Tompkins Cortland Community College

Ten cases of endometrial carcinoma in young women aged 15 to 25 years are presented. Seven of these ten patients exhibited the clinical characteristics of Stein-Leventhal syndrome; of these, three had evidence of polycystic ovaries. Nine of the tumors were well-differentiated, adenoacanthomas (six) or adenocarcinomas (three) and limited to the endometrium. In one case, a moderately differentiated adenosquamous carcinoma involved an ovary and the pelvic wall. Treatment consisted of curettage and progestogens in three patients, one of whom later bore two children. The remainder of the women were treated with abdominal hysterectomy and bilateral salpingo-oophorectomy and/or radiation therapy. All patients for whom follow-up data are available are alive and well without evidence of disease. It is concluded that in selected young patients with well-differentiated endometrial carcinoma limited to the endometrium, conservative hormonal therapy and curettage may be adequate treatment and may preserve fertility.

Point-of-care testing (POCT) is a means of providing patient services more rapidly. Most evaluations of bedside laboratory testing devices have emphasized analytical performance in tertiary care settings. In contrast, the authors compare the operating cost of POCT for glucose and an electrolyte/glucose/blood urea nitrogen chemistry panel with the cost of central laboratory stat testing in a 204-bed community hospital. In scenarios studied, POCT costs exceed central laboratory stat costs from 1.1 to 4.6 times. The more POCT is used, the greater the excess costs compared to the central laboratory. Cost analysis demonstrates that the investment in acquiring automated transport and data management systems for the authors' hospital was far less expensive than POCT for both an individual stat test and on an annual cost basis. The authors urge fiscal caution before indiscriminately implementing POCT.

PURPOSE: To replicate research about confidence level in receiving health teaching from either an overweight or a weight-appropriate RN. METHODS: A quasi-experimental post-test only design was used. Participants were randomly assigned to be shown images of a nurse, either overweight or weight-appropriate, then asked to rate their confidence in health teaching received from that nurse. Descriptive statistics, t test for independent samples, and covariate analyses were performed. RESULTS: A significant difference in confidence p=0.000 was noted between participants who viewed the image of a weight-appropriate nurse and participants who viewed the image of an overweight nurse. CONCLUSIONS: Weight-appropriate nurses may inspire more confidence in their teaching. Further study is indicated to explore the implications of these findings for practice. CLINICAL RELEVANCE: Nurses need to be conscious of clients' perceptions of weight when planning teaching interventions.

About 100 cases of human infections with Mammomonogamus laryngeus (Syngamidae, Syngaminae) have been reported, with virtually all cases originating in the Caribbean Islands and Brazil. This report describes the fifth patient in North America infected with M. laryngeus and the first case documented to originate in Jamaica. The patient complained of a characteristic persistent nonproductive cough and a lump in her throat. M. laryngeus is a nematode in which the male and female are permanently joined in copula, producing a distinctive Y shape. Since there is scant clinical information about this parasite, this report includes a description of the adult worms and eggs, a summary of the epidemiology, and the clinical manifestations in humans. Illustrations are presented to facilitate future identification of this parasite and to expedite treatment.

Recently, Burgess et al. (1) documented the incidence and severity of ipsilateral shoulder pain after thoracotomy, a particularly difficult problem to treat. Although they examined several possible mechanisms for such pain, which included thoracic somatic and visceral as well as phrenic nerve nociception, none of their proposed explanations seemed tenable to them. The following case report demonstrates that such shoulder pain may be mediated by the sympathetic nervous system.

OBJECTIVE: Conventional wisdom and recently published reports suggest that children <48 months of age have a higher mortality rate after burns than older children and adolescents with similar injuries and that young age is a predictor of mortality. This study was done to validate or refute this impression. DESIGN: Retrospective review. SETTING: Regional pediatric burn center. PATIENTS: All children (n = 1223) managed over a recent 8-yr interval (1991-1998) for acute thermal burns. INTERVENTIONS: The survival rate of children <48 months of age was compared with the survival rate of children >/=48 months of age. MEASUREMENTS AND MAIN RESULTS: Of the 1112 children with burns covering <30% of the body surface, 721 (65%) were <48 months of age. After exclusion of one child who was brain dead and became a solid organ donor, there were no deaths in this burn size group. There were 111 children admitted with burns covering >/=30% of the body surface: 47 (42%) with an average age of 2.0 yrs (range, 4 wks to 3 yrs and 11 months) were <48 months of age, and 64 (58%) with an average age of 10.9 yrs (range, 4 yrs to 17 yrs) were >/=48 months of age. There were no clinically important differences between the two groups in burn size (51.9% +/- 18.1% [range, 30%-90%] vs. 56.9% +/- 19.4% [range, 30%-97%]; p =.18) or need for mechanical ventilatory support (30/47 [63.8%] vs. 44/64 [68.8%]; p =.59). The mortality rate in the young group was 0% (0/47) and 10.9% (7/64) in the older group (p =.04). All children who died had large burns (average burn size, 82.9% +/- 11.5%) with concurrent inhalation injury. CONCLUSION: Young age is not a predictor of mortality in burns.

Grassland cultivation is the key measure for restoring "Black Beach," the extremely degraded alpine meadow in the Three River Headwater Area of the Qinghai-Tibetan Plateau. In this study, we examined the inter-specific relationship in the vegetation community of cultivated grasslands with different restoration times through the network analysis method. The results showed that with the extension of restoration time, the development of cultivated grassland would lead to increasing neutral interactions among the plant species. The proportion of species with positive and negative associations in the community decreased, while the number of species-independent pairs increased significantly. The complexity of plant interspecific association (species network density) had more influence on community stability with the extension of recovery time, which can be used to quantify the characteristics of community structure.

Abstract Labeled cholesterol and its esters were injected via the portal vein into bile duct‐cannulated rats, subsequent to a 7 week regimen of either 5% safflower oil or 5% beef tallow in a hypercholesterolemic diet. Analysis of bile collected over a 6 hr period from the safflower group showed 8.6% higher output of bile acids, 13.6% higher conversion of 3 H‐cholesterol to bile acids and 40% higher conversion of [4‐ 14 C]cholesteryl oleate to bile acids than bile collected from the tallow group. During the 1st hr conversion of both oleyl and linoleyl esters of 14 C‐cholesterol to bile acids was much slower than conversion of the free 3 H‐cholesterol to bile acids, thus eliminating these esters as preferred substrate for bile acid formation. However at 6 hr two‐thirds of the injected 14 C of oleyl ester was recovered in the liver, and about half of this was in the form of free cholesterol. Thus cholesterol ester hydrolase, though inhibited by dietary cholesterol, evidently did not impose limitations on formation of free cholesterol for subsequent oxidation reactions. Specific radioactivities were of doubtful significance because of uncertainities as to “active” pool size. The data suggest that dietary linoleate exerts its hypocholesterolemic effect in some manner other than ester formation and that its point of action involves stimulation of cholesterol oxidation to bile acids.

Text correction on mobile devices usually requires precise and repetitive manual control. In this paper, we present EyeSayCorrect, an eye gaze and voice based hands-free text correction method for mobile devices. To correct text with EyeSayCorrect, the user first utilizes the gaze location on the screen to select a word, then speaks the new phrase. EyeSayCorrect would then infer the user's correction intention based on the inputs and the text context. We used a Bayesian approach for determining the selected word given an eye-gaze trajectory. Given each sampling point in an eye-gaze trajectory, the posterior probability of selecting a word is calculated and accumulated. The target word would be selected when its accumulated interest is larger than a threshold. The misspelt words have higher priors. Our user studies showed that using priors for misspelt words reduced the task completion time up to 23.79% and the text selection time up to 40.35%, and EyeSayCorrect is a feasible hands-free text correction method on mobile devices.

Human papillomavirus (HPV) infections are deemed to play a role in the pathogenesis of oral cavity cancer (OCC). However, their exact prevalence and clinical significance remain unclear. Herein, we investigated the prevalence and prognostic value of HPV infections in a large sample of Taiwanese OCC patients.This study was designed as a retrospective cohort study. Between 2004 and 2011, we identified 1002 consecutive patients with newly diagnosed OCC who were scheduled for standard treatment. HPV genotyping was performed in tumor specimens using polymerase chain reaction-based HPV blots. To investigate the temporal trends of HPV infections and their impact on 5-year overall survival (OS), patients were divided into 2 cohorts according to calendar periods: "2004 cohort" (2004-2007; n = 466) and "2008 cohort" (2008-2011; n = 536). Univariate and multivariate Cox regression models were also used to identify the independent predictors of OS in the 2 cohorts. A weighted risk score was assigned to each factor based on the range of their corresponding hazard ratios and validated in both cohorts using the c-statistic.The overall prevalence of HPV infections was 19%, with a trend toward decreasing rates from 2004 to 2011. In patients without risky oral habits, the 5-year OS rate of HPV-positive patients was significantly lower than that of HPV-negative cases (49% vs 80%; P = 0.021). In the 2004 cohort, multivariate analysis identified HPV16, pathological T3/T4, pathological N1/N2, and extracapsular spread as independent adverse prognostic factors for OS. In the 2008 cohort, pathological N1/N2, pathological stage III/IV, and histological tumor depth >8 mm were identified as independent adverse prognostic factors. Using a weighted grading system incorporating HPV16 infection, we devised a prognostic index that identified 4 distinct risk categories with 5-year OS rates ranging from 25% to 89% (c-statistic = 0.76) in the 2004 cohort. The validity of the index was internally confirmed in the 2008 cohort (c-statistic = 0.71).We conclude that HPV infections are common in Taiwanese OCC patients and predict 5-year OS. If independently validated, our composite prognostic score comprising HPV16 infection may be useful for allocating OCC patients to risk-adapted therapies.

No AccessJournal of Urology1 Apr 1973Unilateral Polycystic or Multicystic Kidney Associated with Focal Mural Renal Cell Carcinoma: Presentation of a Case Manuel Posso, David Safadi, and Orrin J. Van Dyk Manuel PossoManuel Posso More articles by this author , David SafadiDavid Safadi More articles by this author , and Orrin J. Van DykOrrin J. Van Dyk More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)60479-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1973 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByFerrer F and McKenna P (2018) Partial Nephrectomy in a Metachronous Multilocular Cyst of the Kidney (Cystic Nephroma)Journal of Urology, VOL. 151, NO. 5, (1358-1360), Online publication date: 1-May-1994.Aoyagi T, Kakudo K, Satoh S, Hata J, Shiramizu M and Tamaoki N (2018) Multilocular Cystic Nephroma in An Adult: Immunohistochemical StudyJournal of Urology, VOL. 138, NO. 2, (397-399), Online publication date: 1-Aug-1987.Tan K, Donner R and Oe P (2018) Renal Carcinoma Associated with Polycystic Kidneys: Occurrence After Chronic Hematuria and HypertensionJournal of Urology, VOL. 118, NO. 2, (322-322), Online publication date: 1-Aug-1977.Davides K, King L, Siconolfi E and Paat F (2018) Multilocular Kidney Disease: Unusual Angiographic AppearanceJournal of Urology, VOL. 116, NO. 2, (246-247), Online publication date: 1-Aug-1976. (2018) CommentJournal of Urology, VOL. 116, NO. 2, (247-247), Online publication date: 1-Aug-1976. Volume 109Issue 4April 1973Page: 559-563 Advertisement Copyright & Permissions© 1973 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Manuel Posso More articles by this author David Safadi More articles by this author Orrin J. Van Dyk More articles by this author Expand All Advertisement Loading ...

Educators in computing and information technology (CIT) suggest a need for graduates going into the workplace to have a better understanding of professionalism and workplace issues. It is not enough for graduates to have technical capabilities. They must understand many aspects of CIT as a discipline. They should be aware of the various types of CIT educational programs, different job titles and ffimctions, and some aspects of the employment supply and demand. They should be aware of the need for each computing worker to have professional responsibility for their work, and an awareness of the importance of appropriate ethical behavior in the group. They must also have an awareness of the impact of information technology on society as a whole and on individuals, and be prepared to handle a variety of issues arising in the workplace. This paper provides a rationale for the inclusion of professionalism in the CIT curriculum. It focuses on the responsibilities of CIT instructors and provides material to assist carrying out this obligation.

Earlier work in this laboratory and that carried out by others demonstrated that after a single dose of aflatoxin B1 (AFB) the resulting liver AFB-DNA adduct levels were directly proportional to dose. Earlier work also showed that after ten daily doses the AFB dose-response relationship with gamma-glutamyl transpeptidase (GGT) positive preneoplastic foci measured at 3 months was sublinear, with a threshold at a dose of about 150 micrograms/kg body weight/day. The objective of this study is to determine the factors influencing the shift in AFB dose-response between AFB-DNA adducts and GGT foci. Male Fisher 344 weanling rats were orally administered one or ten doses of AFB ranging from 50 to 350 micrograms/kg body weight/day. The animals were killed 2 or 24 h after the first AFB dose, or after the tenth AFB dose. The first and tenth doses were tritiated in these animals and 3H-AFB-guanine adducts isolated from liver DNA were measured by HPLC. Another group was killed 3 months after receiving ten doses in order to measure GGT foci development. AFB-guanine adduct levels were directly proportional to dose after the first dose, but after the tenth dose were much lower in the 200-350 micrograms/kg groups than after a single dose. The GGT foci response confirmed earlier work concerning a sublinear response. Among the individual animals in the 200-350 micrograms/kg groups there was a positive relationship, after controlling for dose, between GGT foci development and weight gained both during dosing (P = 0.018) and also to a lesser extent during the early promotional period (P = 0.066). Enzyme activity levels of GGT in liver homogenates were higher in the highest dose groups and reflected biliary proliferation rather than histological GGT stained foci. Urinary levels of AFB metabolites changed proportions in the high dosage multiply dosed animals reflecting alteration in AFB metabolism or excretion. The differences between the linear adduct and the sublinear foci dose-response curves may be the result of non-adduct effects of higher multiple AFB doses on foci formation including acute cytotoxicity, altered AFB metabolism and disposition, enhanced weight gains, or shortened foci latency but not through enhanced guanine adduct levels. Other studies that showed a linear relationship between AFB dose and liver tumor development used continuous feeding of maximal doses an order of magnitude less than the lowest dose in this study and thus avoided acutely toxic effects. We hypothesize that liver tumor development may mirror foci response in a 10-dose AFB regimen with doses above 100 micrograms/kg due to acute toxicity effects.

Abstract The fate of an oral dose of [4‐ 14 C] cholesterol given to rats grown on diets with 20% safflower oil or 20% hydrogenated coconut oil was determined by analysis of digestive tract, feces and tissues. The pattern of isotope distribution did not support the view that rats fed a saturated fat absorb less cholesterol than those fed an unsaturated fat. Fasted animals growth on the diet with 5% of these two fats and beef fallow showed no clear difference in the amount of digitonin‐peecipitable sterol in their intestines. A shorter transit time for intestinal contents was observed with the saturated fat groups. It is concluded that neither absorption of cholesterol from the gut nor secretion of β‐hydroxy sterol into the gut accounts for the hypocholesterolemic effect of polyunsaturated fat.

Although human activities have greatly increased nitrogen (N) and phosphorus (P) inputs to the alpine grassland ecosystems, how soil microbial functional genes involved in nutrient cycling respond to N and P input remains unknown. Based on a fertilization experiment established in an alpine meadow of the Qinghai-Tibetan Plateau, we investigated the response of the abundance of soil carbon (C), N, and P cycling genes to N and P addition and evaluated soil and plant factors related to the observed effects. Our results indicated that the abundance of C, N, and P cycling genes were hardly affected by N addition, while P addition significantly increased most of them, suggesting that the availability of P plays a more important role for soil microorganisms than N in this alpine meadow ecosystem. Meanwhile, when N and P were added together, the abundance of C, N, and P cycling genes did not change significantly, indicating that the promoting effects of P addition on microbial functional genes abundances were overwhelmed by N addition. The Mantel analysis and the variation partitioning analysis revealed the major role of shoot P concentration in regulating the abundance of C, N, and P cycling genes. These results suggest that soil P availability and plant traits are key in governing C, N, and P cycling genes at the functional gene level in the alpine grassland ecosystem.

Recent research has shown that competitiveness is related to performance. However, gaps remain in the literature on the effects of competitiveness on task performance across different performance settings. A review of relevant literature from sport, social, and personality psychology suggested that performance in several contexts—individual, coactive, and conjunctive task demands—would be affected both by trait interpersonal competitiveness and by competitiveness manipulated through subliminal priming. Both factors (task demands and competitiveness) were manipulated in a 2 × 3 experimental design and individual task effort was assessed. Results from the current investigation showed that such priming influenced effort at a coactive persistence task. Results also partially replicated past research on group motivation gains (Hertel, Kerr, & Messé, 1999 Hertel, G., Kerr, N. L. and Messé, L. A. 1999. Revisiting the Koehler effect: Does diversity enhance motivation and performance in groups? Psychologische Beitrage, 41: 320–337. [Google Scholar]; Köhler, 1926 Köhler, O. 1926. Kraftleistungen bei Einzel- und Gruppenabeit. [Physical performance in individual and group situations]. Industrialle Psychotechnik, 3: 274–282. [Google Scholar], 1927 Köhler, O. 1927. Uber den Gruppenwirkungsgrad der menschlichen Korperarbeit und die Bedingung optimaler Kollektivkraftreaktion. [On group efficiency of physical labor and the conditions of optimal collective performance]. Industrialle Psychotechnik, 4: 209–226. [Google Scholar]). Implications for group and individual performance in social, athletic, and work domains are discussed.

Abstract A new technique using T‐cannulated bile ducts has been developed for studying bile acid turnover in the rat by isotope dilution. Applicability of this technique to study the effect of diet on cholate and chenodeoxycholate metabolism is suggested. In tests with the method, the rate of cholate synthesis for rats fed colony diet was twice that for rats fed semisynthetic diet. When sodium glycocholate was fed in the latter diet the half‐life of cholate decreased; the secretion rate of deoxycholate and cholate increased without affecting chenodeoxycholate. Although curves for cholate log specific activity vs. time were linear, those obtained simultaneously for chenodeoxycholate were nonlinear. A double exponential curve was obtained for chenodeoxycholate of colony‐fed rats. Separation of free deoxycholate and chenodeoxycholate was improved through continuous development thin layer chromatography.

We report a patient in whom a solitary splenic lesion detected by computed tomography (CT) was successfully diagnosed by fine-needle aspiration biopsy under CT guidance. The ability to distinguish metastatic carcinoma from lymphoma in the spleen assisted the clinician in making therapeutic decisions. Fine-needle aspiration of spleen is a reasonable diagnostic approach that has been underutilized.

Non-wadeable rivers are relatively understudied compared to smaller, wadeable streams. Currently, protocols exist in most states, including Michigan, to evaluate the ecological condition of wadeable streams, but few protocols exist for larger, non-wadeable rivers. The goal of this research was to develop a multimetric index of biological integrity for Michigan's non-wadeable rivers, and we sampled 28 unique river reaches in Michigan that encompassed a wide range of human impacts and ecological conditions. In each reach, we collected physical, chemical, and macroinvertebrate samples. Using several techniques to eliminate redundancy among metrics and identify those biological attributes that correlated with anthropogenic influences, we developed a useful protocol that will allow the rapid bioassessment of such rivers in Michigan. When used together with the Non-wadeable Habitat Index, the Non-wadeable Index of Biotic Integrity (NW-IBI) will allow objective evaluation of non-wadeable rivers in Michigan.

3D organ contouring is an essential step in radiation therapy treatment planning for organ dose estimation as well as for optimizing plans to reduce organs-at-risk doses. Manual contouring is time-consuming and its inter-clinician variability adversely affects the outcomes study. Such organs also vary dramatically on sizes - up to two orders of magnitude difference in volumes. In this paper, we present BrainSegNet, a novel 3D fully convolutional neural network (FCNN) based approach for automatic segmentation of brain organs. BrainSegNet takes a multiple resolution paths approach and uses a weighted loss function to solve the major challenge of the large variability in organ sizes. We evaluated our approach with a dataset of 46 Brain CT image volumes with corresponding expert organ contours as reference. Compared with those of LiviaNet and V-Net, BrainSegNet has a superior performance in segmenting tiny or thin organs, such as chiasm, optic nerves, and cochlea, and outperforms these methods in segmenting large organs as well. BrainSegNet can reduce the manual contouring time of a volume from an hour to less than two minutes, and holds high potential to improve the efficiency of radiation therapy workflow.