Creativity, Scenographers and the Director – Facilitator or Smotherer? - A Case Study from a Regional Rep Theatre

In theatre we make little attempt to define or study creativity, yet we often demand it of our students. It is hard to define but we owe them a duty to clarify what we mean. My studies examine creativity as a phenomenon embedded in a particular culture - in theatre, the culture of the ‘company’ and the interrelationships within it. This paper looks at what the (somewhat scant) literature perceives the director/scenographer relationship to be and then focuses in on one production at the Oldham Coliseum, using ethnographic techniques: observations of design meetings; interviews with the scenographers and director; and the production itself. Its conclusions reinforce the importance of the director–scenographer relationship as a major factor in the manifestation of scenographic creativity but find that in a ‘traditional’ rep there can be a real relationship of differently-skilled equals, and asks is this better for all? And if so, how can we train our scenography (and directing) students to develop that relationship

Hydrogen bonding interactions of benzylidene type Schiff bases studied by vibrational spectroscopic and computational methods

The structural features of four benzylidene type Schiff bases [(E)-benzaldehyde-N-phenyl imine, (A) (E)-2-hydroxybenzaldehyde-N-phenyl imine (B) (E)-benzaldehyde-N-2-hydroxyphenyl imine (C) (E)-2-hydroxybenzaldehyde-N-2-hydroxyphenyl imine (D)] were studied by FT-IR spectroscopy in solution, photoacoustic and Raman spectroscopies in the solid state and quantum chemical calculations. It was found that molecule D dimerised in the solid state with concomitant loss of aromaticity in the benzylidene ring. Beside the intermolecular C=O...HO hydrogen bonds, intramolecular N-H...C=O hydrogen bonds could be found experimentally as well as computationally. Spectra taken in solution and ab initio quantum chemical calculation helped to identify hydrogen bonding interactions occurring for compounds B and C. Intramolecular OH...N hydrogen bond predominated in molecule B, while this interaction, although it existed, was weaker

Chylorrhea: a rare complication of thoracoscopic discectomy of the thoracolumbar junction

Journal ArticleThe thoracic duct along with the cisterna chyli is a major lymphatic pathway near the anterior thoracolumbar spine. Despite the fragile nature of the lymphatic system and its proximity to the spinal column, chylorrhea is rarely encountered by spine surgeons. The authors present a unique case of chylorrhea associated with a left thoracoscopic, transdiaphragmatic discectomy and fusion for a T12-L1 herniated disc. The anomalous location of the thoracic duct at the left lateral vertebral column contributes to this unusual complication

Syndrome of inappropriate secretion of antidiuretic hormone and hyponatremia after spinal surgery

Journal ArticleHyponatremia caused by an inappropriately high level of antidiuretic hormone secretion after spinal surgery is an uncommon and self-limiting phenomenon that resolves within 2 or 3 weeks. During the early postoperative period, the patient's urine output and serum level of sodium should be monitored closely to prevent possible serious complications of the syndrome of inappropriate secretion of antidiuretic hormone. Symptoms vary depending on the severity of the hyponatremia and can range from mild headache, muscle cramps, nausea, and vomiting to convulsions, coma, and death. Treatment options include fluid restriction, oral intake of salt, and hypertonic saline. It is important that spine surgeons recognize this phenomenon early and treat it appropriately and conservatively to prevent possible serious complications

Thoracoscopic spine surgery for decompression and stabilization of the anterolateral thoracolumbar spine

Journal ArticleThe anterior thoracolumbar spine can be exposed via a variety of approaches. Historically, open anterolateral or posterolateral approaches have been used to gain access to the anterior thoracolumbar spinal column. Although the exposure is excellent, open approaches are associated with significant pain and respiratory problems, substantial blood loss, poor cosmesis, and prolonged hospitalization. With the increasing use of the endoscope in surgical procedures and recent advances in video-assisted thoracoscopic surgery, minimally invasive thoracoscopic spine surgery has been developed to decrease the morbidity associated with open thoracotomy. The purpose of this article is to illustrate the surgical technique of a minimally invasive thoracoscopic approach to the anterolateral thoracolumbar spine and to discuss its potential indications and contraindications in patients with diseases involving the anterior thoracic and lumbar regions

Surgical technique and results of endoscopic anterior spinal canal decompression

Journal ArticleObject. Decompression of the spinal canal in the management of thoracolumbar trauma is controversial, but many authors have advocated decompression in patients with severe canal compromise and neurological deficits. Anterior decompression, corpectomy, and fusion have been shown to be more reliable for spinal canal reconstruction than posterior procedures; however, traditional anterior-access procedures, thoracotomy, and thoracoabdominal approaches are associated with significant complications. Endoscopy-guided spinal access avoids causing these morbidities, but it has not been shown to yield equivalent results in spinal canal clearance. This study was conducted to demonstrate the effectiveness of endoscopic spinal canal decompression and reconstruction quantitatively by using pre- and postoperative computerized tomography (CT) scanning. Methods. Thirty patients with thoracolumbar canal compromise underwent endoscopic anterior spinal canal decompression, interbody reconstruction, and stabilization for fractures (27 cases), and tumor, infection, and severe degenerative disc disease (one case each). The mean follow-up period was 42 months (range 24 months-6 years). Neurological examinations, Frankel grades, radiological studies, and intraoperative findings were prospectively collected. Spinal canal clearance quantified on pre- and postoperative CT scans improved from 55 to 110%. A total of 25% of patients with complete paraplegia and 65% of those with incomplete neurological deficit improved neurologically. The complication rate was 16.7% and included one reintubation, two pleural effusions, one intercostal neuralgia, and one persistent lesion of the sympathetic chain. Conclusions. The authors describe the endoscopic technique of anterior spinal canal decompression in the thoracolumbar spine. The morbidities associated with an open procedure were avoided, and excellent spinal canal clearance was accomplished as was associated neurological improvement

Diffuse large B-cell lymphoma presenting as a sacral tumor

Journal ArticlePrimary lymphomas of the sacrum are rare tumors, reported only in a few cases in the literature. The authors describe two patients with diffuse large B-cell lymphomas presenting as a sacral tumor. In the first case a 52-year-old man presented with progressive back pain, bilateral radicular pain, and saddle block anesthesia secondary to a lytic, expansile soft-tissue mass. The mass arose from the sacrum and eroded through the right S-1 to S-4 foramina and extended into the epidural space of the spinal canal. On magnetic resonance imaging, the sacral mass enhanced homogeneously with Gd. In the second case a 64-year-old man presented with left-sided radicular pain, paresthesias, and progressive weakness due to a lytic soft-tissue mass in the left sacral ala extending into the left L-5 and S-1 foramina. Metastatic workup in each patient demonstrated unremarkable findings. In both cases, an open biopsy procedure was performed after nondiagnostic examination of needle biopsy samples. Histopathological examination showed evidence consistent with diffuse large B-cell lymphoma in both patients. In the first case the disease was classified as Stage IAE, and the patient subsequently underwent four cycles of cyclophosphamide/ doxorubicin/vincristine/prednisone (CHOP)- and rituximab-based chemotherapy followed by consolidation radiotherapy. In the second case the disease was also classified as Stage IAE, and the patient underwent CHOP-based chemotherapy and consolidation radiotherapy. In both cases radiography demonstrated a decrease in size of the sacral lymphomas. The authors review the clinical, radiological, and histological features of sacral lymphomas. Lymphoma should be considered in the differential diagnosis of sacral tumors

Management of brain abscesses associated with halo fixation

Journal ArticleHalo orthoses are commonly used in the management of a variety of cervical spinal pathological conditions. Although placement of the cranial pins was initially believed to be safe with minimal complications, minor complications related to the cranial pins have the potential to create a setting for formation of cerebral abscesses. The risk of death due to cerebral abscesses has declined in the modern antibiotic era, but cerebral abscesses are associated with long-standing neurological morbidity that should not be considered negligible. Prevention by careful pin placement and hygiene and appropriate early management are crucial to prevent more serious complications. The authors report the case of a patient treated with a halo orthosis after incurring cervical spinal trauma who developed a cerebral abscess as a complication related to the cranial pins of the halo fixation device. They review the literature in an attempt to formulate a standardized treatment algorithm to prevent this disease process and to treat an abscess if it should form

Minimally invasive thoracoscopic resection of paraspinal neurogenic tumors: technical case report

Journal ArticleOBJECTIVE: The posterior mediastinum is a common location for benign neurogenic tumors. They are frequently asymptomatic but can present with local compressive or neurological symptoms. METHODS: Thoracoscopy is used increasingly over posterolateral thoracotomy for the removal of these lesions. RESULTS: Complete resection of these tumors through a thoracoscopic approach is possible in most cases, but dumbbell tumors present as special challenges, which require a combined thoracoscopic and open posterior approach. CONCLUSION: In this article, we outline the technique of thoracoscopic resection of paraspinal neurogenic tumors through an operative video and a review of the literature to summarize the surgical outcomes of patients with these lesions