Cressida J. Heyes
- Published in print:
- 2007
- Published Online:
- September 2007
- ISBN:
- 9780195310535
- eISBN:
- 9780199871445
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195310535.001.0001
- Subject:
- Philosophy, Feminist Philosophy
This book argues that we live in an age of somatic subjects, whose authentic identity must be represented through the body. When a perceived mismatch between inner self and outer form occurs, ...
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This book argues that we live in an age of somatic subjects, whose authentic identity must be represented through the body. When a perceived mismatch between inner self and outer form occurs, technologies can step in to change the flesh. Drawing on Wittgenstein's objections to the idea of a private language, and on Foucault's critical account of normalization, this book shows how we have been led to think of ourselves in this way, and suggests that breaking the hold of this picture of the self will be central to our freedom. How should we work on ourselves when so often the kind of self we are urged to be is itself a product of normalization? This question is answered through three case studies that analyze feminist interpretations of transgender politics, the allure of weight-loss dieting, and representations of cosmetic surgery patients. Mixing philosophical argument with personal narrative and analysis of popular culture, the book moves from engagement with Leslie Feinberg on trans liberation, to an auto-ethnography of Weight Watchers meetings, to a reading of Extreme Makeover, to the author's own practice of yoga. The book draws on philosophy, sociology, medicine, cultural studies, and psychology to suggest that these examples, in different ways, are connected to the picture of the somatic subject. Working on the self can both generate new skills and make us more docile; enhance our pleasures and narrow our possibilities; encourage us to take care of ourselves while increasing our dependence on experts. Self transformation through the body can limit us and liberate us at the same time. To move beyond this paradox, the book concludes by arguing that Foucault's last work on ethics provides untapped resources for understanding how we might use our embodied agency to change ourselves for the better.Less
This book argues that we live in an age of somatic subjects, whose authentic identity must be represented through the body. When a perceived mismatch between inner self and outer form occurs, technologies can step in to change the flesh. Drawing on Wittgenstein's objections to the idea of a private language, and on Foucault's critical account of normalization, this book shows how we have been led to think of ourselves in this way, and suggests that breaking the hold of this picture of the self will be central to our freedom. How should we work on ourselves when so often the kind of self we are urged to be is itself a product of normalization? This question is answered through three case studies that analyze feminist interpretations of transgender politics, the allure of weight-loss dieting, and representations of cosmetic surgery patients. Mixing philosophical argument with personal narrative and analysis of popular culture, the book moves from engagement with Leslie Feinberg on trans liberation, to an auto-ethnography of Weight Watchers meetings, to a reading of Extreme Makeover, to the author's own practice of yoga. The book draws on philosophy, sociology, medicine, cultural studies, and psychology to suggest that these examples, in different ways, are connected to the picture of the somatic subject. Working on the self can both generate new skills and make us more docile; enhance our pleasures and narrow our possibilities; encourage us to take care of ourselves while increasing our dependence on experts. Self transformation through the body can limit us and liberate us at the same time. To move beyond this paradox, the book concludes by arguing that Foucault's last work on ethics provides untapped resources for understanding how we might use our embodied agency to change ourselves for the better.
Andrew Ranicki
- Published in print:
- 2002
- Published Online:
- September 2007
- ISBN:
- 9780198509240
- eISBN:
- 9780191708725
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198509240.001.0001
- Subject:
- Mathematics, Geometry / Topology
This book is an introduction to surgery theory, the standard algebraic topology classification method for manifolds of dimension greater than 4. It is aimed at those who have already been on a basic ...
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This book is an introduction to surgery theory, the standard algebraic topology classification method for manifolds of dimension greater than 4. It is aimed at those who have already been on a basic topology course, and would now like to understand the topology of high-dimensional manifolds. This text contains entry-level accounts of the various prerequisites of both algebra and topology. Surgery theory expresses the manifold structure set in terms of the topological K-theory of vector bundles and the algebraic L-theory of quadratic forms. While concentrating on the basic mechanics of surgery, this book includes many worked examples, useful drawings for illustration of the algebra and references for further reading.Less
This book is an introduction to surgery theory, the standard algebraic topology classification method for manifolds of dimension greater than 4. It is aimed at those who have already been on a basic topology course, and would now like to understand the topology of high-dimensional manifolds. This text contains entry-level accounts of the various prerequisites of both algebra and topology. Surgery theory expresses the manifold structure set in terms of the topological K-theory of vector bundles and the algebraic L-theory of quadratic forms. While concentrating on the basic mechanics of surgery, this book includes many worked examples, useful drawings for illustration of the algebra and references for further reading.
Mary Briody Mahowald
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780195176179
- eISBN:
- 9780199786558
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195176170.003.0008
- Subject:
- Philosophy, Feminist Philosophy
Cases illustrating variables relevant to decisions involving teenage pregnancy and motherhood, confidentiality, female genital surgery, and eating disorders are presented. For each topic, empirical ...
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Cases illustrating variables relevant to decisions involving teenage pregnancy and motherhood, confidentiality, female genital surgery, and eating disorders are presented. For each topic, empirical and theoretical factors relevant to the cases are discussed from an egalitarian perspective that addresses the nondominance of minors as well as their capacity for moral agency. A conception of parentalism as an antidote to paternalism and maternalism is proposed.Less
Cases illustrating variables relevant to decisions involving teenage pregnancy and motherhood, confidentiality, female genital surgery, and eating disorders are presented. For each topic, empirical and theoretical factors relevant to the cases are discussed from an egalitarian perspective that addresses the nondominance of minors as well as their capacity for moral agency. A conception of parentalism as an antidote to paternalism and maternalism is proposed.
Mary Briody Mahowald
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780195176179
- eISBN:
- 9780199786558
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195176170.003.0013
- Subject:
- Philosophy, Feminist Philosophy
Cases illustrating the exclusion of women in biomedical research, experimental treatment and maternal fetal surgery, human reproductive cloning, and embryonic stem cell research are presented. For ...
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Cases illustrating the exclusion of women in biomedical research, experimental treatment and maternal fetal surgery, human reproductive cloning, and embryonic stem cell research are presented. For each topic, empirical and theoretical factors are discussed from an “egalitarian perspective” that imputes privileged status to the standpoint of those who are “nondominant”. Implications of different positions about moral status of embryos and fetuses, and about people born with disabilities are also considered.Less
Cases illustrating the exclusion of women in biomedical research, experimental treatment and maternal fetal surgery, human reproductive cloning, and embryonic stem cell research are presented. For each topic, empirical and theoretical factors are discussed from an “egalitarian perspective” that imputes privileged status to the standpoint of those who are “nondominant”. Implications of different positions about moral status of embryos and fetuses, and about people born with disabilities are also considered.
Walter Glannon
- Published in print:
- 2006
- Published Online:
- January 2007
- ISBN:
- 9780195307788
- eISBN:
- 9780199867431
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195307788.003.0005
- Subject:
- Philosophy, Moral Philosophy
This chapter examines different forms of neurosurgery, psychosurgery, and neurostimulation for neurological and psychiatric disorders. It discusses the weighing of benefits and risks in determining ...
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This chapter examines different forms of neurosurgery, psychosurgery, and neurostimulation for neurological and psychiatric disorders. It discusses the weighing of benefits and risks in determining whether neurosurgery or psychosurgery can be justified. The issue of consent from patients figures more importantly in brain surgery than in any other area of neuroethics because of the invasiveness of the procedure and the risk of significant neurological impairment following surgery. It is also because the competence necessary for consent may be impaired by dysfunction of the organ that is both the intended area of intervention and the basis for competence and consent. Different forms of neurostimulation are considered, from electrodes implanted inside the brain, as well as from devices outside the brain. Finally, the possible use of neurostimulation for managing pain is considered.Less
This chapter examines different forms of neurosurgery, psychosurgery, and neurostimulation for neurological and psychiatric disorders. It discusses the weighing of benefits and risks in determining whether neurosurgery or psychosurgery can be justified. The issue of consent from patients figures more importantly in brain surgery than in any other area of neuroethics because of the invasiveness of the procedure and the risk of significant neurological impairment following surgery. It is also because the competence necessary for consent may be impaired by dysfunction of the organ that is both the intended area of intervention and the basis for competence and consent. Different forms of neurostimulation are considered, from electrodes implanted inside the brain, as well as from devices outside the brain. Finally, the possible use of neurostimulation for managing pain is considered.
Cressida J. Heyes
- Published in print:
- 2007
- Published Online:
- September 2007
- ISBN:
- 9780195310535
- eISBN:
- 9780199871445
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195310535.003.0005
- Subject:
- Philosophy, Feminist Philosophy
This chapter shows how cosmetic surgery has evolved to becoming regarded as part of the “normal” process in the quest for identity transformation, arguing that an inner self is externalized so that ...
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This chapter shows how cosmetic surgery has evolved to becoming regarded as part of the “normal” process in the quest for identity transformation, arguing that an inner self is externalized so that the aesthetic body can better represent the person within. It also believes that feminist ethical engagement will need to respond to this talk of self-transformation in kind, providing a way of responding to the suffering cosmetic surgery claims to alleviate, and recognizing the necessity and potential of working on the self as a feminist strategy. Feminists need a richer ethical grammar and vocabulary for talking about our own desires and suffering in this context. This demand for a feminist ethical language arises in part from nearly a century of cultural manufacture of a psychology for potential cosmetic surgery recipients. Cosmetic surgery bears a peculiar burden of justification unlike other medical subspecialties. In some cases the rubric of “reconstructive” procedures can be employed — repairing a cleft palate, rebuilding a face after tumor removal, or grafting skin to burns are all seen as legitimate medical measures that have necessary functional and social effects.Less
This chapter shows how cosmetic surgery has evolved to becoming regarded as part of the “normal” process in the quest for identity transformation, arguing that an inner self is externalized so that the aesthetic body can better represent the person within. It also believes that feminist ethical engagement will need to respond to this talk of self-transformation in kind, providing a way of responding to the suffering cosmetic surgery claims to alleviate, and recognizing the necessity and potential of working on the self as a feminist strategy. Feminists need a richer ethical grammar and vocabulary for talking about our own desires and suffering in this context. This demand for a feminist ethical language arises in part from nearly a century of cultural manufacture of a psychology for potential cosmetic surgery recipients. Cosmetic surgery bears a peculiar burden of justification unlike other medical subspecialties. In some cases the rubric of “reconstructive” procedures can be employed — repairing a cleft palate, rebuilding a face after tumor removal, or grafting skin to burns are all seen as legitimate medical measures that have necessary functional and social effects.
Geoffrey P Dunn and Alan G Johnson (eds)
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780198510000
- eISBN:
- 9780191730184
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198510000.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians ...
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This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy, and other drugs. Surgery, with increasingly minimal access to techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgical option. The text is divided into two sections: the first deals with general issues, varying from quality-of-life measurement to spirituality; and the second illustrates their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeons to change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms.Less
This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy, and other drugs. Surgery, with increasingly minimal access to techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgical option. The text is divided into two sections: the first deals with general issues, varying from quality-of-life measurement to spirituality; and the second illustrates their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeons to change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms.
Jacalyn Duffin
- Published in print:
- 2009
- Published Online:
- January 2009
- ISBN:
- 9780195336504
- eISBN:
- 9780199868612
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195336504.003.0004
- Subject:
- Religion, History of Christianity
An exploration of the problems resolved miraculously. The vast majority are cures from illness. The diseases amendable to miracle cure change through time according to medical science. Some ...
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An exploration of the problems resolved miraculously. The vast majority are cures from illness. The diseases amendable to miracle cure change through time according to medical science. Some conditions, such as cancer, appear consistently through time. Gradually, the cures were of specific organic ailments, with tuberculosis increasing in frequency. Cures of psychic disorders always were rare; from the nineteenth century forward, a diagnosis of hysteria could stop the process. Diseases unknown in past centuries, such as leukemia or multiple sclerosis, appear soon after descriptions in the medical literature. The illness must also have defied up-to-date medical care including surgery. In other words, suffering must be a problem that is thought to be beyond the control of the best medical art of the time.This chapter also examines the nonmedical miracles, including the incorruptibility of the saint’s corpse, preservation from accidental death, and multiplication of food.Less
An exploration of the problems resolved miraculously. The vast majority are cures from illness. The diseases amendable to miracle cure change through time according to medical science. Some conditions, such as cancer, appear consistently through time. Gradually, the cures were of specific organic ailments, with tuberculosis increasing in frequency. Cures of psychic disorders always were rare; from the nineteenth century forward, a diagnosis of hysteria could stop the process. Diseases unknown in past centuries, such as leukemia or multiple sclerosis, appear soon after descriptions in the medical literature. The illness must also have defied up-to-date medical care including surgery. In other words, suffering must be a problem that is thought to be beyond the control of the best medical art of the time.
This chapter also examines the nonmedical miracles, including the incorruptibility of the saint’s corpse, preservation from accidental death, and multiplication of food.
Mushirul Hasan
- Published in print:
- 2009
- Published Online:
- October 2012
- ISBN:
- 9780198063117
- eISBN:
- 9780199080199
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198063117.003.0009
- Subject:
- History, Indian History
It was winter when Captain S. and the author left Oxford and set out for Scotland. Along the way, he observed people gliding swiftly along on the ice. Scotland is divided into highlands and lowlands ...
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It was winter when Captain S. and the author left Oxford and set out for Scotland. Along the way, he observed people gliding swiftly along on the ice. Scotland is divided into highlands and lowlands and features many mountains and forests. The cities are fewer compared to England. Having arrived in Edinburgh, the author proceeded to the house of Captain S.'s father. The author observed how marriage is practiced in Europe. While staying with Captain S.'s family, he learned so many things about him. When Captain S. was in Europe, for example, he was deeply versed in surgery, and (once), for the purpose of dissection, he disinterred the corpse of a poor man. This having been discovered, for fear of his life he embarked on board ship and ran away, and for many days practised as a surgeon in the countries of Malacca and Pegu.Less
It was winter when Captain S. and the author left Oxford and set out for Scotland. Along the way, he observed people gliding swiftly along on the ice. Scotland is divided into highlands and lowlands and features many mountains and forests. The cities are fewer compared to England. Having arrived in Edinburgh, the author proceeded to the house of Captain S.'s father. The author observed how marriage is practiced in Europe. While staying with Captain S.'s family, he learned so many things about him. When Captain S. was in Europe, for example, he was deeply versed in surgery, and (once), for the purpose of dissection, he disinterred the corpse of a poor man. This having been discovered, for fear of his life he embarked on board ship and ran away, and for many days practised as a surgeon in the countries of Malacca and Pegu.
Andrew Ranicki
- Published in print:
- 2002
- Published Online:
- September 2007
- ISBN:
- 9780198509240
- eISBN:
- 9780191708725
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198509240.003.0010
- Subject:
- Mathematics, Geometry / Topology
This chapter gives the definition of a normal map. Killing elements in the relative homotopy group by surgery on a normal map is discussed. The kernel modulesand relative regular homotopy groups of ...
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This chapter gives the definition of a normal map. Killing elements in the relative homotopy group by surgery on a normal map is discussed. The kernel modulesand relative regular homotopy groups of immersions is provided.Less
This chapter gives the definition of a normal map. Killing elements in the relative homotopy group by surgery on a normal map is discussed. The kernel modulesand relative regular homotopy groups of immersions is provided.
Andrew Ranicki
- Published in print:
- 2002
- Published Online:
- September 2007
- ISBN:
- 9780198509240
- eISBN:
- 9780191708725
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198509240.003.0012
- Subject:
- Mathematics, Geometry / Topology
This chapter provides the algebraic construction and geometric properties of the odd-dimensional surgery obstruction groups. It includes quadratic and kernel forms.
This chapter provides the algebraic construction and geometric properties of the odd-dimensional surgery obstruction groups. It includes quadratic and kernel forms.
Andrew Ranicki
- Published in print:
- 2002
- Published Online:
- September 2007
- ISBN:
- 9780198509240
- eISBN:
- 9780191708725
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198509240.003.0013
- Subject:
- Mathematics, Geometry / Topology
This final chapter discusses the surgery exact sequence for the manifold structure set of a Poincaré complex, relating the homotopy theory to the surgery obstruction theory.
This final chapter discusses the surgery exact sequence for the manifold structure set of a Poincaré complex, relating the homotopy theory to the surgery obstruction theory.
Robert C. Knowlton and Lawrence W. Ver Hoef
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195342765
- eISBN:
- 9780199863617
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195342765.003.0007
- Subject:
- Neuroscience, Disorders of the Nervous System
As long as valid assumptions can be made about a focal source, MEG can transform the challenge of EEG based 2D inference of lateralization or regional localization to 3D sublobar indication of ...
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As long as valid assumptions can be made about a focal source, MEG can transform the challenge of EEG based 2D inference of lateralization or regional localization to 3D sublobar indication of epilepsy-related spike generators. As such MEG spike source imaging provides a unique tool for targeting epileptogenic tissue for the surgical treatment of epilepsy. This information can be particularly valuable for patients with neocortical epilepsy in whom intracranial EEG (icEEG) investigations are commonly necessary. MEG localization of spikes may provide more accurate electrode sampling of the cortex responsible for seizures, and as a result, increase epilepsy localization and surgical resection accuracy. Combined with mapping of eloquent cortical function, MEG can play a role in multiple aspects of the preoperative (non-invasive) decision-making—potential to improve (1) patient selection, (2) ICEEG yield, and (3) increase the net number of seizure-free outcomes. Work remains to determine the validity of various analysis methods (stratified on different types of spike sources), and the cost effectiveness of MEG in epilepsy surgery, but it can be concluded that any patients able to proced to surgery that otherwise would not without MEG would contribute evidence to added clinical utility even if the cure rate is unchanged.Less
As long as valid assumptions can be made about a focal source, MEG can transform the challenge of EEG based 2D inference of lateralization or regional localization to 3D sublobar indication of epilepsy-related spike generators. As such MEG spike source imaging provides a unique tool for targeting epileptogenic tissue for the surgical treatment of epilepsy. This information can be particularly valuable for patients with neocortical epilepsy in whom intracranial EEG (icEEG) investigations are commonly necessary. MEG localization of spikes may provide more accurate electrode sampling of the cortex responsible for seizures, and as a result, increase epilepsy localization and surgical resection accuracy. Combined with mapping of eloquent cortical function, MEG can play a role in multiple aspects of the preoperative (non-invasive) decision-making—potential to improve (1) patient selection, (2) ICEEG yield, and (3) increase the net number of seizure-free outcomes. Work remains to determine the validity of various analysis methods (stratified on different types of spike sources), and the cost effectiveness of MEG in epilepsy surgery, but it can be concluded that any patients able to proced to surgery that otherwise would not without MEG would contribute evidence to added clinical utility even if the cure rate is unchanged.
Thomas R. Henry
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195342765
- eISBN:
- 9780199863617
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195342765.003.0008
- Subject:
- Neuroscience, Disorders of the Nervous System
Epilepsy poses unique problems and opportunities for cerebral imaging with positron emission tomography (PET). After reviewing PET methods in epilepsy applications, this chapter addresses the ...
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Epilepsy poses unique problems and opportunities for cerebral imaging with positron emission tomography (PET). After reviewing PET methods in epilepsy applications, this chapter addresses the extensive applications of 2-[18F]fluoro-2-deoxyglucose (FDG) mapping of glucose metabolism in temporal lobe epilepsy (TLE). The widespread zone of interictal metabolic dysfunction is highly associated with sites of ictal onset and propagation in TLE. Interictal FDG PET is used in correlation with ictal electrophysiologic and structural magnetic resonance findings for the purposes of: 1) increasing certainty that the ictal onset zone has been accurately determined by noninvasive studies prior to therapeutic temporal lobe ablation, 2) optimizing selection of intracranial electrode placement sites for ictal monitoring, and 3) prognostication for epilepsy surgery with regard to seizure control.Less
Epilepsy poses unique problems and opportunities for cerebral imaging with positron emission tomography (PET). After reviewing PET methods in epilepsy applications, this chapter addresses the extensive applications of 2-[18F]fluoro-2-deoxyglucose (FDG) mapping of glucose metabolism in temporal lobe epilepsy (TLE). The widespread zone of interictal metabolic dysfunction is highly associated with sites of ictal onset and propagation in TLE. Interictal FDG PET is used in correlation with ictal electrophysiologic and structural magnetic resonance findings for the purposes of: 1) increasing certainty that the ictal onset zone has been accurately determined by noninvasive studies prior to therapeutic temporal lobe ablation, 2) optimizing selection of intracranial electrode placement sites for ictal monitoring, and 3) prognostication for epilepsy surgery with regard to seizure control.
Csaba Juhász and Harry T. Chugani
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195342765
- eISBN:
- 9780199863617
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195342765.003.0009
- Subject:
- Neuroscience, Disorders of the Nervous System
The interictal FDG PET often shows focal cortical hypometabolism in patients with extratemporal epilepsy and can correctly regionalize neocortical epileptic foci in more than 2/3 of the cases, even ...
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The interictal FDG PET often shows focal cortical hypometabolism in patients with extratemporal epilepsy and can correctly regionalize neocortical epileptic foci in more than 2/3 of the cases, even if MRI is non-localizing. In some cases, however, FDG PET overestimates the epileptogenic region, and hypometabolism may extend progressively to involve remote cortical and subcortical regions, thus establishing an epileptic network in chronic epilepsy. On the other hand, hypometabolism can occur adjacent to, rather than completely overlap with, ictal seizure onset zones. Therefore, FDG PET is best used for presurgical evaluation in combination with other clinical, electrophysiological and imaging data to guide intracranial grid placement and optimize tailored neocortical resection. When applied in this manner, the use of FDG PET can improve outcome of extratemporal lobe epilepsy surgery.Less
The interictal FDG PET often shows focal cortical hypometabolism in patients with extratemporal epilepsy and can correctly regionalize neocortical epileptic foci in more than 2/3 of the cases, even if MRI is non-localizing. In some cases, however, FDG PET overestimates the epileptogenic region, and hypometabolism may extend progressively to involve remote cortical and subcortical regions, thus establishing an epileptic network in chronic epilepsy. On the other hand, hypometabolism can occur adjacent to, rather than completely overlap with, ictal seizure onset zones. Therefore, FDG PET is best used for presurgical evaluation in combination with other clinical, electrophysiological and imaging data to guide intracranial grid placement and optimize tailored neocortical resection. When applied in this manner, the use of FDG PET can improve outcome of extratemporal lobe epilepsy surgery.
Aimee F. Luat and Harry T. Chugani
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195342765
- eISBN:
- 9780199863617
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195342765.003.0010
- Subject:
- Neuroscience, Disorders of the Nervous System
The advent of positron emission tomography (PET) scanning using 2-deoxy-2-[18F] fluoro-D-glucose (FDG) has significantly improved our understanding of the pathomechanisms of different pediatric ...
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The advent of positron emission tomography (PET) scanning using 2-deoxy-2-[18F] fluoro-D-glucose (FDG) has significantly improved our understanding of the pathomechanisms of different pediatric epilepsy syndromes. Furthermore, it has dramatically altered our management approach of certain intractable epilepsy syndromes, such as infantile spasms. Glucose metabolism PET scanning has assumed an important role not only in the identification and localization of epileptogenic cortex, but also in assessing the functional integrity of the entire cerebral hemisphere, thereby providing useful diagnostic and prognostic information, including the suggestion of underlying neurometabolic or neurogenetic disorders which may preclude epilepsy surgery. In certain progressive epilepsy syndromes like Rasmussen encephalitis and Sturge-Weber syndrome, PET scanning also may be used to assess disease progression. In this chapter, we discuss the relevant role of brain glucose metabolism PET in understanding the pathogenesis of pediatric epilepsy syndromes with regard to diagnosis and treatment.Less
The advent of positron emission tomography (PET) scanning using 2-deoxy-2-[18F] fluoro-D-glucose (FDG) has significantly improved our understanding of the pathomechanisms of different pediatric epilepsy syndromes. Furthermore, it has dramatically altered our management approach of certain intractable epilepsy syndromes, such as infantile spasms. Glucose metabolism PET scanning has assumed an important role not only in the identification and localization of epileptogenic cortex, but also in assessing the functional integrity of the entire cerebral hemisphere, thereby providing useful diagnostic and prognostic information, including the suggestion of underlying neurometabolic or neurogenetic disorders which may preclude epilepsy surgery. In certain progressive epilepsy syndromes like Rasmussen encephalitis and Sturge-Weber syndrome, PET scanning also may be used to assess disease progression. In this chapter, we discuss the relevant role of brain glucose metabolism PET in understanding the pathogenesis of pediatric epilepsy syndromes with regard to diagnosis and treatment.
Carlos E. A. Batista, Diane C. Chugani, and Harry T. Chugani
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195342765
- eISBN:
- 9780199863617
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195342765.003.0012
- Subject:
- Neuroscience, Disorders of the Nervous System
Alpha[11C]Methyl-L-tryptophan (AMT) was developed initially as a tracer for positron emission tomography (PET) in order to measure brain serotonin synthesis, but subsequent studies have shown that it ...
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Alpha[11C]Methyl-L-tryptophan (AMT) was developed initially as a tracer for positron emission tomography (PET) in order to measure brain serotonin synthesis, but subsequent studies have shown that it also traces the kynurenine pathway. AMT PET has been applied to the study of several populations of patients being evaluated for epilepsy surgery, including lesional (tuberous sclerosis complex, tumors and malformations of cortical development) and nonlesional cases. It has shown a high specificity, but modest sensitivity, in identifying the epileptic focus in cortical regions. However, AMT PET does not have localizing value in assessment of medial temporal lobe epilepsy. AMT PET has increased our understanding of the kynurenine pathway in epilepsy suggesting new pharmacological approaches.Less
Alpha[11C]Methyl-L-tryptophan (AMT) was developed initially as a tracer for positron emission tomography (PET) in order to measure brain serotonin synthesis, but subsequent studies have shown that it also traces the kynurenine pathway. AMT PET has been applied to the study of several populations of patients being evaluated for epilepsy surgery, including lesional (tuberous sclerosis complex, tumors and malformations of cortical development) and nonlesional cases. It has shown a high specificity, but modest sensitivity, in identifying the epileptic focus in cortical regions. However, AMT PET does not have localizing value in assessment of medial temporal lobe epilepsy. AMT PET has increased our understanding of the kynurenine pathway in epilepsy suggesting new pharmacological approaches.
R. Edward Hogan, Elson L. So, and Terence J. O’Brien
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195342765
- eISBN:
- 9780199863617
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195342765.003.0014
- Subject:
- Neuroscience, Disorders of the Nervous System
There is a long history of the association of cerebral blood flow changes during epileptic seizures. The advent of radiopharmaceutical agents to measure cerebral perfusion during seizures has enabled ...
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There is a long history of the association of cerebral blood flow changes during epileptic seizures. The advent of radiopharmaceutical agents to measure cerebral perfusion during seizures has enabled a clinically feasible way to measure ictal cerebral blood flow changes. Studies show that ictal SPECT findings, especially with the use subtraction ictal SPECT techniques, correlate well with other measures of seizure onset and the epileptogenic zone. Ictal SPECT studies are also helpful in predicting outcome after epilepsy surgery. Applications of parametric mapping using ictal SPECT studies have helped to further define regions of perfusion changes in groups of patients with specific regions of seizure onset. Application of parametric mapping techniques in subjects with temporal lobe epilepsy has yielded interesting common patterns of ictal hyperperfusion and hypoperfusion. These studies help define expected patterns of ictal perfusion changes in TLE, as well as shed light on the associated pathophysiology of aspects of ictal semiology, such as the associated changes in consciousness during temporal lobe epileptic seizures.Less
There is a long history of the association of cerebral blood flow changes during epileptic seizures. The advent of radiopharmaceutical agents to measure cerebral perfusion during seizures has enabled a clinically feasible way to measure ictal cerebral blood flow changes. Studies show that ictal SPECT findings, especially with the use subtraction ictal SPECT techniques, correlate well with other measures of seizure onset and the epileptogenic zone. Ictal SPECT studies are also helpful in predicting outcome after epilepsy surgery. Applications of parametric mapping using ictal SPECT studies have helped to further define regions of perfusion changes in groups of patients with specific regions of seizure onset. Application of parametric mapping techniques in subjects with temporal lobe epilepsy has yielded interesting common patterns of ictal hyperperfusion and hypoperfusion. These studies help define expected patterns of ictal perfusion changes in TLE, as well as shed light on the associated pathophysiology of aspects of ictal semiology, such as the associated changes in consciousness during temporal lobe epileptic seizures.
Julie Bruce
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199235766
- eISBN:
- 9780191594816
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199235766.003.0019
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter provides a short overview of chronic pain associated with surgery and presents findings from epidemiological studies, mostly using examples from hernia, breast, and thoracic surgery. ...
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This chapter provides a short overview of chronic pain associated with surgery and presents findings from epidemiological studies, mostly using examples from hernia, breast, and thoracic surgery. Persistent pain has been reported after many other procedures, including thoracic, abdominal, gynaecological, orthopaedic, and amputation surgery. Finally, the chapter concentrates on the epidemiology of chronic post-surgical pain (CPSP), and thus focuses on aetiological factors and population burden rather than clinical interventions evaluating the efficacy of treatment or management of intractable pain.Less
This chapter provides a short overview of chronic pain associated with surgery and presents findings from epidemiological studies, mostly using examples from hernia, breast, and thoracic surgery. Persistent pain has been reported after many other procedures, including thoracic, abdominal, gynaecological, orthopaedic, and amputation surgery. Finally, the chapter concentrates on the epidemiology of chronic post-surgical pain (CPSP), and thus focuses on aetiological factors and population burden rather than clinical interventions evaluating the efficacy of treatment or management of intractable pain.
Andrew Ranicki
- Published in print:
- 2002
- Published Online:
- September 2007
- ISBN:
- 9780198509240
- eISBN:
- 9780191708725
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198509240.003.0004
- Subject:
- Mathematics, Geometry / Topology
Poincaré duality is an isomorphism between the homology and cohomology of a manifold. The chapter introduces the basic duality and the universal Poincaré duality for non-simply-connected manifolds ...
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Poincaré duality is an isomorphism between the homology and cohomology of a manifold. The chapter introduces the basic duality and the universal Poincaré duality for non-simply-connected manifolds using the involution on the fundamental group ring. Poincaré duality governs the homological effect of a surgery. The example of surgery on surfaces is given.Less
Poincaré duality is an isomorphism between the homology and cohomology of a manifold. The chapter introduces the basic duality and the universal Poincaré duality for non-simply-connected manifolds using the involution on the fundamental group ring. Poincaré duality governs the homological effect of a surgery. The example of surgery on surfaces is given.
