Imperialism displaced, imperialism inverted : the trope of the other world in Gulliver's travels and The chronicles of Narnia ; and, Infiltrating the canon : the recreation of the bildungsroman in Sandra Cisneros' The house on Mango Street

"The purpose of the research was to assess the influence of Jonathan Swift's Gulliver's Travels on C.S. Lewis' Chronicles of Narnia, with the primary concerns being Christian Humanism and British imperialism. The primary texts employed were very similar in the ways in which psychological maturity, physical size, and animal imagery were used to present a critique of the evils of empire and imperialism. The research is more concerned with the similarities between Swift and Lewis' respective texts than with the differences between those respective texts. The result of the research showed that while Lewis is less scathing in his critique of imperialism, he "inherits" from Jonathan Swift a sarcastic attitude towards imperialism for the purpose of personal gain. Lewis' text The Four Loves was used as a lens through which Gulliver's Travels and The Chronicles of Narnia can be read with regards to religious hypocrisy. The Biblical character Samson also proved essential as an archetypal Christ parallel to which Gulliver and Aslan can both be compared. The purpose of the research was to assess Cisneros' text from several different angles, with the primary concern being the way in which Cisneros draws on many different concepts, themes, and other texts as a Post-Modern, Mexican-American female author. Among the research's main concerns were the bildungsroman tradition, the notion of the self-made man (or self-made woman, in the case of the protagonist, Esperanza Cordero), and the use of the Biblical discourse, which is employed both implicitly and explicitly throughout Cisnero's text. Cisneros attempts and succeeds to weave these three threads together: Christ is the quintessential "self-made man," and the bildungsroman takes on a new meaning when notions of American dissatisfaction are taken into consideration. Esperanza's name literally means "Lamb of Hope," and this translation by itself acts as a kind of lens through which the text can be read. Cisnero's protagonist comes into her own power by learning from the mistakes as well as the successes of those who have come before her."--Abstract from author supplied metadata

Role of Barium Swallow in Diagnosing Clinically Significant Anastomotic Leak following Esophagectomy

Background Barium swallow is performed following esophagectomy to evaluate the anastomosis for detection of leaks and to assess the emptying of the gastric conduit. The aim of this study was to evaluate the reliability of the barium swallow study in diagnosing anastomotic leaks following esophagectomy. Methods Patients who underwent esophagectomy from January 2000 to December 2013 at our institution were investigated. Barium swallow was routinely done between days 5–7 to detect a leak. These results were compared to clinically determined leaks (defined by neck wound infection requiring jejunal feeds and or parenteral nutrition) during the postoperative period. The sensitivity and specificity of barium swallow in diagnosing clinically significant anastomotic leaks was determined. Results A total of 395 esophagectomies were performed (mean age, 62.2 years). The indications for the esophagectomy were as follows: malignancy (n=320), high-grade dysplasia (n=14), perforation (n=27), benign stricture (n=7), achalasia (n=16), and other (n=11). A variety of techniques were used including transhiatal (n=351), McKeown (n=35), and Ivor Lewis (n=9) esophagectomies. Operative mortality was 2.8% (n=11). Three hundred and sixty-eight patients (93%) underwent barium swallow study after esophagectomy. Clinically significant anastomotic leak was identified in 36 patients (9.8%). Barium swallow was able to detect only 13/36 clinically significant leaks. The sensitivity of the swallow in diagnosing a leak was 36% and specificity was 97%. The positive and negative predictive values of barium swallow study in detecting leaks were 59% and 93%, respectively. Conclusion Barium swallow is an insensitive but specific test for detecting leaks at the cervical anastomotic site after esophagectomy

Second Annual Seminar on Estate Planning

Schedule and materials from the Second Annual Seminar on Estate Planning held by UK/CLE on July 18-19, 1975

Bladder stones – red herring for resurgence of spasticity in a spinal cord injury patient with implantation of Medtronic Synchromed pump for intrathecal delivery of baclofen – a case report

BACKGROUND: Increased spasms in spinal cord injury (SCI) patients, whose spasticity was previously well controlled with intrathecal baclofen therapy, are due to (in order of frequency) drug tolerance, increased stimulus, low reservoir volume, catheter malfunction, disease progression, human error, and pump mechanical failure. We present a SCI patient, in whom bladder calculi acted as red herring for increased spasticity whereas the real cause was spontaneous extrusion of catheter from intrathecal space. CASE PRESENTATION: A 44-year-old male sustained a fracture of C5/6 and incomplete tetraplegia at C-8 level. Medtronic Synchromed pump for intrathecal baclofen therapy was implanted 13 months later to control severe spasticity. The tip of catheter was placed at T-10 level. The initial dose of baclofen was 300 micrograms/day of baclofen, administered by a simple continuous infusion. During a nine-month period, he required increasing doses of baclofen (875 micrograms/day) to control spasticity. X-ray of abdomen showed multiple radio opaque shadows in the region of urinary bladder. No malfunction of the pump was detected. Therefore, increased spasticity was attributed to bladder stones. Electrohydraulic lithotripsy of bladder stones was carried out successfully. Even after removal of bladder stones, this patient required further increases in the dose of intrathecal baclofen (950, 1050, 1200 and then 1300 micrograms/day). Careful evaluation of pump-catheter system revealed that the catheter had extruded spontaneously and was lying in the paraspinal space at L-4, where the catheter had been anchored before it entered the subarachnoid space. A new catheter was passed into the subarachnoid space and the tip of catheter was located at T-8 level. The dose of intrathecal baclofen was decreased to 300 micrograms/day. CONCLUSION: Vesical calculi acted as red herring for resurgence of spasticity. The real cause for increased spasms was spontaneous extrusion of whole length of catheter from subarachnoid space. Repeated bending forwards and straightening of torso for pressure relief and during transfers from wheel chair probably contributed to spontaneous extrusion of catheter from spinal canal in this patient

Report of Seminar on Estate Planning

Reports from the UK/CLE Seminar on Estate Planning held July 19-20, 1974

Report of Third Annual Seminar on Estate Planning

Reports from the UK/CLE Third Annual Seminar on Estate Planning held July 23-24, 1976

Nutrition issues in Codex: health claims, nutrient reference values and WTO agreements: a conference report

BACKGROUND: Codex documents may be used as educational and consensus materials for member governments. Also, the WTO SPS Agreement recognizes Codex as the presumptive international authority on food issues. Nutrient bioavailability is a critical factor in determining the ability of nutrients to provide beneficial effects. Bioavailability also influences the quantitative dietary requirements that are the basis of nutrient intake recommendations and NRVs. HEALTH CLAIMS: Codex, EFSA and some national regulatory authorities have established guidelines or regulations that will permit several types of health claims. The scientific basis for claims has been established by the US FDA and EFSA, but not yet by Codex. Evidence-based nutrition differs from evidence-based medicine, but the differences are only recently gaining recognition. Health claims on foods may provide useful information to consumers, but many will interpret the information to mean that they can rely upon the food or nutrient to eliminate a disease risk. NUTRIENT REFERENCE VALUES: NRVs are designed to provide a quantitative basis for comparing the nutritive values of foods, helping to illustrate how specific foods fit into the overall diet. The INL-98 and the mean of adult male and female values provide NRVs that are sufficient when used as targets for individual intakes by most adults. WORLD TRADE ORGANIZATION AGREEMENTS: WTO recognizes Codex as the primary international authority on food issues. Current regulatory schemes based on recommended dietary allowances are trade restrictive. A substantial number of decisions by the EFSA could lead to violation of WTO agreements