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The sixteenth century has become a focal point for the analysis of the genealogy of political imperialism. It marks the shift from the medieval to the modern age as manifested in the discovery of the New World, the rise of imperial control and expansion, and the historical construction of the individual subject. My dissertation argues that Sidney, Spenser, and Shakespeare, to some extent, all participate in the "imperial" disposition of modern representational thinking. However, all three authors also offer alternatives to imperial and representational thinking. The first chapter uses Heidegger's conception of the work of art in order to assert that art is not always and only a representational copy of an original. For Heidegger, the work of art is not an imitation of a pre-existing thing, nor is it an epiphenomenon of a system of relations. On the contrary, it first founds these relations. The second chapter analyzes the conception of poiesis which Sidney presents in his Defence of Poesie. In some respects, Sidney's definition is merely a reformulation of the representational one. That is, for Sidney poetry imitates the ideal rather than "brasen" nature. However, in other respects, insofar as he draws on certain formulations of the Italian humanists, Sidney conceives of poiesis as a figuring forth of something for the first time. In the third chapter, I turn to Book I of Spenser's The Faerie Queene. This chapter takes issue with contemporary readings of Spenser which assert that he is our "preeminent poet of empire." I point out that the entire conception of the just and true order of things that is presented in Book I speaks against the assertion of an imperial disposition in Spenser. Finally, in the fourth chapter, I deal with Shakespeare's Hamlet in relation to the Cartesian metaphysics of the subject. In modern metaphysics, the sovereign subject becomes master over existence. I demonstrate the ways in which "The Mouse-trap" figures forth this imperial control over nature that the subject wields. However, I also explore the ways in which it presents a non-representational experience of truth along the lines of the pre-metaphysical experience of a-letheia.

Purpose: Men at risk for prostate cancer may concurrently experience chronic prostatitis or pelvic pain. We evaluated the effect of dutasteride on prostatitis-like symptoms in the REDUCE study population. Materials and Methods: REDUCE was a 4-year, randomized, double-blind, placebo controlled study of prostate cancer risk reduction with 0.5 mg dutasteride vs placebo in men 50 to 75 years old with prostate specific antigen 2.5 to 10 ng/ml and a negative prostate biopsy in the previous 6 months. In this analysis we investigated change from baseline in Chronic Prostatitis Symptom Index in men with prostatitis-like pain (Chronic Prostatitis Symptom Index pain subscore 5 or greater) and prostatitis-like syndrome (perineal or ejaculatory pain plus Chronic Prostatitis Symptom Index pain subscore 4 or greater), the proportion of subjects with at least a moderate Chronic Prostatitis Symptom Index response (6-unit or greater improvement) and reports of new onset clinical prostatitis. Results: Of 5,379 men with a total baseline Chronic Prostatitis Symptom Index score 678 (12.6%) had prostatitis-like pain and 427 (7.9%) had prostatitis-like syndrome. Chronic Prostatitis Symptom Index total score decreased significantly at 48 months in the dutasteride group vs placebo in men with prostatitis-like pain (p < 0.0001) and with prostatitis-like syndrome (t test p = 0.03). There were significantly more Chronic Prostatitis Symptom Index responders with dutasteride vs placebo in the prostatitis-like pain (49% vs 37%, respectively, p = 0.0033) and prostatitis-like syndrome (46% vs 35%, Fisher's exact test p = 0.0265) subgroups. Prostatitis was reported as an adverse event by significantly more men randomized to placebo (3.6%) than to dutasteride (2.5%, p = 0.003). Conclusions: Long-term dutasteride therapy resulted in improvement in prostatitis related symptoms in older men with an increased prostate specific antigen.

Purpose: We assessed whether dutasteride enhances the usefulness of total prostate specific antigen for diagnosing clinically significant prostate cancer. Materials and Methods: The 4-year REDUCE study evaluated the efficacy and safety of 0.5 mg dutasteride daily for prostate cancer risk reduction in men with a prostate specific antigen of 2.5 to 10.0 ng/ml and a negative prostate biopsy. Specificity, sensitivity, and positive and negative predictive values of prostate specific antigen for the diagnosis of prostate cancer were assessed. Results: Final prostate specific antigen before biopsy and change from month 6 to final prostate specific antigen performed better for the diagnosis of Gleason score 7-10 tumors in men who received dutasteride vs placebo as assessed by the area under the ROC curves (0.700 vs 0.650, p = 0.0491; and 0.699 vs 0.593, p = 0.0001, respectively). Increases in prostate specific antigen were associated with a higher likelihood of biopsy detectable, Gleason score 7-10 and clinically significant (modified Epstein criteria) prostate cancer. Percentage decreases in prostate specific antigen from baseline to month 6 in the dutasteride arm did not predict prostate cancer overall or Gleason score 7-10 cancer. Conclusions: In men with a previously negative prostate biopsy, prostate specific antigen performed better during the 4-year study as a marker of prostate cancer in men who received dutasteride vs placebo. The degree of prostate specific antigen increase after 6 months was a better indicator of clinically significant cancer in the dutasteride arm than in the placebo arm. Conversely, the initial decrease in prostate specific antigen in men taking dutasteride did not predict the likelihood of prostate cancer.