bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful treatment of mucosa-associated lymphoid tissue lymphoma in a patient with gastric and rectal lesions with metachronous and ectopic development
Authors: Watanabe Takuya , Suda Takeyasu , Hirono Haruka , Hasegawa Katsuhiko , Soga Kenji , Shibasaki Koichi , Umezu Hajime
Published: June 2011

A 75-year-old female, who had an abnormal stomach x-ray finding, was admitted to the hospital for further examination and therapy. Upper GI endoscopy showed reddish and swollen folds on the greater curvature of the gastric body and a biopsy was of this lesion revealed malignant lymphoma (small cell type or mucosa-associated lymphoid tissue (MALT) lymphoma suspected). The patient was infected with Helicobacter pylori ( H. pylori), however, in response to the patient's wishes, a total gastrectomy, omentectomy and splenectomy were performed and the histological diagnosis was gastric MALT lymphoma. Two courses of CHOP therapy (cyclophosphamide (CPM) 750 mg/m2/day, day 1, adriamycin (ADM) 50 mg/m2/day, day 1, vincristine sulfate (VCR) 1.4 mg/m2/day, day 1, prednisolone 100 mg/body, day 1–5) were administered as adjuvant chemotherapy. A colonoscopic examination performed about 4.5 yr after the operation revealed rectal submucosal tumors and the biopsied specimens were diagnosed as malignant lymphoma. A transanal focal resection was performed and the histological diagnosis was metachronous and ectopic development of MALT lymphoma. The histological finding was similar to the gastric lesion. About 4 and 7 yr after the first development of rectal MALT lymphoma, MALT lymphomas developed repeatedly in the rectal lesion, however, these were resected repeatedly and no developmenthas occurred during the past two years. This report presents a very rare case of metachronous and ectopic MALT lymphoma development in the gastric and rectal lesions.
Andries van Aarde as historical Jesus scholar
Authors: Le Roux Jurie
Published: June 2011

This article focuses on Andries van Aarde’s work on the historical Jesus and especially his book, Fatherless in Galilee, which made an important contribution to historical Jesus study in South Africa. In the first part of the article Van Aarde’s historical and social approaches are highlighted, his ongoing reflection on the resurrection described and his work on the Infancy Gospel of Thomas accentuated. In the second part we discuss Van Aarde’s depiction of Jesus as someone who grew up fatherless. For Jesus this meant a lifelong struggle against slander and exclusion from the temple and the presence of God. Jesus nevertheless trusted God who filled Jesus’ emptiness. Jesus was baptised and then started a ministry, focusing on the outcasts of society. He preached that the kingdom of God had come and that the people of this kingdom could experience God, as well as forgiveness of sins. Jesus died but arose in the kerygma. The article also refers to the struggle of the authors of the New Testament writings to understand and express the Jesus event.
(The Markan and Matthean) Jesus’ appropriation and criticism of the Torah: The question of divorce
Authors: Scheffler Eben
Published: June 2011

According to the Gospel of Matthew, Jesus functions as a Moses figure who, in the Sermon on the Mount, gave the new law of the kingdom of God. In this article it is argued that Jesus drew his ethic from his Jewish tradition, as manifested particularly in the Pentateuch. However, although being an inspiring source, to Jesus the Pentateuch (or scripture) was not an authority that could not be challenged or criticised. This is illustrated by focusing on the question of divorce (Mk 10:2–12; Mt 5:27–32; 19:3–12). It is argued that Jesus’ use of the Pentateuch was guided by an ethic of compassion. In view of Jesus’ stance, an uncritical use of the Bible (as manifested for example in many Christian circles) ironically contradicts the Bible’s own message and nature.
‘Suffering Violence’ and the kingdom of heaven (Mt 11:12): A Matthean manual for life in a time of war
Authors: Weaver Dorothy Jean
Published: June 2011

Matthew’s Gospel has much to say about ‘suffering violence’. As Jesus comments (11:12, NRSV), ‘From the days of John the Baptist until now the kingdom of heaven has suffered violence, and the violent take it by force’. Through his narrative rhetoric Matthew offers multi-layered perspectives on life lived vis-à-vis ongoing violence. These perspectives reflect (1) the experiences of the righteous as they encounter violence, (2) the words of Jesus depicting or predicting the sufferings of himself and others, (3) the words of Jesus calling people to faithful responses to violence, and (4) Matthew’s own narrative rhetoric offering theological reflection on the suffering of the righteous. This study examines the Matthean theme of ‘suffering violence’; the first section focuses on the nature and cause of the violence faced by the righteous; the second section focuses both on Jesus’ call to faithful responses to violence and on actual lived responses to violence; the final section focuses on the rhetorical strategy of Matthew’s narrative in relation to the question of violence and assesses Matthew’s theological reflections on the suffering of the righteous. The study concludes with brief reflections on the present-day implications of Matthew’s text for life ‘in a time of war’.
Augustinus’ geschrift ‘De stad van God’ (De ciuitate Dei): Een introductie tot de belangrijkste themata
Authors: Van Oort Johannes
Published: June 2011

The aim of the article is to present an introduction to the main themes of Augustine’s City of God. The key issues concerning the inception and contents of the work are highlighted. The article emphasises that Biblical interpretation played a pivotal role in this work, which is perhaps the most influential of Augustine’s oevre. It is probably because of his work, De ciuitate Dei, that the Church Father Augustine is also influential in the field of the history of Biblical hermeneutics.
Andries van Aarde – A sideways glance: His theological and hermeneutical contribution to the South African scene
Authors: De Villiers Gerda
Published: June 2011

This article pays tribute to Andries van Aarde’s theological and hermeneutical contribution. His research unfolds in three phases: a narrative reading of the text, a social scientific investigation of the context and an ‘ideal construct’ of the historical Jesus. Despite the theoretical nature of these inquiries, Van Aarde indicates convincingly their practical value for the church and society on the whole.
Walter Schmithals: His contribution to the theological and historical interpretation of the New Testament
Authors: Boshoff Piet B.
Published: June 2011

The aim of this article was to explain Walter Schmithals’ unique understanding of the unity of the New Testament message. It focuses on his historical en theological interpretation of the New Testament within the parameters of the historical-critical paradigm. This article describes how Schmithals combines historical criticism with the core tenets of Protestant theology. The following facets were emphasised: Gnosticism, gospel studies and Q, Paul, early Christianity, emperor cult, separation from the synagogue, historical Jesus, apocalypticism, historical Jesus, the relationship between the Old and New Testament, ecclesiology and New Testament ethics.
Festivals, cultural intertextuality, and the Gospel of John’s rhetoric of distance
Authors: Carter Warren
Published: June 2011

Imperial and civic-religious festivals pervaded the late first-century city of Ephesus where John’s Gospel was, if not written, at least read or heard. How did Jesus-believers as likely members of somewhat participationist synagogue communities negotiate such pervasive and public celebration of festivals? Did they participate in, ignore, or oppose such festivals? And how might John’s Gospel have encouraged them to respond?This article engages these questions by focusing on the narrative presentation of festivals in John’s Gospel (some 42 times) as, amongst other things, occasions of conflict and condemnation. Employing Sjef van Tilborg’s notion of ‘interference’, which prioritises the Ephesian civic interface of the Gospel’s audience, the article argues that the cultural intertextuality between the Gospel and an Ephesian context destabilises and problematises Ephesian civic festivals and shows there to be fundamental incompatibilities between Jesus’ work and Ephesian society, thereby seeking Jesus-believers to absent themselves from festivals. The Gospel’s presentation of festivals belongs to the gospel’s rhetoric of distance vis-à-vis societal structures.
Christians reacted differently to non-Christian cults
Authors: Verhoef Eduard
Published: June 2011

Christians were confronted with many other religions during the expansion of Christianity. What was their attitude towards these other religions? Apparently Christians reacted very differently. Earlier I argued that the Christians in Philippi adopted some elements of the cult of Euephenes, an initiate in the Kabeiric cult of Samothrace. The Kabeiric cult was very much present in Thessalonica as well. In this article I argued that, here too, Christians took over some elements of the Kabeiric cult. In some other cities non-Christian cults were eliminated. These different reactions towards other religions and cults seemed to stem from the local situation. In particular, local religious customs seem to have been adopted and to have taken precedence over well-known national or even international religions. Apparently, it was very difficult for people to abandon strong local rituals.In 1997, Andries van Aarde and Sanrie van Zijl published a very interesting article in which they drew attention to the pagan Hellenistic background that may have played a role in the development of Christology. Though more aspects should be taken into consideration it is self-evident to me that the entire history of the Christian church can be understood only against the background of the whole contemporary world. For example, Christians reacted very differently to non-Christian cults after they had assumed power in the Roman Empire. Sometimes temples and shrines were devastated, sometimes they were reused as churches. And sometimes elements of other cults were adopted in a more or less Christianised form. Recently I argued that in Philippi the cult of Euephenes, an initiate in the cult of the Kabeiroi on Samothrace, was succeeded by the veneration of Paul.In the present article, however, I focused on the cult of Kabeiros in Thessalonica and its impact on the cult of Demetrios that was already thriving there, whereby the latter cult began to incorporate elements of the former. I concluded the article with short remark about the way Christians elsewhere adopted or rejected other cults, touching on the question why, in some cases, an older cult was integrated into the Christian cult and why it was terminated in other cases.
God’s health and human health: A proposal for the world of well-being
Authors: Ellens J. Harold
Published: June 2011

This article reflects on people’s presuppositions with regard to God’s mental health as it has been recounted throughout history. The article asserts that the dominant report of a ‘sick god’ has nothing to do with God at all, but is, instead, the manifestation of a sick projection of people who are terrified of the unknown and the unpredictable in life. Such a projection reflects their own fears, which they project upon their own mental image of the mentor who they thought was God. The other, sound, report on God’s mental health has encountered many difficulties in competing with the dominant report. The alternative report has met with much resistance, because it seems so humanly unbelievable, in its claim that God is a God of unconditional grace to all humankind.
Jesus and the law revisited
Authors: Loader William R.G.
Published: June 2011

This article revisited the issue of Jesus’ attitude towards the Torah on the basis of a critical discussion of the most recent extensive treatment of the theme by Meier in his A marginal Jew: Rethinking the historical Jesus: Volume four: Law and love (2009). It engaged Meier’s contribution in the light of contemporary research, concluding that, whilst Meier provided an erudite analysis, his thesis that Jesus’ teaching on divorce and oaths revoked Mosaic law did not convince, for it did not adequately consider the extent to which the contemporary interpretation of the Torah could encompass such radicalisation.
John’s Apocalypse: Dynamic word-images for a new world
Authors: Rosell Sergio
Published: June 2011

The aim of the article is to investigate the function of the symbols and images in the Apocalypse of John. Its aim is to focus on the ‘mental scenarios’ readers are bringing to the text, rather than on John’s supposed lack of ability to convey his message. The article discusses both the symbolic or iconographic and the evocative power within the historical situation which the author of the Apocalypse addresses. The article’s intention is to show how John reveals an alternative way of understanding history through the use of his particular imagery, aided by film theory tools and based on previous work that had perceived the Apocalypse’s ‘theatrical’ nature, in order to discover John’s use of images, their function and the new world he aims to portray.
‘Laat uw Naam geheiligd worden’: Een uiting van eerbied aan God
Authors: Vledder Evert-Jan
Published: June 2011

Along with Norman Metzler, I will argue that the first petition of the Lord’s prayer: ‘Hallowed be thy Name’ (Mt 6:9b) is not the first petition in proper sense. It rather can be seen as a ‘parenthetical doxological phrase’ that describes closer the address ‘Our Father in Heaven’ (Mt 6:9b), following examples in both Jewish and Muslim traditions. The question will be raised whether the devotional address to God is not a stronger base for respectful co-existence and dialogue with each other than a rather general moral demand of ‘having respect for each other’?
Do not worry in Kinywang’anga: Reading Matthew 6:25–34 in a Tanzanian village
Authors: Häkkinen Sakari
Published: June 2011

One of the presumptions of this article is that most of the people in the nascent ‘Christian’ communities were ordinary people struggling with questions of living under harsh conditions in a country that was occupied by an enemy force. Another presumption is that the history of these ordinary people from antiquity needs to be heard. The article aimed, with the help of archaeology, cultural anthropology, social history of antiquity, literature of the time as well as other disciplines, to create a social context of Jesus and his disciples. The article approached the Gospels in the New Testament from the poor, the majority of people living in the 1st century Roman Empire. It gives a brief analysis of one of the poverty texts, namely Matthew 6:25–34. By means of interviews, stories of villagers in Tanzania, as well as their interpretations of the Gospel texts, have been documented. The people of Kinywang’anga serve as a test case for reading the ‘do not worry’ exhortation in the Matthean passage.
Hermeneutics in identity formation: Paul’s use of Genesis in Galatians 4
Authors: Punt Jeremy
Published: June 2011

Paul’s hermeneutics, in dealing with the scriptures and traditions of Israel and his concern for a specific identity for the communities he interacted with, require attention for the reciprocal, interrelationship between hermeneutics and identity in his letters. Paul’s quotations from and allusions to the scriptures of Israel but also his argument which was a re-interpretation of the traditions of Israel, functions in Galatians 4:21–5:1 at one level as counter-argument to the position of his opponents in Galatia but, at another deeper level, also as a forceful attempt to (re)establish and reinforce the identity of the community of followers of Jesus. His appropriation of the scriptures, his revisionist interpretation of the Abraham narrative and in particular his construal of its lasting implications provided the interpretative map on which Paul plotted an emerging ‘Christian’ identity. But, reciprocally, Paul’s sense of a new or renewed identity in Christ also determined the contours of his hermeneutics.
‘Ever old and ever new, keep me travelling along with you’: 21st Century Notae Ecclesiae specifically necessary for churches in southern Africa
Authors: Duncan Graham A.
Published: June 2011

The ecumenical marks of the church – unity, holiness, catholicity and apostolicity – have served it well as defining characteristics since the 4th century CE. The Reformation required that they be redefined in a particular context in terms of the soundness of doctrine preached, celebration of the sacraments and the exercise of discipline. In the 21st century these ecumenical marks are still relevant not only within an ecclesiastical context but in society using Koffeman’s quality markers of these marks – conciliarity, integrity, inclusivity and authenticity.
Does John 17:11b, 21−23 refer to church unity?
Authors: Malan Gert J.
Published: June 2011

In ecumenical circles, John 17:11b, 21–23 has been understood as Jesus’ prayer for church unity, be it confessional or structural. This article questioned such readings and conclusions from historical, literary and sosio-cultural viewpoints. The Fourth Gospel’s language is identified as ’antilanguage’ typical of an ’antisociety’, like that of the Hermetic, Mandean and Qumran sects. Such a society is a separate entity within society at large, but opposes it. Read as a text of an antisociety, John 17:11b, 21–23 legitimises the unity of the separatist Johannine community, which could have comprised several such communities. This community opposed the Judean religion, Gnosticism, the followers of John the Baptist and three major groups in early Christianity. As text from the canon, this Johannine text legitimates tolerance of diversity rather than the confessional or structural unity of the church.
Homeless in Galilee
Authors: Brawley Robert L.
Published: June 2011

This article has located Jesus’ saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic covenant traditions and the prophetic hope expressed especially in Isaiah, Ezekiel and Psalm 37, Jesus proclaimed God’s kingdom as God’s rule over heaven and earth, which implicates restoration of equitable access to the resources of the earth. The Lord’s Prayer, presumptions about the water of Jacob’s well in John 4 and the parable of the unjust steward in Luke 16 are used to demonstrate understandings of violations of equitable access according to Abrahamic covenant traditions and the hope for the restoration thereof.
Finding a place for Jesus as healer in Reformed mission in Africa
Authors: Van Wyk Ignatius W.C.
Published: June 2011

Africa is a continent plagued with many sicknesses and diseases. Self-evidently health and healing would be major concerns and interests of the inhabitants.Reformed mission has formed a strategic alliance with scientifically tested medicine in the past. Africans do not find this alliance sufficient. They, however, need a medical mission that could deal with ‘African sicknesses’. The question is whether we need an alliance with traditional medical practitioners. Because traditional healing is linked to traditional religion, we are confronted with difficult missiological questions.The solution offered in this article concentrates on two dimensions, (1) an openness to and a respect for African culture and religion and (2) a radical rediscovery of Jesus as healer.
Opstandingsverhale en opstandingsdogma
Authors: Spangenberg Izak J.J.
Published: June 2011

Resurrection narratives and the doctrine of resurrectionThe article examined the closing narratives of the four canonical gospels and argued that they should be read as stories and not as historical narratives. These stories, however, show a progressive development and it is evident that the narrators of the later stories embellished the earlier narratives. Christian theologians of later centuries developed these stories into a theology of salvation and linked resurrection to the idea of death being God’s punishment for Original Sin. By doing so, they changed the Gospel of Jesus into the Gospel about Jesus. Currently, people have a different understanding of themselves and the world in which they live. Death is seen as part of the cycle of life and humans, like everything else, will not be resurrected but recycled. That is one of the reasons why Christianity is in dire need of a new paradigm that will take into account the real position of human beings in the cosmos.
Show, tell and re-enact: The reason why the earliest followers of Jesus found the Eucharist meaningful
Authors: Groenewald Jonanda
Published: June 2011

The purpose of this article has been to examine how the earliest followers of Jesus experienced the Eucharist. What was their reason for participating in the Eucharist? What kind of value did this rite add to their lives? What was the meaning attached to it? In the end, this approach might assist us to gain a deeper understanding of this ‘early Christian’ rite, which, in turn, could help us to comprehend what kind of value the Eucharist could add to our lives today.
Chrysostom on hunger and famine
Authors: Stander Hennie
Published: June 2011

This article looked at hunger and famine in Chrysostom’s time. It has always been tragic and ironic that hunger should exist in a world of plenty. This topic has been discussed from an economic, social, theological, philosophical, medical, humanitarian and exegetical perspective. Chrysostom’s statements on this issue are studied, but our concern is only involuntary hunger, whilst voluntary forms of self-denial are being excluded. An attempt is made to define a social construct of poverty and hunger in Chrysostom’s world.
Paul and Africa?
Authors: Loba-Mkole Jean-Claude
Published: June 2011

The relationship between Saint Paul and the continent of Africa has never been a significant point of discussion in the New Testament studies. The same can be observed about other continents, even if the study of the Pauline corpus touches on some countries of Europe and the Middle East. The present article was triggered by the invitation of the Catholic Church to celebrate the 3rd millennium of Paul’s birthday during the period of June 2008 – June 2009, which was declared as the Year of Paul all over the world. It raises and discusses the question of relevance of Paul to Africa and vice versa in the light of intercultural exegesis.
The future existence of the believers according to 2 Thessalonians
Authors: De Villiers Pieter G.R.
Published: June 2011

This article investigated the presentation of the future existence of the believers in Paul’s second letter to the Thessalonians. It analysed how the eschatological language of this letter reflects a situation in Thessalonica which has grown worse since the writing of 1 Thessalonians. It went on to explain to readers how this situation is handled by reflecting on it in terms of a divine plan and by portraying a future in which their suffering will come to an end. A close reading of some passages in 2 Thessalonians which speak of the dispensation which will follow on the glorious return of Christ at the end were presented during the course of this article. It investigated Christ’s glorification at his return and delineated the way in which this return affects and determines the existence of those who accepted Paul’s proclamation of the gospel. The future glory of the Lord is revealed, experienced and shared by believers in a mystical manner. The article ended with a brief discussion on the traditions which determined this perspective, the context in which the eschatological portrait must be understood and how the portrait of the future serves to support the community of saints in their time of suffering.
On pilgrimage with biblical women in their land(s)
Authors: Wainwright Elaine M.
Published: June 2011

Recent sociological and anthropological studies have provided models for examining pilgrimage both in its ancient and contemporary manifestations. Such models can facilitate an examination of the phenomenon of study tours to biblical lands and the multivalence of the discourses associated with such tours. The first part of the article engaged critically with the literature in order to open up some frameworks for examining the study tour to biblical lands. Feminist critical biblical scholarship with its potential for a feminist hermeneutic of creative imagination contributes to the multivalence around the study tour. Therefore, the second part of the article engaged this scholarship in relation to an imagined tour with women of the biblical lands. The article highlighted significant issues for consideration for those planning a study tour of biblical lands, especially in terms of the consideration that ought to be paid to gender.
A son in heaven, but no father on earth: A note in the margin of a ‘Tale of Two Kings’
Authors: Verheyden Joseph
Published: June 2011

The article is meant to offer a comment on the thesis of Andries G. van Aarde about the socalled fatherlessness of Jesus. The author argues for a more critical disposition towards a historical-psychological approach of ancient texts. Jesus’ attitude towards children, which is illustrated in Mark 10:13–16, and the story of Jesus’ birth and of Herod’s reaction to it as told by Matthew, are used as test cases.
Mentorship: A process of nurturing others
Authors: Masango Maake
Published: June 2011

This article is dedicated to Prof. Dr Andries van Aarde who has mentored a large number of students during his time as a lecturer at the University of Pretoria. It is written at the time when workers in South Africa are striking. Industrial psychologists are involved in mediation and aim to develop a culture of understanding between workers and management. The article analyses some causes of tension between managers and workers in the South African context and indicates how mentorship may help to foster growth amongst workers and managers. A case study explores the issue of cultural differences which often lead to misunderstandings, especially when managers do not understand the world in which workers live. The aim of the article is to contribute to existing insights that may help to create a healthy working relationship between managers and workers which will benefit both.
Isaiah 1:2−3, ethics and wisdom. Isaiah 1:2–3 and the Song of Moses (Dt 32): Is Isaiah a prophet like Moses?
Authors: Groenewald Alphonso
Published: June 2011

This article argued that society even today could benefit from the richness of the ethics of the Hebrew Bible. Isaiah 1:2–3 has been used as an example to illustrate the ethics of a biblical text. This text has wisdom traits and literary links with Deuteronomy 32. In a modern, pluralistic society there is a need for a comprehensive ethical view by which one can combine a solid religious foundation, including responsibility towards God, the Creator and Lord of life, with a broad human wisdom gained from a rational understanding of the circumstances of existence for a true human life in a created world of order.
Disaffiliation in associations and the ἀποσυναγωγός of John
Authors: Kloppenborg John S.
Published: June 2011

This article tries to understand what might have been at stake for the synagogue from which the Johannine Jesus partisans had been expelled and what was at stake in the coinage of the term ἀποσυναγωγός. It we refuse to accept naively John’s overlexicalised and retrospective account of the grounds for expulsions and pay attention to the practices of other groups in articulating a disciplinary code, I suggest that what was at stake was deviant behaviour on the part of the Johannine Jesus-partisans: either failure to comply with the larger group’s practices concerning Sabbath observance, or more likely, clique formation.
Congruent ethos in the Second Temple literature of the Old Testament
Authors: Venter Pieter M.
Published: June 2011

Proposing the term ‘congruent ethos’ for studying Old Testament ethics, this article indicates (in line with existing research) that opposing ethical viewpoints are found in the Old Testament. The modus operandi followed was firstly to compare the penitential prayer in Daniel 9:4–19 with those in Ezra 9:6–15 and Nehemiah 9:6–37. This comparison shows that the phenomenon of conflicting ethics was present in Yehud during the Second Temple period. Whilst the Daniel text reflects a more universal attitude, the penitential prayers in Ezra and Nehemiah propose a nationalist view of God and an exclusivist identity for Israel. Although Daniel can be dated later than Ezra-Nehemiah, the tendency to juxtapose an exclusivist viewpoint with an inclusivist one was already present in the earlier period of the Second Temple. This is evidenced by the literature of Isaiah 56–66, Ruth, Jonah, Esther, Tobit, Judith and even Joshua.
Epidemiological review of gastric cancer in India
Authors: Dikshit Rajesh P , Mathur Garima , Mhatre Sharayu , Yeole B B
Published: June 2011

Stomach cancer is the one of the leading cause of cancer in southern region of India. Its incidence is decreasing worldwide yet on global scale stomach cancer remains one of the most common causes of cancer death. Etiology of gastric cancer includes Helicobacter pylori infection, diet and lifestyle, tobacco, alcohol and genetic susceptibility. In this review, we tried to find the contribution of Indian scientist in understanding the descriptive and observational epidemiology of stomach cancer. PubMed was used as a search platform using key words such as "stomach cancer, treatment, clinical characteristics, stomach cancer outcome, epidemiology, etiological factor and their corresponding Mesh terms were used in combination with Boolean operators OR, AND". Most of the reported studies on gastric cancer from India are case report or case series and few are case-control studies. Indian studies on this topic are limited and have observed H. pylori infection, salted tea, pickled food, rice intake, spicy food, soda (additive of food), tobacco and alcohol as risk factors for gastric cancer. More research is required to understand the etiology, develop suitable screening test, to demarcate high-risk population and to develop and evaluate the effect of primary prevention programs.
Gastric cancer in India
Authors: Sharma Atul , Radhakrishnan Venkatraman
Published: June 2011

The incidence of gastric cancer in India is low compared to developed countries, though there are certain geographical areas (Southern part and northeastern states of country) where the incidence is comparable to high-incidence areas of world. Despite the large number of patients being treated for gastric cancer, there are not sufficient publications discussing associated risk factors and outcomes in these patients. This article discusses relevant Indian epidemiological and clinical studies about gastric cancers. This article also highlights the gap in publication from India and developed countries regarding gastric cancer and stresses on collaborative efforts of the Indian scientific community to conduct epidemiological, pathological, and clinical studies to have a new standard of care for Indian patients.
Evolving role of high dose stem cell therapy in multiple myeloma
Authors: Gupta Ajay , Kumar Lalit
Published: June 2011

Conventional chemotherapy has been used in the treatment of multiple myeloma. However the development of autologous stem cell transplant represented a major advance in its therapy. Complete response (CR) rates to the tune of 40-45% were seen and this translated into improvements in progression-free survival and also overall survival in some studies. As a result the autologous stem cell transplants (ASCT) is the standard of care in eligible patients and can be carried out with low treatment-related mortality. Allogenic transplant carries the potential for cure but the high mortality associated with the myeloablative transplant has made it unpopular. Reduced Intensity Stem Cell Transplants (RIST) have been tried with varying success but with a high degree of morbidity as compared to the ASCT. Introduction of newer agents like thalidomide, lenalidomide, bortezomib and liposomal doxorubicin into the induction regimens has resulted in higher CR and very good partial response rates (VGPR) as well as improvement in ease of administration. These drugs have also proved useful in patients with adverse cytogenetics. Recent trials suggest that this has translated into improvements in response rates post-ASCT. There is a suggestion that patients achieving CR/nCR or VGPR after induction therapy should be placed on maintenance and ASCT then could be used as a treatment strategy at relapse. All these trends however await confirmation from further trials. Tandem transplants have been used to augment the results obtained with ASCT and have demonstrated their utility in patients who achieved only a partial response or stable disease in response to the first transplant as well as patients with adverse cytogenetics. Incorporation of bortezomib along with melphalan into the conditioning regimen has also been tried. RIST following ASCT has been tried with varying success but does not offer any major advantage over ASCT and is associated with higher morbidity. It is hoped that recent advances in therapy will contribute greatly to improved survival.
Carnitine levels and cardiac functions in children with solid malignancies receiving doxorubicin therapy
Authors: Khositseth Anant , Jirasakpisarn Suwadee , Pakakasama Samart , Choubtuym Lulin , Wattanasirichaigoon Duangrurdee
Published: June 2011

Aim: Previous studies demonstrated l-carnitine decreasing doxorubicin-induced cardiotoxicity. Our objectives were to study carnitine levels and cardiac functions in children treated with doxorubicin and the effect of short-term l-carnitine supplements. Materials and Methods: Serial carnitine levels and cardiac functions were obtained in children with newly diagnosed solid malignancies before doxorubicin, after cumulative doses of ≥150 mg/m 2 and ≥300 mg/m 2 , respectively. Oral l-carnitine 100 mg/kg/day for 3 days were given to the children treated with doxorubicin at cumulative doses of ≥150 mg/m 2 and ≥300 mg/m 2 . Carnitine levels and cardiac functions were also obtained in those children before and after short-term oral l-carnitine at each cumulative dose of doxorubicin. Results: Five children (3 females), median age of 9.1 years (range 1.5-13 years) with newly diagnosed solid malignancies were enrolled in the study. Free carnitine (FC) tended to decrease while acyl-carnitine (AC) increased making AC/FC ratio increased after cumulative dose of ≥150 and ≥300 mg/m 2 but the statistics was not significant. Left ventricular (LV) systolic function was not significantly changed. Interestingly, LV global function (LV myocardial performance index) was significantly increased after 150 mg/m 2 (median 0.39, 0.27-0.51) and 300 mg/m 2 (median 0.46, 0.27-0.50) when compared to baseline (median 0.28, 0.14-0.48) (P=0.05). Carnitine levels and cardiac functions were not significantly changed after oral l-carnitine supplement at cumulative dose of ≥150 mg/m 2 (n=6) and ≥300 mg/m 2 (n=9). Conclusions: Carnitine levels tended to decrease after doxorubicin treatment. LV global dysfunction was documented early after doxorubicin. However, short-term l-carnitine supplement did not improve cardiac function.
Transilluminating testicular mass
Authors: Mahalik Santosh Kumar , Prasad Alpana , Bhalla Suneeta , Kulshrestha Rajeev
Published: June 2011

Testicular tumor in prepubertal age group is uncommon. Most of the testicular tumors are benign in this age group and present as painless, hard testicular mass. We present a case where a 7 year male child presented to us with painless scrotal swelling, which was cystic and transilluminating, clinically mimicking as hydrocele. On ultrasonography, the mass was solid. Orchidectomy was performed and histopathology revealed mature cystic teratoma.
Extranodal testicular anaplastic versus plasmablastic plasma cell tumor: A rare case with diagnostic dilemma in a developing country
Authors: Martin P. Jovita M , Ramesh Anita , Hercules Simon , Dhanasekar T , Mallikarjuna V S , Mathew Lionel Rohit ,   Silamban
Published: June 2011

Primary testicular plasmacytoma is rare, especially when occurring in the absence of a previous or concurrent diagnosis of multiple myeloma. An 84-year-old gentleman was admitted with complaints of swelling over the right side of scrotum for the past 2 months. Local examination revealed a 10×15 cm tense and tender swelling involving the right scrotum. Therefore, high orchidectomy with excision of hemiscrotum was done. The histopathology revealed testicular plasmacytoma, which was positive for CD 138.
Endoscopic Sclerotherapy for Bleeding Oesophageal Varices: Experience in Gezira State, Sudan
Authors: Mohammed Moawia Elbalal
Published: June 2011

Introduction

Bleeding due to oesophageal varices is the most common cause of upper gastrointestinal tract haemorrhage in Gezira State, Central Sudan. Endoscopic injection sclerotherapy (EST) is a valuable therapeutic modality for the management of variceal bleeding. Other options for treatment such as variceal band ligation are either expensive or unavailable.

Objectives

A retrospective study to evaluate the outcome of (EST) in the management of bleeding oesophageal varices due to portal hypertension in Gezira State, the centre of a developing country, Sudan.

Methods

A total of 1073 patients, during 2001-2010, were carefully selected particularly those with bleeding oesophageal varices consequent to portal hypertension. EST was performed using a standard technique and ethanolamine oleate (5%) was utilized as sclerosing agent.

Results

There were 777 males (72.4%) and 296 females (27.6%) in a ratio of 2.6. The causes of portal hypertension were found to be schistosomal periportal fibrosis (PPF) in 1001 (93.3%) patients, liver cirrhosis in 60 (5.5%) mixed PPF and cirrhosis in seven (0.7%) and portal vein thrombosis in five (0.5%) patients. Full obliteration of varices required a mean of four sessions with a range of 2-6. In the present study 350 (32.6%) patients have been followed up until complete sclerosis of varices.

Conclusion

This study provides evidence that endoscopic injection sclerotherapy is an important component in the management of bleeding oesophageal varices caused by hypertension. It is a safe and effective procedure.
An Exploration of Occupation in Nursing Home Residents with Dementia
Authors: Morgan-Brown Mark , Ormerod Marcus , Newton Rita , Manley Dympna
Published: June 2011

Objectives:

This study evaluated the sitting room environment of two nursing homes in Ireland, using interactive occupation and social engagement as outcome measures and defining these rooms as occupational spaces.

Method:

Snapshot observational recordings were made in the main sitting rooms during the periods of time when the rooms were in most active use. Narrative information was also recorded.

Results:

Residents were more likely to occupy their time in the main sitting room passively, rather than in interactive occupation and social engagement. The nursing home residents with dementia spent approximately 70% of their daily time in the main sitting room areas in states of occupational disengagement.

Discussion:

Additional insight is provided through pragmatic narrative descriptions of the functioning of the main sitting room environment in terms of interactive occupation and social engagement.

Relevance:

The research study demonstrates a methodology for evaluating the sitting room areas of a care environment, using interactive occupation and social engagement as outcome measures, which can be used for descriptive and comparative insights into the performance of care environments.
From All Perspectives: Opinions of Students and Teaching Staff regarding Occupational Therapy Distance Education
Authors: Rogers Laura G , Mulholland Susan , Derdall Michele , Hollis Vivien
Published: June 2011

Introduction:

A Canadian university's entry-to-practice occupational therapy programme offered all six academic courses in the first autumn semester using online technologies.

Method:

This formative study explored the perspectives of the instructors (n = 6) and students (n = 4) who chose this education format for their online teaching and learning. Students and instructors participated in interviews and focus groups.

Findings:

Emerging themes from analysis were issues and recommendations related to course delivery, communication and support, courses particularly suited to distance delivery, and technical assistance.

Conclusion:

This study is unique in presenting the insights of multiple education stakeholders who participated in a whole semester of online rehabilitation courses.
Using Smart Technology in an Enabling Way: A Review of Using Technology to Support Daily Life for a Tenant with Moderate Dementia
Authors: Evans Nina , Carey-Smith Bruce , Orpwood Roger
Published: June 2011

Enabling smart technology uses a system of pre-recorded prompts or messages to support people with dementia to live independently. The aim is to use an integrated messaging system to support an individual's independence. Bath Institute of Medical Engineering evaluated this technology over a 12-month period in a Housing 21, very sheltered housing, flat with a single tenant who had moderate dementia.

This practice experience has highlighted the importance of a therapeutic approach to ensure that the use of technology is optimised for the benefit of vulnerable adults and their families.
Evidence and Ethics in Occupational Therapy
Authors: Shaw Justine , Shaw David
Published: June 2011

Reagon, Bellin and Boniface argue that traditional models of evidence-based practice focus too much on randomised controlled trials and neglect ‘the multiple truths of occupational therapy’ (Reagon et al 2010). This opinion piece points out several flaws in their argument, and suggests that it is unethical to rely on weaker evidence sources when higher quality evidence exists. Ironically, the evidence that they provide to support their argument regarding different types of evidence is itself very weak.
Service implications of implementing guidance for oral bowel cleansing agents in colonoscopy
Authors: Flanagan PK , Ahmed MS , Tin SM , Sarkar S
Published: June 2011

Introduction: Bowel preparation has led to serious adverse events. Consequently, regulatory and advisory bodies have issued guidance, including a risk stratification of patients, aiming to minimise this risk.

Aims: To determine the impact of the new guidance on our current practice of Picolax used in colonoscopy with regard to patient stratification, compliance and service implementation.

Methods: Patients listed for day case colonoscopy during October 2009 were audited using data from the hospital and endoscopy databases. A follow-up, structured patient telephone interview evaluated side effects, the assessment process and patient experience.

Results: Of the participating 112 patients, 97.4% were clinically reviewed before colonoscopy, 98.3% received written instructions and 70% verbal instructions. None had their preparation dispensed by a regulated professional. Although 62% of patients were retrospectively identified as ‘at risk’ (elderly, with congestive cardiac failure, cirrhosis or chronic kidney disease or on angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, diuretics or non-steroidal anti-inflammatory drugs), none were identified before their procedure. Significant events (postural hypotension, collapse, dizziness, palpitations, faint) were seen in 4.4%, all of whom could potentially be identified as ‘at risk’ using a stratification of low estimated glomerular filtration rate*; with relevant co-morbidity (congestive cardiac failure or cirrhosis).

Conclusions: Given the difficulties with compliance and the high prevalence of ‘at risk’ patients, the implementation will be challenging and require significant service redesign.
Mycotic aneurysm of the aorta as a complication of Bacillus Calmette-Guérin instillation
Authors: Maundrell J , Fletcher S , Roberts P , Stein A , Lambie M
Published: June 2011

Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that has been widely used for the treatment of superficial transitional cell carcinoma of the bladder. We describe a rare case of supra-renal mycotic aortic aneurysm secondary to BCG instillation in a 75-year-old male. Patients presenting with systemic symptoms post-instillation, possibly with an aneurysm, should raise suspicion of BCG dissemination, which requires early instigation of anti-mycobacterial drugs.
Monomorphic ventricular tachycardia caused by arsenic trioxide therapy for acute promyelocytic leukaemia
Authors: Ducas RA , Seftel MD , Ducas J , Seifer C
Published: June 2011

Arsenic trioxide has become the treatment of choice for patients with acute promyelocytic leukaemia. Cardiovascular toxicity is known to occur with this therapy, in particular heart rhythm disorders due to QT interval prolongation. We present a case of ventricular arrhythmia with no QT prolongation in a patient receiving arsenic trioxide therapy.
Diagnosis in diabetes: does it matter?
Authors: Thethy I , Robertson L , Swaminathan K
Published: June 2011

The diagnosis of diabetes subtypes in a busy clinic is usually based on the age at onset, phenotype and biochemical diagnostic criteria. Not surprisingly, the focus is predominantly on diagnosing type 1 and type 2 diabetes. More challenging for the physician is to think of monogenic diabetes, which results from gene mutations that reduce beta cell function. Often misdiagnosed as type 1 or type 2 diabetes, maturity-onset diabetes of the young (MODY) is the most common form of monogenic diabetes, accounting for 1–2% of all diabetes cases. A diagnosis of monogenic diabetes has important implications in treatment, the prediction of disease progression and screening of family members. We highlight two cases of monogenic diabetes, where the diagnosis had significant implications in all the above parameters. This is followed by a discussion on the glucokinase and hepatocyte nuclear factor-1 alpha MODY, which together constitute the most frequent cause of MODY syndromes in all populations.
Identifying blood biomarkers to improve the diagnosis of stroke
Authors: Whiteley W
Published: June 2011

Blood biomarkers are useful for the management of many diseases and could be useful for doctors caring for stroke patients, if they accurately predicted a diagnosis or recurrence of stroke. In a series of studies, we systematically reviewed the blood biomarker literature in stroke, determined the performance of existing blood biomarkers for the diagnosis of stroke and examined the value of markers of inflammation to predict recurrent stroke and myocardial infarction.
Better clinical decision making and reducing diagnostic error
Authors: Croskerry P , Nimmo GR
Published: June 2011

A major amount of our time working in clinical practice involves thinking and decision making. Perhaps it is because decision making is such a commonplace activity that it is assumed we can all make effective decisions. However, this is not the case and the example of diagnostic error supports this assertion. Until quite recently there has been a general nihilism about the ability to change the way that we think, but it is now becoming accepted that if we can think about, and understand, our thinking processes we can improve our decision making, including diagnosis. In this paper we review the dual process model of decision making and highlight ways in which decision making can be improved through the application of this model to our day-to-day practice and by the adoption of de-biasing strategies and critical thinking.