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A 65-year-old woman with suspected ascites-associated abdominal distention had elevated CA125 levels. Contrast-enhanced computed tomography to search for the cause of the ascites showed bilateral pleural effusions, ascites, and an ovarian tumor. On magnetic resonance imaging the tumor exhibited a lobulated structure and markedly low signal intensity on both T1- and T2-weighted imaging, with no restrictions on diffusion-weighted images. Progressive enhancement was observed at tumor margins. Meigs syndrome due to fibroma was suspected, and total hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy were performed. Postoperatively, the pleural effusion and ascites resolved promptly without specific treatment. On pathological examination, the ovarian tumor was diagnosed as a benign Brenner tumor with scattered nests of transitional epithelium within a large amount of stroma. Based on the clinical course, the patient was diagnosed with pseudo-Meigs’ syndrome due to a Brenner tumor.

Borderline Brenner tumors (BBT) have a range of morphology that shows considerable overlap with that of malignant Brenner tumors (MBT). In particular, two histological patterns of BBT can be particularly challenging: 1) BBT with intraepithelial carcinoma (BBT-IEC) and 2) BBT with a small nested pattern (BBT-SNP). BBT-IEC is characterized by a tumor with the low-power non-infiltrative silhouette of a conventional BBT, but with increased cytological atypia and mitotic activity similar to that of MBT. Conversely, BBT-SNP is characterized by a complex proliferation of small tumor nests that closely resemble the infiltrative growth pattern of MBT, but without the obligate cytologic atypia and mitotic activity of MBT. We suggest that the combination of p16, p53 and Ki-67 may be helpful in distinguishing these 2 patterns of BBT from both conventional BBT and from MBT. While both conventional BBT and BBT-IEC show a null pattern of p16 expression, our case of BBT-IEC showed aberrant p53 overexpression, albeit with a maturation pattern similar to that described for TP53 mutant mucinous ovarian carcinoma and differentiated vulvar intraepithelial neoplasia (dVIN). Similarly, while BBT-SNP shows an infiltrative-like growth pattern similar to that of MBT, our case also showed a wild-type pattern of p53 expression and a Ki-67 proliferative index similar to areas with conventional BBT histology. In conclusion, in our small case series, we show that the use of immunohistochemistry for p53 and Ki-67 may help to distinguish challenging patterns of BBT from MBT. Further studies are needed to validate this finding in a larger case cohort. • The small nested pattern and intraepithelial carcinoma pattern of borderline Brenner tumors can be difficult to recognize. • The small nested pattern mimics the infiltrative pattern of malignant Brenner tumor. • The intraepithelial carcinoma pattern mimics conventional borderline Brenner tumor. • P53, p16 and Ki-67 may be useful to distinguish the above 2 patterns from their respective mimickers. [ABSTRACT FROM AUTHOR]

Abstract Background Staquet et al. and Brenner both developed correction methods to estimate the sensitivity and specificity of a binary-response index test when the reference standard is imperfect and its sensitivity and specificity are known. However, to our knowledge, no study has compared the statistical properties of these methods, despite their long application in diagnostic accuracy studies. Aim To compare the correction methods developed by Staquet et al. and Brenner. Methods Simulations techniques were employed to compare the methods under assumptions that the new test and the reference standard are conditionally independent or dependent given the true disease status of an individual. Three clinical datasets were analysed to understand the impact of using each method to inform clinical decision-making. Results Under the assumption of conditional independence, the Staquet et al. correction method outperforms the Brenner correction method irrespective of the prevalence of disease and whether the performance of the reference standard is better or worse than the index test. However, when the prevalence of the disease is high (> 0.9) or low (

Background: Staquet et al. and Brenner both developed correction methods to estimate the sensitivity and specificity of a binary-response index test when the reference standard is imperfect and its sensitivity and specificity are known. However, to our knowledge, no study has compared the statistical properties of these methods, despite their long application in diagnostic accuracy studies.Aim: To compare the correction methods developed by Staquet et al. and Brenner.Methods: Simulations techniques were employed to compare the methods under assumptions that the new test and the reference standard are conditionally independent or dependent given the true disease status of an individual. Three clinical datasets were analysed to understand the impact of using each method to inform clinical decision-making.Results: Under the assumption of conditional independence, the Staquet et al. correction method outperforms the Brenner correction method irrespective of the prevalence of disease and whether the performance of the reference standard is better or worse than the index test. However, when the prevalence of the disease is high (> 0.9) or low (< 0.1), the Staquet et al. correction method can produce illogical results (i.e. results outside [0,1]). Under the assumption of conditional dependence; both methods failed to estimate the sensitivity and specificity of the index test especially when the covariance terms between the index test and the reference standard is not close to zero.Conclusion: When the new test and the imperfect reference standard are conditionally independent, and the sensitivity and specificity of the imperfect reference standard are known, the Staquet et al. correction method outperforms the Brenner method. However, where the prevalence of the target condition is very high or low or the two tests are conditionally dependent, other statistical methods such as latent class approaches should be considered. [ABSTRACT FROM AUTHOR]

Objectives: To compare a birth weight-derived (Brenner) and multiple ultrasound-derived [Hadlock, National Institute of Child Health and Human Development (NICHD), International Fetal and Newborn Growth Consortium (INTERGROWTH)] classification systems' frequency of assigning an antenatal estimated fetal weight (EFW) <10% and subsequent detection rate for abnormal umbilical artery Doppler (UAD). Methods: We analyzed 569 consecutive non-anomalous singleton gestations identified by ultrasound with either an abdominal circumference (AC) <3% or EFW <10% at a tertiary medical center between 1/2012 and 12/2016. The biometric measurements were exported for all serial ultrasounds and the sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) were calculated for the diagnosis of any abnormal UAD, absent or reversed end-diastolic flow (AREDF), and small for gestational age (SGA) for each classification method. Results: Brenner classified less patients with EFW <10% (49.7%) vs. the comparison methods (range: 84.2–85.0%; P < 0.001). The sensitivity was highest using Hadlock for detection of any abnormal UAD [96.6%; confidence interval (CI) 92.8–98.8%], AREDF (100%; CI 95.1–100%), and SGA (89.0%; CI 85.4–91.6%). However, there was minimal variation between the Hadlock, NICHD, and INTERGROWTH methods for detection of the studied outcomes. The AUCs for any abnormal UAD, AREDF, and SGA were highest for the Brenner method, but there were a substantial number of false-negative results with lower overall detection rates. Conclusions: Use of a birth weight-derived method to assign a fetal weight <10% as the threshold to initiate UAD surveillance has a lower detection rate for abnormal UAD when compared to ultrasound-derived methods. Despite substantial methodological differences in the creation of the Hadlock, NICHD, and INTERGROWTH methods, there were no differences in the detection rates of abnormal UAD. [ABSTRACT FROM AUTHOR]

Imaging features of benign mixed Brenner tumor and mucinous cystadenomas are rarely reported. This report aims to describe the case of a benign mixed Brenner tumor and mucinous cystadenoma with a dominant Brenner tumor component and to review the typical imaging features of this ovarian neoplasm. [ABSTRACT FROM AUTHOR]

Brenner tumor is a rare ovarian tumor that is a part of the surface epithelial group of ovarian neoplasm. It is usually asymptomatic, and most of the times, it is an incidental pathological finding. They can be subdivided into benign, borderline or proliferative, and malignant neoplasms. The majority of Brenner tumors are benign in nature. Tumors of borderline malignancy are less frequent, and only about 1% of tumors are borderline. Here, we present a rare case of giant Brenner tumor of ovary measuring 28 cm in diameter. This is the case is presented because the giant size of Brenner tumor, although rare gynecologist should be aware of this rare entity.

A confusion persists in the psychoanalytic literature regarding the concept of psychic determinism. Two authors are cited in whose works the concept is identified as foundational to psychoanalysis, in the one case as a “fundamental hypothesis” (Charles Brenner) and in the other as an “underlying presupposition” or assumption (Linda A.W. Brakel). Both claims are based on a conflation of the concept Freud had in mind with a philosophical doctrine going by the same name but meaning something quite different. The philosophical doctrine has no place in psychoanalysis at all, and Freud’s concept does not play a foundational role there. In a second section a restricted concept of psychic determinism is critically examined. A third section deals with the impact of that restricted concept on clinical theory and contemporary controversies about clinical practice. Finally, some possible reasons for this confusion are suggested. [ABSTRACT FROM AUTHOR]

Background: Ovarian cancer accounts for 3% of all cancers in females. About 80% of these are benign, and they occur mostly in young women between 20 and 45 years. Borderline tumors occur at slightly older ages while incidence of malignant tumors increases with age, occurring predominantly in perimenopausal and postmenopausal women. About 190,000 new cases and 114,000 deaths from ovarian cancer are estimated to occur annually worldwide. The aim of the study was to fi nd the incidence of surface ovarian tumor in a tertiary referral centre. Materials and methods: This was a retrospective study carried out in the department of pathology, Manipal Teaching Hospital from January 2001 to December 2012. Specimens were received from the same and other hospitals. Records were retrieved from the departmental data bank and were analyzed. Results: : A total of 310 cases of ovarian tumors have been reported in the same period. Among them, 180 cases were of surface epithelial origin and out of which 24 cases had bilateral tumors. Benign tumors comprised of 148 cases, 6 were borderline and 44 were malignant. Among these, the commonest was serous cystadenoma (98 cases) and the least common was malignant Brenner (2 cases). Combined or mixed tumor was seen in 9 cases. Conclusion: : In our study surface epithelial tumors comprised 58% of all ovarian tumors. In both benign and malignant cases, serous tumor was the commonest followed by mucinous tumors. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 397-402 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7868

Brenner's tumors are transitional cell ovarian tumors composed of mature cells similar to urothelial cells forming nests within a fibromatous stroma. In this observation we report the case of a brenner's tumor diagnosed in a 63 year old female patient. The positive diagnosis was difficult to retain. Brenner tumors are rare fibroepithelial ovarian tumors, representing 1 to 2 % of all ovarian tumors. They are almost always benign. The treatment is essentially surgical and the indication of chemotherapy remains debatable. • Brenner's tumors are transitional cell ovarian tumors composed of mature cells similar to urothelial. • Brenner tumors are rare fibroepithelial ovarian. • it is usually an echogenic mass, with an echogenicity close to the myometrium. • The treatment of ovarian cysts is primarily surgical and the indication of chemotherapy remains debatable. [ABSTRACT FROM AUTHOR]

Is there a crisis in urban studies and particularly in urban theory? Two recent exchanges inCity, the first between Alex Schafran and David Madden and the second between Neil Brenner and Christian Schmid and Richard Walker, raise the question of whether there is a crisis in urban studies and particularly urban theory. I argue that there is no need for a radical rethinking of the ontological and/or epistemological foundations of urban studies, but that we might consider the need for new metaphors or figurations that help us think creatively about our urban conditions and the possibilities for political interventions. In particular, I explore the streetwalker, the nomad and the weed and discuss two cases on the ground: Kigali, Rwanda and Chester, Pennsylvania, USA. [ABSTRACT FROM AUTHOR]

Der Zweck der im vorliegenden Beitrag beschriebenen Untersuchung bestand darin, die Betonstahlbewehrung und nach Möglichkeit auch die Spannglieder auf einer Fläche von insgesamt 8 000 m2 der oberen Brückenfahrbahn des Viadukts 'Viadotto Colle Isarco' an der Brennerautobahn mittels Potentialfeldmessungen auf Korrosionserscheinungen zu untersuchen. So wurden Zonen mit hoher Korrosionswahrscheinlichkeit ermittelt und anschließend durch Öffnen und Sandstrahlen inspiziert. Auf der Grundlage dieser Prüfungen konnte abgeschätzt werden, dass auf etwa 9 % der Gesamtfläche eine hohe Korrosionswahrscheinlichkeit in den Spanngliedern gegeben ist. Bei früheren Inspektionen sind bereits gebrochene Spannglieder festgestellt worden. Sämtliche Brüche wurden dabei im Gewindebereich der Verbindungsgelenke festgestellt. In den korrodierten Spanngliedern, die in den 'aktiven' Zonen abseits der Verbindungsgelenke lagen, wurden dagegen keine Brüche gefunden. Von den gebrochenen Spanngliedern wurden Proben genommen und zur metallurgischen Analyse ins Labor geschickt. Dabei wurden keine Anzeichen für eine Wasserstoffversprödung des verwendeten Stahls festgestellt. Die Brüche, die in den Spanngliedern bei früheren Inspektionen festgestellt worden sind, wurden höchstwahrscheinlich durch Zyklen mit höherer Belastungsermüdung durch Verkehrslasten in Kombination mit Korrosion aufgrund belastungsempfindlicher Verbindungsgelenke verursacht. Corrosion survey of the bridge deck 'Viadotto Colle Isarco'/'Autobahnbrücke Gossensaß' on the Motorway called 'Autostrada del Brennero' in North-Italy The scope of this corrosion survey was to detect and quantify zones with high corrosion probability of the normal reinforcement and if possible the prestressed tendons of a total of 8 000 m2 surface area of the upper bridge deck of the 'Viadotto Colle Isarco'. This viaduct is part of the A22 Motorway called 'Autostrada del Brennero' and lays 10 km's south of the Austrian-Italian border in Italian territory approximately 1 200 m high in the Alps. In case serious problems were found no recommendations were requested at this point of the survey due to the size and the structural complexity of the concrete structure. Zones with high probability of corrosion were identified by the potentials measured and inspected through scarification and sandblasting. Based on this verification it was estimated an approximate 9 % of the total surface area with high probability of corrosion in the prestressed tendons. This amount is based on adding up all measuring points with a potential being more negative than -450 mV divided by the total amount of measuring points. During previous inspections fractured prestressed tendons were found. All the fractures were found in the threaded region of the coupler joints but no fractures were found in corroded tendons laying in the 'active' zones away from the coupler joints. Samples taken from the fractured tendons were sent to the lab for metallurgical analysis and revealed no susceptibility for hydrogen embrittlement of the steel used which has a perlitic microstructure. Fractures found in the tendons in previous inspections are most probably caused by major stress fatigue cycles from traffic loads in combination with corrosion due to the stress-sensitive couplings. Exactly similar cases (Heerdter crossing in Düsseldorf in 1976) were found in old reports, e.g. published in the technical report 26 'Influence of material and processing on Stress Corrosion Cracking of prestressing steel - case studies' by the International Federation for Structural Concrete (fib) in Lausanne. [ABSTRACT FROM AUTHOR]

Brenner tumor is a rare ovarian tumor that is a part of the surface epithelial group of ovarian neoplasm. It is usually asymptomatic, and most of the times, it is an incidental pathological finding. They can be subdivided into benign, borderline or proliferative, and malignant neoplasms. The majority of Brenner tumors are benign in nature. Tumors of borderline malignancy are less frequent, and only about 1% of tumors are borderline. Here, we present a rare case of giant Brenner tumor of ovary measuring 28 cm in diameter. This is the case is presented because the giant size of Brenner tumor, although rare gynecologist should be aware of this rare entity. [ABSTRACT FROM AUTHOR]

This reply defends the need for a specifically materialist historiography of modes of production other than capitalism; argues that Marxists should see history as being driven by the state as much as it is by classes; defends the scientific value of the category 'merchant capitalism'; and explains why Marx came around to seeing the slave plantations as part of 'total capital'. It concludes by suggesting both that Marx allowed for different levels of determination when thinking about the origins of capitalism, and that Brenner's account of the transition in English agriculture has now been seriously weakened by Jane Whittle's critique of it. [ABSTRACT FROM AUTHOR]

Die Herausforderungen bei der Umsetzung von Großprojekten sind vielfältig. Im Projektmanagement liegen sie darin, den Überblick über das Gesamtvorhaben zu bewahren, die Nahtstellen zwischen den Projektbeteiligten zu koordinieren und das Projekt im Spannungsfeld zwischen Terminen, Kosten und Qualität im Hinblick auf die Lebenszykluskosten zu optimieren. Andererseits ist aber auch eine Vielzahl von technischen Hürden zu meistern. Die Erschütterungsschutzmaßnahmen bei der neuen Unterinntalbahn werden exemplarisch für diese unzähligen technischen Herausforderungen näher betrachtet. Um die vorgeschriebenen, sehr niedrigen Immissionsgrenzwerte für Erschütterungen und Sekundärluftschall im bereits hochbelasteten und dichtbesiedelten Unterinntal einzuhalten, sind hochwertige und dauerhaft wirksame Schutzmaßnahmen erforderlich. Eine dem Stand der Technik entsprechende Schutzmaßnahme ist der Einbau von Masse-Feder-Systemen, die die erforderlichen lokalen Anforderungen an die Schutzziele bestmöglich erfüllen. Particular challenges during the construction of the new Lower Inn Valley Railway Line The challenges in the implementation of major projects are diverse. On the one hand, the challenges lie in project management trying to maintain an overview of the entire project and to coordinate the interfaces between the project participants and to optimize the project given the tension between deadlines, costs and quality in terms of life cycle costs. On the other hand, there are also a variety of technical hurdles to overcome. The vibration protection measures in the new Unterinntalbahn be considered an example for so many of these technical challenges in more detail. To comply with the prescribed very low emission limit for shock and secondary airborne noise in the already highly noise exposed and densely populated Lower Inn Valley, high quality and permanently effective protection measures are required. One state-of-the-art protection measure used is the installation of mass-spring systems that meet the necessary requirements for local protection. [ABSTRACT FROM AUTHOR]

In studies of the short story, relatively little attention has been devoted to the role therein of the crux, even though it is one of the critical elements in its fashioning. In the present study I have noted for the first time that, on the basis of the location of the crux within the overall complex of composition of the short story, we are able to draw a distinction among four sub-genres of the short story which differ from one another in their composition, general atmosphere, and meaning. The unique formulations of the crux were accepted in Russian literature of the nineteenth and early twentieth century, and are particularly discernible in the work of Chekhov, who exerted great influence upon the Hebrew short story. These means of formulations found their way from Russian literature into Hebrew literature, as is particularly striking in the works of those authors who grew up and were educated in the Russian milieu and culture and began to write in that language even before they began to write in Hebrew. [ABSTRACT FROM PUBLISHER]

Prominent Israeli writers and critics have repeatedly claimed that it is nearly impossible to write a realist social novel in a social reality that is still in the making. The challenge faced by kibbutz writers was even greater, given the great dynamism of the kibbutz as an arena of social experimentation and the incongruity between a positive, common experience, and the personal, gloomy themes expected from “good literature.” In their attempt to overcome these difficulties, most kibbutz writers produced erotic melodramas set against a documentary background. Had they followed Georg Lukács's and Mikhail Bakhtin's advice, they might have made the kibbutz the narrative material of their novels' plots themselves, rather than the “background” of erotic melodramas. [ABSTRACT FROM PUBLISHER]