Know the changes in the number, size, and composition of ovarian follicles with age d. Know the hormonal determinants of antral follicle formation and follicular growth. Know the determinants of spermatogenesis and the developmental stages at which various phases are reached b. Know the hormonal regulation of Leydig cell steroidogenesis and the rate limiting steps d. Know the steps of testicular differentiation and the developmental ages at which they are reached 4. Know the pros and cons of chorionic gonadotropin or gonadotropin analog treatment of cryptorchidism and the age at which it may be indicated d. Know the pros and cons of surgical treatment of cryptorchidism and the age at which it is indicated. Know the role of measuring testicular products in the diagnosis of cryptorchidism versus anorchia g. Know that the contralateral testis in a patient with an undescended testis might itself be abnormal h. Recognize how compensatory hypertrophy in a testis relates to the function of the other testis i. Know that cryptorchidism may lead to testicular carcinoma, the relative incidence of such carcinoma, and recommend monitoring c. Know that the Mьllerian duct differentiates to the uterus, fallopian tubes, and upper vagina 3. Understand the paracrine actions of anti-Mьllerian hormone during male reproductive development and the time at which it occurs d. Know the paracrine role of testosterone in normal and abnormal Wolffian duct differentiation b. Know that the Wolffian ducts differentiate into the rete testis, efferent ducts, epididymis, vas deferens, and seminal vesicle 2. Know the role of testosterone and dihydrotestosterone in pubertal development of the Wolffian derivatives. Know the embryonic precursors of the male and female external genitalia and the mechanism and timing of their differentiation 2. Know the role of dihydrotestosterone in the differentiation of male external genitalia f. Know the effects of androgens on the pilosebaceous unit on the scalp versus in the pubic and axillary area 2. Understand the physiologic and clinical importance of free (unbound) sex steroid hormone concentrations b. Know the organs that produce testosterone in men and women and the relative proportion secreted by each organ 2. Know the relative roles of secretion and peripheral metabolism in the production of testosterone in men and women 3. Know the structure and function of the androgen receptor and the steroids to which they respond 9. Know patterns of fetal concentrations of estrogens, progestins, androgens, and gonadotropins b. Know the organs that secrete estradiol in males and females and the relative proportion secreted by each organ 3. Know the role of secretion relative to peripheral metabolism in production of estradiol in men and women 4. Know the intracellular signaling pathway of estrogen action within target cells 7. Know the relationship of progesterone secretion to granulosa cell luteinization 2. Know the relative androgenicity of the synthetic progestins used in oral contraceptives d. Know the secretion of androstenedione relative to testosterone by the interstitial cells of ovaries and testes 2. Know the relative contribution of the peripheral metabolism of androstenedione to the synthesis of testosterone and estrone. Know the control of anti-Mьllerian hormone and changes in concentrations throughout development c.
Although phosphate has a low molecular weight and, based on its molecular size, would be expected to be easily cleared by high-flux dialysis membranes, in reality phosphate is cleared rather poorly during dialysis because of its high negative charge and the large number of water molecules that circulate with the phosphate moiety; additionally, because of the large intracellular reservoirs of phosphate and slow transfer from the intracellular to the plasma compartment, net phosphate clearance by dialysis is poor. This results in a time-dependent slow clearance during conventional dialysis, with moderate clearance and declining removal during the first 2 hours of standard hemodialysis, and negligible removal afterward. However, as discussed later, the removal of phosphates is higher during longer dialysis treatments, such as occurs with nocturnal dialysis (approximately 8 hours), because the longer dialysis time allows the timedependent transfer of phosphate from intracellular to the plasma compartment; accordingly, patients treated with nocturnal dialysis often require fewer or no phosphate binders. Extracellular Volume Control (Ultrafiltration) Another important function of hemodialysis is the removal of excess fluid that accumulates in the absence of effective kidney function. Modern dialysis equipment adjusts these hydrostatic pressure gradients by varying the negative ("suction") pressure in the dialysate compartment rather than increasing the pressure in the blood compartment; this avoids the potential for increased lysis of red blood cells. However, as this rapid transfer of plasma water occurs at the inlet of the dialyzer, the concentration of protein (oncotic pressure) rapidly rises in the blood compartment; because these proteins are also negatively charged, there is a corresponding development of a "concentration polarization," whereby there is a rapid increase in negatively charged plasma protein concentration at the membrane surface (inside the blood compartment). This has the effect of disproportionately increasing the oncotic pressure at the interface between the blood compartment and the surface of the membrane. The high oncotic pressure at the surface of these high-flux membranes inhibits further ultrafiltration to the extent that, toward the blood outlet of high-flux dialysis membranes, "reverse filtration" may occur, with dialysate solutions moving across the membrane into the blood compartment. Although there are numerous abnormalities in the concentration of various metabolites that result from kidney failure, acid-base (bicarbonate) balance and potassium concentration are examples of the use of various dialysate solutions to correct such abnormalities. One of the functions of dialysis is to compensate for this metabolic acidosis by replenishing blood bicarbonate. Most often, this is accomplished using formulations of dialysate solutions with bicarbonate concentrations, generally between 30 and 32 mEq/L. However, this product cannot simply be added as a component of dialysate, because the presence of other electrolytes needed in the dialysate (specifically calcium and magnesium) would result in their precipitation as carbonates, thereby reducing the concentration of all three components. Current dialysate delivery technology requires the preparation of two separate dialysate streams, one called "acid concentrate," which combines all the ingredients of dialysate except sodium bicarbonate, and a second stream that contains sodium bicarbonate and sodium chloride. One important detail in the choice of dialysate bicarbonate levels is the presence of acetate in the formulation of the "acid concentrate" mentioned earlier. Depending on the manufacturer and whether the concentrate is liquid or powder, most "acid concentrates" contain 4 to 8 mEq/L of acetate (acetic acid) to maintain an acidic milieu and to prevent precipitation of calcium and magnesium salts. It is important that the prescription for the dialysate bicarbonate take into consideration the concentration of the acetate, because the acetate is rapidly metabolized (Krebs cycle) to bicarbonate on a 1:1 ratio. Thus, when the dialysate prescription is for a "bicarbonate level of 35 mEq/L," the effective total buffer in the dialysate may be as high as 42 mEq/L, depending on the amount of acetate; this may result in marked postdialysis alkalemia. There are ongoing studies about the optimal concentration of total buffer, but most observation data suggest that a total buffer of around 35 to 37 mEq/L is optimal; ideally, such a concentration should be adjusted for each patient, depending on their dietary intake, protein catabolic rate, and the resulting predialysis and postdialysis bicarbonate level. In the absence of kidney function, potassium (and other electrolytes such as magnesium) accumulates in the blood; accordingly, an important function of dialysis is to reduce the potassium concentration between dialysis episodes to a level that prevents significant predialysis hyperkalemia while avoiding significant hypokalemia after dialysis. Because potassium removal depends on the difference in potassium concentration between the blood and the dialysate, in concept the simplest way in which potassium removal can be maximized is to use a dialysate potassium concentration of 0 mEq/L. In the opinion of the author, the optimal dialysate potassium for almost all patients is 2 or 3 mEq/L, and, for patients with a high predialysis potassium level, the best (safest) option is still to use a dialysate potassium of 2 or 3 mEq/L while extending the dialysis duration to remove more potassium but at a slower rate, which reduces the risk of arrhythmias. If the patient is competent to make decisions, and the patient and physician are in agreement, there is little that should stand in the way of carrying out their choice, be it for or against the initiation of dialysis. Such a discussion provides the nephrology team with an opportunity to advise the patient about In the United States, more than 40% of patients who initiate dialysis do so without previous active follow-up by nephrologists, even though most patients have had some interaction with the healthcare system before kidney failure. Even for patients who are followed by nephrologists, there may be reluctance by the patient and even by the nephrologist to discuss fully the therapeutic options for treating kidney failure. Unless such discussion occurs, the patient will typically end up on hemodialysis-ill-prepared, resentful, and depressed. A number of publications have highlighted the advantages of using the 30-20-10 "rule of thumb" for an orderly process of patient referral to a nephrologist and initiation of kidney replacement therapy. It is essential to allay the anxiety and fear common in patients nearing kidney failure. Whenever possible, family members should be included in the decision-making process, and all members of the nephrology team, including the nephrologist, nurses, social workers, transplant coordinators, and dieticians, should participate in this process.
Unimodal sensory association areas then project to heteromodal sensory association areas in the parietal and lateral temporal cortices (Figure 3. The neurons in these heteromodal areas respond to specific combinations of visual, somatosensory, and auditory features. Cortical organization in the cortex is discussed in Chapter 21, "Cortex Topography and Organization. Each primary sensory area receives topographically organized, submodality-specific projections from the corresponding thalamic relay nucleus and subcortical relay neurons. This information is important for visuospatial orientation (the "where" of the object). Different subsets of posterior parietal cortex neurons project to neurons in the premotor cortex. There is a hierarchical and parallel processing of sensory information in the cerebral cortex. Sensory information reaching the primary sensory areas is processed first in the unimodal sensory association areas. Serial processing by neurons in unimodal areas that respond with increased complexity to combinations of features (eg, edges, shapes, direction of movement), which allow representation of the whole object (perception). Each unimodal sensory association area projects to heteromodal sensory association areas in the posterior parietal cortex and lateral temporal cortex. Neurons in these heteromodal areas respond to specific combinations of visual, somatosensory, and auditory features. These heteromodal association areas connect with the prefrontal, and premotor cortex or, via paralimbic areas, with the amygdala and hippocampus (limbic areas). The ventral stream involves neurons of the lateral temporal cortex that are important in the identification of objects, including such features as shape and color (the "what" of the object). Connections of these neurons by the superior and lateral temporal gyrus and temporal pole, with the dominant language network, hippocampus, and amygdala, are essential for object and face recognition, symbolic representation and naming (language), and an emotional reaction to the object. The heteromodal sensory areas also are connected reciprocally with the dorsolateral prefrontal cortex and paralimbic areas. In this system, submodality neurons-those that respond to inputs from tactile receptors and those that receive inputs from proprioceptors-remain segregated at the levels of the dorsal column nuclei, ventral posterior complex of the thalamus, and primary somatosensory cortex (S1). Overview of Sensory Pathways An overview of the sensory pathways is noted in Figure 3. The special somatic afferent systems (vestibular, auditory, and visual) are covered in Chapter 5, "Special Somatic Sensory Afferent Overview. The dorsal stream is involved in visuospatial processing and contains neurons that respond to object location and movement and project to the posterior parietal cortex. The ventral stream involves neurons of the lateral temporal cortex that progressively extract specific features, such as combinations of shapes and colors, that are necessary for object identification ("what"). Neuroscience and Neuroanatomy above enters the fasciculus cuneatus and ascends ipsilaterally. Information ascends to the level of the caudal medulla, where neurons in the fasciculus cuneatus and gracilis synapse with their respective nuclei. From the second-order neuron, axons sweep forward and cross or decussate and become the medial lemniscus. The medial lemniscal fibers rise to the ventroposterior thalamus, where they synapse again. The third-order neurons from the ventroposterior group of the thalamus ascend to the primary sensory cortex. Central Pathways the dorsal columnmedial lemniscal pathway functions to carry conscious proprioception, fine touch, and vibration (Figure 3. The cells of origin for the dorsal columnmedial lemniscal pathway are in the dorsal root ganglion of the spinal nerves. Sensory information from the lower extremities enters the fasciculus gracilis by way of the dorsal root ganglion. Perception of pain includes the sensorydiscriminative (intensity and location), cognitive (bodily sensation), and affective-emotional (suffering) aspects. This chapter reviews the peripheral and central processing of pain and concludes with discussion of pain pathophysiology. Nociceptors may undergo sensitization in the clinical setting of injury or inflammation (because of cytokines, chemokines, growth factors, and autocoids).
In general, after all, there does exist a connection between sober purification and the place made free by it for something quite different, not unlike the relationship between emancipation from the inessential made possible by technological automatization and the leisure achieved thereby for the essential. And yet, if we look more closely at the case at hand, it seems that the split between mere dwelling cubicles16 and that which had once allowed those buildings to participate in the fine arts (those which form the essential)17 is a split out of context, without connection. But Klee, of all people-yet not really of all people-was at the Bauhaus; Lenbach could certainly never have been there. Or, as another sign of rapprochement, a Chagall painting hangs inappropriately, although not as an absolutely foreign body, in the glass foyer of the new Frankfurt theatre; this is possibly a more authentic home for it than in the epigonal rigidity of an old Kaiser Wilhelm memorial church. And above all, an especially remarkable simultaneity: in the midst of the first functionalist19 buildings the Folkwang Museum was opened in Essen; it was stuffed full of displays of expressionisms-only, of course, in the company of primitive and atavistic art, apart from any kind of metallurgic new world functions and forms. To no less a degree, as Hans Curjel has correctly emphasized, the rebellion in form by Picasso, Kandinsky, Boccioni, Kirchner, et al. However, the effect has been limited to frame construction and can hardly be said to have aroused a renaissance of ornament, except in a few cases, here and there, where mere evolutionary reform produced revolutionary reversals. At least this new frame painting did engender an inclination for what we might call qualitative, as opposed to quantitative, construction-to such an extent that, although the effort was never pursued and in fact was even eradicated, veritable living creatures intervened in and emerged from the lines on the drawing board, from a geometry which did not want to remain inorganic. There were a few hopeful signs-but, as can be seen clearly in the conventional figures of the high-rise and the newest of new Brasilia, they have still never retrieved what was lost: the caresses of a Muse. Must architecture alone stop being an art, stop blossoming, indeed stop being as it once was? That it has achieved marvellous feats of engineering technology there is no doubt; but formative imagination is something else. This form of imagination is protean; its everchanging ornamental features are experiments with us, not just with the skeleton within a building, or even with the building as such. The present dichotomy, with mechanical emancipation and its extension into architecture on the one hand, and expressive abundance liberated in the realms of painting and sculpture on the other, must therefore not be made absolute, functionless, insurmountable. The very simultaneous appearance of engineering and expressive forms points to a tertium, to a more fundamental unity underlying this unfinished epoch. Its railway-station character proves to be both tempting and open in terms of productive possibility, both directing and experimental for each of the two factions of the fine arts24 created by it-whereby architecture never wants to forget that it is a fine art. This Exodus character,25 as such able to unite only via a processive utopian common denominator, offers a set of by no means tranquil, least of all classicistic forms, to budding ornamentation. But even in the sphere of pictorial, plastic and architectural formations,26 all of the prevailing figurines and figures, all ornamental forms, as details and as wholes, are still through and through excerpts, departures, flights from themselves. Beauty and form which are more than noble simplicity and serene grandeur: without a doubt, this is the point at stake in the present discussion. But in trying to educate by means of pleasing (thus in the last analysis via classicistic, fixed forms) one must forget that it was precisely the Nazis who built and painted classicistically. One must also consider the young Goethe, standing in front of the Strasburg cathedral in the middle of classicism (to be sure the so-called genuine one), who certainly had no conception of the purity of a glass skyscraper in New York. Indeed, expressly, beauty а la Greque as one of a kind did not exist for him; certainly he did not consider beauty as the entrance way to or as the boundary or fixity of a single principle of art. Instead, the young Goethe discovered a startling principle which arched over the gap between an as yet hardly known primitive art and the Gothic. This statement, made by a man who was then still young, appeared in what was a revolutionary period, i. Today the over-arching category of primitive Gothic has become self-evident; it has expanded and become great through its sympathetic reception in modern painting and sculpture, which have extended it to encompass suspended forms and elastically dynamic space. It has become a thoroughly ornamental style both pictorially and sculpturally: Exodus, as it turns out. Hence the conclusion: he, Goethe, alone exerting a rebellious influence radically different than in the first periods of modern technological art could, reconcile architecture not with the death of imagination usque ad finem but with the other fine arts,29 those which were truly qualified. All this returns time and again to the problem of the new ornament, to sculptural excess-in nuce when it blossoms in the details of a building, in entelechia when it characterizes the all-encompassing principle of the entire building figure. There is and remains an abrupt breach of contract, which historically has never been fulfilled or terminated, a gap in the by no means consummated entelechia according to which architecture was conceived. It characterizes the fundamental nature of Greek art and was the guiding spirit of German classicism of the late eighteenth and early nineteenth century. This is supported by the extended spatial and wandering metaphors in this passage. In both those places he implies that technology (functionalist principles as applied to architecture) facilitated life, eased the burden of the inessential and hence made room for the essential (fine arts and their ornamentation).
So then conflict, crisis change into stasis and seditio, as though they were affecting some domestic habitus that had been thought abandoned. The undominated, the untamed, in earlier times concealed in the domus, is unleashed in the homo politicus and economicus but under the ancient aegis of service, Dienst. Homo re-domesticus in power kills in the street shouting `You are not one of ours. He hides it away in his cellars, reduces it to ashes in the furthest ends of his lowlands. The ruin of the domus makes possible this fury, which it contained, and which is exercised in its name. But apart from this case, the case of evil, I find it hard to think that in general the emancipation of singularities from out of domestic space-time favours, on its own, freedom of thought. So that at the very moment when thought bears witness that the domus has become impossible, and that the faзade is indeed blind, it starts appealing to the house and to the work, in which it inscribes this witnessing. And the fact that there are many houses in the megalopolis nowadays does not mean that there are no longer any works, nor any works to be produced. It means that works are destined to be left idle, deprived of faзades, effaced by their heaping up. Libraries, museums: their richness is in fact the misery of the great conglomerates of council flats. But impossible is not only the opposite of possible, it is a case of it, the zero case. Thinking awakens in the middle of it, from the middle of very old words, loaded with a thousand domesticities. To think, which is to write, means to awaken in them a childhood which these old folk have not yet had. That does not happen without a certain lack of respect, assuredly, but not without respect either. Jean-Franзois Lyotard 261 At any rate, it is only for the last of men, the nihilist, that the disaster of the domus and the rise of the megalopolis to the stars can procure an (evil) delight. Not only for the ingenious one who rushes ahead of what is coming in order to control it, but for his cousin, the well-meaning philosopher, who makes a virtue out of redundancy. It is impossible to think or write without some faзade of a house at least rising up, a phantom, to receive and to make a work of our peregrinations. Lost behind our thoughts, the domus is also a mirage in front, the impossible dwelling. The beginning the awakening, offers itself only at the end as its inscription by the writing of the remembrance, in its working-out. And the dwelling of the work is built only from this passage from awakening to the inscription of the awakening. And there is no roof where, at the end, the awakening will be over, where we will be awake, and the inscription will have ceased to inscribe. But nostalgia for the lost domus is what awakens, and our domain nowadays is the inscription of this awakening. The only kind of thought-but an abject, objective, rejective thought-which is capable of thinking the end of the domus, is perhaps the thought suggested by technoscience. It is decomposed as the big monad forms in its greater complexity, the one that Heidegger, coming from a quite other kind of thinking, from thinking which determined itself quite otherwise, names the Gestell. Much more complete, much more capable of programming, of neutralizing the event and storing it, of mediating what happens, of conserving what has happened. Including, of course, and first of all, the untameable, the uncontrolled domestic remainder. There is a process of complexification, they say, which is initiated and desired by no one, no self, not even that of humanity. A cosmic zone, once called the earth, now a miniscule planet of a small stellar system in a galaxy of pretty moderate size-but a zone where neg-entropy is rife. The domus was too simple, it left too much remainder that it did not succeed in taming.
However, the experimental protocols commonly used to assess mirror neuron activity in humans are not capable of isolating their responses from the many other visual and motor neurons that coexist in the same cortical areas. Activity during each condition was compared with rest to assess "mirror system" activity. In the other experiments, subjects were asked to observe or execute a single repeating hand posture or a sequence of different hand postures. Activity during blocks of different postures was compared with that of repeated posture to measure visual and motor adaptation. Results: Responses across the whole cortex including candidate mirror system areas (defined using the common imitation protocol: anterior intraparietal sulcus and ventral premotor) were comparable across autism and comparison groups in all three experiments. Conclusions: High functioning individuals with autism exhibited normal cortical responses, on average, in candidate mirror system areas. Such selective responses are crucial for proper movement perception as hypothesized by "mirror system" theories. Our results therefore suggest that dysfunctional mirror neurons are not the underlying physiological basis of core autism symptoms. Tager-Flusberg, Boston University School of Medicine Background: Handedness and language functions are highly associated, although the exact nature of this relationship remains unclear. Results: In left-handers, there were significant group differences for the temporal region (p =. In the control group, there were not significant differences between right- and left-handers. Objectives: To assess how the neural response to self-mentalizing is modulated by individual differences in alexithymia. Moreover, such method enables individual analysis, which offers new perspectives like the evaluation the efficiency of a treatment on a single subject. Later stage selects the most discriminant combination of those regions to build a autism vs. Finally, the classifier is applied to new individual images and the prediction (autistic, control) is compared with the true clinical outcome to evaluate the accuracy of the individual classifier. Results:The classification system identified two regions: (i) right superior temporal sulcus (hypoperfusion in autism) (ii) the left postcentral gyrus (hyperperfusion in autism). Objectives:Conversely to voxel-based method we propose a method that simultaneously 75 107. Subjects were instructed to select which of two faces at the bottom of the screen portrayed the same emotion as the face at the top of the screen. The correlation between social anxiety and activation in the fusiform and amygdala suggests that level of social anxiety is critically related to functional abnormalities in these brain regions. The task involves choosing between card decks that result in high immediate monetary gain, but larger future loss ("risky": long-term loss), or low immediate gain, with larger final reward ("safe": long-term gain). Results: In Controls, preference for "safe" choices, reflecting forward thinking and intertemporal competence, when contrasted with disadvantageous risky choices, elicited activation in ventromedial prefrontal, anterior cingulate, and parietal cortices and midcerebellum. Monetary wins, compared to losses, showed increased activation in the caudate, anterior cingulate and cerebellar hemispheres, whilst losses compared to wins showed increased activation in the bilateral inferior prefrontal, insular and cingulate cortices. Final analyses on a larger sample of 20 patients will be presented at the conference and implications of the findings will be discussed. A coherent visual patch was depicted by dots separated by a rotational transformation in space (form coherence) or space-time (motion coherence). Conclusions: the results represent a contribution towards better understanding of the mechanisms mediating visual information processing in autistic spectrum disorders. In a double-blind, counterbalanced design, participants consumed either a tryptophan-free or a balanced amino acid drink at each session. Conclusions:The twin findings of atypical somatic map extent in autism reflect atypical local connectivity. The present findings are a functional imprint of past reports of abnormal anatomy and morphology in autism. There has been more progress on functional long-range connectivity between different brain areas in autism than on local connectivity within a brain area.
Syndromes
This production process weighs down like a dark destiny upon the minds of men and women. Whereas in better off regions one overlooks its natural course and strives to regulate it where not broken off, in these storage spaces one speaks of it in a whispering tone and with a fatalism as if it is misfortune. I was informed that, `For three or four weeks, although the level of redundancies has reduced, new orders have not arrived. The oppressive devotion to the changing vicissitudes of market forces is plainly a typical characteristic of the employment agencies. In the employment agency, the concepts governing it ooze through all pores, and if there is any place where they reign undisputed then it is in this space out of its narrow sphere of power over the discharged workers. This warning is lacking for the textile workers who, on average, are of course less powerfully built than, for instance, the locksmith. The furniture in the waiting room consists of tables and benches, solid rectangular stuff that will bear some hard knocks. Otherwise there falls under the rubric of common property only the wall plastering which, by virtue of the permanent contact with the masses of unemployed, appears not to be in good shape. It is to be assumed that, with the narrowly developed feeling for language in Germany, the public warning is harmlessly intended and is in fact also harmlessly paid attention to . But the words easily disengage themselves from the user who does not understand how to use them and reveal: not what he thought of but rather that which is so self-evident to him that he does not even have to consider it at all. And indeed the placard preaches the sacredness of property with an unceremoniousness such as only the sleepwalker possesses, he who does not concern himself with the provocative effect which such a sermon at such a place achieves if all participants were awake. Of course it states common property; yet for the unemployed, many of whom at present end up as objects of public welfare, the common property too is not common enough in order to forfeit its private character. To the point of superfluity they should still guard and defend this property from whose regular enjoyment, and without being themselves to blame, they are excluded. For a couple of miserable tables and benches that neither deserve the pretentious name of common property, nor do they require preservation or even any special protection. Thus society preserves and protects property; it fences it in, even there where its defence is not at all necessary, with linguistic trenches and ramparts. It probably does it unintentionally, and perhaps one of those affected hardly notices that it does it. But that is precisely the Rethinking Architecture 60 genius of language; that it fulfils instructions that it has not been informed of, and erects bastions in the unconscious. Since in relation to their number that of positions vacant may at the moment be negligible, the activity of waiting becomes almost an end in itself. I have observed that, when the situations vacant are read out, many hardly still listen. Young lads and older people-in dense throngs they guard and defend common property without active employment. The fact that they mostly keep on their caps and hats may be a weak sign of freedom of the will. I do not know of a spatial location in which the activity of waiting is so demoralizing. And this is quite aside from the fact that in these times of stagnation the goal is missing for them: above all what is lacking for them is the brightness. Here, the rebellious desire to make a noise is not permitted, nor does the enforced idleness retain any other kind of inspiration. On the contrary, idleness takes place completely in the shadows and must rely upon the social title of the autocracy who give birth to it. And yet much would be glossed over, for poverty is continuously exposed to its own glare. At one time, it spreads itself out with visible blotches and blemishes and, at another, it retreats in a bourgeois-prim manner into seclusion. In the case of a better dressed tailor, for instance, the cuff of the shirt was selected as the ultimate hidden recess. He contrived to hide it on some occasions whereas at others he outwardly exposed it all the more deliberately.
Immune complex glomerulonephritis and chronic anaerobic urinary infection complications of filariasis. Nephrotic syndrome due to loiasis following a tropical adventure holiday: a case report and review of the literature. Renal disease in lymphatic filariasis: evidence for tubular and glomerular disorders at various stages of the infection. Proteinuria associated with diethylcarbamazine treatment of onchocerciasis (abstract). Apheresis in the management of loiasis with high microfilariaemia and renal disease. Quartan malaria-associated childhood nephrotic syndrome: now a rare clinical entity in malaria endemic Nigeria. Patterns of glomerulonephritis in Zimbabwe: survey of disease characterised by nephrotic proteinuria. The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility. Prognostic indicators of IgA nephropathy in the Chineseclinical and pathological perspectives. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. Proteinuria patterns and their association with subsequent end-stage renal disease in IgA nephropathy. A scoring system to predict renal outcome in IgA nephropathy: a nationwide 10-year prospective cohort study. The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. The natural history of immunoglobulin a nephropathy among patients with hematuria and minimal proteinuria. Efficacy of immunosuppressive therapy in IgA nephropathy presenting with isolated hematuria. Blood pressure reduction associated with preservation of renal function in hypertensive patients with IgA nephropathy: a 3-year follow-up. Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. Controlled prospective trial of prednisolone and cytotoxics in progressive IgA nephropathy. Prognostic indicators in children with IgA nephropathy-report of the Southwest Pediatric Nephrology Study Group. Crescentic, proliferative IgA nephropathy: clinical and histological response to methylprednisolone and intravenous cyclophosphamide. An important role of glomerular segmental lesions on progression of IgA nephropathy: a multivariate analysis. Weight loss interventions in chronic kidney disease: a systematic review and metaanalysis. Excessive body weight as a new independent risk factor for clinical and pathological progression in primary IgA nephritis. Clinicopathological influence of obesity in IgA nephropathy: comparative study of 74 patients. The Oxford IgA nephropathy clinicopathological classification is valid for children as well as adults. Factors associated with progression of IgA nephropathy are related to renal function-a model for estimating risk of progression in mild disease. Prednisolone co-administered with losartan confers renoprotection in patients with IgA nephropathy. Additive antiproteinuric effect of converting enzyme inhibitor and losartan in normotensive patients with IgA nephropathy.
There are children who will leave a game to go and be bored in a corner of the garret. How often have I wished for the attic of my boredom when the complications of life made me lose the very germ of all freedom! And so, beyond all the positive values of protection, the house we were born in becomes imbued with dream values which remain after the house is gone. Centres of boredom, centres of solitude, centres of daydream group together to constitute the oneiric house which is more lasting than the scattered memories of our birthplace. Long phenomenological research would be needed to determine all these dream values, to plumb the depth of this dream ground in which our memories are rooted. And we should not forget that these dream values communicate poetically from soul to soul. We are constantly re-imagining its reality: to distinguish all these images would be to describe the soul of the house; it would mean developing a veritable psychology of the house. To bring order into these images, I believe that we should consider two principal connecting themes: 1 A house is imagined as a vertical being. But with examples, it is not hard to recognize their psychologically concrete nature. Verticality is ensured by the polarity of cellar and attic, the marks of which are so deep that, in a way, they open up two very different perspectives for a phenomenology of the imagination. Indeed, it is possible, almost without commentary, to oppose the rationality of the roof to the irrationality of the cellar. A roof tells its raison dкtre right away: it gives mankind shelter from the rain and sun he fears. Geographers are constantly reminding us that, in every country, the slope of the roofs is one of the surest indications of the climate. But it is first and foremost the dark entity of the house, the one that partakes of subterranean forces. Gaston Bachelard 91 We become aware of this dual vertical polarity of a house if we are sufficiently aware of the function of inhabiting to consider it as an imaginary response to the function of constructing. The dreamer constructs and reconstructs the upper stories and the attic until they are well constructed. And, as I said before, when we dream of the heights we are in the rational zone of intellectualized projects. But for the cellar, the impassioned inhabitant digs and redigs, making its very depth active. But first let us remain in the space that is polarized by the cellar and the attic, to see how this polarized space can serve to illustrate very fine psychological nuances. Jung has used the dual image of cellar and attic to analyse the fears that inhabit a house. The image is the following: Here the conscious acts like a man who, hearing a suspicious noise in the cellar, hurries to the attic and, finding no burglars there decides, consequently, that the noise was pure imagination. To the extent that the explanatory image used by Jung convinces us, we readers relive phenomenologically both fears: fear in the attic and fear in the cellar. But let the master of the house arrive unexpectedly and they return to the silence of their holes. The creatures moving about in the cellar are slower, less scampering, more mysterious. In the cellar, darkness prevails both day and night, and even when we are carrying a lighted candle, we see shadows dancing on the dark walls. As a matter of fact, the image has to be understood phenomenologically in order to give it psychoanalytical efficacy. In our civilization, which has the same light everywhere, and puts electricity in its cellars, we no longer go to the cellar carrying a candle. The psychoanalyst cannot cling to the superficiality of metaphors or comparisons, and the phenomenologist has to pursue every image to the very end. Here, so far from reducing and explaining, so far from comparing, the phenomenologist will exaggerate his exaggeration. For these tales are the Rethinking Architecture 92 realization of childhood fears. In this instance, the dramatic element is too facile, but it exploits natural fears, which are inherent to the dual nature of both man and house.
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