Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
361
result(s) for
"Gray, Keith"
Sort by:
Ostrich boys
After their best friend Ross dies, English teenagers Blake, Kenny, and Sim plan a proper memorial by taking his ashes to Ross, Scotland, an adventure-filled journey that tests their loyalty to each other and forces them to question what friendship means.
Book
Pancreatic Lymphangioma: A Diagnostic and Treatment Dilemma
Cytologic examination is limited due to scant cellularity and is not specific. Because of the lack of epithelial lining, a definitive diagnosis cannot be made based on cytologic criteria only, although the lesion can be suggested from correlation with radiologic studies. Differential diagnosis includes and is not restricted to benign cystic mesothelioma, pancreatic pseudocyst, mucinous cystic lesions of the pancreas, or cystic degeneration of a malignant neoplasm, therefore definitive characterization often requires surgical resection. Endoscopic ultrasound fine needle aspiration with drainage may bring temporary symptomatic relief, but lymphangioma recurrence after drainage has been documented.4 With accurate diagnosis, observation is a possibility in asymptomatic patients, but complete surgical resection is considered the treatment of choice. Because of the possible complications, it should be limited to symptomatic cases or cases with high risk stigmata.
Journal Article
Superman : Rebirth deluxe edition
\"After the stunning events of DC REBIRTH, the world is left without Superman! Luckily, there is another Man of Steel to fill his shoes: the pre-Flashpoint Kal-El! However, can this new Superman protect the world while raising a super-son with his wife, Lois Lane? And should they help their boy use his new and rapidly increasing abilities, or hide them from the world?\"-- Provided by publisher.
Book
A Rare Case of Plasmablastic Lymphoma Mimicking Adenocarcinoma of the Sigmoid Colon
Plasmablastic lymphoma is an aggressive B-cell lymphoma composed of large neoplastic cells resembling terminally differentiated B cells, which reveal the immunophenotype of plasma cells but morphologically look like B immunoblasts.1 It is an uncommon, predominantly extranodal tumor, occurring primarily in immunocompromised individuals.1, 2 Plasmablastic lymphoma rarely involves the gastrointestinal tract,3 with only a few colonic presentations reported.4 We present a case of the oldest reported immunocompetent patient, an 88-year-old male, with plasmablastic lymphoma of the sigmoid colon. Since repeat CT imaging six weeks later showed no significant changes in the colonic wall thickening/mass (Fig. 1A), repeat colonoscopy was performed revealing a nearly obstructing sigmoid colon mass.
Journal Article
The Effect of Multiple Wire Localization in Breast Conservation
Variability exists regarding the surgical technique in breast conservation therapy. The purpose of this project was to determine differences between single (SH) or flanking (FH) hooked needle localization wires used for nonpalpable breast lesions. We retrospectively reviewed 201 female patients at a single institution from 2004 to 2008. All patients had biopsy-proven ductal carcinoma in situ or invasive disease. Comparisons were made in regard to margin status, reoperation, completion mastectomy, size of lesion, and breast specimen volume. SH was placed in 122 patients (61%) and FH in 79 patients (39%). In SH, 23 patients (18%) had positive margins and 31 patients (25%) had reoperations as compared with 31 patients (25%) with positive margin and 36 patients (44%) in the FH cohort ( P = 0.039 and 0.0037). Average lesion size and volume resected was 1.5 cm and 137 cm 3 in SH and 2.85 cm and 188 cm 3 in FH, respectively ( P = 0.0001 and 0.006). Positive margins were associated with lesion size and not volume of tissue excised. The FH technique was associated with more positive margins, reoperation, and completion mastectomy.
Journal Article
Odontogenic Ameloblast Associated Protein as a Novel Biomarker for Human Breast Cancer
Odontogenic Ameloblast Associated Protein (ODAM) is a protein isolated in ameloblasts during odontogenesis. ODAM expression was identified in breast cancer, but its significance remains unknown. The purpose of this study is to determine if ODAM expression can serve as a prognostic marker and provide information regarding treatment in human breast cancer. Breast cancer patients were identified from our tumor registry from 1993 to 2003. Archived breast cancer tissue from 243 patients (stage 0 = 53, stage I = 51, stage II = 53, stage III = 47, stage IV = 39) was stained using monoclonal antibody for ODAM. Presence or absence of immunostaining was correlated with stage, histologic grade, response to chemotherapy, and survival using χ 2 and logistic regression analyses. Tumor nuclear staining for ODAM increased with increasing group stage ( P < 0.001). Staining for ODAM did not correlate with histologic grade or chemotherapy ( P = 0.558, P = 0.093). Improved outcomes within each stage were noted with ODAM staining, statistically significant for stages 0, I, and II ( P < 0.001, P = 0.003, P = 0.003) and underpowered for stages III and IV ( P = 0.724, P = 0.059). Survival benefit associated with tumor nuclear staining increased with advancing stage ( P < 0.001). These results show that ODAM predicts survival in breast cancer. Research is ongoing to determine ODAM's clinical utility and role in carcinogenesis.
Journal Article
3064 Prevalence of, and risk factors for, dementia in adult outpatient referrals to a regional referral hospital in Arusha, Northern Tanzania
ObjectivesThe global burden of dementia is increasing, with the greatest increase predicted to occur in sub-Saharan Africa (SSA). Despite this there are limited previous data on the prevalence of, and risk factors for, dementia in SSA. This study aimed to estimate the prevalence of dementia, and investigate its associations, in those aged 60 years and older attending the outpatient department of Mount Meru Hospital in northern Tanzania. This is the first hospital-based outpatient dementia prevalence and risk factors study to be conducted in an east African population.MethodsThis was a one-phase cross-sectional study. Adults aged 60 years and over attending medical outpatients were screened for dementia using The Identification and Intervention for Dementia in Elderly Africans cognitive screening tool. Those who scored ≤9 were clinically assessed using the DSM-IV criteria. Demographic, medical comorbidity and lifestyle information were collected during a clinical assessment.ResultsPrevalence of dementia was 5.0% (95% confidence interval: 3.7-6.3). Binary logistic regression found female sex (odds ratio (OR)=2.778), having no formal education(OR=6.088), quantity of alcohol consumption (units/week) (OR=1.080), uncorrected visual impairment (OR=4.260), body mass index <18.5kg/m2 (OR=6.588) and stroke (OR=15.790with wide 95% confidence interval (3.48-74.475)) to be significantly, independently associated with dementia.ConclusionsThe prevalence of dementia in this population is lower than previously reported community-based rates in Tanzania, and similar to those in high-income countries.This is the first time the association between uncorrected visual impairment and dementia has been reported in SSA. Other associations identified are in keeping with previous literature. Further research on the management of dementia and its risk factors, and the support and education of carers and patients in east African populations is required to advise future policy.
Journal Article
Intestinal Obstruction in Pregnancy: A Case of Small Bowel Volvulus and Review of the Literature
INTESTINAL OBSTRUCTION IS an unusual complication of pregnancy, most commonly a result of previous laparotomy adhesions or volvulus.1-4 Among those patients who develop intestinal obstruction secondary to volvulus, one-half will present in the third trimester of pregnancy, whereas 25 per cent are noted in puerperium.4
Journal Article
Endotoxin potentiates lung injury in cerulein-induced pancreatitis
In this study we examine the effect of endotoxin (lipopolysaccharide) on lung injury in the setting of acute pancreatitis (AP).
Twelve hourly injections of cerulein (50 μg/kg/h) were used to induce pancreatitis in mice. Intraperitoneal lipopolysaccharide (LPS [6 mg/kg]) was administered 24 hours after the initial cerulein injection. Twenty-four hours after LPS injection, myeloperoxidase (MPO) activity, nuclear factor (NF)-κB activation, and tumor necrosis factor (TNF)-α, interleukin (IL)-6, and chemokines MIP-2 and KC levels were measured in pancreas, liver, and lung tissues. Four groups of mice were studied: cerulein-LPS, cerulein-saline, saline-LPS, and saline-saline treated mice.
Elevated serum lipase confirmed pancreatitis in cerulein treated mice. Lung MPO activity was significantly increased in the cerulein-LPS group. NF-κB was activated in the liver but not in pancreas and lung tissue. Chemokines MIP-2 and KC were elevated in pancreatic tissue only.
These findings suggest that gram-negative infections may be an important predisposition for the development of adult respiratory distress syndrome in the setting of AP and that hepatic NF-κB may mediate multisystem injury.
Journal Article
Primary Cutaneous Melanoma Arising in a Long-Standing Irradiated Keloid
Ionizing radiation has been used therapeutically for a variety of clinical conditions, including treatment of hypertrophic keloids. Keloids may rarely be associated with malignancy, but the use of low-dose ionizing radiation is associated with an increased risk of cutaneous malignancies. We describe a case in which a primary desmoplastic melanoma arose in a long-standing, previously irradiated keloid.
Journal Article