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Careful Examination (careful + examination)
Selected AbstractsFine-needle aspiration biopsy of metastatic malignant melanoma resembling a malignant peripheral nerve sheath tumorDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2008Svetoslav Bardarov M.D. Abstract We report a case of metastatic malignant melanoma resembling a malignant peripheral sheath tumor, which posed a significant diagnostic challenge. The patient is a 76-year-old male, who presented in the emergency room with bilateral chest pain exacerbated by inspiration. The pain was present for 3 week and was not exacerbated by physical exercise. The diagnostic workup revealed bilateral parenchymal pulmonary infiltrates. The CT-scan guided fine-needle aspiration and the core biopsies of the largest pulmonary lesion revealed high-grade spindle cell neoplasm with individual cell apoptosis and necrosis. The immunohistochemical profile on the cell block showed that the cells are positive for Vimentin. The S-100 stain showed only focal positivity. The immunohistochemical stains for HMB45, Melan A, pancytokeratin, and smooth muscle actin were negative. Five years ago the patient was diagnosed with melanoma on the back with Clark level of IV. The melanoma was excised with clear margins and sentinel lymph nodes were negative. Careful examination of patient's previous slides revealed an area of spindle cell melanoma adjacent to a nodular type melanoma. Based on the patient's previous history, current clinico-pathologic presentation and immunohistochemical profile, the diagnosis of metastatic malignant melanoma resembling peripheral nerve sheath tumor was favored over the diagnosis of metastatic malignant spindle cell neoplasm of unknown primary site, which by itself is very rare clinical scenario. Diagn. Cytopathol. 2008;36:754,757. © 2008 Wiley-Liss, Inc. [source] The Effects of Fluorine and Chlorine Substituents across the Fjords of Bifluorenylidenes: Overcrowding and StereochemistryEUROPEAN JOURNAL OF ORGANIC CHEMISTRY, Issue 22 2006Sergey Pogodin Abstract The bistricyclic aromatic enes (BAEs) (E)- and (Z)-1,1,-difluorobifluorenylidene, 1,8,1,,8,-tetrafluorobifluorenylidene, (E)- and (Z)-3,3,-difluorobifluorenylidene, 3,6,3,,6,-tetrafluorobifluorenylidene, and their chlorinated analogues were subjected to a DFT study of overcrowding in their fjord regions. The B3LYP hybrid functional was employed to calculate energies and geometries of the twisted conformations of these BAEs. The diastereomers E11,F2 and Z11,F2 have identical twist angles (, = 37.1°) and similar degrees of overcrowding, but differ in the degree and mode of pyramidalization, ,. In E11,F2, ,(C9) = +,(C9,) = 7.0° (syn -pyramidalization), while in Z11,F2, ,(C9) = ,,(C9,) = 1.0° (anti -pyramidalization). By contrast, in E11,Cl2 and Z11,Cl2, , = 40.6° and 42.7°, respectively. Introducing four halogen substituents results in higher twist angles: , = 40.3° in 181,8,F4 and 52.6° in 181,8,Cl4. Surprisingly, Z11,F2 is more stable than E11,F2 (,H298 = ,1.9 kJ/mol), whereas Z11,Cl2 is less stable than E11,Cl2 (,H298 = 2.2 kJ/mol). Both results are consistent with the experimental relative stabilities of these diastereomers. The unexpected stability of Z11,F2 is explained by a combination of steric and electronic effects. Calculations of Coulomb energies for point charge systems of atoms C, F, and H in the fjord regions shows stabilization of the (Z) diastereomer by ,45.5 kJ/mol. The dipole,dipole interactions in the fjord region destabilize Z11,F2 by 6.4 kJ/mol relative to E11,F2. Careful examination of the NMR spectra of E11,F2 and Z11,F2 shows, in the latter, evidence of long-range fluorine,fluorine coupling over seven bonds (11.4 Hz) and carbon,fluorine coupling over six bonds (4.8 Hz).(© Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2006) [source] Majocchi's granuloma trichophyticum in an immunocompromised patientINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2000Somesh Gupta MD A 40-year-old man with alcoholic liver disease was referred to the dermatology clinic for asymptomatic papulonodular lesions over the face of 15 days' duration. Cutaneous examination revealed multiple, dusky red to yellow, follicular as well as perifollicular papulonodular lesions, varying in size from 0.5 to 2 cm ( Fig. 1). They were distributed over the forehead, cheeks, eyelids, nose, chin, beard area, retroauricular area, and neck. Careful examination revealed well-defined scaly margins on the back of the pinna ( Fig. 2). KOH examination of a scraping from the neck revealed nonpigmented septate hyphae. Histopathologic examination of the excised nodule revealed epitheloid cell granulomas with neutrophilic microabscesses surrounding the hair follicles. Periodic acid,Schiff stain was noncontributory. Culture of an excised nodule on Sabouraud's agar showed growth of Trichophyton rubrum. Considering his liver disease, the patient was initially treated with topical terbinafine. Because of a lack of a satisfactory response this was changed to oral terbinafine 250 mg/day. There was marked regression of the lesions by the sixth day. Unfortunately, the patient succumbed to complications relating to his liver disease. Figure 1. Follicular and perifollicular lesions of Majocchi's granuloma Figure 2. A well-defined scaly margin of tinea on the back of the pina [source] A Bargaining Theory of Minority Demands: Explaining the Dog that Did not Bite in 1990s YugoslaviaINTERNATIONAL STUDIES QUARTERLY, Issue 4 2004Erin Jenne This article develops a general theory of bargaining between a minority, its host state, and outside lobby actor to explain why minorities shift their demands from affirmative action to cultural autonomy to secessionism and back, often in the absence of clear economic or security incentives. This paper uses a simple game tree model to show that if a minority believes that it enjoys significant support from a powerful national homeland or other external actor, it radicalized its demands against the host state, even if the center has credibly committed to protect minority rights. Conversely, if a minority believes that it enjoys no external support, then it will accommodate the host state, even in the presence of significant majority repression. As a general theory of claim-making, this model challenges structural theories of demands that rely on static economic differences or historical grievances to explain claim-making. It also challenges security dilemma arguments that hold that minority radicalization is mainly a function of ethnic fears. The model's hypotheses are tested using longitudinal analysis of Hungarians in Vojvodina during the 1990s, as the Yugoslav dog that "barked but did not bite." Careful examination of claim-making in this case demonstrates the superior explanatory power of the ethnic bargaining model as compared with dominant theories of minority mobilization in the literature. [source] In situ X-ray diffraction analysis of (CFx)n batteries: signal extraction by multivariate analysisJOURNAL OF APPLIED CRYSTALLOGRAPHY, Issue 6 2007Mark A. Rodriguez (CFx)n cathode reaction during discharge has been investigated using in situ X-ray diffraction (XRD). Mathematical treatment of the in situ XRD data set was performed using multivariate curve resolution with alternating least squares (MCR,ALS), a technique of multivariate analysis. MCR,ALS analysis successfully separated the relatively weak XRD signal intensity due to the chemical reaction from the other inert cell component signals. The resulting dynamic reaction component revealed the loss of (CFx)n cathode signal together with the simultaneous appearance of LiF by-product intensity. Careful examination of the XRD data set revealed an additional dynamic component which may be associated with the formation of an intermediate compound during the discharge process. [source] Political Ontology and Institutional Design in Montesquieu and RousseauAMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 2 2010David Lay Williams Historians of political thought have been puzzled by Montesquieu's simultaneous appeals to the diversity of human practices and eternal norms of justice. Isaiah Berlin famously referred to this as an impassable "contradiction" burdening his work. Careful examination of Rousseau's appropriations from and developments on Montesquieu, however, reveal that these observations are not merely reconcilable,they provide a fruitful way to approach legislation and constitution drafting. This is accomplished by understanding his employment of the principle of transcendent constrained indeterminacy. [source] Wildlife and Politics: CAMPFIRE in ZimbabweDEVELOPMENT AND CHANGE, Issue 3 2000Jocelyn Alexander CAMPFIRE programmes have been hailed internationally for the innovative ways in which they have sought to confront the challenges of some of Africa's most marginal regions through the promotion of local control over wildlife management. In Zimbabwe, CAMPFIRE has been cast as an antidote to the colonial legacy of technocratic and authoritarian development which had undermined people's control over their environment and criminalized their use of game. This article explores why such a potentially positive programme went so badly wrong in the case of Nkayi and Lupane districts, raising points of wider significance for comparable initiatives. Local histories and institutional politics need careful examination. The first part of the article thus investigates the historical forces which shaped attitudes to game, while the second part considers the powerful institutional and economic forces which conspired to sideline these historically formed local views. CAMPFIRE in Nkayi and Lupane was further shaped by the legacies of post-independence state violence in this region, and the failure of earlier wildlife projects. This range of factors combined to create deep distrust of CAMPFIRE, and quickly led to open confrontation. [source] Second Language Reading Research on Passage Content and Gender: Challenges for the Intermediate-Level CurriculumFOREIGN LANGUAGE ANNALS, Issue 4 2001Cindy Brantmeier PhD Howevel, a careful examination of available studies reveals disparities among research methods and procedures, thus making it difficult to formulate theories for re-examining the intermediate-level course, where the reading of lengthy, authentic texts begins. To complicate matters further, females begin to outnumber males at the intermediate level, and this gap widens at the advanced levels (Chavez, 2001). This article , through a careful review of the relevant literature , shows that much of the L2 reading process at the intermediate level remains unexplained. Finally, a call for more research at the intermediate level that examines key variables, such as passage content and gender, is made. [source] Tamoxifen modulates apoptosis in multiple modes of action in CreER miceGENESIS: THE JOURNAL OF GENETICS AND DEVELOPMENT, Issue 12 2008Hirohide Takebayashi Abstract Tamoxifen-inducible Cre (CreER) has become a powerful tool for in vivo manipulation of the genome. Here, we investigated opposing effects of tamoxifen on apoptosis during embryogenesis using Olig2,CreER knock-in mice, namely, tamoxifen-induced apoptosis through CreER-mediated toxicity and cytoprotective activity of tamoxifen independent of CreER. First, we examined tamoxifen-induced apoptosis; in the homozygous mice, we observed region-specific apoptosis in the ventral neural tube, with no obvious increase in the heterozygotes. Next, we detected a cytoprotective effect on apoptosis in the homozygous dorsal root ganglia (DRG). This apoptosis is a secondary phenotype of Olig2 -null mice, as Olig2/CreER is not expressed in the DRG. The cytoprotective effect is DRG-specific, because tamoxifen did not rescue apoptosis in the interdigital mesenchyme. These data indicate that tamoxifen has multiple effects on apoptosis during development and caution that careful examination is necessary when interpreting results obtained from tamoxifen-induced recombination: in Olig2-CreER mice, heterozygotes are usable for lineage-tracing experiment without obvious toxicity, while homozygotes show efficient recombination, despite enhanced apoptosis. genesis 46:775,781, 2008. © 2008 Wiley-Liss, Inc. [source] Seismotectonics of the Sinai subplate , the eastern Mediterranean regionGEOPHYSICAL JOURNAL INTERNATIONAL, Issue 1 2003Amos Salamon SUMMARY We define the Sinai subplate, from a seismotectonic perspective, as a distinct component in the plate tectonics of the eastern Mediterranean region. This is based on the tectonic characteristics of a comprehensive listing of all ML, 4 recorded seismicity in the region during the 20th century, on newly calculated and recalculated fault plane mechanisms of first P -wave arrivals and on published solutions based on waveform inversion of broad-band data. The low seismicity level and scarcity of strong events in the region required a thorough search for useful data and a careful examination of the reliability of the focal solutions. We gathered all available records of first P -wave onsets from the ISS and ISC Bulletins and the local seismic networks. Altogether, we were able to calculate 48 new focal mechanisms and 33 recalculated ones of events that occurred during the years 1940,1992. With the increasing number of teleseismic and regional broad-band stations in the later years, we added 37 solutions based on teleseismic and regional waveform inversions of events that occurred during 1977,2001. These mechanisms enabled us to examine the seismotectonic character of the Sinai subplate. The strike and rake directions of the calculated mechanisms usually reflect the geometry and the large-scale type of deformation observed along the boundaries of the Sinai subplate,the Dead Sea Transform, the Cypriot Arc convergent zone and the Suez Rift. Nevertheless, along each of these boundaries we found anomalous solutions that attest to the complexity of the deformation processes along plate margins. Earthquakes along the Dead Sea Transform exhibit mainly sinistral transtension and transpression, reflecting its leaky manner and local change in the transform geometry. The presence of other unexpected mechanisms near the transform, however, reflects the heterogeneous deformation it induces around. As expected, thrust mechanisms along the Cypriot Arc mirror its convergent nature and typical curved geometry. Transtension and transpressional solutions in the eastern segment of the arc reflect the sinistral shear motion between Anatolia and Sinai there. However, shear mechanisms found between Cyprus and the Eratosthenes Seamount pose a problem regarding its collision process. Most intriguing of all are ML, 4 thrust and shear solutions found in the Gulf of Suez. They are associated with predominantly normal mechanisms within a rift zone and therefore constitute a unique phenomenon, yet to be deciphered. [source] The Effect of Ring Size on Reactivity: The Diagnostic Value of ,Rate Profiles'HELVETICA CHIMICA ACTA, Issue 6 2005Eric Masson The rates of cycloalkyl phenyl sulfide formation of a series of homologous bromocycloalkanes upon treatment with sodium benzenethiolate have been determined to ascertain the effect of ring size on reactivity. The ,rate profile', i.e., reaction rate vs. ring size, for these nucleophilic substitutions (SN2) was determined. A linear free-energy relationship could be derived from computed hydride affinities of cycloalkanes and rates of typical SN1 reactions, whereas rates of SN2 reactions exhibited a strong discrepancy from the seven- up to the twelve-membered rings. This discrepancy was rationalized by a careful examination of the geometry of the intermediates and transition states involved in these reactions. [source] Laparoscopic pancreatic surgery: a review of present results and future prospectsHPB, Issue 4 2010Omer S. Al-Taan Abstract Pancreatic surgery is still associated with a relatively high morbidity and mortality compared with other specialties. This is a result of the complex nature of the organ, the difficult access as a result of the retroperitoneal position and the number of technically challenging anastomoses required. Nevertheless, the past two decades have witnessed a steady improvement in morbidity and a decrease in mortality achieved through alterations of technique (particularly relating to the pancreatic anastomoses) together with hormonal manipulation to decrease pancreatic secretions. Recently minimally invasive pancreatic surgery has been attempted by several centres around the world which has stimulated considerable interest in this approach. The majority of the cases attempted have been distal pancreatectomies, because of the more straightforward nature of the resection and the lack of a pancreatic ductal anastomosis, but more recently reports of laparoscopic pancreaticoduodenectomy have started to appear. The reports of the series to date have been difficult to interpret and although the results are claimed to be equivalent or better than those associated with a traditional approach a careful examination of the literature and comparison with the best results previously reported does not presently support this. In the present review we examined all the reports of pancreatic procedures performed laparoscopically and compared the results with those previously achieved at open surgery. [source] Temporal variability of phytoplankton in a salt wedge estuary, the Swan,Canning Estuary, Western AustraliaHYDROLOGICAL PROCESSES, Issue 13 2001Peter A. Thompson Abstract The temporal cycles of variation in salinity, temperature and river flow in the Swan,Canning Estuary plus rainfall in the vicinity are examined. A ,normal' pattern is defined for rainfall and river flow based on long-term median monthly values from available historical data. Long-term monthly median rainfall and median monthly river flow were highly correlated. Deviations from the ,normal' patterns of rainfall and river flow are documented. Three years of detailed data on the temporal distribution of the algal biomass and phytoplankton community composition from the Swan,Canning Estuary are presented and discussed. Significant interannual variability in the phytoplankton biomass was observed with 1996 having a significantly lower median chlorophyll a concentration than 1995 or 1997. Different years also had pronounced differences in the timing, persistence and occurrence of algal blooms. Links with, and between, rainfall, river flow, nutrient concentrations and phytoplankton biomass are made by careful examination of the temporal patterns. Deviations from the proposed ,normal' temporal pattern of physical and chemical environmental factors relevant to the growth of phytoplankton biomass are assessed. Deviations from ,normal' rainfall and river flow, depending upon their timing and intensity, appear to be associated with occurrence of algal blooms. For example, the lack of a dinoflagellate bloom in December 1996 or January 1997 appears to be associated with a wetter than normal spring. Based upon the observed data, published reports and basic principles of algal ecology a set of predicted responses to variation in the major environmental variables (rainfall and river flow) are tabulated. The tabulated predictions are proposed as a useful tool for resource managers. Copyright © 2001 John Wiley & Sons, Ltd. [source] Plantar fibromatosis: Most common sonographic appearance and variationsJOURNAL OF CLINICAL ULTRASOUND, Issue 9 2001Deepak G. Bedi MD Abstract Purpose The aim of this study was to describe the most common sonographic appearances of plantar fibromatosis, thus enabling sonographic diagnosis of this benign, focally invasive fibrous neoplasm. Methods The medical records, pathologic reports, and sonographic reports and images of 22 patients with palpable plantar masses were reviewed retrospectively. The sonographic findings were used to characterize those masses with respect to location, shape, size, and echogenicity. Sixteen patients were included in this study because of the proximity of their lesions to the plantar fascia; 6 patients were excluded because their lesions were metatarsophalangeal bursae or ganglia. Results The 20 feet examined in the 16 patients studied contained 43 distinct lesions, all located on the surface of the plantar fascia. Thirty-seven (86%) of the 43 were 20 mm long or less. Thirty-seven (86%) of the 43 lesions were elongated; the remaining 6 (14%) were round or oval. Twenty-five (68%) of the 37 elongated lesions had tapered ends, and the other 12 (32%) had rounded ends. Thirty-one (72%) of the 43 lesions were hypoechoic; 25 (81%) of these 31 measured as long as 10 mm. Ten (83%) of the 12 lesions that had mixed echogenicity were longer than 10 mm. Conclusions The lesions of plantar fibromatosis were characteristically located on the surface of the plantar fascia, sagittally elongated, most often less than 20 mm long, fusiform, and hypoechoic. Lesions longer than 10 mm often exhibited mixed echogenicity. The superficial location and appearance should strongly suggest plantar fibromatosis, although careful examination is required to exclude other possibilities, such as sarcoma. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:499,505, 2001. [source] Congenital myofibroma of the skin mimicking a piloleiomyomaJOURNAL OF CUTANEOUS PATHOLOGY, Issue 6 2010Takuya Inoue Myofibroma is an uncommon benign soft tissue disorder, which is usually congenital or present in early infancy. Myofibroma usually manifests as a single mass. When there are multiple lesions, the term myofibromatosis is used. The characteristic histopathological feature of the myofibroma is the coexistence of two distinct areas. One area mainly contains plump spindle cells with thin blunt-ended nuclei and eosinophilic cytoplasm, thus indicating myoid characteristics. The other area contains either round or polygonal cells with slightly pleomorphic, hyperchromatic nuclei or small spindle cells typically arranged around a distinct hemangiopericytoma-like vascular pattern. In the present case, the majority of the tumor was composed of the plump myoid spindle cells. This led to an initial diagnosis of a piloleiomyoma. However, the tumor cells were not immunohistochemically positive for desmin. Moreover, careful examination revealed a hemangiopericytoma-like vascular pattern characterized by the presence of high cellular areas with irregular vascular spaces. These features led to the final diagnosis of the myofibroma. It is therefore important to recognize the leiomyoma-like variants of myofibromas. Inoue T, Sada A, Mori T, Misago N, Narisawa Y. Congenital myofibroma of the skin mimicking a piloleiomyoma. [source] Trade and Growth: Reconciling the Macroeconomic and Microeconomic EvidenceJOURNAL OF ECONOMIC SURVEYS, Issue 4 2005Ricardo A. López Abstract., Many empirical studies based on plant-level data have found that firms that enter the export markets are more productive than non-exporters and that this difference in productivity is achieved before firms become involved in exporting. These findings have challenged the traditional view that openness to trade increases productivity and economic growth. This article reconsiders the literature on trade, growth, and trade policies and argues that a careful examination of these new findings is consistent with the idea that exporting increases productivity and economic growth. [source] Effects of the wood extractive betulinol and 17, -oestradiol on reproduction in zebrafish, Danio rerio (Hamilton) , complications due to a bacterial infectionJOURNAL OF FISH DISEASES, Issue 5 2004I Christianson-Heiska Abstract Zebrafish were exposed to the wood extractive betulinol (5 ,g L,1) and to 17, -oestradiol (E2, 0.27 ,g L,1) for 8 weeks in an attempt to study the possible endocrine-disrupting activity of betulinol. Females exposed to betulinol showed increased spawning intensity, while males exposed to betulinol and E2 had increased incidences of structural alterations in the testes. However, histological examination of the fish revealed that they were infected by acid-fast bacteria suspected to be Mycobacterium sp. despite a careful examination of their health state prior to the onset of the experiment. Fish exposed to betulinol and E2 showed more serious consequences of the bacterial infection than control fish indicating that the test chemicals had weakened the immune defence of the fish. When the exposure was repeated with healthy fish, an increase in the proportion of spermatogonia was seen in the testes of betulinol-treated males. A similar alteration, although not statistically significant, was also seen in the first experiment. However, no increase in the incidences of structural alterations in the testes was seen in betulinol- and E2-treated fish in the second experiment. Our study indicates that betulinol might have an endocrine-disrupting effect in zebrafish, but the increase in incidences of structural alterations in the testes might have been caused by a synergistic action between the test compounds and the bacterial infection. Our study stresses the importance of carefully checking the health of experimental fish, not only prior to the onset of an experiment but also upon termination of the experiment, in order to avoid misinterpretation of the results. [source] An Analysis of Possible Mechanisms of Unexpected Death Occurring in Hydatid Disease (Echinococcosis)JOURNAL OF FORENSIC SCIENCES, Issue 4 2009Roger W. Byard M.B.B.S. Abstract:, Most cases of hydatid disease in human populations are due to Echinococcus granulosus. The hydatid life cycle involves passage between definitive hosts such as dogs and intermediate hosts such as sheep. Humans become accidental intermediate hosts following ingestion of food or water contaminated with eggs or by contact with infected dogs. Although hydatid disease may remain asymptomatic, occasional cases of sudden and unexpected death present to autopsy. Causes of rapid clinical decline involve a wide range of mechanisms including anaphylaxis (with or without cyst rupture), cardiac outflow obstruction or conduction tract disturbance, pulmonary and cerebral embolism, pericarditis, cardiac tamponade, myocardial ischemia, pulmonary hypertension, peritonitis, hollow organ perforation, intracerebral mass effect, obstructive hydrocephalus, seizures, cerebral ischemia/infarction, and pregnancy complications. The autopsy assessment of cases therefore requires careful examination of all organ systems for characteristic cystic lesions, as multiorgan involvement is common, with integration of findings so that possible mechanisms of death can be determined. Measurement of serum tryptase and specific IgE levels should be undertaken for possible anaphylaxis. [source] Analyzing technology adoption using microstudies: limitations, challenges, and opportunities for improvementAGRICULTURAL ECONOMICS, Issue 3 2006Cheryl R. Doss Agricultural technology; Adoption; Methods of analysis Abstract Policy makers and interest groups have many questions about the use of improved technologies in developing country agriculture. These include the roles of policies, institutions, and infrastructure in the adoption of improved technologies and their impact on productivity and welfare. Most micro-level adoption studies, however, cannot address these important policy issues. Drawing on an extensive review of the literature on the adoption of agricultural technologies, this article suggests alternative approaches for designing technology adoption studies to make them useful for policy makers. It explores the generic limitations of cross-sectional adoption studies carried out in small numbers of communities and discusses some problems faced in conducting such studies. Recommendations include the use of sampling approaches that allow data from microstudies to be generalized to higher levels of aggregation, adherence to clearly defined terms that are standardized across studies, and careful examination of the assumptions that often underlie such studies. [source] Clinical pitfalls of pain recurrence in endometriosis arising in the posterior vaginal fornixJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2007Masahito Tachibana Abstract Endometriotic nodules in the lower genital tract often cause dysmenorrhea and dyspareunia. We report here a case of posterior vaginal fornix endometriosis that was overlooked for several years. We performed a trans -vaginal resection after the associated pain was not relieved by repetitive gonadotropin-releasing hormone agonist (GnRHa) therapy or abdominal surgery. After the resection, the patient's symptoms disappeared. The patient subsequently conceived and proceeded to a full-term delivery. The pathological diagnosis was ,endometriosis of the vagina.' Immunohistochemical staining revealed that the progesterone receptor-positive cells outnumbered the estrogen receptor-positive cells. We emphasize that the existence of vaginal lesions should be considered in cases in which pain has not improved despite long-term GnRHa administration, or in cases involving dyspareunia. To provide appropriate treatment, attentive evaluation and careful examination of the disease are necessary for a patient with prolonged unsatisfactory progress. [source] The Societal Consequences of Market Reform in PeruLATIN AMERICAN POLITICS AND SOCIETY, Issue 1 2006Moisés Arce ABSTRACT This article analyzes how market reform policies already in place affect social interests, and the feedback effects of those interests on reform processes. The variety of societal responses includes the creation of new societal organizations, reflecting the variable content and asymmetrical distribution of costs and benefits of the policies implemented. Because of this variety even in Peru, where the disorganizing effects of neoliberal reform appear to be strongest, it would seem that the societal impact of economic reform elsewhere in Latin America would also warrant more careful examination. [source] Gallbladder adenocarcinoma arising in Rokitansky,Aschoff sinusPATHOLOGY INTERNATIONAL, Issue 12 2008Tadashi Terada Carcinoma arising from Rokitansky,Aschoff sinus (RAS) is extremely rare; only eight cases have been reported in the literature. Herein is reported a case of minute adenocarcinoma arising in RAS. A 77-year-old Japanese man with gallbladder stones underwent cholecystectomy. A tiny submucosal tumor (1 cm × 1 cm) was incidentally recognized. Histologically, the submucosal tumor was located in the subserosa and, to a lesser extent, in the fibromuscular layer. It was adenocarcinoma. RAS were recognized within the tumor, and there was a gradual transition between RAS and the adenocarcinoma. Mucin histochemistry indicated neutral and acidic mucins in the cytoplasm and lumens of the adenocarcinoma cells. Immunohistochemistry showed that the adenocarcinoma cells were positive for cytokeratin, epithelial membrane antigen, carbohydrate antigen 19-9, K-i67 (labeling = 80%), MUC1, MUC5AC and MUC6. In contrast, the adenocarcinoma cells were negative for CEA, c-erbB2, p53 protein, MUC2 and CD10. In summary, minute subserosal adenocarcinoma, which arose in RAS, was found incidentally; therefore careful examination of resected gallbladders is necessary. [source] Surgical Excision of Pedunculated Supernumerary Digits Prevents Traumatic Amputation NeuromasPEDIATRIC DERMATOLOGY, Issue 2 2003Geoffrey E. Leber The first group consisted of three patients who had among them five traumatic amputation neuromas. In each case these lesions resulted from primary suture ligation of accessory digits in infancy. Secondary surgical excision of the vestigial digit with high ligation and retraction of the accompanying nerve tissue was required in all cases. The second group consisted of six patients who had 12 pedunculated supernumerary digits. Primary surgical excision of these digits was performed with high transection and retraction of the accompanying accessory digital nerve. All patients in this group had excellent cosmetic results with no postoperative neuroma formation. Adult family members who had undergone suture ligation of similar supernumerary digits in infancy accompanied seven of the nine patients in this series. On careful examination, each of these family members had signs and symptoms attributable to traumatic amputation neuromas. We feel identification and high transection of the accessory digital nerve is essential in the treatment of pedunculated supernumerary digits. This treatment prevents traumatic amputation neuromas and yields a better cosmetic result than the traditional method of suture ligation in infancy. [source] Photoperiod at conception predicts C677T-MTHFR genotype: A novel gene-environment interactionAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2010Mark Lucock Data is presented, which suggest that the day length a woman experiences during the periconceptional period predicts the C677T-MTHFR genotype of her child. Logistic regression analysis involving 375 neonates born in the same geographical location within a three year period demonstrated that photoperiod (minutes) at conception predicts both genotype (P = 0.0139) and mutant allele carriage (P = 0.0161); the trend clearly showing that the 677T-MTHFR allele frequency increases as photoperiod increases. We propose a number of explanations, including a hypothesis in which a long photoperiod around conception decreases maternal systemic folate because of UVA induced dermal oxidative degradation of 5-methyl-H4folate, leading to a lower cellular 5,10-methylene-H4folate status. In this scenario, 5,10-methylene-H4folate would be more efficiently used for dTMP and DNA synthesis by 677T-MTHFR embryos than wildtype embryos giving the 677T-MTHFR embryos increased viability, and hence increasing mutant T-allele frequency. Alternate hypotheses include: increased seasonal availability of folate rich foods that genetically buffer any negative effect of 677T-MTHFR in embryos; seasonal oxidative stress lowering embryo-toxic homocysteine; an undefined hormonal effect of photoperiod on the neuroendocrine axis, which mediates genotype/embryo selection. The effect of photoperiod on genotype seems clear, but the speculative molecular mechanism underpinning the effect needs careful examination. Am. J. Hum. Biol., 2010. © 2010 Wiley-Liss, Inc. [source] Submarket Dynamics of Time to SaleREAL ESTATE ECONOMICS, Issue 3 2006Gwilym Pryce We argue that the rush to apply multiple regression estimation to time on the market (TOM) durations may have led to important details and idiosyncrasies in local housing market dynamics being overlooked. What is needed is a more careful examination of the fundamental properties of time to sale data. The approach promoted and presented here, therefore, is to provide an examination of housing sale dynamics using a step-by-step approach. We present three hypotheses about TOM: (i) there is nonmonotonic duration dependence in the hazard of sale, (ii) the hazard curve will vary both over time and across intra-urban areas providing evidence of the existence of submarkets and (iii) institutional idiosyncrasies can have a profound effect on the shape and position of the hazard curve. We apply life tables, kernel-smoothed hazard functions and likelihood ratio tests for homogeneity to a large Scottish data set to investigate these hypotheses. Our findings have important implications for TOM analysis. [source] Postpartum Ovarian Activity and Serum Estradiol-17beta Level in Thai Crossbred Native MaresREPRODUCTION IN DOMESTIC ANIMALS, Issue 1 2007S Panasophonkul Contents To study the postpartum ovarian activities for investigation of first postpartum oestrus, twenty-five Thai crossbred native mares were monitored after parturition by oestrous detection, transrectal palpation and reproductive ultrasonography. Blood samplings were also taken for estradiol-17beta (E2) analysis. The first ovulation occurred within 20 days postpartum in 92% (23/25) of the mares. The mean intervals of foaling to first oestrus and to first ovulation were 10.3 ± 2.9 and 13.4 ± 2.6 days (mean ± SD) respectively. Serum E2 increased from 7.0 ± 2.9 to a peak of 10.8 ± 3.3 pg/ml (mean ± SD) at 2 days before ovulation. In conclusion, from the study, it can be stated that the postpartum breeding management should be considered after day 10 postpartum by careful examination of ovarian activity with various methods. However, the uterine condition should be also estimated associated with the ovarian activity after parturition which may increase breeding performance and foal production. [source] Syncretic Persons: Sociality, Agency and Personhood in Recent Charismatic Ritual Practices among North Mekeo (PNG)THE AUSTRALIAN JOURNAL OF ANTHROPOLOGY, Issue 3 2001Mark Mosko This paper explores the syncretic accommodations made by North Mekeo (PNG) villagers arising from recent historical encounters with Catholic (Sacred Heart) missionaries over issues of ritual authenticity and effectiveness, personhood, and agency in a wider field of Christian evangelism and globalisation. Through a careful examination and comparison of pre-existing ritual notions and practices (e.g., sorcery techniques, mortuary ritual performance, gender rituals) and the recent trends of commodification and enthusiastic Catholic charismatic performance, what might appear to be incongruous religious beliefs and practices are shown to possess numerous remarkably compatible similarities at the level of explicit cultural categorisation and ritual enactment. In accord with long-standing anthropological arguments, recent North Mekeo syncretism thus consists of an integrated, albeit transformed rather than ,confused', mixing of indigenous and exogenous religious elements. Further, in this analysis of recent Melanesian religious change syncretism implies a novel conceptual convergence between syncretic processes and the dynamics of personhood, sociality and agency as construed in the framework of the ,new Melanesian ethnography'. [source] The value of observations.THE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 628 2007II: The value of observations located in singular-vector-based target areas Abstract Data-assimilation experiments have been run in seven different configurations for two seasons to assess the value of observations taken in target regions identified either using singular vectors (SVs) or randomly, and located over the Pacific or the Atlantic Oceans. The value has been measured by the relative short-range forecast error reduction in downstream areas, specifically a North American region for observations taken in the Pacific Ocean, and a European region for observations taken in the Atlantic Ocean. Overall, results have indicated (1) that observations taken in SV-target areas are on average more valuable than observations taken in randomly selected areas, (2) that it is important that the daily set of singular vectors are used to compute the target areas, and (3) that the value of targeted observations depends on the region, the season and the baseline observing system. If the baseline observing system is data-void over the ocean, then the average value of observations taken in SV-target areas is very high. Considering for example winter 2004, SV-targeted observations over the Pacific (Atlantic) reduce the day-2 forecasts error of 500 hPa geopotential height forecasts in the verification region by 27.5% (19.1%), compared to 15.7% (14.9%) for observations taken in random areas. By contrast, if the baseline observing system is data-rich over the ocean, then the average value of observations taken in SV-target areas is rather small. Considering for example winter 2004, it has been estimated that adding SV-targeted observations over the Pacific (Atlantic) would reduce, on average, the day-2 forecasts error in the verification region by 4.0% (2.0%), compared to 0.5% (1.7%) for observations in random areas. These average results have been confirmed by single-case investigations, and by a careful examination of time series of forecast errors. These results indicate that more accurate assimilation systems that can exploit the potential value of localized observations are needed to increase the average return of investments in targeting field experiments. Copyright © 2007 Royal Meteorological Society [source] 1241: Failure of pattern recognitionACTA OPHTHALMOLOGICA, Issue 2010V PURVIN Purpose This course focuses on areas of frequent diagnostic confusion in neuro-ophthalmic diagnosis. Methods The course uses a case-based format. Cases are presented as unknowns, each illustrating the specific clinical feature or features that should point to the correct diagnosis. Results We hope that highlighting common errors in this way will help inspire the clinician to master the material so that such "pitfalls" can be avoided. Conclusion The common theme among the cases is that most neuro-ophthalmic diagnoses derive from the history and careful examination rather than the results of ancillary testing. [source] 3333: The clinical spectrum of corneal dystrophiesACTA OPHTHALMOLOGICA, Issue 2010P KESTELYN Purpose To review the most common corneal dystrophies from the clinician's standpoint. Methods A systematic overview of the natural history and the clinical characteristics of the most common corneal dystrophies will be presented following the anatomic classification: epithelial and anterior stromal dystrophies, stromal dystrophies, and Descemet and endothelial dystrophies. Abundant use of slitlamp images will help to illustrate the most salient clinical features. Conclusion Despite the fact that the knowledge about the genetic mutations responsible for the different corneal dystrophies has led to a better understanding of their basic defect and to molecular tests for their precise diagnosis, in most patients the careful examination at the slitlamp combined with personal and family history will remain the cornerstone for diagnosis, counseling and treatment. [source] | |||||||||||||||||||||||||||||||||||||