The voice of art and the art of medicine

2002 ◽  
Vol 97 (6) ◽  
pp. 1261-1268
Author(s):  
Stan Pelofsky ◽  
Raina Pelofsky
Keyword(s):  
American Association ◽  
Human Beings ◽  
Content Type ◽  
Human Voice ◽  
Practice Of Medicine ◽  
Film Clips ◽  
Authentic Life ◽  
The Voice ◽  
Fine Print

✓ Vincent van Gogh's life, letters, and art are the framework for this existential speech about the nature of alienation, as well as its threat to humanity and to the artful practice of medicine. The honest, human voice expressed in van Gogh's art stands in opposition to alienation, which occurs when we divide the world into two parts: the “perfect” world of science versus the “flawed” world of human experience. Bridging this divide allows for an “authentic” life, one which honestly defines itself and faces difficult human truths. The most difficult truth relates to our own mortality, but it must be faced if we are to understand the value of existence. Film clips from Woody Allen's Hannah and Her Sisters illustrate how an artist's portrayal of these issues can be both profound and humorous, and how art brings us closer to our own humanity and to the essence of medicine. Neurosurgeons are warned about the lure of science and technology as a substitute for purpose and meaning, both as physicians and as human beings. The role of the American Association of Neurological Surgeons is explored and found to offer neurosurgeons a bridge away from alienation and toward a neurosurgical community. Neurosurgeons are urged to find meaning through service to their profession and to find the voice and art of medicine. [Note: Actual film clips were used when this address was delivered. Unofficial transcripts of the clips have been included in this article so that the integrity of the speech would not be compromised.]

Structure and function: organization of a medical specialty for the rest of the 20th century

1982 ◽  
Vol 57 (3) ◽  
pp. 301-308 ◽  
Author(s):  
W. Kemp Clark
Keyword(s):  
20Th Century ◽  
American Association ◽  
Medical Specialty ◽  
Structure And Function ◽  
Concerted Effort ◽  
Content Type ◽  
The Past ◽  
And Function ◽  
Fine Print

✓ The President of the American Association of Neurological Surgeons concentrates on the problems facing the specialty, the achievements of the past, and the mechanisms designed to foster the advancement and role of neurosurgery. To counter the difficult days ahead, he emphasizes the need for concerted effort and action on the part of neurosurgeons within the umbrella of the Association as spokesman for the specialty and advocate for the patients' welfare.

The AANS: The national and international organization for neurological surgery

1992 ◽  
Vol 77 (5) ◽  
pp. 663-668 ◽  
Author(s):  
James T. Robertson
Keyword(s):  
American Association ◽  
International Organization ◽  
Strong Argument ◽  
Content Type ◽  
Harvey Cushing ◽  
International Role ◽  
Neurological Surgery ◽  
Fine Print

✓ The President of the American Association of Neurological Surgeons (AANS) validates the AANS as the national neurosurgical organization. He describes improved management of major committees of neurological surgery by the Joint Officers of the AANS and the Congress of Neurological Surgeons. A strong argument and proclamation are presented to expand the international role of the former Harvey Cushing Society.

Neurosurgery at the crossroads: leadership role of the American Association of Neurological Surgeons

1979 ◽  
Vol 51 (4) ◽  
pp. 429-436 ◽  
Author(s):  
Donald F. Dohn
Keyword(s):  
Patient Care ◽  
Long Range ◽  
American Association ◽  
Leadership Role ◽  
Professional Organizations ◽  
Content Type ◽  
History Of ◽  
Long Range Planning ◽  
Fine Print

✓ The President of the American Association of Neurological Surgeons (AANS) reviews the formative history of the major neurosurgical societies, together with their agreement to consolidate their efforts in the joint AANS. As a united group, the Association has been effective in carrying out relations with other professional organizations and with government. Long-range planning is being pursued steadily to increase the role of organized neurosurgery in maintenance of, and improvement in, patient care, education, and research.

scholarly journals Direct evidence for a key role of protein kinase C in the development of vasospasm after subarachnoid hemorrhage

1992 ◽  
Vol 76 (4) ◽  
pp. 635-639 ◽  
Author(s):  
Shigeru Nishizawa ◽  
Nobukazu Nezu ◽  
Kenichi Uemura
Keyword(s):  
Signal Transduction ◽  
Protein Kinase C ◽  
Protein Kinase ◽  
Direct Evidence ◽  
Control Group ◽  
Content Type ◽  
Kinase C ◽  
Protein Kinase C Activity ◽  
Fine Print

✓ Vascular contraction is induced by the activation of intracellular contractile proteins mediated through signal transduction from the outside to the inside of cells. Protein kinase C plays a crucial role in this signal transduction. It is hypothesized that protein kinase C plays a causative part in the development of vasospasm after subarachnoid hemorrhage (SAH). To verify this directly, the authors measured protein kinase C activity in canine basilar arteries in an SAH model with (γ-32P)adenosine triphosphate and the data were compared to those in a control group. Protein kinase C is translocated to the membrane from the cytosol when it is activated, and the translocation is an index of the activation; thus, protein kinase C activity was measured both in the cytosol and in the membrane fractions. Protein kinase C activity in the membrane in the SAH model was remarkably enhanced compared to that in the control group. The percentage of membrane activity to the total was also significantly greater in the SAH vessels than in the control group, and the percentage of cytosol activity in the SAH group was decreased compared to that in the control arteries. The results indicate that protein kinase C in the vascular smooth muscle was translocated to the membrane from the cytosol and was activated when SAH occurred. It is concluded that this is direct evidence for a key role of protein kinase C in the development of vasospasm.

Incidence of silent hemorrhage and delayed deterioration after stereotactic brain biopsy

1998 ◽  
Vol 89 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Abhaya V. Kulkarni ◽  
Abhijit Guha ◽  
Andres Lozano ◽  
Mark Bernstein
Keyword(s):  
Ct Scan ◽  
Neurological Deficit ◽  
Stereotactic Biopsy ◽  
Brain Biopsy ◽  
Ct Scanning ◽  
Ct Scans ◽  
Stereotactic Brain Biopsy ◽  
Content Type ◽  
Fine Print

Object. Many neurosurgeons routinely obtain computerized tomography (CT) scans to rule out hemorrhage in patients after stereotactic procedures. In the present prospective study, the authors investigated the rate of silent hemorrhage and delayed deterioration after stereotactic biopsy sampling and the role of postbiopsy CT scanning. Methods. A subset of patients (the last 102 of approximately 800 patients) who underwent stereotactic brain biopsies at the Toronto Hospital prospectively underwent routine postoperative CT scanning within hours of the biopsy procedure. Their medical charts and CT scans were then reviewed. A postoperative CT scan was obtained in 102 patients (aged 17–87 years) who underwent stereotactic biopsy between June 1994 and September 1996. Sixty-one patients (59.8%) exhibited hemorrhages, mostly intracerebral (54.9%), on the immediate postoperative scan. Only six of these patients were clinically suspected to have suffered a hemorrhage based on immediate postoperative neurological deficit; in the remaining 55 (53.9%) of 102 patients, the hemorrhage was clinically silent and unsuspected. Among the clinically silent intracerebral hemorrhages, 22 measured less than 5 mm, 20 between 5 and 10 mm, five between 10 and 30 mm, and four between 30 and 40 mm. Of the 55 patients with clinically silent hemorrhages, only three demonstrated a delayed neurological deficit (one case of seizure and two cases of progressive loss of consciousness) and these all occurred within the first 2 postoperative days. Of the neurologically well patients in whom no hemorrhage was demonstrated on initial postoperative CT scan, none experienced delayed deterioration. Conclusions. Clinically silent hemorrhage after stereotactic biopsy is very common. However, the authors did not find that knowledge of its existence ultimately affected individual patient management or outcome. The authors, therefore, suggest that the most important role of postoperative CT scanning is to screen for those neurologically well patients with no hemorrhage. These patients could safely be discharged on the same day they underwent biopsy.

Minds and brains: angels, humans, and brutes

1982 ◽  
Vol 57 (3) ◽  
pp. 309-315
Author(s):  
Mortimer J. Adler
Keyword(s):  
Nervous System ◽  
Animal Behavior ◽  
Personal Experience ◽  
Human Beings ◽  
Content Type ◽  
The Past ◽  
Wide Range ◽  
Conceptual Thought ◽  
The Brain ◽  
Fine Print

✓ In his 1982 Cushing oration, a distinguished philosopher, author, and discerning critic presents a distillate of his phenomenally wide range of personal experience and his familiarity with the great books and teachers of the present and the past. He explores the differences and relationships between human beings, brute animals, and machines. Knowledge of the brain and nervous system contribute to the explanation of all aspects of animal behavior, intelligence, and mentality, but cannot completely explain human conceptual thought.

scholarly journals Ibsen’s The Pillars of Society: Female Protest against Patriarchy

NUTA Journal ◽  
2020 ◽  
Vol 7 (1-2) ◽  
pp. 10-17
Author(s):  
Arjun Dev Bhatta
Keyword(s):  
Feminist Theory ◽  
Social Relationship ◽  
Status Quo ◽  
Human Beings ◽  
Female Characters ◽  
Female Protagonists ◽  
Male Characters ◽  
Patriarchal Power ◽  
The Voice

This study explores social relationship between male and female in Henrik Ibsen’s play “The Pillars of Society”. The first part of the study analyzes a sexist society in which male characters subjugate females through their hegemonic power. The female characters appear meek, submissive and voiceless. The second part of this study examines the revolutionary role of the female characters who raise their voice against all-pervasive patriarchal power. They protest against male formulated institutions which have kept women voiceless and marginalized. Being dissatisfied with the defenders of patriarchal status quo, Ibsen’s female protagonists come to the fore to challenge prevailing social conviction about femininity and domesticity. They lead a crusade to establish their position and identity as human beings equal to men. In this play, the female characters Lona, Martha and Dina hold a revolutionary banner to protest against male domination of female. In their constant struggle, they win while the male characters become loser. This study analyses the voice of these leading female characters in the light of feminist theory proposed by scholars such as Kete Millett and Sylvia Walby.

The role of craniectomy in the treatment of chronic subdural hematomas

1980 ◽  
Vol 52 (6) ◽  
pp. 776-781 ◽  
Author(s):  
George Tyson ◽  
W. Ellis Strachan ◽  
Peter Newman ◽  
H. Richard Winn ◽  
Albert Butler ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Chronic Subdural Hematoma ◽  
Neurological Deterioration ◽  
Neurological Dysfunction ◽  
Consecutive Series ◽  
Content Type ◽  
Significant Clinical Improvement ◽  
Acute Neurological Deterioration ◽  
Fine Print

✓ A consecutive series of 48 adult patients with a chronic subdural hematoma is reported. These patients were treated according to a protocol consisting of a sequence of conventional surgical procedures ranging from simple burr-hole drainage to craniotomy and subdural membranectomy. Seven patients (15%) continued to demonstrate severe neurological dysfunction, or suffered acute neurological deterioration after completion of this protocol. However, after undergoing excision of the cranial vault overlying the hematoma site, six of these seven patients demonstrated a significant clinical improvement. Based on analysis of these seven cases, the authors suggest that craniectomy be considered in those patients who suffer a symptomatic reaccumulation of subdural fluid following craniotomy and membranectomy, or who demonstrate further neurological deterioration as a result of cerebral swelling subjacent to the hematoma site. However, this procedure probably has no efficacy once extensive cerebral infarction has occurred.

Chronic tonsillar herniation in Crouzon's and Apert's syndromes: the role of premature synostosis of the lambdoid suture

1995 ◽  
Vol 83 (4) ◽  
pp. 575-582 ◽  
Author(s):  
Giuseppe Cinalli ◽  
Dominique Renier ◽  
Guy Sebag ◽  
Christian Sainte-Rose ◽  
Eric Arnaud ◽  
...  
Keyword(s):  
Resonance Imaging ◽  
Tonsillar Herniation ◽  
Content Type ◽  
Lambdoid Suture ◽  
High Incidence ◽  
Apert's Syndrome ◽  
Suture Closure ◽  
Crouzon's Syndrome ◽  
Fine Print

✓ The incidence of chronic tonsillar herniation (CTH) was evaluated with magnetic resonance imaging in 44 patients with Crouzon's syndrome and 51 with Apert's syndrome; the incidence was 72.7% in Crouzon's syndrome and 1.9% in Apert's syndrome. All the patients with Crouzon's syndrome and progressive hydrocephalus had CTH, but of 32 individuals with Crouzon's syndrome and CTH, only 15 had progressive hydrocephalus. Five patients with Apert's syndrome were treated for progressive hydrocephalus; none had CTH. The patterns of suture closure in these two groups of patients were studied, and significant differences in coronal, sagittal, and lambdoid sutures were found between patients with Crouzon's and Apert's syndromes. In Crouzon's syndrome, significant differences in the pattern of lambdoid suture closure were found between the groups with and without CTH; in the group with CTH, the lambdoid closure appeared earlier. The authors propose that the high incidence of individuals with CTH who have Crouzon's syndrome is related to the premature synostosis of the lambdoid suture in the first 24 months of age.

Role of hydrodynamic processes in the pathogenesis of peritumoral brain edema in meningiomas

2000 ◽  
Vol 93 (4) ◽  
pp. 594-604 ◽  
Author(s):  
Michael Bitzer ◽  
Thomas Nägele ◽  
Beverly Geist-Barth ◽  
Uwe Klose ◽  
Eckardt Grönewäller ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Brain Edema ◽  
Brain Tissue ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Extracellular Contrast Agent ◽  
Peritumoral Brain Edema ◽  
Hydrodynamic Processes ◽  
Fine Print

Object. In a prospective study, 28 patients with 32 intracranial meningiomas were examined to determine the role of hydrodynamic interaction between tumor and surrounding brain tissue in the pathogenesis of peritumoral brain edema.Methods. Gadolinium—diethylenetriamine pentaacetic acid (Gd-DPTA), an extracellular contrast agent used for routine clinical imaging, remains strictly extracellular without crossing an intact blood—brain barrier. Therefore, it is well suited for investigations of hydrodynamic extracellular mechanisms in the development of brain edema. Spin-echo T1-weighted magnetic resonance images were acquired before and after intravenous administration of 0.2 mmol/kg Gd-DPTA. Additional T1-weighted imaging was performed 0.6, 3.5, and 6.5 hours later. No significant Gd-DPTA diffused from tumor into peritumoral brain tissue in 12 meningiomas without surrounding brain edema. In contrast, in 17 of 20 meningiomas with surrounding edema, contrast agent in peritumoral brain tissue was detectable after 3.5 hours and 6.5 hours. In three of 20 meningiomas with minimum surrounding edema (< 5 cm3), contrast agent effusion was absent. After 3.5 hours and 6.5 hours strong correlations of edema volume and the maximum distance of contrast spread from the tumor margin into adjacent brain parenchyma (r = 0.84 and r = 0.87, respectively, p < 0.0001) indicated faster effusion in larger areas of edema.Conclusions. The results of this study show that significant contrast agent effusion from the extracellular space of the tumor into the interstitium of the peritumoral brain tissue is only found in meningiomas with surrounding edema. This supports the hypothesis that hydrodynamic processes play an essential role in the pathogenesis of peritumoral brain edema in meningiomas.

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