Magnetic resonance imaging of the chest in the evaluation of cancer patients: state of the art

Magnetic resonance imaging (MRI) has several advantages in the evaluation of cancer patients with thoracic lesions, including involvement of the chest wall, pleura, lungs, mediastinum, esophagus and heart. It is a quite useful tool in the diagnosis, staging, surgical planning, treatment response evaluation and follow-up of these patients. In the present review, the authors contextualize the relevance of MRI in the evaluation of thoracic lesions in cancer patients. Considering that MRI is a widely available method with high contrast and spatial resolution and without the risks associated with the use of ionizing radiation, its use combined with new techniques such as cine-MRI and functional methods such as perfusion- and diffusion-weighted imaging may be useful as an alternative tool with performance comparable or complementary to conventional radiological methods such as radiography, computed tomography and PET/CT imaging in the evaluation of patients with thoracic neoplasias.

Whole-body magnetic resonance imaging in children: state of the art

Whole-body imaging in children was classically performed with radiography, positron-emission tomography, either combined or not with computed tomography, the latter with the disadvantage of exposure to ionizing radiation. Whole-body magnetic resonance imaging (MRI), in association with the recently developed metabolic and functional techniques such as diffusion-weighted imaging, has brought the advantage of a comprehensive evaluation of pediatric patients without the risks inherent to ionizing radiation usually present in other conventional imaging methods. It is a rapid and sensitive method, particularly in pediatrics, for detecting and monitoring multifocal lesions in the body as a whole. In pediatrics, it is utilized for both oncologic and non-oncologic indications such as screening and diagnosis of tumors in patients with genetic syndromes, evaluation of disease extent and staging, evaluation of therapeutic response and post-therapy follow-up, evaluation of non neoplastic diseases such as multifocal osteomyelitis, vascular malformations and syndromes affecting multiple regions of the body. The present review was aimed at describing the major indications of whole-body MRI in pediatrics added of technical considerations.

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

Abstract Objective: To propose an algorithm to determine the necessity for ultrasonography-guided fine-needle aspiration (US-FNA) in preoperative axillary lymph node staging of patients with invasive breast cancer. Materials and Methods: Prospective study developed at National Cancer Institute. The study sample included 100 female patients with breast cancer referred for axillary staging by US-FNA. Results: The overall US-FNA sensitivity was set at 79.4%. The positive predictive value was calculated to be 100%, and the negative predictive value, 69.5%. The US-FNA sensitivity for lymph nodes with normal sonographic features was 0%, while for indeterminate lymph nodes it was 80% and, for suspicious lymph nodes, 90.5%. In the assessment of invasive breast tumors stages T1, T2 and T3, the sensitivity was respectively 69.6%, 83.7% and 100%. US-FNA could avoid sentinel node biopsy in 54% of cases. Conclusion: Axillary ultrasonography should be included in the preoperative staging of all patients with invasive breast cancer. The addition of US-FNA in cases of lymph nodes suspicious for malignancy may prevent more than 50% of sentinel lymphadenectomies, significantly shortening the time interval to definitive therapy.

Les expositions universelles comme communautés émotionnelles imaginées: du bon usage des émotions dans l'art d'instruire et de divertir

Cette contribution commence par établir que les expositions universelles sont traversées par un ensemble de dynamiques contradictoires qui reflètent celles intervenant dans le processus de la mondialisation qu'elles ont précisément pour vocation de mettre en scène. Parmi ces différents dynamiques, il en est une qui mérite que l'on s'y arrête de nouveau : celle ayant d'abord opposé sciences et loisirs avant de les associer comme organisateurs de la vie sociale. Comment les expositions universelles ont-elles représenté ces deux types d'activités qui leur ont été centrales ? L'article avance que l'évolution de la fonction de normalisation sociale attachée aux sciences et aux divertissements peut être éclairée par une analyse de l'usage qui a été fait des émotions par les organisateurs et commentateurs de ces manifestations. Le phénomène est examiné à la lumière des concepts d'émotionologie, d'émotif et de communauté émotionnelle développés par les historiens des émotions. This article starts from the premise that international exhibitions are driven by the same contradictory dynamics underlying the process of globalization which they seek to stage. Among these various dynamics, there is need to further study the one that has involved science and leisure as organizers of social life in a dyadic relationship evolving historically from opposition to accommodation. Drawing on the concepts of «emotionolgy », « emotives » and « emotional communities », the study attempts to show how changes in the normalizing functions of science and leisure can be highlighted through the shifting use of emotions by the organizers and commentators of world's fairs.

Bulletin de la Société du livre d'art

1904/01 (N1)-1904/07.

Celebrating Creative Consciousness: Insights Into Oscar Wilde’s Aesthetics

Tutkielmani valottaa irlantilaisen kirjailijan Oscar Wilden (1854-1900) vähemmän tunnettua työtä ja ajattelua taidekriitikkona fin de sièclen ja modernismin välisen siirtymävaiheen estetiikassa. Wilden voidaan sanoa olleen edellä aikaansa estetiikkakäsityksensä suhteen: Hän käsittelee taidekritiikissään teemoja, jotka tulivat keskeisiksi modernismin ja postmodernismin myötä – esimerkiksi kielen pettävyyttä, sellaisten käsitteiden kuin ’todellisuus’, ’luonto’ tai ’yhteiskunta’ sattumanvaraisuutta sekä yhteisön ja yksilön identiteettien fragmentoitumista. Wilde myös kyseenalaistaa – paradoksien, kielellisten nokkeluuksien ja ironian avulla – monia länsimaisessa filosofiassa ’normatiivisina’ pidettyjä arvoja, kuten totuuteen pyrkimisen. Lisäksi hän haastaa taiteenkritiikin akateemisen tradition hylkäämällä sellaiset sen hyveinä pitämät piirteet kuin johdonmukaisuus ja ristiriidattomuus. Tarkastelen Wilden estetiikkakäsitystä pääasiassa esseekokoelman Intentions (1891), etenkin esseen Valehtelun rappio, sekä De Profundis –teoksen (1905) kautta. Tekstejä analysoimalla ja vertaamalla osoitan miten 1890-luvun alkupuolen ja vankilatuomiotaan istuvan Wilden estetiikkakäsitys muuttui ja kehittyi. Wilden kohdalla on syytä puhua taidefilosofiasta taiteenteorian sijaan. Hänen kriittiset esseensä eivät tähtää ’harmonisen’ kokonaisuuden luomiseen tai pragmaattis-loogisen mallin rakentamiseen taiteen ymmärtämiseksi vaan tulvivat ironiaa ja ristiriitaisuuksia. Wildella taideteoksen tarkasteluun liittyy aina eettisiä, ontologisia ja metafyysisiä kysymyksiä, jotka syventävät mutta myös monimutkaistavat esteettistä kokemusta. Keskeinen teema Wildelle onkin taiteen ja elämän vastakkainasettelu sekä niiden välisen yhteyden tunnistaminen ja tunnustaminen: taide on sekä autonomista että subjektiivista. Tämä paradoksi kulminoituu esteettisessä kokemuksessa. Wildelle luomistyö ja vastaanottajan elämys ovat tiedostamattomia prosesseja – tietoista luovuutta ei ole. Esteettinen kuitenkin voidaan yhdistää tietoisuuteen, mutta se edellyttää että myös tietoisuuden on oltava luovaa. Siksipä lähestyäkseen taidetta kritiikin on tultava enemmän taiteen kaltaiseksi – epänormatiiviseksi ja epäloogiseksi. Tässä prosessissa paradokseilla on merkittävä tehtävä: ne muistuttavat siitä, että puhuttaessa taiteesta ei ole oikeita vastauksia, on vain hyviä kysymyksiä.

Understanding Flood Regime Changes in Europe: a state-of-the-art assessment

There is growing concern that flooding is becoming more frequent and severe in Europe. A better understanding of flood regime changes and their drivers is therefore needed. The paper reviews the current knowledge on flood regime changes in European rivers that has traditionally been obtained through two alternative research approaches. The first approach is the data-based detection of changes in observed flood events. Current methods are reviewed together with their challenges and opportunities. For example, observation biases, the merging of different data sources and accounting for nonlinear drivers and responses. The second approach consists of modelled scenarios of future floods. Challenges and opportunities associated with flood change scenarios are discussed such as fully accounting for uncertainties in the modelling cascade and feedbacks. To make progress in flood change research, we suggest that a synthesis of these two approaches is needed. This can be achieved by focusing on long duration records and flood-rich and flood-poor periods rather than on short duration flood trends only, by formally attributing causes of observed flood changes, by validating scenarios against observed flood regime dynamics, and by developing low-dimensional models of flood changes and feedbacks. The paper finishes with a call for a joint European flood change research network.