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Anatomy of Foot Soles

Two lost soles sitting solitary on a fence

Feeling distracted from each other

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Said the compromising one to the other “We are not yet defeeted”
Said the other to the one in a fit of anger “I would hate to be in your shoes”

Said the compromising one  to the other. “Let’s get off our pedestals, resolve our differences, move forward, and walk in the way of righteousness”
Said the non compromising left one to oneself “Was going to say left-sidedness rather than righteousness for the sake of my pride and my tribe, but decided to let it go”
Said the one to the other “It is better if we walk together – otherwise we will only be able to hop with no hope”
Said the one to the one “Let’s pursue One and we will find our soles”

And they walked in step, like one, into the sunset, , foot after foot, hand in hand and lived happily ever after.

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The End

Lessons from sox
Courtesy of dOG WaLK aRT and the  Free Museums Around and In Us

Ashley Davidoff

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Melanoma – A Personal Tragedy

Dad

He was 6 years old in his native Lithuania

a shy boyish smile in a family photograph

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And I noticed his boots-

With both feet sitting squarely on the ground

That was my father

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And then they came..

So the family fled eastward..

And then westward..

A father and a brother died in the heat of a Russian idea and its winter

Again they came..

So the family packed up and fled

A new country, a new hope

Going to school with other boys

Shy and determined in the school football team

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Hard times for the family

A sales job at pitiful pay during pitiful times

Walking many miles to save pennies…

To make pennies

It all helped

Eldest brother by this time was succeeding with a partner who turned out to be rogue

And so now it was brothers in business starting at a low

At first shoemaking was slow- and cumbersome of course

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But time and dedication and the needs of a new family with three sons made good for many years

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And all the sons went into a profession

Just a small black nodule on the calf of his leg

No – not very good

The large glands contained the same foreboding

“Shoe business for sale”… “Sold”

A fever – doctors said it may be OK – but on the other hand it may not

And then it descended

We cried, we cried a lot

I walked along with five others

Two in front

Three to my side

And my mother and brothers were all there

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And I remembered his boots….

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I hope to stand square on the ground,
And walk in his footsteps

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Anatomy of the Liver, Alcohol, and Addiction

The Liver – Just Another Normal Miracle of the Body

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24/7 Clockwork Purple 

The liver is the largest gland in the body and is central to many metabolic functions. It is known as the body’s “metabolic warehouse.”

The liver serves several important functions. It is integral to the digestive system, producing both internal and external secretions. The external secretion, bile, aids in the digestive process, while internal secretions are responsible for the metabolism of both nitrogenous and carbohydrate materials absorbed from the intestine.

Some of the liver’s functions take milliseconds and others take days and sometimes weeks. It secretes bile in order to  alter toxic substances chemically (e.g. converts ammonia to urea), converts glucose to glycogen, and can produce glucose from breaking down certain proteins. The liver also synthesizes triglycerides and cholesterol, breaks down fatty acids and produces plasma proteins necessary for the clotting of blood such as clotting factors I, III, V, VII, IX and XI. Nearly 30% of the blood pumped by the heart passes through the liver each minute.

One of the unique structural features of the liver is its dual blood supply. It is supplied both by an artery (hepatic artery) and a vein (yes a vein!) – the portal vein. The portal vein  drains the gastrointestinal tract of digested metabolic products and transports the nutrients to the liver for processing.

Four to five thousand  years ago, the sheep’s liver held godly powers in the Babylonian culture. The Babylonians, and many cultures thereafter, believed that since the liver was the largest organ, it certainly must be the organ of most importance.

The Cells

Hepatocytes are the major cellular component of the liver, comprising approximately 70% by volume. Structurally they are characterised by their large size and the absence of a basement membrane.  Functionally they are characterised by their remarkable metabolic and regenerative capability.  Kupffer cells are found within the space of Disse and they act as macrophages of the liver, identifying and removing substances and organisms toxic to the body.

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The Cells

The AiA rendering of cells in the round provide an image that is reminiscent of craters on the moon surface.  The thought process behind the image is the formation of tissues from cells.  The building of the whole from the parts starts with the cell and progresses to the tissue and finally the organ.  In this instance, groups of liver cells are artistically combined to form a tissue and an imaginary spherical organ.

Cellular Organization

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Organization of the Liver Cells in Cords Along the Rivers of Blood Flow

The liver  is a compound tubular serous gland. The cells are arranged in plates or cords alongside rivulets of a capillary network called  sinusoids.  The  spaces of Disse are spaces below the lining of the Kupffer cells. The plates and cords are lined by the sinusoids which are the channels which carry blood to the liver.  Just below the sinusoids, between the wall of the sinusoid and the capsule of the liver there is a space called the space of Disse which carries the lymphatic fluid of the liver.

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Organization of the Liver Cells in Cords in the Liver Lobule

The cells of the liver are organized in cords and plates and are organized like spokes of a wheel  around the central vein.  The periphery of the lobule contains  groups of portal triads consisting of portal vein (dark blue), hepatic artery (red) and bile duct (green).

The structural liver unit is called a lobule.  Cellular plates branch and anastomose alongside and in parallel with the sinusoids.  Each lobule measures 1-2mm and is shaped like a hexagon. A central venule lies at the center of the lobule and is the destination of the sinusoids, which carry both hepatic arteriole as well as portal venous blood.  At the periphery of the lobules are sets of portal triads consisting of portal vein, bile duct and hepatic artery.  The biliary system collects bile from the liver and evolves into an independent network terminating in the common bile duct which empties bile, into the duodenum.  The hepatic artery and portal vein supply the liver with metabolic substrates via the sinusoids, and also collect metabolic  products produced by the liver to transport to the rest of the body.

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Anatomy of the Liver in a Nutshell– 

From its Embryonic Beginnings to Full Member of the Society of the Body 

Pleasure

Alcohol – Drink of the Gods in Moderation and Poison of the Devil in Excess

Anatomy of the  Initial Positive Effects of Alcohol

“Drink because you are happy, but never because you are miserable.”
G.K. Chesterton, 

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Social Drinking: The Prostate Having a Drink with the Uterus

The uterus and prostate are out on a date and sharing a cocktail   The uterus approximates a rectangular shape as does the prostate, accounting for their fascination with each other and their similarity with the shape of the wine glass.  The uterus is accompanied by the ovaries and the vagina which forms the stem of the wine glass.  The prostate is accompanied by the Seminal vesicles and Cowper’s glands and the urethra which acts as the stem of the wine glass. The male secretion seen in the urethra consists of a mixture of sperm, prostatic secretions, and seminal vesicle secretions.

Social drinking to celebrate an event is a wonderful means to enable people to open up to each other  

As G.K. Chesterton wrote – “Drink because you are happy, but never because you are miserable.”  

William Shakespeare, in Othello, on the other hand wrote – “I would not put a thief in my mouth to steal my brains.”

Most cultures favor the use of alcohol in celebration of events, and the positive effects of alcohol when used judiciously is to promote a pleasurable feeling via the nucleus accumbens, and to reduce stressful feelings (often social interactions) by reducing inhibitions by acting on the amygdala

Anatomy of the Feeling of Pleasure and the Nucleus Accumbens

The nucleus accumbens is one of the most primitive part of the brain.  It is part of the  basal part of the forebrain.  It is a paired structure. Alcohol promotes pleasure by stimulating the nucleus accumbens.

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The Nucleus Accumbens

The coronal section of the brain shows the nucleus accumbens (ringed red) opposite its partner at the base of the brain.  It lies just inferior to the internal capsule and frontal horns, near the hypoyhalamus

Courtesy Department of Anatomy and Neurobiology at Boston University School of Medicine Dr. Jennifer Luebke , and Dr. Douglas Rosene

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Artistic Rendition of the Nucleus Accumbens on a sagittal T1 Weighted MRI

The nucleus accumbens, which is the site enabling the sensation of pleasure is shown as a red dot at the base of brain near the hypothalamus.

Stress

Anatomy of Stress and the Amygdala

The amygdalae are paired structures that are part of the limbic system that play an important part in emotional reactions including the reactions to stress.  Alcohol reduces the uncomfortable emotion of stress and distress.  Stress, in general is healthy, while distress on the other hand is not.  The distinction between the two is not always obvious.  Social situations are often stressful since in general people are “forced”into a position with “new” people they do not know too well.  Using alcohol in such a social situation disinhibits the individuals, reduces the feeling of stress and promotes a sense of social confidence.. The origin of the physiology is in the amygdala.

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Amygdala of the Forebrain in Sagittal Projection

The amygdala (red arrow)is a nucleus that is part of the limbic system.  It is a paired structure.  They are located deep in the temporal lobes and participate in emotional reactions, memory, and decision making.

 

Peer Pressure 

Stressful social situations are particularly prominent in adolescence when peer pressure is pervasive.  The college experience with new adventures of socialization,  combined with freedom from the constraints of paternal disciplines are ripe for the use of substance abuse.

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Peer Pressure

The scene: Party night – adolescent on the right, different innocent, alone and anxious. The in- crowd on the left are homogenous, powerful in number and stature, and encourage the newcomer to join in and be “one of us” – perhaps drink or smoke – and this is how it starts.
Educate, support, and love your children – Promote confidence in themselves so when they are confronted they can just say “no!”

Loneliness

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Loneliness

Alone and bored, some turn to alcohol to provide relief.  It is a short term, and short sighted relief to the problem

Early Addiction

Every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism.

Carl Jung

The signs of early addiction

There are a few early warning signs that are forebears of early addiction as they start to surface.

They include; drinking alone, hiding and lying about the habit, blacking out, neglecting responsibility, deteriorating relationships, drinking in dangerous circumstances (eg before driving) and inability to quit.

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Too Much of a Good Thing- can make your life tipsy turvy and turn you upside down –

shows bottles of alcohol in different positions and personify the state of inebriation.  Alcoholic intoxication is a form of poisoning, and can make your life tipsy turvy and turn you upside down. The art piece expresses the uncontrolled situation of inebriation.  When the liver cannot metabolize the alcohol due to excess in the blood stream drunkenness ensues. At lower blood levels there is a sensation of elation and lack of social reserve.  With higher levels of alcohol in the blood, cerebral and cerebellar dysfunction ensues with ataxia, imbalance and muscle incoordination.  Forebrain impairment includes disability to make appropriate decisions.  Coma and death can ensue when blood levels are extremely high.

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Drunk Man in the Town Square

A drunk man in the town plaza is toying with the idea of another swig.  His indifference to his environment, and lack of judgement suggests he is inebriated.  However his body language with an outstretched arm holding the bottle and the other hand pointed in another direction may suggest, at least idealistically, symbolically and hopefully subconsciously, that he realises he could go one of two ways “Decision time” he says to himself – “on the one hand I could take a swig .. Yet on the other I may take a different and more healthful course” Which way do you think he would go? (Photograph modified to enable anonymity) 

Cirrhosis

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Normal Liver and Cirrhosis

The left sided image shows the CT scan of a normal liver.  The liver is the biggest structure that you can appreciate on the CT scan and is triangular in shape. The scan on the right shows a liver with cirrhosis.  Alcohol pickles and scars the liver making it look like a knobby shrunken prune. The first image reflects healthy and romantic enjoyment of two people enjoying a beer at sunset. The colorful sunset transposes int a black and white background providing the mood of a lonely alcoholic. The alcoholic drinks in loneliness and in excess, until finally the person and the the bottle do not remain upright symbolically reflecting physical and psychosocial failure.

The Failing Liver

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Normal Liver and Cirrhosis and Ascites

The AiA rendering shows a normal liver on the left, and a person with cirrhosis on the right evidenced by a shrunken, knobbly and pickled liver, jaundice of the skin and a distended abdomen caused by the accumulation of litres of fluid (ascites). In the long run, the addiction results in much suffering, a miserable existence, and immediately life threatening hemorrhagic episodes.

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Alcoholism and Ascites

(Photograph modified to enable anonymity) 

Liver Cancer

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Liver Cancer 

Liver cancer, frequently arises as a complication of cirrhosis and most particularly from alcoholic cirrhosis. The  AiA rendering of the liver shows the inner workings of the organ, now inhibited by the large yellow cancer preventing the clockwork function of the liver. The liver starts to fail as a result of the cirrhosis so that the synthesis of biochemical products that  keep the body going are no longer produced to the degree which they are needed.

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Wasting of Body and Life 

The collage shows normal healthy liver cells (top left) with a healthy appearing torso (CT scan  reconstruction bottom left).  The top right image reflect cancerous hepatic cells where the nuclear to cytoplasmic ratio is too large meaning that the the nuclei are too big and the cytoplasm too scanty.  This finding is one of the typical findings in cancer.  An emaciated torso (bottom right) is seen in contrast to the healthy counterpart.

Artistically the stark reality of health and disease is exposed.  This terrible disease stares at us in stark graphic reality.

Philosophically – the cancer cell is like a rebel in the community, who only has selfish interests and contributes nothing to the welfare of the community.  As a result the whole community of the body  eventually fails, and hence the emaciation of the body.

Lessons?  Kick the Habit Early  or Kick the Bucket

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Life, Cells, the US Constitution, and Trees

Life, Cells,the US Constitution, and Trees  

is an odd combination of concepts.  At first glance the title of the blog reveals a wide discrepancy of ideas, but in fact there are unifying concepts that bring them together.

The United States is one of the advanced cultures of the modern world. Its magnificent constitution states “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”   The wisdom rests firstly in the notion that “we the people” is the focus of all subsequent intentions resolutions and actions.  Secondly it provides hope and promise of a happy and safe society.  This statement of the constitution is satisfied in the biology of the cell, but not to the same extent in the dynamics of society.   We do not fully appreciate what perfection has been accomplished in the microcosm of our bodies nor how apt the opening statement is to the cells that make up living organisms. The cells in truth realise all the promises of the preamble, including a perfect union, justice, tranquility, defence, general welfare, liberty, and posterity.

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Trees, US Ideology, Cells, and the Body

Living structures are characterized by their ability to move, grow, reproduce, acquire and transport metabolic products, and protect themselves — all so they can function and contribute to the bigger community. The cell as the basic building block of life and living organisms performs all the described functions effortlessly, innately and automatically.  For the cell, life happens without struggle or effort.  People perform the same characteristics of life, but many individuals struggle to fulfil basic needs to satisfaction.

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Constitutional Makeup of the Body

The AiA art piece puts the cell in the centre of the body.  The cells, acting in combination with other cells, give life to their person in accordance with the preamble of the constitution. People in combination with other people give life to their society. 

From a physical perspective, biology has worked out a mechanism to keep all the 3.7 trillion cells of a single human being satisfied, fed, protected and fully functioning in their specific capacity. The liver cell is fulfilled in its capacity as a liver cell, and the same for the myocardial and brain cell.  In fact all animal cells live and do what they were born to do, and are fulfilled until disease or death. The world of botany has accomplished similar magnificence.cells-0005-catalogue-signed

Constitutional Makeup of the Tree

Tree cells in combination give life to the tree in accordance with the principles of the constitution.  

The 7.1 billion humans of the earth are still stuttering along, despite the lofty aspirations of the US Constitution.  Many citizens go hungry, innumerable are homeless and countless die in war.  The particular focus of this blog is to observe and appreciate the success of cells in the body, and try to understand and apply the processes that make them so successful to our society at large.

Branching Patterns in Nature – Success Story of Delivery and Waste Removal

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YinYang Tree – From Environment to Life in the Trees

The AiA rendering amplifies the arborising pattern of the roots and the branches in a background of the environment fuelled by the sun, air- filled atmosphere, and the earth.  The tree unit consists of two opposing forces just like the negative and positive forces of the atom.  The bare roots represent one force and the leaf filled flowering branches the other. They need each other and both need the environment (and the environment needs them) to develop, flourish and contribute.  They use a branching system at both ends to move nutrients and water efficiently .

What Do We as A Society Have to Learn from from the Yin-Yang Tree?

Opposing forces, when working together, enable both to flourish as individuals and as a new unit.  We need the man with the woman, the roots with the wings, the roots with the branches, the winter with the summer, the past with the future, the positive with the negative.  In the realm of tubes and flow we need a difference in pressure – a relative positive and a relative negative in order for the contents of the tube to flow.

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In the Leaves

The geometric arborising pattern is universal and is shown in veins of the ivy leaf 

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Heart Shaped Chines Lantern Flower

The dried flower reveals a delicate capillary-like infrastructure which is the transport mechanism for the petals. The flower enfolds and defends a barely appreciated, delicate fruit buried within its husk. The need to protect its fruit  manifests parental love which it can only do because it has an efficient transport mechanism to maintain itself.

 

Branching Patterns in the Body –The Vascular System

Supply and Removal of Metabolites and Waste

The transport systems of biology are exemplified by phenomenal branching tube morphology that is efficient.  The delivery and removal system in the form of arteries, capillaries and veins is 60,000 miles long (2.5 X the distance around the earth) – and with a pump that beats on the average of 72 times per minute,  3.7 trillion cells are continually fed and cleared of waste, and as a result can be  productive and fulfilled. Food is delivered and is waste removed from the front door of every cell constantly.  Each cell understands and applies the Goldilocks principle – “Take Not too much , nor too little, but what is just right for your needs.”

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The Pulsatile Miracle Circulation

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The Circulation; A Pump, Arteries, Capillaries, and Veins

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Capillary Network At the Front Door of the Cells

Specific Circulations

The Brain

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Arterial Tree of the Brain Under the Purple Moon

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Derivation of the Arterial Tree of the Brain Under the Purple Moon

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Arterial Tree of the Brain – External and Internal Carotid Systems

The Heart

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The Crown-Like Coronary Arterial Tree

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Derivation of the Artistic rendering of the The Crown-Like Coronary Arterial Tree

The Lungs

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The Pulmonary Circulation

The Gastrointestinal Tract

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Mesenteric Venous System of the Small Bowel

Note that the abdomen has been turned upside down in order to appreciate the tree like formation of the portal vein and small bowel.  

The liver is seen at bottom left in purple and the spleen (right) in orange

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The Splenic Arterial Tree

 

 The Kidneys

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Renal Veins By Doppler Ultrasound in Spring

 The Liver

 

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The Hepatic Venules

 

Ductal Systems

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Ducts of the Breast

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Histology of the Glands of the Breast

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Bile Ductal System Working Night and Day

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Dilated Biliary Ductal System and the Bonsai Tree

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The Tree of the Prostate Gland

Organs and Other Structures with Tree Like Shapes

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A Forest of Kidney Trees

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Ginkgo Lung Tree

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A Winter Tree of Hands Under the Moonlight

The Brain

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The Brain Tree

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Derivation of the Brain Tree – Artistic Recreation 

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The Arbor Vitae – Tree of Life of the Cerebellum

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Tree -Like Purkinje Cells 

Drawing of Purkinje cells (A) and granule cells (B) from pigeon cerebellum by Santiago Ramón y Cajal, 1899; Instituto Cajal, Madrid, Spain. Public Domain

Drawing by Camillo Golgi of a hippocampus stained using the silver nitrate method and digitally rendered by the artist

This treelike branching pattern of neurons responsible for consciousness seems to be a structural feature of the universe itself.

Realising “We the People” – First Step – Efficient Supply and Removal of Metabolites and Waste for the People of the World

Without adequate food and water, the promise of “We the people” of the preamble of the constitution cannot be fulfilled. Currently 1 in 9 people in the world do not have enough food. Without this basic need they are unable to lead an active and healthy life.  Is it because there is not enough food in the world? Is it because the 3rd world starving countries are too far away from the excess food of the farms of abundance? The skin cell at the tip of the most remote toe or the most remote cell at the top of the head are equally supplied according to their need.  In a healthy individual no cell gets left behind.  Yet many people get left behind in the world.

How to do it?

To some extent we have built and continue to build an arborising network for water supply and waste removal.  In the US 86% of the population have clean water delivered.  In developing countries efficient water supply and sewerage facilities are lacking.  One in 10 people lack safe access to clean water, and 1 in 3 lack access to a toilet (water.org).  Building a similar network that spans the world and delivers food to the front door of all the people of the world is the obvious first step.  Yet it seems like a pipe dream.  The network of information provided by the internet was also a pipe dream for people like Nikola Tesla who had a vision for  a “world wireless system” in the early 1900s. The ability to deliver real time information to the front door via the world wide web is only 30 years old.  Could anybody prior to 20th century imagine such a technological accomplishment?  If only we could deliver food via an innate arborising pattern.  What if, for example, a high calorie liquid energy food could be delivered alongside the arborising water system?  It may not be a classical meal but it is certainly more than nothing. The practical intent of this blog  is to  draw parallels between biology and society, which can learn from an almost perfect delivery and removal system, most commonly in the form of tree-like branching.

The universe has evolved over about 13.7 billion years and  in so doing has the wisdom of time on its side.  Over this time, it has developed systems that optimise energy and efficiency.  We as thinking biological beings have evolved highly developed biological processes over the last 2.4 billion years.  We have developed a mind and free choice.  The mind for us has been a double edged sword – both a gift and a curse.  A gift because it has given us an ego, individuality, tribalism, heterogeneous cultures, poetry, literature, art, theater, science, dance, athletics, religion, and organization, but a curse that has brought ego, selfishness, pride, religion, jealousy, murder, bigotry, prejudice, and tribalism. The desire to live in “a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity” requires that basic biological requirements are available and met.  The cells of the healthy body have acquired the aspirations of the US Constitution.

The cell has no mind nor ego and is therefore waiting only for evolutionary changes.  We as thinking beings want it all now, and continue to try and improve our lot in a lifetime and are too impatient to be happy with our lot.  We therefore push the double-edged envelope with our ego and in so doing while we are social beings we are competitive individuals at the same time.  This creates an internal conflict and conflict with others making perfect union a dream rather than reality.  The start for the world should be an efficient low energy, arborising delivery system, for food and water system for all people.  Without this the US Constitutional aspirations are only a dream.

Hillel recognized the conflict.  “If I am not for myself,” he said, “who will be for me?  And if I am only for myself, what am I.  And if not now when then?”  It is the balance of “I” and “they” that we have to find.  The cells have done it – Why can’t we?

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I am the Colon- In the Bowels of the Body, I Reside and Work

A Poem about the Colon

by Ashley Davidoff MD Copyright 2016

I am the Colon

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I have not captured the imagination of poets, artists, and historians.

Unlike my brothers and sisters the heart, liver, and the brain,

I am usually a subject that is avoided in cultured circles,

And commonly the butt of coarse  jocularity in casual circles. 

My contents are usually used as expletives of disgust and disagreement, 

While my tail end is used in reference to the last and the least. 

 

Let me tell you my story …..

I am the colon – they also call me the large bowel.

Some call me the “large howl” because of the noises that I make.

I do make noises – most of the time I sing a droning song while I go about my work,

Almost like a bass or double bass.

Sometimes I have to let off steam and then the wind instruments take charge,

With sounds that range from a piercing bleat to the beautiful alto furtive blurt.

When my contents are fluid I can tinkle along like a triangle in a percussion band.

Borborygmi they are called –quite a fancy name for a rather primitive sound.

Talking about music, I was surprised to read that Mozart took an interest in me.

His scatological letters are infamous, though admittedly his music is genius.

I am somewhat proud of his obsession for me.

 

So much for what people think or have thought. Let me give you my perspective.

My body is unique!  No other structure in the body comes close.

With my taenia coli and rounded haustra I am adorned in appendices epiploica.

The three beautiful, graceful and gracile taenia run along the entire length of my body.  

I really like these sleek muscles

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Sleek Tenia Coli Muscle and Voluptuous Haustra

So symmetrically positioned around my circumference.

They are always a tad tight, giving me my voluptuous bulges – the haustra.

I like those too.

They give me haughtiness and sometimes a naughtiness – those haughty naughty voluptuous haustra.

…and here it comes again: their fancy shmancy name: “appendices epiploica.”

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The Ugly Appendices Epiploica

I hate them! I don’t understand what function they play …

What in heaven’s name was God thinking when he put those fatty …things!… on my waist?

I detest them!  Do you hear me? D-E-T-E-S-T!

They may have been the fashion in the time of Adam and Eve,

But God, please get with the times – they are way out of fashion.

 

Now all riled up I continue my rant and rave.

Chyme they call it!

Chyme my ass! (Oops, I should not have said that.)

They give it a fancy Latin name to make you think it is elegant.

What would you feel like if you were dealt the grime and sludge that I am dealt?

It is pure muck with all the good things removed – dirty slimy muck!

And this is only the beginning.

Wait for the obnoxious gas that those bacteria fellows produce.

It presses on my sides and makes the jowls of my bowels howl.

Talk about noxious and obnoxious – we should bring OSHA down here.

 

I feel a little better now that I have let off some steam,

So I resign myself to my lot in life and I deal with it and in it.

My cryptic workers – God bless mein lieber kinder, the crypts of Lieberkuhn:

histology, epithelium, crypts of Lieberkuhn, gastrointestinal tract, gastrointestinal system, colon, large bowel, art, anatomy, art in anatomy, Ashley Davidoff MD

God Bless Mein Lieber Crypts of Lieberkuhn

They take that stuff into their crypts and work away at it for hours and sometimes days.

And voila – with bubble, bubble, toil and trouble,

A well molded product of dehydrated debris

Mixed with a tincture of mucus, a bead of sweat, and fermented gas for the rise,

To which I add a drop of color with my stercobilin

To form beautiful compacted nuggets called scybalae.

 

Getting rid of the product and passing it on into the free world is yet another story.

Some wondrous interactions are going on between me and my muscles (and you and your muscles, and your marvelous mind and body).

To cut a long story short, the coordination is quite something until we finally get the job done.

I heave a sigh of relief when I see the fruit of my labor out of the door.

In the end I am very happy to be part of your body,

To do my little thing, retrieve some water, and earn my keep.

So that you can experience another wondrous day, enjoy another meal,

And live to tell another tail … end story.

rectum, gastrointestinal tract, gastrointestinal system, colon, large bowel, art, anatomy, art in anatomy, Ashley Davidoff MD

The End

This poem has been modified from its original version published in the module on The Colon in the The Common Vein web site

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Anatomy of Endometriosis and Adenomyosis

Anatomy of Endometriosis and Adenomyosis

Ashley Davidoff MD

Endometriosis is a disease  caused by misplaced or ectopic endometrial tissues located beyond the uterus most commonly resulting in pain at the time of menstruation. The ectopic endometrial tissue is controlled by the oestrogen and progesterone cycles.  The ectopic tissue  bleeds at the time of menstruation and causes pain.  Since neither the ectopic endometrium nor the blood can be extruded from the body,  recurrent bleeding eventually results in  scar formation which may cause non cyclical chronic pain.

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Chronic Pelvic Pain is Unbearable

Endometriosis and adenomyosis cause horrific pain.  For some the pain  may only occur during the menstrual cycle but for others it can  be constant, day and night, excruciating in nature, invading every aspect of normal daily life .  Pain is a common symptom defined by the International Association for the Study of Pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” This statement characterizes the evolved nature of pain as a warning system and feedback mechanism that influences how we adapt to our environment. However, pain at its core it is  suffering and its persistence can be insufferable for people and diagnostically problematic to those who care for  the sick, as well being  a burdensome cost to society.  

The cause of endometriosis is not truly known.  Long standing hypotheses include spillage of endometrial tissue into the peritoneal cavity via the fallopian tubes or transvascular spread to remote areas .  More recent hypotheses include spillage of stem cells during embryonic development, metaplasia of coelomic epithelium, abnormal vasculogenesis, and environmental factors

Endometriosis occurs in 5-10% of women. When endometrial tissue is located outside of the uterus, it can cause pelvic and back pain, as well as pain with sexual intercourse (dyspareunia). It is also associated with infertility by  distorting  anatomy, (for example Fallopian tube adhesions) , or physiological changes that result in altered immune and hormonal environments with consequent impairment of ovum implantation .

From a structural standpoint, endometriosis most commonly affects the ovaries and Fallopian tubes but can affect any of the pelvic organs including the peritoneal cavity,  bladder, ureters, bowel, broad ligaments, uterosacral ligaments, cul de sac  and even the nerves. Implants range in size from small microscopic implants, but are are commonly about 1-2cm.

genitourinary tract, genitourinary system, uterus, woman, Art in Anatomy, Ashley Davidoff MD

The Intraperitoneal Aspect of the Pelvic Cavity

The peritoneal cavity or coelomic cavity is a large cell lined  space via which almost all the abdominal organs are connected .  It may be considered the suburban space around which the houses of the town are positioned.  The ova are released from the ovary into the peritoneal space, but they are quickly directed by the fimbriae into the Fallopian tubes.

Endometriomas 

Endometriomas are large hemorrhagic cysts that occur on the ovary and  may be up to to 20cms in size.  They are usually  round in shape, much like a large blood blister after they have bled.  The nodules can be red-blue to yellow-brown in color, (chocolate cysts) and occur just below the serosa of the organ to which they are attached.  As the lesions undergo recurrent hemorrhage, they can become associated with fibrosis as stated.  Rarely they may be associated with malignant transformation.(<1%).

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MRI of an Endometrioma

A T2 weighted image of the pelvis (left) with an overlay of colors on the right shows a 10cms endometrioma (overlaid in red) with internal debris better appreciated in the left image.  The large ‘chocolate cyst” lies above the uterus (pink) and compresses the bladder (yellow)

MRI has a 90% specificity and 90% sensitivity for endometriomas.  On T1 weighted images the endometriomas may be bright and do not lose signal on fat suppressed sequences.  Heterogeneity is due to the presence of degraded products.  Septations may also be present.  Both these features are present in the above image . On T2 weighted sequences “shading”   is caused by repeated episodes of bleeding reflecting  hemorrhagic contents in various stages of degradation.  The wall of the endometrioma may contain hemosiderin which leads to a loss of signal on the T2 weighted sequence.

Unusual Locations

Endometriosis is rarely can be more far reaching and may involve the kidneys, brain, diaphragm, and pleura.  When it involves the diaphragm or pleura, shoulder pain may be associated with the entity.  Pleural disease can cause life threatening catamenial pneumothorax induced by the menstrual cycle .

urinary bladder, bladder, genitourinary tract, genitourinary system, woman, Art in Anatomy, Ashley Davidoff MD, endometriosis, CT scan

Endometriosis on the Bladder

A CT scan through the pelvis (left) shows an endometriotic implant  on the bladder wall.  The image on the right shows the endometriotic implant overlaid in maroon on the right anterior surface of the bladder (yellow overlay).  The implant measures about 1.1cms.  The fornix of the vagina is overlaid in pink.  Most peritoneal implants are too small to be visualized by conventional imaging and require laparoscopic evaluation for diagnosis.

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Endometriosis in the Skin of the Groin

A CT scan through the pelvis (left) shows an endometriotic implant  in the subcutaneous region of the skin in the left inguinal region (image a, circled).  The region is magnified in image b and the endometriotic deposit is labelled “e” with maroon overlay.  An ultrasound of the left groin(c)  shows the implanted endometriosis (black) medial to the artery (red) and vein (blue).  In image d, the region of endometriosis (e) is overlaid in maroon.

Clinically the entity more commonly occurs in nulliparous women and the degree of pain is variable.  As endometrial tissue, it is responsive to the cyclical hormonal fluxes, and thus may  bleed in response to hormonal changes. Pain commonly occurs at the time of the menses.  The volume of ectopic endometrial tissue does not correlate with the severity of the pain, but rather with the depth of infiltration into the tissue, or the degree of distension that might occur.  The pain is usually recurring and commonly but not necessarily occurs during the menses. With induction of fibrosis, pain may be caused by other structural changes that are unrelated to the menses.

Diagnosis is suspected clinically and confirmed by ultrasound. When a woman in the reproductive phase of her life presents with pain, the imaging study of choice is a pelvic ultrasound.  Hemorrhage into evolving follicles is a common cause of pelvic pain and these could be also quite large.  This entity has to be differentiated from an endometrioma that has a characteristic ultrasonographic appearance shown below

ovary, ovaries, genitourinary tract, genitourinary system, woman, Art in Anatomy, Ashley Davidoff MD, endometriosis, endometrioma, chocolate cyst, ultrasound,

Endometrioma on Ultrasound

A transvaginal ultrasound of the adnexa shows an endometrioma with characteristic low level echoes reminiscent of the texture of the testes on ultrasound.  The image on the right is an overlay in a biloculate cyst.  Some through transmission is present. 

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Chocolate Cyst  on US and CT

A 25 year old female presents with painful menses. The ultrasound shows a cystic mass in the pelvis with a large amount of debris in the cystic cavity consistent with a chocolate cyst (a).  Image b is an overlay showing the fine granular appearance of the sediment.  When the patient is in decubitus position (c) , the sediment settles to the dependant portions with a clear supernatant.  Image (d) is a CT scan of the same patient, showing a non specific cyst in the left ovary. In this instance CT has little diagnostic value in the characterization of the abnormality other than localising a large cyst, and excluding other causes for the pain.  Although the appearance on the ultrasound is consistent with endometriosis, a hemorrhagic cysts is possible and the distinction may only be made pathologically.

When a female patient in the reproductive age presents with pelvic pain and ultrasound or  MRI are negative,  laparoscopy is indicated both for diagnosis of small or flat lesions lesions  as well as for therapy.    Microscopic deposits which may cause symptoms will not be identified by imaging techniques and will only be seen laparoscopically.  The reluctance to undergo an “invasive” procedure is understandable, but delaying or worse still missing the diagnosis will cause unnecessary long term suffering.

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Laparoscopy

Laparoscopic image of small blood blisters characteristic of endometriotic lesions of the pelvic wall in the peritoneum 

Courtesy Author Hic et nunc.  Acknowledged work is in public domain

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Blood Blisters in the Cul De Sac and Sacrouterine Ligament

Laparoscopic image of endometriotic lesions in the pouch of Douglas and on the sacrouterine ligament.
Courtesy Author Hic et nunc.  Acknowledged work is in public domain

Treatment options depend on patient preference, including whether fertility is desired, but include both medical and surgical options.  Medical management frequently involves suppression of regular menses/hormones .  Surgical options include removal of implants  or surgical induction of menopause (i.e. oophorectomy and hysterectomy).

Adenomyosis

Adenomyosis is a disease of the myometrium caused by misplaced or ectopic endometrium in the myometrium resulting in myometrial hyperplasia and smooth muscle hypertrophy clinically manifesting as pelvic pain and uterine enlargement.   The entity can be focal or diffuse

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Enlarged and Painful Uterus of Adenomyosis

The exact cause of the displacement is not known but it is presumed that a breach in the endometrial myometrial barrier enables a small amount of endometrium to translocate and remain viable.  There is a high prevalence rate with about 40% of hysterectomy specimens displaying the entity.

The junctional zone of the uterus is the epicenter of the structural abnormality The junctional zone is subendometrial smooth muscle that is more compacted, and contains less water in comparison to the outer myometrium. (McCarthy)  The junctional zone is functionally different from the outer myometrium.

junctional zone, genitourinary tract, genitourinary system, uterus, woman, Art in Anatomy, Ashley Davidoff MD, adenomyosis, MRI

The Normal Junctional Zone on MRI

The normal sagittal view of the uterus is a T2 weighted MRI from a 16 year old female with pelvic pain. The myometrium consists of an outer part (dark red) and an inner more homogeneous part called the junctional zone (light maroon)  Since a T2 weighted image is sensitive to water, we understand from this image that the outer part has greater white signal and therefore contains more  water, and likely more vascularity. The junctional zone (light maroon)  on the contrary has less water and therefore is blacker.  The endometrial canal, cervical canal and vaginal cavity are outlined in yellow and the vaginal wall is overlaid in pink.

 Clinically the patient presents with pelvic pain, dysmenorrhea, menorrhagia and may contribute to infertility.  On exam the uterus is enlarged.

The diagnosis is best made by MRI which shows a thickened junctional zone (>10-12mms) s.  The deposition of acute blood, blood degradation products such as iron, or the presence of fluid filled microglandular deposits in the junctional zone make the MRI findings highly specific for the diagnosis.

Treatment options include pain management with NSAIDS, and hormonal manipulation.  Surgery and hysterectomy is the only current option for cure.

MRI

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Adenomyosis with a Thickened Junctional Zone and Enlarged Uterus 

A  T2 weighted MRI (a) shows fluid in the endometrial cavity, surrounded by a thick dark layer of the junctional zone, and then surrounded with a slightly brighter outer myometrium.  The  color overlay in b, shows a small amount of fluid in the endometrial cavity (yellow) surrounded by a thickened subendometrial  junctional zone (light maroon) measuring up to 13 mms characteristic of adenomyosis. The outer myometrium (dark maroon) is normal

The junctional zone thickening is key to the diagnosis of adenomyosis on MRI.  The  junctional zone normally measures 8mm or less.  Between 8-11mm it is considered  indeterminate, and when it measures 12mm or  greater, it is considered diagnostic for the disease.  The junctional zone may thicken normally in the first few days of the menstrual cycle or during myometrial contractions.  Cystic changes in the junctional zone are also characteristic and relatively common and represent small blood blisters.  Linear striations radiating from endometrium to myometrium are also seen but these are not as easy to discern.  These probably reflect a breech in the endometrium reflecting microscopic tears extending into the myometrium.

 Ultrasound

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The Normal Junctional Zone on Ultrasound

A transvaginal ultrasound of a premenstrual woman in the sagittal plane (left) reveals a normal view of the uterus with characteristic premenstrual appearance. Image on the right  is an overlay showing the components of the endometrium and subendometrial layers.  The stripe is almost homogeneously echogenic and thick but also shows a hypoechoic halo of the junctional zone or inner myometrium. (salmon) The homogeneous stripe is made up from two histological layers (barely distinguished by this ultrasound)– the inner stratum functionalis (deep orange) that will shed once the spiral arteries vasoconstrict, and the outer stratum basalis (deep yellow) that will not shed, and will be the basis for regenerating the endometrium in the next cycle. The next layer as stated above is the compact myometrium – the junctional zone (aka inner myometrium) , and is followed by the thicker outer myometrium (maroon).

The junctional zone is hypoechoic  due to decreased water content, and is formed by smooth muscle cells that are tightly packed.  The extracellular matrix and water content are sparse.  It usually measures less than 8mm.

junctional zone, genitourinary tract, genitourinary system, uterus, woman, Art in Anatomy, Ashley Davidoff MD, adenomyosis, ultrasound

Adenomyosis with Ectopic Deposits in the Junctional Zone

Two echogenic nodules (overlaid in green in image on the right) are present  in the subendometrial layer, (junctional zone) in a woman with menorrhagia. The nodules are in close proximity and  have appositional relationships with the endometrial stripe (yellow overlay). They distort the endometrial lining. These findings likely  account for the menorrhagia.  Included in the differential diagnosis are dystrophic changes in prior foci of adenomyosis and submucosal fibroids.  An MRI would assist to characterize  the lesions in the subendometrial layer.

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Art, Anatomy, and Wisdom of the Kidneys

Art Anatomy and Wisdom of the Kidneys 

March is NATIONAL KIDNEY MONTH and March 14 2016 is WORLD KIDNEY DAY – dedicated to my teachers Dr Edward Smith and the late Dr Harry Mellins and  …. so here goes.

adrenal glands, adrenals, suprarenals, kidneys, anatomy, physiology, renal,

The Kidneys and Their Golden Adrenals

serve to preserve our precious water. The kidneys face each other (eye to eye) in the body as trusting life long partners. When the going gets tough for the one, the other is there to fill the void. How much more can one ask of a life long partner?

The Nephron –  The Little People and the Backbone of the Kidney

nephron, proximal tubule, Bowman's capsule, glomerulus, loop of Henle, arteriole, kidneys, renal, genitourinary tract, genitourinary system,bladder, urethra, Art in Anatomy, Ashley Davidoff MDFilter, Flow Concentrate

The story of urine production is the story of the complex physiology.  The diagram simplifies the steps in the production of urine involved in the production of urine using linear and wavy shapes and showing the connectivity and interdependence of the parts.  Blood (red) is filtered by the Bowman’s capsule(blue). The filtered plasma travels through a series of tubes (yellow) called proximal convolued tubule, loop of Henle, then distal convoluted tubule and with the magic of physiology enables water reabsorption and subsequent concentrated urine production. The urine is collected by collecting tubules, and transported via the calyces, renal pelvis and then ureters (orange) to the bladder (oval orange). The final pathway is out back to the environment via the urethra. The art is a combination of minimalism,  linearity, and spherism .

nephron, proximal tubule, Bowman's capsule, glomerulus, loop of Henle, arteriole, kidneys, renal, genitourinary tract, genitourinary system,bladder, urethra, Art in Anatomy, Ashley Davidoff MD

Filter Flow and and Concentate 

Same story – different way of artistically portraying the structural and functional order of urine production

nephron, proximal tubule, Bowman's capsule, glomerulus, loop of Henle, arteriole, kidneys, renal, genitourinary tract, genitourinary system,bladder, urethra

Parts of the Kidney Using Labels

genitourinary tract, genitourinary system, kidneys, nephron, arteriole, glomerulus, proximal convoluted tubule, Bowman's capsule, loop of Henle, distal convoluted tubules, collecting tubules, papilla, calyx, calyces, fornix, infundibulum, pelvis, renal pelvis, ureter, anatomy, kidneys, kidney, renal, Art in Anatomy, Ashley Davidoff MD

Fish Eye View of a Kidney Nephron 

is a sphere providing a view of the tissues making up the micro-tubular structure of the filtering system of the kidneys.  The connections between the tubular systems, arteries and veins, and the positioning of the loops of Henle are essential to the micro-function and macro-function of the kidney.  The style of spherism provides a sense of wholeness.

 kidneys, anatomy, physiology, renal,

An Ocean View of the Nephron

“Ocean View of a Kidney Nephron with Glomerulus Bowman’s Tubules Henle Arterioles and Venules at Sunset”  shows a an out of context depiction of the nephron.    The art piece has a surreal appearance with the sun at the bottom of the ocean and the tubules of the nephron with shapes reminiscent of Miro.  In addition there is a sense of spherism with the vascular system surrounding the nephron and the round shape of the sun. The water theme and the colors create a quiet and peaceful ambiance.

nephron, proximal tubule, Bowman's capsule, glomerulus, loop of Henle, arteriole, venule, kidneys, renal, genitourinary tract, genitourinary system,

Moods of the Kidney Nephron

“Moods of the Kidney Nephron with Glomerulus Bowman’s Tubules Henle Arterioles and Venules in All Colors” is collage of different colors of the nephron indicating different moods.  The art piece has a surreal appearance with a hint of Miro in the shapes of the structures.  The moods projected by the colors are mostly upbeat.

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Kidneys – Macro and Micro

“Kidneys- Macro and Micro” combines the histology of the kidney with its macroscopic image.  The nephron with the arteriole, glomerulus, Bowman’s capsule, proximal and distal convoluted tubules, loop of Henle, and collecting ducts are shown in the their distribution in the cortex and medulla of the kidney.  The collecting ducts enter the papilla, then the calyx and reach the ureters via the infundibulum and renal pelvis.

 

kidneys, nephron, urine, anatomy, water, Art in Anatomy, Ashley Davidoff MD

Kidneys Water to Water

“Water to Water, Dust to Dust – If you have to Pee, then You Must” is one of the captions that has been used to describe this image. 95% of urine is water and the” dust” is represented by organic and inorganic compounds.  These include urea, chloride, sodium, potassium, organic solutes including urea, creatinine, uric acid.  In addition there are trace amounts of enzymes, carbohydrates, hormones, fatty acids, pigments, and mucins.  The inorganic ions include sodium (Na+), potassium (K+), chloride (Cl), magnesium (Mg2+), calcium (Ca2+), ammonium (NH4+), sulfates (SO42-), and phosphates (e.g., PO43-).

kidneys, renal, calyces, ureters, bladder, genitourinary tract, genitourinary system, abdomen. pelvis, X-ray, radiology, Art in Anatomy, Ashley Davidoff MD

Kidneys Ureters and Bladder in Pink

Kidneys, Ureters, and Bladder in Pink” is abdominal X-ray of the abdomen after contrast injection and shows the kidneys, calyces, renal pelvis, ureters and urinary bladder.  The pink hue softens the classical black and white X-ray, but is in contrast to obvious blackened skeletal structures, including the lumbar spine, and pelvic bones. 

The Dancing Kidneys

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The Hora at the Royal Renal Wedding 

“The Kidney Hora at the Royal Renal Wedding” shows the bride and groom in the center of the first hora dance at their wedding. The dancing guests are derived from original CT angiograms showing the renal arteries and kidneys . The bride is derived from a nephrostogram (UPJ traumatic disruption) and the groom was created from a retrograde pyelogram.

kidneys, renal, MRI, MRA, MRV dance, renal arterry, renal vein, genitourinary tract, genitourinary system, Art in Anatomy, Ashley DAvidoff MD

Dancing the Rock ‘N Roll

“Kidneys Doing the Rock and Roll with Arteries and Veins Holding Tight” is the venous phase of an MRI angiogram . The kidneys each in different party colors, with a background of pastel colors gives a feeling or mood of celebration and delight.  The way they are bonded with vein on vein, and artery on artery provides the sense of partners holding tight in a rock and roll dance at the festivity.

kidneys, ureters, dance, flamenco, Fall, bladder, CT scan, art, art in anatomy , Ashley Davidoff

Paso Doble

“Paso Doble of the Kidneys in the Autumn” shows a duet in the Fall.  It portrays the passion of  male and female in a fiery dance.  The image was derived from a CT urogram showing the kidneys, calyces, renal pelves, ureters and bladder.  The mature and mellow colors are reflected in the yellows and oranges but are also characteristic Spanish colors.

kidney, arteries, normal, aorta, CTA, CT scan, radiology, dance, rumba

Renal Arteries Doing the Rumba

“The Renal Arteries Doing the Rumba” shows two fashionable folks pairing in an elegant rumba .  The two images are derived from separate CT angiograms and shows a normal aorta with renal arteries in different projections. The dancer on the left has a sleek twist while the the dancer on the right is in upright position with open arms for his partner.

kidney, arteries, normal, aorta, CTA, CT scan, radiology, dance, hip hop

The Renal Arteries Hip Hopping

“The Renal Arteries Doing the Hip Hop” shows two fashionable folks in a high spirited rippin hot wild Hip Hop dance.  The two images are derived from separate CT angiograms and shows the aging atherosclerotic aorta with the renal arteries in different projections. The dancer on the left has two stents at the origin of the renal arteries that look like part of the dress. The dancer on the right has a small infrarenal aortic aneurysm and an accessory renal artery on the right.  The elongated heads of the dancers give them a funky and wild look.

The Kidney Tree 

genitourinary system, genitourinary tract, kidney, arteries, veins, renal veins, renal arteries, normal, radiology, ultrasound, Doppler, power doppler, trees, branching, , Art in Anatomy, Ashley Davidoff MD.,

Summertime in the Kidney Tree

This art piece shows a color Doppler of the kidney and outlines the renovascular tree .  The black and white has been replaced by a skyblue color, while the red and blue of the Doppler has been replaced by the green, blue and purples of summer color. The image has been given an impressionistic feel with a Seurat pointillism effect.  The result is an image that has a feel of Seurat’s “A Sunday Afternoon on the Island of La Grande Jatte”

kidneys, renal, genitourinary tract, genitourinary system, Doppler ultrasound, veins, color Doppler, radiology, Art in Anatomy, Ashley Davidoff MD, trees, forest

Forest of Trees of the Renal Veins

A rendering of a Doppler ultrasound that has been reconstructed in 3D revealing the veins subtending the kidney.  Artistically the tree like structure of the veins has been rendered to create a forest of trees. The work gives a sense that the viewer is deep within the quiet of the forest, since only the base of the tree trunks dominate the view. The color provides a mood of peacefulness, and the magnification of the trunks provides a spirituality and humbles the viewer in the face of the magnificence and grandeur of nature.

kidneys, anatomy, physiology, renal,

Forest of Trees on CT Urogram

The  CT scan has been reconstructed in the coronal plane revealing the bonds between the kidneys, calyces, pelves, ureters, and the bladder.  Artistically the tree like structure of the kidneys has been rendered to create a bunch of flowers or forest of trees depending on the perspective of the viewer.

Lessons from the Kidney Tree 

genitourinary system, genitourinary tract, kidney, arteries, veins, renal veins, renal arteries, normal, radiology, ultrasound, Doppler, power doppler, trees, branching, , Art in Anatomy, Ashley Davidoff MD., winter, summer

Time for the Summer, Time for the Winter

This artpiece teaches us the unpredictability of fate and time .  The power Doppler ultrasound of the kidneys shows a variation of the renal vasculature.  On the left side, the vascular system is abundant, while on the right side, just the skeleton of the veins is demonstrated. The artist saw this image as an opportunity to explore concepts such as opposites, abundance, paucity, situational changes, time, and life lessons.  Relevant quotes include “Make Hay while the Sun Shines” and “There is a Time for Every  Every Season” .  Artistically a sharp line differentiates the left side from the right.  This abrupt change from the one season to the next can also infer unpredictable, and fateful situational change in  life.  In this case -there is a seasonal change, but the situation could just as easily reflect an abrupt change with the arrival of a devastating disease on the doorstep of life.   This image precedes a similar image showing the browns of the fall to the left and the winter to the right (below).

genitourinary system, genitourinary tract, kidney, arteries, veins, renal veins, renal arteries, normal, radiology, ultrasound, Doppler, power doppler, trees, branching, , Art in Anatomy, Ashley Davidoff MD., winter, fall

Time for the Fall, Time for the Winter

This artpiece teaches us the same lesson of unpredictability of fate and time.  Rather than going from summer to winter as time changes, this image goes from the browns of fall to the black and white of winter

Lessons from the Kidneys

kidneys, anatomy, physiology, renal, calyces, pelvis, ureter, urine, Art in Anatomy, Ashley Davidoff MD

The Pair in Purple

The art piece shows the kidneys with calyces, infundibula, renal pelves, and ureters. The pair have a intimate position as they face each other.  They have the same purpose in life -to rid the body of waste and to preserve water.  There is a commitment by the kidneys to each other  The art represents a promise of the kidneys to stay together through thick and thin – till death do them part. Personal ego plays no part in their relationship.  There is a clarity and simplicity in the art piece at the surface with well known underlying extreme complexity of the physiology.

kidneys, anatomy, physiology, renal, calyces, pelvis, ureter, urine, tree

Said the Kidney to the Heart… 

“You allow me to be myself, and do what I do best.  Without you I would be nothing!”  Said the heart to the kidneys “You rid us of waste and toxins, and you recycle our water. Without you, we all would be nothing!”  This profound conversation between the two organs contains the universal wisdom of biology and life .  We all need to do what we do best.  When we do this, the whole society of cells, organs, or people benefit.  The success of the one is the success of all.  The art piece shows the collaborative  form of the two kidneys resulting in a heart shaped tree.  The color of the trunk of golden urine brings the artistic element back to the reality of the kidney function and the gushing forth of urine.

 

And so ends the story of the Art,  Anatomy and Wisdom of the Kidneys

 

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Anatomy of Winter Water

Anatomy of  Winter Water 

February 2016 in Boston Massachusetts – Ashley Davidoff MD 

 

Winter Water changes its size, shape, position and character depending on the temperature, gravity, time and surrounding confines.

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Snow Outside in Boston

The winter of 2016 in Boston had not been too bad compared to the unforgettable winter of 2015. We  got 8-12 inches on the day this image was taken just a few days before Valentine’s day.  As always the snow left a trail of beauty particularly when viewed from the inside of a warm house.  Though truthfully, a walk in freshly fallen snow among the trees is also a magical experience. The view from our kitchen window is shown above.

On Valentine’s day 2016, 2 or 3 days after the snowstorm, the lowest temp reached -9 degrees F. This was the coldest Valentine’s day since 1957.  It  was zero degrees Fahrenheit when the photograph was taken.

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Frost and Ice on the Window Pane

4 basic layers evolved on the kitchen window.  This is explained diagrammatically in the next image. The real beauty was at the the bottom of the window pane there was a whole bevy of magnificent gems of the winter, hanging on the outside of a double paned kitchen window. The crystals were attached to a large ice droplet.  The result of nature’s work was more beautiful than any man made piece of jewelry.

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Frost and Ice on the Window Pane Explained

The relatively warm top part of the window showed a few ice crystals of collected fallen snow (layer 1) which quickly melted to form small droplets of water (layer 2).  Gravity caused these water bubbles to flow downward and get a little larger as they accumulated smaller droplets to form the bigger drops in the frosted background (layer 3).  When they reached the bottom part of the pane the temperature was lowest  resulting in crystallization and formation of beautiful gem-like structures .

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Gems of Ice Crystal at the Bottom of the Window Pane

Under given conditions in the winter, snow is formed from the water in the clouds and the water gets transformed into a wide variety of sizes, shapes and character.  The result was breathtaking!

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Melted Frost and Ice Gems 

The following day, the temperatures rose and the beautiful forms of crystallized ice, melted into a few nondescript water droplets, still beautiful but in a very rustic way.

 In the Meantime on the Outside Winter Water Creates Miracle Art

As the temperatures rose, I took the dog for a walk in the local park and was greeted by an infinite variety of microcosmic ice formations caused by the rising temperatures.  The puddles of frozen water started to crack, revealing magnificent shapes and a variety of ice and crystal formations in various stages between the solid and liquid form of water. Within a span of 30 minutes, I took over 200 images and here follows the result of the short photographic excursion with my macro lens.

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Ice Crystals on Columns of Thin Ice

 The shapes in this small ice pond took the form of columns of thin transparent ice with horizontal needle-like crystals projecting off the columns.

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Picasso Flying on Thin Ice

The art piece discovered in an ice pond by a macro lens revealed Picasso the eternal artist of yesteryear from the perspective of winter water.  The Picasso-like face in a boot with wings was perceived by the artist.  The formation of ice crystals require special winter conditions. In this case ice bubbles formed around a structure reminiscent of a face with a peaked hat. Waves of water in the ice form the wing-like structures

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Mirror Mirror on The Wall – What Do you See?

The art piece was discovered in an ice pond by a macro lens and reveals an abstraction of shapes. MIRROR MIRROR ON THE WALL..I see an evil queen – What do you see?   The formation of ice crystals and shapes in the thin ice require special winter conditions. In this case sharp white lines form a variety of shapes. Waves of water in the ice form the corrugated structures.

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I See an Evil Witch in the Mirror

What do you see?  The artist’s perception is overlaid in color. The face of the evil witch in the mirror (left) consists  the face with red lips, blue eyes, and a hooked nose.  To the right is a  person with a light green shirt and purple head.

Images of the Architecture of our Ancient Civilization 

 

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Tower of Babel ce Bubbles and Wood Chips

 In this art piece crystalised bubbles  project off pieces of wood chips.  The artist saw the an ill formed Tower of Babel crowned by a beautiful formation of ice bubbles

Images of the Architecture of Our Current Civilization 

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One World Trade Center and Ground Zero in Ice

The art piece is centered on a vertical skyscraper representing One World Trade Center. This art piece is a dedication to the great city of New York from the tiny ice ponds of a Boston park.  One World Trade Center is clustered with other skyscrapers in the center surrounding one of the main avenues traversing the city.  At the base of the skyscrapers, the foundation soil that shines through the ice water reflects the ground zero earth on which this magnificent building with its deep seated history, was built. The iced up East river surrounds Manhattan.  To the left there is a structure that represents the Brooklyn bridge and the wave like ice formation is a continuation of the bridge as it is seen lit up at night that extends from Brooklyn to Manhattan. The whole scene reflects a nighttime scene with city lights that abound.

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One World Trade Center The Brooklyn Bridge and the East River

Lessons of Biology

Images of the Natural World

Birds

pelican, log fish, winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water

Pelican Catching a Log Fish in ice Water

The art piece was discovered in an ice pond using a macro lens and reveals an abstract appreciation of the shapes. To the photographer and artist, a pelican is seen to the left of the image with a wide open beak pursuing one of the two fish swimming in the water.  The shapes of the fish look more like logs.  The small ice ponds in the local park were the source of this photograph.  The macro lens allows the capture of the minute detail, otherwise not appreciated fully by the naked eye.  There has been no electronic alteration to the art of natural form.

Trees and Plants

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Winter Trees of Ice Crystals

A walk in the cold of Boston with a macro lens exposed a tiny forest of winter trees beside a big pond under the warming winter sun.  Crystals of ice lined along a horizontal line reminiscent of a small forest, surrounded by the frozen water.  The surrounding ice pond has its own innate and naturally beautiful shapes.  Above the left side of the forest, the bundle of orange vegetation, likely debris from the previous fall,  represents a ball of warming sun to complete the scene.

The scene reminded me of the photograph of the Grove of Cone Shaped Trees below

B

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Cone Shaped Grove of Trees

The other images below of the ice crystals on the kitchen window and the similar morphology in the botanical world

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Boston Winter Mediterranean Summer 

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Ice Crystals and Arborvitae

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Feather Shaped Ice Crystals Grasses and Flowers 

 

Lessons of Biology

cell, macrophage, nucleus, winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water,

The Marvelous Macrophage – Soldier of the Body

The artist found this brave young macrophage lady in the ice pond of a Boston winter bravely fighting off pathogenic bacteria.  AiA applies the concept of multiple cyst like ice structures to the anatomy of the body, and in this instance to the lysosomes and other organelles in the cell.  The pseudopods of the dendritic cell are presented as the spiculated ice formations emanating from the edge of the white cell.

Human Biology Romance and Reproduction in Ice

garden of Eden, Adam and Eve, breasts, breast, body, torso, winter, water, crystals, ice,

Adam, Eve and the Snake

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A  Female Torso of Ice Floating On a Film of Cold Water

breasts, winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water

Woman Looking at Black Ice

In this art piece a woman is portrayed.  She admires the black ice through the cleft of her breasts.  The solid thick ice has assumed the rounded shapes of a woman’s breasts.  The sheets of black ice is seen in contrast to the white ice that dominate the image.

testes, penis, vas deferens, vasa deferentia, sperm, flagella, spermatozoa, winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water, bubbles,

Abstract of Male Organs and Reproductive Cells

The testes are in the bottom right hand corner filled with reproductive cells (sperm).  At the appropriate time during ejaculation they take a trip via the vas deferentia.  The vasa deferentia are depicted as tubular structures travelling from the testes to the base of the penis down the prostatic urethra where they collect the prostatic secretion. They then travel down the urethra and out into the female geniutal tract.  The race is on as they all seek to win the hand of the queen – the ovum de jour.

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Single Celled Flagellated Cells Looking for a Single Celled Partner

 The shapes that manifest in this instance were small microbubbles with waves of icy water.  The small bubbles are reminiscent of sperm cells and the waves of transparent ice reminiscent of the tail of the sperm.   The race is on!

winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water, ovary, follicles, cysts

Ovary and Follicles in Ice

AiA applies the concept of multiple cyst like ice structures to the anatomy of the body and in this instance to the ovary.  Ice bubbles form around air and other small structures of the earth and create follicular shaped structures of varying size on the ovarian like structure. The formation of ice crystals requires special winter conditions.  Freezing cold and water are basic ingredients. 

winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water, breasts, pregnancy, pregnant, woman, nude

Pregnancy in Ice

In this art piece a pregnancy is portrayed.  The cracked thin ice has assumed the rounded shapes of a woman with a rotund abdomen reminiscent of pregnancy.  The grass of the earth is magnified and illuminated in the pregnant abdomen, and a fetal structure is suggested in the expected location of the uterus.

Lessons of Life 

Time, Natural Disaster, Religion, Love, Sorrow, Fulfillment

Time

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Time Passes – A Cold Reality

The AiA rendering shows a fallen dead life still with beautiful colors of a Fall and a time gone by,  trapped by the ice and cold of the present tense. The message pertains to a yearning for the warmer, richer and mellow days of the autumn.  These are but sweet memories which are confronted by the harsh reality of the present and a cold, and sometimes unforgiving winter.  Though sweet memories are always sweet, one has to be realistic and deal with the present, knowing full well that the future will spring new realities.  Below the ice you may sense just a hint of green of the grass which will be part of the future of this vista.  The life lesson  – time passes.

Natural Disaster, 

winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water, snow, cracked

Snowquake

A natural disaster

Sorrow and Winter Water

eyes, tears, crying, nose, winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water,

Black Eyes, A Shiny Nose and Odd Looking Tears

The art piece reveals a different perspective of ice on the grate of a manhole cover in a Boston winter.  Two square black holes represent the two dark eyes, while the ice on the vertical limb with cracked ice of the manhole cover represents the shiny nose.  Two drops of water on the eyes in odd positions represent the odd looking tears providing the intrigue of the art piece.  What does the artist infer regarding the sadness in the eyes – that is up to you to think about!  Hidden messages abound

Pursuit of Fulfillment with Winter Water

bird, triangle, winter, ice, cold, crystals, ice crystals, temperature, freezing, shapes, ice crystals, frost, temperature, gravity, science, water,

Said the Ice Bird to the Triangle

In this art piece a bird who appears fulfilled in every beautiful way and is trying in a motherly way to teach the triangle a life lesson.  She pleads with the triangle not to lose its roots and foundation, because without the foundation it loses its identity as a triangle.  She then pleads with the triangle to remain true to itself and in that way it will grow and become something more profound – and in this case the artist draws attention to the triangular shape of the bird’s beak that plays a highly important function in the bird’s life. Finally she tells the degenerating triangle that “..if you don’t pull yourself together, you will end up like all the other sticks in my nest!”

Religion Love, Broken Love, Sorrow and Winter Water

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Broken Heart at the Crux of the Cross

taken in the local park after the Boston Valentine’s day freeze.A teardrop is seen at bottom right. The image has a religious feel of course and I also love the way the heart of ice illuminates the oxidized green on the steel grate of the manhole cover. Hidden messages abound.

And that is Boston February 2016 folks- and fun with anatomy of the winter ice water

 

 

References for Winter Water

Water Wiki

Window Frost Wiki

Frost Wiki

Formation of Ice Crystals and Snow 5 star

Guide to Frost

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Heart Shapes in Nature

Heart shapes in nature abound.  The shape of the heart has a deep meaning in almost every culture and whenever one finds a shape reminiscent of the classical shape of heart shape, it provides a little extra beat of excitement.

I have collected such gems over the years and present some in the following blog.

History of the Heart Shape and Implications in our Culture

heart, history, symbol, Jesus Christ, anatomy, heraldry, Valentine's day, sacred heart, heraldry, mood, emotion, Christianity, symbol, icon

History of the Shape of the Heart Icon

 The collage reveals the symbols that contributed to the shape of the heart icon as we know it.  Elements from anatomy of animals that were exposed during sacrifice, from botany with leaves and seeds that reflected similar emotional connections as the heart, and elements of human anatomy associated with attraction, love and romance combined to result in the shape of the icon of the heart as we know it.

Adapted and modified from public domain photograph by Frank Eugene, taken 1898, called Adam and Eve and published in Camera Work no. 30,1910

The Heart Shape in the Skies

heart, clouds, sky, heaven, heart shape, Valentine's day

Heaven’s Heart 

Found a cloud in the sky that said it all… or at least some of it…heaven’s heart.  The art piece is a photograph that reflects all good things about the heart; its place in the heavens, prayer, love, truth, beauty, honesty, and compassion.  The artistic element reflects a window for two way of love and admiration; from the heavens to humankind and mankind to the heavens.

Heart Shapes in the Leaves

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Heart Shaped Leaves of the Linden Tree

The heart shaped leaf of the Linden tree is derived from a photograph taken in Bergen Norway.  The leaf had fallen on a transparent roof and a few drops of water were trapped on its surface.  It reminded me of a tearful end of a romance with tears caught in the heart of the saddened lover.

heart, heart shape, ivy, leaf, heart shape, Valentine's day, romance, love,

Heart Shaped Leaf of the Ivy

The heart shaped Canarian ivy leaf is from a vine. In the art piece the dark green has been lightened to give a freshness to the leaf which is surrounded by a heart shape colored in purple

heart, heart shape, leaf, heart shape, Valentine's day, romance, love,

Heart Shaped Leaf of the Caladium 

The art piece shows a heart-shaped leaf with two beautiful variations of green.  The dark green veins of the leaf are in distinct contrast to the paler green background, creating both complexity to the appearance, and giving us insight into its transport systems. The caladium plant in its many forms has a intensely colored heart shaped and colorful varieties leaf. It belongs to a genus of flowering plants in the family Araceae originating in South America. Almost 1000 variations of the original plant now exist.  Other names include “Angel Wings”, “Heart of Jesus”, and “elephant ear”

heart, heart shape, leaf, heart shape, Valentine's day, romance, love, sweet potato vine

Heart Shaped Leaf of Sweet Potato Vine

The art piece shows the heart-shaped leaf partially illuminated, with an almost mysterious feel of a dark background.  The  leaf of the sweet potato vine arises from a versatile plants around, which grows in sun the sun or shade, in containers, or garden beds. The plant shown here is a bright green or chartreuse. The  beauty of the plant derives not only from the color of the foliage, its flowing nature but also of course  the shape of its leaf

heart, heart shape, leaf, heart shape, Valentine's day, romance, love,

Heart Shaped Leaf of the Black Coral Elephant Ear Plant 

The art piece shows the heart-shaped leaf with unusual black color.  The purple veins of the leaf are difficult to see since they are of a similarly dark color.  The leaf of the Colocasia “Black Coral” Elephant Ear plant is  similar to leaf of the Coladium plant whose members  are also named elephant ears because of the shape.  The leaves can be very large, and are between 8 and 60 inches long.

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Yin Yang Heart Shaped Hosta Leaf 

The heart shaped leaf of the Hosta plant is surrounded by a yin yang swirl of green.  The Hosta plant (aka plantain lilies (Britain) giboshi (Japan) is known for its hardiness and the fact that it thrives in the shade.  There are as many as 45 species with foliage of varying sized leaves and shades of green. Yin Yang relates to a Chinese philosophy that uses opposite forces to bring unity and solidarity.  These opposite forces abound. In the context of love it reflects opposite sexes that come together in reproduction of a new single being. Other examples include night and day, dark and light, fire and water, or positive and negative forces.

Heart Shapes in Flowers Fruits and Seeds

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Chinese Lantern Flower

The Chinese Lantern flower depending on perspective is also heart shaped – . The dried flower reveals a delicate capillary like infrastructure and therefore even more fitting for Valentine’s day.  The delicate flower enfolds and defends a barely appreciated, delicate fruit buried within its husk. The need to protect the fruit of its loins manifests motherly and fatherly love!The herbaceous perennial plant physalis alkekengi enfold and defend the small, delicate fruit buried within their husks, they may be the perfect symbol for protection. Their fiery orange red hue denotes a passion for life, amiability, endurance and vitality.

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Black Walnut Husk

The male and female components occur on the same tree. Imagine the two seeds born out of love between the male and female flowers that occur on the same tree (monoecious species) in a pod that is heart shaped. The image reflects the heart shaped husk with seeds likely removed by squirrels who tore into the heart out of the heart shaped pod – how cruel nature can sometimes be? –  But squirrels will  travel miles, will dig dig deep to retrieve the glorious tasty reward for their tenacious effort. (Acknowledgement Dr Edward Fisher MD Cardiologist)

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Heart Shaped Pod of the Goldenrain Tree

 The pod is lantern shaped reminiscent of the the Chinese lantern flower, and Cape Gooseberry and is about 5cms long and 3cm wide and starts as a green to yellow color and becomes orange to pink in the fall.  The black seeds are 5-8mms in diameter. (Acknowledgement Dr Edward Fisher MD Cardiologist)

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Heart Shaped Pod of the Amour en Cage

The art piece shows the inverted pod surrounded by the more rotund yellow shape of a heart.  The orange fruit peeks out through a defect in the husk.  The French name Amour en Cage (love in a cage) is the most appropriate and romantic term for the fruit!

Heart Shapes that Tell a Story Through the Natural Elements

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Bleeding Heart 

The bleeding heart (aka Lamprocapnos spectabilis, Asian bleeding-heart, Dutchman’s breeches, lyre flower and lady-in-a-bath) belongs to the poppy family Papaveraceae, and is found in China, Japan, Korea and Siberia. It flowers in the early spring with a pink or white flower and is one of the earlier joys of the spring.  It tells a sad story as it opens its heart and pours out its white tears.  The shape is quite unique.

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Heart Shape – Tamarind Seeds at Sunset

The heart shape of the Tamarind  seed is the subject of this art piece. The shape of the seed is heterogeneous.  With Valentine’s day in mind, I searched the many seeds of the leguminous edible fruit at the dinner table, and came up with two heart shaped seeds.

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Rock Lovers Rock

 Rock Lovers Rock shows a pair of heart shaped rocks in a background of sensuous and gentle curves of surrounding rock formation.  Despite the solid and hard nature of the stone and the almost heartless assigned character, the art piece provides a soft and romantic side to the usually lifeless stone.

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Valentine’s Day Walk – a Walnut and a Rock

The male and female components occur on the same tree. Imagine the two seeds born out of love between the male and female flowers that occur on the same tree (monoecious species) in a pod that is heart shaped. The image reflects the heart shaped husk with seeds likely removed by squirrels who tore into the heart out of the heart shaped pod – how cruel nature can sometimes be? –  But squirrels will  travel miles, will dig dig deep to retrieve the glorious tasty reward for their tenacious effort.

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Damaged Heart Shaped Leaf

The art portrays that part of the heart has been lost – but also infers that that all is not lost and there is still a lot of love to give.  The color is sombre, and results in a melancholic mood.

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Heart Shaped Leaves of Love Lost

The art piece shows two heart-shaped leaves (left) of a Linden tree in Norway at lovers’ odds, with tears streaming down their bodies, a bleeding heart (say no more) and the worst – a black leaf – who has totally given up on love. The whole image reminds me of a “Sergeant Pepper’s Lonely Hearts Club Band”.  The thing about romance is that more often than not, it does not reflect basic love.  Love of a child, parent, spouse friend, or animal has a deeper, more meaningful and more basic element of humanity and compassion that is open to all.  Romance is sometimes a closed club.

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Heart Shaped Anthurium at the End of Valentine’s Day

The heart shaped anthurium flower (aka flamingo flower, and laceleaf)  originates in the Americas including northern Mexico and northern Argentina but also in the Caribbean.  In this art piece the flower looks droopy and exhausted after a long day of romance

 

 

heart, lungs, ribs, chest, chest cavity, red pepper, grapes, banana, banana peel, X-ray, radiology, anatomy

Chest of Fruit – Heart Lungs and Ribs

The chest with ribs, heart and lungs are created using fruit. The lungs are grapes, the pulmonary arteries – carrots, the ribs a banana peel and the heart is a red pepper.

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Dogs Have Hearts Too 

It may take a moment to see the face of  labrador with the heart of the chest projected as his mouth and his two black eyes on either side of his cervical spine!  Once you appreciate the eyes – the rest will fall into place

And so ends our story.

 

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Heart Symbolisms – Cultural Anatomy

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Heaven’s Heart 

Heart symbolisms abound in almost every culture.  The heart has been the center of almost every civilization, and assigned the epicentre of physical emotional and spiritual life. In ancient cultures the brain was mostly ignored and its many functions were attributed to the heart.  Despite new knowledge,  many of the ancient cultural concepts remain ingrained in the religion, the psyche, language, literature, poetry, and art of modern civilization.

In the West, the heart has evolved as a symbol of love, in both romantic and religious spheres.  In the East, it is seen as a symbol of wisdom and spirituality.

Heart Symbolisms in History

Ancient belief in almost every major culture put the heart and heart symbolisms at the centre of the body and soul . Life with all its emotions, thoughts and beliefs centered around the heart.

The iconic heart symbol was identified in the culture of the Cro Magnon hunters of Europe before the last Ice Age (10,000-8000 BCE). The inference of the icon to the hunters remains a mystery.

The ancient Egyptians (3500BC-1000 BC) believed the heart controlled the mind and soul, and that it was the center of morality. It was also considered the source of memory, emotions, and personality. They believed that God spoke to individuals through the heart.  There was concern among Egyptians that after death, that the heart might testify against the deceased; to prevent this, the ancient Egyptians often wrapped a heart scarab within the bandages to prevent the heart from speaking. They also preserved the heart during mummification so it would not be weighed during judgement after death.

The 5000 year old ancient Chinese culture believes that the heart is the root of the body, mind and soul of life.  Additionally it controls joy, reflects facial expression, and has important roles in the psyche.

The Jewish culture goes back 5000 years as well. The Old testament, originated around 1500 BC, and references to the heart abound . It is viewed as the organ of conscience, the origin of human action, imagination, determination, emotion, love, virtue and vice, good and evil, humility and pride. The  heart is revealed as the “inner” person:

“the Lord seeth not as man seeth; for man looketh on the outward appearance, but the Lord looketh on the heart” [Samuel 16:7].

Also among many other references

“it grieved him (God) at his heart.”  

Genesis 6:6 

The word “heart” appears 725 times in the  Old testament,

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Art in the Clouds, Love, and Prayer

Love and Prayer …… a cloud in the sky that says it all… or at least some of it…  The art piece is a collection of different modes of prayer with the same goal in mind ie to connect with a higher power. An idea of a central God may not necessarily fit with all religions,.  The central “God” therefore in this piece relates to a central focus of core beliefs.

In Hinduism, a culture that started around 1750 BCE, teaches that the heart is the center of life, action, emotion, consciousness, and the soul. The belief is that it nourishes the organs and supplies  energy for the formation of semen. Similar to Egyptian belief, it has importance in connecting heaven and earth.  It also is the organ where the love of God is experienced.

In ancient Greece, Aristotle, who lived in the 4th century B.C., described  the heart as the most important organ of the body. He considered it the seat of intelligence, motion, sensation and vitality.

In Christianity the heart reflects love, piety, and charity.  In the art of the middle ages and thereafter, the flaming heart reflects religious passionate fervor.  A flaming heart pierced by an arrow symbolizes faith despite trial, and repentance.  The New Testament started in the middle of the 1st century AD. Jesus repeatedly uses “pure of heart”

Paul prays

“that Christ may dwell in your hearts through faith;” [Ephesians 3:3].

The word “heart” appears 105 times in the New Testament.

In the 1st millennium AD in ancient Mexico, the Teotihuacan culture believed that the the teyolia – the spiritual force of the heart, was responsible for life.

Galen who lived in the second century A. D., reaffirmed the Greek concepts of  the heart and promoted it as the organ most closely related to the soul.

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The Heart of Galen – Creator of the Vital Spirit

The AiA rendering shows the body according to Galen. Heat plays a central role in his theory.  He believed the heart was closely related to the soul and the source of the body’s heat . The liver, he taught was the primary source of the humors that controlled the body, and that the heart played a subordinate role.

At the beginning of the eleventh century, the Persian, Avicenna (980-1037 AD), authored  “The Book of Healing” that included medical and philosophical content.  Avicenna describes the heart as the source of life.

The Aztecs a nomadic tribe of northern Mexico, arrived in Mesoamerica in the 13th century and reached their pinnacle in the 15th century. They believed that the heart, or the yollotli, was the seat of life and the soul. Before cremation a green jewel was placed in the mouth of the dead person to represent the heart.  The culture also believed that human sacrifice for the offering of the heart to the Gods was required for ongoing prosperity.  It was a ritual performed at the highest level and required to  honour the gods.  Interestingly the yollotli was also a standard of measurement from the mid chest to the tip of the outstretched arm, equivalent to about 3 feet.

In summary the heart was central to the body mind of soul in so many cultures that it pervaded day to day life,  and therefore became central to the emotional aspects of most, if not all cultures. The innate need to represent these emotions in all facets of life including religion, philosophy, literature, poetry, music,  and art was a natural outcome.

The History of the Icon

heart, history, symbol, Jesus Christ, anatomy, heraldry, Valentine's day, sacred heart, heraldry, mood, emotion, Christianity, symbol, icon

History of the Shape of the Heart Icon

 The collage reveals the symbols that contributed to the shape of the heart icon as we know it.  The shape of the heart became familiar to cultures who hunted or sacrificed animals (image top left).  The heart shaped leaves and seeds had parallel emotional connections.  The silphium seed for example (seen as golden heart shaped structure above) , was used by ancient Greeks for contraception and was reproduced on their coins.  Organs relating to the nitty gritty of romance including breasts, mons pubis, buttocks and scrotum have rotund shape that has parallels in the icon of the heart .  It is no wonder that the the shape gained popularity and application to the romantic elements of life.   
This art piece was adapted and modified from public domain photograph by Frank Eugene, taken 1898, called Adam and Eve and published in Camera Work no. 30,1910 

Art and the Heart – A History

heart, history, symbol, Jesus Christ, anatomy, heraldry, Valentine's day, sacred heart, heraldry, mood, emotion, Christianity, symbol, icon

History of Heart Symbolism

The earliest use of the heart as a symbol of love is found in an art piece in the middle of the 13th century.  The collage depicts, romantic, religious, devotion, emotion, bravery, heraldry, mathematics, geometry, botany, card games, Valentine’s day, and finally and central in the art piece – the traditional emoticon.  

Literature and the Heart 

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Shakespeare and the Heart

From the late Middle Ages onward, literature and poetry romanticize the heart.  The above art piece used information  from the Oxford Shakespeare Concordance and identifies the frequency of the word heart and heart related words  (eg heartless and heartily).  More than 1100 instances were found. 

In the Divine Comedy,  Dante (1265-1321) refers to

Love, which is quickly kindled in the gentle heart,
seized this man for the fair form that was
taken from me, and the manner still hurts me.

Also…

Pride, Envy, and Avarice are
the three sparks that have set these hearts on fire.

Valentine’s day itself first became associated with romance during the time of Geoffrey Chaucer (1343–1400).

Literature in which the word “heart” appears in the title from the late 18th, 19th and early 20th century include among many; Heart of the Midlothian – Sir Walter Scott (1771-1832), The Tell Tale Heart by  Edgar Allen Poe (1809-1849,  Heart of Darkness by Joseph Conrad (1857-1924), The Heart of Man by Erich Fromm (1900-1980),  Heartbreak House by George Bernard Shaw (1856-1950), The Heart is a Lonely Hunter by Carson McCullers (1917-1967), Bury My Heart at Wounded Knee: An Indian History of the American West by Dee Brown (1908 – 2002)

Poetry and the Heart 

The association of the heart and love abound in poetry.

Charles d’Orlean was a member of the French Royal family who lived in the 15th century. While captive in England he wrote love poems such as the one translated below

Because I cannot see you,
My heart complains day and night,
Lovely lady, peerless one of France,
And has charged me to write you
That he does not have all he desires
In the Prison of Discontent.

 by Charles d’Orlean and translated by David A. Fein 

Some famous poems of the the late 19th and early 20th century which include the word heart in the title; My Heart and I  by  Elizabeth Barrett Browning (1806-1861), If I Can Stop One Heart From Breaking, Emily Dickinson (1830-1886), Never Give All The Heart, William Butler Yeats (1865-1939), Flame Heart Claude McKay (1889-1948),  The Trusting Heart, Dorithy Parker (1893 -1967),  I Carry Your Heart with Me – EE Cummings  (1894-1962),  The Laughing Heart Charles Bukowski (1920-1994)  

Music and the Heart

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Middle Ages Music, Heart and Love

AiA combined two art pieces that are in the public domain; Heart shaped musical score of Baude Cordier is an offering of love to a lady.  Christian and Muslim playing Lutes from the Canticles of Holy Mary during the reign of Alfonso X El Sabio (1221–1284) 

Recent Music and the Heart

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The Heart in Modern Song

Song ..another emotional outlet for the expression of love romance, and spirituality in culture. Between 1956 and 1978, 15 artists used the word “HEART” in the title of their song and each sold more than a million copy of their records.

Evolving Use of Heart Symbolisms

Valentines Day is a classical example of the persistent use of the symbol of the heart as a symbol of love and romance and it appears on all types of commercial products.  The icon of the heart for communication on the web, in emails, electronic messaging, graffiti, in all sorts of arts and crafts abound almost adnauseum.

We seem to be returning to the world of hieroglyphics – and the icon of the heart almost always sends a positive message – and so … that is always good!

References

Jager Eric  – Reading the Book of the heart from the Middle Ages to the twenty First Century; University of Chicago Press