Lux – Light; pellucidem
The middle of the human brain contains a membrane structure that separates the two halves of the cerebrum. This membrane, a septum, so fine that it allows light to pass through it, it is almost translucent; pel-lucid, named in Latin; the septum pel lucidum, i.e. the dividing wall that is translucent.
Absence of the septum pellucidum occurs in certain congenital conditions and because the septum is involved with formation of the tracts concerning vision, it is often associated with blindness, and incidentally many other neurological problems.
I have included the X-ray of a newborn baby with congenital absence of this structure as well as absence of other brain structures. The Chest X-ray itself was normal.
The image consists of two base images; a red flower, colour inverted, and a layer of rusty iron is subtracted. Light (lux in Latin) is provided by a picture of a candle overlaid to give focus to the image.
Cancer of the kidneys classically spreads to the lungs giving rounded deposits that are supposed to look like cannon-balls.
This image contains only one photograph, apart from the X-ray of a man with cannon-ball metastases from a kidney carcinoma. The base picture comes from a leaf with fungus marking the surface with multiple tiny black spots. The fungal spots were selectively copied and pasted on the top layer and given a spray with a white brush to produce the granular almost snowy appearance symbolising fragments of the cancer swept in showers by the blood-stream into the lungs. The remainder of the components of the image are painted on using various brushes in Photoshop, including a “bubble” brush.
Joints and Juvenile RA
Most people know about Rheumatoid Arthritis but there is also a Juvenile form (JRA) that affects the joints of children. It used to be known as Still’s disease, though the eponym has largely fallen away. This disease affects the joints of young children and as opposed to the adult form which begins by affecting the joints of the fingers and toes, this goes for the larger joints first. Typically there is joint pain and morning stiffness. It causes inflammation of the synovial tissues which increases blood flow to the bones in the area. This makes the bone grow faster, but also makes them fuse earlier, so they are tall thin children and short adults due to growth retardation. The synovial tissue proliferates and eats away at the bone around the joint and effectively destroys the joint tissue, similarly though less marked than the adult form. The commonest complication is eye disease which can if left untreated lead to blindness. Uncommonly it may follow the adult form and lung fibrosis may occur though this complication is late. The X-ray in this image is from an adult who had JRA as a child, who now has severe disease of the shoulder joints and fibrosis at the bases of both lungs.
The layers combined in this image are from the crimson skin of a red fruit, this is paired with a green concrete wall stained with algae, and the border is from a granite paving stone. I interposed a layer of pure white into which I cut “holes” using a masking tool, and allowed the under layer to shine through. By careful use of the Curves tool I was able to soften the colours considerably leaving a concentration of colour over the left shoulder and neck of the X-ray.
Ivory, Indigo and Influenza
The aim in this image was to show and contrast the two colours ivory and indigo. I did so by using simple plain layers of each colour and then “cutting” holes in each to allow the other to shine through. This was laid over separate green and red layers that combined to give some contrasting colour. The overall rough texture is a layer of plaster in a pale yellow colour. The X-ray of a person with influenza pneumonia is laid on top in three separate layers was used to provide depth to the image by giving a reference point.
Influenza kills many people every year, taking mostly the old and very young. Prevention is so important and the disease is imminently preventable with vaccination! Yet programs for vaccination take up less than 30% of the population, and presumably for political reasons – cost mainly – vaccination programs concentrate mainly on health workers and elderly.
The two pillars of modern medical ethics are based on the concepts of “helping” and “doing no harm” otherwise “therapeutics” and “prevention”. Xenophon in 400 BC said – As there are persons who mend torn garments, so there are physicians who heal the sick; but your duty is far nobler, and one befitting of a just person, namely to keep people in health. (Cryopaedia 400 BC.) But, although prevention is so very important, it is often seen in the medical profession as less important than treating sick people. It’s like Pandora’s box; we fail to keep a lid on the problem with preventative measures preferring to treat it once the disease is out there, the Ebola crisis in West Africa was a perfect example. There is a fair amount of misinformation regarding vaccination “I thought vaccinations against flu don’t work”, and quite spurious reasons – “I don’t like injections”. (There is even a body of misrepresentation by the anti-vaccination faction.)
But prevention with annual vaccination is important; influenza is unpredictable. The virus constantly changes. Immunity from vaccination declines over time. An annual flu vaccination is the first and best way to protect against influenza.
Heart of Stone
For this image I chose a man with heart failure following a cardiac infarction – a heart attack. This is due to deposition of cholesterol plaques in the arteries, particularly those supplying the heart muscle. The plaques frequently calcify, sometimes known as hardening of the arteries. (Reference Ezekiel 11:19 “And I will take the heart of stone out of their flesh and give them a heart of flesh.”) These days cardiac vessels can often be dilated using small intra-arterial balloons. But I selected pictures of stone and concrete surfaces with textures to match. For the binding chest pain of a myocardial infarct I found an old picture of a wooden water-tank taken in Maui years ago. It was covered with orange algae and bound around with hoops of steel. The surface texture was highlighted. This gave plaques of colour on the image like calcified plaques in arteries. The final picture is full of tension and darkness. It’s appropriate because myocardial infarction, although it has dropped considerably with improved first aid treatment and wide availability of equipment such as defibrillators, remains a leading cause of mortality worldwide.
G for Genetic and gaucher’s
Today’s alphabetical challenge was G. There are very few medical conditions starting with G, and Gaucher’s disease is one of them. This is a genetic storage disease in which metabolic products of cells cannot be expelled from cells due to a deficiency in one of the enzyme processes. This results in a massive build-up of unwanted product within the cell. Big cells mean big organs, and those organs which store the particular metabolite (in this instance a sphingolipid) are most affected. Big spleens, livers, and particularly deformed bones are characteristic. The earliest treatment consisted of extracting the deficient enzyme from human placentas and giving this as an injection for life. This has now been superseded by a complex process of recombining DNA in a bacterium which then produces this enzyme and bypasses the risks of using human material.
In the past, and even when I was training, these patients were considered incurable and allowed to die. Scientific breakthroughs, like enzyme substitution therapy, has allowed some people with this condition to live a reasonable life. At the same time some people thus afflicted have lived for many years with accompanying financial, emotional, and other hardships to themselves and families, without hope of recovery.
This image includes the Chest X-ray of a boy with Gaucher’s syndrome from the radiology museum of cases. It also includes a red flower, and a faded grey and pink banana leaf texture. These combine to give a star-burst which I see as symbolic of the hope for a breakthrough in gene therapy which can alleviate this condition.
OK, OK the link here is fairly tenuous, but the aphorism “Form Follows Function” was one drummed into me during my paediatric training. It is actually an architectural term, but applies just as well. to developmental anatomy This man with Poland’s syndrome is a case in point. This is a condition in which congenital absence of the pectoralis muscle on one side of the body occurs. Without normal muscle function pulling on the underlying ribs, they fail to form properly and the person has a flattened, often quite deformed thorax. Apart from not looking very nice, the condition is benign and seldom causes problems.
An interesting piece of history; the condition was described in 1841 by Alfred Poland, a Surgeon at Guys Hospital in London who dissected the body of a convict with this condition by the name of George Elt.
In a reference to St Therese of Lisieux “I will let forth a shower of roses” this image has a shower of daisies photographed in Dunster, BC Canada, about three years ago. This was segmented, the flowers lifted and warped to produce the shower falling over distant russet clad hills (But look the morn, in russet mantle clad – Shakespeare – to honour his death on 23rd April 1616, 400 years ago yesterday)