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This contribution examines the relatively unresearched doctoral thesis of Hans Urs von Balthasar as a Germanist, particularly in relation to the role that the reading of the Russian religious philosopher Nikolai Berdyaev played in the development of Balthasar's earliest theological thought. The authors argue that Berdyaev provided the young Germanist with a markedly eschatological point of departure for his nascent theological reflections. Although Balthasar had to renounce certain aspects of Berdyaev's thought, this eschatological orientation received from Berdyaev nevertheless remained recognizable through Balthasar's mature theological works. [ABSTRACT FROM AUTHOR]

ABSTRACT Efforts to conserve stream and river biota could benefit from tools that allow managers to evaluate landscape-scale changes in species distributions in response to water management decisions. We present a framework and methods for integrating hydrology, geographic context and metapopulation processes to simulate effects of changes in streamflow on fish occupancy dynamics across a landscape of interconnected stream segments. We illustrate this approach using a 482 km2 catchment in the southeastern US supporting 50 or more stream fish species. A spatially distributed, deterministic and physically based hydrologic model is used to simulate daily streamflow for sub-basins composing the catchment. We use geographic data to characterize stream segments with respect to channel size, confinement, position and connectedness within the stream network. Simulated streamflow dynamics are then applied to model fish metapopulation dynamics in stream segments, using hypothesized effects of streamflow magnitude and variability on population processes, conditioned by channel characteristics. The resulting time series simulate spatially explicit, annual changes in species occurrences or assemblage metrics (e.g. species richness) across the catchment as outcomes of management scenarios. Sensitivity analyses using alternative, plausible links between streamflow components and metapopulation processes, or allowing for alternative modes of fish dispersal, demonstrate large effects of ecological uncertainty on model outcomes and highlight needed research and monitoring. Nonetheless, with uncertainties explicitly acknowledged, dynamic, landscape-scale simulations may prove useful for quantitatively comparing river management alternatives with respect to species conservation. Published 2012. This article is a U.S. Government work and is in the public domain in the USA. [ABSTRACT FROM AUTHOR]

Background: Suicide by means of self-inflicted stab wounds is relatively uncommon and little is known about this population and their management. Materials and Methods: Retrospective review of adult trauma patients admitted to our Level-1 trauma center between January 2005 and October 2009 for management of non-fatal, self-inflicted stab wounds. Results: Fifty-eight patients were evaluated with self-inflicted stab wounds. Four patients died due to their injuries (mortality, 7%). Of the non-fatal stab wounds, 78% were male ranging in age from 19-82 (mean: 45 years). The most common injury sites were the abdomen (46%), neck (33%), and chest (20%). In terms of operative interventions, 56% of abdominal operations were therapeutic, whereas 100% of neck and chest operations were therapeutic. When assessing for suicidal ideation, 44 patients (81%) admitted to suicidal intentions whereas 10 patients(19%) described "accidental" circumstances. Following psychiatric evaluation, 8 of the 10 patients with "accidental injuries" were found to be suicidal. Overall, 54 patients (98%) met criteria for a formal psychiatric diagnosis with 48 patients (89%) necessitating inpatient or outpatient psychiatric assistance at discharge. Conclusions: Compared to previous reports of stab wounds among trauma patients, patients with self- inflicted stab wounds may have a higher incidence of operative interventions and significant injuries depending on the stab location. When circumstances surrounding a self-inflicted stabbing are suspicious, additional interviews by psychiatric care providers may uncover a suicidal basis to the event. Given the increased incidence of psychiatric illness in this population, it is imperative to approach the suicidal patient in a multidisciplinary fashion. [ABSTRACT FROM AUTHOR]

Pneumobilia is mostly observed on computed tomography (CT) following surgical biliary-enteric anastomosis and biliary manipulation through endoscopic procedures. Although pneumobilia can be seen in pathological conditions, post-surgical pneumobilia is typically not associated with morbidity. In the present article, we report a case in which blunt abdominal trauma led to the evacuation of pre-existing pneumobilia causing pneumoperitoneum. Given that the subsequent laparotomy proved to be non-therapeutic, this report adds to the few cases of intra-peritoneal free air not helped by surgical intervention. [ABSTRACT FROM AUTHOR]

Context: Modafinil, a wake-promoting drug used to treat narcolepsy, is increasingly being used as a cognitive enhancer. Although initially launched as distinct from stimulants that increase extracellular dopamine by targeting dopamine transporters, recent preclinical studies suggest otherwise.Objective: To measure the acute effects of modafinil at doses used therapeutically (200 mg and 400 mg given orally) on extracellular dopamine and on dopamine transporters in the male human brain.Design, Setting, and Participants: Positron emission tomography with [(11)C]raclopride (D(2)/D(3) radioligand sensitive to changes in endogenous dopamine) and [(11)C]cocaine (dopamine transporter radioligand) was used to measure the effects of modafinil on extracellular dopamine and on dopamine transporters in 10 healthy male participants. The study took place over an 8-month period (2007-2008) at Brookhaven National Laboratory.Main Outcome Measures: Primary outcomes were changes in dopamine D(2)/D(3) receptor and dopamine transporter availability (measured by changes in binding potential) after modafinil when compared with after placebo.Results: Modafinil decreased mean (SD) [(11)C]raclopride binding potential in caudate (6.1% [6.5%]; 95% confidence interval [CI], 1.5% to 10.8%; P = .02), putamen (6.7% [4.9%]; 95% CI, 3.2% to 10.3%; P = .002), and nucleus accumbens (19.4% [20%]; 95% CI, 5% to 35%; P = .02), reflecting increases in extracellular dopamine. Modafinil also decreased [(11)C]cocaine binding potential in caudate (53.8% [13.8%]; 95% CI, 43.9% to 63.6%; P < .001), putamen (47.2% [11.4%]; 95% CI, 39.1% to 55.4%; P < .001), and nucleus accumbens (39.3% [10%]; 95% CI, 30% to 49%; P = .001), reflecting occupancy of dopamine transporters.Conclusions: In this pilot study, modafinil blocked dopamine transporters and increased dopamine in the human brain (including the nucleus accumbens). Because drugs that increase dopamine in the nucleus accumbens have the potential for abuse, and considering the increasing use of modafinil, these results highlight the need for heightened awareness for potential abuse of and dependence on modafinil in vulnerable populations. [ABSTRACT FROM AUTHOR]

Discusses how English Renaissance poet Aemilia Lanyer's construction of her authorial integrity rests on both complete and incomplete understandings of her dream vision poem 'The Authors Dreame. To the Ladie Marie, the Countesse Dowager of Pembrooke.' Lanyer's criticism of the literary patronage system as it existed in her day; Reasons why Lanyer chose to employ the dream vision form for her dedication to Mary Sidney.

The activation and subsequent differentiation of naive CD4+ T cells into functionally distinct effector cells is a vital step in the generation of an effective immune response to protein antigens. To analyse the development of effector T cells following the activation of resting, naive CD4+ T cells, we have utilized a transgenic mouse model in which the majority ofT cells express a common T-cell receptor Vβ molecule. The resting T cells were purified and stimulated in vitro with staphylococcal enterotoxin B, in the presence of accessory cells expressing class II major histocompatibility complex (MHC) molecules. We found that the cells which developed from these primary cultures were capable of producing varying levels of interleukin-2 (IL-2), IL-4 and interferon-γ (IFN-γ) following restimulation with anti-Vβ8 antibody, irrespective of whether B cells or macrophages/dendritic cells were the accessory cells in the primary cultures. The addition of [L-4 during primary stimulation enhanced the differentiation of IL-4-producing cells and suppressed the expansion of IFN-γ-producing cells, especially when B cells were the antigen-presenting cells (APC). Neutralization of endogenously produced IL-1, even in the presence of exogenous IL-4, did not inhibit the differentiation of IL-4-producing T cells. Strikingly, IL-10 completely suppressed the development of effector T cells when adherent macrophages/dendritic cells were utilized as accessory cells in the primary cultures, but had minimal effect in the presence of B cells. IFN-γ suppressed the generation of IL-4-producing cells, presumably by inhibiting their expansion following primary activation. Finally, in vitro-generated IL-4-producing T cells were the most potent helpers for B lymphocytes. Thus, exogenous cytokines alter the patterns of T-cell differentiation in vitro, and the effects of cytokines vary depending on the types of accessory cells present during initial T-cell activation. [ABSTRACT FROM AUTHOR]

Several therapeutic regimes for solar urticaria were evaluated. A short course of PUVA therapy produced a marked increase in the minimal dose of radiation required to produce urticaria in the six patients treated. This objective evidence of improvement was supported by the patients' reports of greatly increased tolerance to sun-exposure. Chlorpheniramine, an antihistamine, produced a slight increase in the minimal dose of radiation necessary to produce urticaria but its effectiveness was limited by side-effects. Indomethacin, an inhibitor of prostaglandin synthetase, produced no beneficial effect. [ABSTRACT FROM AUTHOR]

The purposes of this study were (a) to examine the role of social evaluative concerns in the self-report of sympathy and in the relation of sympathy to helping; and (b) to determine the role of "altruistic personality" traits and situationally induced vicarious emotional responses in the intention to help. Dispositional and situational self-reports of sympathy and other vicarious emotional reactions were obtained for persons who also were given the opportunity to assist a needy other. Moreover, dispositional measures of concern with social evaluation and an altruistic orientation were obtained, and a bogus pipeline manipulation was instituted for half the study participants. Both dispositional and situational self-reported sympathy were positively related to helping, as were other personality indices viewed as reflecting altruistic characteristics. The relations for the dispositional indices of sympathy were not due solely to social evaluative concerns or to other egoistic concerns. The effects on intended helping of dispositional sympathy, perspective taking, and the tendency to ascribe responsibility for others to the self appeared to be both direct and mediated by situational sympathetic responding. Finally, situational sadness did not mediate the effects of sympathetic responsiveness. [ABSTRACT FROM AUTHOR]

Total knee arthroplasty is a successful surgery for the majority of patients with osteoarthrosis of the knee. Approximately 5% of patients undergoing total knee arthroplasty experience loss of motion or arthrofibrosis. Manipulation under anesthesia (MUA) is generally indicated for patients who do not achieve >90° of flexion by 6-12 weeks postoperatively. Complications from MUA are rare but can be devastating. We describe a novel technique for MUA with no reported major complications in our review of 78 patients. The average flexion improved from 80.0 (±3.8) before manipulation to 115.4 (±2.1) after manipulation. There were no major complications including fracture or extensor mechanism injury. Keywords: Total knee complications, Manipulation under anesthesia, Arthrofibrosis, Post operative stiffness, Total knee manipulation

The article discusses the processes of resuscitation, medical rehabilitation, and recovery among trauma patients with multiple injuries. A case of a 73-year-old man is presented with injuries sustained from a ladder fall, resulting to a fractured pelvis with links of tachycardia and hypotension. His was found to have multiple fractures sustained in the rib area, spine, and a splenic injury. Emergency splenectomy and pre-pelvic hemostatic packing were performed by trauma surgeon as orthopedic surgeons performed external fixation of the pelvis for temporary stabilization and proceeded to conduct an abdominal closure and definitive pelvic fixation after two days. The patient was then discharged to an acute rehabilitation facility after a month of hospital admission.

Mucinous metaplasia occurs uncommonly in cutaneous pathology, usually at specialized anatomic locations (genitalia, palms, and soles) and within restricted pathologic contexts (inflammation and trauma). Here, we report a unique case of eccrine mucinous metaplasia associated with an apocrine cystadenoma. A 13-year-old girl had an asymptomatic, 4-mm nodule on the chest. Histopathology demonstrated a typical apocrine cystadenoma in the upper and middle dermis. Adjacent to this lesion was a cluster of coiled eccrine secretory glands, of which the inner layer was almost entirely replaced by benign-appearing cells containing abundant, non-sulfated acid mucopolysaccharides. At 10 months' follow up, there was no recurrence. Our case demonstrates that, very uncommonly, mucinous metaplasia may be associated with a pathogenetically separate, adjacent proliferative adenomatous lesion, in this instance, an apocrine cystadenoma.Jiang J, Petronic-Rosic V, Hoag J, Shea CR. Eccrine mucinous metaplasia associated with an apocrine cystadenoma. [ABSTRACT FROM AUTHOR]