Jumping for recognition: Women's ski jumping viewed as a struggle for rights.

With the campaign for women's participation in international and Olympic ski jumping as a practical case, sport's potential for recognition of individual rights is explored. In line with Honneth's influential ethical theory, recognition of rights refers to a mutual recognition between persons of each other as rational and responsible agents with an equal right to take part in the public formation and development of their community or practice. The argument is that women ski jumpers were entitled to compete as they had actual and/or potential capabilities and skills to contribute in the public formation and development of their sport. Their exclusion was a violation of individual rights. At a more general level, sport is discussed as a sphere for recognition of rights. It is argued that the basic principles of equal opportunity to take part and to perform make sport a particularly clear and potent sphere for such recognition, and also for the identification of rights violations. In sport, rights, or the violation of rights, are demonstrated in concrete and embodied ways. It is concluded that struggles for recognition and individual rights are a continuous process in sport as in most other human institutions and practices.

Residue depletion of melamine and cyanuric acid in catfish and rainbow trout following oral administration.

The intentional addition of triazines such as melamine to animal feeds and the lack of information about residue accumulation in food animals caused global concerns for food safety during 2007 and 2008. We report the results of a good laboratory practices (GLP) study to determine melamine and cyanuric acid residues in catfish and trout filets harvested at 1, 3, 7, 14, 28, and 42 days after a single oral dose of 20 mg/kg body weight of melamine, cyanuric acid, or melamine and cyanuric acid together. Peak melamine concentrations were 12.73 mg/kg (ppm) in catfish (mean = 9.98), 12.26 mg/kg in trout (mean = 7.89) on day 1. Within 7 days (catfish) or 14 days (trout) residues were <2.5 mg/kg, a level in foods accepted by many risk assessors worldwide to be unlikely to pose health risks to consumers. Peak cyanuric acid residues also occurred on day 1, 0.68 mg/kg in catfish (mean = 0.46), 2.59 mg/kg in trout (mean = 0.86). Cyanuric acid muscle residues were <2.5 mg/kg by day 3. The half-lives for melamine and cyanuric acid ranged between 1 and 4 days. Renal crystals formed in fish given both melamine and cyanuric acid, persisting for weeks after the single dose.

Predictors of suboptimal surgical cytoreduction in women with advanced epithelial ovarian cancer treated with initial chemotherapy.

The objective of this study was to retrospectively evaluate predictors of suboptimal surgical cytoreduction (SSC) in women with advanced epithelial ovarian cancer (EOC) treated with initial chemotherapy (IC). All women with EOC treated with IC at our hospital between January 1, 1995, and January 1, 2003, were eligible; 128 patients met inclusion criteria and underwent retrospective chart review. Eighty-four patients (66%) had an optimal surgical cytoreduction (OSC), 14 patients (11%) had an SSC, and 30 (23%) patients were treated with chemotherapy only (CO). Patients in the SSC group had more small-bowel mesentery disease on preoperative computed tomography (CT) scan compared to the OSC group (38% SSC vs 6% OSC, P = 0.024). Patients in the SSC group were also more likely to have disease on the liver surface, small-bowel surface, large-bowel mesentery, bladder peritoneum, spleen, and diaphragm that was not reported on preoperative CT but found at surgery. More patients in the SSC group had chemoresistant disease (indicated by stable or progressive disease on CT scan [56% SSC vs 17% OSC, P = 0.05]) and less of a decrease in their CA-125 values (69% SSC vs 93% OSC, P

Vulvar melanoma: a retrospective analysis and literature review.

OBJECTIVE: This review focuses on current directions in the staging and treatment of melanoma of the vulva. METHODS: All women treated for invasive melanoma of the vulva at the University of Virginia Health Sciences Center from 1980 through 2000 were identified through a retrospective review of the records of the Division of Gynecologic Oncology. Their treatments and outcomes were then analyzed and presented. RESULTS: Over the 20-year study period, 14 cases of melanoma of the vulva were identified. Of the 14 patients treated with curative intent, 6 developed recurrences following the completion of primary therapy, and all are dead from their disease. The mean duration from completion of therapy to recurrence was 7.5 months; the mean survival following recurrence was 17 months. CONCLUSION: One-centimeter skin margins appear adequate for vulvar melanomas <1 mm thick, and 2-cm margins appear adequate for intermediate-thickness melanomas (1-4 mm). In all cases it is necessary to include at least a 1-cm-deep margin extending through the subcutaneous fat to the muscular fascia below. Elective node dissection seems to offer no additional advantage in superficial lesions <0.76 mm thick, and its role in deeper lesions is still uncertain.

Levels of cognitive and linguistic development in Angelman syndrome: a study of 20 children.

Angelman syndrome (AS) is a genetic disorder associated with severe developmental delay. The purpose of this study was to investigate cognitive and linguistic development in AS. Piaget's developmental model was used to evaluate the test results. The participants comprised 20 children (14 boys and 6 girls) aged 2-14 years (median age 7.4 years). AS was diagnosed either according to typical clinical criteria or confirmatory genetic testing. Cognitive functioning was evaluated with Griffiths' Mental Development Scale. Language development was also evaluated with Receptive-Expressive Emergent Language Scale 2 (REEL-2). Cognitive functioning, based on results on the Performance Scale, never exceeded Piaget's sensorimotor stage, 0-2 years. The median mental age for language development was 9 months. Expressive verbal vocabulary consisted of less than 2 words (n = 11), 2-3 words (n = 7) and 4-5 words (n = 2). Analyses according to REEL-2 did not indicate a consistent discrepancy between impressive and expressive language.

Blood gases and oximetry: calibration-free new dry-chemistry and optical technology for near-patient testing.

The first calibration-free Near-Patient-Testing instrument (NPT7) for blood gases, pH and oximetry has been developed. With cartridges of 30 single-use cuvettes, the NPT7 needs no preparation prior to sample aspiration, no manual calibration, and no maintenance apart from paper and cartridge changes and regulatory quality control. Each cuvette measures pCO2, pO2, pH, total hemoglobin (ctHb), oxygen saturation (sO2), fractions of carboxyhemoglobin (FCOHb) and methemoglobin (FMetHb) on 95 microl whole blood with a 110-s measuring cycle. The measurement principles are as follows: pCO2-three-wavelength infrared spectroscopy of dissolved CO2; pO2-measurement of O2-induced changes in the decay time of phosphorescence; pH-the absorbance spectra change of an azo-dye color indicator; and oximetry is performed with a 128-wavelength spectrophotometer. We determined the within and between instrument variations with tonometered whole blood on seven prototype instruments, using between one and five control levels per analyte. The 95% analytical performance limits: +/-(/Bias/ +2 xS(T)) in the NPT7 instrument matched the analytical performance criteria for the measured quantities as defined by AACC guidelines. The application of these optical measuring methods for blood gases, pH and oximetry in single-use devices introduces a new concept into point-of-care testing (POCT), where preanalytical activities otherwise associated with instrument preparation are eliminated.

Topotecan in squamous cell carcinoma of the cervix: A Phase II study of the Gynecologic Oncology Group.

PURPOSE: The activity and toxicity of topotecan were evaluated in a multicenter Phase II study for patients with previously treated squamous cell carcinoma of the uterine cervix. PATIENTS AND METHODS: Histologic confirmation of the primary diagnosis was required, as well as adequate performance status and vital organ function and the presence of measurable disease. Patients were allowed one prior regimen of systemic therapy, usually platinum-based. A two-stage accrual design was utilized with early stopping criteria and monitoring of toxicity. Topotecan was administered at 1.5 mg/m(2) per day for 5 consecutive days on a 21-day cycle with modifications based on hematologic toxicity. RESULTS: Forty-five patients were entered. Two patients were ineligible (incorrect tumor type) and 2 were inevaluable (never received therapy). One additional patient was not evaluable for response (nonmeasurable disease). A median of 2 cycles was administered to each patient (range: 1-17 cycles) with grade 4 neutropenia in 68% and grade 4 thrombocytopenia in 39% of patients, but without treatment-related deaths. Nonhematologic toxicity was generally mild and not dose-limiting. The overall (complete and partial) response rate among evaluable patients with measurable disease was 12.5% with stable disease in an additional 37. 5%. Median progression-free survival was 2.1 months. CONCLUSIONS: As a single agent topotecan shows modest antitumor activity, with manageable hematologic and nonhematologic toxicity, in patients with previously treated squamous cell carcinoma of the cervix. Further evaluation in chemotherapy-naive patients or in combination with cisplatin and/or radiation may be indicated.

Gianotti-Crosti syndrome presenting as lichenoid dermatitis.

Papular acrodermatitis of childhood (Gianotti-Crosti syndrome) is an uncommon, self-limited disease characterized by an erythematous papular eruption symmetrically distributed on the face and limbs and mild lymphadenopathy, thought to be of viral origin. The histopathologic findings are nonspecific and include focal parakeratosis, mild spongiosis, superficial perivascular infiltrate, papillary dermal edema, and extravasated red blood cells. Interface changes with some basal vacuolization may be present, but are not a conspicuous feature. We present a 2 1/2-year-old boy with multiple papules and plaques on the face and extremities and cervical lymphadenopathy. Histopathologic analysis showed compact orthokeratosis, focal parakeratosis, hypergranulosis, psoriasiform epidermal hyperplasia, and a dense lichenoid lymphohistiocytic infiltrate with extensive exocytosis of mononuclear cells. Immunoperoxidase staining with CD 1 a revealed clusters of Langerhans cells in the epidermis and in the papillary dermis. In view of the clinical findings, a diagnosis of Gianotti-Crosti syndrome was made. Although there are a few reports describing a lichenoid pattern of infiltration in Gianotti-Crosti syndrome, this histologic pattern is not widely known. This case is presented to illustrate the fact that Gianotti-Crosti syndrome can present as lichenoid dermatitis, and, especially in children, should be added to the differential diagnoses of lichenoid infiltrates.

Glenohumeral motion in patients with rotator cuff tears: a comparison of asymptomatic and symptomatic shoulders.

The purpose of this study was to determine whether there was a relationship between altered scapular plane glenohumeral kinematics end shoulder pain. Subjects were divided into 3 groups: normal volunteers (n = 10), patients with symptomatic rotator cuff tears severe enough to warrant surgery (n = 10), and subjects with no symptoms who had tears documented on magnetic resonance imaging and normal examination (n = 10). Humeral kinematics were observed with a computer-enhanced modification of the Poppen and Walker technique. Scapular plane x-ray films were obtained at 0 degree, 30 degrees, 60 degrees, 90 degrees, 120 degrees, and 150 degrees of elevation. Measurements were made by 3 independent observers blinded to the diagnosis, and data interpretation was performed based on mean values for independent observers. Results showed a high degree of interobserver and intraobserver reliability (coefficients = 0.96 and 0.95, respectively). The symptomatic and asymptomatic groups showed progressive superior translation of the humeral head on the glenoid with increasing arm elevation. The normal group, in contrast, maintained a constant center of rotation along the geometric center of the glenoid. Symptomatic and asymptomatic rotator cuff tear groups showed superior head migration from 30 degrees to 150 degrees, which was significantly different from those seen in the normal group. No significant difference between the symptomatic and asymptomatic groups was demonstrated with the small numbers used in this study. The presence of a rotator cuff tear was associated in a disruption of normal glenohumeral kinematics in the scapular plane. Because significant superior migration of the humeral head was seen in both the asymptomatic and symptomatic rotator cuff groups, painless and normal shoulder motion is possible in the presence of abnormal glenohumeral kinematics. Abnormal glenohumeral kinematics alone was not an independent factor, which could explain the occurrence of symptoms.

Histologic features of lichen sclerosus et atrophicus in a surgical scar.

A 76-year-old woman presented with a 7-mm, hard, pink nodule at the site of an appendectomy scar of more than 70 years' duration. The clinical impression at the time of biopsy was that of a keloid. Surprisingly, light microscopic examination revealed classic histologic features of late-stage lichen sclerosus et atrophicus (LSA) overlying a scar. Elastic tissue stain highlighted the unusual presence of abundant nodules of elastin in the reticular dermis only.

Polymerase chain reaction-denaturing gradient gel electrophoresis (PCR/DGGE)-based detection of clonal T-cell receptor gamma gene rearrangements in paraffin-embedded cutaneous biopsies in cutaneous T-cell lymphoproliferative diseases.

Polymerase chain reaction (PCR)-based amplification of T-cell receptor (TCR)-gamma genes is a novel technique that can detect a clone of T cells comprising less than 1% of the total T cells in a lymphoid infiltrate. Besides greater sensitivity than Southern blotting, this technique can be performed with smaller quantities of lower molecular weight genomic DNA as template. We retrospectively analyzed 12 paraffin-embedded biopsies of cutaneous T-cell lymphoma (CTCL), 1 case suspicious for CTCL, 1 case of granulomatous slack skin, and 8 cases of inflammatory skin diseases to determine if PCR-denaturing gradient gel electrophoresis (PCR-DGGE) analysis can detect TCR-gamma gene rearrangements on paraffin-embedded specimens. We were able to amplify Vgamma1-8 TCR sequences in each case and detected a dominant clone in 9 of 12 cases of CTCL and in granulomatous slack skin. We analyzed Vgamma9 sequences in 9 cases of CTCL and detected a dominant clone in 4 cases. This study demonstrates that PCR-DGGE can easily be applied retrospectively to cutaneous biopsies of lymphoproliferative diseases when fresh tissue is not available.

Primary breast carcinoma of the vulva: a case report and literature review.

BACKGROUND: In 1872, Hartung was the first to describe the case of a fully formed mammary gland arising in the left labium majora of a 30-year-old woman. Since Hartung's initial report, 38 additional cases of ectopic vulvar breast tissue have been described. This case report describes the rare occurrence of primary mammary adenocarcinoma arising within the vulva. CASE: A 64-year-old G4P4 white female presented with a 4-year history of a 2 x 1 cm firm, indurated, raised lesion of the left lateral mons. A wide local excision with ipsilateral inguinofemoral lymphadenectomy was performed. Given histological findings characteristic of both invasive ductal carcinoma and invasive lobular carcinoma, in conjunction with the presence of estrogen and progesterone receptors within the tumor, a diagnosis of infiltrating adenocarcinoma arising within ectopic breast tissue was made. CONCLUSIONS: Thirty-nine reported cases of ectopic breast tissue arising within the vulva have been reported in the world literature. Though the diagnosis of primary breast carcinoma arising within the vulva is based primarily upon histologic pattern, estrogen and progesterone receptor positivity provide supporting evidence. Given the rarity of this condition, guidelines for therapy are unavailable; we therefore suggest looking to the current management of breast cancer in order to establish a sensible approach.

Endometrial stromal sarcoma of the vulva arising in extraovarian endometriosis: a case report and literature review.

BACKGROUND: Extraovarian malignant transformation of endometriosis is a rare event; 52 cases have been reported. We describe the first published account in the world literature of an endometrial stromal sarcoma (ESS) arising in the vulva from a focus of endometriosis. CASE: A 34-year-old G4 P3 morbidly obese white female was seen with a 1-year history of a palpable lesion arising within the superior aspect of the left labium majus. Radical left hemivulvectomy with clitorectomy was performed. The histopathologic findings were consistent with ESS arising from endometriosis associated with the extrapelvic portion of the round ligament within the canal of Nuck. Twenty months later metatastatic ESS developed in the upper lobe of the right lung and the patient underwent wedge resection. Nine months later she developed a recurrent pulmonary nodule at the site of the previous wedge resection and underwent successful right pulmonary lobectomy. The patient was last seen in October 1995 and had no evidence of disease at that time. CONCLUSIONS: Since approximately 0.7-1.0% of patients with endometriosis have lesions that will ultimately undergo malignant transformation, consideration should be given to bilateral oophorectomy at the time of abdominal surgery in patients with significant endometriosis.

Atypical glandular cells of undetermined significance: a five-year retrospective histopathologic study.

OBJECTIVE: Our purpose was to ascertain the types and frequency of pathologic conditions associated with atypical glandular cells of undetermined significance on Papanicolaou smears. STUDY DESIGN: A 5-year retrospective review of screening cervical cytologic examinations diagnosed as atypical glandular cells of undetermined significance was performed at the University of Virginia to determine pathologic findings associated with atypical glandular cells of undetermined significance on Papanicolaou smears stratified by subtype and overall. RESULTS: Pathologic findings for the respective Papanicolaou smears with the diagnosis of atypical glandular cells of undetermined significance not otherwise specified, favor benign, squamous intraepithelial lesions, and favor neoplasia through the follow-up interval were as follows: squamous intraepithelial lesions in 11%, 8%, 38%, and 20%; adenocarcinoma in situ in 3%, 0%, 0%, and 10%; endometrial hyperplasia in 3%, 5%, 1%, and 2%; and cancer in 8%, 3%, 1%, and 7%. Overall, 63 patients (32%) had preinvasive or invasive lesions. CONCLUSIONS: Atypical glandular cells of undetermined significance on Papanicolaou smears were correlated with significant findings in 45% of patients (32% with preinvasive or invasive lesions and 13% with benign lesions). A prompt and aggressive workup is recommended.

Langerhans cell histiocytosis in the elderly: a report of three cases.

Langerhans cell histiocytosis is most common in children and is unusual in the elderly. We describe 3 cases of langerhans cell histiocytosis limited to the skin in elderly patients. Biopsy specimens showed a dermal infiltrate abutting the epidermis composed of atypical langerhans cells with abundant eosinophilic cytoplasm and a "kidney-shaped" nucleus. Immunoperoxidase stain CD1a was positive in all 3 cases and S-100 stain was positive in 2. Electron microscopy revealed Birbeck granules in the cytoplasm of the atypical langerhans cells in 2 cases. Langerhans cell histiocytosis with skin involvement has a chronic course with an overall good prognosis. However, cutaneous manifestations may precede systemic involvement by many years.

Antibiotics in irrigation solution for cataract surgery. A laboratory investigation of the pharmacological stability and bacteriological susceptibility.

PURPOSE: To evaluate the appropriateness of a prophylactic use of Gentamicin and Vancomycin in the irrigation solution for cataract surgery. METHODS: A laboratory study of the pharmacological stability and the bacteriological susceptibility of the two antibiotics and epinephrine in the irrigation solution. RESULTS: Gentamicin and Vancomycin are pharmacologically stable in concentrations above the MIC-values of most Gram positive and Gram negative bacteria without reaching toxic levels. CONCLUSION: Although it seems tempting to add Gentamicin and Vancomycin in irrigation solutions for cataract surgery, major objections to such a prophylactic use of antibiotics have been stated, specially focusing on the risk of emerging resistance to the antibiotics, and the financial implications.

Malignant melanoma of the vagina and locoregional control: radical surgery revisited.

BACKGROUND: Anecdotal reports and retrospective case reviews suggest improved locoregional control, and possibly overall survival, with radical surgical extirpation as the primary management of vaginal melanoma. This study seeks to reevaluate, through case presentation and literature review, the usefulness of radical pelvic surgical procedures in the management of vaginal melanoma. CASE: Seven cases of primary vaginal melanoma were seen at the University of Virginia Hospital from 1966 to 1996; each was compared in terms of primary management, disease-free interval, sites of relapse, and overall survival. All patients who died of their disease relapsed locally prior to their death, with the exception of two patients who underwent wide local excision (WLE) followed by postoperative high-dose fractionation teletherapy. CONCLUSIONS: The use of WLE followed by high-dose fractionation teletherapy in the primary management of vaginal melanoma appears to provide excellent locoregional control, without the attendant morbidity and physical disfigurement associated with more radical surgical resection. The results reported here, as well as other published reports, suggest that locoregional control may be obtained with even large melanomas with radiotherapy when administered in high individual fractions (greater than 400 cGy/fx). This type of response is consistent with the higher response rate seen with cutaneous melanomas when large individual fractions are compared to conventional fractionation. Because of the extremely poor survival with vaginal melanoma regardless of primary therapy, novel therapeutic strategies, including further investigation into the use of high-dose fractionation irradiation, are urgently needed.

Male-specific DNA in the dioecious species Atriplex garrettii (Chenopodiaceae).

The mechanism of sex determination in dioecious species of the genus Atriplex (Chenopodiaceae) has not been determined. This paper reports the discovery of a male-specific DNA fragment in the diploid dioecious species A. garrettii. DNA samples extracted individually from ten male and ten female plants were bulked by sex. Random amplified polymorphic DNA (RAPD) fragments were generated in the two bulks in order to identify markers that were polymorphic between male and female plants. A total of 158 decamer primers were tested. A 2075 base-pair (bp) male-specific DNA fragment generated with the OPAF-14 primer was identified. The fragment was cloned and partially sequenced and 24-mer primers that exclusively amplified this fragment were constructed. When 124 male plants, 126 female plants, and one hermaphroditic plant were tested individually, the male-specific 2075-bp DNA fragment was present in the hermaphrodite and all but one of the male plants, and was absent in all female plants. A smaller DNA fragment (~1800 bp) that was homologous to the 2075-bp fragment was amplified from the single male plant that lacked the 2075-bp fragment. Cytogenetic analysis revealed no apparent heteromorphic sex chromosomes. These observations suggest that sex determination in A. garrettii is genetic, with no evidence of heteromorphic sex chromosomes.