Unknown book. Read 16 reviews from the world's largest community for readers. Rumsfeld's statement brought much fame and public attention to the concepts of known knowns, known unknowns, and unknown unknowns, but national security and intelligence professionals have long used an analysis technique referred to as the Johari window.The idea of unknown unknowns was created in 1955 by two American psychologists, Joseph Luft (1916–2014) and Harrington Ingham (1916.
Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas. Cancers often spread from their primary site (the part of the body where the cancer started) to one or more metastatic sites (other parts of the body). Cancers are named based on their primary site, regardless of where in the body they spread. For example, a lung cancer that spreads to the liver is still classified as lung cancer and not as liver cancer.
Sometimes it’s not clear where a cancer may have started. When cancer is found in one or more metastatic sites but the primary site cannot be determined, it is called a cancer of unknown primary (CUP) or an occult primary cancer. This happens in a small portion of cancers.
Further tests may eventually find the primary site of some of these cancers. When this happens, they are no longer considered a cancer of unknown primary and are renamed and treated according to where they started.
As an example, a person has an enlarged lymph node on the side of their neck. When it is removed, cancer is found. But under the microscope it does not look like a cancer that normally starts in lymph nodes. At this point it might be considered a cancer of unknown primary. The way it looks under the microscope might suggest that the cancer started in the mouth, throat, or voice box (larynx). When this area is examined, a small cancer of the larynx might be found. From then on, the patient is said to have laryngeal cancer rather than a cancer of unknown primary and will get treated for that type of cancer.
In many cases, the source of the cancer is never determined. The most thorough search still might not find the primary site. Even when doctors do autopsies on people who have died of cancer of unknown primary, they are often still unable to find the site where the cancer started.
The main reason to look for the primary site of a CUP is to guide treatment. Since a cancer that starts in one place needs the same treatments when it spreads, knowing where a cancer started tells the doctor what types of treatments to use. This is especially important for certain cancers that respond well to specific chemotherapy or hormone drugs. When the types of cancer that respond best to treatment have been ruled out by tests, it usually becomes less important to find the exact origin or cancer type.
But even if the primary site is not known, treatment can still be successful. How the cancer cells look under the microscope, the results of lab tests, and information about which organs it has already affected can help doctors predict what kinds of treatment might be helpful.
To learn more about how cancers start and spread, see What Is Cancer?
General cancer types
Cancers are classified by their primary site. They can also be grouped by the types of cells in them, how the cancer cells look under the microscope, and on results of certain lab tests on the cells. Knowing the type of cell might give doctors a clue as to where the cancer started. When the cancer cells closely resemble normal cells of the organ where they start, the cancer is called well differentiated. When the cells do not look much like normal cells, the cancers are called poorly differentiated. Cancers of unknown primary are often poorly differentiated.
Carcinomas
A carcinoma is a cancer that begins in the cells that line the inside or outside of a body organ. These cells are called epithelial cells. There are different types of carcinomas, depending on how the cancer cells look when seen with a microscope. The most common types are squamous cell carcinoma and adenocarcinoma.
Squamous cell cancers
Cancers formed by flat cells that look like cells normally found on the surface of the skin or the linings of certain organs are called squamous cellcancers orsquamous cell carcinomas. Squamous cell cancers can start in the mouth, throat, esophagus, lungs, anus, cervix, vagina, and some other organs.
Adenocarcinomas
Cancers that develop from gland cells (cells that secrete a substance) are called adenocarcinomas. Gland cells are found in many organs of the body, including some that are not usually thought of as glands. For example, most cancers in the stomach, intestines, and colon are adenocarcinomas. About 4 of 10 lung cancers are adenocarcinomas. Adenocarcinomas can also develop in many other organs.
Other cancer types
Less common types of cancer can develop from other cell types.
- Lymphomas develop from cells of the immune system found in lymph nodes and several other organs.
- Melanomas develop from cells that produce the skin’s tan or brown color.
- Sarcomas develop from connective tissue cells that usually are present in tendons, ligaments, muscle, fat, bones, cartilage, and related tissues.
- Germ cell tumors can develop in the testes (testicles) in men or the ovaries in women, or in the parts of the body where these organs developed in the fetus.
This list is not intended to include all types of cancers but merely to name the most common ones.
Broad categories of cancers of unknown primary
When first looking at the cancer cells under a microscope, doctors usually classify a cancer of unknown primary (CUP) into 1 of 5 broad categories. Many of these cancers can be better classified later on, after more extensive testing.
Adenocarcinoma
As noted before, these cancers develop from gland cells. They make up about 6 of 10 cases of CUP.
Poorly differentiated carcinoma
![Unknown Unknown](https://i.ytimg.com/vi/pao0rYs97Ek/maxresdefault.jpg)
When looking at these cancers under a microscope, there is enough detail to tell that they are carcinomas, but the cells are too irregular to classify them further. These cancers make up about 3 of 10 cases of CUP. On further testing, about 10% of these turn out to be lymphoma, melanoma, or sarcoma.
Squamous cell cancer
These cancers look like the flat cells on the surface of the skin or the linings of certain organs.
Poorly differentiated malignant neoplasm
These are clearly cancers, but the cells are so abnormal that the doctor can’t tell what type of cell they may have started from. Most of them turn out to be lymphomas, sarcomas, or melanomas. Some turn out to be carcinomas upon further testing.
Neuroendocrine carcinoma
These rare cancers start from cells of the diffuse neuroendocrine system. This system has cells that are like nerve cells in certain ways and like hormone-makingendocrine cells in other ways. These cells do not form an actual organ like the adrenal or thyroid glands. Instead, they are scattered throughout other organs like the esophagus, stomach, pancreas, intestines, and lungs. These cancers account for a small number of CUP cases. (Some poorly differentiated cancers are found to be neuroendocrine carcinomas upon further testing.)
Unknown Pokemon
Even when doctors don’t know where the cancer started, they do their best to classify the type of cancer. This can help them select the best treatment. Some cancers respond very well to specific treatments, so it is very important to classify the cancer as much as possible. This is best done by looking at the cancer under a microscope and doing special tests in the lab (see Tests for a Cancer of Unknown Primary).
Other types
Lymphoma often does not have a clear primary site, but it’s not considered a CUP.
Although the primary site of a melanoma may not be clear, once a cancer is classified as a melanoma, it’s no longer called a CUP.
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Unknown Woman Korean Drama
Rumsfeld during a Pentagonnews briefing in February 2002
'There are known knowns' is a phrase from a response United States Secretary of DefenseDonald Rumsfeld gave to a question at a U.S. Department of Defense (DoD) news briefing on February 12, 2002, about the lack of evidence linking the government of Iraq with the supply of weapons of mass destruction to terrorist groups.[1]
Rumsfeld stated:
Reports that say that something hasn't happened are always interesting to me, because as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns—the ones we don't know we don't know. And if one looks throughout the history of our country and other free countries, it is the latter category that tend to be the difficult ones.[1]
The statement became the subject of much commentary including a documentary film, The Unknown Known, directed by Errol Morris.[2]
Origin[edit]
Rumsfeld's statement brought much fame and public attention to the concepts of known knowns, known unknowns, and unknown unknowns, but national security and intelligence professionals have long used an analysis technique referred to as the Johari window. The idea of unknown unknowns was created in 1955 by two American psychologists, Joseph Luft (1916–2014) and Harrington Ingham (1916–1995) in their development of the Johari window. They used it as a technique to help people better understand their relationship with themselves as well as others.
The term was also commonly used inside NASA.[3] Rumsfeld himself cited NASA administratorWilliam Graham in his memoir; he wrote that he had first heard 'a variant of the phrase' from Graham when they served together on the Commission to Assess the Ballistic Missile Threat to the United States during the late-1990s.[4] Kirk Borne, an astrophysicist who was employed as a data scientist at NASA Goddard Space Flight Center at the time, noted in an April 2013 TED talk that he had used the phrase 'unknown unknowns' in a talk to personnel at the Homeland Security Transition Planning Office a few days prior to Rumsfeld's remarks, and speculated that the term may have percolated up to Rumsfeld and other high-ranking officials in the defense department.[5]
The terms 'known unknowns' and 'unknown unknowns' are often used in project management and strategic planning[6] circles.
Known unknowns refers to 'risks you are aware of, such as canceled flights....'[7]
Unknown unknowns are risks that come from situations that are so unexpected that they would not be considered. 'For example, prior to the invention of the personal computer, manufacturers of typewriters probably didn't foresee the risks to their business.'[7] Contemporary usage is largely consistent with the earliest known usages. For example, the term was used in evidence given to the British Columbia Royal Commission of Inquiry into Uranium Mining in 1979:
Unknown Proxies
Site conditions always pose unknowns, or uncertainties, which may become known during construction or operation to the detriment of the facility and possibly lead to damage of the environment or endanger public health and safety. The risk posed by unknowns is somewhat dependent on the nature of the unknown relative to past experience. This has led me classify unknowns into one of the following two types: 1. known unknowns (expected or foreseeable conditions), which can be reasonably anticipated but not quantified based on past experience as exemplified by case histories (in Appendix A) and 2. Unknown unknowns (unexpected or unforeseeable conditions), which pose a potentially greater risk simply because they cannot be anticipated based on past experience or investigation.Known unknowns result from recognized but poorly understood phenomena. On the other hand, unknown unknowns are phenomena which cannot be expected because there has been no prior experience or theoretical basis for expecting the phenomena.[8]
The term also appeared in a 1982 New Yorker article on the aerospace industry, which cites the example of metal fatigue, the cause of crashes in de Havilland Cometairliners in the 1950s.[9]
Reaction[edit]
While the remarks initially led to some ridicule towards the Bush administration in general and Rumsfeld in particular, the consensus regarding it has shifted over the years, and it now enjoys some level of respect. For example, Rumsfeld's defenders have included Canadian columnist Mark Steyn, who called it 'in fact a brilliant distillation of quite a complex matter',[10] and Australian economist and bloggerJohn Quiggin, who wrote, 'Although the language may be tortured, the basic point is both valid and important.'[11]
Psychoanalytic philosopher Slavoj Žižek says that beyond these three categories there is a fourth, the unknown known, that which we intentionally refuse to acknowledge that we know: 'If Rumsfeld thinks that the main dangers in the confrontation with Iraq were the 'unknown unknowns', that is, the threats from Saddam whose nature we cannot even suspect, then the Abu Ghraib scandal shows that the main dangers lie in the 'unknown knowns'—the disavowed beliefs, suppositions and obscene practices we pretend not to know about, even though they form the background of our public values.'[12]
German sociologists Daase and Kessler (2007) agree with a basic point of Rumsfeld in stating that the cognitive frame for political practice may be determined by the relationship between what we know, what we do not know, what we cannot know, but Rumsfeld left out what we do not like to know.[13]
The event has been used in multiple books to discuss risk assessment.[2][14]
Rumsfeld named his autobiography Known and Unknown: A Memoir. In an 'Author's Note' at the start of the book, he expressly acknowledged the source of his memoir's title and mentioned a few examples of his statement's prominence, including a Wikipedia article.[15]The Unknown Known is the title of Errol Morris's 2013 biographical documentary film about Rumsfeld.[16]
In addition, the comment earned a Foot in Mouth Award.
Analytical sciences[edit]
The term 'known unknowns' has been applied to the identification of chemical substances using analytical chemistry approaches, specifically mass spectrometry. In many cases, an unknown to an investigator that is detected in an experiment is actually known in the chemical literature, a reference database, or an internet resource. These types of compounds are termed 'known unknowns'. The term was originally coined by Little et al.[17] and reported a number of times in the literature since then as a general approach.[18][19][20][21]
See also[edit]
References[edit]
- ^ ab'Defense.gov News Transcript: DoD News Briefing – Secretary Rumsfeld and Gen. Myers, United States Department of Defense (defense.gov)'.
- ^ abGirard, John; Girard, JoAnn (June 1, 2009). A Leader's Guide to Knowledge Management: Drawing on the Past to Enhance Future Performance. Business Expert Press. pp. 55–. ISBN9781606490198. Retrieved February 10, 2014.
- ^'NASA Program Management and Procurement Procedures and Practices: Hearings Before the Subcommittee on Space Science and Applications of the Committee on Science and Technology, U.S. House of Representatives, Ninety-seventh Congress, First Session, June 24, 25, 1981'. 1981.
- ^Rumsfeld, Donald (2011). Known and Unknown: A Memoir. New York: Penguin Group. p. xiv. ISBN9781101502495.
- ^'Big Data, Small World: Kirk Borne at TEDxGeorgeMasonU'. Retrieved September 14, 2015.
- ^'Strategy Under Uncertainty'. November 1997.
- ^ abBiafore, Bonnie (December 14, 2011). 'Project Management Fundamentals'. Lynda.com. Lynda.com/LinkedIN. Retrieved October 17, 2015.
- ^Statement of Evidence of E. D'Appolonia, D'Appolonia Consulting Engineers, Pittsburgh, Pennsylvania. Phase V: Waste Disposal. Proceedings of the British Columbia Royal Commission of Inquiry into Uranium Mining. ISBN978-0-7718-8198-5. 0005037606.
- ^Newhouse, J. (June 14, 1982), 'A reporter at large: a sporty game; 1-betting the company', New Yorker, pp. 48–105.
- ^Steyn, Mark (December 9, 2003). 'Rummy speaks the truth, not gobbledygook'. Daily Telegraph. Retrieved October 30, 2008.
- ^Quiggin, John (February 10, 2004). 'In Defense of Rumsfeld'.
- ^'What Rumsfeld Doesn't Know That He Knows About Abu Ghraib'. Retrieved February 23, 2009.
- ^Knowns and Unknowns in the 'War on Terror': Uncertainty and the Political Construction of Danger, Christopher Daase and Oliver Kessler, Security Dialogue, December 2007; vol. 38, 4: pp. 411–434.
- ^Neve, Geert de; Luetchford, Peter (2008). Hidden Hands in the Market: Ethnographies of Fair Trade, Ethical Consumption, and Corporate Social Responsibility. Emerald Group Publishing. pp. 252–. ISBN9781848550582. Retrieved February 10, 2014.
- ^Rumsfeld, Donald (2011). Known and Unknown: A Memoir. New York: Penguin Group. p. xiii. ISBN9781101502495.
- ^Scott (2014). 'Not Giving an Inch in a Battle of Wits and Words; Deciphering Donald H. Rumsfeld in 'The Unknown Known''. The New York Times. Retrieved April 4, 2014.
- ^Little, J.L.; Cleven, C.D.; Brown, S.D. (2011). 'Identification of 'Known Unknowns' utilizing accurate mass data and chemical abstracts service databases'. J. Am. Soc. Mass Spectrom. 22 (2): 348–359. Bibcode:2011JASMS..22..348L. doi:10.1007/s13361-010-0034-3. PMID21472594.
- ^Little, James L. (2011). 'Identification of 'known unknowns' utilizing accurate mass data and ChemSpider'. Journal of the American Society for Mass Spectrometry. 23 (1): 179–185. doi:10.1007/s13361-011-0265-y. PMID22069037.
- ^Stein, S. (2012). 'Mass Spectral Reference Libraries: An Ever-Expanding Resource for Chemical Identification'. Analytical Chemistry. 84 (17): 7274–7282. doi:10.1021/ac301205z. PMID22803687.
- ^McEachran, Andrew D.; Sobus, Jon R.; Williams, Antony J. (2016). 'Identifying known unknowns using the US EPA's CompTox Chemistry Dashboard'. Analytical and Bioanalytical Chemistry. 409 (7): 1729–1735. doi:10.1007/s00216-016-0139-z. PMID27987027.
- ^Schymanski, Emma L.; Williams, Antony J. (2017). 'Open Science for Identifying 'Known Unknown' Chemicals'. Environmental Science and Technology. 51 (10): 5357–5359. Bibcode:2017EnST...51.5357S. doi:10.1021/acs.est.7b01908. PMC6260822. PMID28475325.
Unknown Frozen 2
External links[edit]
Unknown Comics
- 'Defense Department Briefing'. C-SPAN. February 12, 2002.
Reporter:37:19 ...Because there are reports that there is no evidence of a direct link between Baghdad and some of these terrorist organizations.
Rumsfeld: Reports that say that something hasn't happened are always interesting to me... - 'DoD News Briefing – Secretary Rumsfeld and General Myers'. Transcript. Press Operations. US Department of Defense. February 12, 2002.
- Logan, David C. (March 1, 2009). 'Known knowns, known unknowns, unknown unknowns and the propagation of scientific enquiry'. Journal of Experimental Botany. 60 (3): 712–4. doi:10.1093/jxb/erp043. PMID19269994.
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