When you look away: “Reality” and Hemingway’s Verbal Imagination

Cet article étudie “Cat in the Rain” de Hemingway en analysant les effets produits dans le texte eu égard aux choix stylistiques et narratifs spécifiques faits par Hemingway. Pourquoi une femme américaine regarde-t-elle d’une fenêtre située au deuxième étage un chat sous la pluie, et pas d’une fenêtre située au premier ? Pourquoi l’identité du chat peut-elle être mise en doute, et pas celle de George, le mari de la femme ? La technique narrative et stylistique telle qu’utilisée dans la nouvelle, montre comment l’écrivain perçoit la relation entre le langage et la réalité, laquelle réalité ne peut être représentée verbalement.This article discusses Hemingway’s “Cat in the Rain” by examining the effects produced in the text thanks to the specific stylistic and narrative choices made by Hemingway. Why does an American woman look down from the second-floor room at a cat in the rain, and not from the first-floor window? Why can the cat’s identity be questioned, and not George’s, the woman’s husband? The stylistic and narrative technique used in the story, shows in fact how the writer perceives the relation between language and reality, which, Hemingway suggests, cannot be verbally represented

When you look away: “Reality” and Hemingway’s Verbal Imagination

Cet article étudie “Cat in the Rain” de Hemingway en analysant les effets produits dans le texte eu égard aux choix stylistiques et narratifs spécifiques faits par Hemingway. Pourquoi une femme américaine regarde-t-elle d’une fenêtre située au deuxième étage un chat sous la pluie, et pas d’une fenêtre située au premier ? Pourquoi l’identité du chat peut-elle être mise en doute, et pas celle de George, le mari de la femme ? La technique narrative et stylistique telle qu’utilisée dans la nouvelle, montre comment l’écrivain perçoit la relation entre le langage et la réalité, laquelle réalité ne peut être représentée verbalement.This article discusses Hemingway’s “Cat in the Rain” by examining the effects produced in the text thanks to the specific stylistic and narrative choices made by Hemingway. Why does an American woman look down from the second-floor room at a cat in the rain, and not from the first-floor window? Why can the cat’s identity be questioned, and not George’s, the woman’s husband? The stylistic and narrative technique used in the story, shows in fact how the writer perceives the relation between language and reality, which, Hemingway suggests, cannot be verbally represented

Discordant Immune Marker Expression Between Preoperatively Biopsied and Matched Surgically Resected Specimens in Patients With Oral Squamous Cell Carcinoma

Programmed cell death ligand 1 (PD-L1) expression and tumor-associated immune cell (TAIC) density can be the biomarkers of survival outcome and for predicting the efficacy of immune checkpoint inhibitors in oral squamous cell carcinoma (OSCC), but whether single biopsy accurately reflects the values of these parameters in resected specimens is unclear. To clarify this, we evaluated the concordance of immune marker expression (PD-L1, PD-1, CD3, CD4, CD8, and CD68) between 39 paired biopsied and surgically resected specimens obtained from patients with OSCC at Kobe City Medical Center General Hospital between July 2011 and January 2016. Immune marker expression was assessed using immunohistochemistry. PD-L1 expression was consistent between the biopsied and surgically resected specimens in only 76.9% of cases. TAIC density was significantly lower in biopsied than in surgically resected specimens. There was considerable discordance in immune marker expression between biopsied and surgically resected specimens. We should take into consideration that PD-L1 positivity and TAIC density would be underestimated by single small biopsies compared to the estimations by surgically resected specimens

Clinical utility of the Vesical Imaging-Reporting and Data System for muscle-invasive bladder cancer between radiologists and urologists based on multiparametric MRI including 3D FSE T2-weighted acquisitions

Objectives: To investigate the clinical utility of the Vesical Imaging-Reporting and Data System (VI-RADS) by comparing its diagnostic performance for muscle-invasive bladder cancer (MIBC) between radiologists and urologists based on multiparametric MRI, including three-dimensional (3D) fast spin-echo (FSE) T2-weighted acquisitions. Methods: This study included 66 treatment-naïve patients (60 men, 6 women; mean age 74.0 years) with pathologically proven bladder cancer who underwent multiparametric MRI, including 3D FSE T2-weighted imaging, before transurethral bladder tumour resection between January 2010 and November 2018. The MRI scans were categorised according to the five-point VI-RADS score by four independent readers (two board-certified radiologists and board-certified urologists each), blinded to the histopathological findings. The VI-RADS scores were compared with the postoperative histopathological diagnosis. Interobserver agreement was assessed using weighted kappa coefficients. ROC analysis and generalised estimating equations were used to evaluate the diagnostic performance. Results: Forty-nine (74.2%) and 17 (25.8%) tumours were confirmed to be non-MIBC and MIBC, respectively, based on pathological examination. The interobserver agreement was good-to-excellent between all pairs of readers (range, 0.73–0.91). The urologists’ sensitivity/specificity values for DCE-MRI VI-RADS scores were significantly lower than those of radiologists. No significant differences were observed for the overall VI-RADS score. The AUC for the overall VI-RADS score was 0.94, 0.92, 0.89, and 0.87 for radiologists 1 and 2 and urologists 1 and 2, respectively. Conclusions: The VI-RADS score, based on multiparametric MRI including 3D FSE T2-weighted acquisitions, can be useful for radiologists and urologists to determine the bladder cancer muscle invasion status preoperatively. Key Points: • VI-RADS (using multiparametric MRI including 3D FSE T2-weighted acquisitions) achieves good to excellent interobserver agreement and has similar diagnostic performance for detecting muscle invasion by both radiologists and urologists. • The diagnostic performance of the overall VI-RADS score is high for both radiologists and urologists, particularly due to the dominant effect of diffusion-weighted imaging on the overall VI-RADS score. • The sensitivity and specificity values of the T2WI VI-RADS scores for four readers in our study (using 3D FSE T2-weighted acquisitions) were similar (with slightly higher specificity values) to previously published results (using 2D FSE T2-weighted acquisitions)

A Case of Gastroparesis after Cryoballoon Ablation followed by Medication-Induced Recovery within 6 Months

Atrial fibrillation (AF) is the most common cardiac arrhythmia, and cryoballoon ablation was developed as a new treatment modality for symptomatic AF. Gastroparesis is rarely reported as a transient complication of ablation, and its frequency and risk are not clear. We experienced a rare case of gastroparesis after cryoballoon ablation followed by medication-induced recovery within 6 months