Camouflaged Uptake Following Incidental Focus-on-Form Episodes

The efficacy of focus-on-form(FonF)within the context of communicatively-oriented language activities is measured via uptake.Uptake is defined as learners’verbal responses immediately following either preemptive or reactive FonF instruction(Loewen,2004).The present study investigated what is(not)meant and(not)measured through this definition of uptake.Drawing on the audio-recorded analysis of 20 hours of communicatively–oriented interactions in an intermediate IELTS class with two teachers,this study investigates the frequency of preemptive and reactive incidental FonF,and the subsequent occurrence of uptake in an English as a foreign language context.This study also provided an in-depth qualitative analysis of these classes through field notes,learner notes,and video-recorded data to explore the instances of uptake moves that were not captured through audio-recorded data.The quantitative findings of this study demonstrated a very low and disappointing uptake rate.Furthermore,the study did not find a significant difference between reactive and preemptive FonF in terms of uptake rate.Nonetheless,the qualitative data revealed a myriad of uptake instances not observable via the initial data analysis.Based on these findings,a new definition of uptake is suggested,which includes camouflaged uptake and learners’immediate oral responses to FonF.Since uptake is used to gauge the efficacy of incidental FonF in primarily meaning–oriented classes,it is concluded that audio-recorded data just show the tip of the iceberg as far as the uptake rate is concerned.Thus,second language acquisition researchers are recommended to employ multiple indices to examine the effectiveness of FonF instruction.

Focal incidental colorectal fluorodeoxyglucose uptake:Should it be spotlighted?

Fluorine-18 fluorodeoxyglucose(F-18 FDG)positron emission tomography/computed tomography(PET/CT)has emerged as a cornerstone in cancer evaluation imaging,with a well-established history spanning several years.This imaging modality,encompassing the examination of the body from the base of the skull to the upper thighs,comprehensively covers the chest and abdominopelvic regions in a singular scan,allowing for a holistic assessment of nearly the entire body,including areas of marginal interest.The inherent advantage of this expansive scan range lies in its potential to unveil unexpected incidental abnormal hypermetabolic areas.The identification of incidental focal FDG uptake within colorectal regions during PET/CT scans is not an uncommon occurrence,albeit fraught with challenges associated with non-specific FDG uptake.The presence of benign colorectal lesions or physiological uptake poses a particular obstacle,as these may manifest with FDG uptake levels that mimic malignancy.Consequently,physicians are confronted with a diagnostic dilemma when encountering abnormal FDG uptake in unexpected colorectal areas.Existing studies have presented divergent results concerning these uptakes.Standardized uptake value and its derivatives have served as pivotal metrics in quantifying FDG uptake in PET images.In this article,we aim to succinctly explore the distinctive characteristics of FDG,delve into imaging findings,and elucidate the clinical significance of incidental focal colorectal uptake.This discussion aims to contribute valuable insights into the nuanced interpretation of such findings,fostering a comprehensive understanding.

Radical cholecystectomy without liver resection for peritoneal side early incidental gallbladder cancer

Gallbladder cancer(GBC)is a rare disease with a poor prognosis.Simple cholecystectomy may be an adequate treatment only for very early disease(Tis,T1a),whereas reoperation is recommended for more advanced disease(T1b and T2).Radical cholecystectomy should have two fundamental objectives:To radically resect the liver parenchyma and to achieve adequate clearance of the lymph nodes.However,recent studies have shown that compared with lymph node dissection alone,liver resection does not improve survival outcomes.The oncological roles of lymphadenectomy and liver resection is distinct.Therefore,for patients with incidental GBC without liver invasion,hepatic resection is not always mandatory.

Hemangioblastoma Incidentally Discovered at CT Scan in Bamako: About a Case

Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hemangioblastoma through observation. We report the case of a 38-year-old patient referred to the radiology and Medical Imaging Department of the Marie Curie Medical Clinic in Bamako, Mali, for an orbito-cerebral CT scan in a context of bilateral eyelid edema. The examination was performed using multi-slice computed tomography (16 slices) with reconstruction in the 3 planes of space without and with the injection of an iodinated contrast agent. The CT scan was crucial in making the diagnosis of hemangioblastoma incidentally, which allowed for adequate management. The patient was operated on, and the radiological outcome was favorable, without significant cystic formation, after postoperative control and clinical signs were resolved. CT can be an interesting alternative in countries like ours despite MRI being the examination of choice in hemangioblastomas.

A Quasi-Experimental Study of English Vocabulary Teaching Based on Incidental Acquisition

Recent years have witnessed a phenomenon that major English teachers in China have adopted the traditional teaching pattern, mechanically linking English pronunciations directly with the meaning of Chinese, which gradually dampens learners’ enthusiasm. The chief purpose of this paper was to design one English vocabulary teaching lesson based on incidental acquisition. More specifically, the questions raised are, on the one hand, whether incidental vocabulary teaching imprints differences on the learning outcomes for middle school students, and, on the other hand, whether incidental acquisition results in positive feedback between teachers and students. The technique we applied was referred to as questionnaires and interviews addressed to a sample of 68 students. Focusing on the effect of incidental vocabulary acquisition, the analysis demonstrated that it could enhance students’ vocabulary capacity. In addition, it was interesting to note that excellent students and average students tended to embrace the new teaching style while underachievers were on the opposite side. On this basis, it is recommended for English teachers to design English vocabulary lessons, adopting visual, auditory, oral, reading or writing training. More precisely, they should use phonics rules and patterns, holistic learning, classified vocabulary teaching, visual illustration or multimedia teaching to give lessons effectively and expand learners’ vocabulary.

An improved algorithm based on equivalent sound velocity profile method at large incident angle

With the development of ultra-wide coverage technology,multibeam echo-sounder(MBES)system has put forward higher requirements for localization accuracy and computational efficiency of ray tracing method.The classical equivalent sound speed profile(ESSP)method replaces the measured sound velocity profile(SVP)with a simple constant gradient SVP,reducing the computational workload of beam positioning.However,in deep-sea environment,the depth measurement error of this method rapidly increases from the central beam to the edge beam.By analyzing the positioning error of the ESSP method at edge beam,it is discovered that the positioning error increases monotonically with the incident angle,and the relationship between them could be expressed by polynomial function.Therefore,an error correction algorithm based on polynomial fitting is obtained.The simulation experiment conducted on an inclined seafloor shows that the proposed algorithm exhibits comparable efficiency to the original ESSP method,while significantly improving bathymetry accuracy by nearly eight times in the edge beam.

Study on the optimal incident proton energy of ^(7)Li(p,n)^(7)Be neutron source for boron neutron capture therapy

Boron neutron capture therapy(BNCT)is recognized as a precise binary targeted radiotherapy technique that effectively eliminates tumors through the^(10)B(n,α)^(7)Li nuclear reaction.Among various neutron sources,accelerator-based sources have emerged as particularly promising for BNCT applications.The^(7)Li(p,n)^(7)Be reaction is highly regarded as a potential neutron source for BNCT,owing to its low threshold energy for the reaction,significant neutron yield,appropriate average neutron energy,and additional benefits.This study utilized Monte Carlo simulations to model the physical interactions within a lithium target subjected to proton bombardment,including neutron moderation by an MgF_(2)moderator and subsequent BNCT dose analysis using a Snyder head phantom.The study focused on calculating the yields of epithermal neutrons for various incident proton energies,finding an optimal energy at 2.7 MeV.Furthermore,the Snyder head phantom was employed in dose simulations to validate the effectiveness of this specific incident energy when utilizing a^(7)Li(p,n)^(7)Be neutron source for BNCT purposes.

IMPROVING MATERIAL REMOVAL RATE OF BRITTLE CERAMICS THROUGH HONING INCIDENTAL TENSILE STRESSES

The stress intensity factors and stress conditions of machining cracks are analyzed by fracture mechanics on the basis of honing characteristics and of brittle ceramic mechanical behavior.Because the honing incidental tensile stresses effectively decrease the critical grinding stresses and increase the stress intensity factors of machining cracks,the honing process can be carried out easily.The results show that honing can be an efficient machining method for brittle materials.

Prevalence of incidental prostate cancer in patients undergoing radical cystoprostatectomy： data from China and other Asian countries

The purpose of this study is to investigate the frequency of prostate cancer （Pca） discovered incidentally in radical cystoprostatectomy specimens in Asia and to determine the feasibility of prostate-sparing cystectomy （PSC） for Asian patients. Ninety-two male bladder cancer patients who underwent radical cystoprostatectomy at our center between January 2003 and January 2008 were included in this study. The mean age of patients was 67.1 years （range： 32-75 years）. Prostate-specific antigen （PSA） levels and digital rectal examination （DRE） results before surgery were obtained retrospectively. Prostates of all patients were embedded and sectioned at 5-mm intervals. The same pathologist examined the prostatic tissues from radical cystoprostatectomy specimens. Finally, a structured literature review was performed using MEDLINE and PUBMED to estimate the occurrence of incidental Pca in Asia. Of the 92 patients, 3 （3.3%） were found to have Pca; in one out of three （33.3%） patients the disease was clinically significant due to a Gleason grade 4 carcinoma. Eight articles were included in our review. The overall incidence of Pca discovered incidentally in radical cystoprostatectomy specimens in Asia was 9.9% （64/642）. When age was restricted to 〈 60 years, only 7 out of 222 （3.2%） patients were found to have synchronous Pca, and none of the cases was clinically significant. The occurrence of Pca in radical cystoprostatectorny specimens in Asia is much lower than that in Western countries. PSC might be feasible for Asian patients under a strict preoperative selection.

Incidental gall bladder cancers:Are they truly incidental?

AIM: To seek and analyze features suggestive of gallbladder cancer(GBC) on preoperative imaging and intraoperative findings in patients diagnosed as having incidental GBC(IGBC). METHODS: The study was conducted on 79 patients of IGBC managed in our department over a 10-year period(2003-2012). Review of preoperative imaging and operative notes was done to ascertain any suspicion of malignancy-in-retrospect.RESULTS: Of the 79 patients, Ultrasound abdomen showed diffuse thickening, not suspicious of malignancy in 5 patients, and diffuse suspicious thickening was seen in 4 patients. Focal thickening suspicious of malignancy was present in 24 patients. Preoperative computed tomography/magnetic resonance imaging was done in 9 patients for suspicion of malignancy. In 5 patients, dif-ficult Cholecystectomy was encountered due to dense/inflammatory adhesions. Intraoperative findings showed focal thickening of the gallbladder and a gallbladder mass in 9 and 17 patients respectively. On overall analysis, 37 patients had preoperative imaging or intraoperative findings suggestive of malignancy, which was either a missed GBC or an unsuspected/unexpected GBC. In 42(53.2%) patients, there was no evidence suggestive of malignancy and was an unanticipated diagnosis.CONCLUSION: Our study highlights a potential and not-so-rare pitfall of Laparoscopic Cholecystectomy. A greater awareness of this clinical entity along with a high index of suspicion and a low threshold for conversion to open procedure, especially in endemic areas may avert avoidable patient morbidity and mortality.

Incidental non-benign gallbladder histopathology after cholecystectomy in an United Kingdom population: Need for routine histological analysis?

AIM To analyse the range of histopathology detected in the largest published United Kingdom series of cholecystectomy specimens and to evaluate the rational for selective histopathological analysis.METHODS Incidental gallbladder malignancy is rare in the United Kingdom with recent literature supporting selective histological assessment of gallbladders after routine cholecystectomy.All cholecystectomy gallbladder specimens examined by the histopathology department at our hospital during a five year period between March 2008 and March 2013 were retrospectively analysed.Further data was collected on all specimens demonstrating carcinoma,dysplasia and polypoid growths.RESULTS The study included 4027 patients.The majority(97%) of specimens exhibited gallstone or cholecystitis related disease.Polyps were demonstrated in 44(1.09%),the majority of which were cholesterol based(41/44).Dysplasia,ranging from low to multifocal high-grade was demonstrated in 55(1.37%).Incidental primary gallbladder adenocarcinoma was detected in 6 specimens(0.15%,5 female and 1 male),and a single gallbladder revealed carcinoma in situ(0.02%).This large single centre study demonstrated a full range of gallbladder disease from cholecystectomy specimens,including more than 1% neoplastic histology and two cases of macroscopically occult gallbladder malignancies.CONCLUSION Routine histological evaluation of all elective and emergency cholecystectomies is justified in a United Kingdom population as selective analysis has potential to miss potentially curable life threatening pathology.

Incidental prostate cancer in radical cystoprostatectomy specimens

Aim： To investigate the rates of prostate cancer （PCa） in radical cystoprostatectomy （RCP） specimens for bladder cancer in China's Mainland. To determine the follow-up outcome of patients with two concurrent cancers and identify whether prostate-specific antigen （PSA） is a useful tool for the detection of PCa prior to surgery. Methods： From January 2002 to January 2007, 264 male patients with bladder cancer underwent RCP at our center. All patients underwent digital rectal examination （DRE） and B ultrasound. Serum PSA levels were tested in 168 patients. None of the patients had any evidence of PCa before RCP. Entire prostates were embedded and sectioned at 5 mm intervals. Results： Incidental PCa was observed in 37 of 264 （14.0%） RCP specimens. Of these, 12 （32.4%） were clinically significant according to an accepted definition. The PSA levels were not significantly different between patients with PCa and those without PCa, nor between patients with significant PCa and those with insignificant PCa. Thirty-four patients with incidental PCa were followed up. During a mean follow-up period of 26 months, two patients with PSA 〉 4 ng/mL underwent castration. None of the patients died of PCa. Conclusion： The incidence of PCa in RCP specimens in China's Mainland is lower than that in most developed countries. PSA cannot identify asymptomatic PCa prior to RCP. In line with published reports, incidental PCa does not impact the prognosis of bladder cancer patients undergoing RCE

Predictors of incidental gallbladder cancer in elderly patients

BACKGROUND： At the time of diagnosis, most patients with gallbladder cancer are in advanced stage and the cancer is unresectable. Long-term survivors are usually seen in a small number of patients with incidental gallbladder cancer. This study aimed to identify preoperative predictors of incidental gallbladder cancer in elderly patients.METHODS： A total of 4014 patients of more than 44 years old who had undergone cholecystectomy at our department from January 2000 to December 2010 were retrospectively reviewed Univariate and multivariate modalities were used to identify the predictive factors of incidental gallbladder cancer.RESULTS： Twenty-nine of the 4014 patients who had under gone cholecystectomy for benign gallbladder diseases were histologically diagnosed as having incidental gallbladder can cer. Multivariate analysis identified that elevated carbohydrate antigen 19-9 combined with carcinoembryonic antigen and/or carbohydrate antigen 125 （P=0.045）, a gallbladder polyp greater than or equal to 1.2 cm （P=0.043） and focal gallblad der wall thickening of more than or equal to 5 mm （P=0.002）were predictive factors of incidental gallbladder cancer.CONCLUSION： Cholecystectomy is suggested for patients with these predictive factors and intraoperative frozen section should be considered to rule out carcinoma.

Comparison of clinical and histopathological features of patients who underwent incidental or emergency appendectomy

BACKGROUND Incidental appendectomy can be defined as the removal of a clinically normal appendix during another surgical procedure unrelated to appendicitis or other appendicular diseases.AIM To compare the demographic, biochemical, and histopathological features of the patients who underwent incidental and standard appendectomy.METHODS The demographic, biochemical, and histopathological data of 72 patients(Incidental App group) who underwent incidental appendectomy during living donor hepatectomy at our Liver Transplant Center between June 2009 and December 2016 were compared with data of 288 patients(Acute App group) who underwent appendectomy for presumed acute appendicitis. The Incidental App group was matched at random in a 1:4 ratio with the Acute App group in the same time frame. Appendectomy specimens of both groups were re-evaluated by two experienced pathologists.RESULTS Statistically significant differences were found between groups in terms of age(P= 0.044), white blood cell count(P < 0.001), neutrophil(P < 0.001), lymphocyte(P< 0.001), red cell distribution width(P = 0.036), mean corpuscular hemoglobin(P= 0.001), bilirubin(P = 0.002), appendix width(P < 0.001), and presence of acute appendicitis histopathologically(P < 0.001). However, no statistically significant differences were found between groups in terms of gender, platelet, mean platelet volume, mean corpuscular volume, platelet distribution width, appendix length. While the most common histopathological findings in the Incidental App group were normal appendix vermiformis(72.2%), fibrous obliteration(9.7%)and acute appendicitis(6.9%), the most common histopathological findings in the Acute App group were non-perforated acute appendicitis(62.8%), perforated appendicitis(16.7%), lymphoid hyperplasia(8.3%), and appendix vermiformis(6.3%).CONCLUSION Careful inspection of the entire abdominal cavity is useful for patients undergoing major abdominal surgery such as donor hepatectomy. We think that experience is parallel to the surgeon's foresight, and we should not hesitate to perform incidental appendectomy when

Clues to predict incidental gallbladder cancer

Background: Consequences of incidental gallbladder cancer(iGBC) following cholecystectomy may include repeat operation(depending on T stage) and worse survival(if bile spillage occurred), both avoidable if iGBC were suspected preoperatively.Methods: A retrospective single-institution review was done. Ultrasound images for cases and controls were blindly reviewed by a radiologist. Chi-square and Student’s t tests, as well as logistic regression and Kaplan–Meier analyses were used. A P ≤ 0.01 was considered significant.Results: Among 5796 cholecystectomies performed 2000–2013, 26(0.45%) were iGBC cases. These patients were older(75.61 versus 52.27 years), had more laparoscopic-to-open conversions(23.1% versus3.9%), underwent more imaging tests, had larger common bile duct diameter(7.13 versus 5.04 mm) and higher alkaline phosphatase. Ultrasound imaging showed that gallbladder wall thickening(GBWT) without pericholecystic fluid(PCCF), but not focal-versus-diffuse GBWT, was associated significantly with iGBC(73.9% versus 47.4%). On multivariable logistic regression analysis, GBWT without PCCF, and age were the strongest predictors of iGBC. The consequences iGBC depended significantly on intraoperative bile spillage, with nearly all such patients developing carcinomatosis and significantly worse survival.Conclusions: Besides age, GBWT, dilated common bile duct, and elevated alkaline phosphatase, number of preoperative imaging modalities and the presence of GBWT without PCCF are useful predictors of iGBC.Bile spillage causes poor survival in patients with iGBC.

Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

AIM:To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging(MRI)-enterography in patients with suspected or known Crohn's disease(CD). METHODS:Incidental findings were defined as unexpected lesions outside the small intestine,not previously known or suspected at the time of referral, and not related to inflammatory bowel disease.Through a systematic review of medical charts we analyzed the clinical impact of incidental findings,and compared the MRI findings with subsequent diagnostic procedures. RESULTS:A total of 283 patients were included in the analysis,and MRI detected active CD in 31%,fistula in 1.4%and abscess in 0.7%.Extra-intestinal findings notrelated to CD were recorded in 72 patients(25%),of which 58 patients(20%)had 74 previously unknown lesions.Important or incompletely characterized findings were detected in 17 patients(6.0%).Incidental findings led to 12 further interventions in 9 patients(3.2%) revealing previously unknown pathological conditions in 5(1.8%).One patient(0.4%)underwent surgery and one patient was diagnosed with a malignant disease. MRI detected incidental colonic lesions in 16 patients of which additional work-up in 4 revealed normal anatomy. Two patients(0.7%)benefitted from the additional examinations,whereas incidental findings led to unnecessary examinations in 9(3.2%). CONCLUSION:In a minority of patients with suspected or known CD,important incidental findings are diagnosed at MRI-enterography.However,a substantial number of patients experience unnecessary morbidity because of additional examinations of benign or normal conditions.

Neuroendocrine tumor incidentally detected during living donor hepatectomy: A case report and review of literature

To our best knowledge, no case of a tumor that was incidentally detected during living donor hepatectomy(LDH) has been reported in the English language medical literature. We present two cases in which grade Ⅰ neuroendocrine tumors(NET) were incidentally detected during our twelve-year LDH experience. First Case: A 26-yearold male underwent LDH for his brother suffering from HBV-related chronic liver disease(CLD). After right lobe LDH, intestinal length was measured as part of a study concerning the relationship between small intestinal lengths and surgical procedure. At this stage, a mass lesion with a size of 10 mm × 10 mm was detected on the antimesenteric surface, approximately 90 cm proximal to the ileocecal valve. A wedge resection with primary intestinal anastomosis was performed. Second Case: A 29-year-old male underwent right lobe LDH for his father with hepatitis B virus(HBV)-related CLD. An abdominal exploration immediately prior to the closure of the incision revealed that the appendix vermiformis was edematous and had firmness with a size of 8-10 mm at its tip. An appendectomy was performed. The pathological examinations of the specimens of both patients revealedgrade 1 NET. In conclusion, even if patients undergoing LDH are healthy individuals, whole abdominal cavity should be gently palpated and all findings recorded after completing laparotomy. Suspected masses or lesions should be confirmed by frozen section examination. Such an approach would avert potential medicolegal issues.

Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease

AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease(CD).METHODS In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control(UICC).RESULTS During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6(1.2%) patients(4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43(27-66)years and a median history of CD of 16(7-36) years. Malignant lesions were found in the rectum(n = 4, 66.7%), descending colon(n = 1, 16.7%) and ileocolon(n = 1, 16.7%). According to the UICC classification two patients were stages as?Ⅰ(33.3%), whereas the other patients were classified as stage ⅡA(16.7%), stage ⅢB(16.7%), stage ⅢC(16.7%) and stage Ⅳ(16.7%), respectively. After a median follow-up of 2(0.03-8) years only 1 patient is still alive.CONCLUSION The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum.

Incidental gallbladder cancer during laparoscopic cholecystectomy:Managing an unexpected finding

AIM:To evaluate the impact of incidental gallbladder cancer on surgical experience.METHODS:Between 1998 and 2008 all cases of cholecystectomy at two divisions of general surgery,one university based and one at a public hospital,were retrospectively reviewed.Gallbladder pathology was diagnosed by history,physical examination,and laboratory and imaging studies [ultrasonography and computed tomography(CT)].Patients with gallbladder cancer(GBC) were further analyzed for demographic data,and type of operation,surgical morbidity and mortality,histopathological classification,and survival.Incidental GBC was compared with suspected or preoperatively diagnosed GBC.The primary endpoint was diseasefree survival(DFS).The secondary endpoint was the difference in DFS between patients previously treated with laparoscopic cholecystectomy and those who had oncological resection as first intervention.RESULTS:Nineteen patients(11 women and eight men) were found to have GBC.The male to female ratio was 1:1.4 and the mean age was 68 years(range:45-82 years).Preoperative diagnosis was made in 10 cases,and eight were diagnosed postoperatively.One was suspected intraoperatively and confirmed by frozen sections.The ratio between incidental and nonincidental cases was 9/19.The tumor node metastasis stage was:pTis(1),pT1a(2),pT1b(4),pT2(6),pT3(4),pT4(2);five cases with stageⅠa(T1 a-b);two with stageⅠb(T2 N0);one with stage Ⅱa(T3 N0);six with stage Ⅱb(T1-T3 N1);two with stage Ⅲ(T4 Nx Nx);and one with stage Ⅳ(Tx Nx Mx).Eighty-eight percent of the incidental cases were discovered at an early stage(≤Ⅱ).Preoperative diagnosis of the 19 patients with GBC was:GBC with liver invasion diagnosed by preoperative CT(nine cases),gallbladder abscess perforated into hepatic parenchyma and involving the transversal mesocolon and hepatic hilum(one case),porcelain gallbladder(one case),gallbladder adenoma(one case),and chronic cholelithiasis(eight cases).Every case,except one,with a T1b or more advanced invasion underwent Ⅳb + Ⅴ wedge liver resection and pericholedochic/hepatoduodenal lymphadenectomy.One patient with stage T1b GBC refused further surgery.Cases with Tis and T1a involvement were treated with cholecystectomy alone.One incidental case was diagnosed by intraoperative frozen section and treated with cholecystectomy alone.Six of the nine patients with incidental diagnosis reached 5-year DFS.One patient reached 38 mo survival despite a port-site recurrence 2 years after original surgery.Cases with non incidental diagnosis were more locally advanced and only two patients experienced 5-year DFS.CONCLUSION:Laparoscopic cholecystectomy does not affect survival if implemented properly.Reoperation should have two objectives:R0 resection and clearance of the lymph nodes.

Comparing the Effects of Different Post-Listening Output Tasks on Second Language Incidental Vocabulary Acquisition:Revisiting the Involvement Load Hypothesis

Based on the Involvement Load Hypothesis, the present study investigated the differential effects of three post-listening output tasks(gap-filling, translation, and sentence-making) on immediate acquisition and retention of such vocabulary dimensions as productive knowledge of orthography,receptive recall of meaning and form, and productive knowledge of grammatical functions. Ninety second-year English majors were divided into three groups to finish listening plus one of the postlistening tasks. The results showed that the post-listening output tasks had positive effects on immediate acquisition of productive vocabulary knowledge, partially in agreement with the Involvement Load Hypothesis. However, the effects on vocabulary knowledge retention were found to be largely inconsistent with the Involvement Load Hypothesis. The finding thus challenges this hypothesis in that involvement load is not the only determining factor and suggests that the theoretical construct of involvement load should be constructed with more caution.