A childhood passion becomes a career for romance author

When she was 10 years old Crystal Hubbard wrote "Disco Cleopatra," a play about a 17-year-old roller skating queen. In another childhood story, "Ants," Hubbard tells the tale of a girl who breaks her leg and eats ice cream in bed all day only to find ants have invaded her leg cast.

By age 13 Hubbard was a prolific writer and shrewd businesswoman.

She playfully confesses, "I would let the neighborhood kids read my work for 15 cents per page at the playground." Writing became an outlet for Hubbard's young imagination and emotions. Her love of writing was matched only by her love of reading.

Dubbed the eccentric in her family of two girls, Hubbard possesses a …

2 floors of WSJ headquarters in NYC evacuated

Police evacuated The Wall Street Journal's mailroom and another floor of the newspaper's building after several envelopes were opened that contained a suspicious white powder later found to be harmless.

Police say at least four envelopes were opened and others were left unopened in the mailroom Wednesday. The Journal said it had received more than a dozen …

Leaky ship of Congress must be plugged

When the former chairman of the Senate Intelligence Committee,Sen. David Durenberger (R-Minn.), has to be questioned by the SenateEthics Committee for publicly revealing the secret Americanrecruitment of a foreign official, it is time for the U.S. Congressto recognize that its committee structure for overseeing sensitiveintelligence operations is leaking badly at the top.

When the former vice chairman of the Senate IntelligenceCommittee, Sen. Patrick Leahy (D-Vt.), is forced to resign because ofhis unauthorized disclosure to the press of a committee document, itis time for a bipartisan majority to consider seriously the oneinstitutional change in congressional …

Cage-Free Eggs Rolling Off the Farms

FORT RECOVERY, Ohio - The 13,000 hens roam the barn floor, spread their wings and duck into nest boxes covered by red plastic flaps to provide a dark area that encourages egg-laying.

Three months earlier, the same barn housed nearly four times as many chickens, but they were confined to small wire cages stacked on top of each other.

Egg farms are increasing their production of cage-free eggs, spending hundreds of thousands of dollars to convert barns by tearing out cages, installing new floors, reconfiguring feed and water lines, and changing ventilation systems.

"It's a growing market," said Jerry Knapke, operations manager for Fort Recovery Equity, the nation's …

Reports: Model Ruslana Korushnova dies in fall from NYC building in apparent suicide

A cover model for European Vogue has fallen to her death from her Manhattan apartment building in an apparent suicide.

The New York Post and Newsday say 20-year-old Ruslana Korushnova died Saturday afternoon in the Financial District. The newspapers cited unnamed officials and police.

Police …

From the Editors: System still riddled with inequities

From the Editors: System still riddled with inequities

Read it and weep.

At Collins High School in North Lawndale, school improvement means hall sweeps and holding pens, students signing contracts to get free spiral notebooks and the specter of gates being installed in washrooms to keep kids from hiding out in them.

Meanwhile, serving students better at the impressive new Northside College Preparatory High School means free e-mail accounts and personal computers. At the equally impressive new Payton College Prep, students can learn web-site design and how to play the guitar. If the students at Collins, one of five schools undergoing intervention, had free e-mail accounts, computers and guitar lessons--in other words, if they had a curriculum and activities that excited them--maybe all that whip-cracking wouldn't be necessary.

But, no, the School Board's remedy for dysfunctional high schools is to turn up the heat, even though that approach failed three years ago with reconstitution, rather than cultivate a culture of success from the ground up, the approach it has used with some of its new college prep high schools.

The crackdown at Collins is focused mainly on faculty. Monitors check daily to see whether teachers have posted the objectives of their lessons and are teaching to them. Teachers with frequent absences and tardies have been "written up," as well they should be. As with reconstitution, however, intervention ran many of the school's better teachers out the door, students told CATALYST Contributing Editor Jody Temkin. More teachers want out, but a freeze has been put on transfers, casting them as ducks in a shooting gallery.

When it comes to middle-income high achievers, the board knows how to grow a school. Its creation of Northside and Payton proved that. In both cases, the board built new buildings, loading them with weather stations, planetariums and other attractive extras. Equally important, it gave the new principals plenty of time to recruit new teachers, develop an attractive curriculum and get the word out.

However, as the board moved south with its college prep program, it lowered its standards, making 11th-hour decisions on principals and facilities, and, initially, planning only minor investments in existing physical plant. The South Side schools were afterthoughts.

Reporting by Associate Editor Debra Williams indicates that Jones and Southside college preps are recovering from their hurried start-ups. But Lindblom College Prep in West Englewood is a sham. The board removed the principal just as it rechristened the former technical school; a year later, it promoted that principal to central office and installed an interim principal. Boths teachers and parents are confused about what's going on. Not surprisingly, the school has had trouble attracting enough 8th-graders whose test scores meet prep-school requirements; this year's freshman class numbers just 75 students. In contrast, Payton, on the edge of the Gold Coast, is bursting with applicants and has 370 freshmen.

To make good on its pledge to create at least one star high school in each section of the city, the board needs to get serious about Lindblom: Hire a permanent, first-rate leader and give him or her the time to recruit a first-rate faculty and plan a first-rate program. Follow up with the money to carry out that program. Finally, give Lindblom College Prep the same kind of public send-off that Northside and Payton got.

Then the board needs to take this approach to Collins and every other high school in the city: Create a pool of strong leaders who know how to work with teachers and communities to rebuild schools, and provide support for these community-based efforts. Communities, in turn, need to take responsibility for seeing that the board does right by their schools.

Surgical images: soft tissue: Right paraduodenal hernia

A 17-year-old man was admitted to our clinic complaining about intermittent cramping abdominal pain and postprandial nausea of several months' duration. He reported that the pain was worse when supine, especially after the meals, and was relieved in the upright position. He mentioned no previous abdominal operation.

Clinical examination revealed a palpable, slightly tender mass in the epigastrium, which, however, could not be palpated when the patient stood upright. Results from an endoscopic examination of the upper gastrointestinal tract were normal. Small-bowel follow-through films taken with diatrizoate meglumine/diatrizoate sodium (Gastrografin�) showed that the jejunum occupied the upper-right part of the abdomen. Multiple jejunal loops were compressed into an ovoid mass situated behind the stomach (Fig. 1). A delay of transit in the jejunum was also documented.

In view of these findings, the patient underwent an exploratory laparotomy, during which a large right paraduodenal hernia was identified holding almost 1 metre of the jejunum. Afferent and efferent loops of jejunum could be seen entering and leaving the hernia sac. The medial border of the hernia neck consisted of the superior mesenteric and ileocolic artery; the upper and lateral borders were transverse mesocolon (Fig. 2). Exploration of the abdominal cavity revealed no other pathologic findings. The ascending and descending colon were fixated normally on the posterior abdominal wall. The jejunum was easily reduced into the peritoneal cavity and the hernia defect was closed with interrupted sutures.

The postoperative course was uneventful. The patient reported that his preoperative symptoms had not returned.

Right paraduodenal hernias account for about 25% of paraduodenal hernias, the most common type of internal hernia. (Their precise incidence is unknown, since a certain percentage remain asymptomatic throughout the person's lifetime.) These hernias are probably the result of delayed reentry of the small bowel in the abdominal cavity, leading to its entrapment under the mesentery of the ascending colon.1 There seems to be a clear male predisposition, with a ratio of about 3:1.2

Paraduodenal hernias may present with acute intestinal obstruction or intermittent postprandial epigastric pain. Their presence should be suspected without history of previous laparotomy, especially in young patients with intermittent obstructive episodes. Because the herniation of the small bowel through the hernia orifice can be intermittent, preoperative diagnosis is not always possible.3,4

Surgical repair of right paraduodenal hernias includes reduction of the protruding jejunum and closure of the hernia orifice. Large defects of the mesentery may be covered with use of a mesh.

[Reference]

References

1. Andrews E. Duodenal hernia-a misnomer. Surg Gynecol Obstet 1923;37:847-52.

2. Berardi RS. Paraduodenal hernias. Surg Gynecol Obstet 1981;152:99-110.

3. Dritsas ER, Ruiz OR, Kennedy GM, Blackford J, Hasl D. Paraduodenal hernia: a report of two cases. Am Surg 2001;67:733-5.

4. Yoo HY, Mcrgclas J, Seibert DG. Paraduodenal hernia: a treatable cause of upper gastrointestinal tract symptoms. J Clin Gastroenterol 2000;31:226-9.

Competing interests: None declared.

[Author Affiliation]

Submitted by Basilios Papaziogas, MD, Anastasio Souparis, MD, John Makris, MD, Athanasios Alexandrakis, MD, and Thomas Papaziogas, MD, PhD, of the 2nd Surgical Clinic, Aristoteles University of Thessaloniki, Thessaloniki, Greece

Correspondence to: Dr. Basilios Papaziogas, Bl. Fanariou str. 16, 551 33 Thessaloniki, Greece; fax 0030 310-992563; papaziog@med.auth.gr

Submissions to Surgical Images, soft-tissue section, should be sent to the section editors: Dr. David P. Girvan, Victoria Hospital Corporation, PO Box 5375, Station B, London ON N6A 5A5 or Dr. Nis Schmidt, Department of Surgery, St. Paul's Hospital, 1081 Burrard St., Vancouver BC V6Z 1Y6.