Paradoxical emboli through the patent foramen ovale as the suspected cause of myocardial and renal infarction in a 48-year-old woman

We review the case of a 48-year-old woman who underwent elective percutaneous patent foramen ovale closure following successive renal and myocardial infarction with normal renal and coronary arteries, probably as a consequence of paradoxical emboli.

Add a Dash of Rhetoric, a Pinch of Technical Communication, a Handful of Pedagogy, and Mix Well: Cookbooks and Recipes as Instructional Texts, and What Domestic Texts from 1870 to 1935 Can Teach Us About Technical Communication

Through the use of rhetoric centered on authority and risk avoidance, scientific method has co-opted knowledge, especially women's everyday and experiential knowledge in the domestic sphere. This, in turn, has produced a profound affect on technical communication in the present day. I am drawing on rhetorical theory to study cookbooks and recipes for their contributions to changes in instructional texts. Using the rhetorical lenses of metis (cunning intelligence), kairos (timing and fitness) and mneme (memory), I examine the way in which recipes and cookbooks are constructed, used and perceived. This helps me uncover lost voices in history, the voices of women who used recipes, produced cookbooks and changed the way instructions read. Beginning with the earliest cookbooks and recipes, but focusing on the pivotal temporal interval of 1870-1935, I investigate the writing and rhetorical forces shaping instruction sets and domestic discourse. By the time of scientific cooking and domestic science, everyday and experiential knowledge were being excluded to make room for scientific method and the industrial values of the public sphere. In this study, I also assess how the public sphere, via Cooperative Extension Services and other government agencies, impacted the domestic sphere, further devaluing everyday knowledge in favor of the public scientific model. I will show how the changes in the production of food, cookbooks and recipes were related to changes in technical communication. These changes had wide rippling effects on the field of technical communication. By returning to some of the tenets and traditions of everyday and experiential knowledge, technical communication scholars, practitioners and instructors today can find new ways to encounter technical communication, specifically regarding the creation of instructional texts. Bringing cookbooks, recipes and everyday knowledge into the classroom and the field engenders a new realm of epistemological possibilities.

The Domestic Natural Gas Shortage in China

This thesis analyzes the domestic shortage in the Chinese natural gas market. Both the domestic supply and demand of natural gas are growing fast in China. However, the supply cannot catch up with the demand. Under the present pricing mechanism, the Chinese natural gas market cannot get the equilibrium by itself. Expensive imports are inadequate to fill the increasing gap between the domestic demand and supply. Therefore, the shortage problem occurs. Since the energy gap can result in the arrested development of economics, the shortage problem need to be solved. This thesis gives three suggestions to solve the problem: the use of Unconventional Gas, Natural Gas Storage and Pricing Reform.

An unusual case of galactorrhea in a postmenopausal woman complicating breast reduction

Galactorrhea is a relatively common condition, but has rarely been seen following breast reduction surgery. To date there are only seven cases reported in the literature, all in premenopausal women. Postsurgical galactorrhea is a diagnosis of exclusion and differential diagnosis is extensive. Common causes should be excluded first. We present the case of a 56-year-old postmenopausal woman who underwent bilateral breast reduction and developed galactorrhea 2 months postoperatively. MRI scan of the skull as well as Thyroid-Stimulating Hormone (TSH), prolactin levels were normal. She was on long-term hormonal replacement therapy. Because of suspected nerve-related pain in her right breast she was commenced on amitriptyline. We hypothesise that galactorrhea may have been caused by underlying neuroma or irritation of the anterior branch of the T4 intercostal nerve or hormonal replacement therapy or a combination of both.