AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GI...AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GISTs on surgical resection or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) in Kitasato University East Hospital or Kitasato University Hospital. We studied 53 of these patients(34 with resected tumors and 19 with unresected tumors) whose tumors could be measured on EUS on at least two successive occasions. The histopathological diagnosis was GIST in 34 patients, leiomyoma in 5, schwannoma in 3, ectopic pancreas in 1, hamartoma in 1, cyst in 1, Brunner's adenoma in 1, and spindle-cell tumor in 7. We retrospectively calculated the DT of GISTs on the basis of the time course of EUS findings to estimate the growth rate of such tumors.RESULTS The DT was 17.2 mo for GIST, as compared with 231.2 mo for leiomyoma, 104.7 mo for schwannoma, 274.9mo for ectopic pancreas, 61.2 mo for hamartoma, 49.0 mo for cyst, and 134.7 mo for Brunner's adenoma. The GISTs were divided into risk classes on the basis of tumor diameters and mitotic figures(Fletcher's classification). The classification was extremely low risk or low risk in 28 patients, intermediate risk in 3, and high risk in 3. DT of GIST according to risk was 24.0 mo for extremely low-risk plus low-risk GIST, 17.1 mo for intermediate-risk GIST, and 3.9 mo for high-risk GIST. DT of GIST was significantly shorter than that of leiomyoma plus schwannoma(P < 0.05), and DT of high-risk GIST was significantly shorter than that of extremely low-risk plus low-risk GIST(P < 0.05).CONCLUSION For GIST, a higher risk grade was associated with a significantly shorter DT. Small SMTs should initially be followed up within 6 mo after detection.展开更多
An observer at Iguazu Falls tries to make sense of the inexpressible natural wonder through the texts of Jorge Luis Borges＇s essays and poems. Borges＇s paradoxes of time, immortality, and eternity give meaning to th...An observer at Iguazu Falls tries to make sense of the inexpressible natural wonder through the texts of Jorge Luis Borges＇s essays and poems. Borges＇s paradoxes of time, immortality, and eternity give meaning to the vision, while the natural wonder gives substance to those idealist concepts derived from Berkeley. As a reader of Borges＇s fictions, I yield up my personal identity to an impersonal dreaming consciousness that resembles Berkeley＇s mind as a consciousness sustaining the reality I perceive. Borges writes in his poem ＂Dawning＂ that ＂ideas are not like marble, everlasting, but ever-renewing like a forest or a river＂. The cataracts of Iguazu are both eternal and immortal, eternal in the sense of removing our consciousness of time and confusing past, present, and future in constant repetition, and immortal in the sense of only existing in individual drops of water constantly disappearing and renewing in infinite repetition. The cataracts are perfect emblems of this immortality. The cataracts are time, infinite moments of immortality, moving forward, accelerating, repeating themselves identically, until they achieve a certain eternity, no motion, suspended in time. I am Berkeley＇s Eternal Spirit, the consciousness evoked by Borges in his essay, ＂A New Refutation of Time＂. Distance from the immediate impact of the Falls helps transform fear and horror into sublimity. The closer to the Falls, the more the observer feels fear and anguish at his own insignificance, a fear of annihilation. Aesthetic distance requires an image or word, something that exempts us from immediate contact, and allows us to descend into the whirlpool and come back to the calm surface. The vision evoked in writing and reading fiction is both prior and subsequent to the reading. Our vision of the universe is always inexpressible, a problem of accommodating something overwhelming to the limited schemata we use to grasp existence.展开更多
Beyond the existing academic viewpoints, clarifying the scientific meaning of the rule of law in China in the binary interaction between subject and object is the prerequisite for reifying the rule of law in China fro...Beyond the existing academic viewpoints, clarifying the scientific meaning of the rule of law in China in the binary interaction between subject and object is the prerequisite for reifying the rule of law in China from an abstract symbol to a logic in action. The subject dimension of rule of law in China subsumes the legal consciousness, self confidence, independence and self-improvement of the subject. The object dimension of the rule of law in China focuses the relation mode and governance pattern between right and power. In the dimension of time, the rule of law in China is the unification of history and reality of China model. In the dimension of space, the rule of law in China is committed to seeking the right to speech, governance, management and development from the perspective of globalization.展开更多
文摘AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GISTs on surgical resection or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) in Kitasato University East Hospital or Kitasato University Hospital. We studied 53 of these patients(34 with resected tumors and 19 with unresected tumors) whose tumors could be measured on EUS on at least two successive occasions. The histopathological diagnosis was GIST in 34 patients, leiomyoma in 5, schwannoma in 3, ectopic pancreas in 1, hamartoma in 1, cyst in 1, Brunner's adenoma in 1, and spindle-cell tumor in 7. We retrospectively calculated the DT of GISTs on the basis of the time course of EUS findings to estimate the growth rate of such tumors.RESULTS The DT was 17.2 mo for GIST, as compared with 231.2 mo for leiomyoma, 104.7 mo for schwannoma, 274.9mo for ectopic pancreas, 61.2 mo for hamartoma, 49.0 mo for cyst, and 134.7 mo for Brunner's adenoma. The GISTs were divided into risk classes on the basis of tumor diameters and mitotic figures(Fletcher's classification). The classification was extremely low risk or low risk in 28 patients, intermediate risk in 3, and high risk in 3. DT of GIST according to risk was 24.0 mo for extremely low-risk plus low-risk GIST, 17.1 mo for intermediate-risk GIST, and 3.9 mo for high-risk GIST. DT of GIST was significantly shorter than that of leiomyoma plus schwannoma(P < 0.05), and DT of high-risk GIST was significantly shorter than that of extremely low-risk plus low-risk GIST(P < 0.05).CONCLUSION For GIST, a higher risk grade was associated with a significantly shorter DT. Small SMTs should initially be followed up within 6 mo after detection.
文摘An observer at Iguazu Falls tries to make sense of the inexpressible natural wonder through the texts of Jorge Luis Borges＇s essays and poems. Borges＇s paradoxes of time, immortality, and eternity give meaning to the vision, while the natural wonder gives substance to those idealist concepts derived from Berkeley. As a reader of Borges＇s fictions, I yield up my personal identity to an impersonal dreaming consciousness that resembles Berkeley＇s mind as a consciousness sustaining the reality I perceive. Borges writes in his poem ＂Dawning＂ that ＂ideas are not like marble, everlasting, but ever-renewing like a forest or a river＂. The cataracts of Iguazu are both eternal and immortal, eternal in the sense of removing our consciousness of time and confusing past, present, and future in constant repetition, and immortal in the sense of only existing in individual drops of water constantly disappearing and renewing in infinite repetition. The cataracts are perfect emblems of this immortality. The cataracts are time, infinite moments of immortality, moving forward, accelerating, repeating themselves identically, until they achieve a certain eternity, no motion, suspended in time. I am Berkeley＇s Eternal Spirit, the consciousness evoked by Borges in his essay, ＂A New Refutation of Time＂. Distance from the immediate impact of the Falls helps transform fear and horror into sublimity. The closer to the Falls, the more the observer feels fear and anguish at his own insignificance, a fear of annihilation. Aesthetic distance requires an image or word, something that exempts us from immediate contact, and allows us to descend into the whirlpool and come back to the calm surface. The vision evoked in writing and reading fiction is both prior and subsequent to the reading. Our vision of the universe is always inexpressible, a problem of accommodating something overwhelming to the limited schemata we use to grasp existence.
文摘Beyond the existing academic viewpoints, clarifying the scientific meaning of the rule of law in China in the binary interaction between subject and object is the prerequisite for reifying the rule of law in China from an abstract symbol to a logic in action. The subject dimension of rule of law in China subsumes the legal consciousness, self confidence, independence and self-improvement of the subject. The object dimension of the rule of law in China focuses the relation mode and governance pattern between right and power. In the dimension of time, the rule of law in China is the unification of history and reality of China model. In the dimension of space, the rule of law in China is committed to seeking the right to speech, governance, management and development from the perspective of globalization.
