Intrahepatic cholangiocarcinoma is a malignant neoplasm arising from the biliary epithelium, which frequently invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenals, and br...Intrahepatic cholangiocarcinoma is a malignant neoplasm arising from the biliary epithelium, which frequently invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenals, and brain. However, distant skeletal muscle metastasis of cholangiocarcinoma has never been described before to the best of our knowledge and, furthermore, Budd-Chiari syndrome secondary to intrahepatic cholangiocarcinoma is also extremely rare. Here we present the first case overall of distant muscle metastasis from intrahepatic cholangiocarcinoma presenting as Budd-Chiari syndrome. A 44-year-old man admitted to the hospital with complaints of abdominal distension, edema of both legs, back pain and anorexia of 30 d' duration. Computed tomography and ultrasonography-guided percutaneous muscle biopsy established intrahepatic cholangiocarcinoma with disseminated thrombosis from inferior vena cava to bilateral iliac and femoral veins, and multiple skeletal muscle metastases in bilateral buttock and erector spinal muscle.展开更多
In 1329-1334, George the Brilliant took advantage of the situation created in the llkhanate, eliminated his political opponents and restored the territorial integrity of Georgia. He created a solid legal basis for the...In 1329-1334, George the Brilliant took advantage of the situation created in the llkhanate, eliminated his political opponents and restored the territorial integrity of Georgia. He created a solid legal basis for the country and regulated the ecclesiastic area. He was in West Georgia in 1329-1332/1333. The llkhanid coin was not minted in Georgia during that period; yet, soon the king of Georgia, which had already been united by that time, restored relations with llkhanids and returned to Tbilisi, which implied making the already united Georgia subject to Mongols. Ilkhanid coins and later, coins of Chobanids, the Golden Horde and Jalayirids circulated during the reign of George the Brdhant. In 1338-1339 George the Brilliant conquered Ossetia and Ilkhanid coins were disseminated on the territory of the Golden Horde after that. Formally, Georgia remained under the control of Ilkhanids, which was replaced by Chobanids in 1338 and the governors of the Golden Horde in 757/1356; and in parallel and afterwards by Jalayirids, which is evidenced by written sources as well as numismatic data; Despite formal dependence on the foreign power, which is evidenced by the deployment of 10,000 troops at the border of Georgia as well, the country enjoyed a rather wide internal autonomy. Participation of George the Brilliant in sending envoys for the purpose of the redemption of the Jvari （Cross） Monastery in Palestine in 1316/7, 1320 cannot be assumed. It seems that in those years envoys were sent by Constantine, the king of West Georgia. All the above do not diminish the merits of George V to the Georgian nation and his historic role in terms of the political unification of the country, the creation of a legal basis for it and the regulation of ecclesiastic affairs--the accomplishments of the king, who deservedly bears the name ＂the Brilliant＂.展开更多
This paper deals with a case study of a context-sensitive solution of the Jamestown Corridor, located along James City County and the City of Williamsburg in Virginia. The corridor is an important passageway to many t...This paper deals with a case study of a context-sensitive solution of the Jamestown Corridor, located along James City County and the City of Williamsburg in Virginia. The corridor is an important passageway to many tourist attractions in the Historic Triangle of Hampton Roads. During the improvement process, the project should minimize the congestions impacts, maximize convenience, safety and reliability of the surrounding transportation systems, minimize social impact to the local community and address long-term capacity issues. Through the project, the agencies involved learned that projects near any of the historic resources must be context-sensitive and should include all stakeholders early and often to make sure that a comprehensive schedule was developed. They also learned that time should be considered for review and input from key regional stakeholders for a variety of issues.展开更多
Multilingual Education Programs Regulation was adopted and the implementation of bilingual educational reform started in Georgia in 2010. The paper presents research results on readiness of non-Georgian schools to imp...Multilingual Education Programs Regulation was adopted and the implementation of bilingual educational reform started in Georgia in 2010. The paper presents research results on readiness of non-Georgian schools to implement multilingual educational programs effectively. The research studied the important factors influencing the effectiveness of bilingual educational programs, specifically （1） type of program, （2） human resources of schools and teachers professional development, （3） bilingual education as shared vision for all school stakeholders, and （4） community and parental involvement in designing and implementation of bilingual educational programs. The following research methods were used during the research： （1） quantitative and qualitative content analysis of bilingual educational programs of 26 non-Georgian schools of Kvemo Kartli and Samtskhe-Javakheti regions of Georgia, （2） quantitative survey of non-Georgian school principals through questionnaires, and （3） quantitative survey of non-Georgian schools＇ teachers of different subjective groups through questionnaire. The study revealed that schools are implementing mostly ＂weak＂ bilingual educational programs. The schools implementing bilingual educational programs do not have sufficient human resources, bilingual education is not a shared vision for all school stakeholders and parents and community are not actively involved in designing and implementation of the programs.展开更多
文摘Intrahepatic cholangiocarcinoma is a malignant neoplasm arising from the biliary epithelium, which frequently invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenals, and brain. However, distant skeletal muscle metastasis of cholangiocarcinoma has never been described before to the best of our knowledge and, furthermore, Budd-Chiari syndrome secondary to intrahepatic cholangiocarcinoma is also extremely rare. Here we present the first case overall of distant muscle metastasis from intrahepatic cholangiocarcinoma presenting as Budd-Chiari syndrome. A 44-year-old man admitted to the hospital with complaints of abdominal distension, edema of both legs, back pain and anorexia of 30 d' duration. Computed tomography and ultrasonography-guided percutaneous muscle biopsy established intrahepatic cholangiocarcinoma with disseminated thrombosis from inferior vena cava to bilateral iliac and femoral veins, and multiple skeletal muscle metastases in bilateral buttock and erector spinal muscle.
文摘In 1329-1334, George the Brilliant took advantage of the situation created in the llkhanate, eliminated his political opponents and restored the territorial integrity of Georgia. He created a solid legal basis for the country and regulated the ecclesiastic area. He was in West Georgia in 1329-1332/1333. The llkhanid coin was not minted in Georgia during that period; yet, soon the king of Georgia, which had already been united by that time, restored relations with llkhanids and returned to Tbilisi, which implied making the already united Georgia subject to Mongols. Ilkhanid coins and later, coins of Chobanids, the Golden Horde and Jalayirids circulated during the reign of George the Brdhant. In 1338-1339 George the Brilliant conquered Ossetia and Ilkhanid coins were disseminated on the territory of the Golden Horde after that. Formally, Georgia remained under the control of Ilkhanids, which was replaced by Chobanids in 1338 and the governors of the Golden Horde in 757/1356; and in parallel and afterwards by Jalayirids, which is evidenced by written sources as well as numismatic data; Despite formal dependence on the foreign power, which is evidenced by the deployment of 10,000 troops at the border of Georgia as well, the country enjoyed a rather wide internal autonomy. Participation of George the Brilliant in sending envoys for the purpose of the redemption of the Jvari （Cross） Monastery in Palestine in 1316/7, 1320 cannot be assumed. It seems that in those years envoys were sent by Constantine, the king of West Georgia. All the above do not diminish the merits of George V to the Georgian nation and his historic role in terms of the political unification of the country, the creation of a legal basis for it and the regulation of ecclesiastic affairs--the accomplishments of the king, who deservedly bears the name ＂the Brilliant＂.
文摘This paper deals with a case study of a context-sensitive solution of the Jamestown Corridor, located along James City County and the City of Williamsburg in Virginia. The corridor is an important passageway to many tourist attractions in the Historic Triangle of Hampton Roads. During the improvement process, the project should minimize the congestions impacts, maximize convenience, safety and reliability of the surrounding transportation systems, minimize social impact to the local community and address long-term capacity issues. Through the project, the agencies involved learned that projects near any of the historic resources must be context-sensitive and should include all stakeholders early and often to make sure that a comprehensive schedule was developed. They also learned that time should be considered for review and input from key regional stakeholders for a variety of issues.
文摘Multilingual Education Programs Regulation was adopted and the implementation of bilingual educational reform started in Georgia in 2010. The paper presents research results on readiness of non-Georgian schools to implement multilingual educational programs effectively. The research studied the important factors influencing the effectiveness of bilingual educational programs, specifically （1） type of program, （2） human resources of schools and teachers professional development, （3） bilingual education as shared vision for all school stakeholders, and （4） community and parental involvement in designing and implementation of bilingual educational programs. The following research methods were used during the research： （1） quantitative and qualitative content analysis of bilingual educational programs of 26 non-Georgian schools of Kvemo Kartli and Samtskhe-Javakheti regions of Georgia, （2） quantitative survey of non-Georgian school principals through questionnaires, and （3） quantitative survey of non-Georgian schools＇ teachers of different subjective groups through questionnaire. The study revealed that schools are implementing mostly ＂weak＂ bilingual educational programs. The schools implementing bilingual educational programs do not have sufficient human resources, bilingual education is not a shared vision for all school stakeholders and parents and community are not actively involved in designing and implementation of the programs.
