Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease

The coexistence of thyroid diseases with primary hyperparathyroidism （PHPT） can present a challenge in the clinical diagnosis and management for these patients. This study aims to determine the frequency of coexisting thyroid gland lesions in a consecutive series patients with PHPT, and to analyze the clinical features, diagnosis and treatment of these patients. Twenty-two cases of a total of 52 PHPT patients who had synchronous thyroid and parathyroid pathology were surgically managed in this study Thirteen patients had ipsilateral thyroid nodules, and 9 patients had thyroid nodules in contralateral or bilateral side. Seven patients underwent direct parathyroidectomy and hemithyroidectomy via a mini-incision （about 3 cm）, while other 15 procedures were converted to Kocher incision. Seventeen nodular goiter （32.7%）, 2 thyroiditis （3.8%）, 2 thyroid adenoma （3.8%） and 1 thyroid carcinoma （1.9%） coexisting with parathyroid adenoma were pathologically diagnosed. The sensitivity of preoperative ultra- sonography （US） and methoxy-isobutyl-isonitrile （MIBI） scintigraphy for parathyroid lesions was 63.6% and 85.7%; and the overall positive predictive values for MIBI and US were 100% and 95.5% respectively. A high incidence of thyroid diseases that coexisted with PHPT in literatures was briefly reviewed. Our study illustrated the need for clinical awareness of concomitant PHPT and thyroid disease. A combination of US, computed tomography （CT） and MIBI scintigraphy would be recommended for preoperative localization of enlarged parathyroid adenoma and for evaluation of thyroid lesions. Synchronous treatment of associated thyroid abnormalities is desirable, and open minimally invasive surgical approach with additional resection of isolated ipsilateral thyroid nodules is possible in some of these patients.     

Biology Intensive Orientation for Students (BIOS): a biology "boot camp"

The Biology Intensive Orientation for Students (BIOS) Program was designed to assess the impact of a 5-d intensive prefreshman program on success and retention of biological science majors at Louisiana State University. The 2005 pilot program combined content lectures and examinations for BIOL 1201, Introductory Biology for Science Majors, as well as learning styles assessments and informational sessions to provide the students with a preview of the requirements of biology and the pace of college. Students were tracked after their BIOS participation, and their progress was compared with a control group composed of students on the BIOS waiting list and a group of BIOL 1201 students who were identified as the academic matches to the BIOS participants (high school GPA, ACT score, and gender). The BIOS participants performed significantly better on the first and second exams, they had a higher course average, and they had a higher final grade than the control group. These students also had higher success rates (grade of “A,” “B,” or “C”) during both the fall and spring semesters and remained on track through the first semester of their sophomore year to graduate in 4 yr at a significantly higher rate than the control group.     

宇宙中生命的命运

几十亿年以前的宇宙太热因而生命无法存在。亿万斯年以后，宇宙将变得寒冷而且空空如也，以致无论多么聪明的生命都将消亡。     

通灵的漂移

19世纪上半叶，进化论陷入了猜测的泥潭。这种情况一直持续到达尔文和华莱士整理出一个证据体系并提出自然选择这一进化驱动机制为止。     

航行到超重岛

1940年春天元素镎的发现使化学家们神魂颠倒地开始了对未知海域的旅行。在这个超铀世界里，原子核中的质子已超过铀的92个质子的数量，它们都具有不寻常的独特的性质。这些重元素中大量的电子使化学家洞悉原子中电子的排列以及是如何化学结合的。这些元素用于从核武器到烟雾探测器等广大的范围里。     

1988年的夏季

对1988年干旱的详细考察。1988年夏季，美国大陆的百分之七十以上遭受酷热和干旱。田野变得一片枯黄，一些湖泊和池塘消失得无影无踪，谷物产量下降了30-40％。正如许多美国人所担心的，这是不是由温室效应造成的不可逆转的全球性变热的开端呢?或者，这是否仅仅是某一个夏季的现象，纯属地球气候中的一次自然扰动呢?     

网络是无法管理的

现在，竭力改进域名系统的工作已进入第三个年头的重要阶段——交出域名系统将是美国政府从网络管理中脱身的计划的最后一步。看来还是在几年前就宣称因特网实际上无法管理的那些网络狂热者说得对。