Discrimination between invasive pulmonary aspergillosis and pulmonary lymphoma using CT

OBJECTIVE: The purpose was to assess the characteristic CT features of invasive pulmonary aspergillosis (IPA) and pulmonary lymphoma (PL) and to analyze the potential to distinguish the two entities using CT. METHODS: The CT images of 70 patients with either proven IPA (n=35) or PL (n=35) were evaluated retrospectively and independently by two radiologists (reader 1 [R1] and reader 2 [R2]), analyzing images for presence, number and characteristics of pulmonary nodules and masses, ground-glass opacities, consolidations and other interstitial changes. RESULTS: Interreader agreement was moderate (4/33 CT features), good (9/33) or excellent (20/33). Pulmonary nodules (P=0.045 [R1], P=0.001 [R2]), nodules with spiculated outer contours (P<0.001 [R1], P=0.001 [R2]), nodules with a halo sign (P<0.001 [R1+R2]), nodules with homogeneous (P=0.030 [R1], P=0.006 [R2]) and inhomogeneous (P=0.001 [R1], P<0.001 [R2]) attenuation patterns, nodules with cavitation (P=0.006 [R1], P=0.003 [R2]) and wedge-shaped, pleural-based consolidations (P<0.001 [R1+R2]) occurred significantly more often in patients with IPA, while masses without a halo sign (P=0.03 [R1], P=0.01 [R2]), lobar consolidations with bronchogram (P=0.02 [R1+R2]) and consolidations with homogeneous attenuation patterns (P<0.001 [R1+R2]) were found significantly more frequent in PL-patients. CONCLUSIONS: Those CT features can therefore be considered suggestive for either IPA or PL. However, in most cases the diagnosis cannot be made based on CT findings solely because no single feature gained a high sensitivity and specificity concomitantly. Furthermore, the logistic regression did not show a combination that was significantly better than the best univariate predictor

Sources of community : mythical groundwork of Early Modern identities

Jakub Koryl’s lengthy chapter, “Sources of Community: Mythical Groundwork of Early Modern Identities”, stands out in terms of its theoretical nature and comprehensive scope. At the same time it goes to the heart of the question of confessional identity and otherness, and thus provides an illuminating perspective on many of the themes covered in both this section and the volume as a whole. Drawing on case-studies from both the Lutheran and Catholic Reformation, Korylseeksto offer a newaccount of confessional-identity building from the late Middle Ages through to the Enlightenment. In particular, he argues that in the early modern period the theme of myth - and especially the rival German and Roman “myths” of Reformation - became the driving force for the creation of new confessional identities, harnessing and uniting into one powerful synthesis, social, intellectual, political and religious forces. Then, following in the footsteps of Hans Blumenberg, Charles Taylor and others, Koryl traces the roots of the modern conception of identity to late medieval Nominalism and its overturning of the medieval analogical and hierarchical understanding of reality. According to Koryl, it was this philosophical move which helped release the creative - and destructive - interplay of forces that shaped the early modern confessional landscape for the next two centuries. Importantly, this situation gave minority views a new voice in European affairs, allowing them eventually to construct their own (secular) myths and take on the dominant, majority role they exercise in the world today