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Getting Started Picking a topic Something of interest to you Something interesting Something controversial Something argumentative Getting organized Outlining your paper Creating a keyword list Getting research. General Outline of a Paper Introduction Thesis statement Argument-evidence paragraph 1 Argument-evidence paragraph 2 Argument-evidence paragraph 3 Summary of the shawshank Argument Conclusion. Dream Team: The Effectiveness Essay? Example Outline Thesis Beans are a more healthy source of. Reagan Challenger? protein than beef. The Effectiveness Essay? Beans are fat-free. (Or, you can point out. Differences Between Us And Europe? that beef is not fat-free) Beans are low-sodium. (Or, you can point out. Of Teamwork Essay? that beef is not low-sodium) Beans are cholesterol-free. (Or, you can point out is as, that. beef is not cholesterol-free) Conclusion Based on the facts that they are. fat-free, low-sodium, and cholesterol free, beans. are definitely a more healthy source of Team: The Effectiveness Essay protein. Is As Important As Leadership? Research Evidence for Dream The Effectiveness argumentative essays can be. objective like facts, statistics, and case. studies or anecdotal your personal. experiences Objective evidence will require research you. can use sources like books, articles, websites, Research Articles in san vitale exterior, magazines, newspapers, and The Effectiveness, journals.
can be found using the Librarys databases. Books can be found using the Librarys online. Hindu About Reincarnation? catalog. Good websites can be found using engines like. Keywords Regardless of where you seek resources books, articles, or websites the Dream Essay best way to search. for resources is is as Important keyword searching Keywords represent the most important parts of. Dream Team: Of Teamwork Essay? your thesis statement or argument Before you start searching, develop a list of. keywords from your argument.
Keywords Example Thesis Beans are a more healthy source of. Differences Between Europe? protein than beef. Beans ? legumes Source Healthy health Protein Beef red meat Cholesterol You will combine them together using AND! Remember you arent limited to Dream Team: The Effectiveness, the actual words. from the thesis use related words or alternate. ideas! Also, look to your arguments for keywords, too those are key ideas! The Librarys Resources Books. Hindu? Looking Up Books Catalog. Dream Team: The Effectiveness Of Teamwork? beans and of gibbons, health. Look!
Additional keyword ideas! The Stacks are the Dream Team: of Teamwork books that CAN be checked out. The Shawshank Redemption? They are housed on Dream Team: The Effectiveness, the 2, 3, 4, and hindu about, 5 floors of. the Library. Team: The Effectiveness? The first letter will help you. figure out which floor. A-F 2nd floor G-P 3rd floor Q 4th floor R-Z 5th floor Delta Stacks are in exterior, our Stacks, so no worries!
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Full-text articles in hindu beliefs about reincarnation, Ebsco will either be HTML, PDF, or both. Dream The Effectiveness Of Teamwork Essay? If you dont see HTML or PDF (or. both), then the Essay is as as Leadership article is Dream Team: not available in full. This will cite the article for Tear Ducts you! Abstracts are a summary of the article. Quotations Citations Quotations when you use text from Team: The Effectiveness, a resource in. your own writing Citations how you acknowledge resources youve. Quotations Indirect Quotation Some researchers note. that children are totally insensitive to Characterization Glass Essay, their. parent's shyness (Zimbardo 62).Direct.
Quotation Zimbardo notes that children are. Team: The Effectiveness? totally insensitive to their parent's shyness (62).Paraphrase While not all children are, research has shown that some children are. insensible to speech, the introversion or timidity of. Team: The Effectiveness Of Teamwork? their parent or parents (Zimbardo 62). Essay Tear Ducts? Citations Book Langland, William. The Effectiveness Essay? Piers the of gibbons v ogden Ploughman. Dream The Effectiveness? Baltimore Penguin Books, Ltd., 1974. Journal article Thibodeau, P.L., and S.J.
Melamut. Ergonomics in. the Electronic Library. Bulletin of the Medical. Library Association 83.3 (July 1995) 322-329. Cultural Differences Between Europe? Citations Journal article from a database Becker, Karen.
The Characteristics of. Dream The Effectiveness Of Teamwork? Bibliographic Instruction in san vitale exterior, Relation to the. Causes and Dream The Effectiveness of Teamwork Essay, Symptoms of beliefs about reincarnation Burnout. Dream Team: Of Teamwork? RQ 32.3 (Spring. Reagan Speech Text? 1993) 346-357. The Effectiveness Of Teamwork? EBSCO ERIC. ULM University. Library, Monroe, LA. 19 May 2009.
Citations Website Lowe, Megan. The Shawshank Redemption Characters? Citations Guide MLA Style. Megan. Lowe _at_ ULM. 8 June 2006. University of Louisiana. at Team: of Teamwork Essay, Monroe. Hindu? 12 June 2007 lthttp//www.ulm.edu/lowe/ MLAcitationguide.htmlgt. Remember citations are important for Dream The Effectiveness of Teamwork Essay two reasons They allow you to san vitale, give credit where credit is. due, which keeps you from Dream Team: Essay, plagiarism and Characterization in The Glass Menagerie Essay, cheating. charges Allows readers to The Effectiveness of Teamwork Essay, retrace your research steps and. Cultural Differences Europe? look at The Effectiveness of Teamwork, the actual resources you used. Significance Of Gibbons V Ogden? Question Answer Time. Argumentative Essay FYI Presentation http//www.ulm.edu/lowe/argumentativeessay.pp. Dream Team: Of Teamwork Essay? t Sites Consulted for beliefs reincarnation Presentation Bogacizi University Writing Center Glendale Community College English Dept.
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An essay on tropical cyclones Essay. A tropical cyclone is a particular type of Dream, lowpressure system. It is called a hurricane in theUnited States and a typhoon in Asia. Tropicalcyclones are areas of warm, moist air risingrapidly. The upward ?ow of Essay, air is de?ected by Dream, theCoriolis effect (winds de?ected by the Earth#8217;srotation), creating a rotation around a centralcore, known as the `eye#8217;. Tropical cyclones areoften accompanied by very strong winds (gusts ofover 300 kilometres per hour have been recorded),torrential rain (1800 millimetres in 24 hours havebeen recorded) and very rough seas. A storm surge can occur when a tropicalcyclone approaches or crosses a coastline. Thevery low atmospheric pressure and the stress ofstrong winds on the sea surface produce a rise insea level above the normal tide level (see the diagram). Among the destructive and death-dealingfeatures of tropical cyclones, sea action and?oods are ranked as more signi®cant than winds. Tropical cyclones need the energy provided bywarm water vapour (sea waters of at least 27°Celsius). Usually they die out if they move inlandaway from the Essay water vapour, or out of the tropics,away from the warmth.
This is why tropical coastalareas, such as the Caribbean Sea (CentralAmerica), the north-west Paci®c and north-eastAustralia, between 5° and 15° north and south, arecommonly affected by tropical cyclones. The formation of a tropical cycloneHugecumulonimbusclouds form. Out?ow`Eye#8217; of Team: Essay, thecycloneWarm airspirals upquickly. Cool air ?ows into the centralarea to replace rising air. Differences Us And Europe. Warm seawater isevaporatedand rises up. The map shows the paths of major Australiancyclones since 1970. Tropical cyclones occur innorthern Australia between December and Dream Team: Essay, April,with the greatest activity usually occurringbetween January and Menagerie Essay, March. The number ofcyclones varies considerably from year to year, thefrequency usually determined by The Effectiveness, the temperatureof the oceans in the tropical waters around northernAustralia.
The Australian Bureau of Meteorologytracks an average of ten cyclones per cultural us and europe year in theAustralian region. Of these, six may be expected tocross the Australian coast. We will examine twomajor tropical cyclones that have hit different partsof Australia and their effects on people. Major Australian cyclones since 1970On 20 December 1974, a low pressure systemseveral hundred kilometres north of Darwin wasnoticed by the Bureau of Meteorology. By late thenext day, satellite pictures indicated that it haddeveloped into a tropical cyclone.
It was named`Tracy#8217;, and a warning was issued by of Teamwork Essay, the TropicalCyclone Centre in Darwin. Cultural Differences Between. Tracy intensi®ed overthe next two days as it moved south-west andthen curved south-east towards Darwin. Dream Team: The Effectiveness Of Teamwork. Thecyclone was tracked continuously by the Bureauof Meteorology at Darwin Airport. Soon after midnight on Christmas Day, thecyclone approached the city with wind gusts inexcess of 100 kilometres per hour, and thedestruction of the city began. Tracy passeddirectly over Darwin. Redemption Characters. It had wind gusts rangingfrom 217 to 240 kilometres per Team: Essay hour. Winds were abating in Darwin by Characterization in The Essay, 6.30 amas the Dream Team: The Effectiveness Essay cyclone weakened and moved furtherinland and degenerated into a raindepression. Tracy was a small cyclone in area butvery intense, with a central pressure of950 hectopascals. Its destructive effect wastotal, because it passed directly overDarwin and hit just as the residents of thecity were preparing to enjoy themselves at beliefs about reincarnation Christmas. Impacts and responsesTracy was Australia#8217;s most destructive cyclone.
Itcaused the deaths of Dream of Teamwork, 65 people ? of these, 16 wererep or ted missing at sea. As well, there were145 serious injuries and over 500 minorinjuries. Between 50 and 60 per cent ofbuildings were damaged beyond repair. Damage from the cyclone was over $4180million. Following the cyclone, more than35 000 people had to Glass Menagerie be evacuated ? few ofthem still had homes, there were no essentialservices and the threat of Dream, disease was amajor problem. Many people reacted heroically, workingat great risk to rescue trapped people. Governmentresponse included the provision ofemergency services and Followership is as Important, the building of Dream of Teamwork Essay, anew Darwin ? one that should be betterable to Essay is as withstand any future tropicalcyclones. After Tropical Cyclone Tracy, newbuilding codes were introduced.
Roofs fornew houses had to be tied to the foundations,and cladding was required to protecthomes from ?ying debris. One of the largest tropical cyclones to threatenQueensland in more recent times was TropicalCyclone Justin, which formed off the coast ofnorth Queensland in March 1997. Dream Team: Essay. It broughtwinds of Ducts, up to 150 kilometres per hour, largewaves, heavy rain and ?ooding. The cyclonestayed in Dream of Teamwork Essay the area for over two weeks with somechanges of position. It was unusual in that itremained almost stationary for up to ®ve consecutivedays. Tropical Cyclone Justin left a path of destruction,including the devastation of sugar, pawpaw andbanana crops and severe damage to roads, bridgesand powerlines. Some buildings were also damaged? including the destruction of a $5 millionmarina in Cairns. Large areas of beach wereeroded by the huge waves and heavy swell. Therewas also some damage to parts of the Great BarrierReef.
This is not unusual and not necessarilyserious, as the breakup of hard corals is seen bymany scientists as part of the natural `build-up andbreak-down#8217; cycle of reef and island development. The total cost of the damage to Queensland was$150 million. Tragically, the cyclone also causedthe deaths of 33 people, 26 inhttp://cimss.ssec.wisc.edu/tropic/tropic.htmlhttp://www.ntlib.nt.gov.au/tracy/advanced/Met/cyclones.html. Beliefs About. University/College: University of Arkansas System. Type of paper: Thesis/Dissertation Chapter. Date: 30 July 2016. Let us write you a custom essay sample on Dream Team: The Effectiveness of Teamwork An essay on tropical cyclones. for only $16.38 $13.9/page.
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Science/Ovarian Cancer term paper 5715. Of all gynecologic malignancies, ovarian cancer continues to have the. highest mortality and is the most difficult to The Effectiveness of Teamwork diagnose. In the United States. female population, ovarian cancer ranks fifth in absolute mortality among. cancer related deaths (13,000/yr). In most reported cases, ovarian cancer, when first diagnosed is in stages III or IV in about 60 to redemption 70% of Dream Team: The Effectiveness of Teamwork patients.
which further complicates treatment of the disease (Barber, 3). Early detection in ovarian cancer is hampered by in The Glass Menagerie the lack of Team: of Teamwork appropriate. tumor markers and clinically, most patients fail to develop significant. symptoms until they reach advanced stage disease. The characteristics. of ovarian cancer have been studied in primary tumors and in Essay is as established.
ovarian tumor cell lines which provide a reproducible source of tumor material. Among the major clinical problems of ovarian cancer, malignant progression, rapid emergence of drug resistance, and associated cross-resistance remain. unresolved. Ovarian cancer has a high frequency of metastasis yet generally. remains localized within the peritoneal cavity. Tumor development has been. associated with aberrant, dysfunctional expression and/or mutation of.
various genes. This can include oncogene overexpression, amplification or. mutation, aberrant tumor suppressor expression or mutation. Dream The Effectiveness Of Teamwork Essay! Also, subversion. of host antitumor immune responses may play a role in the pathogenesis of.
cancer (Sharp, 77). Ovarian clear cell adenocarcinoma was first described by reagan speech text Peham in 1899 as. hypernephroma of the Team: The Effectiveness Essay, ovary because of its resemblance to renal cell carcinoma. By 1939, Schiller noted a histologic similarity to mesonephric tubules and. classified these tumors as mesonephromas. Hindu About! In 1944, Saphir and Lackner described. two cases of The Effectiveness of Teamwork hypernephroid carcinoma of the ovary and proposed clear cell adenocarcinoma as an differences between, alternative term. Clear cell tumors of the ovary are now. generally considered to be of mullerian and in the genital tract of mullerian origin. A number of examples of clear cell adenocarcinoma have been reported to arise. from the epithelium of an endometriotic cyst (Yoonessi, 289).
Occasionally, a renal. cell carcinoma metastasizes to the ovary and may be confused with a primary clear. Ovarian clear cell adenocarcinoma (OCCA) has been recognized as a distinct. histologic entity in the World Health Organization (WHO) classification of Dream Essay ovarian. tumors since 1973 and is the most lethal ovarian neoplasm with an overall five year. survival of only Characterization in The Glass 34% (Kennedy, 342). Clear cell adenocarcinoma, like most ovarian. cancers, originates from the ovarian epithelium which is Team: The Effectiveness of Teamwork a single layer of cells found on. the surface of the ovary. Patients with ovarian clear cell adenocarcinoma are typically.
above the age of 30 with a median of 54 which is the shawshank similar to that of Dream Team: ovarian epithelial. cancer in general. OCCA represents approximately 6% of ovarian cancers and bilateral. ovarian involvement occurs in differences less that 50% of patients even in advanced cases. The association of OCCA and endometriosis is well documented (De La Cuesta, 243). This was confirmed by Kennedy et al who encountered histologic or intraoperative.
evidence of endometriosis in 45% of The Effectiveness of Teamwork their study patients. Transformation. from endometriosis to clear cell adenocarcinoma has been previously demonstrated in. sporadic cases but was not observed by Kennedy et al. Hypercalcemia occurs in Essay Followership is as Important a. significant percentage of patients with OCCA.
Patients with advanced disease are more. typically affected than patients with nonmetastatic disease. Patients with OCCA are also. more likely to have Stage I disease than are patients with ovarian epithelial cancer in. general (Kennedy, 348). Histologic grade has been useful as an initial prognostic determinant in some studies. of epithelial cancers of the ovary. The grading of ovarian clear cell adenocarcinoma has.
been problematic and is complicated by the multiplicity of histologic patterns found in. the same tumor. Similar problems have been found in Dream Team: Essay attempted grading of clear cell. adenocarcinoma of the endometrium (Disaia, 176). Cultural Us And! Despite these problems, tumor. grading has been attempted but has failed to demonstrate prognostic significance.
However, collected data suggest that low mitotic activity and a predominance of clear. cells may be favorable histologic features (Piver, 136). Risk factors for OCCA and ovarian cancer in general are much less clear than for. other genital tumors with general agreement on two risk factors: nulliparity and family. history. Dream The Effectiveness Of Teamwork Essay! There is a higher frequency of carcinoma in the shawshank unmarried women and in married.
women with low parity. Gonadal dysgenesis in children is associated with a higher risk. of developing ovarian cancer while oral contraceptives are associated with a decreased. risk. Genetic and candidate host genes may be altered in susceptible families. Among. those currently under investigation is BRCA1 which has been associated with an.
increased susceptibility to breast cancer. Approximately 30% of Dream Team: of Teamwork Essay ovarian adenocarcinomas. express high levels of differences between HER-2/neu oncogene which correlates with a poor prognosis. (Altcheck, 375-376). Dream The Effectiveness Essay! Mutations in differences between host tumor suppresser gene p53 are found in 50% of.
ovarian carcinomas. There also appears to be a racial predilection, as the vast majority. of cases are seen in Caucasians (Yoonessi, 295). Considerable variation exists in the gross appearance of ovarian clear cell. adenocarcinomas and they are generally indistinguishable from other epithelial ovarian.
carcinomas. They could be cystic, solid, soft, or rubbery, and may also contain. hemorrhagic and Team: Essay, mucinous areas (O'Donnell, 250). Microscopically, clear cell. carcinomas are characterized by the presence of variable proportions of clear and hobnail. cells. The former contain abundant clear cytoplasm with often centrally located nuclei, while the latter show clear or pink cytoplasm and Essay Tear, bizarre basal nuclei with atypical. cytoplasmic intraluminal projections.
The cellular arrangement may be tubulo acinar, papillary, or solid, with the The Effectiveness of Teamwork, great majority displaying a mixture of these patterns. The. hobnail and clear cells predominate with tubular and solid forms, respectively (Barber, Clear cell adenocarcinoma tissue fixed with alcohol shows a high cytoplasmic. glycogen content which can be shown by means of special staining techniques. Abundant extracellular and rare intracellular neutral mucin mixed with sulfate and. carboxyl group is Ducts usually present. The clear cells are recognized histochemically and. ultrastructurally (short and blunt microvilli, intercellular tight junctions and desmosomes, free ribosomes, and Dream Team: The Effectiveness, lamellar endoplasmic reticulum). Between! The ultrastructure of hobnail and.
clear cells resemble those of the similar cells seen in clear cell carcinomas of the. remainder of the female genital tract (O'Brien, 254). Team: The Effectiveness! A variation in patterns of histology. is seen among these tumors and frequently within the between, same one. Whether both tubular components with hobnail cells and the solid part with clear cells.
are required to establish a diagnosis or the presence of just one of the patterns is. sufficient has not been clearly established. Fortunately, most tumors exhibit a mixture of. these components. Benign and borderline counterparts of Dream Team: The Effectiveness Essay clear cell ovarian. adenocarcinomas are theoretical possibilities. Yoonessi et al reported that nodal. metastases could be found even when the disease appears to be grossly limited to the. pelvis (Yoonessi, 296).
Examination of retroperitoneal nodes is essential to allow for. more factual staging and reagan text, carefully planned adjuvant therapy. Surgery remains the backbone of treatment and generally consists of removal of the. uterus, tubes and ovaries, possible partial omentectomy, and nodal biopsies. The.
effectiveness and value of of Teamwork Essay adjuvant radiotherapy and chemotherapy has not been clearly. demonstrated. Beliefs About Reincarnation! Therefore, in patients with unilateral encapsulated lesions and. histologically proven uninvolvement of the contralateral ovary, omentum, and biopsied. nodes, a case can be made for (a)no adjuvant therapy after complete surgical removal. and (b) removal of only the diseased ovary in an occasional patient who may be young. and desirous of preserving her reproductive capacity (Altchek, 97).
In the more adv- anced stages, removal of the Team: The Effectiveness of Teamwork, uterus, ovaries, omentum, and as much tumor as possible. followed by challenger text pelvic radiotherapy (if residual disease is Dream The Effectiveness of Teamwork limited to the pelvis) or. chemotherapy must be considered. The chemotherapeutic regimens generally involve. adriamycin, alkylating agents, and cisPlatinum containing combinations (Barber, 442).
OCCA is of epithelial origin and often contains mixtures of other epithelial tumors. such as serous, mucinous, and endometrioid. Characters! Clear cell adenocarcinoma is characterized. by large epithelial cells with abundant cytoplasm. Because these tumors sometimes. occur in association with endometriosis or endometrioid carcinoma of the ovary and.
resemble clear cell carcinoma of the endometrium, they are now thought to be of. mullerian duct origin and variants of endometrioid adenocarcinoma. Clear cell tumors of. the ovary can be predominantly solid or cystic. In the solid neoplasm, the clear cells are. arranged in Dream Team: of Teamwork Essay sheets or tubules. Challenger Text! In the cystic form, the neoplastic cells line the spaces. Five-year survival is approximately 50% when these tumors are confined to of Teamwork the ovaries, but these tumors tend to be aggressive and spread beyond the ovary which tends to make.
5-year survival highly unlikely (Altchek, 416). Some debate continues as to as Leadership whether clear cell or mesonephroid carcinoma is a. separate clinicopathological entity with its own distinctive biologic behavior and natural. history or a histologic variant of endometrioid carcinoma. In an Team: The Effectiveness of Teamwork, effort to characterize. clear cell adenocarcinoma, Jenison et al compared these tumors to Essay on Broken Tear the most common of. the epithelial malignancies, the serous adenocarcinoma (SA). Histologically determined.
endometriosis was strikingly more common among patients with OCCA than with SA. Other observations by Jenison et al suggest that the biologic behavior of clear cell. adenocarcinoma differs from that of SA. They found Stage I tumors in Dream Team: Essay 50% of the. observed patient population as well as a lower incidence of bilaterality in OCCA. (Jenison, 67-69). Additionally, it appears that OCCA is characteristically larger than. SA, possibly explaining the greater frequency of symptoms and signs at presentation. There is controversy regarding talc use causing ovarian cancer.
Until recently, most. talc powders were contaminated with asbestos. Conceptually, talcum powder on differences between, the. perineum could reach the ovaries by Dream of Teamwork Essay absorption through the cervix or vagina. Since. talcum powders are no longer contaminated with asbestos, the risk is hindu beliefs reincarnation probably no longer. important (Barber, 200). The high fat content of whole milk, butter, and meat products. has been implicated with an increased risk for ovarian cancer in general.
The Centers for Disease Control compared 546 women with ovarian cancer to 4,228. controls and Dream Team: Essay, reported that for women 20 to 54 years of age, the use of oral. contraceptives reduced the risk of ovarian cancer by redemption characters 40% and the risk of ovarian cancer. decreased as the duration of oral contraceptive use increased. Even the Team: Essay, use of oral. contraceptives for three months decreased the Essay Followership as Leadership, risk. The protective effect of oral. contraceptives is to reduce the relative risk to 0.6 or to decrease the Team: The Effectiveness Essay, incidence of Characterization Glass Menagerie disease. by 40%.
There is a decreased risk as high as 40% for women who have had four or. more children as compared to nulliparous women. There is an Dream Team:, increase in the incidence. of ovarian cancer among nulliparous women and a decrease with increasing parity. The. incessant ovulation theory proposes that continuous ovulation causes repeated trauma. to the cultural between us and europe, ovary leading to the development of Dream Team: of Teamwork Essay ovarian cancer. Incidentally, having two or. more abortions compared to never having had an abortion decreases one's risk of. developing ovarian cancer by 30% (Coppleson, 25-28). It is commonly accepted that cancer results from a series of genetic alterations that.
disrupt normal cellular growth and differentiation. In The Essay! It has been proposed that genetic. changes causing cancer occur in of Teamwork two categories of Essay is as normal cellular genes, proto- oncogenes and Team: The Effectiveness Essay, tumor suppressor genes. Genetic changes in proto-oncogenes facilitate. the transformation of the shawshank redemption a normal cell to a malignant cell by production of an altered or. overexpressed gene product. Such genetic changes include mutation, translocation, or. amplification of proto-oncogenes Tumor suppressor genes are proposed to Dream Team: of Teamwork prevent.
cancer. Inactivation or loss of these genes contributes to development of the shawshank characters cancer by the. lack of a functional gene product. This may require mutations in both alleles of a tumor. suppressor gene. Dream The Effectiveness! These genes function as regulatory inhibitors of cell proliferation, such. as a DNA transcription factor, or a cell adhesion molecule. Loss of on Broken Ducts these functions.
could result in abnormal cell division or gene expression, or increased ability of cells in. tissues to detach. Cancer such as OCCA most likely results from the dynamic interaction. of several genetically altered proto-oncogenes and tumor suppressor genes (Piver, 64- Until recently, there was little evidence that the origin of ovarian was genetic. Before. 1970, familial ovarian cancer had been reported in only five families. A familial cancer.
registry was established at Roswell Park Cancer Institute in 1981 to document the. number of cases occurring in the United States and to study the mode of inheritance. If. a genetic autosomal dominant transmission of the disease can be established, counseling. for prophylactic oophorectomy at Dream Team: Essay an appropriate age may lead to a decrease in the death. rate from Tear Ducts, ovarian cancer in such families. The registry at Roswell Park reported 201 cases of The Effectiveness of Teamwork ovarian cancer in 94 families in. 1984. From 1981 through 1991, 820 families and 2946 cases had been observed. Familial ovarian cancer is not a rare occurrence and cultural us and, may account for 2 to 5% of all cases.
of ovarian cancer. Three conditions that are associated with familial ovarian cancer are. (1) site specific, the Dream Team: The Effectiveness Essay, most common form, which is restricted to ovarian cancer, and (2) breast/ovarian cancer with clustering of ovarian and redemption, breast cases in extended pedigrees. (Altchek, 229-230). Dream Team: The Effectiveness! One characteristic of inherited ovarian cancer is Essay Tear that it occurs at a. significantly younger age than the non-inherited form. Cytogenetic investigations of sporadic (non-inherited) ovarian tumors have revealed. frequent alterations of chromosomes 1,3,6, and The Effectiveness Essay, 11.
Many proto-oncogenes have been. mapped to these chromosomes, and deletions of segments of chromosomes (particularly. 3p and 6q) in some tumors is consistent with a role for loss of tumor suppressor genes. Recently, a genetic linkage study of Characterization Glass familial breast/ovary cancer suggested linkage of. disease susceptibility with the RH blood group locus on chromosome 1p. Allele loss involving chromosomes 3p and 6q as well as chromosomes 11p, 13q, and. 17 have been frequently observed in Essay ovarian cancers. Besides allele loss, point mutations. have been identified in the tumor suppressor gene p53 located on chromosome17p13. Deletions of chromosome 17q have been reported in Followership Important as Leadership sporadic ovarian tumors suggesting. a general involvement of this region in ovarian tumor biology.
Allelic loss of MYB and. ESR genes map on chromosome 6q near the provisional locus for Dream Team:, FUCA2, the locus for. a-L-fucosidase in serum. Low activity of a-L-fucosidase in serum is more prevalent in. ovarian cancer patients. This suggests that deficiency of a-L-fucosidase activity in serum. may be a hereditary condition associated with increased risk for developing ovarian. cancer.
This together with cytogenetic data of losses of 6q and the allelic losses at 6q. point to the potential importance of chromosome 6q in hereditary ovarian cancer. Activation of normal proto-oncogenes by reagan challenger text either mutation, translocation, or gene. amplification to produce altered or overexpressed products is Team: The Effectiveness Essay believed to play an. important role in the development of ovarian tumors. Activation of several proto- oncogenes (particularly K-RAS, H-RAS, c-MYC, and cultural differences between us and, HER-2/neu) occurs in ovarian. tumors.
However, the significance remains to be determined. It is controversial as to. whether overexpression of the Dream The Effectiveness of Teamwork Essay, HER-2/neu gene in ovarian cancer is associated with poor. prognosis. As Leadership! In addition to studying proto-oncogenes in tumors, it may be beneficial to. investigate proto-oncogenes in germ-line DNA from members of families with histories. of ovarian cancer (Barber, 323-324).
It is questionable whether inheritance or rare. alleles of the H-RAS proto-oncogene may be linked to Team: of Teamwork Essay susceptibility to ovarian cancers. Diagnosis and Treatment. The early diagnosis of hindu about ovarian cancer is Dream Team: a matter of chance and not a triumph of. scientific approach. In most cases, the finding of a pelvic mass is the reagan challenger speech text, only available. method of diagnosis, with the exception of functioning tumors which may manifest.
endocrine even with minimal ovarian enlargement. Symptomatology includes vague. abdominal discomfort, dyspepsia, increased flatulence, sense of bloating, particularly. after ingesting food, mild digestive disturbances, and pelvic unrest which may be present. for several months before diagnosis (Sharp, 161-163). There are a great number of imaging techniques that are available. Ultrasounds, particularly vaginal ultrasound, has increased the rate of pick-up of early lesions, particularly when the Dream The Effectiveness, color Doppler method is used. Cultural Us And! Unfortunately, vaginal sonography. and CA 125 have had an increasing number of false positive examinations.
Pelvic. findings are often minimal and not helpful in making a diagnosis. However, combined. with a high index of suspicion, this may alert the physician to the diagnosis. These pelvic signs include: Mass in the ovarian area. Relative immobility due to fixation of adhesions.
Irregularity of the tumor. Shotty consistency with increased firmness. Tumors in the cul-de-sac described as a handful of knuckles. Relative insensitivity of the mass. Increasing size under observation. Bilaterality (70% for ovarian carcinoma versus 5% for benign cases) (Barber, 136) Tumor markers have been particularly useful in monitoring treatment, however, the.
markers have and Dream of Teamwork, will probably always have a disadvantage in identifying an early. tumor. To date, only two, human gonadotropin (HCG) and alpha fetoprotein, are. known to be sensitive and specific. The problem with tumor markers as a means of. making a diagnosis is that a tumor marker is developed from Essay Followership Important, a certain volume of tumor. By that time it is no longer an early but rather a biologically late tumor (Altchek, 292). Many reports have described murine monoclonal antibodies (MAbs) as potential tools.
for diagnosing malignant ovarian tumors. Yamada et al attempted to develop a MAb. that can differentiate cells with early malignant change from adjacent benign tumor cells. in cases of borderline malignancy. They developed MAb 12C3 by immunizing mice with. a cell line derived from Dream The Effectiveness of Teamwork, a human ovarian tumor. The antibody reacted with human. ovarian carcinomas rather than with germ cell tumors.
MAb 12C3 stained 67.7% of. ovarian epithelial malignancies, but exhibited an extremely low reactivity with other. malignancies. MAb 12C3 detected a novel antigen whose distribution in normal tissue is. restricted. Europe! According to Dream Team: The Effectiveness Yamada et al, MAb 12C3 will serve as a powerful new tool for. the histologic detection of early malignant changes in cultural differences europe borderline epithelial neoplasms. MAb 12C3 may also be useful as a targeting agent for cancer chemotherapy (Yamada, Currently there are several serum markers that are available to help make a diagnosis.
These include CA 125, CEA, DNB/70K, LASA-P, and serum inhibin. Recently the. urinary gonadotropin peptide (UCP) and Essay, the collagen-stimulating factor have been. added. Differences Between Europe! Although the tumor markers have a low specificity and sensitivity, they are often.
used in screening for ovarian cancer. A new tumor marker CA125-2 has greater. specificity than CA125. In general, tumor markers have a very limited role in screening. for ovarian cancer. The common epithelial cancer of the Team: The Effectiveness, ovary is unique in Essay Followership is as as Leadership killing the Dream of Teamwork Essay, patient while being, in the vast majority of the cases, enclosed in about reincarnation the anatomical area where it initially. developed: the peritoneal cavity. Even with early localized cancer, lymph node. metastases are not rare in the pelvic or aortic areas.
In most of the The Effectiveness, cases, death is due to. intraperitoneal proliferation, ascites, protein loss and cachexia. The concept of. debulking or cytoreductive surgery is reagan speech currently the dominant concept in treatment. The first goal in debulking surgery is inhibition of debulking surgery is inhibition of. the vicious cycle of malnutrition, nausea, vomiting, and dyspepsia commonly found in. patients with mid to advanced stage disease. Dream The Effectiveness! Cytoreductive surgery enhances the. efficiency of chemotherapy as the survival curve of the Essay on Broken Ducts, patients whose largest residual. mass size was, after surgery, below the 1.5 cm limit is the Team: of Teamwork Essay, same as the curve of challenger speech text the.
patients whose largest metastatic lesions were below the 1.5 cm limit at the outset. The aggressiveness of the debulking surgery is a key question surgeons must face. when treating ovarian cancers. The debulking of very large metastatic masses makes no. sense from the oncologic perspective. Dream Team: Essay! As for extrapelvic masses the debulking, even if. more acceptable, remains full of danger and Essay on Broken Tear, exposes the patient to a heavy handicap.
For these reasons the extra-genital resections have to be limited to lymphadenectomy, omentectomy, pelvic abdominal peritoneal resections and rectosigmoid junction. resection. That means that stages IIB and IIC and stages IIIA and IIB are the only true. indications for extrapelvic cytoreductive surgery. Colectomy, ileectomy, splenectomy, segmental hepatectomy are only exceptionally indicated if they allow one to perform a. real optimal resection. The standard cytoreductive surgery is the total hysterectomy with.
bilateral salpingoophorectomy. This surgery may be done with aortic and pelvic lymph. node sampling, omentectomy, and, if necessary, resection of the rectosigmoidal junction. The concept of administering drugs directly into the peritoneal cavity as therapy of. ovarian cancer was attempted more than three decades ago.
However, it has only been. within the last ten years that a firm basis for Essay, this method of challenger speech text drug delivery has become. established. The essential goal is to expose the tumor to higher concentrations of drug. for longer periods of time than is possible with systemic drug delivery. Several agents. have been examined for their efficacy, safety and The Effectiveness of Teamwork Essay, pharmacokinetic advantage when. administered via the peritoneal route. Cisplatin has undergone the most extensive evaluation for regional delivery. Cisplatin. reaches the systemic compartment in Essay significant concentrations when it is administered.
intraperitoneally. Dream Team:! The dose limiting toxicity of intraperitoneally administered cisplatin is. nephrotoxicity, neurotoxicity and emesis. The depth of penetration of cisplatin into reagan, the. peritoneal lining and tumor following regional delivery is only 1 to 2 mm from the. surface which limits its efficacy.
Thus, the Dream, only patients with ovarian cancer who would. likely benefit would be those with very small residual tumor volumes. Overall, approximately 30 to 40% of patients with small volume residual ovarian cancer have. been shown to demonstrate an objective clinical response to the shawshank redemption characters cisplatin-based locally. administered therapy with 20 to 30% of patients achieving a surgically documented. complete response. As a general rule, patients whose tumors have demonstrated an. inherent resistance to cisplatin following systemic therapy are not considered for. treatment with platinum-based intraperitoneal therapy (Altchek, 444-446).
In patients with small volume residual disease at the time of second look laparotomy, who have demonstrated inherent resistance to platinum-based regimens, alternative. intraperitoneal treatment programs can be considered. Other agents include. mitoxantrone, and recombinant alpha-interpheron. Intraperitoneal mitoxanthone has. been shown to Team: The Effectiveness of Teamwork Essay have definite activity in small volume residual platinum-refractory ovarian. cancer. Unfortunately, the dose limiting toxicity of the agent is abdominal pain and. adhesion formation, possibly leading to bowel obstruction.
Recent data suggests the. local toxicity of mitoxanthone can be decreased considerably by delivering the agent in. Ovarian tumors may have either intrinsic or acquired drug resistance. Many. mechanisms of drug resistance have been described. Expression of the MDR1 gene that. encodes the drug efflux protein known as p-glycoprotein, has been shown to confer the. characteristic multi-drug resistance to clones of on Broken some cancers.
The most widely. considered definition of platinum response is response to first-line platinum treatment. and disease free interval. Primary platinum resistance may be defined as any progression. on treatment. Secondary platinum resistance is the absence of progression on primary. platinum-based therapy but progression at the time of platinum retreatment for relapse. Second-line chemotherapy for recurrent ovarian cancer is dependent on preferences of. both the patient and physician.
Retreatment with platinum therapy appears to offer. significant opportunity for clinical response and The Effectiveness Essay, palliation but relatively little hope for. long-term cure. Paclitaxel (trade name: Taxol), a prototype of the taxanes, is cytotoxic. to ovarian cancer. Approximately 20% of hindu platinum failures respond to standard doses of. paclitaxel. Studies are in progress of dose intensification and intraperitoneal. administration (Barber, 227-228). Dream Of Teamwork Essay! This class of drugs is now thought to represent an. active addition to the platinum analogs, either as primary therapy, in combination with.
platinum, or as salvage therapy after failure of platinum. In advanced stages, there is suggestive evidence of in The Glass Menagerie Essay partial responsiveness of OCCA to. radiation as well as cchemotherapy, adriamycin, cytoxan, and cisPlatinum-containing. combinations (Yoonessi, 295). Dream Team: The Effectiveness Essay! Radiation techniques include intraperitoneal radioactive. gold or chromium phosphate and external beam therapy to reagan challenger speech text the abdomen and pelvis. The. role of radiation therapy in treatment of of Teamwork Essay ovarian canver has diminished in prominence as.
the spread pattern of ovarian cancer and the normal tissue bed involved in the treatment. of this neoplasm make effective radiation therapy difficult. When the residual disease. after laparotomy is bulky, radiation therapy is Essay particularly ineffective. If postoperative. radiation is prescribed for a patient, it is important that theentire abdomen and pelvis are. optimally treated to elicit a response from the tumor (Sharp, 278-280). In the last few decades, the Dream Team:, aggressive attempt to optimize the treatment of. ovarian clear cell adenocarcinoma and ovarian cancer in Essay on Broken Tear Ducts general has seen remarkable. improvements in the response rates of patients with advanced stage cancer without.
dramatically improving long-term survival. The promises of new drugs with activity. when platinum agents fail is Dream Team: The Effectiveness of Teamwork encouraging and fosters hope that, in the decades to come, the endeavors of surgical and pharmacoogical research will make ovarian cancer an. easily treatable disease. Altchek, A., Deligdisch, L. (1996). Diagnosis and Management of Ovarian Disorders. New York: Igaku Shoin.
Barber, H. (1993). Ovarian Carcinoma: Etiology, Diagnosis, and redemption, Treatment. New York: Coppleson, M. (Ed.). Dream Team: The Effectiveness Essay! (1981). Gynecologic Oncology (vol. 2). New York: Churchill. Current Clinical Trials Oncology. (1996). Text! Green Brook, NJ: Pyros Education.
De La Cuesta, R., Eichorn, J. (1996). Histologic transformation of benign. endometriosis to Team: The Effectiveness of Teamwork early epithelial ovarian cancer. Challenger Speech Text! Gynecologic Oncology, 60, 238- Disaia, P, Creasman, W. (1989). Clinical Gynecologic Oncology (3rd ed.). St.
Louis: Jenison, E., Montag, A., Griffiths, T. (1989). clear cell adenocarcinoma of the ovary: a clinical analysis and comparison with serous carcinoma. Gynecologic Oncology, Kennedy, A., Biscotti, C. Dream! (1993). Histologic correlates of progression-free interval and. survival in ovarian clear cell adenocarcinoma. Essay! Gynecologic Oncology, 50, 334-338. Kennedy, A., Biscotti, C. Dream The Effectiveness! (1989).
Ovarian clear cell adenocarcinoma. Gynecologic. Oncology, 32, 342-349. O'Brien, M., Schofield, J., Tan, S. Differences Between! (1993). Clear cell epithelial ovarian cancer: Bad. prognosis only in early stages. Gynecologic Oncology, 49, 250-254. O'Donnell, M, Al-Nafussi, A. (1995). Intracytoplasmic lumina and mucinous inclusions. in ovarian carcinoma.
Histopathology, 26, 181-184. Piver, S. (Ed.). (1987). Ovarian Malignancies. New York: Churchill Livingstone. Sharp, F., Mason, P., Blackett, T., Berek, J. (1995). Team: Of Teamwork! Ovarian Cancer 3. New York:
Chapman Hall Medical. Yamada, K., Kiyoshi, O. (1995). Monoclonal antibody, Mab 12C3, is challenger a sensitive. immunohistochemical marker of early malignant change in Team: of Teamwork Essay epithelial ovarian tumors. Anatomic Pathology, 103, 288-294. Yoonessi, M., Weldon, D., Sateesh, S. (1984). Clear cell ovarian carcinoma. Journal. of Surgical Oncology, 27, 289-297. Our writers are all Uni graduates able to work effectively on any level under time constraints.
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