Rheumatoid Arthritis (RA) and Guillain-Barre Syndrome (GBS)

Rheumatoid Arthritis (RA) and Guillain-Barre Syndrome (GBS) Inflammation is a protective reaction associated with vascular tissues in response to different stimuli such as irritants and pathogens. In addition, other causes of inflammation may include physical injuries and immune reactions on body cells and tissues. Therefore, inflammatory reactions serve to eliminate the stimuli and start the process of healing on damaged cells, tissues, and organs (Ferrero-Miliani et al., 2007, p. 227). Conversely, these inflammatory reactions can be chronic or acute. This essay presents the etiology, pathogenesis, diagnosis, clinical manifestations, prognosis, and the treatment of Rheumatoid Arthritis (RA) and Guillain-Barre Syndrome (GBS). Rheumatoid Arthritis (RA) Scenario: 45 years old woman started with severe pain in her hands and feet. She noticed that she could not shake her wrists whilst she was doing PE with her students in the gym. About 2 month later, when she was working in her yard, the pain became even more pronounced. She was digging the yard for make a path way. The garden working was difficult to do because every day her feet hurt and the strength in her hands was so reduced that even lifting a large boiling pot in the staff kitchen was difficult. At night times she put her hands under her pillow to try to reduce the pain so that she could sleep. Chronic immune inflammatory reactions can occur on synovial tissues in response to the synovitis, synovial cells, and the accumulated synovial fluid in the joints. This type of autoimmunity causes Rheumatoid arthritis (Majithia Geraci, 2007). The symptoms of RA are not only limited to the articular regions but they can also spread to other parts of the body. Therefore, RA affects the joints, skin, lungs, kidneys, blood vessels, heart, and other systemic tissues. In addition, the disorder leads to destruction of the ankylosis and cartilage lining the joints. It also causes nodular lesions on the skin and diverse inflammatory reactions on different systemic tissues (Majithia Geraci, 2007, p. 937). The clinical diagnosis of RA involves physical examination of symptoms, blood tests, x-ray radiographic imaging, and other differential diagnoses, which are aimed at distinguishing the symptoms of RA from other disorders. Moreover, the pathogenesis of RA entails proliferation and fibrosis of cells; the destruction of cartilage and bones; and pannus formation. These changes are caused by the activities of proteolytic enzymes, cytokines, and prostanoids in the synovial region (Majithia Geraci, 2007, p. 937). Here, inflammation is mediated by Tumor Necrosis Factor-alpha and Interleukin-1 (IL-1), which are the most notable pro-inflammatory cytokines in the disease process of RA. The two cytokines enhance the production of other inflammatory elements such as nitric oxide (NO) and prostaglandin E2 (PGE2). However, IL-1 has shown prominence in the pathogenesis of RA. Initial IL-1 release stimulates osteoblasts, synoviocytes, and chondrocytes. The cells take part in the inflammatory reactions, bone destruction, and pannus formation. Furthermore, the inflammatory reactions elevate the secretion of IL-1 relative to the progress of the disease. In addition, IL-1 stimulates the movement of neutrophils into the synovial region; the production and differentiation of lymphocytes; and finally the activation of macrophages. Additional IL-1 production leads to severe erosion of bone and cartilage, produces pain, and impairs tissue repair (Majithia Geraci, 2007). Lastly, Rheumatoid arthritis can be treated using medications such as analgesics, steroids, and disease-modifying antirheumatic drugs (DMARDs). In addition, non-pharmacological therapies such as physical therapy and nutritional therapy can halt the development of the disease. Conversely, the prognosis of RA shows varied symptoms in different patients such as disabilities, poor prognostic factors, and sometimes death (Majithia Geraci, 2007, p. 939). Guillain-Barre Syndrome (GBS) Scenario: A 33 years old man have a burning, sensitive, irritated sensation under his skin that spread throughout his arms and upper body over few months in the beginning of 2010. He noticed his sense of balance was lost. Then over a several weeks more symptoms presented themselves. His hands began to shake and tremor, his ears began buzzing, tickly in his left foot and the muscle spasms appeared, and muscle strength getting weak and pain grew in his thighs. His speech became jumbled and his left pupil dilated. Acute infections of the peripheral nervous system can cause an autoimmune reaction in response to the pathogens and the host tissues. These immune responses are targeted at pathogens such as bacteria and the influenza virus but instead they attack the gangliosides of the nerve tissues (Hughes et al., 1999). This is the basis of GBS, which leads to inflammatory demyelination of the nerves and multiple neuropathies. Consequently, GBS is characterized by impaired sense of position, paralysis, absence of fever, areflexia, and symmetrical weaknesses that begin with the legs and spread to the upper limbs and finally to the face. Conversely, analyses of the cerebrospinal fluid and electrodiagnostics provide important insights into the diagnosis of GBS. In addition, observable paralysis and areflexia can be used as the immediate indicators of GBS. However, additional differential diagnoses are important to distinguish the symptoms of GBS with other disorders such as the Motor Neuron Disease (Hughes et al., 1999, p. 74). The pathogenesis of GBS is associated with immune responses targeted at an acute infection. However, the pathogens involved in the infection contain epitopes resembling some components of the peripheral nervous system. Therefore, the immune reaction attacks the nerve components causing acute inflammation on the myelin sheath or the axon (Hughes et al., 1999). Furthermore, the inflammatory reactions cause severe demyelination in the nodes of Ranvier and nerve roots. These inflammatory reactions are mediated by both the cellular and humoral immune components such as activated T-lymphocytes, which invade the demyelinated regions and attract macrophages that destroy the nerve membranes. Additional demyelination is thus, mediated by the macrophages and components of the complement system. Lastly, the treatment of GBS entails providing supportive care for patients with paralyzed diaphragms and intravenous injections of immunoglobulin for stable patients. In addition, administration of plasmapheresis is recommended. Conversely, except for isolated cases of persistent areflexia, the prognosis of GBS shows that most patients begin recovering at the forth week after the onset and they can be completely healed after a few months or one year. Conclusion The essay presents a detailed discussion on two inflammatory conditions, which are caused by immune responses that target cells, tissues, and organs in the body. Therefore, the essay examines the etiology, clinical manifestations, diagnosis, pathogenesis, treatment, and the prognosis of Rheumatoid arthritis and Guillain-Barre Syndrome (GBS). From the discussions above, it can be deduced that inflammation is a serious complication, which occurs in the whole body or within a specific tissue and causes acute or chronic symptoms. However, most inflammatory conditions are treatable and preventable.

Workplace Promotion Research :: essays research papers

Workplace Promotion   Ã‚  Ã‚  Ã‚  Ã‚  In order to be promoted at work, it has always been said to put your best foot forward, strive to be the best, or always give 110%. Recent studies conducted by MSN, as well as references to books such as The Case for Marriage by Linda Waite and Maggie Gallagher, state other influences can impact the chances of enhancing a career. The hypotheses made suggests that if you are too successful in your current position then you have less likely a change to be recognized for an advancement; married individuals seem to be happier in the workplace and tend to be more successful. Many individuals consider themselves hard workers and yet seem to be overlooked for promotions because they are too hard to replace. If these hypotheses are true, how can a single person elevate themselves within the company? Being visible by showing superiors you are reliable and on their team will increase the chances for a promotion. Working with individuals the supervisor is familiar with as well as showing you can be trusted are also important for moving up in the organization. A similar article in Career builder on MSN suggests that married individuals are favored by their employers and recognized for promotions. How can this be true? According to their study, married people have better mental health, live longer, and are 15% happier than single individuals. Married individuals are preferred over single individuals by employers since they tend to be happier, which leads to higher production.   Ã‚  Ã‚  Ã‚  Ã‚  It is difficult to fill a position of someone who is seen by the company as irreplaceable; individuals can easily be passed over for a promotion if they are superior in their current position.

Fool Chapter 18

EIGHTEEN KITTEN'S CLAWS We entered Castle Gloucester in stealth, which does not suit me, as you might guess. I am better suited to entering a room with a series of somersaults, a clack-stick, rude noise, and a â€Å"top o' the mornin' to ye, tossers!† I'm fitted out in bells and puppets, for fuck's sake. All this sneaking and subterfuge was wearing on me. I followed the Earl of Gloucester through a secret hatch in the stable and into a tunnel that passed under the moat. We waded through a foot of cold water in the dark, making for a slosh in my step as well as a jingle. I'd never fit Drool through the narrow passage, even if I could chase the dark with a torch. The tunnel opened through another hatch in the floor of the dungeon. The earl took his leave in the very torture chamber where I had met Regan. â€Å"I'm off to arrange the passage for your master to Dover, fool. I still have a few servants who are true to me.† I felt indebted to the old man for helping me into the castle, especially given his former bitterness toward me. â€Å"Steer clear of the bastard, your grace. I know he is your favored son, but not rightly so. He's a villain.† â€Å"Don't disparage Edmund, fool. I know your conniving ways. Only last evening he stood with me in protest against Cornwall's treatment of the king.† I could tell Gloucester about the letter I'd forged in Edgar's hand, about the bastard's plan to usurp his brother, but what could he do? Likely he'd storm into Edmund's quarters and the bastard would murder him on the spot. â€Å"Right, then,† said I. â€Å"Be careful, my lord. Cornwall and Regan are a four-fanged viper, and if they should turn their venom on Edmund, you must let him go. Do not come to his aid, lest you, too, are scratched with poisonous pricks.† â€Å"My last true son. Shame on you, fool,† said the earl. He scoffed and hurried out of the dungeon and up the stairs. I thought to prevail upon one god or another to protect the old man, but if the gods were working in my favor, they would continue unbidden, and if they opposed, there was no need to alert them to my cause. It pained me, but I took off my shoes and hat and tucked them into my jerkin to still the bells. Jones had remained back at the hovel with Lear. The laundry lay in the lower levels of the castle, so I made my way there first. The laundress with the aforementioned knockers of the smashing persuasion was hanging a basketload of shirts by the fire when I entered. â€Å"Where's Drool, love?† I asked. â€Å"Hidden,† she said. â€Å"I know he's bloody hidden, otherwise asking would have been superfluous, wouldn't it?† â€Å"Just want me to give him up, then? How do I know you're not out to kill him? That old knight who brought him here said not to let anyone know where he was.† â€Å"But I'm here to get him out of the castle. Rescue him, as it were.† â€Å"Aye, you say that, but – â€Å" â€Å"Listen, you bloody tart, give up the git!† â€Å"Emma,† said the laundress. I sat down on the hearth and rested my head in my hands. â€Å"Love, I've spent the night in a storm with a witch and two raving nutters. I've a brace of wars to see to, as well as the summary violation of two princesses and consequent cuckolding of a pair of dukes. I'm heartbroken, aggrieved for the loss of a friend, and the great drooling lummox that is my apprentice is evidently wandering the castle in search of a mortal chest wound. Pity a fool, love – another non sequitur may dash my brittle sanity to splinters.† â€Å"My name is Emma,† said the laundress. â€Å"I'm right here, Pocket,† said Drool, standing up in the great cauldron. A pile of laundry on his head had been concealing his great empty melon as he lurked in the water. â€Å"Knockers hided me. She's a love.† â€Å"You see,† said Emma. â€Å"He keeps calling me Knockers.† â€Å"It's a compliment, love.† â€Å"It's disrespectful,† she said. â€Å"My name's Emma.† I will never understand women. The laundress, it would seem, dressed in a manner that accentuated, indeed, celebrated her bosoms – a tightly cinched waist pushing bits up until they bloomed out of a swooping neckline – yet a chap notices and the lady takes offense. I will never understand it. â€Å"You know he's a complete nitwit, don't you, Emma?† â€Å"Just the same.† â€Å"Fine. Drool, apologize to Emma for saying how smashing her knockers are.† â€Å"Sorry about your knockers,† said Drool, bowing his head so his laundry hat dropped back into the drink. â€Å"Satisfied, Emma?† I asked. â€Å"I suppose.† â€Å"Good. Now, do you know where Captain Curan, the commander of King Lear's knights might be?† â€Å"Oh yes,† said Emma. â€Å"Lord Edmund and the duke consulted me this morning on all the military matters, as they are wont to do – me being a laundress and having access to all the best bloody tactics and strategies and the lot.† â€Å"Sarcasm will make your tits fall off,† said I. â€Å"Will not,† said she, her arm going to a support position. â€Å"It's a known fact,† I said, nodding earnestly, then looking to Drool, who also nodded earnestly and said, â€Å"It's a known fact,† note for note in my voice. â€Å"That's bloody spooky.† Emma shuddered. â€Å"You lot can get out of my laundry.† â€Å"Very well, then,† said I. I motioned for Drool to climb out of the cauldron. â€Å"I thank you for looking after the Natural, Emma. I wish there were something I could – â€Å" â€Å"Kill Edmund,† she said. â€Å"Pardon?† â€Å"The son of a guild builder were going to marry me before I came to work here. A respected man. Edmund took me against my will and bragged about it in the village. My lad wouldn't have me then. No one worth his salt will have me, except the bastard, and him whenever he wants. ‘Tis Edmund who commanded that I wear this low frock. Says he'll set me out with the pigs if I don't give him service. Kill him for me.† â€Å"But lass, I'm just a fool. A clown. A small one at that.† â€Å"There's more to you than that, you black-hatted rascal. I've seen them wicked daggers at your back, and I can see who's pulling the strings round this castle, and it ain't the duke or the old king. Kill the bastard.† â€Å"Edmund beated me,† said Drool. â€Å"And she do have smashing knockers.† â€Å"Drool!† â€Å"Well, she do.† â€Å"All right, then,† said I, taking the laundress's hand. â€Å"But in time. We've things to accomplish first.† I bowed over her hand, kissed it, then turned on my heel and padded barefoot out of the laundry to set history. â€Å"Heinous fuckery,† Drool whispered to the laundress with a wink. I hid Drool in the gatehouse among the heavy chains that I had used for my escape when I pursued Lear into the storm. Getting the lummox up on the wall and to the gatehouse undetected was no small task, and he left a dripping trail on the stones until we gained the castle exterior, but the guard was light in the tempest, so most of the way we went across the top of the walls unseen. My feet felt as if they'd been set in ice by the time I came back in to a fire, but there was no other way. Drool in the tight space of the secret tunnel, with his fear of the dark was not something I would wish on an enemy. I found a woolen blanket and wrapped the lout in it to await my return. â€Å"Guard my shoes and my satchel, Drool.† I made my way, dodging from nook to cranny, through the kitchen, to the servants' entrance into the great hall, hoping I might get a moment with Regan there. The hall's massive fireplace would be an enticement for the princess on such a frigid day, for as much as she took to the activities of a dungeon, she was drawn to heat like a cat. Because Castle Gloucester had no curtain wall, even the great hall was fitted with arrow loops, so the edifice might be defended at all levels from an attack by water. The arrow loops, while shuttered, were notoriously drafty, so arrases[40] were hung over the alcoves against the wind – the perfect place for a fool to watch, warm himself, and find his moment. I slipped into the room behind a brace of serving girls and into the alcove nearest the fireplace. She was there, by the fire, in a heavy, hooded, black fur robe, only her face revealed to the world. I pulled the tapestry aside and was about to call to her when the latch was thrown on the hall's main doors and the Duke of Cornwall entered, wearing his usual finery with the red lion crest on his chest, but more pointedly, Lear's crown – the one the old man had thrown on the table that fateful night at the White Tower. Even Regan seemed startled to see it on the head of her husband. â€Å"My lord, is it prudent to wear the crown of Britain when our sister is still in the castle?† â€Å"Right, right, we must keep up appearances as if we don't know that Albany raises an army against us.† Cornwall took the crown off and hid it under a cushion by the hearth. â€Å"I am to meet Edmund here and lay a plan for the duke's undoing. One hopes that your sister can be kept out of harm's way.† Regan shrugged. â€Å"If she throws herself under destiny's hooves, who are we to save her brains from being pulped?† Cornwall took her in his arms and kissed her passionately. Oh lady, thought I, push him away lest you debase your lovely lips with villainy. Then it occurred to me, and perhaps rather later than it should have, that she would no more taste villainy than a garlic eater will taste the stinking rose on another. The lady had evil on her breath already. Even as the duke held her tight and professed his adoration of her, she wiped her mouth on her sleeve behind his back. She pushed the duke away when the bastard Edmund entered the hall. â€Å"My lord,† said Edmund, only nodding to Regan. â€Å"Our plans for Albany must be delayed. Look at this letter.† The duke took the parchment from Edmund. â€Å"What?† said Regan. â€Å"What, what, what?† â€Å"France has landed forces. He knows of unrest between ourselves and Albany and has hidden forces in coastal cities all over Britain.† Regan snatched the parchment out of Cornwall's hand and read it for herself. â€Å"This is addressed to Gloucester.† Edmund bowed in false contrition. â€Å"Aye, milady, I found it in his closet and brought it here as soon as I saw its contents.† â€Å"Guard!† called Cornwall. The great doors opened and a soldier looked in. â€Å"Bring me the Earl of Gloucester. Give no deference to his title, he is a traitor.† I looked for a way back to the kitchen, to perhaps find Gloucester and warn him of the bastard's treachery, but Edmund faced the alcove where I was hiding and there was no getting out undiscovered. I opened the shutter to the arrow loop. Even if I could manage to wiggle through it, the wall was a sheer drop to the lake below. I palmed the shutter closed and latched it. The latch on the main doors clanked again and I returned to the gap between the wall and the tapestry, from which I saw Goneril enter, trailed by two soldiers who held Gloucester by the arms. The old man looked as if he had given up already and hung between the soldiers like a drowned man. â€Å"Hang him,† said Regan, turning to warm her hands by the fire. â€Å"What is this?† said Goneril. Cornwall handed her the letter and stood looking over her shoulder while she read. â€Å"Pluck out his eyes,† she said, making an effort not to look at Gloucester. Cornwall took the letter gently from her hand and put his hand on her shoulder in brotherly support. â€Å"Leave him to our displeasure, sister. Edmund, keep our sister company and see her safely home. Lady, tell your duke we must unite against this foreign force. We'll send dispatches quickly between us. Go now, Earl of Gloucester, you do not want to see the dealings with this traitor.† Edmund couldn't conceal a smile upon being addressed by the title he had lusted after for so many years. â€Å"I will,† said Edmund. He offered his arm to Goneril, who took it. They started out of the hall. â€Å"No!† said Regan. Everyone stopped. Cornwall stepped between Regan and her sister. â€Å"Lady, now is the time when we must all be united against the foreign power.† Regan gritted her teeth and turned back to the fire, waving them away. â€Å"Go.† Edmund and Goneril left the hall. â€Å"Bind him to that chair, then leave us,† Cornwall commanded his soldiers. They tied the old earl to a heavy chair and stood back. â€Å"You are my guests,† said Gloucester. â€Å"Do me no foul play.† â€Å"Filthy traitor,† said Regan. She took the letter from her husband and threw it in the old man's face. She grabbed a pinch of Gloucester's beard and yanked it out. The earl yowled. â€Å"So white, and such a traitor,† she said. â€Å"I am no traitor. I am loyal to my king.† She pulled another pinch from his beard. â€Å"What letters do you have late from France? What is their plan?† Gloucester looked at the parchment on the floor. â€Å"I have only that.† Cornwall charged up to Gloucester and pulled the old man's head back by the back of his hair. â€Å"Speak now, to whose hands have you sent the lunatic king? We know you've sent him aid.† â€Å"To Dover. I sent him to Dover. Only a few hours ago.† â€Å"Why Dover?† said Regan. â€Å"Because I would not see your cruel nails pluck out his old eyes or your sister tear his flesh with her boarish fangs. Because there are those who would care for him there. Not put him out in the storm.† â€Å"He lies,† said Regan. â€Å"There's a smashing torture chamber in the dungeon, shall we?† But Cornwall would not wait. In a second he was sitting astraddle the old man and was digging his thumb into Gloucester's eye socket. Gloucester screamed until his voice broke and there was a sickening pop. I reached for one of my throwing daggers. The main door to the hall cracked and heads popped up in the stairwell from the kitchen. â€Å"Why Dover?† said Regan. â€Å"Thou carrion bird!† said Gloucester with a cough. â€Å"Thou she-devil, I'll not say.† â€Å"Then you'll not see light again,† said Cornwall, and he was on the old man again. I would not have it. I drew back my dagger to cast it, but before I could, a band like ice encircled my wrist and I looked to see the girl ghost right beside me, staying my throw, in fact, paralyzing me. I could move only my eyes to look back on the horror playing out in the great hall. Suddenly a boy brandishing a long butcher knife ran out of the kitchen stairwell and leapt on the duke. Cornwall stood and tried to draw his sword, but could not get it clear of the scabbard before the boy was on him, plunging the knife into his side. As the lad pulled back to stab again Regan drew a dagger from the sleeve of her robe and plunged it into the boy's neck, then stepped back from the spray of blood. The boy clawed at his neck and fell. â€Å"Away!† Regan shrieked, waving the dagger at the servants in the kitchen stairwell and the main door and they all disappeared like frightened mice. Cornwall climbed unsteadily to his feet and plunged his sword into the boy's heart. Then he sheathed his sword and felt his side. His hand came away bloody. â€Å"Serves you right, you scurvy vermin,† said Gloucester. With that Cornwall was on him again. â€Å"Out, foul jelly!† he shouted, digging his thumb into the earl's good eye, but in that instant Regan's dagger snapped down and took the eye. â€Å"Don't trouble yourself, my lord.† Gloucester passed out then from the pain and hung limp in his bonds. Cornwall stood and kicked the old man's chest, knocking him over backward. The duke looked on Regan with adoring eyes, filled with the warmth and affection that can only come from watching your wife dirk another man's eye out on your behalf, evidently. â€Å"Your wound?† said Regan. Cornwall held his arm out to his wife and she walked into his embrace. â€Å"It glanced across my ribs. I'll bleed some and it pains me, but if bound, it'll not be mortal.† â€Å"Pity,† said Regan, and she plunged her dagger under his sternum and held it as his heart's blood poured over her snowy-white hand. The duke seemed somewhat surprised. â€Å"Bugger,† he said, then he fell. Regan wiped her dagger and her hands on his tunic. She sheathed the blade in her sleeve, then went to the cushion where Cornwall had hidden her father's crown, pulled back her hood, and fitted it on her head. â€Å"Well, Pocket,† said the Duchess, without turning to the alcove where I was hidden. â€Å"How does it fit?† I was somewhat surprised (although somewhat less so than the duke). The ghost released me then, and I stood behind the tapestry, my knife still poised for the throw. â€Å"You'll grow into it, kitten,† said I. She looked to my alcove and grinned. â€Å"Yes, I will, won't I? Did you want something?† â€Å"Let the old man go,† I said. â€Å"King Jeff of France has landed his army at Dover, that's why Gloucester sent Lear there. You'd be wise to set a camp farther south. Rally your forces, with Edmund's and Albany's at the White Tower, perhaps.† The great doors creaked and a head peeked in, a helmeted soldier. â€Å"Send for a physician,† Regan called, trying to sound distressed. â€Å"My lord has been wounded. Throw his attacker on the dung heap and cast this traitor out the front gate. He can smell his way to Dover and his decrepit king.† In a moment the chamber was filled with soldiers and servants and Regan walked out, casting one last look and a sly smile to my hiding place. I have no idea why she left me alive. I suspect it's because she still fancied me. I slipped out through the kitchen and made my way back to the gatehouse. The ghost stood over Drool, who was cowering under his blanket in the corner. â€Å"Come on, you lovely brute, give us a proper snog.† â€Å"Leave him be, wisp!† said I, although she was nearly as solid as a mortal woman. â€Å"Balls up[41] your jaunty murdering for the day, did I, fool?† â€Å"I might have saved the old man's second eye.† â€Å"You wouldn't have.† â€Å"I might have sent Regan to join her duke in whatever hell he inhabits.† â€Å"No, you wouldn't have.† Then she held up a ghostly finger, cleared her throat, and rhymed: â€Å"When a second sibling's base derision, Proffers lies that cloud the vision, And severs ties that families bind, Shall a madman rise to lead the blind.† â€Å"You've said that one, already.† â€Å"I know. Bit prematurely, too. Sorry. I think you'll find it much more relevant now. Even a slow git like yourself can solve the riddle now, I reckon.† â€Å"Or you could just fucking tell me what it means,† said I. â€Å"Sorry, can't do it. Ghostly mystery and whatnot. Ta.† And with that she faded away through the stone wall. â€Å"I dinna shag the ghost, Pocket,† wailed Drool. â€Å"I dinna shag her.† â€Å"I know, lad. She's gone. Get up now, we've got to monkey down the drawbridge chains and find the blind earl.†

Beautiful-Sounding Words Competitions and Composition

What do you think is the most beautiful-sounding word in English? Consider these unpredictable choices by well-known writers, and then encourage your students to write about their favorite words. In a Beautiful Words contest held in 1911 by the Public Speaking Club of America, several submissions were deemed insufficiently beautiful, among them grace, truth, and justice. In the judgment of Grenville Kleiser, then a popular author of books on oratory, The harshness of the g in grace and the j in justice disqualified them, and truth was turned down because of its metallic sound (Journal of Education, Feb  1911). Among the acceptable entries were melody, virtue, harmony, and hope. Over the years there have been countless playful surveys of the most beautiful-sounding words in English. Perennial favorites include lullaby, gossamer, murmuring, luminous, Aurora Borealis, and velvet. But not all recommendations have been so predictable—or so obviously euphonious. When the New York Herald Tribune asked poet Dorothy Parker for her list of beautiful words, she replied, To me, the most beautiful word in the English language is cellar-door. Isnt it wonderful? The ones I like, though, are check and enclosed.James Joyce, author of Ulysses, chose cuspidor as the single most beautiful word in English.In the second volume of the Book of Lists, philologist Willard R. Espy identified gonorrhea as one of the ten most beautiful words.Poet Carl Sandburg chose Monongahela.Another poet, Rosanne Coggeshall, selected sycamore.Ilan Stavans, a Mexican-American essayist and lexicographer, dismissed the clichà ©s on a British Council survey of beautiful words (which included mother, passion, and smile) and instead nominated moon, wolverine, anaphora, and precocious.The favorite word of British author Tobias Hill is dog. Though he acknowledges that canine is a beautiful word, fit for a medieval greyhound in a tapestry, he prefers the spareness of the Anglo-Saxon in England.Novelist Henry James said that for him the most beautiful words in English were summer afternoon.When British essayist Max Beerbohm found out that gondola had been chosen as one of the most beautiful words, he replied that scrofula sounded the same to him. Of course, like other beauty contests, these verbal competitions are shallow and absurd. Yet consciously or not, dont most of us favor certain words for their sound as well as their sense? A Composition Assignment In her book Poets Pen, Betty Bonham Lies turned the beautiful-words list into a composition assignment for student writers: Assignment: Bring in to class two lists of words: the ten most beautiful words in the English language and the ten ugliest —  by sound only. Try to blot out what the words mean, and listen only to how they sound.In class: Have the students write their words on two blackboards or sheets of newsprint: the beautiful words on one, the ugly on the other. Put in some of your own favorites of both kinds. Then talk about what elements in the words seem to make them either attractive or unattractive. Why is pandemonium so euphonious when its meaning is a wild uproar? Why does crepuscular sound unpleasant when twilight is lovely? Discuss disagreement among students; ones beautiful word might be anothers ugly. ...Ask students to write a poem or a prose paragraph using at least five of the beautiful or ugly words. Tell them not to think about form. They might write a narrative, a vignette, a description, a list of metaphors or similes, or total nonsense. Then have them share what they have written.( The Poets Pen: Writing Poetry With Middle and High School Students. Libraries Unlimited, 1993) Now if youre in a sharing mood, why not pass along your nominations for the most beautiful words in English?