Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10–30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.
examine 2013 worldwide usage data for ebrary and E-book Library (EBL) covering hundreds of thousands of titles. They examine usage patterns across academic libraries globally and establish benchmarks useful to libraries and consortia for local planning. Sessions versus availability, the use of higher-quality e-books, broad disciplinary differences, performance relative to predicted use, and level of immersion are considered. Levine-Clark is in the process of analyzing ebrary and
Kari Paulson is the President and founder of Ebook Library (EBL), a subsidiary of Ebooks Corporation. Kari has more than a decade of experience with e-book technology, working closely with both publishers and libraries to continue to innovate e-book access models and technology. She currently oversees EBL's global operations and thoroughly enjoys the challenges of working in a high growth, rapidly changing space in libraries and publishing.Most interested in the opportunities and challenges posed by the intersection of technology and publishing, Kari was an early and an ongoing advocate for trialling new technologies and access models, such as mobile access and patron-driven acquisition. A regular speaker at international conferences and events, she considers herself enormously fortunate to have the opportunity to work in many diverse communities and cultures across the globe.Growing up in the arctic winters in Minnesota, Kari was drawn to winter sports and began her career as a professional figure skater in Europe.
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