Surgeon Education, Engaging with the Immanence of Events of Practice: an exploration of the ontological and ethical dimensions of surgical training and practice

This thesis contrasts the construction of medical knowledge that surgeons must acquire to practice with the kind of knowing that arises unpredictably, through actual events of surgical practice. Such knowing is demonstrated through the research process in which surgeons discuss events of practice and their strategies for coping. As such, the thesis argues that this kind of knowing is central to the onto- epistemological task of becoming a surgeon and is therefore, a crucial pedagogic dimension of such becoming. In actual situations of practice, surgeons may be forced to respond, act and think in ways that exceed the approved teachings of surgical knowledge and technical skills. This is not to diminish or disregard the structured programmes of education and training. Instead, I advocate reconfiguring the dominant models of surgical teaching and learning to include pedagogies that are sensitive to the immanent nature of clinical relations and practice. Whilst established clinical knowledge may be said to be abstracted from actual occasions of practice, knowing that emerges through the contingencies of such occasions is grounded in the ‘thisness’ of practice. In this practical immediacy, affective experiencing is a critical precursor to clinical strategies. The thesis draws upon theories of affect and becoming from Alfred North Whitehead, Gilles Deleuze, Brian Massumi and Gilbert Simondon. In analysing the policy documentation and training materials, the thesis draws from the theories of Michel Foucault, Judith Butler and Pierre Bourdieu. This investigation identified affective relations that form and develop within the local flows of experiencing of an event of practice. These forms of ‘thinking-feeling’ contribute to the entangled subjectivities and heterogenous obligations that can expand surgeons’ capacities of becoming. A pedagogy of the surgical event attempts to engage with a learner’s ideas and intensities of experience, triggered by the affective connections that arise when coping with the thisness of contingent events of practice. These immanent relations express how an event of practice comes to matter to a surgeon, how it attains significance

Endobronchial ultrasound and bronchial artery embolization for Dieulafoy's disease of the bronchus in a teenager: A case report

Dieulafoy's disease of the bronchus is a relatively rare cause of hemoptysis. It can be completely asymptomatic and diagnosed as an incidental finding on bronchoscopy. At the other end of the spectrum, it can present with potentially fatal hemorrhage. We present a case of a 13-year old boy who suffered from massive hemoptysis. Endobronchial ultrasound (EBUS) and bronchial artery embolization (BAE) proved useful in the initial management. This case may support the role of EBUS in the diagnosis of Dieulafoy's disease as well as other intrapulmonary vascular lesions

Design, synthesis and evaluation of novel heterodimers of donepezil and huperzine fragments as acetylcholinesterase inhibitors

Four series of novel heterodimers comprised of donepezil and huperzine A (HupA) fragments were designed, synthesized, and evaluated in search of potent acetylcholinesterase (AChE) inhibitors as potential therapeutic treatment for Alzheimer's disease. Heterodimers comprised of dimethoxyindanone (from donepezil), hupyridone (from HupA), and connected with a multimethylene linker, were identified as potent and selective inhibitors of AChE. Diastereomeric heterodimers (RS,S)-17b (with a tetramethylene linker) exhibited the highest potency of inhibition towards AChE with an IC50 value of 9 nM and no detectable inhibitory effect on butyrylcholinesterase at 1 mM. (C) 2012 Elsevier Ltd. All rights reserved

Imaging findings of Paragonimus westermani

Purpose: To analyze the imaging findings of pulmonary and extra-pulmonary paragonimiasis. Methods: The imaging findings of serologically and clinically confirmed 22 cases of Paragonimus westermani infection identified over a five-year period (2010–2015) were retrospectively analyzed. Chest CT (n = 22), brain CT (n = 2) & MRI (n = 1), abdomen CT (n = 3) scans were available. Results: Chest CT scan was abnormal in 20 patients and the CT findings were as follows: nodule (n = 18), ground glass opacity (GGO) (n = 12), worm cyst (n = 10), migration track (n = 7), fibrosis (n = 5), pleural effusion (n = 15), pleural thickening (n = 10), pleural calcification (n = 1). Hilar or mediastinal lymphadenopathy was noted in three patients. Brain CT scan showed patchy low density in the left occipital lobe in one patient and patchy mixed density in the right basal ganglia and kidney-shaped low density area in the left basal ganglia in another patient. Brain MRI scan revealed a circular lesion with ring enhancement in the right parietal lobe. Abdominal CT scan showed conglomerated small cystic or serpentine lesions and migration track in the right lobe of liver and spleen. Conclusions: The imaging findings of P. westermani is so diverse and non-specific due to its complex life cycle and several life stages during infestation of human; however, common features include nodule, GGO, worm cyst, migration track, pleural effusion, pleural thickening on chest CT scan; patchy low or mixed density lesions on brain CT scan; ring enhancing lesion on brain MRI scan; conglomerated small cystic or serpentine lesions and migration track in liver and spleen on abdominal CT scan. The characteristic imaging features of paragonimiasis are worm cyst and migration track

Additional file 1: Table S1. of Neuroprotective effect of a novel Chinese herbal decoction on cultured neurons and cerebral ischemic rats

Assessments of physiological parameters before, during and after ischemia (MCAO) in control and PSR pre-treated rats. Figure S1. Representative TTC-stained brain slices for sham and MCAO rats, with the latter animals divided into 4 groups that were pre-treated with vehicle, 1.1 g/kg, 2.2 g/kg or 5.5 g/kg PSR. Figure S2. Representative TTC-stained brain slices for sham and MCAO rats, with the latter animals divided into 4 groups that were post-treated with vehicle, 1.1 g/kg, 2.2 g/kg or 5.5 g/kg PSR. (DOCX 3065 kb

Additional file 1: Table S1. of Neuroprotective effect of a novel Chinese herbal decoction on cultured neurons and cerebral ischemic rats

Assessments of physiological parameters before, during and after ischemia (MCAO) in control and PSR pre-treated rats. Figure S1. Representative TTC-stained brain slices for sham and MCAO rats, with the latter animals divided into 4 groups that were pre-treated with vehicle, 1.1 g/kg, 2.2 g/kg or 5.5 g/kg PSR. Figure S2. Representative TTC-stained brain slices for sham and MCAO rats, with the latter animals divided into 4 groups that were post-treated with vehicle, 1.1 g/kg, 2.2 g/kg or 5.5 g/kg PSR. (DOCX 3065 kb