A rare case of gingival metastases from papillary thyroid carcinoma

Metastatic oral malignancy accounts for 1% of all oral cancers. Oral soft tissue involvement is rare and accounts for less than 0.1% of all oral tumours with the attached gingiva being the commonest site affected. We present the first reported case of a papillary thyroid carcinoma (PTC) with sarcomatoid transformation giving rise to gingival metastasis. A 71 year old man with a history of PTC presented with an asymptomatic gingival swelling adjacent to his lower right lateral incisor. Subsequent biopsy of the lesion confirmed PTC metastasis with aggressive sarcomatoid features. We present a clinical photograph of the gingival swelling and the pathology images demonstrating both the papillary and sarcomatoid features of the gingival biopsy. The prognosis of PTC is usually excellent but some histological variants of PTC behave more aggressively. The histology in our case demonstrated solid areas and sarcomatoid transformation and behaved far more aggressively than typical PTC. Sarcomatoid transformation in PTC has not been previously described and indicates a poor prognosis and the need for planning urgent palliation. These lesions can present a diagnostic challenge to both pathologists and clinicians in identifying the lesion as metastatic and locating the primary cancer. This case demonstrates the need for vigilance amongst health professionals when presented with an oral soft tissue mass in patients with a known primary malignancy. This may be the first evidence of disseminated disease and emphasises a low threshold to biopsy oral soft tissue lesions in patients with a history of malignant disease

Tenencia compartida en la ley de conciliacion vulnera el principio superior del niño y adolescente en la Provincia de Satipo

La tesis titulada sobre Tenencia compartida en la ley de conciliación vulnera el principio superior del niño y adolescente en la provincia de Satipo siendo el enunciado del problema ¿De qué manera la tenencia compartida en la ley de conciliación vulnera el principio superior del niño y adolescente en la provincia de Satipo? y el objetivo general Analizar de qué manera la tenencia compartida en la ley de conciliación vulnera el principio superior del niño y adolescente en la provincia de Satipo. Siendo el supuesto que la tenencia compartida en la ley de conciliación si vulnera el principio superior del niño y adolescente en la provincia de Satipo. Que, se utilizó como método general el método científico y el tipo de investigación fue aplicada y el nivel fue descriptivo siendo el diseño no experimental donde se realizó entrevista a abogados aplicando la técnica la entrevista siendo el instrumento la guía de entrevista. Que, los resultados se dieron a través de la entrevista por el cual existe una coincidencia entre el entrevistado 1 y 2 por el cual en la conciliación no se profundiza el ambiente en dónde va a permanecer ni con la madre ni con el padre esto le corresponde las entidades del Estado hacer el dicho seguimiento y es contrario al entrevistado 3 por el cual todo quedaría a criterio del fiscal la posibilidad de la aplicación excepcional que deberá ser, además, debidamente fundamentada a fin de evitar la arbitrariedad y es contrario al entrevistado 1 por el cual describe que se debe ajustar a lo que dicen las normas vigentes y que será obligatorio iniciar el ejercicio de la acción penal en caso de la presencia del delito por otro lado implicaría la arbitrariedad, por consiguiente se estaría alterando el interés superior del niño y del adolescente. Llegando a la conclusión que se analizó que la tenencia compartida en la ley de conciliación vulnera el principio superior del niño y adolescente en la provincia de Satipo a razón que no se puede hacer el seguimiento después de la conciliación en la protección de sus derechos del niño o adolescente

Connectionist perspectives on language learning, representation and processing.

The field of formal linguistics was founded on the premise that language is mentally represented as a deterministic symbolic grammar. While this approach has captured many important characteristics of the world\u27s languages, it has also led to a tendency to focus theoretical questions on the correct formalization of grammatical rules while also de-emphasizing the role of learning and statistics in language development and processing. In this review we present a different approach to language research that has emerged from the parallel distributed processing or \u27connectionist\u27 enterprise. In the connectionist framework, mental operations are studied by simulating learning and processing within networks of artificial neurons. With that in mind, we discuss recent progress in connectionist models of auditory word recognition, reading, morphology, and syntactic processing. We argue that connectionist models can capture many important characteristics of how language is learned, represented, and processed, as well as providing new insights about the source of these behavioral patterns. Just as importantly, the networks naturally capture irregular (non-rule-like) patterns that are common within languages, something that has been difficult to reconcile with rule-based accounts of language without positing separate mechanisms for rules and exceptions

B Cells in Murine Cervical Lymph Nodes are Conventional B-2 Cells

We investigated the characteristic features of cervical lymph node B cells to determine whether their behavior differs from that of B cells located elsewhere, because cervical lymph nodes may be exposed to continual antigenic stimulation from the naso- and/or oropharynx. B cells were isolated from cervical lymph nodes, spleen and peritoneal fluid of mice, cultured in medium, and exposed to various stimuli. The expression of various surface molecules characteristic of lymphoid B cells was assayed by flow cytometry, and immunoglobulin secreted into the culture supernatants was evaluated by enzyme-linked immunosorbent assay. B220+ cells were cultured in medium alone or with lipopolysaccharide, and their entrance into S phase in response to stimuli was measured by proliferative assays. Phenotypic characteristics of cervical lymph node B cells included CD5low, CD23high, CD43low, B7.1low, B7.2low, and Syndecan-1low. Unstimulated lymphoid B cells did not secrete immunoglobulin, but, upon stimulation, secretion of IgM was increased more than secretion of IgA and IgG. B cells actively entered S phase after 48 hr stimulation. These results show that B cells in cervical lymph nodes are conventional B2 cells, like splenic B cells

Syringomyelia and Chiari Syndrome Registry: advances in epidemiology, clinical phenotypes and natural history based on a North Western Italy cohort.

Background. Syringomyelia and Chiari Syndrome are classified as rare diseases, but current known occurrence in Europe is missing. The increased ability to diagnose these pathologies by magnetic resonance imaging and its widespread availability has led to an increase of reported cases, often asymptomatic, with the need to standardize definitions, diagnostic criteria and treatments.Aims. We present shared Interregional Recommendations developed with the primary aim to estimate Syringomyelia and Chiari Syndrome prevalence and incidence in North Western Italy, with special reference to symptomatic forms.Methods. An agreement for the standardization of definitions, classifications, diagnostic criteria and surgical Recommendations was reached by the multidisciplinary Interregional Piemonte and Valle d’Aosta Chiari-Syringomyelia Consortium (Delphi method); next, in 2011 a census for Syringomyelia and Chiari Malformation was performed through the Interregional Piemonte and Valle d’Aosta Rare Disease Registry, integrated by a dedicated form in order to estimate prevalence and incidence.Results. 436 patients, 292 females, met shared interregional diagnostic criteria. Syringomyelia prevalence was estimated in 4.84:100 000; Chiari Malformation prevalence was 7.74:100 000; incidence was 0.82:100 000 and 3.08:100 000 respectively. Demographics, neuroradiological parameters and aetiology were reported (in symptomatic and asymptomaticforms). Finally, symptoms and signs, familiar and natural history were analyzed.Conclusions. First Italian epidemiological data (prevalence, incidence) on Chiari and syringomyelia was collected, according to shared diagnostic Recommendations. Future perspectives include the adoption of these Recommendations at national level to standardize the access to diagnosis and care process and promote multicenter clinical trials

Explaining Evidence Denial as Motivated Pragmatically Rational Epistemic Irrationality

This paper introduces a model for evidence denial that explains this behavior as a manifestation of rationality and it is based on the contention that social values (measurable as utilities) often underwrite these sorts of responses. Moreover, it is contended that the value associated with group membership in particular can override epistemic reason when the expected utility of a belief or belief system is great. However, it is also true that it appears to be the case that it is still possible for such unreasonable believers to reverse this sort of dogmatism and to change their beliefs in a way that is epistemically rational. The conjecture made here is that we should expect this to happen only when the expected utility of the beliefs in question dips below a threshold where the utility value of continued dogmatism and the associated group membership is no longer sufficient to motivate defusing the counter-evidence that tells against such epistemically irrational beliefs

Bridgewater “Comments” on 80 Years of Men’s and Women’s Sports

Sports media is important because it shapes the perceptions, aspirations and dreams of the viewers (Angelini, 2008). It shows the viewers the skill and athletic achievement of both male and female athletes. The media allows viewers to witness the athletic prowess of their favorite athletes on TV and in print. Within sports media, the viewers are able to learn about the many different sports that are offered around the world. The viewers are able to get a sense about who the athletes are, their talents, their sport and their achievement. It is apparent that sports media has a huge impact on the people around the world who watch games, buy magazines, and endorse their favorite team by collecting team and player memorabilia