Mountains of Sublimity, Mountains of Fatigue: Towards a History of Speechlessness in the Alps

The discovery of the Alps in the second half of the eighteenth century spawned an aesthetics of sublimity that enabled overwhelmed beholders of mountains to overcome their confusion symbolically by transforming initial speechlessness into pictures and words. When travelers ceased to be content with beholding mountains, however, and began climbing them, the sublime shudder turned into something else. In the snowy heights, all attempts to master symbolically the challenging landscape was thwarted by vertigo, somnolence, and fatigue. After 1850, physiologists intervened, using the Alpine terrain as a laboratory landscape that was ideally suited to examine one of the most threatening concerns of fin de siècle industrial societies: fatigue. This essay examines how the picturesque voyage turned into an experimental physiology of fatigue, and how the "wordless subjectivity” of romantic travelers turned into the "wordless objectivity” of life scientist

Introduction: The Laboratory of Nature - Science in the Mountains

"Today I made the ascent of the highest mountain in this region, which for good reasons is called Ventosum, guided only by the desire to see the extraordinary altitude of the place” (Petrarque [1336] 1880, 6-7). Petrarch's ascent of the Mont Ventoux in 1336, or rather his account of it, established the mountain as a distinctive place for experiencing and understanding nature and self. Since then, the mountain has been sought out in increasing numbers by those pursuing spiritual elevation, bodily exertion, and/or scientific investigation. To this day, a pilgrimage church, several hotels, and an observatory are characteristically perched atop Mont Ventoux. And it is famous among cyclists as a legendarily difficult étape of the Tour de Franc

Mountains of sublimity, mountains of fatigue: Towards a history of speechlessness in the Alps

ISSN:1474-0664ISSN:0269-889

Introduction: The Laboratory of Nature – Science in the Mountains

ISSN:1474-0664ISSN:0269-889

A Randomized Controlled Clinical Trial Comparing 20 Gauge and 23 Gauge Vitrectomy for Patients with Macular Hole or Macular Pucker

IntroductionTo compare the transconjunctival sutureless 23 gauge (G) pars plana vitrectomy (PPV) with 20 G PPV regarding inflammation, safety, visual outcome and patient comfort.MethodsWe included 103 patients with symptomatic macular hole or macular pucker, scheduled for vitrectomy in this prospective, randomized, controlled, mono-center clinical trial. Patients were randomized 1:1 to either 20G PPV (n=51) or 23G PPV (n=52). All eyes underwent standard 20G or 23G PPV with membrane peeling. Primary outcome measure was change in aqueous humor flare 3weeks after surgery compared with baseline. Secondary outcome measures were flare values 2days and 26weeks after surgery, subjective discomforts measured with a visual analog scale, best-corrected visual acuity, duration of surgery, intraocular pressure (IOP) and adverse events.ResultsThere was no significant difference in change of flare 3weeks after PPV [- 1.7, 95% CI (- 6.3 to 2.9), p=0.466]. Both groups showed a significant increase in flare 2 days after surgery (20G: p<0.001, 23G: p=0.002), but only the 20G group after 3weeks (p=0.011). The gain in visual acuity after 3 weeks was higher after 23G PPV (4.2 95% CI (0.4-8.0, p=0.029), but without a difference after 6months. The duration of surgery was shorter in the 23G group (p<0.001). Patient comfort 3weeks after surgery was greater after 23G PPV (foreign body sensation p=0.002; itching: p=0.021). However, the rate of complications did not differ between the groups.ConclusionThe primary aim, showing the superiority of the 23G group regarding the change of flare value from baseline to 3weeks after surgery, was not met, but the level of inflammation decreased faster after 23G PPV. Clear advantages of the 23G PPV were a lower risk of postoperative IOP elevation, a shorter surgery time, faster visual recovery and greater patient comfort in the early postoperative phase.Clinical Trial Registration NumberClinicalTrials.gov NCT01969929

A randomized controlled clinical trial comparing 20 gauge and 23 gauge vitrectomy for patients with macular hole or macular pucker

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