Surgical resection for non-small cell lung cancer : clinical features and outcomes for a consecutive series at an Irish tertiary referral centre

Background: Few patients diagnosed with lung cancer are still alive 5 years after diagnosis. The aim of the current study was to conduct a 10-year review of a consecutive series of patients undergoing curative-intent surgical resection at the largest tertiary referral centre to identify prognostic factors. Methods: Case records of all patients operated on for lung cancer between 1998 and 2008 were reviewed. The clinical features and outcomes of all patients with non-small cell lung cancer (NSCLC) stage I-IV were recorded. Results: A total of 654 patients underwent surgical resection with curative intent during the study period. Median overall survival for the entire cohort was 37 months. The median age at operation was 66 years, with males accounting for 62.7 %. Squamous cell type was the most common histological subtype, and lobectomies were performed in 76.5 % of surgical resections. Pneumonectomy rates decreased significantly in the latter half of the study (25 vs. 16.3 %), while sub-anatomical resection more than doubled (2 vs. 5 %) (p < 0.005). Clinico-pathological characteristics associated with improved survival by univariate analysis include younger age, female sex, smaller tumour size, smoking status, lobectomy, lower T and N status and less advanced pathological stage. Age, gender, smoking status and tumour size, as well as T and N descriptors have emerged as independent prognostic factors by multivariate analysis. Conclusion: We identified several factors that predicted outcome for NSCLC patients undergoing curative-intent surgical resection. Survival rates in our series are comparable to those reported from other thoracic surgery centres. © 2012 Royal Academy of Medicine in Ireland.

Medieval knights amid the gum-trees : the experience of European heritage tourism in south-east Queensland, Australia

This paper is interested in the way in which the heritage of another place, time, and culture is repurposed for popular consumption in an experience economy, as well as the way in which the visitors experience their own past and the past of others. We trace the processes of engagement, education and nostalgia that occur when the European heritage is presented in a postcolonial context and an Australian environment. The information presented includes the results of qualitative and quantitative research conducted at the Abbey Museum over the December-Jan. period of 2012-13.

Suggestive linkage of 2p22-25 and 11q12-13 with low bone mineral density at the lumbar spine in the Irish population

Osteoporosis is a disease characterized by low bone mineral density (BMD) and poor bone quality. Peak bone density is achieved by the third decade of life, after which bone is maintained by a balanced cycle of bone resorption and synthesis. Age-related bone loss occurs as the bone resorption phase outweighs the bone synthesis phase of bone metabolism. Heritability accounts for up to 90% of the variability in BMD. Chromosomal loci including 1p36, 2p22-25, 11q12-13, parathyroid hormone receptor type 1 (PTHR1), interleukin-6 (IL-6), interleukin 1 alpha (IL-1α) and type II collagen A1/vitamin D receptor (COL11A1/VDR) have been linked or shown suggestive linkage with BMD in other populations. To determine whether these loci predispose to low BMD in the Irish population, we investigated 24 microsatellite markers at 7 chromosomal loci by linkage studies in 175 Irish families of probands with primary low BMD (T-score ≤ -1.5). Nonparametric analysis was performed using the maximum likelihood variance estimation and traditional Haseman-Elston tests on the Mapmaker/Sibs program. Suggestive evidence of linkage was observed with lumbar spine BMD at 2p22-25 (maximum LOD score 2.76) and 11q12-13 (MLS 2.55). One region, 1p36, approached suggestive linkage with femoral neck BMD (MLS 2.17). In addition, seven markers achieved LOD scores > 1.0, D2S149, D11S1313, D11S987, D11S1314 including those encompassing the PTHR1 (D3S3559, D3S1289) for lumbar spine BMD and D2S149 for femoral neck BMD. Our data suggest that genes within a these chromosomal regions are contributing to a predisposition to low BMD in the Irish population.

Between Herbals et alia: Intertextuality in Medieval English Herbals

This study reports a corpus-based study of medieval English herbals, which are texts conveying information on medicinal plants. Herbals belong to the medieval medical register. The study charts intertextual parallels within the medieval genre, and between herbals and other contemporary medical texts. It seeks to answer questions where and how herbal texts are linked to each other, and to other medical writing. The theoretical framework of the study draws on intertextuality and genre studies, manuscript studies, corpus linguistics, and multi-dimensional text analysis. The method combines qualitative and quantitative analyses of textual material from three historical special-language corpora of Middle and Early Modern English, one of which was compiled for the purposes of this study. The text material contains over 800,000 words of medical texts. The time span of the material is from c. 1330 to 1550. Text material is retrieved from the corpora by using plant name lists as search criteria. The raw data is filtered through qualitative analysis which produces input for the quantitative analysis, multi-dimensional scaling (MDS). In MDS, the textual space that parallel text passages form is observed, and the observations are explained by a qualitative analysis. This study concentrates on evidence of material and structural intertextuality. The analysis shows patterns of affinity between the texts of the herbal genre, and between herbals and other texts in the medical register. Herbals are most closely linked with recipe collections and regimens of health: they comprise over 95 per cent of the intertextual links between herbals and other medical writing. Links to surgical texts, or to specialised medical texts are very few. This can be explained by the history of the herbal genre: as herbals carry information on medical ingredients, herbs, they are relevant for genres that are related to pharmacological therapy. Conversely, herbals draw material from recipe collections in order to illustrate the medicinal properties of the herbs they describe. The study points out the close relationship between medical recipes and recipe-like passages in herbals (recipe paraphrases). The examples of recipe paraphrases show that they may have been perceived as indirect instruction. Keywords: medieval herbals, early English medicine, corpus linguistics, intertextuality, manuscript studies

Irish Folklore Commission 1935-1970 : history, ideology, methodology

Between 1935 and 1970 the state-funded Irish Folklore Commission (Coimisiún Béaloideasa Éireann) assembled one of the great folklore collections of the world under the direction of Séamus Ó Duilearga (James Hamilton Delargy). The aim of this study is to recount and assess the work and achievement of this commission. The cultural, linguistic, political and ideological factors that had a bearing on the establishment and making permanent of the Commission and that impinged on many aspects of its work are here elucidated. The genesis of the Commission is traced and the vision and mission of Séamus Ó Duilearga are outlined. The negotiations that preceded the setting up of the Commission in 1935 as well as protracted efforts from 1940 to 1970 to place it on a permanent foundation are recounted and examined at length. All the various collecting programmes and other activities of the Commission are described in detail and many aspects of its work are assessed. This study also deals with the working methods and conditions of employment of the Commission s field and Head Office staff as well as with Séamus Ó Duilearga s direction of the Commission. In executing this work extensive use has been made of primary sources in archives and libraries in Ireland, Sweden, Finland, Estonia, and North America. This is the first major study of this world-famous institute, which has been praised in passing in numerous publications, but here for the first time its work and achievement are detailed comprehensively and subjected to scholarly scrutiny. This study should be of interest not only to students of Irish oral tradition but to folklorists everywhere. The history of the Irish Folklore Commission is a part of a wider history, that of the history of folkloristics in Europe and North America in particular. Moreover, this work has relevance for many areas of the developing world today, where conditions are not dissimilar to those that pertained in Ireland in the 1930's when this great salvage operation was funded by the young, independent Irish state. It is also hoped that this work will be of practical assistance to scholars and the general public when utilising these collections, and that furthermore it will stimulate research into the assembling of other national collections of folklore as well as into the history of folkloristics in other countries, subjects which in recent years are beginning to attract more and more scholarly attention.

Modelling discard ogives from Irish demersal fisheries

Annual discard ogives were estimated using generalized additive models (GAMs) for four demersal fish species: whiting, haddock, megrim, and plaice. The analysis was based on data collected on board commercial vessels and at Irish fishing ports from 1995 to 2003. For all species the most important factors influencing annual discard ogives were fleet (combination of gear, fishing ground, and targeted species), mean length of the catch and year, and, for megrim, also minimum landing size. The length at which fish are discarded has increased since 2000 for haddock, whiting, and plaice. In contrast, discarded length has decreased for megrim, accompanying a reduction in minimum landing size in 2000.

Resolution of K.K.S.I. trustees regarding Irish famine

Digital image

Conrad Summenhart's theory of individual rights and its medieval background

This study focuses on the theory of individual rights that the German theologian Conrad Summenhart (1455-1502) explicated in his massive work Opus septipartitum de contractibus pro foro conscientiae et theologico. The central question to be studied is: How does Summenhart understand the concept of an individual right and its immediate implications? The basic premiss of this study is that in Opus septipartitum Summenhart composed a comprehensive theory of individual rights as a contribution to the on-going medieval discourse on rights. With this rationale, the first part of the study concentrates on earlier discussions on rights as the background for Summenhart s theory. Special attention is paid to language in which right was defined in terms of power . In the fourteenth century writers like Hervaeus Natalis and William Ockham maintained that right signifies power by which the right-holder can to use material things licitly. It will also be shown how the attempts to describe what is meant by the term right became more specified and cultivated. Gerson followed the implications that the term power had in natural philosophy and attributed rights to animals and other creatures. To secure right as a normative concept, Gerson utilized the ancient ius suum cuique-principle of justice and introduced a definition in which right was seen as derived from justice. The latter part of this study makes effort to reconstructing Summenhart s theory of individual rights in three sections. The first section clarifies Summenhart s discussion of the right of the individual or the concept of an individual right. Summenhart specified Gerson s description of right as power, taking further use of the language of natural philosophy. In this respect, Summenhart s theory managed to bring an end to a particular continuity of thought that was centered upon a view in which right was understood to signify power to licit action. Perhaps the most significant feature of Summenhart s discussion was the way he explicated the implication of liberty that was present in Gerson s language of rights. Summenhart assimilated libertas with the self-mastery or dominion that in the economic context of discussion took the form of (a moderate) self-ownership. Summenhart discussion also introduced two apparent extensions to Gerson s terminology. First, Summenhart classified right as relation, and second, he equated right with dominion. It is distinctive of Summenhart s view that he took action as the primary determinant of right: Everyone has as much rights or dominion in regard to a thing, as much actions it is licit for him to exercise in regard to the thing. The second section elaborates Summenhart s discussion of the species dominion, which delivered an answer to the question of what kind of rights exist, and clarified thereby the implications of the concept of an individual right. The central feature in Summenhart s discussion was his conscious effort to systematize Gerson s language by combining classifications of dominion into a coherent whole. In this respect, his treatement of the natural dominion is emblematic. Summenhart constructed the concept of natural dominion by making use of the concepts of foundation (founded on a natural gift) and law (according to the natural law). In defining natural dominion as dominion founded on a natural gift, Summenhart attributed natural dominion to animals and even to heavenly bodies. In discussing man s natural dominion, Summenhart pointed out that the natural dominion is not sufficiently identified by its foundation, but requires further specification, which Summenhart finds in the idea that natural dominion is appropriate to the subject according to the natural law. This characterization lead him to treat God s dominion as natural dominion. Partly, this was due to Summenhart s specific understanding of the natural law, which made reasonableness as the primary criterion for the natural dominion at the expense of any metaphysical considerations. The third section clarifies Summenhart s discussion of the property rights defined by the positive human law. By delivering an account on juridical property rights Summenhart connected his philosophical and theological theory on rights to the juridical language of his times, and demonstrated that his own language of rights was compatible with current juridical terminology. Summenhart prepared his discussion of property rights with an account of the justification for private property, which gave private property a direct and strong natural law-based justification. Summenhart s discussion of the four property rights usus, usufructus, proprietas, and possession aimed at delivering a detailed report of the usage of these concepts in juridical discourse. His discussion was characterized by extensive use of the juridical source texts, which was more direct and verbal the more his discussion became entangled with the details of juridical doctrine. At the same time he promoted his own language on rights, especially by applying the idea of right as relation. He also showed recognizable effort towards systematizing juridical language related to property rights.

Memory and Gender in Medieval Europe 900-1200

Review of Memory and Gender in Medieval Europe, 900-1200 by Elizabeth van Houts (Toronto UP, 1999).

HER2 positive gastric and gastroesophageal adenocarcinoma; An Irish tertiary center experience

Background: Trastuzumab has been approved for patients with human epidermal growth factor receptor 2 (HER2) over expression and gene amplification metastatic gastric cancer. Here we present the prevalence of HER2 positive gastric cancer in an Irish population, the use of Trastuzumab in first line and beyond progression. Methods: The study was conducted in St James's Hospital, Dublin. A retrospective analysis of the date of patients with HER2 positive gastric cancer over a period of 3 years was carried out. Her2 positive was defined as immunohistochemistry (IHC) score of +3, of IHC score of +2 and increased gene copy number by fluorescence in situ hybridization (FISH). Overall survival was calculated from the day of initiation of treatment with Trastuzumab until death. Results: During the study period 140 patients with gastric and gastro-esophageal junction adenocarcinoma were treated. Out of those, 30 (21.4%) had HER2 positive disease. Among HER2 positive disease patients 18 (12.8%) were treated with first line Trastuzumab containing regimen with a median overall survival of 13 months. Nine (50%) developed progressive disease while on Trastuzumab and of those, 4 (22.2%) patients continued on Trastuzumab beyond progression, two (11.1%) of whom achieved stable disease and a prolonged survival. Conclusion: HER2 positivity rate in an Irish population with advanced gastric and gastro-esophageal junction adenocarcinoma is 21.4%. Treatment with Trastuzumab in the first line in combination with chemotherapy is a reasonable approach. Continuation of Trastuzumab beyond progression is a feasible strategy that requires further exploration.

Medieval pulse of great earthquakes in the central Himalaya: Viewing past activities on the frontal thrust

The Himalaya has experienced three great earthquakes during the last century1934 Nepal-Bihar, 1950 Upper Assam, and arguably the 1905 Kangra. Focus here is on the central Himalayan segment between the 1905 and the 1934 ruptures, where previous studies have identified a great earthquake between thirteenth and sixteenth centuries. Historical data suggest damaging earthquakes in A.D. 1255, 1344, 1505, 1803, and 1833, although their sources and magnitudes remain debated. We present new evidence for a great earthquake from a trench across the base of a 13m high scarp near Ramnagar at the Himalayan Frontal Thrust. The section exposed four south verging fault strands and a backthrust offsetting a broad spectrum of lithounits, including colluvial deposits. Age data suggest that the last great earthquake in the central Himalaya most likely occurred between A.D. 1259 and 1433. While evidence for this rupture is unmistakable, the stratigraphic clues imply an earlier event, which can most tentatively be placed between A.D. 1050 and 1250. The postulated existence of this earlier event, however, requires further validation. If the two-earthquake scenario is realistic, then the successive ruptures may have occurred in close intervals and were sourced on adjacent segments that overlapped at the trench site. Rupture(s) identified in the trench closely correlate with two damaging earthquakes of 1255 and 1344 reported from Nepal. The present study suggests that the frontal thrust in central Himalaya may have remained seismically inactive during the last similar to 700years. Considering this long elapsed time, a great earthquake may be due in the region.