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When taking a patient to surgery for an adnexal mass, preoperative risk should be assessed based on ultrasound ndings, CA-125 level if available, and family history. If the patient has a signi cant preoperative risk for malignancy, the patient should be consented for the possibility of full surgical staging as appropriate (including complete hysterectomy and bilateral salpingo-ophorectomy). If future fertility is desired, fertility-sparing surgical staging should be performed. A more unsettling scenario is when the patient has a low preoperative risk but a malignancy is encountered and the patient s desire to retain fertility is not known. The surgeon has two options: terminate the surgery and return at a later date for completion of staging, or speak to a family member, if available, and discuss the options for immediate staging versus completion surgery at a later date. In either case, a surgeon with the appropriate training to properly stage the patient s malignancy should perform the surgery. Regardless of the surgical decision, the safety of the patient should always be the surgeon s number one priority.

Vulvo-vaginal symptoms are among the most common reasons that women seek health care; upward of 6 million physician of ce visits are made by women of all age ranges for vulvo-vaginal symptoms.1 Despite such staggering statistics, most clinicians are not adequately prepared to diagnose and treat chronic vulvo-vaginal symptoms. Overlapping clinical appearance, symptoms, and pathophysiology, compounded by nonspeci c histology on biopsy, are the main causes for confusion. This chapter will focus on the following six nonmalignant vulvo-vaginal conditions that clinically may raise concern about premalignant processes: r Lichen sclerosis r Contact dermatitis r Lichen simplex chronicus r Lichen planus r Plasma cell vulvitis r Desquamative in ammatory vaginitis These conditions share overlapping symptoms of itching and burning to variable degrees. Collectively, these conditions are challenging to care

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data are not again needed. The result is that real-time on-line programs can run inde nitely without over owing memory. 15.16 The major steps in a real-time on-line program are data acquisition; data screening; data processing; output validity checks; and program output. 15.17 After development off-line using a fuzzy expert system shell, the program can be recoded using a procedural language, possibly replacing fuzzy logic with interval logic. 15.18 The rst stage is to acquire data on disk so that the program can be written and debugged off-line. If the program is to be closed-loop, a way of simulating the process should be found so that the dynamics of a program run can be checked. Processes may be simulated by a digital computer program, an analog computer, or some other process model that will accept the expert system output and produce a response that can be input to the expert system.

Despite the versatility of the Blackberry s platform, many of your Blackberry s most interesting capabilities are specific to the BlackBerry device. In fact, in order for your program to take full advantage of the fact that it is running on a BlackBerry, you need to use BlackBerry-specific application program interfaces (APIs) when writing the program. The BlackBerry APIs give you functions that allow you to interact with the BlackBerry device itself. These include user interface, BlackBerry networking, menus, file storage, notifications, and built-in BlackBerry applications such as e-mail, contacts, and the web browser. Because the BlackBerry APIs are not part of the Java MIDP 2.0 specification, using the BlackBerry APIs in your programs means that your programs will not work on any other Java platform. Unless you re running your application on the BlackBerry Device Simulator (a fantastic feature I discuss later in this chapter), you will not be able to run your programs on Windows, Mac, or other Java environments. Although using the BlackBerry APIs breaks the Java applications run everywhere theory, it is simply the reality of choosing between writing a program that will run on any computer and writing a program that looks and works like a good BlackBerry software application. There is certainly room for both kinds of programs in the world, and the designers of the BlackBerry device let you make that choice yourself.

addCode ("SRV1", 1, {"ftpA://code/srv1/main.class", "ftpA://code/srv1/aux.class"}); addCode ("SRV1", 2, {"ftpB://opt/srv1/main.class", "ftpB://opt/srv1/aux.class"}); addCode ("SRV1", 3, "ftpC://context/srv1/main.class", "ftpC://context/srv1/aux.class"});

Much research has been carried out to study the electromigration pattern as well as the factors that affect electromigration [1 64, 72 135]. In this section, the basic mechanisms and associated factors affecting electromigration are discussed.

To summarize, duration and convexity are important risk-measuring variables for bonds. While duration might be sufficient for scenarios where only small changes in yield are involved, both duration and convexity generally are required to capture the full effect of a price change in most fixed income securities.

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