bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastric Metastasis of Triple Negative Invasive Lobular Carcinoma
Authors: Geredeli Caglayan , Dogru Osman , Omeroglu Ethem , Yilmaz Farise , Cicekci Faruk
Published: May 2015

Invasive lobular carcinomas are the second most common type (5% to 15%) of invasive breast carcinomas. The most frequent sites of breast cancer metastasis are the local and distant lymph nodes, brain, lung, liver, and bones; metastasis to the gastrointestinal system, especially to the stomach, is rare. When a mass is detected in an unusual place in a patient with invasive lobular carcinoma, it should be kept in mind that such a mass may be either a second primary carcinoma or the metastasis of an invasive lobular carcinoma. In this report, we present a case of gastric metastasis from triple-negative invasive lobular breast cancer. It is important to make an accurate diagnosis by distinguishing gastric metastasis from breast cancer in order to select the best initial treatment for systemic diseases of breast cancer. Considering our case, healthcare professionals should take into account that cases with invasive lobular breast cancer may experience unusual metastases.
Pediatric Metastatic Odontogenic Ghost Cell Carcinoma: A Multimodal Treatment Approach
Authors: Ahmed Safia K. , Watanabe Masayo , deMello Daphne E. , Daniels Thomas B.
Published: May 2015

Odontogenic ghost cell carcinoma (OGCC) is a rare and aggressive tumor wherein optimal treatment remains uncertain. We report the first pediatric metastatic OGCC case treated with multimodal therapy: surgery, adjuvant chemoradiation, and adjuvant immunotherapy. Adjuvant therapy was utilized due to locally advanced disease with pathologic features indicative of high recurrence risk. This multimodal approach was modeled after management of primary head and neck cancer, where adjuvant chemoradiation and immunotherapy are associated with improved outcomes. Our patient is alive and disease free at 14 months indicating a potentially positive role for multimodal therapy in the management of OGCC.
High Grade Leiomyosarcoma Mimicking a Recurrent Angiomyxoma in the Perineum
Authors: Sood Neha , Swaika Abhisek , Hanooshi Bashar , Waldorf James , Peterson Jennifer , Wu Kevin , Attia Steven , Dinh Tri A.
Published: May 2015

Perineal leiomyosarcoma is an extremely rare and aggressive cancer with a high metastatic potential and no defined standard treatment. There are only a few (six) reported cases in the literature. We report the case of a 67-year-old woman with a perineal leiomyosarcoma arising at the same site of a previously resected superficial angiomyxoma. Initially, she was treated for a presumptive recurrence of angiomyxoma. As she did not respond to medical therapy, she underwent repeat surgical excision. Pathology revealed a high grade leiomyosarcoma, histologically strikingly distinct from the initial diagnosis. She received adjuvant local radiation therapy, and remains without evidence of recurrent disease 36 months after completion of all therapy. This is the first reported case of a high grade perineal leiomyosarcoma originating at the same site as a resected benign superficial angiomyxoma. Our case emphasizes the necessity of a prompt histological diagnosis in cases of presumed recurrent perineal angiomyxoma.
Access to Care for Chagas Disease in the United States: A Health Systems Analysis
Authors: Manne-Goehler Jennifer , Reich Michael R. , Wirtz Veronika J.
Published: May 2015

There are 300,000 estimated cases of Chagas disease in the United States but limited data on access to care. This study analyzed trends in access to care for Chagas disease in the United States and assessed the national and state barriers to access. Data on cases in blood donors and drug releases were obtained from the AABB (formerly American Association of Blood Banks) and U.S. Centers for Disease Control and Prevention (CDC), respectively. Semi-structured in-depth interviews were conducted with 30 key informants at the national level and in five states where treatment had been released. Interview responses were analyzed according to the health systems dimensions of regulation, financing, payment, organization, and persuasion. Data indicate that 1,908 cases were identified in the blood donation system from 2007 to 2013 and that CDC released 422 courses of benznidazole or nifurtimox during this period. The barriers to access at the national level include limited diagnostic and institutionalized referral and care processes, lack of financing for patient-care activities, and limited awareness and training among providers. This study demonstrates that access to treatment of Chagas disease in the United States is limited. The lack of licensing is only one of several barriers to access, highlighting the need for a health systems perspective when scaling up access to these essential medicines.
Balanced Scorecard na Gestão Universitária: mapeamento sobre o tema utilizando o proknow-c
Authors: Matos Lucas dos Santos , Petri Sergio Murilo
Published: May 2015

A crescente importância do ensino superior no cenário econômico e social tem obrigado as universidades a melhorarem seus métodos de gestão, e uma das formas utilizadas tem sido a aplicação do Balanced Scorecard. Esta pesquisa, de natureza exploratório-descritiva, com abordagem quali-quantitativa, objetiva construir o conhecimento necessário sobre a utilização do Balanced Scorecard na gestão universitária, realizando um mapeamento sobre o tema a partir das delimitações dos pesquisadores. Esse conhecimento é tangibilizado pela seleção de artigos relevantes e com reconhecimento científico sobre o tema. É utilizada análise bibliométrica da literatura internacional, por meio do processo Knowledge Development Process – Constructivist (ProKnow-C). Os principais resultados obtidos foram: (i) International Journal of Educational Management é o periódico de maior destaque; (ii) “Commodification of education and academic LABOUR - using the balanced scorecard in a university setting” destaca-se entre os artigos; (iii) Janne Kettunen é o autor mais prolífico.
Polar processing in a split vortex: Arctic ozone loss in early winter 2012/2013
Authors: Manney G. L. , Lawrence Z. D. , Santee M. L. , Livesey N. J. , Lambert A. , Pitts M. C.
Published: May 2015

Abstract. A sudden stratospheric warming (SSW) in early January 2013 caused the Arctic polar vortex to split and temperatures to rapidly rise above the threshold for chlorine activation. However, ozone in the lower stratospheric polar vortex from late December 2012 through early February 2013 reached the lowest values on record for that time of year. Analysis of Aura Microwave Limb Sounder (MLS) trace gas measurements and Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) polar stratospheric cloud (PSC) data shows that exceptional chemical ozone loss early in the 2012/13 Arctic winter resulted from a unique combination of meteorological conditions associated with the early-January 2013 SSW: unusually low temperatures in December 2012, offspring vortices within which air remained well isolated for nearly 1 month after the vortex split, and greater-than-usual vortex sunlight exposure throughout December 2012 and January 2013. Conditions in the two offspring vortices differed substantially, with the one overlying Canada having lower temperatures, lower nitric acid (HNO3), lower hydrogen chloride, more sunlight exposure/higher ClO in late January, and a later onset of chlorine deactivation than the one overlying Siberia. MLS HNO3 and CALIPSO data indicate that PSC activity in December 2012 was more extensive and persistent than at that time in any other Arctic winter in the past decade. Chlorine monoxide (ClO, measured by MLS) rose earlier than previously observed and was the largest on record through mid-January 2013. Enhanced vortex ClO persisted until mid-February despite the cessation of PSC activity when the SSW started. Vortex HNO3 remained depressed after PSCs had disappeared; passive transport calculations indicate vortex-averaged denitrification of about 4 parts per billion by volume. The estimated vortex-averaged chemical ozone loss, ~ 0.7–0.8 parts per million by volume near 500 K (~21 km), was the largest December/January loss in the MLS record from 2004/05 to 2014/15.
Investigating the observed sensitivities of air quality extremes to meteorological drivers via quantile regression
Authors: Porter W. C. , Heald C. L. , Cooley D. , Russell B.
Published: May 2015

Abstract. Air pollution variability is strongly dependent on meteorology. However, quantifying the impacts of changes in regional climatology on pollution extremes can be difficult due to the many non-linear and competing meteorological influences on the production, transport, and removal of pollutant species. Furthermore, observed pollutant levels at many sites show sensitivities at the extremes that differ from those of the overall mean, indicating relationships that would be poorly characterized by simple linear regressions. To address this challenge, we apply quantile regression to observed daily ozone (O3) and fine particulate matter (PM2.5) levels and reanalysis meteorological fields in the United States over the past decade to specifically identify the meteorological sensitivities of higher pollutant levels. From an initial set of over 1700 possible meteorological indicators (including 28 meteorological variables with 63 different temporal options) we generate reduced sets of O3 and PM2.5 indicators for both summer and winter months, analyzing pollutant sensitivities to each for response quantiles ranging from 2–98%. Primary drivers of high-quantile O3 levels include temperature and relative humidity in the summer, while winter O3 levels are most commonly associated with incoming radiation flux. Drivers of summer PM2.5 include temperature, wind speed, and tropospheric stability at many locations, while stability, humidity, and planetary boundary layer height are the key drivers most frequently associated with winter PM2.5. We find key differences in driver sensitivities across regions and quantiles. For example, we find nationally averaged sensitivities of 95th percentile summer O3 to changes in maximum daily temperature of approximately 0.9 ppb °C−1, while the sensitivity of 50th percentile summer O3 (the annual median) is only 0.6 ppb °C−1. This gap points to differing sensitivities within various percentiles of the pollutant distribution, highlighting the need for statistical tools capable of identifying meteorological impacts across the entire response spectrum.
Black carbon aerosol in winter northeastern Qinghai-Tibetan Plateau, China: the effects from South Asia pollution
Authors: Wang Q. Y. , Huang R.-J. , Cao J. J. , Tie X. X. , Ni H. Y. , Zhou Y. Q. , Han Y. M. , Hu T. F. , Zhu C. S. , Feng T. , Li N. , Li J. D.
Published: May 2015

Abstract. Black carbon (BC) aerosol at high-altitude Qinghai-Tibetan Plateau has potential effects on the regional climate and hydrological cycle. An intensive measurement campaign was conducted at Qinghai Lake (∼ 3200 a.s.l.) at the edge of the northeastern Qinghai-Tibetan Plateau during winter using a ground-based single particle soot photometer (SP2) and a photoacoustic extinctiometer (PAX). The average BC concentration and number fraction of coated BC were found to be 160 ± 190 ng m-3 and 59.3% for the entire campaign, respectively. Significant enhancements of BC loadings and number fraction of coated BC were observed during pollution episode, with an average value of 390 ng m-3 and 64.6%, respectively. The mass size distribution of BC particles showed lognormal distribution with a peak diameter of ∼ 187 nm regardless of the pollution level. Five-day backward trajectory analysis combined with the fire counts map suggests that the biomass burning air masses from North India contributing to the increased BC loadings during the campaign. The potential source contribution function (PSCF) model further proves that North India is an important potential region influencing northeastern Qinghai-Tibetan Plateau during the pollution episode. The BC mass absorption cross section (MACBC) at λ = 532 nm was slightly larger during pollution episode (10.2 m2 g-1) than in clean days (8.9 m2 g-1), likely due to the higher mixing state of BC with other chemical components during pollution episode. The number fraction of coated BC particles showed positive correlation with light absorption, suggesting that the increase of coated BC particles will enhance the light absorption. The estimated BC direct radiative forcing was +0.93 W m-2 for pollution episode, which is 2 times larger than that in clean days. Our study provides insight into the potential climatic impacts of BC aerosol transported to the Qinghai-Tibetan Plateau from South Asian regions, and is also useful for future modeling studies.
Roads at risk: traffic detours from debris flows in southern Norway
Authors: Meyer N. K. , Schwanghart W. , Korup O. , Nadim F.
Published: May 2015

Abstract. Globalisation and interregional exchange of people, goods, and services has boosted the importance of and reliance on all kinds of transport networks. The linear structure of road networks is especially sensitive to natural hazards. In southern Norway, steep topography and extreme weather events promote frequent traffic disruption caused by debris flows. Topographic susceptibility and trigger frequency maps serve as input into a hazard appraisal at the scale of first-order catchments to quantify the impact of debris flows on the road network in terms of a failure likelihood of each link connecting two network vertices, e.g. road junctions. We compute total additional traffic loads as a function of traffic volume and excess distance, i.e. the extra length of an alternative path connecting two previously disrupted network vertices using a shortest-path algorithm. Our risk metric of link failure is the total additional annual traffic load, expressed as vehicle kilometres, because of debris-flow-related road closures. We present two scenarios demonstrating the impact of debris flows on the road network and quantify the associated path-failure likelihood between major cities in southern Norway. The scenarios indicate that major routes crossing the central and north-western part of the study area are associated with high link-failure risk. Yet options for detours on major routes are manifold and incur only little additional costs provided that drivers are sufficiently well informed about road closures. Our risk estimates may be of importance to road network managers and transport companies relying on speedy delivery of services and goods.
Interactions between the Somali Current eddies during the summer monsoon: insights from a numerical study
Authors: Akuetevi C. Q. C. , Barnier B. , Verron J. , Molines J.-M. , Lecointre A.
Published: May 2015

Abstract. Three hindcast simulations of the global ocean circulation differing by resolution (1/4 or 1/12°) or parameterization or atmospheric forcing are used to study the fast interactions between the large anticyclonic eddies generated by the Somali Current system during the Southwest Monsoon. The present investigation of the Somalian coherent eddy structures allows us to identify the origin and the subsequent development of the cyclones flanked upon the Great Whirl (GW) previously identified by Beal and Donohue (2013) in satellite observations and to establish that similar cyclones are also flanked upon the Southern Gyre (SG). These cyclones are identified as major actors in mixing water masses within the large eddies and offshore the coast of Somali. All three simulations bring to light that during the period when the Southwest Monsoon is well established, the SG moves northward along the Somali coast and encounter the GW. The interaction between the SG and the GW is a collision without merging, collision during which the GW is pushed to the east of Socotra Island, sheds several smaller patches of anticyclonic vorticity, and often reforms into the Socotra Eddy, thus proposing a formation mechanism for the Socotra Eddy. During this process, the GW gives up its place to the SG which in turn becomes a new Great Whirl. This process is robust throughout the three simulations.
INSTITUCIONALIZAÇÃO DA ASSEMBLEIA LEGISLATIVA DO ESTADO DE SÃO PAULO (ALESP): EVIDÊNCIAS DE UM PARLAMENTO SUBNACIONAL BRASILEIRO
Authors: Fiore Danilo Cesar
Published: May 2015

O artigo procura mensurar o grau de institucionalização da Assembleia Legislativa do Estado de São Paulo (ALESP) no período recente a partir de indicadores consagrados da literatura em ciência política. Além de uma breve revisão teórica sobre o conceito, são apresentados resultados empíricos que demonstram crescente institucionalização deste Poder Legislativo subnacional. Ao final, são discutidas as implicações destes achados a partir da crítica à própria noção de institucionalização e de sua aplicação para a compreensão da dinâmica do sistema político e federativo brasileiros.
INEFICÁCIA DOS INSTRUMENTOS DE CONTROLE: REFLEXOS DE UMA CULTURA POLÍTICA PATRIMONIALISTA
Authors: Sperandio Santos Nair De Lourdes
Published: May 2015

A corrupção no Brasil, apesar do controle das instâncias fiscalizadoras, tem se apresentado como um fenômeno persistente na trajetória histórica política. Este artigo tem o objetivo de apresentar a ineficácia dos instrumentos utilizados pelas instâncias institucionais fiscalizadoras para o enfrentamento da corrupção no Brasil, sob a perspectiva da cultura política patrimonialista. A metodologia desta pesquisa é de abordagem qualitativa e se apropria de revisão bibliográfica pertinente à construção histórica brasileira e análise de legislações. O tema se torna relevante, não somente pela sua atualidade na esfera pública do Brasil, mas também pela atuação do fenômeno da corrupção com características contrárias aos princípios que regem os regimes republicanos, essencialmente a separação das esferas pública e privada. Traz os princípios constitucionais que possibilitam seu afastamento, especialmente o princípio da impessoalidade. Destaca-se que as reformas, as legislações específicas e o controle das instâncias institucionais fiscalizadoras para inibi-lo ou combatê-lo, têm se apresentado insuficientes e ineficazes. Conclui-se como uma das grandes necessidades neste âmbito, a intensificação da participação da sociedade civil em um espírito político crítico, capaz de romper com a força das condutas culturais e atuar como instrumento que iniba a propagação do fenômeno.
NOTAS METODOLÓGICAS DE UMA PESQUISA SOBRE AS POLÍTICAS PÚBLICAS DE ESPORTE
Authors: Toledo Renata Maria , Silva Bega Maria Tarcisa
Published: May 2015

Este trabalho visa a expor a estrutura teórico-metodológica que confere sustentação a uma pesquisa de doutoramento em sociologia, ainda em curso, cujo enfoque são as políticas públicas setoriais de esporte que se desenvolveram ao longo das gestões de Jaime Lerner (1995-2002) e Roberto Requião (2003-2010). Dividido em duas partes, o texto apresenta, na primeira seção, o processo de construção do objeto de pesquisa, identificando os pontos de inflexão que sofreu desde o projeto original da até a formatação final da problematização sobre a qual nos debruçamos em nosso estudo. Em seguida, efetua uma explanação sobre a estrutura metodológica, o quadro de informações utilizadas bem como as respectivas fontes para levantamento dos dados que se fizeram necessários para a análise do referido objeto.
O ESTADO E A AÇÃO POLÍTICA ORGANIZADA: COOPERATIVISMO AGROPECUÁRIO NO ESTADO DO PARANÁ (1907-1988)
Authors: Ricken Francis Augusto Goes , Stöberl Paulo Roberto
Published: May 2015

O cooperativismo agropecuário ocupa papel relevante na economia do Paraná, alcançando elevado percentual no PIB estadual, bem como respeitável número de participação humana (OCEPAR, 2013). Em análise histórica do “movimento cooperativo” notamos a presença de intensa tutela estatal nas cooperativas até 1988. Para entendimento da dimensão e influencia do Estado em um setor privado da sociedade, procedemos análise das ações estatais, incluindo a atividade legislativa, no período de (1907-1988). Comprovamos a influencia do Estado desde a formação dos grupos organizados cooperativos até a o apoio à estruturação da entidade de representação, sendo esta presença do Estado elemento essencial na arquitetura que resultou a estruturação do “sistema cooperativo” paranaense da atualidade. Metodologicamente dividimos a análise em quatro períodos históricos principais: (i) definição legal das primeiras organizações cooperadas (1907-1938); (ii) estruturação dos grupos cooperativos (1944-1964); (iii) institucionalização da entidade de representação (1965-1971); (iv) regulação do cooperativismo – criação e extinção da tutela estatal nas organizações cooperativas (1971-1988). As conclusões preliminares demonstram que o cooperativismo passou por diversas fases de desenvolvimento até alcançar o pleno estabelecimento de uma organização liberta do Estado com ação em prol dos interesses de seus membros (OLSON, 2011; MANCUSO, 2007; COSTA, 2012).
Platelets and vascular inflammation of the brain
Authors: Mezger M. , Göbel K. , Kraft P. , Meuth S. G. , Kleinschnitz C. , Langer H. F.
Published: May 2015

There is emerging evidence that platelets have an important role in inflammation beyond their involvement in hemostasis. Platelets can contribute to inflammatory reactions via crosstalk both with immune cells and endothelial cells. Inflamed vessels are characterized by the presence of activated endothelial cells. These activated endothelial cells upregulate receptors necessary for leukocyte recruitment, but also for the adhesion of platelets. Subsequently, immune cells can bind to platelets through adhesion receptors presented on the platelet surface, thus supporting leukocyte recruitment to the vessel wall. There are several neurological diseases associated with vascular inflammation including multiple sclerosis (MS) and stroke. Increased markers of platelet activation could be demonstrated in patients suffering from MS compared to healthy individuals. Reports from murine models indicate that platelets may be of importance for disease progression and severity by mediating leukocyte recruitment as one potential underlying mechanism. Blocking platelet function disease severity was considerably ameliorated. Moreover, processes of tissue remodelling may be influenced by platelet derived mediators. Whether a role of platelets for vascular inflammation can be extrapolated to further neurological diseases will have to be investigated in further in depth experimental and clinical trials.

Platelets and platelet associated mechanisms may offer novel starting points to understand neurovascular diseases from a different point of view and to develop novel approaches to access the disease.
A rare entity in adults: Bilateral Hutch diverticulum with calculi
Authors: Telli Onur , Guclu Adil Gucal , Haciyev Perviz , Burgu Berk , Gogus Cagatay
Published: May 2015

Congenital bladder diverticulum (CBD) is a very uncommon entity in adults. CBD could be unilateral or bilateral and is caused by a congenital weakness in the bladder musculature. CBD is differentiated from the paraureteral or Hutch type of diverticula. A 42-year-old male presented with bilateral Hutch diverticulum and multiple diverticulum calculus on intravenous pyelography. Cystoscopy revealed bladder diverticulum just medial to the left ureteral orifice with multiple calculi; the patient successfully underwent endoscopic laser cystolithotripsy with resolution of his urinary tract infection. To the best of our knowledge, this is the first case report presenting stone formation of CBD in an adult.
The influence of membranous stretched urethral length and urethral circumference on postoperative recovery of continence after radical prostatectomy: A pilot study
Authors: Cho Dae Sung , Lee Eun Ju , Kim Se Joong , Kim Sun Il
Published: May 2015

Introduction: We investigate the influence of stretched membranous urethral length (SUL) and urethral circumference (UC) on postoperative recovery of continence after radical prostatectomy (RP).Methods: To evaluate the distal continence zone intraoperatively, we individually measured and recorded stretched membranous urethral length (distance between the urogenital diaphragm and the prostate apex with cephalad retraction, SUL) and urethral circumference (UC) after exposure of the urethra. We analyzed the association between magnetic resonance imaging-measured membranous urethral length (MRIL) and urethral diameter (MRID) and intraoperative SUL and UC and influence on return to continence.Results: The mean patient age, SUL and UC were 66.5 ± 6.0 years, 24.2 ± 3.3 mm, and 27.5 ± 4.4 mm, respectively. MRIL and MRID were 11.3 ± 1.6 mm and 10.6 ± 1.9mm, respectively. In the bivariate correlation analysis, there was no statistically significant correlation between SUL and MRIL (p = 0.201) and between UC and MRID (p = 0.124). In the Kaplan-Meier curve analysis, cumulative continence rates between the two groups dichotomized at the median value according to age (p = 0.0519), SUL (p = 0.6583), UC (p = 0.4031), MRIL (p = 0.4042), and MRID (p = 0.8191) were not significantly different. High SUL-to-MRIL ratio (>2.2) was the only significant predictor of lower cumulative continence rate (p = 0.0457).Conclusions: MRIL measured during surgery was not associated with postoperative continence recovery after RP. We observed that an excessively long membranous urethra compared to the urethral length on preoperative MRI is predictive of poorer postoperative continence recovery. However, small sample size and potential confounding surgical factors limit the significance of this study.
Primitive neuroectodermal tumour of the kidney: An unusual case mimicking renal angiomyolipoma with minimal fat
Authors: Xie Jing , Wen Jin , Bi Ya-lan , Li Han-zhong
Published: May 2015

Primitive neuroectodermal tumour (PNET) is a highly aggressive neoplasm that develops classically in the central nervous system. PNET of the kidney (rPNET) is extremely rare. Recently, a 23-yearold woman complained of left flank pain and intermittent hematuria for 3 months and was admitted to our hospital. A computed tomography (CT) scan and magnetic resonance imaging demonstrated a 5.1 × 4.4-cm heterogenous mass with unconspicuous reinforcement in the upper pole of the left kidney. F18-FDG positron emission tomography CT (PET-CT) revealed the mass as a benign lesion with internal extensive bleeding. Renal angiomyolipoma with minimal fat was diagnosed. Three months later, a CT scan showed that the mass shrank to 3.1 × 2.6 cm and nephron-sparing surgery of the left kidney was performed at the patient’s request. However, histologic features and immunohistochemical analysis confirmed the diagnosis of rPNET. Five cycles of combined chemotherapy were executed. At the 11-month follow-up, the patient showed no evidence of metastasis or recurrence.
The role of steroid treatment in intractable cystitis glandularis: A case report and literature review
Authors: Yuksel Ozgur Haki , Urkmez Ahmet , Erdogru Tibet , Verit Ayhan
Published: May 2015

Cystitis glandularis is a proliferative disease of the urinary bladder epithelium. It is rare in children. We report a case of a 23-yearold female with intractable macroscopic hematuria and severe irritative bladder symptoms persisting for 13 years. The patient, who had undergone open and endoscopic bladder surgery at various medical centres, is currently being followed up at our clinic. Cystoscopy revealed multiple edematous papillary tumours on the bladder neck, trigone, and lateral wall on both sides and she underwent transurethral resection of the bladder tumour. The pathological diagnosis was cystitis glandularis in accordance with the histopathological reports obtained from the other medical centres. Her condition was resistant to transurethral resection, partial cystectomy, intravesical mitomycin, and bacillus Calmette-Guerin (BCG) treatment; it eventually could have affected the upper urinary tract. Oral steroid treatment was given for 6 months; after treatment, her symptoms improved and the cystoscopy revealed a dramatic improvement in her condition.
Intravesical bacillus Calmette-Guérin versus chemohyperthermia for high-risk non-muscle-invasive bladder cancer
Authors: Ekin Rahmi Gokhan , Akarken Ilker , Zorlu Ferruh , Tarhan Huseyin , Kucuk Ulku , Yildirim Ekin Zubeyde , Divrik Rauf Taner
Published: May 2015

Introduction: Patients with high-risk non-muscle invasive bladder cancer (NMIBC) need adjuvant intravesical treatment after surgery. Although bacillus Calmette-Guérin (BCG) is highly effective, new adjuvant treatments to decrease recurrences and toxicity have been studies. We performed a retrospective propensity score-matched study to compare the efficacy of BCG and chemohyperthermia (C-HT).Methods: We included 1937 patients diagnosed with bladder cancer between January 2004 and January 2014. The primary efficacy endpoint was recurrence-free interval. Patients treated with C-HT were matched with patients treated with BCG using propensity score- matched analysis. Cox-regression models were used to estimate the association between intravesical treatments and the presence of recurrence and progression.Results: Of the 710 patients treated with intravesical treatments, 40 and 142 were eligible for inclusion in C-HT and BCG groups, respectively. Following case matching, there were no differences in patient or tumour characteristics between treatment groups. The 2-year recurrence-free interval in C-HT and BCG groups were 76.2% and 93.9%, respectively (p = 0.020). C-HT treatment (hazard ratio [HR] 5.42; 95% confidence interval [CI] 1.11–26.43; p = 0.036) and high-grade tumour (HR 4.60; 95% CI 1.01–20.88; p = 0.048) are associated with an elevated odds of tumour recurrence. In multivariate Cox-regression analysis, there was no significant difference between C-HT and BCG in the odds of recurrence (p = 0.054). There were no differences in progression between C-HT and BCG.Conclusion: C-HT is not as effective treatment as BCG in high-risk NMIBC patients who are BCG-naive. Although, there were no significant difference in the odds of recurrence, recurrence-free interval is significantly improved by the administration of BCG.
Isolated epididymal injury after blunt scrotal trauma from high velocity paintball round
Authors: Dale Robert , Hoag Nathan A.
Published: May 2015

Isolated epididymal injury without associated underlying scrotal or testicular injury in the setting of blunt trauma is exceedingly rare. We present a case of an isolated epididymal injury incurred after scrotal trauma from a high velocity paintball round. Ultrasound demonstrated an enlarged, hypoechoic left epididymis with no evidence of underlying testicular injury. This case highlights the importance of obtaining imaging to evaluate for signs of testicular rupture, potentially obviating the need for surgery. It also reinforces the need for appropriate protective gear when participating in activities with potential for high velocity scrotal trauma.
The World Health Organization Classification of Skeletal Muscle Tumors in Pediatric Rhabdomyosarcoma: A Report From the Children's Oncology Group
Authors: Rudzinski Erin R. , Anderson James R. , Hawkins Douglas S. , Skapek Stephen X. , Parham David M. , Teot Lisa A.
Published: May 2015

Context

Since 1995, the International Classification of Rhabdomyosarcoma has provided prognostically relevant classification for rhabdomyosarcoma (RMS) and allowed risk stratification for children with RMS. The International Classification of Rhabdomyosarcoma includes botryoid and spindle cell RMS as superior-risk groups, embryonal RMS as an intermediate-risk group, and alveolar RMS as an unfavorable-risk group. The 2013 World Health Organization (WHO) classification of skeletal muscle tumors modified the histologic classification of RMS to include sclerosing RMS as a type of spindle cell RMS separate from embryonal RMS. The current WHO classification includes embryonal, alveolar, spindle cell/sclerosing, and pleomorphic subtypes of RMS and does not separate the botryoid subtype.

Objective

To determine if the WHO classification applies to pediatric RMS.

Design

To accomplish this goal, we reviewed 9 consecutive Children's Oncology Group clinical trials to compare the WHO and International Classification of Rhabdomyosarcoma classifications with outcome and site of disease.

Results

Except for a subset of low-risk RMS, the outcome for botryoid was not significantly different from typical embryonal RMS when analyzed by primary site. Similarly, pediatric spindle cell and sclerosing patterns of RMS did not appear significantly different from typical embryonal RMS, with one exception: spindle cell RMS in the parameningeal region had an inferior outcome with 28% event-free survival.

Conclusion

Our data support use of the WHO RMS classification in the pediatric population, with the caveat that histologic diagnosis does not necessarily confer the same prognostic information in children as in adults.
Using Local Flaps in a Chest Wall Reconstruction after Mastectomy for Locally Advanced Breast Cancer
Authors: Park Joo Seok , Ahn Sei Hyun , Son Byung Ho , Kim Eun Key
Published: May 2015

Background Surgical ablation for locally advanced breast cancer results in large chest wall defects, which can then be managed with local flaps or skin grafts. The purpose of this article is to evaluate the outcomes of three types of local skin flaps.

Methods Among 25 local flaps in 24 patients, 6 were bilateral advancement (BA) flaps, 9 were thoracoabdominal (TA) flaps, and 10 were thoracoepigastric (TE) flaps. Clinical outcomes were compared including complications, the need for a secondary surgical intervention, and the timing of adjuvant therapy.

Results The mean defect size was 436.2 cm2. Two patients with TA flaps and 6 patients with TE flaps developed distal flap necrosis, and skin grafts were needed to treat 2 patients with TE flaps. Radiation was administered to the BA, TA, and TE patients after average postoperative durations of 28, 30, or 41 days, respectively. The incidence of flap necrosis tended to be higher in TE patients, which lead to significant delays in adjuvant radiation therapy (P=0.02).

Conclusions Three types of local skin flaps can be used to treat large chest wall defects after the excision of locally advanced breast cancer. Each flap has its own merits and demerits, and selecting flaps should be based on strict indications based on the dimensions and locations of the defects.
Contralateral Breast Symmetrisation in Immediate Prosthetic Breast Reconstruction after Unilateral Nipple-Sparing Mastectomy: The Tailored Reduction/Augmentation Mammaplasty
Authors: Salgarello Marzia , Visconti Giuseppe , Barone-Adesi Liliana , Franceschini Gianluca , Masetti Riccardo
Published: May 2015

Background In the literature on nipple-sparing mastectomy (NSM) with one-stage immediate implant reconstruction, contralateral symmetrisation has drawn little attention, with many surgeons still performing standard cosmetic mammaplasty procedures. However, standard implant-based mammaplasty usually does not result in proper symmetry with the mastectomy side, especially regarding breast projection, overall shape, and volume distribution.

Methods We retrospectively reviewed 19 consecutive patients undergoing unilateral NSM with immediate prosthetic reconstruction and contralateral simultaneous symmetrisation by using the tailored reduction/augmentation mammaplasty technique between June 2012 and August 2013.

Results The average follow-up time was 13 months (range, 10-24 months). No major complications, such as infection, haematoma, and nipple-areola complex necrosis, were experienced.

Conclusions Our experience suggests that simultaneous contralateral symmetrisation with tailored reduction/augmentation mammaplasty after unilateral immediate implant reconstruction after NSM facilitates durable and pleasant symmetric outcomes.
Use of a Barbed Suture Tie-Over Technique for Skin Graft Dressings: A Case Series
Authors: Joyce Kenneth M , Joyce Cormac W , Mahon Nicola , Kelly Jack L
Published: May 2015

Background A tie-over dressing is the accepted method to secure skin grafts in order to prevent haematoma or seroma formation. We describe the novel application of a barbed suture tie-over for skin graft dressing. The barbs act as anchors in the skin so constant tensioning of the suture is not required.

Methods From January 2014 to August 2014 we used the technique in 30 patients with skin defects requiring split-thickness or full-thickness grafts. Patient demographics, clinicopathological details and graft outcome were collected prospectively.

Results The majority of cases were carried out for split-thickness skin grafts (n=19) used on the lower limb (n=20). The results of this novel technique were excellent with complete (100%) graft take in all patients.

Conclusions Our results demonstrate the clinical application of a barbed device for securing skin grafts with excellent results. We find the technique quick to perform and the barbed device easy to handle, which can be applied without the need for an assistant.
Four Flaps Technique for Neoumbilicoplasty
Authors: Lee Young Taek , Kwon Chan , Rhee Seung Chul , Cho Sang Hun , Eo Su Rak
Published: May 2015

The absence or disfigurement of the umbilicus is both cosmetically and psychologically distressing to patients. The goal of aesthetically pleasing umbilical reconstruction is to create a neoumbilicus with sufficient depth and good morphology, with natural-looking superior hooding and minimal scarring. Although many reports have presented techniques for creating new and attractive umbilici, we developed a technique that we term the "four flaps technique" for creating a neoumbilicus in circumstances such as the congenital absence of the umbilicus or the lack of remaining umbilical tissue following the excision of a hypertrophic or scarred umbilicus. This method uses the neighboring tissue by simply elevating four flaps and can yield sufficient depth and an aesthetically pleasing shape with appropriate superior hooding.
A Portable Mirror Stand for Clinical Facial Photo Documentation
Authors: Supit Laureen , Prasetyono Theddeus OH
Published: May 2015

In plastic surgery, patient photography is a vital component of clinical, educational, legal, and research documentation. Optimal acquisition of photographic data requires a dedicated photography studio or a three-dimensional anatomic scanner, both of which are financially impractical for most clinicians. Simplified photo standardization is proposed for use in random clinical settings by using a portable device called the Mirror Stand (MirS). This model device aims to mimic a studio environment by incorporating the basic elements of producing consistent photographs. The pilot MirS is designed for facial photography. Images of 40 random subjects were obtained using the MirS with three different cameras. Real anthropometric measurements of each subject were collected, compared with the photographic measurements, and analyzed. In this study, all three cameras produced equally reliable measurements. Actual facial measurements were comparable to the photogrammetric measurements obtained from photographs taken using the MirS. A constant formula was derived; it allowed the conversion of photographic values into real anthropometric values. The MirS produced consistent photographs with respect to the measurements. The photographs obtained could be translated reliably into their real anthropometric measurements. Therefore, the MirS can be applied in daily practice, providing an efficient alternative for obtaining a standard justifiable photograph.
Sofosbuvir: an all-around drug in hepatitis C treatment new era – The first phase
Authors: Ciancio Alessia
Published: May 2015

Chronic hepatitis C virus (HCV) infection is a slowly progressive disease affecting more than 185 million people worldwide. For many years, the combination of pegylated interferon (Peg-IFN) plus ribavirin (RBV) has been the backbone of treatment for patients infected with HCV. More than two years ago, the first generation direct-acting antiviral agents (DAAs) – the protease inhibitors boceprevir and telaprevir – were approved for treatment of genotype 1 patients, doubling the cure rate. The new DAAs that have been developed, are effective for multiple genotypes, improve rates of sustained viral response with fewer side effects, simplify dosing and drug-drug interactions, and in some patients, offer the promise of interferon-free and/or ribavirin-free therapy. These new agents include the recently approved second generation protease inhibitor, the HCV NS5B polymerase inhibitor sofosbuvir and the NS3/4A protease inhibitor simeprevir as well as several other agents that are currently in later phases of development. With sofosbuvir-based regimens, successful interferon-free treatment is now available across all genotypes. In fact sofosbuvir is very effective in combination with Peg-interferon and ribavirine or with ribavirine alone or with other direct anti-viral agents. The following assessment evaluates the evidence on the clinical effectiveness and harms of sofosbuvir for the treatment of chronic hepatitis C.
Prolégomènes à la représentation analytique des musiques électroacoustiques
Authors: Couprie Pierre
Published: May 2015

Partant de la pratique de la transcription dans l’analyse des musiques électroacoustiques, cet article pose les fondements d’une nouvelle forme de représentation. Inscrite au coeur même des méthodes d’analyse musicale, la représentation analytique permet de tisser un ensemble de formes symboliques dans des visualisations complexes associant des données acoustiques et musicales sur les oeuvres. Son caractère modulaire et ouvert en fait un outil très intéressant pour la recherche musicale, que ce soit dans le domaine de l’analyse musicale ou de la création artistique.
Les deux corps du droit. La nature et le rôle du droit dans la pensée de Claude Lefort1
Authors: Simard Augustin
Published: May 2015

On rend souvent hommage à Claude Lefort pour avoir avancé une compréhension originale de la démocratie, qui met en son centre une réflexion sur le droit en rupture avec l’individualisme libéral et l’anti-juridisme marxiste. Même si cette réflexion a connu un certain écho dans les années 1980, elle a été largement ignorée par les efforts subséquents pour renouveler la théorie politique sur la base d’une relation « co-originaire » (Habermas) entre démocratie et droits fondamentaux. Comme cet article cherche à le montrer, ce fait tient pour une part à la singularité du contexte politico-intellectuel français, mais aussi et surtout à une difficulté fondamentale quant à la manière d’approcher l’objet « droit ». La réflexion de Lefort s’efforce en effet de combiner deux compréhensions du droit (comme médium et comme institution) qui ne sont pas parfaitement congruentes, même si elles informent toutes deux sa conception de la démocratie. Il en résulte un va-et-vient constant entre un registre agonistique, inspiré par l’oeuvre de Machiavel, et un registre « libéral », insistant sur le caractère formel et « désincorporé » du droit. C’est sur ce dernier point que les propos de Lefort conservent quelque chose d’ambigu et d’inachevé.
Claude Lefort : portée et limite d’une phénoménologie politique
Authors: Louis Agnès
Published: May 2015

L’oeuvre de Claude Lefort peut être présentée comme une phénoménologie du politique. Pour lui, la vie sociale se donne en effet comme la manifestation d’une logique politique propre à chaque société. Autrement dit, le politique constitue un véritable « phénomène » apparaissant à travers les différents aspects de la coexistence sociale. Cette analyse permet à Lefort de réaffirmer la consistance propre du politique et de redéfinir le rôle du penseur politique. Cependant, la phénoménologie de Lefort semble négliger certains aspects de notre expérience politique. En particulier, elle fait peu de place à l’analyse des opinions politiques qui s’opposent en démocratie.
La division originaire du social. Lefort lecteur de Lacan ?
Authors: Colonna d’Istria Pauline
Published: May 2015

Cet article propose une réflexion sur le rapport entre pensée politique et théorie psychanalytique dans l’oeuvre de Claude Lefort, notamment à partir d’une analyse de la notion de « division originaire » du social. L’importance conférée par Lefort à la notion de conflit dans sa reconceptualisation du fait démocratique est le plus souvent rattachée à sa relecture de Machiavel : pour comprendre la place et le rôle fondamental du conflit politique, il faut en quelque sorte jouer Machiavel contre Marx. Or, si le terme de conflit est bien présent dans son oeuvre comme synonyme de désaccord, d’opposition, et même comme conflit de classes, le terme est recouvert par celui de division dont Lefort précise qu’elle est originaire. Et s’il fallait, pour cerner les enjeux de cette thèse, se tourner vers Lacan plutôt que vers Machiavel ? Bien que Lefort n’approfondisse nulle part clairement la référence à la psychanalyse, l’empreinte de certains concepts (symbolique, Loi, désir) est, dans son oeuvre, presque partout palpable, et nous croyons utile d’opérer, voire de reconstruire certains rapprochements.
Le chagrin d’Achille et la colère de Brad : réflexion sur une médiation oubliée dans la représentation des affects extrêmes
Authors: Lamoureux Johanne
Published: May 2015

À partir d’une critique de l’interprétation du personnage d’Achille par Brad Pitt dansTroie(Troy, 2004), cet article montre que le jeu de l’acteur, lorsqu’il s’agit d’exprimer les affects extrêmes de la colère et du chagrin qui caractérisent le héros homérique, reconduit des conventions figuratives et des effets de censure déjà mis en place par la représentation des mêmes épisodes au sein des beaux-arts. Or c’est là une médiation négligée par les spécialistes des études cinématographiques et desqueer studiesqui ont beaucoup commenté le film, en déclinant la longue liste des écarts entre l’oeuvre épique et son adaptation cinématographique, mais sans tenir compte de la tradition figurative, revisitée par la peinture de la fin duxviiie siècle, qui s’est trouvée elle aussi confrontée aux difficultés d’adapter visuellement la démesure affective et expressive de l’Achille d’Homère, pour un public dont l’idéal antique de beauté virile s’appuyait désormais sur un canon classique postérieur de plusieurs siècles à l’Iliade.
Charles Koechlin et l’amour des stars. L’acteur et son jeu comme moteur expressif d’une musique de cinéma idéale
Authors: Duchesneau Michel
Published: May 2015

Dans les années 1930, le compositeur Charles Koechlin (1867-1950) se découvre une passion pour le cinéma parlant ; outre ses articles sur le sujet, il a laissé des notes personnelles et des projets de scénarios et de musiques de film, allant jusqu’à concevoir des scénarios cinématographiques pour une musique qui n’existe pas et une musique pour des images qui n’existent pas — mais qui, dans son imaginaire, sont à la fois compatibles et de la plus haute tenue artistique. À cette passion s’ajoute celle qu’il éprouve pour les stars du cinéma et plus particulièrement pour l’actrice Lilian Harvey (1906-1968) ; Koechlin sublimera cet amour en musique et composera plus d’une centaine de pièces réunies dans les deux Albums de Lilian et dans Le portrait de Daisy Hamilton. Cet article tente une analyse des trois éléments cinématographiques — mouvement, ligne et expression — que Koechlin s’attache à transposer en musique dans ses « sketches pour un film imaginaire », et montre qu’au-delà des principes esthétiques qui l’animent, le compositeur trouve dans l’image sonore un matériau d’un dynamisme, d’une plasticité et d’une sensualité qu’aucune autre forme d’inspiration n’avait pu lui donner jusque-là.