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The patient isdiagnosed with idiopathic autoimmune hemolytic ane-mia

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Diagram showing three transmembraneproteins involved in the formation of zonula occludens: occludin, claudin, and junctional adhesion molecule (JAM). At the same time, in response tolocal growth factors, fibroblasts and vascular endothelial cellsbegin to proliferate and migrate into the delicate fibrin matrixof the blood clot, forming the granulation tissue, a special-ized type of tissue characteristic of the repair process. In places,the membranous labyrinthforms the lining of the bony labyrinth; in other places, there is a separation of the two

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When I start to think about fall and september will do that to you, I often remember picking Concord grapes on my grandparents weekend farm. I loved the scent and color of these deep purple grapes. Concord grapes are not easy to find.  They originated in the 1800’s in Concord Massachusetts. Today, these grapes are primarily found in New York, Massachusetts and the Pacific Northwest.  I find them briefly in the farmer’s markets or a few specialty stores. Almost every knows this grape from Concord Grape Jelly, but I have found not many people buy these grapes fresh. I think it’s the fact that the grapes are loaded with seeds, but the delicious grape flavor is worth the trouble with the seeds.

 

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Concord Grape Ice Cream
Makes approximately 1 1/2 quarts

Ingredients
2 pounds Concord Grapes, stemmed
1 cup whole milk
2 cups heavy cream
3/4 cup superfine granulated sugar
pinch fine sea salt
optional: Concord Grape Jelly

Equipment: ice cream maker

Directions
Puree half the grapes in a food processor until smooth. Take a medium bowl and place over it a fine sieve, pressing the mixture into the mesh with the back of a spoon. Discard the solids remaining in the sieve. Repeat process with the remaining grapes. You should have approximately 1 1/2 cups grape juice. In a medium sauce pan place the milk, cream, sugar and salt. Heat and stir until the sugar is dissolve. Pour into bowl with the grape juice and blend. Cover with plastic wrap and chill in the refrigerator for at least 4 hours. Freeze in an ice cream maker according to directions and then place in an airtight container and put into the freezer to firm up for at least 3 hours. Serve plain or melt a few tablespoons of concord grape jelly in the mircowave for 30 seconds. The jelly will turn into a syrup you can then spoon over the ice cream. Serve along with peanut butter shortbread.

Peanut Butter Shortbread
Makes 36 small cookies

Ingredients
8 tablespoons softened unsalted butter ( 1 stick)
1/4 cup confectioner’s sugar
1/2 teaspoon vanilla
1 1 /4 cup all purpose flour
1/2 teaspoon fine sea salt
1/3 cup smooth peanut butter

Directions
Using the paddle attachment of an electric mixer, beat the butter,sugar, vanilla and salt until creamy and light, about 2 minutes. Place mixer on low speed and add the flour. Once combined add the peanut butter and blend well. Remove from the bowl and divide the dough into two and place onto two sheets of plastic wrap. Shape each into a log about 3/4 inch thick. Wrap into the plastic and place into the refrigerator to chill for 2 hours. To bake, preheat oven to 350 degrees F. Unwrap logs and slice into 1/4 inch rounds using a serrated knife. Arrange slices onto a baking sheet about an inch apart. Bake for 10 to 15 minutes until light brown at the edges. Cool baking sheets for a minute and then transfer cookies to rack to cool completely.

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I think every holiday is a great excuse for a little celebration! I love finding reasons for a little decorating and some holiday theme cooking. St Patrick’s Day is no exception. So when I sat down to think of an Irish twist to one of my regular recipes, I came up with this Irish Coffee gelato . It just took some instant expresso and irish whiskey to transform one of my gelato recipes. Once you try this gelato you’ll want every day to be St. Patrick’s Day, as for me, I won’t be waiting for St. Patrick’s Day to make this recipe again! Enjoy!

From By the Bay , wishing found Irish food memories!
Maryann
Irish Coffee and Chocolate Chip Gelato
Makes 1 quart
Ingredients
2 cups whole milk
4 tablespoons instant espresso coffee
3/4 cup sugar
5 large egg yolks
pinch of kosher salt
1/2 cup heavy cream
3 tablespoons irish whiskey
4 ounces bittersweet chocolate, chopped
2 teaspoons vegetable oil
Directions
Place in a saucepan milk and instant espresso coffee. Bring milk to a simmer, whisking to dissolve the coffee powder. In another bowl whisk sugar, egg yolks and salt together and keep to the side. Gradually add a little milk to the egg mixture whisking the mixture to temper the eggs . Continue to slowly add the milk. Make sure to do this step slowly, so not to scramble the eggs. Once you have added the milk to the eggs, return the mixture to the saucepan on medium heat until the mixture thickens into a custard. The custard will coat the back of the spoon, and the temperature will be between 170 to 175 degrees F. This will take about 5 minutes. Strain the mixture through a fine mesh sieve into a bowl. Add the heavy cream and whiskey and stir. Chill in the refrigerator for 4 hours. To make gelato, place chilled custard into an ice cream maker according to manufacturer’s instructions. When the mixture starts to thicken, melt chocolate in a bowl with the oil using the microwave, do in 30 seconds intervals stirring in between until melted., this will take 2 to 3 times. Cool slightly and pour chocolate into gelato while churning. The chocolate will become chips as it continues to churn. Once completed place into an air tight plastic container and keep in the freezer until ready to serve.