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This article reflects on evidence drawn from an evaluation of the impact of a scholarship programme for students from disadvantaged backgrounds at Macquarie University, Sydney. In addition to evidence of improved retention rates, the article suggests that qualitative data derived from a number of interviews with scholarship recipients highlight the substantial contribution the programme has made towards a number of positive outcomes. The key themes of the narrative evidence – including resources, belonging, security, independence, motivation, engagement and confidence – collectively describe a broad, rich notion of student success that includes enhanced academic outcomes and elements of personal growth and development. The findings add weight to emergent arguments that financial support schemes need to be seen as more than tools for incentivising enrolment, and instead as key institutional or sectoral mechanisms for encouraging and supporting the successful participation of disadvantaged students in highe...

During the modern conflict in Northern Ireland, the paramilitaries played an important role in shaping communal identities. The loyalist Ulster Volunteer Force (UVF) and the Ulster Defence Association (UDA) enjoyed significant support in the Protestant community and should be understood as one expression of Protestant insecurity. This article considers the nature of this manifestation of Protestant fear during the formative years after the formation of the UDA in 1971 and up to the end of Andy Tyrie’s leadership of the organisation in 1988. It argues that the evidence uncovered by an examination of paramilitary literature, as well as that of the loyalist political parties which were affiliated with the UVF and UDA, reveals a complex persona that cannot be understood as entirely violent and exclusive. Instead, after outlining evidence for moderation, it explores what this evidence can reveal about the emergence of political thinking within parts of the UVF and UDA, and concludes that the literatur...

Gaseous fuels are generally easier to handle and burn than are liquid or solid fuels. Gaseous fossil fuels include natural gas (primarily methane and ethane) and liquefied petroleum gases (LPGs) primarily propane and butane. Gaseous man-made or artificial fuels are mostly derived from liquid or solid fossil fuels. Liquid fossil fuels have evolved from animal remains through eons of deep underground reaction under temperature and pressure, while solid fuel evolved from vegetable remains. Properties that concern most users of natural gases relate to the heat available from their combustion, flow characteristics, and burnability in a variety of burner types. Natural gases are classified as “sweet” or “sour,” depending on their content of sulfur compounds. Properties that concern most users of natural gases relate to the heat available from their combustion, flow characteristics, and burnability in a variety of burner types. LPGs are by-products of natural gas production and of refineries. Keywords: gaseous fuels; liquefied petroleum gases (LPGs); natural gases; vegetable remains

Air can be heated by burning fuel or by recovering waste heat from another process. In either case, the heat can be transferred to air directly or indirectly through air heaters. This chapter lists the gross Btu of fuel input required to heat one standard cubic foot of air from a given inlet temperature to a given outlet temperature. In addition to the cost of the heat exchanger for preheating the combustion air, there are many other costs that have to be weighed. Changing temperatures from end to end of high-temperature heat exchangers and from time to time during high-temperature furnace cycles cause thermal stress, often resulting in leaks and shortened heat exchanger life. Corrosion, fouling, and condensation problems continue to limit the applications of heat recovery equipment of all kinds. Despite all the costs and warnings, there are many benefits associated with the use of combustion air preheating systems. Keywords: combustion air preheating systems; direct air heaters; fuel costs; heat exchangers; indirect air heaters

The major source of liquid fossil fuels is crude petroleum; other sources are shale and tar sands. Synthetic hydrocarbon fuels—gasoline and methanol—can be made from coal and natural gas. Ethanol, some of which is used as an automotive fuel, is derived from vegetable matter. Properties of fuels reflect the characteristics of the crude. Paraffinic crudes have a high concentration of straight-chain hydrocarbons, which may leave a wax residue with distillation. Aromatic and naphthenic crudes have concentrations of ring hydrocarbons. Asphaltic crudes have a preponderance of heavier ring hydrocarbons and leave a residue after distillation. Kerosene is used mainly in wick-fed illuminating lamps and kerosene burners. The most important requirements of aircraft jet fuel relate to freezing point, distillation range, and level of aromatics. The chapter lists the properties of a residual fuel oil (DMF) from one shale pilot operation and of a shale crude oil. Keywords: crude petroleum; hydrocarbon fuels; kerosene; liquid fossil fuels; shale crude oil

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A 46-year-old woman presented with a pelvic mass. At the time of operation a large, exophytic, multinodular tumor extended into the peritoneal cavity and right broad ligament from a pedunculated attachment to the uterus in the region of the right cornu. On external examination the lesion had the appearance of cotyledonoid dissecting leiomyoma. On microscopic examination bulbous processes were composed of benign smooth muscle arranged in interlacing fascicles or swirls; there was focal hydropic degeneration. Significant nuclear atypia, mitotic activity, and coagulative tumor necrosis were not encountered. No intravascular involvement was present. There was no demonstrable parent leiomyoma or intramural dissecting component, and thus the case differed from previously reported cases of both cotyledonoid dissecting leiomyoma and intramural dissecting leiomyoma. This tumor represents another variation in the group of benign uterine smooth muscle tumors with unusual growth patterns.

The concept of minimal deviation melanoma is presented in diagrammatic form. In this approach, the precursors of melanoma are presented as having two dimensions and melanomas as having three dimensions. In turn, the relativity between dimensionalities and recommendations for treatment (as indirect correlates of prognostications) provides guidelines for the structuring of two major boundaries along the axis of the diagram. Finally, the domains defined by the two boundaries include borderline lesions, intermediate lesions, and “real melanomas.” The lesions in the borderline and intermediate categories qualify as melanocytic neoplasias of indeterminant malignant potential; in these two categories, the predictability of metastases hardly justifies the use of the designation, malignant melanoma.

Background The development of lupus erythematosus-like (LE-like) features in patients with cutaneous T-cell lymphoma (CTCL) has not been reported previously in the literature. Both diseases, however, have been etiologically linked to retroviruses. Objective Our purpose was to report four cases of patients with CTCL who developed LE-like features during the course of their disease, and to evaluate for evidence of antibodies to retroviruses in the sera of these patients. Patients Four patients with biopsy-proven CTCL with clinical or histologic features of systemic lupus erythematosus (SLE) were evaluated for clinical and laboratory criteria for SLE. Only one patient demonstrated four American Rheumatism Association (ARA) criteria sufficient for the diagnosis of SLE. The remaining three patients demonstrated one or two criteria for SLE. In addition, the sera of these patients were examined by Western blot analysis for evidence of human immunodeficiency virus type I (HIV-I), human T-cell lymphotrophic virus type I (HTLV-I), or human intracisternal A-type particle type I (HIAP-I) retroviral proteins. Each patient demonstrated antibodies to some of the retroviral proteins examined. The sera of two patients reacted to proteins for HIAP-I, and the sera of two patients reacted to p24 gag proteins of HIV-I. No patient reacted to HTLV-I proteins. Conclusions Our report identifies four patients with CTCL who developed LE-like features during the course of their disease. Although the etiology of CTCL and SLE has not been well established, each has been linked to retroviruses. Evidence of antibodies to retroviral proteins was identified in each of our patients by Western blot analysis. Although the clinical and laboratory findings in these cases do not resolve the etiologic role of retroviruses in CTCL or SLE, they suggest that retroviruses may have a role in the pathogenesis of the clinical phenomenon reported in these four patients.

Low-level (300 m) aircraft observations, taken within an intense extratropical storm during Intensive Observation Period 2 of the Experiment on Rapidly Intensifying Cyclones over the Atlantic, are used to document the near-surface frontal structure in the interior of the storm at 1800 UTC 14 December 1988, when the storm was at its maximum depth (959 mb). The flight data revealed that a well-defined occluded front spiraled into the low, making one-and-one-half turns about the center. The front followed the inner boundary of a spiral cloud and moisture band seen in satellite visible, infrared, and water vapor imagery. The results provide support for the idea that sharp occluded, or occluded-like, fronts can wrap around the core of deep ocean storms and that satellite imagery can be helpful in locating such fronts.

A polar low that developed over the western Bering Sea on 7 March 1977 and tracked across St. Paul Island is investigated using observations and the Pennsylvania State University–National Center for Atmospheric Research Mesoscale Model Version 5 (MM5). A series of fine-mesh (20 km) simulations are performed in order to examine the structure of the cyclone and the airflow within it and to determine the physical processes important for its development. Observations show that the low formed near the ice edge in a region of moderate low-level baroclinicity and cold-air advection when an upper-level trough, or lobe of anomalously large potential vorticity (PV), broke off from a migratory, upper-level cold low over Siberia and advanced into the region. A full physics model experiment, initialized 24 h prior to the appearance of the polar low, produced a small, intense cyclone having characteristics similar to the observed low. The simulated low more closely resembled an extratropical cyclone than a typ...

The current classification of malignant melanomas gives recognition to superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma, and nodular types. In addition, neurotropic and desmoplastic types are recognized. The relativity inherent in the diagnosis of melanoma, provides the basis for the classification of melanomas on the basis of size. Lesions measuring 1 mm or less in vertical dimensions are unlikely to metastasize; they qualify as borderline melanocytic neoplasia of indeterminant malignant potential. The current classification has little relevancy to the category of variant nevi with the exceptions of malignant cellular blue nevus and melanoma arising in giant congenital nevi. A classification of variant melanomas as related to variant nevi is proposed. From a different perspective, a classification of melanomas with attention to nesting and cytological patterns in vertical growth is proposed: this alternate approach gives recognition to lesions that might otherwise be classified as "nevoid" melanomas. It also provides a default category for lesions that might otherwise be assigned to the Spitz nevus-like category. All of these tools for the manipulation of the real and virtual images of melanomas have been emphasized in the concept of minimal deviation melanoma.

Modeling studies have consistently shown the importance of latent heat release in explosive marine cyclogenesis. However, a systematic evaluation of precipitation parameterization in the simulation of marine cyclones has been rare in the literature. This paper is the third in a series of modeling studies on the ERICA IOP 5 storm. The objective is to assess the performance of various subgrid-scale cumulus parameterization and resolvable-scale microphysics schemes in the simulation of the storm using the Penn State–NCAR mesoscale model MM5 at grid resolutions of 20 and 60 km. Emphasis is placed on the intensity, distribution, and character of precipitation and on the mesoscale low pressure centers embedded within the synoptic-scale cyclone. Principal findings are as follows. The distribution and intensity of precipitation, its partitioning into grid-resolvable and subgrid-scale portions, the atmospheric thermodynamic structure in the precipitation region, and the evolution of mesoscale low pressure...

The PSU-NCAR mesoscale model (MM4) is used to simulate a polar low that developed over Hudson Bay in December 1988. The structure and characteristics of the simulated low are documented, and results are presented of sensitivity experiments aimed at elucidating the physical mechanisms involved in the cyclogenesis. The low formed over an ice-free region in the eastern bay as an amplifying upper-level cold trough advanced into the region. The model depicted the polar low as a small, relatively shallow system embedded within the larger cold low. It resembled a miniature hurricane in structure but lacked hurricane-force winds. The lapse rate near its center was moist neutral to 550 mb (4 km); anticyclonic outlow occurred at and immediately below that level. The sensitivity experiments revealed that fluxes of heat and moisture from the region of open water and the associated condensation heating in deep organized convection were essential to the development. Sensible heating alone produced a relatively weak low and no low formed in an experiment with a completely ice-covered bay. The feedback between the surface fluxes and wind speed enhanced the intensification, especially in an experiment with the sea surface temperature raised by 8 °C. Winds of minimal hurricane intensity were attained in the latter experiment when the feedback effect was included but not when it was disallowed. A sizable impact of the ice-edge configuration was found. It is concluded that the Hudson Bay polar low formed as a consequence of latent heat release in deep organized convection that formed when an upper-level cold low moved over a relatively warm body of open water from which large fluxes of heat and moisture took place. Baroclinic forcing appeared to play little direct role in the low development. Instead, the configuration of the upstream ice boundary provided an important initiating and organizing mechanism. DOI: 10.1034/j.1600-0870.1995.00123.x

Reported are five cases of an unusual histological variant of glomus tumor that we have designated epithelioid glomus tumor. Unlike conventional glomus tumors, which consist of small polygonal cells with dark round nuclei and scanty cytoplasm, the epithelioid lesions were composed of large polygonal to spindle-shaped cells with abundant eosinophilic cytoplasm and large, irregularly shaped nuclei: The cells had both epithelioid and myoid qualities. Two of the cases studied were predominantly epithelioid, with small remnants of conventional glomus tumor at the periphery. The three other lesions were purely epithelioid. Epithelioid glomus tumors are of particular importance because they may be mistaken for other lesions histologically. Both benign and malignant epithelial lesions may be considered in the differential diagnosis; spindle-cell lesions, such as schwannoma, leiomyoma, hemangiopericytoma, and others, are in the histological differential diagnosis. Immunohistochemical and ultrastructural studies indicated that epithelioid glomus tumors had characteristics identical to those of conventional glomus tumors: the cells showed features consistent with smooth muscle derivation. The epithelioid areas frequently exhibited cytological atypicality—features that we believe to be a manifestation of cellular degeneration or senescence (analogous to "ancient" change in schwannomas or symplastic change in leiomyomas) rather than evidence of neoplastic progression. Simple surgical excision seems to have been curative (mean duration of follow-up of 4 years in the three cases in which such information was available). To our knowledge, no similar cases have previously been reported.

Numerical experiments with dry, inviscid models started from small normal-mode perturbations in baroclinic jet flows provide examples of ideal baroclinic cyclone development. This paper examines, with use of the Pennsylvania State University-National Center for Atmospheric Research Mesoscale Model, cyclone development under conditions that resemble the ideal experiments in lacking initial surface fronts and in neglecting latent heating and surface fluxes but that differ from most ideal experiments in including surface friction and an initial large upper-level disturbance. The initial state of the simulation is that of the intense, explosive Experiment on Rapidly Intensifying Cyclones over the Atlantic intensive observation period 4 storm. Issues highlighted are the timing and rate of deepening, the rapidity and intensity of frontal formation, the frontal structure, the airflow relative to the cyclone and fronts, and the nature of the occlusion and warm-core seclusion processes. Principal findings...

Summary Results are presented of a study comparing cerbB2 (neu or Her2) expression as assessed immunohistochemically in breast neoplasia using a panel of 6 commercially available antibodies. The antibodies were examined utilizing conventional formalin fixed paraffin embedded tissue, and compared with molecular analysis of gene amplification. The aim was to determine the practical utility of each antibody, assessing ease of use, specific and non-specific staining characteristics, and expense, thus allowing a specific recommendation as to antibody of choice for immunohistochemical assessment of cerbB2 expression. Reassuringly, amongst the 38 breast lesions (36 carcinomas, 2 fibroadenomas) subjected to immunohistochemistry (IHC) with the panel of 6 antibodies (Ab), no gross discrepancy of staining pattern was seen. Of the 38 cases, 10 were positive (26%), where at least one Ab demonstrated clear cytoplasmic membrane staining. Of a total of 45 breast lesions (43 carcinomas, 2 fibroadenomas), including all those examined by IHC, the total number of cases showing cerbB2 amplification by DNA analysis was 14 (31%). Using the DNA amplification as a base line for comparison, one Ab (Ne. 4) was found to stain 6’ of the 14 cases of breast carcinoma that were assessed as showing amplification at the DNA level. Four Abs (1,3,5,6) stained 5 of these cases. However, Abs 3,4 and 6 displayed artefactual cytoplasmic staining (in the absence of membrane staining) that precluded the practical use of these reagents. Therefore, based on additional considerations of cost and ease of use, Ab No. 1 was finally chosen for recommendation from the 6 Ab panel.

An observational study, employing spectral methods, is first made to establish a background for a modeling effort of the mesoscale gravity-wave event of 15 December 1987. The waves are found to have wavelengths of 100–160 km, phase speeds of approximately 30 m s−1, and lifetimes of over 6 h. Conditions for their maintenance are evaluated, indicating the presence of a wave duct and a supportive role for wave-CISK. Convection, shearing instability, and geostrophic adjustment are all implicated as possible source mechanisms for the observed waves. The case is then simulated with the Pennsylvania State University–National Center for Atmospheric Research MM4 mesoscale forecast model, with the following primary objectives: (i) to test the model's ability to simulate a mesoscale gravity-wave event, (ii) to examine in detail the environments of mesoscale gravity-wave development, and (iii) to investigate the mechanisms of mesoscale gravity-wave generation and maintenance. The full-physics control experim...

The ERICA IOP 5 storm was the third strongest cyclone observed during the three-month Experiment on Rapidly Intensifying Cyclones over the Atlantic (ERICA) and the least successfully predicted by the operational models. This paper documents the storm development with use of nearly all available observational data and presents the results of a simulation of the storm carried out by the Pennsylvania State University-NCAR mesoscale Model MM4. The observations reveal that the storm formed in two stages: a first stage in which a weak, eastward-moving upper-level trough over the Gulf states excited the growth of two disturbances over the Gulf Stream, and a second stage in which a rapidly moving, moderately intense short-wave trough from the north-central states interacted with the more northerly of the two disturbances, producing rapid intensification. Maximum deepening rates were 11 mb (6 h)−1 and 33 mb (24 h)−1. At the mature stage a thermal gradient of 7°C (35 km)−1 was observed near the surface by ...

This paper continues the study of the ERICA IOP 5 storm begun in a companion paper. The latter documented the storm development, utilizing both conventional and special observations, and presented the results of a successful simulation of the storm by the Pennsylvania State University-NCAR Mesoscale Model MM4. At 24 h into the simulation, the MM4 predicted a central pressure of 984 mb, close to the observed value, whereas the Nested Grid Model (NGM) of the National Meteorological Center forecasted a depth of only 997 mb for the same hour. Here the results of experiments designed to test the sensitivity of the development to latent heating, surface energy fluxes, Gulf Stream position, and grid size are first presented. A high sensitivity to latent heating and a moderate sensitivity to the other parameters are found. A comparison with other cases in the literature reveals that the sensitivity to latent heating, and to the fluxes, was unusually large. In view of this finding, further diagnosis is ma...

Patterns in giant congenital nevi are classified as to extent of cellular involvement of the reticular dermis and by the quality of the fibrous matrix. In addition, classifications are influenced by degrees of cellular atypia. Two general categories are defined. In one, the phenomena are relatively independent of those operative at the dermal – epidermal interface. The lesions are characterized as dermal congenital tumorous dysplasias-blastomas. They are subdivided into major, intermediate, and minor categories and into mature and immature variants. In these variants, disparate populations in the patterns of nodules and plaques (lumpy-bumpy variants) qualify as dermal variants of minimal deviation melanoma as seen in the setting of giant congenital nevi. The respective melanomas in this category are small-cell malignant neoplasms (melanoblastomas of infancy and childhood). In a second category in the clinical setting of giant congenital nevus, rare childhood and some adult melanomas of a more common histologic type evolve from lentiginous and junctional components in patterns that recapitulate those of the dysplastic nevus syndrome. The suspicious areas in all categories are evaluated by the same clinical criteria. In the dysplasia -blastoma category, enlarging nodules must be biopsied. The criteria for the evaluation of lesions in the dysplastic nevus syndrome and in the category of minimal deviation melanoma have application to the unstable regions in giant congenital nevi.

A very fine mesh model simulation of the Ocean Ranger storm of February 1982 is used to study the thermal structure and airflow in an intense marine cyclone. In particular, the study investigates the structures of the occluded front and the secluded pool of warm air in the simulated cyclone and examines the formation of these structures with the help of a large number of air trajectories. It was found that in the model simulation the largest thermal gradient occurred along the occluded front, not along the warm or cold fronts, and that the intense gradient was a product of strong warm and occludofrontogenesis in the inflowing air. The occluded front was embedded within air that was earlier located within the baroclinic zone ahead of the low center, not air that was in proximity to the historical warm and cold fronts. The warm air in the seclusion likewise originated in the baroclinic zone ahead of the low. The seclusion at low levels resulted from a tongue of slower moving, relatively warm air be...

PURPOSE To evaluate the prognostic importance of immunocytochemically determined c-erbB-2 overexpression in the primary tumors of patients with breast cancer. PATIENTS AND METHODS Primary tumors from 1,506 breast cancer patients (760 node-negative and 746 node-positive) who were treated in the International (Ludwig) Breast Cancer Study Group Trial V were studied. Node-negative patients were allocated randomly to either a single cycle of perioperative chemotherapy (PeCT) or no adjuvant treatment, and node-positive patients received either a prolonged chemotherapy (with tamoxifen for postmenopausal patients) or a single perioperative cycle. RESULTS Tumors from 16% of the node-negative patients and 19% of the node-positive patients were found to be c-erbB-2-positive. In both groups c-erbB-2 positivity correlated with negative progesterone receptors (PR), negative estrogen receptors (ER), and high tumor grade. Lobular carcinomas were all negative, and, thus support the view that such tumors represent a defined subtype of breast carcinoma. The expression of c-erbB-2 was prognostically significant for node-positive but not for node-negative patients. However, in both subgroups, the prognostic significance was greater for patients who had received more adjuvant therapy. For node-positive patients, the effect of prolonged-duration therapy on disease-free survival (DFS) was greater for patients without c-erbB-2 overexpression (hazards ratio [HR], = 0.57; 95% confidence interval [CI], 0.46 to 0.72) than for those with c-erbB-2 overexpression (HR, 0.77; 95% CI, 0.51 to 1.16). Similarly, for node-negative patients, the effect of PeCT on DFS was greater for those without c-erbB-2 overexpression (HR, 0.82; 95% CI, 0.61 to 1.09) than for those with c-erbB-2 overexpression (HR, 1.22; 95% CI, 0.66 to 2.25). CONCLUSION We conclude that tumors with overexpression of the c-erbB-2 oncogene are less responsive to cyclophosphamide, methotrexate, and fluorouracil (CMF)-containing adjuvant therapy regimens than those with a normal amount of gene product.

High spatial and temporal resolution fields generated by a mesoscale prediction model are used to study a case of rapid marine cyclogenesis (26 mb in 12 h) within the context of potential vorticity (PV) thinking. The case, which occurred on 23 February 1987 near the east coast of the United States, was well simulated by the model, as was verified by ship reports and satellite imagery. Three components of the cyclone were investigated: 1) a surface thermal anomaly (or surrogate PV anomaly), 2) a low-level, diabatically produced PV anomaly in and near the frontal cloud band, and 3) a dry PV anomaly of upper-tropospheric and lower-stratosphoric origin. Trajectory tracing revealed that the surface thermal anomaly was caused primarily by northward transport of warm air into the central region of the low. Although surface sensible heat flux also contributed to the warm anomaly, a sensitivity experiment, run with the flux withheld, showed that it had little impact on the depth of the storm. Furthermore,...

The designation combined nevus gives recognition to mixed cytologic patterns. In the common variant, plump, pigmented spindle cells form fascicles among nests of ordinary nevus cells. In other variants, one or several cellular components that share cytologic features with either a blue nevus or a Spitz nevus are represented. Ninety-five cases, 49% of which were of the common type, were studied. Grossly, most of the lesions were darkly pigmented papules or nodules. The clinical diagnosis in three-fourths of the cases was nevus, blue nevus, or melanoma. Fifteen percent had concomitant histologic features of melanocytic dysplasia, and most of these lesions were of the common type. For the common variant, the cytologic features, pattern of apparent infiltration, and variable representation of the features of a premalignant melanocytic dysplasia often mislead a pathologist in interpreting and predicting biologic potential. In combined nevi, the phenotypic diversity and genetic lability of melanocytic nevus cells is manifested.

The effect of surface sensible and latent heat fluxes on explosive cyclogenesis has been found to be quite variable. Sensitivity tests reveal little or no influence in some cases and dramatic effects in others. However, in nearly all cases where little impact was found, the predicted deepening rate was significantly less than the observed rate, opening the possibility that the unexplained deepening might be a consequence of a shortcoming of the flux formulation. We present here the results of a test of the impact of the fluxes in a case of extreme deepening that was accurately predicted by the ECMWF T106 operational model. In the test the fluxes were switched off during the 24-h period of most rapid deepening. The result was to change the predicted deepening rate of 48 mb by only 1 mb. This confirms that in certain circumstances the concurrent fluxes can have negligible effect on the deepening despite their great importance in other situations. It is shown that downward heat and moisture fluxes (...

A series of eight numerical experiments were conducted on seven cases of explosive marine cyclogenesis, using the Pennsylvania State University/National Center for Atmospheric Research (PSU/NCAR) mesoscale model. The main objective was to elucidate the role of surface energy fluxes both during and preceding rapid deepening. Results from the 24-h experiments initialized at the commencement of the period of most rapid deepening showed that the fluxes occurring during this stage had essentially no effect on the deepening rate. However, substantial effects of the fluxes were found in 48-h experiments initialized early in the development. When the fluxes were withheld from the 48-h simulations, the predicted cyclones were weakened on average by 7.1 mb at 24 hours and 13.5 mb at 48 hours. Evidently the fluxes occurring during the 24 hours preceding rapid deepening did affect the storm development throughout its lifetime. Additional 48-h experiments confirmed the relatively small impact of the concurren...

The implications of cytologic atypia, patterns of growth, stromal refractoriness, and immune responses in actinic keratoacanthoma are examined here in a speculative manner with the following conclusion: keratoacanthoma is a generic designation for a spectrum of invasive, keratinocytic hyperplasias. In this context, hyperplasia may affect both genomically normal and abnormal keratinocytes. In keratoacanthoma, it does so indiscriminately. The universality of the process in which both benign and neoplastic clones are affected qualifies as immunostimulation. The affected keratinocytes, regardless of genomic characteristics, extend beyond their sustaining stroma into retinaculum and the basement membrane, as an immunologic barrier, is disrupted. Following a period in which the stroma and the immune response are refractory, one or more clones of keratinocytes are exposed to an immune response. For the adnexal contributions, the eventual encounter with the immune response is brief and short-lived. The fate of these genomically intact cells is predictable: complete regression is the inviolate pathway. For the genomically deranged populace, the results of the encounter are unpredictable and potentially manifold. The options, variably expressed, include regression, spatial progression (expansion in space), and neoplastic progression (expansion in the number and types of neoplastic clones). In some actinic keratoacanthomas, neoplastic clones are represented in either focal or extensive carcinomalike patterns from the inception of the hyperplasia. In them, a potential for neoplastic progressions is inherent. If autonomous, aggressive clones are selected in the progressions, the transition from universal hyperplasia (keratoacanthoma) to malignancy (carcinoma) is effected. In the transition, hyperplastic, genomically intact, follicular keratinocytes are not affected; actinically deranged keratinocytes are. The final pathway for an individual evolving lesion is unpredictable, but in some cases it leads to biologic carcinoma (carcinoma ex-keratoacanthoma).

A review and proposed new classification of benign acquired neoplasms which differentiate towards hair follicle structures is presented. Seventeen neoplasms are discussed with an in-depth review of the literature.

In order to correlate changes in morphology to changes in molecular attributes, we constructed a tissue microarray of thin and thick melanomas selected to represent progression from dysplasia to early and advanced melanoma. Hematoxylin and eosin (H&E) staining and immunohistology with antibodies to cyclin D1, p16, Ki67, and Bcl-2 were performed. Observations were interpreted using a revised paradigm for the dysplasia-melanoma sequence in which the early steps of melanomatous growth develop in an accretive fashion similar to the growth of the common acquired nevus. The co-expression of cyclin D1 and p16 persisted from dysplasia to early melanomatous vertical growth. Malignant transformation characterized by absence of p16 and presence of increased cyclin D1 and increased Ki67 and confirmed by clinically documented metastasis occurred during the process of evolving melanomatous vertical growth. The interplay of mutated BRAF, cyclin D1, and p16 with anti-apoptosis and failure of senescence may account for the existence of nevi and dysplastic nevi and for their relationship to melanoma, and may indirectly account for the infrequency of nevi in the lentiginous melanomas that lack mutated BRAF. These observations suggest a need for more detailed study of transformation to malignancy in the various subsets of melanoma.

Cutaneous sarcoidosis often masquerades as many other disease entities. We describe the case of a 56-year-old African American man with a 1-year history of progressively enlarging nodules and plaques of the face resulting in a leonine appearance and madarosis. The diagnosis of cutaneous sarcoidosis was made after skin biopsy results revealed noncaseating granulomas without evidence of foreign body, mycobacteria, or deep fungal infection. A thorough systemic workup was void of other comorbidities. The reports of tumoral sarcoidosis or sarcoidosis presenting with leonine facies are rare, and those cases that have been reported have been linked to other systemic findings.

Minimal deviation melanoma is a controversial entity encompassing a heterogeneous group of lesions cytologically in the spectrum between recognized subtypes of nevi and conventional "primary configuration" melanomas and reported to have a better prognosis than the latter. To evaluate the distinctiveness of minimal deviation melanoma, Ki-67 proliferation rates and p53 expression in minimal deviation melanomas were compared with those in compound nevi, Spitz nevi, and vertical growth phase superficial spreading malignant melanoma. Twelve examples of each lesion were immunostained with antibodies to the Ki-67 and p53 proteins and evaluated by a pathologist who was blind to the diagnoses. The mean Ki-67 (MIB-1) proliferation rates for the compound nevi, Spitz nevi, minimal deviation melanomas, and superficial spreading malignant melanomas were 0, 3%, 13%, and 25%, respectively. The mean Ki-67 proliferation rate was statistically greater in the minimal deviation melanomas than in the compound nevi or the Spitz nevi (P

I graduated from Braintree (Massachusetts) High School in June 1940 in the period between the Great Depression—the effects of which were still being felt — and U.S. entry in World War II. Though I was a good student with well-rounded abilities and no strong leaning toward any particular subject or career choice, it was assumed that I would join two mathematically and scientifically talented classmates in attending the Massachusetts Institute of Technology (MIT). Certainly math and science had been two of my favorite subjects, and I would have welcomed the opportunity to go to a school like MIT or another elite school such as Harvard. However, the tuition at these institutions was out of reach for my family, even when supplemented by a scholarship awarded at my graduation. Consequently it was decided that I would enroll in the fall at a less expensive school, Boston College, where I would satisfy my love for numbers by majoring in accounting. Actually it was the depression mentality, not the fondness for numbers, which shaped my choice of major. Decent jobs were scarce in those days, and I was reminded by family and friends that certified public accountants (CPAs) were well paid and reliably employed.

We report four cases of an unusual uterine smooth muscle neoplasm. All patients were of reproductive age, ranging from 23 to 41 years old, and had a pelvic mass or an enlarged uterus. Two also had menstrual irregularities. At laparotomy, an exophytic congested bulky tumor resembling placental tissue extended from the uterine wall into the broad ligament and pelvic cavity. In one case the tumors were bilateral but unequal in size. On gross examination, these exophytic components were the most distinctive feature. On microscopic examination the basic lesion appeared to be a dissecting leiomyoma with growth at its periphery in sinuous dissecting patterns and extensive degenerative changes. Some microscopic features, including dissecting growth patterns, distinctive connective tissue alterations, and a rich component of vessels, overlap with those seen in several leiomyoma variants, including infiltrating leiomyoma, leiomyoma with perinodular hydropic degeneration, and intravenous leiomyomatosis. An intravascular component was not a feature. The distinctive gross appearance and microscopic features are embodied in the designation, "cotyledonoid dissecting leiomyoma." The follow-up information available for three cases supports the benign nature of the tumor.

Multilocular renal cyst is an uncommon lesion of controversial histogenesis. The authors report a case of renal multilocular cyst with mullerian (ovarian)-like stroma. We suggest that this finding would support a dysontogenetic origin for the lesion.

BACKGROUND Soft tissue augmentation with processed fat has been used clinically for several years. This material has been termed "autologous collagen" since it was presumed it was composed primarily of collagen and fibrous tissue from lipocyte cell walls. OBJECTIVE To examine the histologic behavior of dermis implanted with processed fat. METHOD Volunteers were injected with processed fat intradermally in the post auricular area and these sites were biopsied at one week, one month, and three months. RESULTS Early biopsies revealed no intact adiopocytes but a significant inflammatory infiltrate. Subsequently biopsies revealed replacement of the inflammatory reaction with cellular fibrosis and expansion of the dermis. CONCLUSION Intradermal injection of processed fat results in deposition of fibrous material and collagen due to the response of the recipient site. The material itself contains very little collagen.

Between 1958 and 1990, 82 patients with acral lentiginous melanoma were treated by the Tulane Surgical Service with regional perfusion, excision of lesion, and lymph node dissection. The patient group comprised 27 white men, 29 white women, 18 black men, and 8 black women, with an average age of 61 years. More foot lesions than hand lesions were reported, and all the black men had foot lesions. In stage I patients, overall 5-year survival rates were 65% at 5 years and 44% at 10 years, with differences by race and gender. The black men did poorest, with a 13% 10-year survival rate. Survival rates were worse with increasing disease stage when calculated using univariate analysis. The 5-year survival rate of all patients with stage III and stage IV disease was 26%. A multivariate analysis was performed in 78 of 82 patients in whom all variables of Clark's level, age, race, stage, and sex were known. A strong relationship was observed between decreasing survival time and increasing Clark's level, with stage of marginal significance. In a multivariate analysis of patients with stage I disease, an increasing level of invasion was found to be significant, with a trend for a relationship to thickness. A trend toward decreased survival time was observed in men and blacks.

PURPOSE An international trial (formerly Ludwig Trial V) has been conducted in 1,275 subjects to ascertain if perioperative chemotherapy is beneficial for node-negative breast cancer patients and to identify subgroups of patients who benefit from this therapy. PATIENTS AND METHODS Node-negative breast cancer patients were randomized to receive either one cycle of perioperative chemotherapy or no adjuvant treatment. A detailed pathology review was conducted in 1,203 of the 1,275 patients enrolled. Stepwise Cox regression analysis was used to search for factors either predicting chemotherapeutic responsiveness and/or influencing disease-free survival (DFS). RESULTS As expected, primary tumor size, grade, and the presence of peritumoral vascular invasion are the most important prognostic factors. Perioperative chemotherapy provides a DFS advantage at 5 years of median follow-up and such treatment is more effective for estrogen receptor-negative than for estrogen receptor-positive tumors, for histologic grade 2 and 3 than for grade 1 tumors, and for patients in whom no axillary lymph node metastases were found even after serial sectioning and review by the Central Pathology Laboratory. CONCLUSION Hormone receptor status and tumor grade are important factors for predicting responsiveness to perioperative chemotherapy in node-negative breast cancer.

A distinctive systematized epithelial nevus and associated multifocal carcinomas of the microcystic and sclerosing sweat duct type affected the lower extremities of a 9-year-old girl. The carcinomas were well differentiated and were both adenosyringomatous and microcystic. They qualify as microcystic and compound. In both the epithelial nevi and the carcinoma, primordial potentials are recapitulated.