Severe esophageal injuries occurring after general anesthesia in two cats: case report and literature review

Two healthy cats underwent elective surgical procedures under general anesthesia. One developed severe esophagitis leading to esophageal rupture, mediastinitis, and pyothorax. The other cat developed esophageal stricture, diverticulum formation, and suspected iatrogenic perforation. Both cats had signs of dysphagia and regurgitation beginning a few days after anesthesia. The first cat also had severe dyspnea due to septic pleural effusion and pneumomediastinum. In the second cat, endoscopy revealed diffuse esophagitis, an esophageal stricture, and a large esophageal diverticulum. Rupture of the esophageal wall occurred while inflating the esophagus for inspection. Due to the poor prognosis, both cats were euthanized. Necropsy revealed severe esophageal changes. Postanesthetic esophagitis has been previously described in dogs and cats; however, severe life-threatening esophageal injuries rarely occur as a sequel to general anesthesia. To the authors' knowledge, esophageal rupture secondary to perianesthetic reflux has never been reported in cats.

High-grade supraclavicular soft tissue sarcoma as secondary malignancy after successful treatment of acute myeloid leukemia: case report and literature review

It is well known that the treatment protocols for hematopoetic neoplasms carry a high risk of long-term oncogenicity. However, few reports have been published of sarcomas as secondary malignancies. An unusual case report of a soft tissue sarcoma appearing as a secondary cancer is presented, with a review of the published data. The present report involves a soft tissue sarcoma of the neck that occurred 18 years after curative treatment of acute myeloid leukemia by induction chemotherapy and bone marrow transplantation. Consecutive graft-versus-host disease affected the cervical skin. Soft tissue sarcomas appearing as secondary tumors are rare in oncology. The presented case describes the appearance of a sarcoma 18 years after curative treatment of acute myeloid leukemia. This is only the second case of this type reported in published studies.

Scales of Impact: Settlement History and Landscape Change in the Gordion Region, Central Anatolia

The expansion of agriculture in the Near East during the middle Holocene significantly altered the physical landscape. However, the relationship between the scale of agriculture and the magnitude and timing of the environmental impacts is not well known. The Gordion Regional Survey provides a novel dataset to compare settlement density during archaeological periods to rates of environmental disruption. Sediment samples from alluvial cores directly date the environmental disruption, which can be matched to period-specific settlement intensities in the watershed as constructed from archaeological survey ceramics. Degradation rates rose sharply within a millennium of the earliest Chalcolithic occupation. Early Bronze Age (EBA) land use induced the greatest rates of environmental degradation, although settlement density was relatively low on the landscape. The degradation rate subsequently decreased to one-third its early peak by the Iron Age, even as settlement intensity climbed. This trajectory reveals how complex interaction effects can amplify or subdue the responses of the landscape-land use system. Prior to settlement, landscape soil reservoirs were highly vulnerable, easily tipped by early agricultural expansion. Subsequent reduced rates of erosion are tied both to changes in sociopolitical organization and to depletion of the vulnerable soil supply.

Reading Readings: An Approach to the Relationship between Television and Literature at School

The main problem addressed by this research was that of what are the relations between TV viewing at home and studying literature at school, and how an adequate position on this can be reached. As well as the theoretical background, it involved an experimental study with classes of second and sixth grade students, discussing and observing their reactions to and interpretations of a number of animated cartoons. The work is divided into four parts - Is there a Class in this Text?, Stories of Reading, Narratives of Animation and Animation of Narratives, and The (Three) Unrepeatable (Pigs). Beginning, Middle End - which examine the tensions between the "undiscriminating sequence" of the televisual flow and a way of "thinking", "making" and "doing" education that presupposes a fundamental belief in possible re-productions, copies unescaping, following the original, or competing. The work focuses on animated cartoons, seeing them not merely as a part of the flow of television, but as an allegory of reading this flow, of the flow within the flow itself. What they question - "identity", "end", "followability" - is what is most important to teaching. Thus the interest in the metamorphoses of animated films is an interest in the tensions which their "strange law/flow" introduces into the field of teaching - this totally forbidden place of saying everything.

Clinicopathologic correlations of silent corticotroph adenomas of the pituitary: report of four cases and literature review

Silent corticotroph adenomas (SCA) are rare pituitary tumors with histologic hallmarks of corticotroph differentiation, including ACTH immunoreactivity, but lacking clinical evidence of Cushing's syndrome. We report on four female patients, aged 19-66 years, each presenting with a nonfunctional macroadenoma. Leading symptoms were headache in two cases and visual field deficits in one. One patient was incidentally diagnosed while undergoing cranial MRI for an unrelated condition. Three patients had marked obesity; none of them presented constitutional signs of Cushing's syndrome. Serum cortisol levels were moderately elevated in the two patients systematically tested in this respect. Marginal to moderate hyperprolactinemia was present in two cases. Two patients also were shown to be deficient in either gonadotroph or thyrotroph axis, while a third had a combined insufficiency of both gonadotroph and thyrotroph axis. MRI scans revealed intratumoral hemorrhage and/or cystic change in three cases, as well as tumor-related occlusive hydrocephalus in one. The latter patient was biopsied only, while the remaining underwent gross total resection. Histologically, all four lesions were diagnosed as SCA subtype I displaying intense immunoreactivity for ACTH. In three tumors, scattered cells coexpressed PRL as well. In addition, Crooke's hyaline change was noted in a significant number of tumor cells and in residual non-neoplastic corticotrophs in one case each. With MIB-1 labeling indices of 1-3%, none of the tumors qualified as atypical adenoma. We conclude that SCAs are more likely to be discovered as expansile tumors, whose advanced local space-occupying character at surgery rather than an inherently aggressive growth potential may negatively influence the clinical outcome. Subtle morphologic evidence of corticotroph suppression in residual pituitary adjacent to tumor lends further support to literature data indicating minimal or intermittent functional activity in this tumor type.

Re-thinking Teaching About Atrocity: Human Rights Comparative History and Critical Pedagogy

This paper will explore re-framing historic atrocity and its relationship to Holocaust and Genocide education. The origins of genocide studies and its links to Holocaust studies will be traced to discuss the impact of new scholarship and framings on genocide education in the classroom.

Graves' ophthalmopathy: natural history and treatment outcomes

The pathogenesis of Graves' ophthalmopathy has not been yet clarified, and from a therapeutic standpoint Graves' ophthalmopathy remains an enigma. The natural course and effects of different treatment regimens are poorly documented.