5 research outputs found

    Diagnostic relevance of metastatic renal cell carcinoma in the head and neck: An evaluation of 22 cases in 671 patients

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    ABSTRACT Purpose Renal cell carcinoma (RCC) is a malignant tumor that metastasizes early, and patients often present with metastatic disease at the time of diagnosis. The aim of our evaluation was to assess the diagnostic and differential diagnostic relevance of metastatic renal cell carcinoma (RCC) with particular emphasis on head and neck manifestations in a large patient series. Patients and methods We retrospectively evaluated 671 consecutive patients with RCC who were treated in our urology practice between 2000 and 2013. Results Twenty-four months after diagnosis, 200/671 (30%) of RCC had metastasized. Distant metastases were found in 172 cases, with 22 metastases (3.3%) in the head and neck. Cervical and cranial metastases were located in the lymph nodes (n=13) and in the parotid and the thyroid gland, tongue, the forehead skin, skull, and paranasal sinuses (n=9). All head and neck metastases were treated by surgical excision, with 14 patients receiving adjuvant radiotherapy and 9 patients receiving chemotherapy or targeted therapy at some point during the course of the disease. Five patients (23%) survived. The mean time of survival from diagnosis of a head and neck metastasis was 38 months, the shortest period of observation being 12 months and the longest 83 months. Discussion and conclusion Our findings show that while RCC metastases are rarely found in the neck, their proportion among distantly metastasized RCC amounts to 13%. Therefore, the neck should be included in staging investigations for RCC with distant metastases, and surgical management of neck disease considered in case of resectable metastatic disease. Similarly, in patients presenting with a neck mass with no corresponding tumor of the head and neck, a primary tumor below the clavicle should be considered and the appropriate staging investigations initiated

    Moderne pikareske Romane?: Ein Vergleich zwischen GĂĽnter Grass' Die Blechtrommel und Saul Bellow's The adventures of Augie March

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    In this thesis, I compare Günter Grass' Die Blechtrommel (The Tin Drum) to Saul Bellow's The Adventures of Augie March, with particular attention to the picaresque features of both works. Initially, the concept of picaresque is defined, especially in its differentiation from the bildungsroman, its historical development, and contemporary usage. The picaresque differs from the bildungsroman in that its ending is not a confirmation of the rules of society, but rather shows a renunciation of them. In addition society is depicted more negatively than in a bildungsroman. Concerning the history of the picaresque it should be noted that even if the form developed in 16th century Spain, it soon spread and was adapted to other countries' literary traditions, thus it should not be seen as a purely Spanish form of literature. Since it was adapted in numerous other countries, the picaresque tradition is remarkably diverse. Therefore, to be able to compare two modern novels with different national backgrounds and a variety of different influences, I use the theory of modes created by Robert Scholes, that allows the identification of picaresque units in a narration, even if the narration is not completely written as a picaresque, and Claudio Guillén's theory that enables the categorization of works according to the proximity they have to the picaresque formula. Various themes and motives of a picaresque novel are then explored in greater length. In analysing and comparing the novels I found the following: while Die Blechtrommel can be called a picaresque novel in a broader sense, The Adventures of Augie March cannot: it contains a large section dominated by the picaresque myth, but the ending is closer to the bildungsroman. Despite the differences, the comparison of both works is useful, because they cover the same time period from the different perspectives of the respective nations. The novels mirror the situations in Germany and the US including the differences between the countries after WW II. The Germans had to struggle with guilt and could not see the future as positively as the Americans. (Published By University of Alabama Libraries

    Robert Schumann's 'Frauenliebe und -Leben' and Dominick Argento's 'From the diary of Virginia Woolf': a comparative analysis

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    Robert Schumann's Frauenliebe und -leben and Dominick Argento's From the Diary of Virginia Woolf are two song cycles that enjoy frequent performances. Argento modeled the large-scale form and dramatic concept of his own work after Schumann's cycle: eight songs depicting chronological moments from a woman's life feature a return in the last song to thematic material from the first song. With this comparative analysis of these two song cycles, the author argues that the two works have more in common than a broad schematic design. The song cycles are linked on many important musical and dramatic levels. Due to the preponderance in both Frauenliebe und -leben and From the Diary of Virginia Woolf of strophic- and rondo-like writing, there is an obsessive quality that becomes apparent, though the object of obsession is different in each of the cycles. In the Schumann cycle, it is the patriarchal view that a woman's obsession should be her husband, family, and home life. While in the Argento cycle, it is an artist's obsession with her writing and her own thoughts on the complexity of life that directs the listener. This document examines the similarities and differences between the two song cycles, primarily through musical means but taking into account text and drama, as well. Aspects such as text, concept, large- and small-scale formal structures, recurring motivic material, accompaniment, character and mood, and performance considerations all bear some degree of similarity between the two cycles and are examined here to show why they effectively complement one another in performance. A thorough understanding of both works and how they relate to each other also helps to inform the artists' performance. (Published By University of Alabama Libraries
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