Adenocarcinoma pleomórfico de células giganates de vías biliares(osteoclastoma like)

Las células gigante tipo osteoclásticas (CGTO) del páncreas son una entidad poco frecuente descrito originalmente por Rosaien 1968, caracterizado por osteoclastos, que son células gigantes mononucleares idénticas a las células del estroma observadas en tumores óseos. Desde entonces, hay pocos informes de los tumores que contienen células gigantes en otras localizaciones anatómicas. Las CGTO se pueden distinguir de las células gigantes tipo pleomórficas (CGTP), debido a la falta de un marcado pleomorfismo nuclear asociado. A menudo, un carcinoma de páncreas histológicamente reconocibles acompaña CGTO, dando lugar a un mal resultado. Formas puras de CGTO presentan un mejor pronóstico porque se necesita mucho tiempo para desarrollar metástasis, pero esta forma es muy raros, con pocos casos reportados en la literatura Inglésa. La mayoría de veces se discute el diagnóstico de benignidad de estos tumores basados en la evaluación de inmunohistoquímica. El presente caso se trata de una paciente de sexo femenino de 56 años de edad con cuadro caracterizado por dolor tipo cólico que mejora con antiespasmódicos, de varios meses de evolución, con periodos de remisión y exacerbación. A examen físico presenta: en piel y mucosas ligero tinte subictérico, a nivel abdominal: abdomen doloroso de forma difusa sin viseromegalias o masas palpables

Revisiting the origin and development of pleonastic that in English

The origin of pleonastic that can be traced back to Old English where it could appear in syntactic constructions consisting of a preposition + demonstrative pronoun (i.e. for þy þat, for þæm þe) or a subordinator (i.e. oþ þat). Its diffusion with other subordinators is considered an early Middle English development as a result of the standardization of this item as the general subordinator in the period, which motivated its use as a pleonastic word in combination with all kinds of conjunctions (i.e. now that, gif that, when that, etc.) and prepositions (i.e. before that, save that, in that). Its use considerably increased in late Middle English, declining throughout the 17th century. The list of subordinating elements includes relativizers (i.e. this that), adverbial relatives (i.e. there that) and a number of subordinators (i.e. after, as, because, before, beside, for, if, since, sith, though, until, when, while, etc.). The present paper pursues the following objectives: a) to analyse the use and distribution of pleonastic that in a corpus of early English medical writing (in the period 1375-1700); b) to classify the construction in terms of the two different varieties of medical texts, i.e. treatises and recipes; and c) to assess the decline of the construction with the different conjunctive words. The data used as sources of evidence come from The Corpus of Early English Medical Writing, i.e. Middle English Medical Texts (MEMT for the period 1375-1500) and Early Modern English Medical Texts (EMEMT for the period 1500-1700).

The Joycean Sublime

The purpose of my thesis is to analyze notions of the sublime in James Joyce’s Ulysses and how the sublime is evoked and presented in Joyce’s work. The present work will examine concepts of the sublime from the Classical and Medieval period, through the Enlightenment, and into the Romantic era to develop my own definition. Placing the sublime in a historical perspective allows me to discover how the sublime is at work through Joyce’s creative use of complex narrative approaches. The beauty of aesthetic perfection was achieved by employing all of Joyce’s artistic faculties. My thesis investigates how Ulysses’ experimental writing technique, unique structuring, and difficult prose created a work of genius which evokes the sublime. By analyzing Joyce’s use of language, unconventional narrative, and ambiguity in Ulysses I will explore how the sublime is aroused.

Breaking old and new ground: a comparative study of coastal and inland naming in Berwickshire

This thesis investigates the place-names of four parishes in Berwickshire and compares coastal and inland naming patterns. Berwickshire is a large county that borders on northern England and historically formed part of Anglo-Saxon Northumbria. Partly due to the survival of extensive archives from the medieval priory of Coldingham, preserved in Durham Cathedral Archives, this county holds some of Scotland’s earliest recorded place- names. The parishes that form the research area are grouped together in the north-east of the county. Two of these parishes, Abbey St Bathans and Bunkle & Preston, are inland, and two, Cockburnspath and Coldingham, have extensive coastlines. The diversity of this group of parishes allows a comparative study of the place-names of coastal and inland areas to be undertaken. The topography of Berwickshire’s thirty-two parishes is very varied, and the four parishes have been chosen to reflect this range of landscapes. The place-names within the four parishes examined in this thesis derive almost exclusively from Old English, Older Scots, Modern Scots including Standard Scottish English, with a small minority derived from Old Norse, Gaelic, and Brittonic. The chronology of Old English, Older Scots, and Modern Scots is defined as given in the Concise Scots Dictionary: Old English is the period up to 1100, Older Scots is the period 1100-1700, and Modern Scots is the period 1700 onwards (CSD, 1985: xiii). Often with place-names it is not possible to give a precise dating for the coining of a toponym. For the purposes of this study, the language label given for a toponym is that of the date of the earliest record of the place-name with earlier linguistic evidence supplementing discussion. This thesis focuses on the names of topographic features, for example hills, rocks and woodland, and the role of perception in their naming. In order to compare the role of perception in inland and coastal naming, this thesis includes a diachronic study of the toponymy of the research area, along with two case studies. The first of these is a study of the toponymy of relief features, which focuses on generic elements in order to compare the perception of one type of referent in the two environments. The second is a study of the ‘colour’ category, which focuses on qualifying elements in order to compare the use of colour terms in the two environments. This thesis is the first comparative study of inland and coastal place-names, and it is one of the first to investigate new ways of using fieldwork as a central part of its methodology. In doing so it proposes innovative and nuanced ways to understand the toponymy of diverse landscapes within a community.

Regional variation and change in the history of English strong verbs

This thesis investigates how the strong verb system inherited from Old English evolved in the regional dialects of Middle English (ca. 1100-1500). Old English texts preserve a relatively complex system of strong verbs, in which traditionally seven different ablaut classes are distinguished. This system becomes seriously disrupted from the Late Old English and Early Middle English periods onwards. As a result, many strong verbs die out, or have their ablaut patterns affected by sound change and morphological analogy, or transfer to the weak conjugation. In my thesis, I study the beginnings of two of these developments in two strong verb classes to find out what the evidence from Middle English regional dialects can tell us about their origins and diffusion. Chapter 2 concentrates on the strong-to-weak shift in Class III verbs, and investigates to what extent strong, mixed and weak past tense and participle forms vary in Middle English dialects, and whether the variation is more pronounced in the paradigms of specific verbs or sub-classes. Chapter 3 analyses the regional distribution of ablaut levelling in strong Class IV verbs throughout the Middle English period. The Class III and IV data for the Early Middle English period are drawn from A Linguistic Atlas of Early Middle English, and the data for the Late Middle English period from a sub-corpus of files from The Penn-Helsinki Parsed Corpus of Middle English and The Middle English Grammar Corpus. Furthermore, The English Dialect Dictionary and Grammar are consulted as an additional reference point to find out to what extent the Middle English developments are reflected in Late Modern English dialects. Finally, referring to modern insights into language variation and change and linguistic interference, Chapter 4 discusses to what extent intra- and extra-linguistc factors, such as token and type frequency, stem structure and language contact, might correlate with the strong-to-weak shift and ablaut levelling in Class III and IV verbs in the Middle English period. The thesis is accompanied by six appendices that contain further information about my distinction of Middle English dialect areas (Appendix A), historical Class III and IV verbs (B and C) and the text samples and linguistic data from the Middle English text corpora (D, E and F).

Iliac-hepatic arterial bypass for compromised collateral flow during modified Appleby operation for advanced pancreatic cancer

Involvement of the celiac trunk and common hepatic artery are two of the most common forms of vascular invasion by tumours of the distal pancreas, and until recently this finding was considered a contra-indication to resection. We described a modified Appleby operation for locally advanced distal pancreatic cancer with compromised hepatic collateral flow that needed hepatic arterial revascularization, successfully accomplished by left external iliac-hepatic arterial bypass with Dacron prosthesis. Patient recovery was uneventful and he was discharged on the 10th postoperative day. Postoperative angio-CT disclosed a patent arterial bypass. Patient is well and asymptomatic 13 months after operation. At the time of this writing, postoperative CT scan showed no evidence of disease and CA 19-9 level is normal. There is a well established rationale to perform extended resection of pancreatic carcinomas that compromise vascular structures. Modified Appleby procedure can safely be performed, has oncological advantages to palliative procedures and provides relief of pain but is reserved for selected patients. Preservation of hepatic arterial flow has utmost importance to avoid hepatobiliary complications as liver necrosis, liver abscess, gallbladder necrosis or cholecystitis. In this case, hepatic revascularization was particularly challenging, but was successfully accomplished by left external iliac-hepatic arterial bypass. To our knowledge this type of arterial bypass has never been described so far in the English literature and its description may be important for surgeons dealing with advanced pancreatic cancer. (C) 2009 Elsevier Ltd. All rights reserved.

Chryseobacterium in burn wounds

Chryseobacteria are gram negative organisms, formerly known as Flavobacteria, which rarely cause infections of burn wounds. This article documents three casts of Chryseobacterium infection in burn wounds and adds to the other two cases that have been reported in English literature. Two patients died, with one of the deaths linked to a Chryseobacteria bacteraemia. In two patients, there was an associated history of first aid treatment with untreated water. Patients whose burn wounds are suspected to be infected with Chryseobacterium require wound excision and coverage in combination with antibiotic therapy such as ciprofloxacin, vancomycin and rifampicin. (C) 2001 Elsevier Science Ltd and ISBI. All rights reserved.

Pancreatic involvement in co-infection visceral leishmaniasis and HIV: histological and ultrastructural aspects

The involvement of the gastrointestinal tract in the co-infection of HIV and Leishmania is rarely reported. We report the case of an HIV-infected adult man co-infected with a disseminated form of leishmaniasis involving the liver, lymph nodes, spleen and, as a feature reported for the first time in the English literature, the pancreas. Light microscopy showed amastigote forms of Leishmania in pancreatic macrophages and immunohistochemical staining revealed antigens for Leishmania and also for HIV p24. Microscopic and ultrastructural analysis revealed severe acinar atrophy, decreased zymogen granules in the acinar cytoplasm and also nuclear abnormalities such as pyknosis, hyperchromatism and thickened chromatin. These findings might correspond to the histologic pattern of protein-energy malnutrition in the pancreas as shown in our previous study in pancreas with AIDS and no Leishmania. In this particular case, the protein-energy malnutrition may be due to cirrhosis, or, Leishmania or HIV infection or all mixed. We believe that this case represents the morphologic substratum of the protein energy malnutrition in pancreas induced by the HIV infection. Further studies are needed to elucidate these issues.

Embrutar-se les mans : una aproximació al pensament de la novel·la d'Ian McEwan

El treball pretén fer una aproximació al pensament de la novel·la de l'autor britànic Ian McEwan, fent especial èmfasi en els trets postmoderns de la seva producció enmarcats dins la nova ficció britànica.

"Maurice" de James Ivory . ¿Traïció a la Tradició Clàssica en adaptar la novel·la d'E. M. Forster?

D'acord amb els estudis sobre literatura i cinema i des del punt de vista de la influència de la Tradició Clàssica -Tradició Grega Clàssica, en aquest cas-, aquest article és una anàlisi acurada de les traïcions inevitables -fins a un cert punt- dels guionistes respecte dels textos literaris que adapten. Tanmateix, malgrat ser pràcticament inevitable, el Dr. Pau Gilabert Barberà indica quins són en opinió seva els límits que Ivory/Hesketh-Harvey no haurien d'haver ultrapassat a fir de no diluir el temperament hel·lènic de "Maurice" d'E. M. Forster.

Grècia i amor platònic a Maurice d'E. M. Forster, o la grandesa i els límits de l'Antiguitat com a inspiració.

L'objectiu d¿aquest article és mostrar com, malgrat la idealització evident de Grècia i l'amor platònic en diferents autors de l'Anglaterra Victoriano-Eduardina, ambdós tenen els seus límits. Per explicar-ho, doncs, l'autor presenta una anàlisi minuciosa del text anglès i, alhora, fa constants referències al textos grecs implícits, com ara el Simposi i el Fedre de Plató i tal vegada fins i tot l'Eròtic de Plutarc en cerca d'una tradició clàssica que és cabdal per entendre l'Anglaterra de principis del segle XX.

Grecia y amor platónico en Maurice de E.M. Forster, o la grandeza y los límites de la Antigüedad como inspiración

El objetivo de este artículo es mostrar cómo, pese a la evidente idealización de Grecia y el amor platónico en la Inglaterra Victoriano-Eduardina, ambos tienen sus límites. Para explicarlo, pues, el autor presenta un análisis minucioso del texto inglés y, a la vez, se refiere constantemente a los textos griegos implícitos como el Simposio y el Fedro de Platón y tal vez incluso el Erótico de Plutarco en busca de una tradición clásica que es capital para entender la Inglaterra de principios del siglo XX

Greece and Platonic Love in E. M. Forster's Maurice, or the greatness and limits of Antiquity as a source of inspiration.

The aim of this article is to show how, although the evident idealization of Greece and Platonic love throughout the Victorian-Edwardian England, both also show their limits. In order to make it clear the author refers constantly to the implicit Greek texts such as Plato's Symposium and Phaedrus and perhaps even to Plutarch¿s Eroticus in search of a Classical Tradition which is highly significant in order to understand that England at the beginning of the twentieth century.

"Maurice" de James Ivory . ¿Traición a la Tradición Clásica al adaptar la novela de E. M. Forster?

De acuerdo con los estudios sobre literatura y cine y desde el punto de vista de la influencia de la Tradición Clásica -Tradición Griega Clásica, en este caso-, este artículo es un análisis minucioso de las traiciones inevitables ¿hasta un cierto punto- de los guionistas a los textos literarios que adaptan. Sin embargo, a pesar de ser prácticamente inevitable, el Dr. Pau Gilabert Barberà indica cuáles son en su opinión los límites más allá de los cuales Ivory/Hesketh-Harvey no deberían haber ido a fin de no diluir el temperamento helénico de "Maurice" de E. M. Forster.