Clinical aspects of gestational trophoblastic disease: A review based partly on 25-year experience of a statewide registry

Background: Gestational trophoblastic disease is a fascinating group of pregnancy disorders characterised by abnormal proliferation of trophoblast, ranging from benign to malignant. Because the disease is uncommon, there is a need to formulate management with the assistance of collective information. Methodology: A review of available information from English written literature was undertaken especially data reported by registries around the world (Charing Cross Hospital in England, the North-western University and the New England area in the USA as well as our own experience in Queensland, Australia). Where possible, collated data from relevant studies were analysed to answer some of the questions posed in clinical practice, with reference to metastatic disease to liver and brain, twinning of molar gestation and coexisting fetus, and placental-site tumour. Results: We found that molar gestation can be classified according to its clinical presentation which influences the time taken to reach human chorionic gonadotropin (HCG) 'negativity' and the risk of persisting disease. Categorisation of risk is the basis for choice of chemotherapy to achieve good outcomes. Metastases to liver and brain remain problems in management; the development of 'new' metastases during chemotherapy is a very poor prognostic factor. In the variant of twinning with molar gestation and coexisting fetus, it is important to elucidate the fetal karyotype in planning management: a 69XXX fetus is not salvageable but a normal 46XX or 46XY fetus faces the prospect of early preterm delivery. The placental-site tumour is very rare; localised disease is curable by surgery; chemotherapy is less effective in disseminated disease. From collated worldwide data, the recurrence rate after one mole is 1.3% and after two or more is 20%. Reproductive outcome in subsequent pregnancies, even after multidrug chemotherapy, is not different from the general population. Because of the increased risk long-term of second tumours after multidrug chemotherapy a closer surveillance of these patients is necessary Conclusion: In general, the disease in its persisting or malignant form is 'a cancer model par excellence' because of an identifiable precursor condition, a reliable HCG marker, and sensitivity of the disease to cytotoxic drugs. With current management, retention of fertility is possible and normal reproductive outcome assured.

Beyond the sphere of the English facial approximation literature: Ramifications of German papers on western method concepts

In the English literature, facial approximation methods have been commonly classified into three types: Russian, American, or Combination. These categorizations are based on the protocols used, for example, whether methods use average soft-tissue depths (American methods) or require face muscle construction (Russian methods). However, literature searches outside the usual realm of English publications reveal key papers that demonstrate that the Russian category above has been founded on distorted views. In reality, Russian methods are based on limited face muscle construction, with heavy reliance on modified average soft-tissue depths. A closer inspection of the American method also reveals inconsistencies with the recognized classification scheme. This investigation thus demonstrates that all major methods of facial approximation depend on both face anatomy and average soft-tissue depths, rendering common method classification schemes redundant. The best way forward appears to be for practitioners to describe the methods they use (including the weight each one gives to average soft-tissue depths and deep face tissue construction) without placing them in any categorical classificatory group or giving them an ambiguous name. The state of this situation may need to be reviewed in the future in light of new research results and paradigms.

Speech disorder in preschool children exposed to Cantonese and English

Speech disorder in monolingual Cantonese- or English-speaking children has been well described in the literature. There appear to be no reports, however, that describe speech-disordered children who have been exposed to both languages. Here we report on the error patterns of two preschool speech-disordered children who were learning two languages. Both children's first language was Cantonese, but they were also exposed to English through the media and child care. Their disorders were of unknown aetiology. The following questions were asked of the data: (a) Do bilingual children, suspected of having speech problems, make errors in Cantonese and English that reflect delay or disorder when compared with normative data on monolingual speech development in each language? (b) How does the children's speech differ from other bilingual children from the same language learning background? (c) Are the children's speech difficulties apparent in both languages? (d) Is the pattern of errors the same in both languages or do language-specific processes operate? The results bear on theories of acquisition, disorder and bilingualism; they also have clinical implications for speech-language pathologists whose caseloads include bilingual preschool children.

The English-only movement: A communication analysis of changing perceptions of language vitality

This paper reexamines the potential impact of the English-only movement on linguistic minorities and Anglos' perceptions of their own and minority groups' language vitality. Of particular interest is the Hispanic population-the fastest growing minority in the U.S. Communication scholars have paid only scant attention to the English-only movement and how it affects the social and communication climate for Latinos. However, literature reviews prepared for the American Psychological Association and for the Teachers of English to Speakers of Other Languages (in 1991 and 1995, respectively) concluded that English-only initiatives have negative consequences for limited-English proficiency groups. Revisiting this still-growing issue in the light of more recent studies across disciplines and media reports, we examine how Anglo support for English-only policies limits the use, promotion, and salience of minority languages like Spanish in institutional settings and in the linguistic landscape and suggest directions for future research.

A metalinguistic approach to deconstructing the concepts of 'face' and 'politeness' in Chinese, English and Japanese

In this paper we investigate the concepts of 'face' and 'politeness'. We introduce a metalanguage which we believe is a framework for simplifying the analysis of 'face' and 'politeness'. This metalanguage is based on the observation that both 'face' and 'politeness' involve external evaluations of people. This common element is represented in the metalanguage as B what A shows A thinks of B and what B thinks A thinks of B. The implications of the metalanguage for the analysis of Chinese mian and lion ('face') and English face are then discussed. This is followed by an analysis of examples of politeness in English and teineisa ('politeness') in Japanese. We conclude that the metalanguage may be further developed for use in comparisons of 'face' and 'politeness' across cultures. (C) 2003 Elsevier B.V. All rights reserved.

Revisiting the conceptualisation of politeness in English and Japanese

The issue of what in fact constitutes politeness remains a source of considerable debate amongst researchers. There is mounting evidence that although there may be common underlying elements, politeness is conceptualised differently across cultures. A comparison of the notions of politeness in English and teinei, reigi tadashii and keii hyoogen in Japanese indicates that these respective terms encompass somewhat different conceptual ranges. Politeness in English refers to showing consideration for others and demonstrating a polished self-presentation. In Japanese, on the other hand, it encompasses showing respect (with a strong nuance of vertical respect involved) and consideration towards the position and quality of character of others, and modesty about oneself While politeness in both English and Japanese involves showing one thinks well of others (other-oriented politeness) and showing one does not think too highly of oneself (self-oriented politeness), differences in the underlying conceptualisation of politeness give rise to different ways of expressing politeness. It is thus difficult to maintain the assumption that politeness can be defined in the same way across different cultures, although this does not necessarily preclude the identification of common elements of politeness across cultures. © Walter de Gruyter.

Processing of English words with fine acoustic contrasts and simple tones: A mismatch negativity study

The purpose of this study was to compare the robustness of the event-related potential (ERP) response, called the mismatch negativity (MMN), when elicited by simple tone stimuli (differing in frequency, duration, or intensity) and speech stimuli (CV nonword contrast /de:/ vs. /ge:/ and CV word contrast /deI/ vs. /geI/). The study was conducted using 30 young adult subjects (Groups A and B; n = 15 each). The speech stimuli were presented to Group A at a stimulus onset asynchrony (SOA) of 610 msec and to Group B at an SOA of 900 msec. The tone stimuli were presented to both groups at an SOA of 610 msec. MMN responses were elicited by the simple tone stimuli (66.7%-96.7% of subjects with MMN "present," or significantly different from zero, p < 0.05) but not the speech stimuli (10% subjects with MMN present for nonwords, 10% for words). The length of the SOA (610 msec or 900 msec) had no effect on the ability to obtain consistent MMN responses to the speech stimuli. The results indicated a lack of robust MMN elicited by speech stimuli with fine acoustic contrasts under carefully controlled methodological conditions. The implications of these results are discussed in relation to conflicting reports in the literature of speech-elicited MMNs, and the importance of appropriate methodological design in MMN studies investigating speech processing in normal and pathological populations.

English language education in policy studies

Content-based instruction (CBI) is increasingly important in curriculum development for second-language acquisition (SLA), as language and non-language departments in universities are finding the integration of core-content as part of the second language curriculum to be beneficial. With this in mind, this paper describes the English program at Nanzan University’s Faculty of Policy Studies and examines the synergy presently being developed between core-content and English language instruction there. Specifically, this paper seeks to shed light on how instructors can reflect on the meaning of language instruction at higher education through an illustration of our activities.

There is no subjunctive in English

The western classical tradition identifies three moods: indicative, subjunctive, imperative. Protagoras split the indicative into interrogative and declarative. Palmer 2001, 2003 argues for only two: indicative and subjunctive. Given any of these classifications of mood, English has no category of mood and so has no subjunctive. Instead it has certain clause-types which express hypotheticality and which can be subsumed to the irrealis branch of the apparently universal category realis~irrealis; to which subjunctives, optatives, jussives and the like can also be subsumed.