef; BORDER-TOP: #fff 10px =
solid
}
#main_banner IMG {
	WIDTH: 728px; HEIGHT: 90px
}
#footer_ad IMG {
	WIDTH: 728px; HEIGHT: 90px
}
#footer_ad A {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; PADDING-TOP: 0px
}
#footer_ad IMG {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; PADDING-TOP: 0px
}
DIV#main_banner {
	BORDER-TOP: #fff 10px solid
}
#main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 10px; PADDING-RIGHT: 376px; =
FONT-SIZE: 0.85em; PADDING-TOP: 10px
}
#main_fulltext_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 10px; PADDING-RIGHT: 376px; =
FONT-SIZE: 0.85em; PADDING-TOP: 10px
}
#main_fulltext_content {
=09
}
DIV.info_outline_closed #main_content {
	PADDING-RIGHT: 73px !important
}
DIV.info_outline_closed #main_fulltext_content {
	PADDING-RIGHT: 73px !important
}
#fulltext_body #main_content {
	PADDING-RIGHT: 218px !important
}
#fulltext_body #main_fulltext_content {
	PADDING-RIGHT: 218px !important
}
#main_content DL {
	LIST-STYLE-TYPE: none; MARGIN: 10px 0px 20px
}
#main_content DT {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; FONT-WEIGHT: bold; PADDING-TOP: 0px
}
#main_content DD {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; WIDTH: 99%; =
PADDING-RIGHT: 0px; COLOR: #333; PADDING-TOP: 0px
}
* HTML #main_content DD {
	WIDTH: auto
}
#main_content DD A {
	COLOR: #233b93
}
BODY.home #main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 190px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.archive #main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 190px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.outline_open #main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 190px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.outline_open #main_fulltext_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 190px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.archive #main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 190px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.toc #main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 190px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.outline_open {
	BACKGROUND: url(../../images/left_bg.gif) repeat-y left top
}
BODY.outline_closed {
	BACKGROUND: url(../../images/left_bg_narrow.gif) repeat-y left top
}
BODY.outline_closed #main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 73px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.outline_closed #main_fulltext_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 73px; PADDING-RIGHT: 376px; =
PADDING-TOP: 10px
}
BODY.outline_closed #left_column {
	WIDTH: 63px
}
BODY.wide #main_content {
	PADDING-BOTTOM: 0px; PADDING-LEFT: 10px; PADDING-RIGHT: 10px; =
PADDING-TOP: 10px
}
#fulltext_body #left_column UL {
	LIST-STYLE-TYPE: none
}
DIV.article_links {
	LINE-HEIGHT: 1.4em; MARGIN-TOP: 3px; MARGIN-BOTTOM: 5px; COLOR: #333; =
FONT-SIZE: 0.8em
}
DIV.article_links A {
	COLOR: #25428e; FONT-SIZE: 1.25em
}
#footer {
	TEXT-ALIGN: center; BACKGROUND: #eae5c8; HEIGHT: 6em; CLEAR: both; =
BORDER-TOP: #fff 10px solid
}
#footer UL {
	LIST-STYLE-TYPE: none
}
#top_links UL {
	LIST-STYLE-TYPE: none
}
#footer_content {
	MIN-WIDTH: 450px; MARGIN: 1em auto 0px; WIDTH: 30em
}
#main_content H4 {
	PADDING-BOTTOM: 0px; MARGIN: 0px 0px 8px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; FONT-SIZE: 13px; PADDING-TOP: 0px
}
#main_fulltext_content H4 {
	PADDING-BOTTOM: 0px; MARGIN: 0px 0px 8px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; FONT-SIZE: 13px; PADDING-TOP: 0px
}
#footer_content H4 {
	PADDING-BOTTOM: 0px; MARGIN: 0px 13px 0px 0px; PADDING-LEFT: 0px; =
WIDTH: 73px; PADDING-RIGHT: 0px; FLOAT: left; HEIGHT: 51px; PADDING-TOP: =
0px
}
#footer_content H4 IMG {
	WIDTH: 73px; DISPLAY: block; HEIGHT: 51px
}
* HTML #footer_content H4 A IMG {
	DISPLAY: none
}
* HTML #footer_content H4 A {
	BACKGROUND-IMAGE: url(../../images/cell_press.gif); Z-INDEX: 1; WIDTH: =
73px !important; DISPLAY: block; HEIGHT: 51px !important
}
#footer_content FORM {
	TEXT-ALIGN: left; PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; FLOAT: left; PADDING-TOP: 0px
}
#footer_content UL {
	PADDING-BOTTOM: 0px; MARGIN: 3px 0px 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; FONT-SIZE: 0.7em; PADDING-TOP: 0px
}
#footer_content UL LI {
	FLOAT: left; COLOR: #888885
}
#footer_content UL LI A {
	COLOR: #888885; MARGIN-LEFT: 3px; TEXT-DECORATION: none
}
#footer_content UL LI A:hover {
	TEXT-DECORATION: underline
}
#footer SELECT {
	VERTICAL-ALIGN: bottom
}
#footer INPUT.image {
	MARGIN: 0px; VERTICAL-ALIGN: bottom
}
#footer INPUT#footer_go {
	MARGIN: 0px; VERTICAL-ALIGN: bottom
}
#footer P.copyright {
	PADDING-BOTTOM: 0px; LINE-HEIGHT: 1.2em; MARGIN: 0px 0px 0px 3px; =
PADDING-LEFT: 0px; PADDING-RIGHT: 0px; COLOR: #888885; CLEAR: left; =
FONT-SIZE: 0.7em; PADDING-TOP: 0px
}
#footer P.copyright A {
	COLOR: #888885; TEXT-DECORATION: none
}
#footer P.copyright A:hover {
	TEXT-DECORATION: underline
}
#left_column {
	POSITION: relative; WIDTH: 180px; BACKGROUND: #e9ece3; FLOAT: left; =
FONT-SIZE: 0.85em; BORDER-TOP: #fff 10px solid; PADDING-TOP: 10px
}
#right_column {
	WIDTH: 356px; BACKGROUND: #dee4f0; FLOAT: right; FONT-SIZE: 0.85em; =
BORDER-TOP: #fff 10px solid; PADDING-TOP: 10px
}
#fulltext_body #right_column {
	WIDTH: 208px
}
DIV.info_outline_closed #right_column {
	WIDTH: 63px !important
}
#right_column P {
	PADDING-BOTTOM: 10px; MARGIN: 0px; PADDING-LEFT: 10px; PADDING-RIGHT: =
10px; PADDING-TOP: 10px
}
#main_boombox {
	PADDING-LEFT: 10px; MARGIN-BOTTOM: 15px; PADDING-TOP: 10px
}
#floating_login_form {
	Z-INDEX: 2009999; BORDER-BOTTOM: #ccc 2px solid; POSITION: absolute; =
BORDER-LEFT: #ccc 2px solid; PADDING-BOTTOM: 6px; PADDING-LEFT: 6px; =
WIDTH: 21.8em; PADDING-RIGHT: 6px; BACKGROUND: #dee4f0; COLOR: #005587; =
FONT-SIZE: 0.8em; BORDER-TOP: #ccc 2px solid; TOP: 2.6em; RIGHT: 9999pt; =
BORDER-RIGHT: #ccc 2px solid; PADDING-TOP: 12px
}
#subscribe_main {
	PADDING-BOTTOM: 1em; MARGIN: 2em 0px 1.5em; PADDING-LEFT: 1em; WIDTH: =
660px; PADDING-RIGHT: 1em; BACKGROUND: #dee4f0; CLEAR: both; =
PADDING-TOP: 1em
}
#floating_login_form LABEL {
	LINE-HEIGHT: 1.7em; WIDTH: 6.5em; DISPLAY: block; FLOAT: left; CLEAR: =
left; FONT-WEIGHT: bold
}
#floating_login_form INPUT {
	BORDER-BOTTOM: #6f9ebd 1px solid; BORDER-LEFT: #6f9ebd 1px solid; =
WIDTH: 9.5em; DISPLAY: block; MARGIN-BOTTOM: 5px; FLOAT: left; =
BORDER-TOP: #6f9ebd 1px solid; BORDER-RIGHT: #6f9ebd 1px solid
}
#floating_login_form INPUT.hidden {
	BORDER-RIGHT-WIDTH: 0px; MARGIN: 0px; BORDER-TOP-WIDTH: 0px; =
BORDER-BOTTOM-WIDTH: 0px; BORDER-LEFT-WIDTH: 0px
}
#login_submit {
	MARGIN: 5px 0px 0px 6.5em
}
* HTML #login_submit {
	MARGIN: 5px 0px 0px 3.3em
}
#forgotlink {
	DISPLAY: block; COLOR: #005587; MARGIN-LEFT: 6.8em; CLEAR: both; =
FONT-SIZE: 11px
}
#floating_login_form #rememberme_label {
	LINE-HEIGHT: 1.3em; MARGIN: 2px 0px 0px 6.8em; WIDTH: 120px !important; =
FONT-SIZE: 11px; FONT-WEIGHT: normal
}
* HTML #floating_login_form #rememberme_label {
	MARGIN: 2px 0px 0px 3.4em
}
#welcome {
	POSITION: relative; TEXT-ALIGN: right; LINE-HEIGHT: 1.68em; =
PADDING-RIGHT: 4px; DISPLAY: block; BACKGROUND: #e4ddc5; FLOAT: right; =
COLOR: #a0412f; FONT-SIZE: 0.9em
}
#auto_login {
	BORDER-RIGHT-WIDTH: 0px !important; BORDER-TOP-WIDTH: 0px !important; =
BORDER-BOTTOM-WIDTH: 0px !important; BORDER-LEFT-WIDTH: 0px !important
}
A#close_login {
	POSITION: absolute; TEXT-ALIGN: center !important; PADDING-BOTTOM: 2px; =
LINE-HEIGHT: 18px; PADDING-LEFT: 2px; WIDTH: 18px; DISPLAY: block; =
HEIGHT: 18px; TOP: 4px; RIGHT: 4px; TEXT-DECORATION: none
}
A#close_login:hover {
	BACKGROUND: #4b7639; COLOR: #fff
}
P.alert {
	TEXT-ALIGN: right; PADDING-BOTTOM: 0.2em !important; MARGIN-TOP: 0px; =
PADDING-RIGHT: 13px; COLOR: #f55; FONT-SIZE: 0.85em !important; =
FONT-WEIGHT: bold; PADDING-TOP: 0px
}
.loginError {
	TEXT-ALIGN: right; PADDING-BOTTOM: 0.2em !important; MARGIN-TOP: 0px; =
PADDING-RIGHT: 13px; COLOR: #f55; FONT-SIZE: 0.85em !important; =
FONT-WEIGHT: bold; PADDING-TOP: 0px
}
#floating_login_form DIV.error {
	TEXT-ALIGN: right; PADDING-BOTTOM: 0.2em !important; MARGIN-TOP: 0px; =
PADDING-RIGHT: 13px; COLOR: #f55; FONT-SIZE: 0.85em !important; =
FONT-WEIGHT: bold; PADDING-TOP: 0px
}
#main_content DIV.alert {
	BORDER-BOTTOM: #000 1px solid; TEXT-ALIGN: left !important; =
BORDER-LEFT: #000 1px solid; PADDING-BOTTOM: 10px; LINE-HEIGHT: 16px =
!important; MARGIN-TOP: 1em; PADDING-LEFT: 36px; WIDTH: 26.3em; =
PADDING-RIGHT: 0.5em; FONT-SIZE: 1em; BORDER-TOP: #000 1px solid; =
BORDER-RIGHT: #000 1px solid; PADDING-TOP: 10px
}
#main_content DIV.registerwide {
	WIDTH: 620px !important
}
#main_content DIV.alertwide {
	WIDTH: 57.3em !important
}
#main_content .registerform DIV.alert {
	WIDTH: 57.5% !important; MARGIN-BOTTOM: 1em !important
}
#main_content #main_search DIV.alert {
	WIDTH: auto !important
}
#main_content DIV.errormsg {
	BACKGROUND: url(../../images/msg_icon_error.gif) #efefef no-repeat 5px =
8px
}
#main_content DIV.alertmsg {
	BACKGROUND: url(../../images/msg_icon_alert.gif) #efefef no-repeat 5px =
4px
}
#main_content DIV.infomsg {
	BACKGROUND: url(../../images/msg_icon_info.gif) #efefef no-repeat 5px =
4px
}
#main_content DIV.confirmmsg {
	BACKGROUND: url(../../images/msg_icon_confirm.gif) #efefef no-repeat =
5px 8px
}
INPUT.checkbox {
	WIDTH: auto !important; FLOAT: left !important
}
#main_content H3 {
	PADDING-BOTTOM: 0px; MARGIN: 10px 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; FONT-SIZE: 1.1em; PADDING-TOP: 0px
}
#main_fulltext_content H3 {
	PADDING-BOTTOM: 0px; MARGIN: 10px 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; FONT-SIZE: 1.1em; PADDING-TOP: 0px
}
#main_content H2 {
	PADDING-BOTTOM: 0px; MARGIN: 0px 0px 5px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; COLOR: #a0412f; FONT-SIZE: 1.3em; PADDING-TOP: 0px
}
#main_fulltext_content H2 {
	PADDING-BOTTOM: 0px; MARGIN: 0px 0px 5px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; COLOR: #a0412f; FONT-SIZE: 1.3em; PADDING-TOP: 0px
}
#main_content H3 {
	PADDING-BOTTOM: 0px; MARGIN: 14px 0px 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; COLOR: #a0412f; FONT-SIZE: 1.2em; PADDING-TOP: 0px
}
#main_fulltext_content H3 {
	PADDING-BOTTOM: 0px; MARGIN: 14px 0px 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; COLOR: #a0412f; FONT-SIZE: 1.2em; PADDING-TOP: 0px
}
#left_column H2 {
	MARGIN: 0px; COLOR: #a0412f; FONT-SIZE: 1.3em !important
}
#right_column H2 {
	MARGIN: 0px; COLOR: #a0412f; FONT-SIZE: 1.3em !important
}
.cover_panel .handle {
	PADDING-LEFT: 21px; DISPLAY: block !important; BACKGROUND: =
url(../../images/cover_panel_top.gif) no-repeat 0px 0px; PADDING-TOP: =
28px
}
.cover_panel {
	MARGIN-BOTTOM: 20px !important; BACKGROUND: =
url(../../images/cover_panel_bottom.gif) no-repeat 0px 100%; =
MARGIN-LEFT: 10px
}
.cover_panel P {
	TEXT-ALIGN: center; PADDING-BOTTOM: 10px; MARGIN: 0px; PADDING-LEFT: =
0px; PADDING-RIGHT: 10px; FONT-SIZE: 0.9em; PADDING-TOP: 0px
}
.home_panel {
	MARGIN-BOTTOM: 20px; BACKGROUND: =
url(../../images/left_panel_bottom.gif) no-repeat 0px 100%; MARGIN-LEFT: =
10px
}
.home_panel .handle {
	POSITION: relative; MARGIN: 0px; PADDING-LEFT: 15px; BACKGROUND: =
url(../../images/left_panel_top.gif) no-repeat 0px 0px; PADDING-TOP: =
15px
}
#article_outline H4 {
	POSITION: relative; MARGIN: 0px; PADDING-LEFT: 15px; BACKGROUND: =
url(../../images/left_panel_top.gif) no-repeat 0px 0px; PADDING-TOP: =
15px
}
#archive_outline H4 {
	POSITION: relative; MARGIN: 0px; PADDING-LEFT: 15px; BACKGROUND: =
url(../../images/left_panel_top.gif) no-repeat 0px 0px; PADDING-TOP: =
15px
}
#article_outline H4 {
	FONT-SIZE: 1.3em
}
#archive_outline H4 {
	FONT-SIZE: 1.3em
}
#article_outline H4 A {
	COLOR: #a0412f; FONT-SIZE: 1em; TEXT-DECORATION: none
}
#archive_outline H4 A {
	COLOR: #a0412f; FONT-SIZE: 1em; TEXT-DECORATION: none
}
#left_column UL {
	PADDING-BOTTOM: 10px; LIST-STYLE-TYPE: none; PADDING-LEFT: 15px; =
PADDING-RIGHT: 0px; PADDING-TOP: 5px
}
#left_column UL LI UL {
	PADDING-BOTTOM: 0px !important
}
.home_panel UL LI {
	PADDING-BOTTOM: 5px; PADDING-RIGHT: 20px !important; FONT-SIZE: 0.9em
}
.home_panel UL LI A {
	COLOR: #273c99
}
.right_panel {
	PADDING-BOTTOM: 5px; MARGIN-BOTTOM: 10px; BACKGROUND: =
url(../../images/right_panel_bottom.gif) no-repeat 0px 100%; =
MARGIN-LEFT: 10px; FONT-SIZE: 0.8em
}
#article_options {
	PADDING-BOTTOM: 5px; MARGIN-BOTTOM: 10px; BACKGROUND: =
url(../../images/right_panel_bottom.gif) no-repeat 0px 100%; =
MARGIN-LEFT: 10px; FONT-SIZE: 0.8em
}
.right_panel {
	FONT-SIZE: 0.9em
}
#article_options H4 {
	PADDING-BOTTOM: 2px !important; MARGIN-BOTTOM: 0px; FONT-SIZE: 1.4em =
!important
}
#right_column .right_panel .handle {
	PADDING-LEFT: 15px; BACKGROUND: url(../../images/right_panel_top.gif) =
no-repeat 0px 0px; PADDING-TOP: 15px
}
#article_options H4.handle {
	PADDING-LEFT: 15px; BACKGROUND: url(../../images/right_panel_top.gif) =
no-repeat 0px 0px; PADDING-TOP: 15px
}
#fulltext_body #right_column .right_panel .handle {
	BACKGROUND: url(../../images/right_panel_top_ft.gif) no-repeat 0px 0px
}
#fulltext_body #article_options H4.handle {
	BACKGROUND: url(../../images/right_panel_top_ft.gif) no-repeat 0px 0px
}
#fulltext_body .right_panel {
	BACKGROUND: url(../../images/right_panel_bottom_ft.gif) no-repeat 0px =
100%
}
BODY#fulltext_body #article_options {
	BACKGROUND: url(../../images/right_panel_bottom_ft.gif) no-repeat 0px =
100%
}
#fulltext_body #article_options H4.handle {
	POSITION: relative
}
#right_column H3 {
	PADDING-BOTTOM: 5px; MARGIN: 0px; PADDING-LEFT: 15px; PADDING-RIGHT: =
0px; FONT-SIZE: 1em; PADDING-TOP: 5px
}
#right_column H4 {
	PADDING-BOTTOM: 5px; MARGIN: 0px; PADDING-LEFT: 15px; PADDING-RIGHT: =
0px; FONT-SIZE: 1em; PADDING-TOP: 5px
}
#right_column H4 {
	PADDING-BOTTOM: 5px; MARGIN: 0px; PADDING-LEFT: 15px; PADDING-RIGHT: =
0px; COLOR: #a0412f; FONT-SIZE: 1.3em; PADDING-TOP: 5px
}
#right_column .right_panel P {
	PADDING-BOTTOM: 8px; PADDING-LEFT: 15px; PADDING-RIGHT: 15px; =
FONT-SIZE: 1em; PADDING-TOP: 8px
}
#right_column UL {
	LIST-STYLE-TYPE: none; MARGIN: 5px 5px 5px 18px
}
#right_column UL LI {
	PADDING-LEFT: 14px; PADDING-RIGHT: 15px; BACKGROUND: =
url(../../images/right_bull.gif) no-repeat left 0.6em
}
#fulltext_body #right_column UL LI {
	BACKGROUND: 0px 50%
}
#right_column UL LI A {
	LINE-HEIGHT: 1.5em; DISPLAY: block; FONT-SIZE: 1.1em
}
#right_column DL {
	LIST-STYLE-TYPE: none; MARGIN: 5px 5px 5px 16px
}
#right_column DT {
	PADDING-RIGHT: 15px
}
#right_column DD {
	PADDING-RIGHT: 15px
}
#right_column DT {
	FONT-WEIGHT: bold
}
TABLE#search_results {
	WIDTH: 99%
}
TABLE#search_results TH {
	PADDING-LEFT: 18px
}
TABLE#search_results TD {
	PADDING-LEFT: 18px
}
TABLE#search_results TD {
	PADDING-BOTTOM: 8px; PADDING-TOP: 8px
}
TABLE#search_results TH {
	LINE-HEIGHT: 1.75em; PADDING-RIGHT: 10px; WHITE-SPACE: nowrap; =
BACKGROUND: #005587; COLOR: #fff
}
TABLE#search_results TH.last {
	TEXT-ALIGN: center
}
TABLE#search_results TD.last {
	TEXT-ALIGN: center
}
TABLE#search_results .col-author {
	WIDTH: 20%
}
TABLE#search_results .col-title {
	WIDTH: 40%
}
TABLE#search_results TD {
	PADDING-RIGHT: 10px
}
TABLE#search_results TR.shade1 TD {
	BACKGROUND: #fff
}
TABLE#search_results TR.shade2 TD {
	BACKGROUND: #e9ece5
}
TABLE#search_results TR TD A {
	COLOR: #233b93
}
.registerform STRONG {
	LINE-HEIGHT: 1.8em
}
.registerform {
	PADDING-BOTTOM: 1em; MARGIN: 1em 0px 1.5em; PADDING-LEFT: 1em; WIDTH: =
640px; PADDING-RIGHT: 1em; BACKGROUND: #dee4f0; PADDING-TOP: 1em
}
.login_box {
	PADDING-BOTTOM: 1em; MARGIN: 1em 1.1em 1.5em 0px; MIN-HEIGHT: 12.8em; =
PADDING-LEFT: 1em; WIDTH: 28em; PADDING-RIGHT: 1em; BACKGROUND: #dee4f0; =
FLOAT: left; PADDING-TOP: 1em
}
* HTML DIV.login_box {
	HEIGHT: 12.8em
}
.ind_sub {
	HEIGHT: 10em !important
}
.ind_sub P {
	MARGIN-TOP: 0px; HEIGHT: 5em !important
}
.ind_sub A.button {
	TEXT-ALIGN: center; MARGIN: 0px auto; WIDTH: 22em !important; DISPLAY: =
block !important; FLOAT: none
}
#ppvAccess INPUT.button {
	TEXT-ALIGN: center; MARGIN: 0px auto; WIDTH: 22em !important; DISPLAY: =
block !important; FLOAT: none
}
#main_content #main_supp A.button {
	TEXT-ALIGN: center; WIDTH: 12em !important; DISPLAY: inline; FLOAT: =
left; MARGIN-RIGHT: 0.4em !important
}
#main_fulltext_content #main_supp A.button {
	TEXT-ALIGN: center; WIDTH: 12em !important; DISPLAY: inline; FLOAT: =
left; MARGIN-RIGHT: 0.4em !important
}
.login_box H3 {
	PADDING-BOTTOM: 0px !important; MARGIN: 0px 0px 10px; PADDING-LEFT: 0px =
!important; PADDING-RIGHT: 0px !important; PADDING-TOP: 0px !important
}
DIV.login_box LABEL {
	LINE-HEIGHT: 2em; WIDTH: 8.7em; PADDING-RIGHT: 0.7em; DISPLAY: block; =
WHITE-SPACE: nowrap; FLOAT: left; CLEAR: left !important
}
.login_box FORM {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; PADDING-TOP: 0px
}
#pw_username {
	LINE-HEIGHT: 2em
}
DIV.login_box LABEL SPAN.note {
	LINE-HEIGHT: 1em !important; WIDTH: 8.5em; WHITE-SPACE: normal =
!important; FONT-SIZE: 0.8em
}
DIV.login_box INPUT {
	WIDTH: 10em; DISPLAY: block; FLOAT: left
}
.registerform INPUT {
	WIDTH: 16em; DISPLAY: block; MARGIN-BOTTOM: 2px; FLOAT: left
}
.registerform FIELDSET LABEL {
	WIDTH: 18em; DISPLAY: block; FLOAT: left
}
TABLE#email_alerts {
	PADDING-BOTTOM: 5px; WIDTH: 640px
}
#email_alerts TD INPUT {
	WIDTH: 20px; FLOAT: left; CLEAR: none
}
#email_alerts LABEL {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; WIDTH: auto =
!important; PADDING-RIGHT: 0px; FLOAT: left !important; CLEAR: none =
!important; FONT-WEIGHT: normal !important; PADDING-TOP: 0px
}
TABLE#email_alerts TH {
	BORDER-BOTTOM: #102f1b 1px solid; PADDING-BOTTOM: 2px; MARGIN-TOP: 5px
}
TABLE#email_alerts TD {
	LINE-HEIGHT: 1.6em; PADDING-TOP: 2px
}
P.buttons {
	TEXT-ALIGN: right
}
P.alerts {
	WIDTH: 664px
}
#edit_search {
	POSITION: absolute; TEXT-ALIGN: center; PADDING-BOTTOM: 3px; =
PADDING-LEFT: 5px; WIDTH: 6em; PADDING-RIGHT: 5px; DISPLAY: block; =
BACKGROUND: #4b7639; COLOR: #fff; TOP: 0px; RIGHT: 0px; FONT-WEIGHT: =
bold; TEXT-DECORATION: none; PADDING-TOP: 3px
}
#edit_search:hover {
	TEXT-DECORATION: underline
}
P#results_no {
	POSITION: relative
}
DIV.result-pages {
	BORDER-BOTTOM: #ccc 1px solid; BORDER-LEFT: #ccc 1px solid; =
PADDING-BOTTOM: 4px; MARGIN: 4px 0px; PADDING-LEFT: 4px; PADDING-RIGHT: =
4px; CLEAR: both; BORDER-TOP: #ccc 1px solid; BORDER-RIGHT: #ccc 1px =
solid; PADDING-TOP: 4px
}
DIV.result-pages P {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; WIDTH: 20%; =
PADDING-RIGHT: 0px; FLOAT: left; PADDING-TOP: 0px
}
DIV.result-pages UL {
	TEXT-ALIGN: right; LIST-STYLE-TYPE: none; WIDTH: 70%; FLOAT: right
}
DIV.result-pages UL LI {
	DISPLAY: inline
}
DIV.result-pages UL LI A {
	COLOR: #25428e
}
.registerform DIV.alert {
	WIDTH: 57.5% !important; MARGIN-BOTTOM: 1em !important
}
.registerform SELECT {
	MARGIN: 0.2em 0px; WIDTH: 39%; FLOAT: left
}
SELECT#reg_title {
	MIN-WIDTH: 16em; WIDTH: 20%; MARGIN-RIGHT: 30%
}
SELECT#titleId {
	MIN-WIDTH: 16em; WIDTH: 20%; MARGIN-RIGHT: 30%
}
SELECT.reg_title {
	MIN-WIDTH: 16em; WIDTH: 20%; MARGIN-RIGHT: 30%
}
.register_error {
	COLOR: #8e0101; CLEAR: both; FONT-WEIGHT: bold
}
.subscribe_error {
	COLOR: #8e0101; CLEAR: both; FONT-WEIGHT: bold
}
.feedback_error {
	COLOR: #8e0101; CLEAR: both; FONT-WEIGHT: bold
}
FIELDSET {
	BORDER-RIGHT-WIDTH: 0px; BORDER-TOP-WIDTH: 0px; BORDER-BOTTOM-WIDTH: =
0px; BORDER-LEFT-WIDTH: 0px
}
FIELDSET.reg_comms LABEL {
	LINE-HEIGHT: 1.6em; WIDTH: 100% !important; WHITE-SPACE: nowrap
}
* HTML FIELDSET.reg_comms LABEL {
	LINE-HEIGHT: 2em
}
FIELDSET.reg_comms LABEL INPUT {
	MARGIN-RIGHT: 0.6em !important
}
* HTML FIELDSET.reg_comms LABEL INPUT {
	MARGIN-RIGHT: 0.2em !important
}
A.usernameavailable {
	LINE-HEIGHT: 2.2em; WIDTH: 16em; DISPLAY: block; FLOAT: left; =
MARGIN-LEFT: 0.4em; FONT-SIZE: 0.9em
}
LABEL#loginlabel {
	COLOR: #dee4f0 !important
}
LABEL#clearlabel {
	COLOR: #dee4f0 !important
}
#send {
	MARGIN-LEFT: 9.5em
}
#_eventId_login {
	MARGIN-LEFT: 9.5em
}
* HTML #send {
	MARGIN-LEFT: 4.75em; CLEAR: both
}
.registerform LABEL {
	CLEAR: left; FONT-WEIGHT: bold
}
A#alerts_fpw {
	PADDING-BOTTOM: 0.8em; PADDING-LEFT: 2.5em; WIDTH: 6.7em; DISPLAY: =
block !important; FLOAT: left; FONT-SIZE: 0.8em !important
}
SPAN#fpw {
	LINE-HEIGHT: 1em; PADDING-LEFT: 11.7em; DISPLAY: block; CLEAR: both; =
FONT-SIZE: 0.8em !important
}
.subscribe_button {
	WIDTH: 247px; FLOAT: left
}
.subscribe_button .button {
	WIDTH: 190px; MARGIN-BOTTOM: 8px
}
FORM#subscribe_online {
	WIDTH: 247px; FLOAT: left
}
FORM#renew_online {
	WIDTH: 247px; FLOAT: left
}
FORM#activate {
	WIDTH: 247px; FLOAT: left
}
FORM#activate {
	PADDING-BOTTOM: 10px; WIDTH: 230px; FLOAT: left
}
.subscribe_button {
	WIDTH: 230px; FLOAT: left
}
INPUT.ecomm_go {
	LINE-HEIGHT: 1em; MARGIN-TOP: 2px; HEIGHT: 22px; MARGIN-LEFT: 4px =
!important
}
.registerform INPUT.button {
	WIDTH: 9em; DISPLAY: block; MARGIN-BOTTOM: 2px; FLOAT: left
}
FORM#subscribe {
	PADDING-BOTTOM: 0px; MARGIN: 20px 0px 10px; PADDING-LEFT: 0px; WIDTH: =
750px; PADDING-RIGHT: 0px; PADDING-TOP: 0px
}
#select_journal UL {
	MARGIN-TOP: 5px; MARGIN-LEFT: 20px
}
select_product UL {
	MARGIN-TOP: 5px; MARGIN-LEFT: 20px
}
#your_info UL {
	MARGIN-TOP: 5px; MARGIN-LEFT: 20px
}
#select_journal LI {
	COLOR: #005587; FONT-WEIGHT: bold
}
#your_info LI {
	COLOR: #005587; FONT-WEIGHT: bold
}
#j_price {
	LINE-HEIGHT: 2em; WIDTH: 20em; DISPLAY: block; FLOAT: left; COLOR: =
#005587; FONT-SIZE: 1.2em
}
#select_product LABEL {
	DISPLAY: block
}
#subscribe_rates TD {
	PADDING-BOTTOM: 5px
}
#subscribe_rates TH {
	PADDING-BOTTOM: 5px
}
#ecom_trail {
	BORDER-BOTTOM: #ccc 1px solid; PADDING-BOTTOM: 5px; PADDING-LEFT: 1em; =
WIDTH: 640px; PADDING-RIGHT: 1em; MARGIN-BOTTOM: 10px; BORDER-TOP: #ccc =
1px solid; PADDING-TOP: 5px
}
.ecom_trail_selected {
	TEXT-ALIGN: center; WIDTH: 200px; FLOAT: left; COLOR: #005587; =
FONT-SIZE: 1.1em; FONT-WEIGHT: bold
}
.ecom_trail_notselected {
	TEXT-ALIGN: center; WIDTH: 200px; FLOAT: left; COLOR: #333; FONT-SIZE: =
1.1em; FONT-WEIGHT: bold
}
.ecom_trail_sep {
	TEXT-ALIGN: center; WIDTH: 10px; FLOAT: left
}
#ecom_pricebox {
	DISPLAY: block; CLEAR: both
}
P#priceContainer {
	PADDING-BOTTOM: 10px !important; PADDING-LEFT: 0px !important; WIDTH: =
557px; PADDING-RIGHT: 0px !important; DISPLAY: block; COLOR: #005587; =
CLEAR: both; FONT-SIZE: 1.4em; PADDING-TOP: 20px !important
}
P#priceContainer STRONG.label {
	LINE-HEIGHT: 1em; WIDTH: 24.5%; COLOR: #000
}
P#priceContainer INPUT {
	FLOAT: right; FONT-SIZE: 0.7em
}
#journal_price {
	DISPLAY: block; FLOAT: left; MARGIN-LEFT: 20px !important
}
* HTML #journal_price {
	MARGIN-LEFT: 0px
}
#add_button {
	MARGIN-TOP: 30px; DISPLAY: block; FLOAT: right; MARGIN-RIGHT: 31px
}
#update_button {
	FLOAT: right; MARGIN-RIGHT: 31px !important
}
* HTML #add_button {
	MARGIN-RIGHT: 16px !important
}
* HTML #update_button {
	MARGIN-RIGHT: 16px !important
}
* HTML INPUT.continue {
	MARGIN-RIGHT: 16px !important
}
#discountCode {
	WIDTH: 280px
}
#pricing_explanations {
	MARGIN: 30px 0px 0px 20px; CLEAR: both
}
INPUT.continue {
	FLOAT: right !important; MARGIN-RIGHT: 31px !important
}
.form_panel UL {
	PADDING-BOTTOM: 15px; LIST-STYLE-TYPE: none; MARGIN: 0px; PADDING-LEFT: =
25px; PADDING-RIGHT: 15px; DISPLAY: block; BACKGROUND: =
url(../../images/form_panel_top.gif) no-repeat 0px 0px; CLEAR: both; =
PADDING-TOP: 15px
}
.form_panel LI {
	LINE-HEIGHT: 1.4em; MARGIN-BOTTOM: 0.4em; COLOR: #000 !important; =
FONT-WEIGHT: normal !important
}
.form_panel {
	MARGIN: 20px auto 10px; WIDTH: 580px; BACKGROUND: =
url(../../images/form_panel_bottom.gif) no-repeat 0px 100%; CLEAR: both
}
.form_panel P.first {
	PADDING-BOTTOM: 15px; MARGIN: 0px; PADDING-LEFT: 25px; PADDING-RIGHT: =
15px; BACKGROUND: url(../../images/form_panel_top.gif) no-repeat 0px =
0px; PADDING-TOP: 15px
}
.advanced_search LABEL {
	MARGIN-TOP: 0.5em; WIDTH: 21.5%; DISPLAY: block; FLOAT: left; CLEAR: =
left; FONT-WEIGHT: bold
}
.registerform LABEL {
	MARGIN-TOP: 0.5em; WIDTH: 24.5%; DISPLAY: block; FLOAT: left; CLEAR: =
left; FONT-WEIGHT: bold
}
.jrnl_main {
	WIDTH: 160px !important
}
.advanced_search INPUT {
	MARGIN: 0.2em 0px; WIDTH: 48.5%; DISPLAY: block; FLOAT: left
}
.registerform INPUT {
	MARGIN: 0.2em 0px; WIDTH: 48.5%; DISPLAY: block; FLOAT: left
}
.registerform STRONG {
	MARGIN: 0.2em 0px; WIDTH: 48.5%; DISPLAY: block; FLOAT: left
}
.registerform STRONG {
	LINE-HEIGHT: 1.8em
}
.registerform #email_alerts INPUT {
	WIDTH: auto !important
}
.advanced_search INPUT.radio {
	WIDTH: auto !important
}
.advanced_search INPUT.button {
	HEIGHT: 1.8em !important
}
.advanced_search SELECT {
	MARGIN: 0.4em 0px; FLOAT: left; CLEAR: right
}
STRONG.toc_pages {
	COLOR: #6f6f6f
}
#short_fields {
	PADDING-LEFT: 21.5%; PADDING-TOP: 1em
}
#short_fields LABEL {
	PADDING-LEFT: 0px; WIDTH: auto !important; WHITE-SPACE: nowrap; FLOAT: =
left; MARGIN-LEFT: 0px; CLEAR: none; MARGIN-RIGHT: 0.5em
}
#radio_fields LABEL {
	PADDING-LEFT: 0px; WIDTH: auto !important; WHITE-SPACE: nowrap; FLOAT: =
left; MARGIN-LEFT: 0px; CLEAR: none; MARGIN-RIGHT: 0.5em
}
#adv_jnrl_holder LABEL {
	PADDING-LEFT: 0px; WIDTH: auto !important; WHITE-SPACE: nowrap; FLOAT: =
left; MARGIN-LEFT: 0px; CLEAR: none; MARGIN-RIGHT: 0.5em
}
#from_fields LABEL {
	PADDING-LEFT: 0px; WIDTH: auto !important; WHITE-SPACE: nowrap; FLOAT: =
left; MARGIN-LEFT: 0px; CLEAR: none; MARGIN-RIGHT: 0.5em
}
#from_fields {
	PADDING-TOP: 0.5em
}
#from_fields LABEL {
	POSITION: static; WIDTH: auto !important; DISPLAY: inline !important; =
FLOAT: left
}
#radio_fields LABEL {
	LINE-HEIGHT: 1.65em !important; MARGIN-RIGHT: 0.5em
}
LABEL#srch_from {
	PADDING-LEFT: 24.4%; WIDTH: 100px; CLEAR: left
}
LABEL#searchYearFrom {
	PADDING-LEFT: 24.4%; WIDTH: 100px; CLEAR: left
}
INPUT#srch_pub_all {
	MARGIN-BOTTOM: 0.5em
}
#short_fields INPUT {
	WIDTH: 2.3em !important; MARGIN-RIGHT: 0.8em
}
#radio_fields INPUT {
	LINE-HEIGHT: 1em !important; MARGIN-TOP: 0em; WIDTH: auto !important; =
CLEAR: none; VERTICAL-ALIGN: top; MARGIN-RIGHT: 0.2em; PADDING-TOP: 0px
}
#from_fields INPUT {
	WIDTH: auto !important; DISPLAY: inline !important; FLOAT: none =
!important; CLEAR: none !important; VERTICAL-ALIGN: middle
}
FIELDSET {
	PADDING-BOTTOM: 0px; BORDER-RIGHT-WIDTH: 0px; MARGIN: 0px; =
PADDING-LEFT: 0px; PADDING-RIGHT: 0px; BORDER-TOP-WIDTH: 0px; =
BORDER-BOTTOM-WIDTH: 0px; BORDER-LEFT-WIDTH: 0px; PADDING-TOP: 0px
}
FORM.advanced_search {
	PADDING-BOTTOM: 1em; MARGIN: 1em 0px 1.5em; PADDING-LEFT: 1em; =
PADDING-RIGHT: 1em; BACKGROUND: #dee4f0; PADDING-TOP: 1em
}
* HTML FORM.advanced_search {
	MARGIN: 0px
}
.advanced_search {
	MARGIN-BOTTOM: 1em !important
}
FORM.advanced_search P {
	CLEAR: both
}
LABEL#label_srch_dates {
	WIDTH: 20.5% !important; DISPLAY: block; CLEAR: left
}
FIELDSET#radio_fields {
	PADDING-TOP: 1em
}
FIELDSET#misc_fields {
	PADDING-TOP: 1em
}
INPUT.srch_submit {
	MARGIN-TOP: 0.2em !important; WIDTH: 8em !important; FLOAT: left; =
MARGIN-LEFT: 0.5em !important
}
INPUT.srch_reset {
	MARGIN-TOP: 0.2em !important; WIDTH: 8em !important; FLOAT: left; =
MARGIN-LEFT: 0.5em !important
}
INPUT.srch_reset {
	MARGIN: 0.5em 0px 0px; DISPLAY: block
}
#search_tips {
	PADDING-BOTTOM: 1em; MARGIN-TOP: 0em; PADDING-LEFT: 1em; WIDTH: 700px; =
PADDING-RIGHT: 1em; MARGIN-BOTTOM: 1em; BACKGROUND: #e9ece3; CLEAR: =
left; MARGIN-RIGHT: 20px; PADDING-TOP: 1em
}
#search_tips H3 {
=09
}
#search_tips UL {
	MARGIN: 1em 2em 1em 2.2em
}
#search_tips UL LI {
	MARGIN-BOTTOM: 0.5em
}
DIV.cell_journals {
	MARGIN-TOP: 3px; WIDTH: 290px; FLOAT: left
}
DIV.jrnl_main {
=09
}
DIV.cell_journals INPUT {
	LINE-HEIGHT: 12px !important; CLEAR: left
}
DIV.cell_journals LABEL {
	LINE-HEIGHT: 12px !important; PADDING-LEFT: 7px !important; WIDTH: =
140px; DISPLAY: block; CLEAR: right; FONT-WEIGHT: normal
}
.error_note {
	CLEAR: both
}
#info1 {
	DISPLAY: none
}
#info2 {
	DISPLAY: none
}
.ecomm_submit_buttons {
	PADDING-BOTTOM: 20px; PADDING-LEFT: 0px; PADDING-RIGHT: 0px; CLEAR: =
both; PADDING-TOP: 25px
}
.reg_note {
	DISPLAY: block !important; COLOR: #333; MARGIN-LEFT: 20em !important; =
CLEAR: both !important; FONT-SIZE: 0.9em
}
.basket_price {
	FONT-WEIGHT: bold
}
.basket_subtotal {
	FONT-SIZE: 1.1em
}
#basket {
	MARGIN-TOP: 10px
}
.basket_billing {
	PADDING-BOTTOM: 15px; MARGIN: 15px 15px 15px 0px; PADDING-LEFT: 15px; =
WIDTH: 265px; PADDING-RIGHT: 15px; BACKGROUND: #fff; FLOAT: left; =
PADDING-TOP: 0px
}
.basket_billing H3 {
	PADDING-BOTTOM: 0px; MARGIN-TOP: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; PADDING-TOP: 0px
}
.registerform H3 {
	CLEAR: both
}
#promoCode {
	WIDTH: 243px
}
P.price {
	COLOR: #005587; FONT-SIZE: 1.4em
}
SPAN.price-note {
	PADDING-LEFT: 20px; COLOR: #333; FONT-SIZE: 0.65em; FONT-WEIGHT: normal
}
INPUT#clearbutton {
	MARGIN: 0px 4px 0px 9.5em; WIDTH: 7em !important
}
* HTML INPUT#clearbutton {
	MARGIN: 0px 0.4em 0px 4.75em
}
P.note {
	COLOR: #8e0101; FONT-WEIGHT: bold
}
#rss {
	PADDING-BOTTOM: 1em; PADDING-LEFT: 1em; WIDTH: 400px; PADDING-RIGHT: =
1em; BACKGROUND: #dee4f0; PADDING-TOP: 0.5em
}
.search_highlighter {
	BACKGROUND: #ff0
}
#main_content TD .search_highlighter {
	COLOR: #000 !important
}
#main_content H3 .search_highlighter {
	COLOR: #000 !important
}
#article_options SPAN.search_highlighter {
	BACKGROUND-COLOR: transparent !important
}
#article_outline SPAN.search_highlighter {
	BACKGROUND-COLOR: transparent !important
}
P.article_doi SPAN.search_highlighter {
	BACKGROUND-COLOR: transparent !important
}
P.article_source SPAN.search_highlighter {
	BACKGROUND-COLOR: transparent !important
}
#article_options UL LI {
	MARGIN-BOTTOM: 3px
}
#left_column UL LI {
	MARGIN-BOTTOM: 3px
}
#article_options UL LI {
	BACKGROUND: none transparent scroll repeat 0% 0%
}
#article_options UL LI A {
	BACKGROUND: none transparent scroll repeat 0% 0%
}
#subscribe_sum {
	MARGIN-TOP: 10px; WIDTH: 582px; BACKGROUND: #fff; CLEAR: both
}
#subscribe_sum TD {
	PADDING-BOTTOM: 4px; PADDING-LEFT: 4px; PADDING-RIGHT: 4px; COLOR: =
#005587; FONT-WEIGHT: bold; PADDING-TOP: 4px
}
#subscribe_sum TD A {
	WIDTH: 1.4em; DISPLAY: block; BACKGROUND: #4b7639; COLOR: #fff; =
FONT-SIZE: 0.8em; TEXT-DECORATION: none
}
#subscribe_sum TD A:hover {
	BACKGROUND: #005587
}
#subscribe_sum TD A {
	BORDER-RIGHT-WIDTH: 0px; MARGIN: 0px auto; WIDTH: 1.4em; DISPLAY: =
block; BACKGROUND: #4b7639; BORDER-TOP-WIDTH: 0px; BORDER-BOTTOM-WIDTH: =
0px; COLOR: #fff; FONT-SIZE: 0.8em; BORDER-LEFT-WIDTH: 0px; =
TEXT-DECORATION: none
}
#subscribe_sum INPUT.submit {
	TEXT-ALIGN: center; PADDING-BOTTOM: 0px; BORDER-RIGHT-WIDTH: 0px; =
PADDING-LEFT: 0px; WIDTH: 20px; PADDING-RIGHT: 0px; BACKGROUND: #4b7639; =
FLOAT: none !important; BORDER-TOP-WIDTH: 0px; BORDER-BOTTOM-WIDTH: 0px; =
COLOR: #fff; FONT-SIZE: 0.9em; VERTICAL-ALIGN: bottom; =
BORDER-LEFT-WIDTH: 0px; PADDING-TOP: 0px
}
#subscribe_sum FORM {
	TEXT-ALIGN: center; PADDING-BOTTOM: 0px !important; MARGIN: 0px; =
PADDING-LEFT: 0px !important; PADDING-RIGHT: 0px !important; =
PADDING-TOP: 0px !important
}
#subscribe_sum FORM.radioform {
	TEXT-ALIGN: left !important
}
#subscribe_sum TH {
	PADDING-BOTTOM: 5px; PADDING-LEFT: 4px; PADDING-RIGHT: 4px; =
FONT-WEIGHT: bold; PADDING-TOP: 5px
}
A#login_fpw {
	PADDING-LEFT: 2.2em; WIDTH: 6.7em; DISPLAY: block !important; FLOAT: =
left; FONT-SIZE: 0.8em !important
}
#remember_inline_label {
	PADDING-BOTTOM: 0.4em; PADDING-LEFT: 0.25em; WIDTH: 10em; FLOAT: left =
!important; CLEAR: none !important; FONT-SIZE: 0.8em !important
}
#main_content #select_product .alert {
	WIDTH: 565px !important
}
.infobubble {
	Z-INDEX: 100000; BORDER-BOTTOM: #4b7837 2px solid; POSITION: absolute; =
BORDER-LEFT: #4b7837 2px solid; PADDING-BOTTOM: 10px; BACKGROUND-COLOR: =
#efefef; TEXT-INDENT: -1px; PADDING-LEFT: 10px; WIDTH: 290px; =
PADDING-RIGHT: 10px; DISPLAY: none; FONT-SIZE: 1.1em; BORDER-TOP: =
#4b7837 2px solid; TOP: 0px; BORDER-RIGHT: #4b7837 2px solid; =
PADDING-TOP: 8px; LEFT: -317px
}
.infobubble A {
	DISPLAY: inline !important
}
.mlktScroll {
	BORDER-BOTTOM: #cccccc 1px solid; BORDER-LEFT: #cccccc 1px solid; =
PADDING-BOTTOM: 2px; BACKGROUND-COLOR: #ffffff; PADDING-LEFT: 2px; =
WIDTH: 270px; PADDING-RIGHT: 2px; HEIGHT: 100px; OVERFLOW: auto; =
BORDER-TOP: #cccccc 1px solid; BORDER-RIGHT: #cccccc 1px solid; =
PADDING-TOP: 2px
}
.mlktLink {
	Z-INDEX: 100000; POSITION: relative; WIDTH: 280px
}
#fulltext_body .mlktLink {
	WIDTH: 140px
}
.mlktEmpty {
	PADDING-BOTTOM: 5px; BACKGROUND-COLOR: #ffffff; PADDING-LEFT: 5px; =
PADDING-RIGHT: 5px; PADDING-TOP: 5px
}
P.article_type {
	COLOR: #bab5a2; FONT-SIZE: 1.4em; FONT-WEIGHT: bold
}
#article_abstract H2 {
	COLOR: #1e1c1d
}
#article_outline {
	POSITION: fixed; PADDING-BOTTOM: 0px; PADDING-LEFT: 0px; WIDTH: 160px; =
PADDING-RIGHT: 0px; MARGIN-BOTTOM: 115px; BACKGROUND: =
url(../../images/left_panel_bottom.gif) no-repeat 0px 100%; HEIGHT: =
auto; FONT-SIZE: 0.9em; TOP: 267px; MARGIN-RIGHT: 1%; PADDING-TOP: 0px; =
LEFT: 10px
}
#archive_outline {
	PADDING-BOTTOM: 4px; PADDING-LEFT: 0px; WIDTH: 160px; PADDING-RIGHT: =
0px; MARGIN-BOTTOM: 25px; BACKGROUND: =
url(../../images/left_panel_bottom.gif) no-repeat 0px 100%; HEIGHT: =
auto; MARGIN-LEFT: 10px; FONT-SIZE: 0.9em; TOP: 267px; MARGIN-RIGHT: 1%; =
PADDING-TOP: 0px
}
* HTML #article_outline {
	HEIGHT: 220px
}
* HTML #archive_outline {
	HEIGHT: 220px
}
* HTML #archive_outline {
	MARGIN-TOP: 60px !important; HEIGHT: 220px
}
#article_outline_list {
	MARGIN: 7px 7px 10px 0px; MAX-HEIGHT: 160px !important; OVERFLOW: auto
}
#article_outline_list_archive {
	MARGIN: 7px 7px 10px 0px; MAX-HEIGHT: 160px !important; OVERFLOW: auto
}
BODY.toc #article_outline_list {
	WIDTH: 135px
}
DIV.outline_closed DIV#article_outline {
	DISPLAY: none
}
DIV.info_outline_closed DIV#article_options {
	DISPLAY: none
}
#article_options UL {
	MARGIN-TOP: 0px
}
DIV.outline_closed DIV#article_outline UL {
	DISPLAY: none !important
}
DIV.outline_closed DIV#article_outline H4 {
	DISPLAY: none !important
}
#article_outline UL LI A {
	LINE-HEIGHT: 1.4em; PADDING-RIGHT: 4px; DISPLAY: block; FONT-SIZE: 1em; =
TEXT-DECORATION: none
}
#article_outline UL LI A:hover {
	TEXT-DECORATION: underline !important
}
A#open_link {
	POSITION: fixed; TEXT-ALIGN: center; WIDTH: 45px; DISPLAY: none; =
BACKGROUND: url(../../images/outline_open.jpg) no-repeat left top; =
HEIGHT: 146px; COLOR: #fff; TOP: 267px; FONT-WEIGHT: bold; =
TEXT-DECORATION: none; LEFT: 10px
}
A#open_link IMG {
	POSITION: absolute; DISPLAY: none; TOP: 16px; LEFT: 19px
}
A#open_link:hover IMG {
	DISPLAY: block !important
}
A#open_info_link {
	POSITION: relative; TEXT-ALIGN: center; WIDTH: 45px; DISPLAY: none; =
BACKGROUND: url(../../images/outline_info_open.jpg) no-repeat left top; =
HEIGHT: 146px; COLOR: #fff; MARGIN-LEFT: 10px; FONT-WEIGHT: bold; =
TEXT-DECORATION: none
}
A#open_info_link IMG {
	POSITION: absolute; DISPLAY: none; TOP: 119px; LEFT: 17px
}
A#open_info_link:hover IMG {
	DISPLAY: block !important
}
A#close_link {
	POSITION: absolute; FONT-SIZE: 0.9em; TOP: 15px; RIGHT: 12px
}
#close_info_link {
	POSITION: absolute; COLOR: #a0412f; FONT-SIZE: 0.9em; TOP: 20px; RIGHT: =
30px; TEXT-DECORATION: none
}
A#close_link:hover {
	COLOR: #4b7837 !important
}
A#close_info_link:hover {
	COLOR: #4b7837 !important
}
BODY.outline_closed DIV#article_outline {
	DISPLAY: none
}
BODY.outline_closed {
=09
}
BODY.outline_closed DIV#article_outline UL {
	DISPLAY: none !important
}
BODY.outline_closed DIV#article_outline H4 {
	DISPLAY: none !important
}
* HTML {
	BACKGROUND-IMAGE: url(../../images/spacer.gif); BACKGROUND-ATTACHMENT: =
fixed; BACKGROUND-REPEAT: no-repeat
}
* HTML #link_holder {
	POSITION: absolute; DISPLAY: block; TOP: 0px; LEFT: 10px
}
* HTML DIV#link_holder {
	; TOP: expression( ( 13 + ( ignoreMe =3D =
document.documentElement.scrollTop ? document.documentElement.scrollTop =
:=20
document.body.scrollTop ) ) + 'px' ); ; LEFT: expression( ( 10 + ( =
ignoreMe2 =3D document.documentElement.scrollLeft ? =
document.documentElement.scrollLeft :=20
document.body.scrollLeft ) ) + 'px' )
}
* HTML #article_outline {
	POSITION: absolute; MARGIN-TOP: 13px; TOP: 0px; LEFT: 0px
}
* HTML #toc_outline {
	POSITION: absolute; MARGIN-TOP: 13px; TOP: 0px; LEFT: 0px
}
* HTML DIV#article_outline {
	; TOP: expression( ( 0 + ( ignoreMe =3D =
document.documentElement.scrollTop ? document.documentElement.scrollTop =
:=20
document.body.scrollTop ) ) + 'px' ); ; LEFT: expression( ( 10 + ( =
ignoreMe2 =3D document.documentElement.scrollLeft ? =
document.documentElement.scrollLeft :=20
document.body.scrollLeft ) ) + 'px' )
}
* HTML DIV#toc_outline {
	; TOP: expression( ( 0 + ( ignoreMe =3D =
document.documentElement.scrollTop ? document.documentElement.scrollTop =
:=20
document.body.scrollTop ) ) + 'px' ); ; LEFT: expression( ( 10 + ( =
ignoreMe2 =3D document.documentElement.scrollLeft ? =
document.documentElement.scrollLeft :=20
document.body.scrollLeft ) ) + 'px' )
}
H2#top_title {
	COLOR: #1e1c1d
}
#fulltext_body H3 {
	TEXT-TRANSFORM: uppercase
}
#main_content H4 {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; COLOR: #a0412f; PADDING-TOP: 0px
}
#main_fulltext_content H4 {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; COLOR: #a0412f; PADDING-TOP: 0px
}
A.ja50-ce-cross-ref {
	TEXT-DECORATION: none
}
.ja50-figure {
	BORDER-BOTTOM: #005587 1px solid; BORDER-LEFT: #005587 1px solid; =
PADDING-BOTTOM: 10px; PADDING-LEFT: 10px; PADDING-RIGHT: 10px; =
MARGIN-BOTTOM: 1em; BACKGROUND: #e6ebf0; BORDER-TOP: #005587 1px solid; =
BORDER-RIGHT: #005587 1px solid; PADDING-TOP: 10px
}
DIV.large-figure {
	OVERFLOW-X: auto
}
.figbox {
	BORDER-BOTTOM: #333 1px solid; BORDER-LEFT: #333 1px solid; =
PADDING-BOTTOM: 10px; PADDING-LEFT: 10px; PADDING-RIGHT: 10px; =
BACKGROUND: #efefef; BORDER-TOP: #333 1px solid; BORDER-RIGHT: #333 1px =
solid; PADDING-TOP: 10px
}
.article_figure TD IMG {
	BORDER-BOTTOM: #005587 1px solid; BORDER-LEFT: #005587 1px solid; =
BORDER-TOP: #005587 1px solid; MARGIN-RIGHT: 1em; BORDER-RIGHT: #005587 =
1px solid
}
.article_figure TD A:hover IMG {
	BORDER-BOTTOM: #333 1px solid; BORDER-LEFT: #333 1px solid; =
PADDING-BOTTOM: 1px; PADDING-LEFT: 1px; PADDING-RIGHT: 1px; BORDER-TOP: =
#333 1px solid; MARGIN-RIGHT: 1em; BORDER-RIGHT: #333 1px solid; =
PADDING-TOP: 1px
}
.ja50-ce-label {
	COLOR: #a0412f; FONT-WEIGHT: bold
}
.ja50-ce-caption {
	PADDING-TOP: 1em
}
.article_figure_versions {
	MARGIN-TOP: 2em
}
.article_figure_versions A {
	COLOR: #a0412f; MARGIN-RIGHT: 2em
}
#main_content P.sub_buttons A.button {
	TEXT-ALIGN: center !important; PADDING-BOTTOM: 4px !important; MARGIN: =
0px; PADDING-LEFT: 4px !important; WIDTH: 200px !important; =
PADDING-RIGHT: 4px !important; PADDING-TOP: 4px !important
}
#main_content_popup {
	POSITION: relative; PADDING-BOTTOM: 10px; PADDING-LEFT: 10px; WIDTH: =
600px; PADDING-RIGHT: 10px; PADDING-TOP: 10px
}
A#close_popup {
	TEXT-ALIGN: right; PADDING-BOTTOM: 4px; PADDING-LEFT: 4px; =
PADDING-RIGHT: 4px; DISPLAY: block; MARGIN-BOTTOM: 1.2em; BACKGROUND: =
#005587; COLOR: #fff; FONT-WEIGHT: bold; TEXT-DECORATION: none; =
PADDING-TOP: 4px
}
A#close_popup:hover {
	TEXT-DECORATION: underline
}
.left_box {
	HEIGHT: 16em
}
.right_box {
	HEIGHT: 16em
}
#main_supp {
	MAX-WIDTH: 650px
}
* HTML #main_supp {
	WIDTH: 650px
}
#main_supp DL {
	PADDING-BOTTOM: 1em; MARGIN: 0px
}
#main_supp DT {
	MARGIN-TOP: 1em; MARGIN-BOTTOM: 0.3em; FONT-WEIGHT: normal
}
#journal_price {
	DISPLAY: block; FLOAT: left; MARGIN-LEFT: 100px
}
* HTML #journal_price {
	MARGIN-LEFT: 80px
}
P#priceContainer STRONG.label {
	LINE-HEIGHT: 1em; WIDTH: 24.5%; COLOR: #000
}
#add_button {
	MARGIN-TOP: 30px; DISPLAY: block; FLOAT: right; MARGIN-RIGHT: 31px
}
#update_button {
	FLOAT: right; MARGIN-RIGHT: 31px !important
}
* HTML #add_button {
	MARGIN-RIGHT: 16px !important
}
* HTML #update_button {
	MARGIN-RIGHT: 16px !important
}
* HTML INPUT.continue {
	MARGIN-RIGHT: 16px !important
}
#discountCode {
	WIDTH: 280px
}
#article_abstract H2 {
	COLOR: #1e1c1d
}
A#rss_link {
	PADDING-BOTTOM: 21px; LINE-HEIGHT: 45px; MARGIN: 0px 0px 15px 15px; =
PADDING-LEFT: 26px; WIDTH: 100%; PADDING-RIGHT: 0px; BACKGROUND: =
url(../../../images/rss_icon.gif) no-repeat 0px 0px; HEIGHT: 20px; =
TEXT-DECORATION: none; PADDING-TOP: 3px
}
#main_content H2.advanced A {
	Z-INDEX: -1; POSITION: absolute; MARGIN: 0px; COLOR: #005587; =
FONT-SIZE: 0.8em; TOP: 5px; RIGHT: 0px; TEXT-DECORATION: none
}
#checkbox_fields {
	MARGIN-TOP: 8px; MARGIN-BOTTOM: 0.5em
}
#main_supp H2 {
	COLOR: #1e1c1d
}
P.article_supplement {
	PADDING-BOTTOM: 0px; MARGIN: 0px 0px 5px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; COLOR: #a0412f; FONT-SIZE: 1.3em; FONT-WEIGHT: bold; =
PADDING-TOP: 0px
}
.article_comment {
	PADDING-BOTTOM: 20px; PADDING-LEFT: 20px; PADDING-RIGHT: 20px; =
MARGIN-BOTTOM: 25px; BACKGROUND: #dee4f0; PADDING-TOP: 10px
}
A.top {
	MARGIN-TOP: 10px; DISPLAY: block; COLOR: #005587; FONT-WEIGHT: bold
}
#main_supp H3 {
	MARGIN-BOTTOM: 10px; CLEAR: both
}
#main_content_popup {
	POSITION: relative; PADDING-BOTTOM: 10px; PADDING-LEFT: 10px; WIDTH: =
600px; PADDING-RIGHT: 10px; PADDING-TOP: 10px
}
#feedback_popup {
	MAX-WIDTH: 480px
}
* HTML #feedback_popup {
	WIDTH: 480px
}
.popup_caption {
	BORDER-BOTTOM: #ccc 2px solid; BORDER-LEFT: #ccc 2px solid; =
PADDING-BOTTOM: 0.3em; PADDING-LEFT: 0.3em; PADDING-RIGHT: 0.3em; =
BORDER-TOP: #ccc 2px solid; BORDER-RIGHT: #ccc 2px solid; PADDING-TOP: =
0.3em
}
.popup_caption P {
	MARGIN-TOP: 0px
}
A#close_popup {
	TEXT-ALIGN: right; PADDING-BOTTOM: 4px; PADDING-LEFT: 4px; =
PADDING-RIGHT: 4px; DISPLAY: block; MARGIN-BOTTOM: 1.2em; BACKGROUND: =
#005587; COLOR: #fff; FONT-WEIGHT: bold; TEXT-DECORATION: none; =
PADDING-TOP: 4px
}
A#close_popup:hover {
	TEXT-DECORATION: underline
}
#main_content_popup .article_figure_versions {
	MARGIN: 0.75em 0px
}
BODY.popup #expander {
	WIDTH: 650px !important; OVERFLOW: hidden
}
BODY.popup #expander {
	BACKGROUND: none transparent scroll repeat 0% 0%
}
BODY.popup #main_content {
	WIDTH: 650px !important; OVERFLOW: hidden
}
#adv_jnrl_holder {
	WIDTH: 450px; FLOAT: left
}
#purchase_sub {
	TEXT-ALIGN: center !important; WIDTH: 28em
}
#expander #purchase_sub INPUT.button {
	TEXT-ALIGN: center; MARGIN: 0px 2em; WIDTH: 22em !important; DISPLAY: =
block !important; FONT-FAMILY: arial,verdana, helvetica
}
.registerform SELECT.exp {
	WIDTH: 120px !important; MARGIN-RIGHT: 5px
}
#registerStatus {
	HEIGHT: 20px
}
STRONG.pages {
	PADDING-LEFT: 1em
}
H2#leading_edge {
	COLOR: #a0412f !important
}
H2#research {
	COLOR: #02558b !important
}
#toc_panel UL {
	MARGIN-TOP: 15px
}
#toc_panel UL LI {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; PADDING-TOP: 0px
}
#toc_panel UL LI A {
	PADDING-BOTTOM: 10px; DISPLAY: block; COLOR: #a0412f; FONT-WEIGHT: =
bold; TEXT-DECORATION: none
}
#toc_panel UL LI A:hover {
	TEXT-DECORATION: underline
}
#toc_panel H4 {
	PADDING-LEFT: 15px; PADDING-RIGHT: 15px; FONT-SIZE: 1em; FONT-WEIGHT: =
normal
}
.login_box .ecomm_submit_buttons {
	PADDING-TOP: 10px !important
}
#add_j_button {
	WIDTH: 9.2em
}
P.caption {
	PADDING-BOTTOM: 0px !important; MARGIN: 0px; PADDING-LEFT: 0px =
!important; PADDING-RIGHT: 0px !important; PADDING-TOP: 0px !important
}
#archive_panel {
	POSITION: absolute; WIDTH: 100%; BACKGROUND: #fff; HEIGHT: 240px; TOP: =
250px; PADDING-TOP: 10px; LEFT: 0px
}
#year_selector {
	POSITION: relative; WIDTH: 180px; BACKGROUND: #e9ece3; FLOAT: left; =
HEIGHT: 200px; FONT-SIZE: 0.85em; MARGIN-RIGHT: 10px; PADDING-TOP: 40px
}
#year_selector LABEL {
	POSITION: absolute; TEXT-ALIGN: center; WIDTH: 170px; DISPLAY: block; =
COLOR: #a0412f; FONT-SIZE: 1.3em; TOP: 10px; FONT-WEIGHT: bold; LEFT: =
10px
}
#year_selector SELECT {
	MARGIN: 0px auto; WIDTH: 5em; DISPLAY: block; HEIGHT: 200px
}
#archive_panel TABLE {
	WIDTH: 900px; FLOAT: left; MARGIN-LEFT: 10px
}
#pb-productslider {
	Z-INDEX: 0; LIST-STYLE-TYPE: none
}
#pb-productslider .pb-productimage {
	LIST-STYLE-TYPE: none
}
#subscribe_sum TD INPUT.radio {
	PADDING-BOTTOM: 0px !important; LINE-HEIGHT: 30px; PADDING-LEFT: 0px =
!important; WIDTH: 30px !important; PADDING-RIGHT: 0px !important; =
DISPLAY: block; BACKGROUND: #fff; FLOAT: left; VERTICAL-ALIGN: middle =
!important; PADDING-TOP: 0px !important
}
#subscribe_sum TD.radiocell {
	VERTICAL-ALIGN: bottom
}
#subscribe_sum TD P {
	DISPLAY: inline
}
#expander .adv_tips {
	BORDER-TOP: #fff 34px solid
}
#renewJournalForm TD.updated-price {
	COLOR: #4b7837 !important
}
P.vsp_sub {
	PADDING-BOTTOM: 0px; MARGIN: 14px 0px 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; COLOR: #a0412f; FONT-SIZE: 1.2em; FONT-WEIGHT: bold; =
PADDING-TOP: 0px
}
P.vsp_fulltext_sub {
	PADDING-BOTTOM: 0px; MARGIN: 10px 0px; PADDING-LEFT: 0px; =
PADDING-RIGHT: 0px; COLOR: #a0412f; FONT-SIZE: 1.2em; FONT-WEIGHT: bold; =
PADDING-TOP: 0px
}
#article_text P {
	LINE-HEIGHT: 1.6em
}
DIV.summary {
	LINE-HEIGHT: 1.6em
}
DIV.ja50-ce-caption {
	LINE-HEIGHT: 1.6em
}
.ja50-ce-table {
	BORDER-BOTTOM: #4b7837 1px solid; BORDER-LEFT: #4b7837 1px solid; =
PADDING-BOTTOM: 4px; OVERFLOW-Y: visible; MIN-HEIGHT: 100px; =
PADDING-LEFT: 4px; PADDING-RIGHT: 10px; MARGIN-BOTTOM: 10px; BACKGROUND: =
#e9ece3; HEIGHT: auto; OVERFLOW: scroll; BORDER-TOP: #4b7837 1px solid; =
BORDER-RIGHT: #4b7837 1px solid; PADDING-TOP: 4px
}
* HTML .ja50-ce-table {
	WIDTH: 566px; OVERFLOW: hidden
}
* HTML .outline_closed .ja50-ce-table {
	WIDTH: 686px
}
.ja50-table TH {
	PADDING-RIGHT: 5px !important; WHITE-SPACE: nowrap
}
.ja50-table TD {
	PADDING-RIGHT: 5px !important; WHITE-SPACE: nowrap
}
#expander TD.ja50-article-history {
	WIDTH: 100%; WHITE-SPACE: nowrap
}
.ja50-ce-table {
	FONT-SIZE: 0.9em
}
.ja50-table-body {
	PADDING-TOP: 5px
}
.ja50-table TH {
	BORDER-BOTTOM: #333 1px solid; TEXT-ALIGN: left; PADDING-BOTTOM: 5px; =
PADDING-LEFT: 0px; PADDING-RIGHT: 0px; BORDER-TOP: #333 1px solid; =
PADDING-TOP: 5px
}
.ja50-table-header-cell {
	PADDING-BOTTOM: 0.4em; COLOR: #4b7837; FONT-SIZE: 1em; FONT-WEIGHT: =
bold
}
.ja50-article-history {
	BORDER-TOP: #4b7837 1px solid; PADDING-TOP: 0.4em
}
BODY.home #cover_plus {
	PADDING-BOTTOM: 15px; DISPLAY: block
}
#coverpopup {
	Z-INDEX: 99999999; BORDER-BOTTOM: #ccc 2px solid; POSITION: absolute; =
TEXT-ALIGN: justify; BORDER-LEFT: #ccc 2px solid; PADDING-BOTTOM: 20px; =
PADDING-LEFT: 20px; WIDTH: 691px; PADDING-RIGHT: 20px; DISPLAY: none; =
BACKGROUND: #dee4f0; FONT-SIZE: 0.9em; OVERFLOW: auto; BORDER-TOP: #ccc =
2px solid; TOP: 25px; BORDER-RIGHT: #ccc 2px solid; PADDING-TOP: 20px; =
LEFT: 152px
}
#coverpopup IMG {
	BORDER-BOTTOM: #000 1px solid; TEXT-ALIGN: center; BORDER-LEFT: #000 =
1px solid; PADDING-BOTTOM: 8px; MARGIN: 0px auto; PADDING-LEFT: 8px; =
PADDING-RIGHT: 8px; DISPLAY: block; BACKGROUND: #fff; BORDER-TOP: #000 =
1px solid; BORDER-RIGHT: #000 1px solid; PADDING-TOP: 8px
}
#coverpopup H3 {
	TEXT-ALIGN: center; MARGIN: 5px 0px; COLOR: #a0412f !important; =
FONT-SIZE: 1.2em !important
}
#coverpopup A#close_popup {
	POSITION: absolute; TEXT-ALIGN: center; WIDTH: 20px; DISPLAY: block; =
BACKGROUND: none transparent scroll repeat 0% 0%; COLOR: #333; =
FONT-SIZE: 1.2em; TOP: 10px; RIGHT: 10px; FONT-WEIGHT: bold
}
#coverpopup A#close_popup:hover {
	BACKGROUND: #4b7837; COLOR: #fff; TEXT-DECORATION: none
}
#console FORM#defaultLoginForm {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 2px; PADDING-RIGHT: =
0px; DISPLAY: inline; BACKGROUND: 0px 50%; PADDING-TOP: 0px
}
INPUT#login_link {
	BORDER-RIGHT-WIDTH: 0px !important; WIDTH: 36px !important; =
BORDER-TOP-WIDTH: 0px !important; BORDER-BOTTOM-WIDTH: 0px !important; =
BORDER-LEFT-WIDTH: 0px !important; MARGIN-RIGHT: 3px
}
#expander #renewNow {
	COLOR: #a0412f !important
}
#article_text P A {
	COLOR: #005587
}
#article_text #article_meta P A {
	COLOR: #000; TEXT-DECORATION: none
}
#article_text P A:hover {
	TEXT-DECORATION: underline
}
.ja50-table-header-cell {
	WHITE-SPACE: nowrap
}
#sub_ind {
	PADDING-BOTTOM: 4px; MARGIN-TOP: 5px; PADDING-LEFT: 4px; PADDING-RIGHT: =
4px; BACKGROUND: #fff; PADDING-TOP: 4px
}
#sub_ind H4 {
	PADDING-BOTTOM: 0px; MARGIN: 3px 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; COLOR: #000; PADDING-TOP: 0px
}
#sub_ind H5 {
	PADDING-BOTTOM: 0px; MARGIN: 3px 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; COLOR: #000; PADDING-TOP: 0px
}
#sub_ind H5 {
	FONT-SIZE: 1em
}
#thumb_panel A {
	TEXT-ALIGN: center; MARGIN: 25px auto 15px; DISPLAY: block
}
BODY.wide P.buttons {
	WIDTH: 664px
}
DL.featured {
	PADDING-BOTTOM: 8px; PADDING-LEFT: 8px; PADDING-RIGHT: 8px; BACKGROUND: =
#e6ebf0; PADDING-TOP: 8px; -moz-border-radius: 10px; border-radius: =
10px; -webkit-border-radius: 10px
}
DL.sponsored {
	PADDING-BOTTOM: 8px; PADDING-LEFT: 8px; PADDING-RIGHT: 8px; BACKGROUND: =
#ebf0eb; PADDING-TOP: 8px; -moz-border-radius: 10px; border-radius: =
10px; -webkit-border-radius: 10px
}
.featured_ad .handle {
	DISPLAY: block !important; BACKGROUND: =
url(../../images/right_ad_wide_top.gif) no-repeat 0px 0px
}
.featured_ad {
	BACKGROUND: url(../../images/right_ad_wide_bottom.gif) no-repeat 0px =
100%
}
.featured_ad LI {
	FONT-SIZE: 0.9em
}
.featured_ad DD {
	PADDING-BOTTOM: 10px
}
#main_fulltext_content H5 {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; FONT-SIZE: 1em !important; PADDING-TOP: 0px
}
#ppvback {
	DISPLAY: block; FLOAT: left
}
#subscribe_sum P {
	LINE-HEIGHT: 20px !important
}
#fulltext_body DL DT A {
	COLOR: #005587 !important
}
BODY.toc #main_content SPAN {
	PADDING-BOTTOM: 1px; PADDING-LEFT: 9px; PADDING-RIGHT: 9px; BACKGROUND: =
#005587; COLOR: #fff; FONT-SIZE: 0.9em; FONT-WEIGHT: bold; PADDING-TOP: =
1px
}
BODY.archive #main_content SPAN {
	PADDING-BOTTOM: 1px; PADDING-LEFT: 9px; PADDING-RIGHT: 9px; BACKGROUND: =
#005587; COLOR: #fff; FONT-SIZE: 0.9em; FONT-WEIGHT: bold; PADDING-TOP: =
1px
}
.rel_jrnl {
	COLOR: #005587 !important
}
#issueContainer {
	MARGIN-TOP: 245px; BACKGROUND: url(../../images/left_bg.gif) repeat-y =
left top
}
#issueContainer #main_content {
	BORDER-TOP: #fff 10px solid
}
#expander #issueContainer #left_column {
	BORDER-TOP: #fff 20px solid
}
#expander #issueContainer #right_column {
	BORDER-TOP: #fff 20px solid
}
* HTML #article_outline_list_archive LI {
	PADDING-LEFT: 12px !important
}
#article_outline_list_archive LI UL {
	PADDING-BOTTOM: 0px !important; LIST-STYLE-TYPE: none; PADDING-LEFT: =
0px !important; PADDING-RIGHT: 0px !important; MARGIN-LEFT: 0.1em; =
PADDING-TOP: 0px !important
}
#article_outline_list_archive LI UL LI {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; PADDING-TOP: 0px
}
#article_outline_list_archive LI A {
	PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-LEFT: 0px; PADDING-RIGHT: =
0px; DISPLAY: block; TEXT-DECORATION: none; PADDING-TOP: 0px
}
#article_outline_list_archive LI A:active {
	TEXT-DECORATION: underline
}
#article_outline_list_archive LI A:hover {
	TEXT-DECORATION: underline
}
UL#article_outline_list_archive {
	TEXT-ALIGN: left; PADDING-BOTTOM: 8px; LIST-STYLE-TYPE: none; =
PADDING-LEFT: 8px; PADDING-RIGHT: 10px; MARGIN-BOTTOM: 8px; HEIGHT: =
auto; MAX-HEIGHT: 25em; OVERFLOW: auto; PADDING-TOP: 8px
}
UL#article_outline_list_archive LI UL {
	PADDING-BOTTOM: 0.4em !important; MARGIN: 0px; PADDING-LEFT: 0px =
!important; PADDING-RIGHT: 1em !important; BACKGROUND: #e6ebf0; =
PADDING-TOP: 0.4em !important
}
UL#article_outline_list_archive LI A {
	TEXT-ALIGN: left; MARGIN: 0.5em 0px 0.5em 5px; PADDING-LEFT: 20px; =
DISPLAY: block; BACKGROUND: url(../../images/top_link_arrow_on.gif) #fff =
no-repeat left top; FONT-SIZE: 1.2em; FONT-WEIGHT: bold; =
TEXT-DECORATION: none
}
UL#article_outline_list_archive LI A:hover {
	TEXT-DECORATION: underline
}
UL#article_outline_list_archive LI UL LI A {
	BACKGROUND: none transparent scroll repeat 0% 0%; FONT-SIZE: 1em; =
FONT-WEIGHT: normal; TEXT-DECORATION: none
}
UL#article_outline_list_archive LI UL {
	LIST-STYLE-TYPE: none; MARGIN: 0px
}
* HTML UL#article_outline_list_archive {
	HEIGHT: 23.5em
}
#container {
	BACKGROUND: #fff
}
#productbrowser {
	BACKGROUND: url(/images/scroll_bg.jpg) no-repeat 50% top
}
#pb-productslidertrack {
	BACKGROUND: url(/images/scroll_bar.gif) no-repeat
}
#pb-productsliderhandleimage {
	BACKGROUND: url(/images/scroll_handle.gif) no-repeat
}
BODY.archive {
	BACKGROUND: none transparent scroll repeat 0% 0%
}
BODY.flat {
	BACKGROUND: url(../../images/left_bg.gif) repeat-y left top
}
#toc_panel {
	POSITION: relative; HEIGHT: 1%
}
#panel_nav {
	PADDING-BOTTOM: 5px; PADDING-LEFT: 36px
}
#left_column_flat {
	Z-INDEX: 99999; POSITION: absolute; TOP: 272px; LEFT: 0px
}
.flat #left_column {
	PADDING-TOP: 250px !important
}
* HTML .flat #left_column {
	PADDING-TOP: 410px !important
}
#abstract_body #article_options UL {
	WIDTH: 310px
}
#existing_subs {
	PADDING-BOTTOM: 1em; MARGIN: 1em 0px 1.5em; PADDING-LEFT: 1em; WIDTH: =
460px; PADDING-RIGHT: 1em; BACKGROUND: #fff; PADDING-TOP: 1em
}
#existing_subs TD {
	PADDING-BOTTOM: 0.5em; COLOR: #005587; FONT-WEIGHT: bold; PADDING-TOP: =
0.2em
}
#fulltext_body #article_options {
	POSITION: relative !important
}
DIV#cover_detail {
	WIDTH: 100%; FONT-SIZE: 0.9em
}
DIV#cover_detail IMG {
	TEXT-ALIGN: center; MARGIN: 0px auto 0.7em; DISPLAY: block
}
#bookmark_this {
	POSITION: absolute; DISPLAY: block !important; COLOR: #fff !important; =
TOP: 3px; RIGHT: 20px
}
* HTML #bookmark_this {
	RIGHT: 373px
}
* HTML #fulltext_body #bookmark_this {
	RIGHT: 233px
}
#bookmark_this UL {
	BORDER-BOTTOM: #ccc 1px solid; TEXT-ALIGN: left; BORDER-LEFT: #ccc 1px =
solid; PADDING-BOTTOM: 8px; LIST-STYLE-TYPE: none; PADDING-LEFT: 10px; =
WIDTH: 138px; PADDING-RIGHT: 10px; DISPLAY: none; BACKGROUND: #fff; =
FLOAT: none; MARGIN-LEFT: 2px; BORDER-TOP: #ccc 1px solid; BORDER-RIGHT: =
#ccc 1px solid; PADDING-TOP: 5px
}
#bookmark_this:hover UL {
	DISPLAY: block !important
}
#expander #bookmark_this UL.shown {
	DISPLAY: block !important
}
#bookmark_this UL LI A {
	PADDING-LEFT: 25px; DISPLAY: block; HEIGHT: 22px; FONT-SIZE: 11px; =
TEXT-DECORATION: none
}
#bookmark_this UL LI A:hover {
	COLOR: #333
}
#bookmark_this UL LI {
	BORDER-BOTTOM: #fff 1px solid; POSITION: relative; LINE-HEIGHT: 20px
}
#bookmark_this UL LI IMG {
	POSITION: absolute; TOP: 0px; LEFT: 0px
}
#article_type_holder {
	POSITION: relative
}
DIV#left-col-editors {
=09
}
DIV#left-col-thisweeks {
	PADDING-LEFT: 10px; PADDING-RIGHT: 10px
}
DIV#left-col-editors H3 {
	MARGIN: 0px
}
#article_nav A {
	BORDER-BOTTOM: #bab5a2 1px solid; TEXT-ALIGN: center; BORDER-LEFT: =
#bab5a2 1px solid; PADDING-BOTTOM: 5px; MARGIN-TOP: 10px; PADDING-LEFT: =
10px; WIDTH: 100px; PADDING-RIGHT: 10px; DISPLAY: inline-block; =
MARGIN-BOTTOM: 10px; COLOR: #005587; FONT-SIZE: 11px; BORDER-TOP: =
#bab5a2 1px solid; BORDER-RIGHT: #bab5a2 1px solid; TEXT-DECORATION: =
none; PADDING-TOP: 5px
}
DIV#jobsbox {
	PADDING-BOTTOM: 30px; LINE-HEIGHT: 1.5em; BACKGROUND-COLOR: #e9ece3; =
MARGIN: 20px 0px; PADDING-LEFT: 20px; PADDING-RIGHT: 20px; FONT-SIZE: =
0.9em; PADDING-TOP: 20px; -webkit-border-radius: 10px; =
-moz-border-radius-bottomleft: 10px; -moz-border-radius-bottomright: =
10px; -moz-border-radius-topleft: 10px; -moz-border-radius-topright: =
10px
}
DIV.jt_job_position {
	MARGIN-TOP: 10px; FONT-WEIGHT: bold
}
#free_article {
	POSITION: relative; MARGIN-BOTTOM: -63px; LEFT: 281px
}
* HTML #free_article {
	TOP: 3px
}
*:first-child + HTML #free_article {
	TOP: 3px
}
.right_panel {
	MIN-HEIGHT: 70px; HEIGHT: auto !important; FONT-SIZE: 0.9em
}
#article_rss A {
	TEXT-DECORATION: none !important
}
#article_rss {
	FLOAT: right; FONT-SIZE: 12px; FONT-WEIGHT: normal
}
#article_rss IMG {
	POSITION: relative; TOP: 5px
}
H2 #article_rss {
	POSITION: relative; MARGIN-TOP: -25px; DISPLAY: block
}
#most_read_box #image_a {
	DISPLAY: block; MARGIN-BOTTOM: 15px; MARGIN-LEFT: 15px; =
TEXT-DECORATION: none !important
}
#most_read_box #image_a IMG {
	POSITION: relative; TOP: 5px
}
BODY.toc #main_content SPAN.free {
	BACKGROUND: #e4ddc5; COLOR: #a0412f !important; MARGIN-LEFT: 5px
}
LI.pb-productimage A {
	TEXT-DECORATION: none
}
LI.pb-productimage A SPAN {
	TEXT-DECORATION: underline
}

------=_NextPart_000_0000_01C9B893.36AED2E0
Content-Type: application/octet-stream
Content-Transfer-Encoding: quoted-printable
Content-Location: http://www.cell.com/js/cell/bubble.js

function findPosY(obj) {
    var curtop =3D 0;
    if(obj.offsetParent) {
        while(1) {
            curtop +=3D obj.offsetTop;
            if(!obj.offsetParent) { break; }
            obj =3D obj.offsetParent;
        }
    }
    else if(obj.y) {
        curtop +=3D obj.y;
    }
    return curtop;
}

function getWindowHeight() {
    var windowHeight=3D0;
    if(typeof(window.innerHeight) =3D=3D 'number') {
        windowHeight =3D window.innerHeight;
    }
    else {
        if(document.documentElement && =
document.documentElement.clientHeight) {
            windowHeight =3D document.documentElement.clientHeight;
        }
        else {
            if(document.body && document.body.clientHeight) {
                windowHeight =3D document.body.clientHeight;
            }
        }
    }
    return windowHeight;
}

var OPAC =3D 0;
var InfoBubble =3D {

    bubbleTimeout: 1,
    currentBubble: null,
    timeoutBubbleID: null,
    currentLink: null,

    show: function(aID, bID) {
        var disableFade =3D 0;
        if(this.currentBubble) {
            disableFade =3D 1;
        }
        var aBubble =3D document.getElementById(aID);
        if(aBubble && aBubble !=3D this.currentBubble) {
            this.hide();
            var aBubbleLink =3D document.getElementById(bID);
            aBubbleLink.style.background =3D '#EFEFEF';
            this.currentLink =3D aBubbleLink;
            if(disableFade =3D=3D 0) {
                aBubble.style.filter =3D 'alpha(opacity=3D0)';
                aBubble.style.opacity =3D 0;
            }
            else {
                aBubble.style.filter =3D '';
                aBubble.style.opacity =3D '';
            }
            aBubble.style.display =3D 'inline';
            var heightFromTop =3D findPosY(aBubble) - =
document.body.scrollTop;
            if(getWindowHeight() < (aBubble.offsetHeight + =
heightFromTop)) {
                //aBubble.style.top =3D (getWindowHeight() - =
(aBubble.offsetHeight + heightFromTop)) - 5;
            }
            else {
                if(heightFromTop < 0) {
                    aBubble.style.top =3D (Math.abs(heightFromTop)) + 5;
                }
                else {
                    aBubble.style.top =3D 5;
                }
            }
            this.currentBubble =3D aBubble;
            if(disableFade =3D=3D 0) {
                setTimeout('InfoBubble.fadeIn()',300);
                OPAC =3D 0;
            }
        }

        if(this.timeoutBubbleID) {
            clearTimeout(this.timeoutBubbleID);
        }
    },

    hide: function() {
        if(this.currentBubble) {
            this.currentLink.style.background =3D '#FFFFFF';
            this.currentBubble.style.display =3D 'none';
            this.currentBubble.style.top =3D 0;
            this.currentBubble =3D null;
            if(this.timeoutBubbleID) {
                clearTimeout(this.timeoutBubbleID);
            }=20
        }
    },

    timeout: function() {
        if(OPAC =3D=3D 0) {
            InfoBubble.hide();
        }
        else {
            this.timeoutBubbleID =3D setTimeout('InfoBubble.hide()', =
this.bubbleTimeout * 1000);
        }
    },

    fadeIn: function() {
        if(this.currentBubble) {
            OPAC =3D OPAC + .10;
            OPAC =3D (OPAC>1)?1:OPAC;
            this.currentBubble.style.filter =3D =
'alpha(opacity=3D'+parseInt(100*OPAC)+')';
            this.currentBubble.style.opacity =3D OPAC;
            if(OPAC<1) {
                setTimeout('InfoBubble.fadeIn()',25);
            }
        }
    }
}

------=_NextPart_000_0000_01C9B893.36AED2E0
Content-Type: application/octet-stream
Content-Transfer-Encoding: quoted-printable
Content-Location: http://www.cell.com/js/cell/loginValidator.js

function validateLogin() {
	if(document.getElementById("userName").value=3D=3D"" || =
document.getElementById("password").value=3D=3D"") {
		document.getElementById("loginError").innerHTML =3D "Please enter a =
valid User Name and Password.";
		return false;
	}
	return true;
}

function validateAlertsLogin() {
	if(document.eaLogin.userName.value=3D=3D"" || =
document.eaLogin.password.value=3D=3D"") {
		document.getElementById("alertsLoginError").innerHTML =3D "Please =
enter a valid User Name and Password.";
		return false;
	}
	return true;
}

function validateLoginForDiagnosticPage() {
	if(document.getElementById("userName").value=3D=3D"" || =
document.getElementById("password").value=3D=3D"") {
		return false;
	}
	return true;
}

function validateRenewOnlineLogin() {
	if(document.renewLoginForm.userName.value=3D=3D"" || =
document.renewLoginForm.password.value=3D=3D"") {
		document.getElementById("renewOnlineloginError").innerHTML =3D "Please =
enter a valid User Name and Password.";
		document.getElementById("renewOnlineloginError").className =3D "alert =
errormsg";
		return false;
	}
	return true;
}

------=_NextPart_000_0000_01C9B893.36AED2E0
Content-Type: application/octet-stream
Content-Transfer-Encoding: quoted-printable
Content-Location: http://www.cell.com/js/cell/utils.js

function LTrim( value ) {
=09
	var re =3D /\s*((\S+\s*)*)/;
	return value.replace(re, "$1");
=09
}

// Removes ending whitespaces
function RTrim( value ) {
	var re =3D /((\s*\S+)*)\s*/;
	return value.replace(re, "$1");
=09
}

// Removes leading and ending whitespaces
function trim( value ) {
	return LTrim(RTrim(value));
}

function validateInputField(fieldId, minLength, errorDivId, =
errorMessage) {
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(fieldId).value));
	if(trimmedFieldValue.length < minLength) {
	=09
		setErrorMessage(fieldId,errorMessage);
		return false;
	} else {
		if(document.getElementById(errorDivId).innerHTML !=3D "")
			removeErrorMessage(fieldId);
		return true;
	}
}

function validateInputFieldForSimpleForms(fieldId, minLength, =
errorDivId, errorMessage) {
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(fieldId).value));
	if(trimmedFieldValue.length < minLength) {
		document.getElementById(errorDivId).className =3D "alert errormsg";
		document.getElementById(errorDivId).innerHTML =3D errorMessage;
		document.getElementById(errorDivId).style.display =3D "block";
		return false;
	} else {
	=09
		if(document.getElementById(errorDivId).innerHTML !=3D "")
		{
			document.getElementById(errorDivId).innerHTML =3D "";
			document.getElementById(errorDivId).className =3D "";
			document.getElementById(errorDivId).style.display =3D "none";=09
		}
		return true;
	}
}

function validateActivateInputField(fieldId, minLength, errorDivId, =
errorMessage) {
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(fieldId).value));
	var message =3D document.getElementById(errorDivId).innerHTML;
	if(trimmedFieldValue.length < minLength) {=09
		document.getElementById(errorDivId).innerHTML =3D errorMessage;
		document.getElementById(errorDivId).className =3D "alert errormsg =
alertwide";
		document.getElementById(errorDivId).style.display =3D "block";
		return false;
	}else if(!(message =3D=3D errorMessage)){
		return true;
	}=20
	else {=09
		document.getElementById(errorDivId).innerHTML =3D "";
		document.getElementById(errorDivId).className =3D "";
		document.getElementById(errorDivId).style.display =3D "none";	=09
		return true;
	}
}

function validateActivateInputFieldForSimpleForms(fieldId, minLength, =
errorDivId, errorMessage) {
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(fieldId).value));
	var message =3D document.getElementById(errorDivId).innerHTML;
	if(trimmedFieldValue.length < minLength) {=09
		document.getElementById(errorDivId).innerHTML =3D errorMessage;
		document.getElementById(errorDivId).className =3D "alert errormsg";
		document.getElementById(errorDivId).style.display =3D "block";
		return false;
	}else if(!(message =3D=3D errorMessage)){
		return true;
	}=20
	else {=09
		document.getElementById(errorDivId).innerHTML =3D "";
		document.getElementById(errorDivId).className =3D "";
		document.getElementById(errorDivId).style.display =3D "none";=09
		return true;
	}
}
function validateCustomerNumberInputField(fieldId, minLength, =
errorDivId, errorMessage) {
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(fieldId).value));
	if(trimmedFieldValue.length < minLength) {
=09
		document.getElementById(errorDivId).innerHTML =3D errorMessage;
		return false;
	}=20
	else {
			if(document.getElementById(errorDivId).innerHTML !=3D "")
				document.getElementById(errorDivId).innerHTML =3D "";
			return true;
		}
		return true;
}

function validateSelectField(fieldId, errorDivId, errorMessage) {
	if(document.getElementById(fieldId).selectedIndex=3D=3D0) {
		setErrorMessage(fieldId,errorMessage);
		return false;
	} else {
		removeErrorMessage(fieldId);
		return true;
	}
}

function validateEmailField(emailAddressDivId, errorDivId, errorMessage) =
{
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(emailAddressDivId).value));
	var emailReg =3D =
/^([a-zA-Z0-9_\.\-])+\@(([a-zA-Z0-9\-])+\.)+([a-zA-Z0-9]{2,4})+$/;
	var regex =3D new RegExp(emailReg);
	var valid =3D regex.test(trimmedFieldValue);
	if(valid) {
		if(document.getElementById(errorDivId).innerHTML !=3D "")
			removeErrorMessage(emailAddressDivId,errorMessage);
	} else {
		setErrorMessage(emailAddressDivId,errorMessage);
	}
	return valid;
}

function validateEmailFieldForSimpleForms(emailAddressDivId, errorDivId, =
errorMessage) {
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(emailAddressDivId).value));
	var emailReg =3D =
/^([a-zA-Z0-9_\.\-])+\@(([a-zA-Z0-9\-])+\.)+([a-zA-Z0-9]{2,4})+$/;
	var regex =3D new RegExp(emailReg);
	var valid =3D regex.test(trimmedFieldValue);

	if(valid) {
			if(document.getElementById(errorDivId).innerHTML !=3D ""){
					document.getElementById(errorDivId).innerHTML =3D "";
					document.getElementById(errorDivId).className =3D "";
					document.getElementById(errorDivId).style.display =3D "none";
			}
		} else {
			document.getElementById(errorDivId).innerHTML =3D errorMessage;		=09
			document.getElementById(errorDivId).className =3D "alert errormsg";
			document.getElementById(errorDivId).style.display =3D "block";
		}
	return valid;
}

function validateUserName() {
	return validateInputField('registrationUsername', 6, =
'registrationUsername_error', 'Please enter a User Name that is at least =
6 characters long.');
}

function validatePassword() {
	return validateInputField('registrationPassword', 6, =
'registrationPassword_error', 'Please enter a Password that is at least =
6 characters long.');
}

function validateConfirmPassword() {
	if(document.getElementById('registrationPassword').value !=3D =
document.getElementById('confirmPassword').value) {
		document.getElementById('confirmPassword_error').innerHTML =3D "Please =
ensure the Passwords match.";
		return false;
	} else {
		document.getElementById('confirmPassword_error').innerHTML =3D "";
		return true;
	}=09
}

function doCitationDownload()
{
	var url =3D "about:blank";
    var windowOptions =3D =
"width=3D680,height=3D480,innerWidth=3D680,innerHeight=3D480,top=3D0,left=
=3D50,screenX=3D0,screenY=3D0,scrollbars=3Dyes,resizable=3Dyes,toolbar=3D=
yes,status=3Dyes";   =09
	//var windowOptions =3D =
"width=3D700,height=3D500,left=3D150,top=3D150,screenX=3D150,screenY=3D15=
0,resizable=3Dyes,scrollbars=3Dno";
	var form =3D document.forms["citationExportForm"];
	var popWin =3D window.open(url,"ExportCitations",windowOptions);
    popWin.focus();
    form.target =3D "ExportCitations";
    form.submit();
	return true;
}

/*New Login form*/


function loginform(){
if(document.getElementById('login_link')){
if(document.getElementById('loginError').innerHTML!=3D''){
	document.getElementById('floating_login_form').style.right=3D'0pt';=09
}

var logintoggle =3D document.getElementById('login_link');
logintoggle.onclick=3Dfunction(){
	=
if(document.getElementById('floating_login_form').style.right=3D=3D'20pt'=
){	=09
		document.getElementById('floating_login_form').style.right=3D'9999pt';
	} else {
		document.getElementById('floating_login_form').style.right=3D'20pt';
		document.forms.LoginForm.userName.focus();
	}
	return false;
	}
}
}


function domFunction(f, a)
{
	//initialise the counter
	var n =3D 0;
=09
	//start the timer
	var t =3D setInterval(function()
	{
		//continue flag indicates whether to continue to the next iteration
		//assume that we are going unless specified otherwise
		var c =3D true;

		//increase the counter
		n++;
=09
		//if DOM methods are supported, and the body element exists
		//(using a double-check including document.body, for the benefit of =
older moz builds [eg ns7.1]=20
		//in which getElementsByTagName('body')[0] is undefined, unless this =
script is in the body section)
		if(typeof document.getElementsByTagName !=3D 'undefined' && =
(document.getElementsByTagName('body')[0] !=3D null || document.body =
!=3D null))
		{
			//set the continue flag to false
			//because other things being equal, we're not going to continue
			c =3D false;

			//but ... if the arguments object is there
			if(typeof a =3D=3D 'object')
			{
				//iterate through the object
				for(var i in a)
				{
					//if its value is "id" and the element with the given ID doesn't =
exist=20
					//or its value is "tag" and the specified collection has no members
					if
					(
						(a[i] =3D=3D 'id' && document.getElementById(i) =3D=3D null)
						||
						(a[i] =3D=3D 'tag' && document.getElementsByTagName(i).length < 1)
					)=20
					{=20
						//set the continue flag back to true
						//because a specific element or collection doesn't exist
						c =3D true;=20

						//no need to finish this loop
						break;=20
					}
				}
			}

			//if we're not continuing
			//we can call the argument function and clear the timer
			if(!c) { f(); clearInterval(t); }
		}
	=09
		//if the timer has reached 60 (so timeout after 15 seconds)
		//in practise, I've never seen this take longer than 7 iterations [in =
kde 3=20
		//in second place was IE6, which takes 2 or 3 iterations roughly 5% of =
the time]
		if(n >=3D 60)
		{
			//clear the timer
			clearInterval(t);
		}
	=09
	}, 250);
}


function getElementsByClassName(strClass, strTag, objContElm) {
  strTag =3D strTag || "*";
  objContElm =3D objContElm || document;
  var objColl =3D objContElm.getElementsByTagName(strTag);
  if (!objColl.length &&  strTag =3D=3D "*" &&  objContElm.all) objColl =
=3D objContElm.all;
  var arr =3D new Array();
  var delim =3D strClass.indexOf('|') !=3D -1  ? '|' : ' ';
  var arrClass =3D strClass.split(delim);
  for (var i =3D 0, j =3D objColl.length; i < j; i++) {
    var arrObjClass =3D objColl[i].className.split(' ');
    if (delim =3D=3D ' ' && arrClass.length > arrObjClass.length) =
continue;
    var c =3D 0;
    comparisonLoop:
    for (var k =3D 0, l =3D arrObjClass.length; k < l; k++) {
      for (var m =3D 0, n =3D arrClass.length; m < n; m++) {
        if (arrClass[m] =3D=3D arrObjClass[k]) c++;
        if (( delim =3D=3D '|' && c =3D=3D 1) || (delim =3D=3D ' ' && c =
=3D=3D arrClass.length)) {
          arr.push(objColl[i]);
          break comparisonLoop;
        }
      }
    }
  }
  return arr;
}

function onLoadOfFullText(cont)
{
// To cover IE 5.0's lack of the push method
Array.prototype.push =3D function(value) {
  this[this.length] =3D value;
}
//var cont =3D document.getElementById('main_content');

if(!is_safari){
var crosslinks =3D getElementsByClassName('ja50-ce-cross-ref','a', =
cont);
for(i=3D0;i<crosslinks.length;i++){
=09
	crosslinks[i].onmouseover=3Dfunction(){
		this.parentNode.style.position =3D "static";	=09
		this.style.position =3D "relative";	=09
		myname =3D this.getAttribute('name');
		if(myname.indexOf('bib') !=3D-1){
			refid =3D myname.replace('back-','');
			var newdiv =3D document.createElement('div');
			newdiv.setAttribute('id', refid+'box');
			newdiv.setAttribute('class', 'inlineref');
			newdiv.style.position =3D "absolute";
			newdiv.style.width =3D "24em";
			newdiv.style.padding =3D "5px";
			newdiv.style.color =3D "#333";
			newdiv.style.height =3D "auto";
			=
if(document.getElementById('fulltext_body').className=3D=3D'outline_close=
d'){
				newdiv.style.left =3D "-10px";
			}
			else {
				newdiv.style.left =3D "-12em";
			}
			newdiv.style.zIndex =3D "999999999";
			newdiv.style.fontSize =3D ".9em";
			newdiv.style.textDecoration =3D "none";
			newdiv.style.top =3D "20px";
			newdiv.style.background =3D "#efefef";
			newdiv.style.border =3D "2px solid #005587";
			newdiv.style.display =3D "block";
			reftest =3D document.getElementById(refid).innerHTML;
			reftest =3D  reftest.replace(/<a href[^>]*>[\s\S]+<\/a>/ig,"");
			newdiv.innerHTML =3D reftest;
			this.appendChild(newdiv);
				}
			}

	crosslinks[i].onmouseout=3Dfunction(){
		this.style.position =3D "static";	=09
		myname =3D this.getAttribute('name');
		if(myname.indexOf('bib') !=3D-1){
			refid =3D myname.replace('back-','');
		    var oNodeToRemove =3D document.getElementById(refid+'box');
		    if(oNodeToRemove)
		    oNodeToRemove.parentNode.removeChild(oNodeToRemove);
		}
	}
	}
}
}
function refresh()
{
	var sURL =3D unescape(window.location.pathname);
    window.location.href =3D sURL;
}
function reloadWithParam(paramName , paramValue)
{
	var sURL =3D unescape(window.location.pathname);
	sURL =3D sURL + '?' +paramName +'=3D' + paramValue;
    window.location.href =3D sURL;
}

function archivelist() {

       // if the user clicks on an anchor link within a top-level list =
item in ul#article_outline_list_archive,
       // make the child UL be class 'open'=20
       archivepanel =3D =
document.getElementById('article_outline_list_archive');
       mylinks =3D archivepanel.getElementsByTagName('A');
       for (var i=3D0; i<mylinks.length; i++){
               // only call this function if it's a top level link
               =
if(mylinks[i].parentNode.parentNode.id=3D=3D'article_outline_list_archive=
'){
                mylinks[i].onclick =3D function(){
                       if(this.parentNode.className=3D=3D'open'){
                        this.parentNode.className=3D'closed';
                        }
                       else {
                               this.parentNode.className=3D'open';
                       }
                       return false;
                 }
         }
   }=20
}

function jumpLinks(){
		var outline =3D document.getElementById('article_outline_list');
		if(outline){
		var jumplinks =3D outline.getElementsByTagName('A');
		for(i=3D0;i<jumplinks.length;i++){		=09
			mylinks =3D jumplinks[i].parentNode.getElementsByTagName('UL');
			// skip if there are no lists below this
			if(mylinks.length=3D=3D0){
				jumplinks[i].parentNode.className =3D 'nochildren';
				continue;			=09
				}
			// skip if this tag is not a top-level descendent of the holding list
			if(jumplinks[i].parentNode.parentNode.getAttribute('id') =
!=3D'article_outline_list')
				continue;
			jumplinks[i].onclick=3Dfunction(){
			if(this.parentNode.className=3D=3D'open')
				this.parentNode.className=3D'closed';
			else
				this.parentNode.className=3D'open';
			}
		}
		}
	}
=09




    // convert all characters to lowercase to simplify testing
    var agt=3Dnavigator.userAgent.toLowerCase();
    var appVer =3D navigator.appVersion.toLowerCase();

    // *** BROWSER VERSION ***

    var is_minor =3D parseFloat(appVer);
    var is_major =3D parseInt(is_minor);

    var is_opera =3D (agt.indexOf("opera") !=3D -1);
    var is_opera2 =3D (agt.indexOf("opera 2") !=3D -1 || =
agt.indexOf("opera/2") !=3D -1);
    var is_opera3 =3D (agt.indexOf("opera 3") !=3D -1 || =
agt.indexOf("opera/3") !=3D -1);
    var is_opera4 =3D (agt.indexOf("opera 4") !=3D -1 || =
agt.indexOf("opera/4") !=3D -1);
    var is_opera5 =3D (agt.indexOf("opera 5") !=3D -1 || =
agt.indexOf("opera/5") !=3D -1);
    var is_opera6 =3D (agt.indexOf("opera 6") !=3D -1 || =
agt.indexOf("opera/6") !=3D -1); // 020128- abk
    var is_opera7 =3D (agt.indexOf("opera 7") !=3D -1 || =
agt.indexOf("opera/7") !=3D -1); // 021205- dmr
    var is_opera8 =3D (agt.indexOf("opera 8") !=3D -1 || =
agt.indexOf("opera/8") !=3D -1); // 09-19-2006 jonw=20
    var is_opera9 =3D (agt.indexOf("opera 9") !=3D -1 || =
agt.indexOf("opera/9") !=3D -1); // 09-19-2006 jonw

    var is_opera5up =3D (is_opera && !is_opera2 && !is_opera3 && =
!is_opera4);
    var is_opera6up =3D (is_opera && !is_opera2 && !is_opera3 && =
!is_opera4 && !is_opera5); // new020128
    var is_opera7up =3D (is_opera && !is_opera2 && !is_opera3 && =
!is_opera4 && !is_opera5 && !is_opera6); // new021205 -- dmr
    var is_opera8up =3D (is_opera && !is_opera2 && !is_opera3 && =
!is_opera4 && !is_opera5 && !is_opera6 && !is_opera7); // 09-19-2006 - =
jonw
    var is_opera9up =3D (is_opera && !is_opera2 && !is_opera3 && =
!is_opera4 && !is_opera5 && !is_opera6 && !is_opera7 &&!is_opera8); // =
09-19-2006 - jonw

    // Note: On IE, start of appVersion return 3 or 4
    // which supposedly is the version of Netscape it is compatible =
with.
    // So we look for the real version further on in the string
    // And on Mac IE5+, we look for is_minor in the ua; since=20
    // it appears to be more accurate than appVersion - 06/17/2004

    var is_mac =3D (agt.indexOf("mac")!=3D-1);
    var iePos  =3D appVer.indexOf('msie');
    if (iePos !=3D-1) {
       if(is_mac) {
           var iePos =3D agt.indexOf('msie');
           is_minor =3D =
parseFloat(agt.substring(iePos+5,agt.indexOf(';',iePos)));
       }
       else is_minor =3D =
parseFloat(appVer.substring(iePos+5,appVer.indexOf(';',iePos)));
       is_major =3D parseInt(is_minor);
    }

    // ditto Konqueror
                                     =20
    var is_konq =3D false;
    var kqPos   =3D agt.indexOf('konqueror');
    if (kqPos !=3D-1) {                =20
       is_konq  =3D true;
       is_minor =3D =
parseFloat(agt.substring(kqPos+10,agt.indexOf(';',kqPos)));
       is_major =3D parseInt(is_minor);
    }                                =20

    var is_getElementById   =3D (document.getElementById) ? "true" : =
"false"; // 001121-abk
    var is_getElementsByTagName =3D (document.getElementsByTagName) ? =
"true" : "false"; // 001127-abk
    var is_documentElement =3D (document.documentElement) ? "true" : =
"false"; // 001121-abk

    var is_safari =3D =
((agt.indexOf('safari')!=3D-1)&&(agt.indexOf('mac')!=3D-1))?true:false;
    var is_khtml  =3D (is_safari || is_konq);

    var is_gecko =3D =
((!is_khtml)&&(navigator.product)&&(navigator.product.toLowerCase()=3D=3D=
"gecko"))?true:false;
    var is_gver  =3D 0;
    if (is_gecko) is_gver=3Dnavigator.productSub;

    var is_fb =3D ((agt.indexOf('mozilla/5')!=3D-1) && =
(agt.indexOf('spoofer')=3D=3D-1) &&
                 (agt.indexOf('compatible')=3D=3D-1) && =
(agt.indexOf('opera')=3D=3D-1)  &&
                 (agt.indexOf('webtv')=3D=3D-1) && =
(agt.indexOf('hotjava')=3D=3D-1)     &&
                 (is_gecko) && (navigator.vendor=3D=3D"Firebird"));
    var is_fx =3D ((agt.indexOf('mozilla/5')!=3D-1) && =
(agt.indexOf('spoofer')=3D=3D-1) &&
                 (agt.indexOf('compatible')=3D=3D-1) && =
(agt.indexOf('opera')=3D=3D-1)  &&
                 (agt.indexOf('webtv')=3D=3D-1) && =
(agt.indexOf('hotjava')=3D=3D-1)     &&
                 (is_gecko) && =
((navigator.vendor=3D=3D"Firefox")||(agt.indexOf('firefox')!=3D-1)));
    var is_moz   =3D ((agt.indexOf('mozilla/5')!=3D-1) && =
(agt.indexOf('spoofer')=3D=3D-1) &&
                    (agt.indexOf('compatible')=3D=3D-1) && =
(agt.indexOf('opera')=3D=3D-1)  &&
                    (agt.indexOf('webtv')=3D=3D-1) && =
(agt.indexOf('hotjava')=3D=3D-1)     &&
                    (is_gecko) && (!is_fb) && (!is_fx) &&
                    =
((navigator.vendor=3D=3D"")||(navigator.vendor=3D=3D"Mozilla")||(navigato=
r.vendor=3D=3D"Debian")));
    if ((is_moz)||(is_fb)||(is_fx)) {  // 032504 - dmr
       var is_moz_ver =3D (navigator.vendorSub)?navigator.vendorSub:0;
       if(is_fx&&!is_moz_ver) {
           is_moz_ver =3D agt.indexOf('firefox/');
           is_moz_ver =3D agt.substring(is_moz_ver+8);
           is_moz_ver =3D parseFloat(is_moz_ver);
       }
       if(!(is_moz_ver)) {
           is_moz_ver =3D agt.indexOf('rv:');
           is_moz_ver =3D agt.substring(is_moz_ver+3);
           is_paren   =3D is_moz_ver.indexOf(')');
           is_moz_ver =3D is_moz_ver.substring(0,is_paren);
       }
       is_minor =3D is_moz_ver;
       is_major =3D parseInt(is_moz_ver);
    }
   var is_fb_ver =3D is_moz_ver;
   var is_fx_ver =3D is_moz_ver;

    var is_nav  =3D ((agt.indexOf('mozilla')!=3D-1) && =
(agt.indexOf('spoofer')=3D=3D-1)
                && (agt.indexOf('compatible') =3D=3D -1) && =
(agt.indexOf('opera')=3D=3D-1)
                && (agt.indexOf('webtv')=3D=3D-1) && =
(agt.indexOf('hotjava')=3D=3D-1)
                && (!is_khtml) && (!(is_moz)) && (!is_fb) && (!is_fx));

    // Netscape6 is mozilla/5 + Netscape6/6.0!!!
    // Mozilla/5.0 (Windows; U; Win98; en-US; m18) Gecko/20001108 =
Netscape6/6.0
    // Changed this to use navigator.vendor/vendorSub - dmr 060502  =20
    // var nav6Pos =3D agt.indexOf('netscape6');
    // if (nav6Pos !=3D-1) {
    if ((navigator.vendor)&&
        =
((navigator.vendor=3D=3D"Netscape6")||(navigator.vendor=3D=3D"Netscape"))=
&&
        (is_nav)) {
       is_major =3D parseInt(navigator.vendorSub);
       // here we need is_minor as a valid float for testing. We'll
       // revert to the actual content before printing the result.=20
       is_minor =3D parseFloat(navigator.vendorSub);
    }

    var is_nav2 =3D (is_nav && (is_major =3D=3D 2));
    var is_nav3 =3D (is_nav && (is_major =3D=3D 3));
    var is_nav4 =3D (is_nav && (is_major =3D=3D 4));
    var is_nav4up =3D (is_nav && is_minor >=3D 4);  // changed to =
is_minor for
                                                // consistency - dmr, =
011001
    var is_navonly      =3D (is_nav && ((agt.indexOf(";nav") !=3D -1) ||
                          (agt.indexOf("; nav") !=3D -1)) );

    var is_nav6   =3D (is_nav && is_major=3D=3D6);    // new 010118 mhp
    var is_nav6up =3D (is_nav && is_minor >=3D 6); // new 010118 mhp

    var is_nav5   =3D (is_nav && is_major =3D=3D 5 && !is_nav6); // =
checked for ns6
    var is_nav5up =3D (is_nav && is_minor >=3D 5);

    var is_nav7   =3D (is_nav && is_major =3D=3D 7);
    var is_nav7up =3D (is_nav && is_minor >=3D 7);

    var is_nav8   =3D (is_nav && is_major =3D=3D 8);
    var is_nav8up =3D (is_nav && is_minor >=3D 8);

    var is_ie   =3D ((iePos!=3D-1) && (!is_opera) && (!is_khtml));
    var is_ie3  =3D (is_ie && (is_major < 4));

    var is_ie4   =3D (is_ie && is_major =3D=3D 4);
    var is_ie4up =3D (is_ie && is_minor >=3D 4);
    var is_ie5   =3D (is_ie && is_major =3D=3D 5);
    var is_ie5up =3D (is_ie && is_minor >=3D 5);
   =20
    var is_ie5_5  =3D (is_ie && (agt.indexOf("msie 5.5") !=3D-1)); // =
020128 new - abk
    var is_ie5_5up =3D(is_ie && is_minor >=3D 5.5);                // =
020128 new - abk
=09
    var is_ie6   =3D (is_ie && is_major =3D=3D 6);
    var is_ie6up =3D (is_ie && is_minor >=3D 6);

    var is_ie7   =3D (is_ie && is_major =3D=3D 7);
    var is_ie7up =3D (is_ie && is_minor >=3D 7);

// KNOWN BUG: On AOL4, returns false if IE3 is embedded browser
    // or if this is the first browser window opened.  Thus the
    // variables is_aol, is_aol3, and is_aol4 aren't 100% reliable.

    var is_aol   =3D (agt.indexOf("aol") !=3D -1);
    var is_aol3  =3D (is_aol && is_ie3);
    var is_aol4  =3D (is_aol && is_ie4);
    var is_aol5  =3D (agt.indexOf("aol 5") !=3D -1);
    var is_aol6  =3D (agt.indexOf("aol 6") !=3D -1);
    var is_aol7  =3D ((agt.indexOf("aol 7")!=3D-1) || =
(agt.indexOf("aol7")!=3D-1));
    var is_aol8  =3D ((agt.indexOf("aol 8")!=3D-1) || =
(agt.indexOf("aol8")!=3D-1));

    var is_webtv =3D (agt.indexOf("webtv") !=3D -1);
   =20
    // new 020128 - abk
   =20
    var is_TVNavigator =3D ((agt.indexOf("navio") !=3D -1) || =
(agt.indexOf("navio_aoltv") !=3D -1));=20
    var is_AOLTV =3D is_TVNavigator;

    var is_hotjava =3D (agt.indexOf("hotjava") !=3D -1);
    var is_hotjava3 =3D (is_hotjava && (is_major =3D=3D 3));
    var is_hotjava3up =3D (is_hotjava && (is_major >=3D 3));

    // end new
=09
    // *** JAVASCRIPT VERSION CHECK ***
    // Useful to workaround Nav3 bug in which Nav3
    // loads <SCRIPT LANGUAGE=3D"JavaScript1.2">.
    // updated 020131 by dragle
    var is_js;
    if (is_nav2 || is_ie3) is_js =3D 1.0;
    else if (is_nav3) is_js =3D 1.1;
    else if ((is_opera5)||(is_opera6)) is_js =3D 1.3; // 020214 - dmr
    else if (is_opera7up) is_js =3D 1.5; // 031010 - dmr
    else if (is_khtml) is_js =3D 1.5;   // 030110 - dmr
    else if (is_opera) is_js =3D 1.1;
    else if ((is_nav4 && (is_minor <=3D 4.05)) || is_ie4) is_js =3D 1.2;
    else if ((is_nav4 && (is_minor > 4.05)) || is_ie5) is_js =3D 1.3;
    else if (is_nav5 && !(is_nav6)) is_js =3D 1.4;
    else if (is_hotjava3up) is_js =3D 1.4; // new 020128 - abk
    else if (is_nav6up) is_js =3D 1.5;

    // NOTE: In the future, update this code when newer versions of JS
    // are released. For now, we try to provide some upward =
compatibility
    // so that future versions of Nav and IE will show they are at
    // *least* JS 1.x capable. Always check for JS version compatibility
    // with > or >=3D.

    else if (is_nav && (is_major > 5)) is_js =3D 1.4;
    else if (is_ie && (is_major > 5)) is_js =3D 1.3;
    else if (is_moz) is_js =3D 1.5;
    else if (is_fb||is_fx) is_js =3D 1.5; // 032504 - dmr
   =20
    // what about ie6 and ie6up for js version? abk
   =20
    // HACK: no idea for other browsers; always check for JS version=20
    // with > or >=3D
    else is_js =3D 0.0;
    // HACK FOR IE5 MAC =3D js vers =3D 1.4 (if put inside if/else jumps =
out at 1.3)
    if ((agt.indexOf("mac")!=3D-1) && is_ie5up) is_js =3D 1.4; // 020128 =
- abk
   =20
    // Done with is_minor testing; revert to real for N6/7
    if (is_nav6up) {
       is_minor =3D navigator.vendorSub;
    }

    // *** PLATFORM ***
    var is_win   =3D ( (agt.indexOf("win")!=3D-1) || =
(agt.indexOf("16bit")!=3D-1) );
    // NOTE: On Opera 3.0, the userAgent string includes "Windows =
95/NT4" on all
    //        Win32, so you can't distinguish between Win95 and WinNT.
    var is_win95 =3D ((agt.indexOf("win95")!=3D-1) || =
(agt.indexOf("windows 95")!=3D-1));

    // is this a 16 bit compiled version?
    var is_win16 =3D ((agt.indexOf("win16")!=3D-1) ||
               (agt.indexOf("16bit")!=3D-1) || (agt.indexOf("windows =
3.1")!=3D-1) ||
               (agt.indexOf("windows 16-bit")!=3D-1) );

    var is_win31 =3D ((agt.indexOf("windows 3.1")!=3D-1) || =
(agt.indexOf("win16")!=3D-1) ||
                    (agt.indexOf("windows 16-bit")!=3D-1));
=09
	var is_winme =3D ((agt.indexOf("win 9x 4.90")!=3D-1));    // new 020128 =
- abk
    var is_win2k =3D ((agt.indexOf("windows nt 5.0")!=3D-1) || =
(agt.indexOf("windows 2000")!=3D-1)); // 020214 - dmr
    var is_winxp =3D ((agt.indexOf("windows nt 5.1")!=3D-1) || =
(agt.indexOf("windows xp")!=3D-1)); // 020214 - dmr

    // NOTE: Reliable detection of Win98 may not be possible. It appears =
that:
    //       - On Nav 4.x and before you'll get plain "Windows" in =
userAgent.
    //       - On Mercury client, the 32-bit version will return =
"Win98", but
    //         the 16-bit version running on Win98 will still return =
"Win95".
    var is_win98 =3D ((agt.indexOf("win98")!=3D-1) || =
(agt.indexOf("windows 98")!=3D-1));
    var is_winnt =3D ((agt.indexOf("winnt")!=3D-1) || =
(agt.indexOf("windows nt")!=3D-1));
    var is_win32 =3D (is_win95 || is_winnt || is_win98 ||
                    ((is_major >=3D 4) && (navigator.platform =3D=3D =
"Win32")) ||
                    (agt.indexOf("win32")!=3D-1) || =
(agt.indexOf("32bit")!=3D-1));

    var is_os2   =3D ((agt.indexOf("os/2")!=3D-1) ||
                    (navigator.appVersion.indexOf("OS/2")!=3D-1) ||
                    (agt.indexOf("ibm-webexplorer")!=3D-1));

    var is_mac    =3D (agt.indexOf("mac")!=3D-1);
    if (is_mac) { is_win =3D !is_mac; } // dmr - 06/20/2002
    var is_mac68k =3D (is_mac && ((agt.indexOf("68k")!=3D-1) ||
                               (agt.indexOf("68000")!=3D-1)));
    var is_macppc =3D (is_mac && ((agt.indexOf("ppc")!=3D-1) ||
                                (agt.indexOf("powerpc")!=3D-1)));
    var is_macosx =3D (is_mac && (agt.indexOf("os x")!=3D-1));

    var is_sun   =3D (agt.indexOf("sunos")!=3D-1);
    var is_sun4  =3D (agt.indexOf("sunos 4")!=3D-1);
    var is_sun5  =3D (agt.indexOf("sunos 5")!=3D-1);
    var is_suni86=3D (is_sun && (agt.indexOf("i86")!=3D-1));
    var is_irix  =3D (agt.indexOf("irix") !=3D-1);    // SGI
    var is_irix5 =3D (agt.indexOf("irix 5") !=3D-1);
    var is_irix6 =3D ((agt.indexOf("irix 6") !=3D-1) || =
(agt.indexOf("irix6") !=3D-1));
    var is_hpux  =3D (agt.indexOf("hp-ux")!=3D-1);
    var is_hpux9 =3D (is_hpux && (agt.indexOf("09.")!=3D-1));
    var is_hpux10=3D (is_hpux && (agt.indexOf("10.")!=3D-1));
    var is_aix   =3D (agt.indexOf("aix") !=3D-1);      // IBM
    var is_aix1  =3D (agt.indexOf("aix 1") !=3D-1);
    var is_aix2  =3D (agt.indexOf("aix 2") !=3D-1);
    var is_aix3  =3D (agt.indexOf("aix 3") !=3D-1);
    var is_aix4  =3D (agt.indexOf("aix 4") !=3D-1);
    var is_linux =3D (agt.indexOf("inux")!=3D-1);
    var is_sco   =3D (agt.indexOf("sco")!=3D-1) || =
(agt.indexOf("unix_sv")!=3D-1);
    var is_unixware =3D (agt.indexOf("unix_system_v")!=3D-1);
    var is_mpras    =3D (agt.indexOf("ncr")!=3D-1);
    var is_reliant  =3D (agt.indexOf("reliantunix")!=3D-1);
    var is_dec   =3D ((agt.indexOf("dec")!=3D-1) || =
(agt.indexOf("osf1")!=3D-1) ||
           (agt.indexOf("dec_alpha")!=3D-1) || =
(agt.indexOf("alphaserver")!=3D-1) ||
           (agt.indexOf("ultrix")!=3D-1) || =
(agt.indexOf("alphastation")!=3D-1));
    var is_sinix =3D (agt.indexOf("sinix")!=3D-1);
    var is_freebsd =3D (agt.indexOf("freebsd")!=3D-1);
    var is_bsd =3D (agt.indexOf("bsd")!=3D-1);
    var is_unix  =3D ((agt.indexOf("x11")!=3D-1) || is_sun || is_irix || =
is_hpux ||
                 is_sco ||is_unixware || is_mpras || is_reliant ||
                 is_dec || is_sinix || is_aix || is_linux || is_bsd || =
is_freebsd);

    var is_vms   =3D ((agt.indexOf("vax")!=3D-1) || =
(agt.indexOf("openvms")!=3D-1));
// additional checks, abk
	var is_anchors =3D (document.anchors) ? "true":"false";
	var is_regexp =3D (window.RegExp) ? "true":"false";
	var is_option =3D (window.Option) ? "true":"false";
	var is_all =3D (document.all) ? "true":"false";
// cookies - 990624 - abk
	document.cookie =3D "cookies=3Dtrue";
	var is_cookie =3D (document.cookie) ? "true" : "false";
	var is_images =3D (document.images) ? "true":"false";
	var is_layers =3D (document.layers) ? "true":"false"; // gecko m7 bug?
// new doc obj tests 990624-abk
	var is_forms =3D (document.forms) ? "true" : "false";
	var is_links =3D (document.links) ? "true" : "false";
	var is_frames =3D (window.frames) ? "true" : "false";
	var is_screen =3D (window.screen) ? "true" : "false";

// java
	var is_java =3D (navigator.javaEnabled());

// Flash checking code adapted from Doc JavaScript information;=20
// see http://webref.com/js/column84/2.html

   var is_Flash        =3D false;
   var is_FlashVersion =3D 0;

   if ((is_nav||is_opera||is_moz||is_fb||is_fx||is_safari)||
       (is_mac&&is_ie5up)) {
      var plugin =3D (navigator.mimeTypes &&=20
                    navigator.mimeTypes["application/x-shockwave-flash"] =
&&
                    =
navigator.mimeTypes["application/x-shockwave-flash"].enabledPlugin) ?
                    =
navigator.mimeTypes["application/x-shockwave-flash"].enabledPlugin : 0;
//      if (plugin) {
      if (plugin&&plugin.description) {
         is_Flash =3D true;
         is_FlashVersion =3D =
parseInt(plugin.description.substring(plugin.description.indexOf(".")-1))=
;
      }
   }

   if (is_win&&is_ie4up)
   {
      document.write(
         '<scr' + 'ipt language=3DVBScript>' + '\n' +
         'Dim hasPlayer, playerversion' + '\n' +
         'hasPlayer =3D false' + '\n' +
         'playerversion =3D 10' + '\n' +
         'Do While playerversion > 0' + '\n' +
            'On Error Resume Next' + '\n' +
            'hasPlayer =3D =
(IsObject(CreateObject("ShockwaveFlash.ShockwaveFlash." & =
playerversion)))' + '\n' +
            'If hasPlayer =3D true Then Exit Do' + '\n' +
            'playerversion =3D playerversion - 1' + '\n' +
         'Loop' + '\n' +
         'is_FlashVersion =3D playerversion' + '\n' +
         'is_Flash =3D hasPlayer' + '\n' +
         '<\/sc' + 'ript>'
      );
   }
  =20
   function showRSSFeedPopUp(){
   var url =3D "/AJHG/Rss Feed";
    var windowOptions =3D =
"width=3D680,height=3D480,innerWidth=3D680,innerHeight=3D480,top=3D0,left=
=3D50,screenX=3D0,screenY=3D0,scrollbars=3Dyes,resizable=3Dyes,toolbar=3D=
yes,status=3Dyes";   =09
	//var windowOptions =3D =
"width=3D700,height=3D500,left=3D150,top=3D150,screenX=3D150,screenY=3D15=
0,resizable=3Dyes,scrollbars=3Dno";
	var popWin =3D window.open(url,"Rss Feed",windowOptions);
    popWin.focus();
	return true;
   }
  =20
   =20
function validateCardNumber(cardNumber) {
	validateInputField(cardNumber, 1, cardNumber+'_error', 'Please enter =
your Card Number.');
	var cardNumberReg =3D /^[0-9]{13,16}/;
	var regex =3D new RegExp(cardNumberReg);
	var element =3D document.getElementById(cardNumber);
	if(!regex.test(element.value))
	{
		setErrorMessage(cardNumber,"Please enter a valid Card Number.");
	}
	else
	{
		removeErrorMessage(cardNumber);
	}	=09
}

function validateCardExpiry(errorFieldId) {
	if (document.yourInformationForm.cardExpiryDateMonth.selectedIndex =
=3D=3D 0 ||document.yourInformationForm.cardExpiryDateYear.selectedIndex =
=3D=3D 0) {
		setErrorMessage(errorFieldId,'Please select your card Expiration =
Date');
		return false;
	} else if =
(isExpriationDateInValid(document.yourInformationForm.cardExpiryDateYear.=
options[document.yourInformationForm.cardExpiryDateYear.selectedIndex].va=
lue,document.yourInformationForm.cardExpiryDateMonth.options[document.you=
rInformationForm.cardExpiryDateMonth.selectedIndex].value)){
		setErrorMessage(errorFieldId,'Please check your card Expiration =
Date');
		return false;
	} else {
		removeErrorMessage(errorFieldId);=09
		return false;
	}
}

function isExpriationDateInValid(year, month) {
	var currentDate =3D new Date();
	if(year > currentDate.getFullYear()) {
		return false;
	}
	if(year =3D=3D currentDate.getFullYear()) {
		if( (month-1) >=3D currentDate.getMonth())
		{
			return false;
		}
	}
	return true;
}

function checkAll(scope) {
					boxes =3D scope.getElementsByTagName('input');
					if(!document.getElementById('search_all').checked){
						for(var i=3D0;i<boxes.length;i++) {
							boxes[i].checked=3Dfalse;
						}									=09
					}
					else {
						for(var i=3D0;i<boxes.length;i++) {
							boxes[i].checked=3Dtrue;
						}				=09
					}
				}

function unCheckAll(checkbox){
					if(!checkbox.checked && =
document.getElementById('search_all').checked){
					document.getElementById('search_all').checked =3D false;
					}
				}

bookmark_ie6_startList =3D function() {
if (document.all&&document.getElementById) {
 if(document.getElementById("bookmark_this")){
=09
bookmark =3D document.getElementById("bookmark_this");
var bookmark_list =3D document.getElementById("bookmark_list");
 bookmark.onmouseover =3D function() {
	=09
	=09
		bookmark_list.style.display=3D"block";
	=09
		=09
 }
 bookmark.onmouseout =3D function() {
	bookmark_list.style.display=3D"none";
 }
 }
 }

}
window.onload=3Dbookmark_ie6_startList;				
------=_NextPart_000_0000_01C9B893.36AED2E0
Content-Type: application/octet-stream
Content-Transfer-Encoding: quoted-printable
Content-Location: http://www.cell.com/js/cell/searchValidator.js

function validateSearch() {
	var valid =3D true;
	if (!validateSearchVolumeBox()) valid=3Dfalse;
	if (!validateSearchPageBox()) valid=3Dfalse;
	if (!validateSearchVolumeBox() && !validateSearchPageBox()){
		document.getElementById("searchError").innerHTML =3D "Please enter a =
number in the volume and page fields.";
	 	valid=3Dfalse;
	}=09
	if(document.getElementById("search_terms").value=3D=3D"" && =
document.getElementById("search_volume").value=3D=3D"" && =
document.getElementById("search_page").value=3D=3D""){
		document.getElementById("searchError").innerHTML =3D "Please enter a =
search term.";
		valid=3Dfalse;
	}
    return valid;	=09
}

function validateSearchPageBox() {
	if(isNaN(document.getElementById("search_page").value)){
		document.getElementById("searchError").innerHTML =3D "Please enter a =
number in the page field.";
		return false;
	}=09
	return true;
=09
}


function validateSearchVolumeBox() {
	if(isNaN(document.getElementById("search_volume").value)){
		document.getElementById("searchError").innerHTML =3D "Please enter a =
number in the volume field.";
		return false;
	}=09
	return true;
}


function validateSearchTerms(){
	if(document.getElementById("searchTerms").value=3D=3D"" && =
document.getElementById("searchVolume").value=3D=3D"" && =
document.getElementById("searchStartPage").value=3D=3D"" && =
document.getElementById("searchAuthor").value=3D=3D"" &&
	 document.getElementById("searchIssue").value=3D=3D"" && =
document.getElementById("searchTitleAbstract").value=3D=3D"" && =
document.getElementById("searchAffiliation").value=3D=3D""){
	 	document.getElementById("searchError").className =3D "alert =
errormsg";
		document.getElementById("searchError").innerHTML =3D "Please enter the =
search term.";
		return false;
	 }
	 return true;
}

function validateSearchDOI(){
	if(document.getElementById("searchDOI").value=3D=3D""){
	 	document.getElementById("searchError").className =3D "alert =
errormsg";
		document.getElementById("searchError").innerHTML =3D "Please enter the =
search term.";
		return false;
	 }
	 return true;
}
------=_NextPart_000_0000_01C9B893.36AED2E0
Content-Type: application/octet-stream
Content-Transfer-Encoding: quoted-printable
Content-Location: http://www.cell.com/js/cell/registrationValidator.js


function validateCustomerNumber(customerNumber , errMessage){
return validateCustomerNumberInputField(customerNumber, 1, =
customerNumber + '_error', errMessage);
}

function validateUserName(userName , errMessage) {
	return validateInputField(userName, 6, userName + '_error', =
errMessage);
}

function validateRegisterUserName(userName , errMessage) {
	var trimmedFieldValue =3D new =
String(trim(document.getElementById(userName).value));
	if(trimmedFieldValue.length < 6  ) {
		setErrorMessage(userName,errMessage);
		return false;
	}=20
	else{=20
		if(trimmedFieldValue.indexOf(" ") !=3D -1){
			document.getElementById(userName + '_error').innerHTML =3D "User Name =
cannot contain spaces.";
			return false;
		}
		else {
			if(document.getElementById(userName + '_error').innerHTML !=3D "")
				removeErrorMessage(userName);
			return true;
		}
	}
}
function setErrorMessage(errorDivId,errorMessage)
{
		document.getElementById(errorDivId + '_error').innerHTML =3D =
errorMessage;
		document.getElementById('formLevel_error').innerHTML =3D 'Please =
correct the errors displayed in red below and resubmit the form.';
		document.getElementById('formLevel_error').className =3D 'alert =
registerwide errormsg';
}

function removeErrorMessage(errorDivId)
{
		document.getElementById(errorDivId + '_error').innerHTML =3D "";
		document.getElementById('formLevel_error').innerHTML =3D "";
		document.getElementById('formLevel_error').className =3D "";

}
function validatePassword(password , errMessage) {
	return validateInputField(password, 6, password + '_error',errMessage =
);
}

function validateResetPassword(password , errMessage) {
	return validateInputFieldForSimpleForms(password, 6, password+'_error', =
errMessage);=09
}

function validateOriginalPasswordField(password , errMessage) {
	return validateInputFieldForSimpleForms(password, 1, password+'_error', =
errMessage);=09
}


function validateResetConfirmPassword(password) {
	if(document.getElementById(password).value !=3D =
document.getElementById('confirmPassword').value) {
		document.getElementById('confirmPassword_error').className=3D"alert =
errormsg";
		document.getElementById('confirmPassword_error').innerHTML =3D "Please =
ensure the passwords match.";
		return false;
	} else {
		if(document.getElementById('confirmPassword_error').innerHTML !=3D "") =
{
			document.getElementById('confirmPassword_error').innerHTML =3D "";
			document.getElementById('confirmPassword_error').className=3D"";
		}
		return true;
	}
}

function validateConfirmPassword(password) {
	if(document.getElementById(password).value !=3D =
document.getElementById('confirmPassword').value) {
			document.getElementById('confirmPassword_error').innerHTML =3D =
"Please ensure the Passwords match.";
		return false;
	} else {
		if(document.getElementById('confirmPassword_error').innerHTML !=3D "")
			document.getElementById('confirmPassword_error').innerHTML =3D "";
		return true;
	}
}

function validateFirstName() {
	return validateInputField('firstName', 1, 'firstName_error', 'Please =
enter your first name.');
}

function validateLastName(lastName , errMessage) {
	return validateInputField(lastName, 1, lastName + '_error', =
errMessage);
}

function validateNameForFeedback(name , errMessage) {
	return validateInputField(name, 1, name + '_error', errMessage);
}

function validateSubject(subject, errMessage) {
	return validateInputField(subject, 1, lastName + '_error', errMessage);
}
function validateLastNameForSimpleForms(lastName , errMessage) {
	return validateInputFieldForSimpleForms(lastName, 1, lastName + =
'_error', errMessage);
}

function validateTitleId() {
	return validateSelectField('titleId', 'titleId_error', 'Please select =
your title.');
}

function validateCountryId() {
	return validateSelectField('countryId', 'countryId_error', 'Please =
select your country.');
}
function validatejobTitleId() {
	return validateSelectField('jobTitleId', 'jobTitleId_error', 'Please =
select your job title.');
}
function validateworkSettingId() {
	return validateSelectField('workSettingId', 'workSettingId_error', =
'Please select your work setting.');
}
function validateprincipalFieldId() {
	return validateSelectField('principalFieldId', =
'principalFieldId_error', 'Please select your principal field.');
}

function validateEmailAddress() {
	if(validateInputField('emailAddress', 1, 'emailAddress_error', 'Please =
enter your email address.')) {
		return validateEmailField('emailAddress', 'emailAddress_error', =
'Please enter a valid email address.');
	}
	return false;
}

function validateEmailAddressForSimpleForms()
{
	if(validateInputFieldForSimpleForms('emailAddress', 1, =
'emailAddress_error', 'Please enter your email address.')) {
		return validateEmailFieldForSimpleForms('emailAddress', =
'emailAddress_error', 'Please enter a valid email address.');
	}
	return false;
}

function validateActivateClaimInputField(fieldName , fielderrMessage) {
	return validateActivateInputField(fieldName, 1, fieldName + '_error', =
fielderrMessage);
}

function validateActivateClaimInputFieldForSimpleForms(fieldName , =
fielderrMessage) {
	return validateActivateInputFieldForSimpleForms(fieldName, 1, fieldName =
+ '_error', fielderrMessage);
}
function validateRegistrationFields() {
	var valid =3D true;
	if (!validateCustomerNumber('customerNumber','Please enter your =
Customer Number.')) valid =3D false;
	if (!validateRegisterUserName('registrationUsername','Please enter a =
User Name that is at least 6 characters long.')) valid=3Dfalse;
	if (!validatePassword('registrationpassword','Please enter a Password =
that is at least 6 characters long.')) valid=3Dfalse;
	if (!validateFirstName()) valid=3Dfalse;
	if (!validateLastName('lastName','Please enter your last name.')) =
valid=3Dfalse;
	if (!validateEmailAddress()) valid=3Dfalse;
	if (!validateTitleId()) valid=3Dfalse;
	if (!validateCountryId()) valid=3Dfalse;
	if (!validatejobTitleId()) valid=3Dfalse;
	if (!validateprincipalFieldId()) valid=3Dfalse;
	if (!validateworkSettingId()) valid=3Dfalse;
    if (!validateConfirmPassword()) valid=3Dfalse;
    return valid;
=09
}=20

function validateChangePasswordFields() {
	var valid =3D true;
	var trimmedFieldValue =3D new =
String(trim(document.getElementById('original').value));
	if(!trimmedFieldValue.length>0)
	{
			originalerrormsg =3D "Please enter your Original Password.";
	}
	trimmedFieldValue =3D new =
String(trim(document.getElementById('newPassword').value));
	if(trimmedFieldValue.length>0)
	{
		newpassworderrormsg =3D "Please enter New Password that is at least 6 =
characters long.";
	}
	else
	{
		newpassworderrormsg =3D "Please enter your New Password.";
	}
=09
	if (!validateOriginalPasswordField('original',originalerrormsg)) =
valid=3Dfalse;
	if (!validateResetPassword('newPassword',newpassworderrormsg)) =
valid=3Dfalse;
	if (!validateResetConfirmPassword('newPassword')) valid=3Dfalse;
	return valid;
}


function validateForgotPasswordFields(){
	var valid =3D true;
	document.getElementById('errorMessage_error').innerHTML =3D "";
	document.getElementById('errorMessage_error').className =3D "";
	if (!validateLastNameForSimpleForms('lastName','Please enter your last =
name.')) valid=3Dfalse;
	if (!validateEmailAddressForSimpleForms()) valid=3Dfalse;
    return valid;
}
function validateEmailAddressForForgotPassword()
{
	document.getElementById('errorMessage_error').innerHTML =3D "";
	document.getElementById('errorMessage_error').className =3D "";
	if(validateInputFieldForSimpleForms('emailAddress', 1, =
'emailAddress_error', 'Please enter your email address.')) {
		return validateEmailFieldForSimpleForms('emailAddress', =
'emailAddress_error', 'Please enter a valid email address.');
	}
	return false;
}
function validateLastNameForForgotPassword(lastName , errMessage) {
	document.getElementById('errorMessage_error').innerHTML =3D "";
	document.getElementById('errorMessage_error').className =3D "";
	return validateInputFieldForSimpleForms(lastName, 1, lastName + =
'_error', errMessage);
}
function validateActivateClaimFields() {
	var valid =3D true;
	if (!validateCustomerNumber('activateCustomerNumber','Please enter your =
Customer Number.')) valid =3D false;
	if (!validateUserName('activateUserName','Please enter your User =
Name.')) valid=3Dfalse;
	if (!validatePassword('activatePassword','Please enter your =
Password.')) valid=3Dfalse;
	if (!validateLastName('activateLastName','Please enter your Last =
Name.')) valid=3Dfalse;
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=09
}


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var WT=3Dnew Object();
var DCSext=3Dnew Object();
var gDoms =3D "";=20
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