Metastatic liver disease--a review

A common site of metastasis due to various forms of primary malignancies, is the liver. At present, increased screening of patients at risk has allowed early detection of the disease. Consequently, surgeons have started to perform hepatic resection for metastatic cancer, with the help of new or improved techniques with an enlarged spectrum of indications. New therapeutic modalities have also become available with the use of anti-cancer drugs, via new delivery devices, prior or after liver resection. Locoregional transarterial immuno-chemotherapy and isolated liver perfusion belong to this form of therapy. Although prognosis has improved impressively and low mortality and morbidity have emerged through improved surgical procedures, many patients still succumb to the disease due to locoregional recurrence of metastatic liver disease.     

Moving into the information era: does the current nursing paradigm still hold?

The transition into the information era is characterized by society's passage through three crossroads representing a change from: (a) technology to post-technology; (b) rigid jobs and hierarchies to dejobbing and vanishing hierarchies; and (c) limited competition to competition dominating all markets. These transitions have caused dramatic changes in the health care system at large and escalating problems that cannot be solved within the current paradigm of nursing. Among the nursing problems that were identified are those including difficulties in: (a) defining the relative contribution of nursing vis a vis other health professions; (b) the scope and dimensions of nursing authority; (c) implementing all aspects of the nursing intervention; (d) actualizing caring in nursing intervention; and (f) implementing the nursing process as a major thinking process in the profession. The analysis of the state of nursing suggests that the current clinical paradigm fails to consolidate the economic and quality issues into the core of nursing. It is not capable of solving central professional problems and emerging dilemmas. Considering that under the current paradigm, nursing has difficulties in highlighting to clients and the system alike where nursing can make a difference, it is questionable whether such a paradigm can ensure the existence of nursing in the future.     

Resolution of lexical ambiguity: Evidence from an eye movement priming paradigm.

Subjects' eye movements were monitored while they read 2-sentence passages of text. A target-word region was defined in the 2nd sentence of each passage. During the initial 35 ms of a target region eye fixation, an ambiguous word was presented as a prime. A target word subsequently replaced the prime during the fixation. Priming was measured by comparing fixation times on targets preceded by semantically related versus unrelated ambiguous primes. The type of prior context (consistent vs. inconsistent), type of ambiguous prime (biased vs. balanced), and strength of instantiated meaning (dominant vs. subordinate) could all affect priming. Priming effects were only found when the prior context was consistent with the dominant sense of a biased ambiguous prime. The results are discussed in terms of models of ambiguity resolution: The data seem most consistent with a reordered access model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Central core disease--a congenital myopathy

A case is reported of a 28-year-old woman with central core disease who prior to muscle biopsy was diagnosed to have muscular dystrophy. Histologic evaluation confirmed a diagnosis of central core disease, a nonprogressive or slowly progressive disorder of voluntary muscle belonging to a group of muscle diseases called benign congenital myopathies. The clinical and pathologic features fo this benign disorder are reviewed. Two sons were examined and found to be normal.     

Borreliosis--Lyme disease--a growing clinical problem

Neovascularization on the center of rabbit cornea was induced by 5N.NaOH alkali burns. We studied the change in localization of acidic fibroblast growth factor (a-FGF) and basic fibroblast growth factor (b-FGF) through corneal neovascularization with immunohistochemistry, using eyes which we enucleated on the 3rd, 7th, and 14th day. Moreover, by co-cultivation of rabbit corneal stromal cells and adrenal cortical vascular endothelium of bovine, a capillary-like code was induced, in which we also studied the localization of a-FGF and b-FGF on the 3rd, 7th, and 14th day. On the 14th day after the alkali burn we recognized intrastromal neovascularization and positive staining of a-FGF and b-FGF around it. Strong staining of a-FGF was observed in goblet cells through the experimental period. In control eyes we recognized positive reaction of a-FGF in corneal and conjunctival epithelium. In co-cultured cells, we recognized positive staining of both a-FGF and b-FGF around the capillary-like code which was induced among the corneal stromal cells.     

The effect of the gap paradigm on the latency of human smooth pursuit of eye movement

When a temporal gap is introduced between the extinction of a central fixation target and the illumination of an eccentric target (the gap paradigm), normal human subjects initiate saccadic eye movements towards the eccentric target at lower latency than when there is no gap. The aim of this study was to examine the latency of human smooth pursuit eye movements using a modified gap paradigm. Smooth pursuit latency was reduced in gap tasks, and the magnitude of reduction was related to the duration of the gap. The distribution of smooth pursuit latencies was also altered. It thus appears that human smooth pursuit latency is modulated in a similar manner to saccade latency in gap tasks.     

Linear IgA disease--a review of four patients

Four cases of Linear IgA Disease (LAD) seen over a five year period are reviewed and our most recent LAD patient is described in detail. We summarise data on our patients and outline clinicopathologic features, aetiology and management of this unusual but important condition.     

A patient with acromegalic heart disease--a case report

A perioperative anesthetic management of a 69 year old woman with acromegaly whose clinical course was characterized by severe heart failure is described. The patient showed symptoms of massive cardiomegaly. Endocrine studies indicated that her pituitary tumor was active with hyperproduction of growth hormone. There was no demonstrable evidence for other known causes of heart disease. Following hormonal therapy using continuous subcutaneous infusion of somatostatin for about two months, there was improvement in daily activity and reduction in heart size. After the improvement of cardiac function, transsphenoidal hypophysectomy was performed under general anesthesia and its perioperative course was quite uneventful. We conclude that because cardiac involvement such as left ventricular dilatation in acromegaly might be reversible with proper treatment, any surgical procedure, as long as the case is elective, should be considered after hormone therapy.     

The Paget's disease--a gerontological study (author's transl)

Authors found Paget's disease in cases among 1500 patients who considered themselves as healthy. They established their diagnosis on the basis of radiological and laboratory examinations. The incidence rate of Paget's disease was 0,7%, however it must be more frequent in the old groups. The familiar incidence of this illness is not frequent, thus it is rather intriguing that three persons i.e., 2 sisters and 1 brother is one family were found to have Paget's disease showing similar clinical and radiological symptoms. After three years the comparative examinations of two returning aged women showed a progress of Paget's disease. This manifested in exacerbation of osteopathy and increased the activity of the serum-alkaline-phosphatase. The cases of Paget's disease were reported by the authors because of the radiological interest, familiar incidence and the gerontological-geriatrical aspects.     

Splenectomies for Hodgkin's disease--a study of the period 1984-1994

Explorative laparotomy with ensuing splenectomy in Hodgkin's disease is applied for the first time in the Stanford University in the late 60-ies. Opinions on the pros and cons of the method in terms of number of cases, complications and the like are largely dissenting. The analysis covers 153 patients with Hodgkin's disease subjected to splenectomy. Primary diagnosis is made on the ground of lymph node biopsy. Wide spreading of the disease, coincidence of diagnoses in different locations and complications are briefly discussed, with recommendations made concerning improvement of the organization of sample handling and correlation with the clinical findings.     

On paradigm shifts.

Three points of issue raised by E. M. Segal and R. Lachman's (see record 1972-22033-001) article on paradigm shifts in psychology are discussed: (1) that scientists are more concerned with a paradigm than a world view, (2) the criteria for identifying scientific revolution, and (3) the demise of stimulus-response behaviorism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aortic dissection in a patient receiving chemotherapy for Hodgkin's disease--a case report

Cancer chemotherapy is associated with a wide range of vascular toxicities, which may be related to endothelial cell damage by these agents. The authors describe a patient with Hodgkin's disease who developed an atypical aortic dissection while receiving MOPP/ABV chemotherapy (nitrogen mustard, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine). They would place aortic dissection on the list of potential vascular complications associated with antineoplastic agents.     

Occupational and environmental exposures and nonspecific lung disease--a review of selected studies

Selected studies show that nonspecific lung diseases are a major occupational and environmental health hazard. Exposure to mineral dusts (such as cement and brown coal) and organic dusts (cotton, hemp and flour) as well as manganese and gaseous irritants causes significant upper respiratory tract injury. Possible additive effects of mixed exposures, combined exposure to dusts and gaseous irritants of the upper respiratory tract, individual susceptibility, and mechanisms of nonspecific respiratory effects of exposures are considered. Interpretation of the results is difficult due to uncontrolled confounding. Measures for preventing lung impairments include exposure reduction and preemployment examination of workers.     

Cowden's disease--a report on the first case in Korea and literature review

Cowden's disease, or multiple hamartoma syndrome, is an uncommon condition with characteristic mucocutaneous lesions associated with abnormalities of the breast, thyroid, and gastrointestinal tract. We describe a 32-year-old man with oral mucosal papillomatosis and plantar hyperkeratosis as a definite case of Cowden's disease according to the criteria proposed by Salem and Steck. The patient also had a thyroid mass and numerous gastrointestinal polyps endoscopically. Histologically the polyps were hamartomatous or hyperplastic polyps. The oral papillary lesions were fibroepithelial polyps and the thyroid mass was a follicular adenoma. We review the literature on this entity and summarize the pertinent findings. To the best of our knowledge, this is the first documented case of Cowden's disease in a Korean.     

Developmental hematopoiesis

Hematopoiesis is a developmental process that evolves throughout the lifespan of an individual. Most work in the field has focused on events occurring in the adult bone marrow (BM). In the embryo, blood and endothelial cell generation begins very early after gastrulation, in defined intraembryonic mesodermic sites. Recent multidisciplinary studies, taking advantage of classic embryological and gene targeting technology in various species, have provided a new image of embryofetal lymphohemopoiesis, which includes the suggestion of developmental compartmentalization or waves. The first hematopoietic stem cells (HSC) migrate further and home in an ordered sequence of supporting microenvironments depending on scarcely known molecular requirements. These early hematopoietic progenitors show important differences in their cell biology and differentiation potentialities with respect to those present in adult stages; this fact, together with specific microenvironmental influences, define a process that diverges significantly from that occurring in the BM. Here, we update the latest developments in the field, the new understanding of lymphohemopoiesis in prenatal life, and the novel questions that this emerging paradigm is producing.