Determinism is a philosophical view, where all events are determined completely by previously existing causes. Deterministic theories throughout the history of philosophy have developed from diverse and sometimes overlapping motives and considerations. The opposite of determinism is some kind of indeterminism (otherwise called nondeterminism) or randomness. Determinism is often contrasted with free will, although some philosophers claim that the two are compatible.Determinism is often used to mean causal determinism, which in physics is known as cause-and-effect. This is the concept that events within a given paradigm are bound by causality in such a way that any state of an object or event is completely determined by its prior states. This meaning can be distinguished from other varieties of determinism mentioned below. Debates about determinism often concern the scope of determined systems; some maintain that the entire universe is a single determinate system, and others identifying more limited determinate systems (or multiverse). Historical debates involve many philosophical positions and varieties of determinism. They include debates concerning determinism and free will, technically denoted as compatibilistic (allowing the two to coexist) and incompatibilistic (denying their coexistence is a possibility). Determinism should not be confused with the self-determination of human actions by reasons, motives, and desires. Determinism is about interactions which affect our cognitive processes in our life. It is about the cause and the result of what we have done. Cause and result are always bounded together in cognitive processes.
Adenomyomatosis is a benign condition characterized by hyperplastic changes of unknown cause involving the wall of the gallbladder. Adenomyomatosis is caused by an overgrowth of the mucosa, thickening of the muscular wall, and formation of intramural diverticula or sinus tracts termed Rokitansky–Aschoff sinuses, also called entrapped epithelial crypts. Signs and symptoms
Pathophysiology
Rokitansky–Aschoff sinuses
Rokitansky–Aschoff sinuses are pseudodiverticula or pockets in the wall of the gallbladder. They may be microscopic or macroscopic. Histologically, they are outpouchings of gallbladder mucosa into the gallbladder muscle layer and subserosal tissue as a result of hyperplasia and herniation of epithelial cells through the fibromuscular layer of the gallbladder wall.Rokitansky–Aschoff sinuses are not of themselves considered abnormal but they can be associated with cholecystitis.They form as a result of increased pressure in the gallbladder and recurrent damage to the wall of the gallbladder. Associations
Black pigment gallstones can form in Rokitansky–Aschoff sinuses of the gallbladder after the fourth to fifth decades of life in absence of the typical risk factors for bilirubin supersaturation of bile. Hence, they are associated with gallstones (cholelithiasis). Cases of gall bladder cancer have also been reported to arise from Rokitansky–Aschoff sinuses. Diagnosis
Abdominal ultrasound has low accuracy in differentiating gall bladder adenomyomatosis from cancer and is operator dependent. However, it is used as the exam of the first-line due to its wide availability. Ultrasound findings may show thickened gall bladder wall, tiny anechoic spaces (Rokitansky–Aschoff sinuses or RAS), and twinkling artifact (or comet-tail reverberation).