The Body as a Community (in progress) The Common Vein Copyright 2007 Introduction This chapter is intended to draw the parallels that exist between the functional units in the body, and their equivalents in a community of people, and introduce the consequences to the system when there is disorder. There are also some examples of what may be needed to convert the disorder to order. The module is lacking from the point of view of detail and depth, since the intention is to provide breadth and context. In keeping with the philosophy of this work, we start learning with the most basic of concepts and attempt to give context and an infrastructure to the information. We progress thereafter in stepwise fashion to greater detail and complexity. (inverted pyramid concept – see approach to learning) As we build the community of people into the village, town or city we observe the units to unity effect of a larger unit that is more powerful than the individual parts. In the body, the little people, or the cells, are located and organized in a variety of functional patterns. There are doctors, lawyers, butchers, bakers, and candlestickmakers. There are garbage collectors, water and sewerage workers, government workers, policemen, teachers, emergency medical responders, and long term care specialists. They are all there as we know them in our town and city experience- we just have to identify them. Within each of these levels is a community that has a structural and functional organization that is remarkably similar to the units that make them up and each depends on the other for its health. The country has no value if it has no people and the body no body if it has no cells. This chapter however focuses on the functional and collaborative organizational system of the organs, resulting in a series of systems that in conjunction, enable the person to survive, grow and be fulfilled. These systems have two relative states – order and disorder, or health and disease, or survivability and lack of it. There exists a continued and continual process that is required to maintain health and homeostasis because time is moving, conditions are changing, and adaptation is essential for survival. The two states – which can also be viewed as relatively positive and relatively negative can be reversed with appropriate resources and adaptation. The healers of the world, sometimes the government, sometimes the people, sometimes the police force and sometimes the doctors, sometimes the street sweepers, and sometimes the lawyers and often the teachers – in fact the functioon of most of us – our function is to to try and and change the world from a state of relative negativity to a world of relative positivity. Functionality of Systems The institutions of the organs and body systems have the following major role
The Central Nervous System The central nervous system is the government of our body. It ensures minute to minute survival as well as survival from week to week, month to month and year to year. It coordinates body function including the functions of production, transport, and protection, while it enables the organism to grow toward fulfilment. Malfunction of any the controlling functions of the nervous system brings disorder to the system. A stroke for example, is caused by the loss of blood supply to part of the brain caused by thrombosis of the artery. After about 4 minutes of lack of supply there will be death of the brain tissue supplied by that artery. The final functional outcome depends on the vessel involved and the extent of the damage, and will range from transient malfunction (also called a transient ischemic attack and abbreviated as TIA), through recoverable disease, to permanent impairment and in the extreme – death. Psychiatric disease is another dramatic example of loss of control of the brain over the body with resulting devaststing effects not only of the person but on the community. A “paralysed” city has broad implications but is one in which the day to day function is halted for one of many reasons. The word “paralysed” draws the parallel with implied paralysis of a stroke discussed above in which functionality is lost because one of the control systems has become impaired. While the asassination of John Kennedy brought an emtional paralysis to our country, the democratic organization with systems in place allowed full and ongoing functionality. On the other hand with the fall of the relative autocracy of Saddam Hussein in Iraq, a true paralysis resulted with loss of life and loss of maintenance of services more akin to the devastating effects of a cerebral stroke. The chaos of Iraq persists at this writing – 2 years after autocratic control of the country was lost and as the coutry tries through democratic process to regain control of its component people. Either way, the point of discussion is to reveal the importance of control systems in the body and in the towns, cities, and country, and the dramatic and terrible consequences when control systems are in disarray. Endocrine System The nervous system works in conjunction and is helped by the endocrine system which controls metabolic activity, as well as promoting growth and reproduction. It also contributes to water and salt maintenance. Its functional tools are the hormones produced by the specialised cellular workers in its factories which are scattered throughout the body. The endocrine system controls the supply and demand of the metabolic economy of the body. It ensures appropriate distribution and use of metabolic resources. The departments of economic affairs and their equivalents in the towns and cities formulate policies and programs relating to internal and external use of resources. The annual budget enables appropriate use of resources to ensure maintenance of life and optimise growth and fulfilment for the members of the society. The pituitary gland is the master gland of the endocrine system. One of the hormones it produces from the anterior pituitary gland is called growth hormone or somatotropin, which if produced in excess will result in acromegaly, (aka gigantism) while dwarfism is caused by lack of production. The apartheid government of South Africa did not apportion economic resources fairly to its citizens, resulting in poverty for a large proportion of its citizens (economic and social dwarfism)and excessive wealth for priviliged others. (economic and social gigantism) The resulting disproportionate use of resources led to excessive growth for one section of the society and stunted growth for the other. The function of the Federal Reserve in the USA parallels to some extent the function of the thyroid gland in that setting the prime rate enables some control of the basic economic activity for the country, much in the way that the thyroid controls the basic metabolic rate for the body. Thyroxine does not stand alone and it needs substrate (products) and use for the products to execute a balanced and healthy situation. In thyrotoxicosis there is an excess of of thyroxine (and a relative paucity of substrate) and the resulting overactivity is a patient who is at a high level of unnecessary activity. A paucity of thyroxine results in underactivity and is called myxedema. In this instance there is too little thyroxine, a relative excess of substrate that does not get used. In the community, the parallels relate to a state of health when the supply of materials and goods is in balance with the demands of the community. Overproduction of goods (without appropriate need and use) or unerproduction with insufficient products below the needs of the community are unhealthy situations. Inflation is defined as an economic situation when too much money chases too few goods (almost like too much thyroxine chasing relatively little substrate) and this results in a rise of cost for the goods. Recession is defined as a slowing of the economy and usually follows a boom and may precede a depression. The brain is assisted by the autonomic nervous system and peripheral nervous system which represent the lines of communication between the central governing body and the people. The autonomic nervous system maintains the automaticity of body function, increasing the activity when necessary and slowing it down during sleep hours. It controls the respiratory centre for example and the rate and rhythm of breathing is under its direct control. Again breathing is so essential to life that the process is a seamless event with no thought nor concious effort. The Respiratory System The respiratory system has the life sustaining role of bringing oxygen to the body. Oxygen is needed to regenerate ATP from ADP through a process called oxidative phosphorylation. ATP is the only source of chemical energy that the body can use (bioenergy)) Failure of delivery of oxygen results in irreversible brain injury after about 4 minutes and irreversible cardiac muscle injury after 10-15 minutes. Most othe tissues are slightly more forgiving for the lack of oxygen but the time is usually counted in terms of minutes before irreversible change and death occurs. The oxygen from our atmosphere is mostly produced by photosynthesis, a process which occurs in plant life and which breaks down carbon dioxide and water to produce oxygen and sugars. Oxygen is thus part of environment to the same extent that the interstitial space surrounds and is part of the environment of the cells.
Therapeutic Intervention
There are many factors that are prerequisites for the sustenance of life. Sometimes it is the energy itself that we are concerned with (ATP) and sometimes it is the facilitators (oxygen, enzymes, cofactors, coenzymes, hormones). Electricity, oil, gas, propane, solar , and nuclear energy are some of the more commonly used forms. The failure of delivery of any one of these may bring significantt discomfort and inconvenience but will not usually lead to death and irreversible injury. Cardiovascular System The cardiovascular system consisting of the heart, arteries, veins, and capillaries functions as one of the many tubular transport systems of the body. It represents the roads and highways, railways and airways, seaways and riverways of the transport systems as we know them in our towns and cities. The cardiovascular system enables the delivery of essential raw and refined products, and the removal and transport of waste to the appropriate dumps. Disease of the vessels is commonly due to obstruction and a consequent inability of supply to meet demand. In the case of arterial obstruction to the coronary arteries the consequent myocardial infarction can and often results in death. The event of a highway accident results in a mere inconvenience – but imagine the devastation if the water supply were suddenly cut off as is seen when a city is under siege, or when main water spplies are lost. Survival is of course threatened.
In the cardiovascular system the relatively positive pressure in the left sided systemic circulation created by the left ventricle, enables flow throught the capillary circulation, perfusion of the cells tissues and organs, and subsequent return of the blood to the relatively low pressure of the right side of the heart. The pulmonary circulation on the other hand is serviced by the pumping action of the right ventricle, which creates a positive force and flow to the capillaries of the lung and subsequent return to the low pressure of the left atrium. Congestion
Rupture
Interruption of Flow and Repair
Gastrointestinal System The gastrointestinal system is the food basket and the garbage removal service of the body. It is responsible for taking in, pocessing, transporting, absorbing, and excreting food and water, the raw products of metabolism. The gastrointestinal system is the breadbasket of our bodies. It receives the food, processes, absorbs, stores, and transports the food, and helps either to recycle needed products, or eliminate unwanted products. It thus functions as the equivalent of our farms, food processing plants, grocery, food delivery systems, water and sewerage works, and recycling plants. Food and the Community – Road from Farm to the Cell
– functionality the stroke that may result in paralysis of the person.A similar event where vital supply to the controlling institutions may be seen in the oft used tactic of yesteryear of a siege of a city. In this instance it is a lack of supply to the whole city, but the term paralysed city would be appropriate brainis related to permanent affecting the verbal function, results in an inability to communicate needs – such as hunger and thirst – survival needs. A coup of a government, or in the case of the curent realtively leaderless situation in Iraq, gives a sense of
The respiratory system brings fuel to the fire by providing oxygen for all metabolic events. This oxygen is required not only for the maintenance and sustenance of life but is also required for every specialised and productive function. The community requires sustained supplies of adequate and clean air, food and water for sustenance. The clean air comes to our cities and as long as we are vigilant As our industrial world evolved, the machines that we built required alternate sources of energy in the form of electricity and fuel. The factories that process, package and store our food for example are dependant on these alternate and costly sources of energy that are not freely available like the air we breathe. Thus the viability of our factories in general, and our food factories specifically, are dependant on these alternate sources of energy and hence our viability and survival to some extent is dependant on them too. This was not the case when we livee the hunter gatherer lifestyle.valuable and sourceswithout these energy sources and they have become the sources of our food, and to lesser The most frequently used fuel is electricity which is often used in conjunction with oil and or gas. Unlike the oxygen which is freely available to our bodies the energies that are vital to the function of the factories of our city come with a price which closes for the night, the fuel requirement of oxygen is always needed.
The genitourinary system
Factories are an essential component of our community. They manufacture and process critical items such as food, clothing, and building materials, – all essential for our survival. We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a The needs of human biology include survival, growth, and fulfilment. Consider the city in which you live and you will find that in general, the core of the city contains components in some form of these three elements. The cell in its turn has to have similar elements. While it is easy to recognise the survival, and to some extent growth in the life of a cell, the fulfilment aspect is not as obvious. As human conciousness emerges as a result of the power of the units to unity of cellular accumulation, the needs for individual fulfilment at many levels becomes comprehensible. On the other hand as one moves beyond the individual to the family and then to communities of progressively enlarging sizes, the aspects of survival and growth are fairly easy to see and understand while the element of fulfilment becomes even a more difficult concept. We are going to look at the city (or the village or town for that matter and we are going to look at its survival, growth and fulfilment as best we can to expose how the biology in the person translates into the city. The makeup of the city. The city has elements that include resources for survival, resources for growth, and resources for fulfilment. Resources for survival include sources for food ,water, protectionclothing, and housing, and the provision of an environment that has safety institutions of public safety Departments Shopping centre – food Water departmentEnvironment/building/police Survival: Neither the cell nor the city can survive without air water and food. Students of biology understand the acquisition of air and oxygen through the breathing mechanisms championed by the respiratory system, while the acquisition, processing and use of food and water is understood by the study of the gastrointestinal system. The pattern of acquisition, transport, processing, and exportation are repeating principles in all of biology. It is therefore not surprising that a city, which an extension of the biology that resides within it, functions along the same principles. The air we breathe is as natural a form of the environment of the city, as the interstitial fluids that bathe our cells. It comes free and is key to our survival – every second of it – the difference between life and death of a city and a cell, is totally dependant on this entity – air and oxygen – and fortunately for the city – it coms relatively easy. Air and Oxygen:
Our need for oxygen is so essential to life, that for most – it is packaged with life itself and we have no struggle to obtain it except under exceptional circumstances. While the person and city are naturally exposed to the oxygen source, the cell is dependant on transport mechanisms to bring the oxygen to it. Thus the upper powers of the hiearchy (the body and its systems) are in control of this essential element of life for the cell. If they, for whatever reason lose control of oxygen supply to the cells in the form of airway obstruction or occlusion of a coronary or cerebral artery, the overall survival of the biological unit becomes threatened. In this example we see and start to understand the interdependancy of biological units. In the case of the city (town or village) and the person air and oxygen is a given and oft unappreciated gift, while in the case of the tissues and cells, it is a commodity that has to be earned to some extent and has to be delivered. The cell is at the mercy of others in the team to deliver air regulalrly and efficiently. In the same way that we have to “earn’ our food by working, earning, positioning ourselvs to receive and transporting our food, the cells and tissues have to earn their supply of oxygen. Thus for example the heart cell has to position itself in its place of employment (cardiac tissue in the borough of the thoracic cavity) It holds hands in syncitial format with the other cells in its production line which has positioned itself near the rivers of the arterial system in order to efficiently receive the oxygen (and other metabolic products) necessary for its function. Its work starts early in the morning of its original birth, and it practices its trade of contraction and relaxation which it learned from the school housed in the genetics of contractile evolutionary lessons. Its work consists a pumping action and as a result it can “earn” reactive vasodilation (brokered by the Nobel winning nitrous oxide mechanism). If it works harder based on physiological need (perhaps a run in the park by the CEO) it will earn and receive more food. Thus the pattern of earn by positioning a biological unit in a work environment, doing the work, earning the reward, is for the myocardial cell in its use of oxygen and food what it is for the individual who earns money for food. The city receives as a gift the oxygen from the environment. It has to ensure that this gift remains untainted and is kept free of pollutants. Water and Food When it comes to food and water, the concepts are the same but the story is a little different. Both the cell, and the individual become slave to the larger community to provide the essential units, while they retain masterhood for eventual survival. A healthy city will have mechanisms in place to acquire and deliver food and water regularly and efficiently. We start to talk of relative scarcity of the commodity, and a need to “earn” the food and water. While clean water through the evolution of the sciences comes to most cities through a tubular systems, it comes with a cost albeit relatively small, and we therefore have to earn iour water Our ability to position ourselves to “earn” our food and water for survival seems to me to be no different from the myocardial or liver cell that has learned a skill that is valuable for the community. “If you give you get ” I tell my children – this is so fundamental in all of biology. The delivery of water to biological units has a larger latitude in terms of the time when compared to the delivery of oxygen. Whereas the need for oxygen delivery is measured in seconds and minutes the delivery and use of food and water can be measured in multiples of minutes and hours. Water and food to the cell is delivered in the same way as air is delivered – via tubular systems. The tissues keep themselves bathed in just the right amount of water, at the right temperature. Water to the person and city comes from reservoirs and water plants via tubular systems. Whereas water is almost as The food to the person has to be earned. there is an order in the world that is beyond our comprin order and ouThe biological world in general tends to be hostile with each biological unit fighting for survival. The need for food, fluid, oxygen, is obvious, and the need for a a safe and clean environment is a large part of the survival.SuWhen we look at biological units, including the cell, organs, persons or communities we take in things, process them and give them out. The cell mostly has no choice about where it is positioned in life. It is slave to its circumstance Raw materials Hospitals
Supermarkets
:aw and Order
Ridding Waste Garbage
References Chase Dunn and Jorgensen Regions and Interaction Networks. a World-Systems Perspective |
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => A trash can with styrofoam boxes from McDonalds, diet coke cans and Kit Kat wrappers. Does our garbage tell a story of the way we live? Courtesy Ashley Davidoff MD. 02013p code accessory interesting garbage waste radiologists and detectives Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => A trash can with styrofoam boxes from McDonalds, diet coke cans and Kit Kat wrappers. Does our garbage tell a story of the way we live? Courtesy Ashley Davidoff MD. 02013p code accessory interesting garbage waste radiologists and detectives Davidoff photography )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Garbage [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Garbage )
DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Rules of the Road An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Rules of the Road An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Rules of the Road [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Rules of the Road )
DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Law and Order 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Law and Order 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Law and Order [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Law and Order )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => 83937.800 city wall safety protection Porto Portugal Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => 83937.800 city wall safety protection Porto Portugal Davidoff photography )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Walled Body 49640 bone rib thoracic spine spinous processes scapula protection support CTscan volume rendering Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Walled Body 49640 bone rib thoracic spine spinous processes scapula protection support CTscan volume rendering Davidoff MD )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Walled City of Porto 83936 city wall safety protection Porto Portugal Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Walled City of Porto 83936 city wall safety protection Porto Portugal Davidoff photography )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => 83936 city wall safety protection Porto Portugal Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => 83936 city wall safety protection Porto Portugal Davidoff photography )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Free and Fresh Air for the City New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Free and Fresh Air for the City New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Free and Fresh Air for the City [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Free and Fresh Air for the City )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Courtesy Ashley Davidoff MD 01217 code esophagus + vein + ;liver portal vein spleen splenic vein left gastric vein coronary vein IMV inferior mesenteric vein fx short gastric varices + angiography transhepatic venogram anatomy [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Courtesy Ashley Davidoff MD 01217 code esophagus + vein + ;liver portal vein spleen splenic vein left gastric vein coronary vein IMV inferior mesenteric vein fx short gastric varices + angiography transhepatic venogram anatomy )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => The Portal System [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => The Portal System )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => 82001p.800 Bruge Belgium interesting accessory urine urinary system genitourinary tract urine out put Courtesy of Ashley Davidoff MD Davidoff photo [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => 82001p.800 Bruge Belgium interesting accessory urine urinary system genitourinary tract urine out put Courtesy of Ashley Davidoff MD Davidoff photo )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => Urination [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => Urination )
DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => The Liver Factory 44426b01 liver hepatic clockwork purple anatomy Courtesy Ashley Davidoff Davidoff art [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => The Liver Factory 44426b01 liver hepatic clockwork purple anatomy Courtesy Ashley Davidoff Davidoff art )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => A Narrowed Artery and a Repaired Artery The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => A Narrowed Artery and a Repaired Artery The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD )
DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => Alveoli of the Lung – Factory Workers This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => Alveoli of the Lung – Factory Workers This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => (object value omitted) [nextElementSibling] => (object value omitted) [nodeName] => table [nodeValue] => The Gold Dome of the State House of Massachusetts – Central Control Brain – Central Control 83562.800 city Boston skyline gold dome government centre state house control law Davidoff photography 14798b08.800 brain anatomy physiology cerebrum cerebral autonomic nervous system central nervous system peripheral nervous system eyes ears mouth nose taste sight heart cardiovascular system respiratoty system lungs gastrointestinal system liver pancreas kidney spleen adrenals gentourinary system genitalia normal anatomy davidoff art TCV the common vein [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => The Gold Dome of the State House of Massachusetts – Central Control Brain – Central Control 83562.800 city Boston skyline gold dome government centre state house control law Davidoff photography 14798b08.800 brain anatomy physiology cerebrum cerebral autonomic nervous system central nervous system peripheral nervous system eyes ears mouth nose taste sight heart cardiovascular system respiratoty system lungs gastrointestinal system liver pancreas kidney spleen adrenals gentourinary system genitalia normal anatomy davidoff art TCV the common vein )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => table [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 1 [previousElementSibling] => [nextElementSibling] => [nodeName] => table [nodeValue] => The Body as a Community (in progress) The Common Vein Copyright 2007 Introduction This chapter is intended to draw the parallels that exist between the functional units in the body, and their equivalents in a community of people, and introduce the consequences to the system when there is disorder. There are also some examples of what may be needed to convert the disorder to order. The module is lacking from the point of view of detail and depth, since the intention is to provide breadth and context. In keeping with the philosophy of this work, we start learning with the most basic of concepts and attempt to give context and an infrastructure to the information. We progress thereafter in stepwise fashion to greater detail and complexity. (inverted pyramid concept – see approach to learning) As we build the community of people into the village, town or city we observe the units to unity effect of a larger unit that is more powerful than the individual parts. In the body, the little people, or the cells, are located and organized in a variety of functional patterns. There are doctors, lawyers, butchers, bakers, and candlestickmakers. There are garbage collectors, water and sewerage workers, government workers, policemen, teachers, emergency medical responders, and long term care specialists. They are all there as we know them in our town and city experience- we just have to identify them. Within each of these levels is a community that has a structural and functional organization that is remarkably similar to the units that make them up and each depends on the other for its health. The country has no value if it has no people and the body no body if it has no cells. This chapter however focuses on the functional and collaborative organizational system of the organs, resulting in a series of systems that in conjunction, enable the person to survive, grow and be fulfilled. These systems have two relative states – order and disorder, or health and disease, or survivability and lack of it. There exists a continued and continual process that is required to maintain health and homeostasis because time is moving, conditions are changing, and adaptation is essential for survival. The two states – which can also be viewed as relatively positive and relatively negative can be reversed with appropriate resources and adaptation. The healers of the world, sometimes the government, sometimes the people, sometimes the police force and sometimes the doctors, sometimes the street sweepers, and sometimes the lawyers and often the teachers – in fact the functioon of most of us – our function is to to try and and change the world from a state of relative negativity to a world of relative positivity. Functionality of Systems The institutions of the organs and body systems have the following major role Maintenance of life – the coordinated process of the systems that keep things alive and moving Fulfilment of life – the effects of a healthy system that allows the parts of the system to thrive and grow In order to accomplish these roles there are systems in place in both the healthy body and the healthy city that work in unison Controlling Systems Production systems- the factories Transport systems Protective systems Systems for growth and reproduction. The Central Nervous System The central nervous system is the government of our body. It ensures minute to minute survival as well as survival from week to week, month to month and year to year. It coordinates body function including the functions of production, transport, and protection, while it enables the organism to grow toward fulfilment. The Gold Dome of the State House of Massachusetts – Central Control Brain – Central Control 83562.800 city Boston skyline gold dome government centre state house control law Davidoff photography 14798b08.800 brain anatomy physiology cerebrum cerebral autonomic nervous system central nervous system peripheral nervous system eyes ears mouth nose taste sight heart cardiovascular system respiratoty system lungs gastrointestinal system liver pancreas kidney spleen adrenals gentourinary system genitalia normal anatomy davidoff art TCV the common vein Malfunction of any the controlling functions of the nervous system brings disorder to the system. A stroke for example, is caused by the loss of blood supply to part of the brain caused by thrombosis of the artery. After about 4 minutes of lack of supply there will be death of the brain tissue supplied by that artery. The final functional outcome depends on the vessel involved and the extent of the damage, and will range from transient malfunction (also called a transient ischemic attack and abbreviated as TIA), through recoverable disease, to permanent impairment and in the extreme – death. Psychiatric disease is another dramatic example of loss of control of the brain over the body with resulting devaststing effects not only of the person but on the community. Normal and Global Ischemia after Cardiac Arrest The two images represent a diffusion weighted MRI image which measures Brownian motion of molecules. In acute infarction there is restricted Brownian motion of the affected area and the image can be manipulated to present this a s a bright region. In this case the acute infarction or ischemia (b) is relatively bright compared to the white and gray matter of the normal (a) 49433c02.800 brain cerebral cerebrum white matter gray matter basal ganglia fx increase intensity in gray matter relative decrease in intensity in white matter dx global ischemia question brain death probable irreversible brain death cerebral infarction s/p arrest MRI DWI diffusion weighted imaging normal and abnormal Courtesy Ashley Davidoff MD Stroke – Chronic impairment In this unfortunate 60 year old a stroke which is seen in the high superior and anterior frontal lobe as a low density abnormality in a, overlaid in green in b, resulted in a significant functional defect including spastic deformity and functional loss of the left arm and hand. 48641c01.800 60 year old male brain area of decreased attenuation in the superior anterior frontal laobe fx encephalomalacia dx chronic infarction CTscan 3 D resurface rendering Courtesy Ashley Davidoff MD A “paralysed” city has broad implications but is one in which the day to day function is halted for one of many reasons. The word “paralysed” draws the parallel with implied paralysis of a stroke discussed above in which functionality is lost because one of the control systems has become impaired. While the asassination of John Kennedy brought an emtional paralysis to our country, the democratic organization with systems in place allowed full and ongoing functionality. On the other hand with the fall of the relative autocracy of Saddam Hussein in Iraq, a true paralysis resulted with loss of life and loss of maintenance of services more akin to the devastating effects of a cerebral stroke. The chaos of Iraq persists at this writing – 2 years after autocratic control of the country was lost and as the coutry tries through democratic process to regain control of its component people. Either way, the point of discussion is to reveal the importance of control systems in the body and in the towns, cities, and country, and the dramatic and terrible consequences when control systems are in disarray. Endocrine System The nervous system works in conjunction and is helped by the endocrine system which controls metabolic activity, as well as promoting growth and reproduction. It also contributes to water and salt maintenance. Its functional tools are the hormones produced by the specialised cellular workers in its factories which are scattered throughout the body. The endocrine system controls the supply and demand of the metabolic economy of the body. It ensures appropriate distribution and use of metabolic resources. The departments of economic affairs and their equivalents in the towns and cities formulate policies and programs relating to internal and external use of resources. The annual budget enables appropriate use of resources to ensure maintenance of life and optimise growth and fulfilment for the members of the society. The pituitary gland is the master gland of the endocrine system. One of the hormones it produces from the anterior pituitary gland is called growth hormone or somatotropin, which if produced in excess will result in acromegaly, (aka gigantism) while dwarfism is caused by lack of production. The apartheid government of South Africa did not apportion economic resources fairly to its citizens, resulting in poverty for a large proportion of its citizens (economic and social dwarfism)and excessive wealth for priviliged others. (economic and social gigantism) The resulting disproportionate use of resources led to excessive growth for one section of the society and stunted growth for the other. A Single Abnormal Gigantic Floret – Gigantism a Quirk of Nature Variations in Size in Humans 61229p flower allium size large elongated greater than the 90th percentile abnormally enlarged Davidoff photography Former Olympian Olga Korbut (C) stands between Manute Bol (L) and William “The Refrigerator” Perry (R) during the weigh-in for Celebrity Boxing 2 in Los Angeles, California Tuesday, May 14, 2002. Korbut will face Darva Conger and Bol will face Perry during the boxing event which will air May 22 on Fox. REUTERS/John Hayes 54916.800 Olga 5feet 1 inch Manut Bol 7foot 7 inches William Perry 6’2” 370lbs The function of the Federal Reserve in the USA parallels to some extent the function of the thyroid gland in that setting the prime rate enables some control of the basic economic activity for the country, much in the way that the thyroid controls the basic metabolic rate for the body. Thyroxine does not stand alone and it needs substrate (products) and use for the products to execute a balanced and healthy situation. In thyrotoxicosis there is an excess of of thyroxine (and a relative paucity of substrate) and the resulting overactivity is a patient who is at a high level of unnecessary activity. A paucity of thyroxine results in underactivity and is called myxedema. In this instance there is too little thyroxine, a relative excess of substrate that does not get used. In the community, the parallels relate to a state of health when the supply of materials and goods is in balance with the demands of the community. Overproduction of goods (without appropriate need and use) or unerproduction with insufficient products below the needs of the community are unhealthy situations. Inflation is defined as an economic situation when too much money chases too few goods (almost like too much thyroxine chasing relatively little substrate) and this results in a rise of cost for the goods. Recession is defined as a slowing of the economy and usually follows a boom and may precede a depression. The brain is assisted by the autonomic nervous system and peripheral nervous system which represent the lines of communication between the central governing body and the people. The autonomic nervous system maintains the automaticity of body function, increasing the activity when necessary and slowing it down during sleep hours. It controls the respiratory centre for example and the rate and rhythm of breathing is under its direct control. Again breathing is so essential to life that the process is a seamless event with no thought nor concious effort. System of Wires Nerves and Autonomic Ganglia In this scene of Johannesburg taken from the highway, we can view the vital lines of electrical energy that are essential to maintain the city. In the distance we see the city that the electrical lines serves. We also see other elements that have biological equivalents. – the fence that protects and prevents and forms a border between the highway and the property of the homes that reside on the other side. An old goldmine dump to the left of the picture – the tall post office tower for communication and a host of office buildings for collaborative effort. 57692 city electricity air energy essential community need Johannesburg South Africa fence capsule tcv the common vein Davidoff photography 83925 elctricity node ganglion nerve control telephone cable box connections communication control systems nerves Davidoff photography Normal CXR and one with Pacemaker needed for Complete Heart Block Secondary to Involvement of the Conduction System of the Heart by Sarcoidosis 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 49740b03.800 hx 34 male heart cardiac pacemaker lung chronic interstitial lung disease fibrosis inflammation dx sarcoidosis of the heart with complicated by involvement of the A-V atrioventricular node with complete heart block necessitating an urgent pacemaker placement TCV applied biology complete heart block Davidoff MD The Respiratory System The respiratory system has the life sustaining role of bringing oxygen to the body. Oxygen is needed to regenerate ATP from ADP through a process called oxidative phosphorylation. ATP is the only source of chemical energy that the body can use (bioenergy)) Failure of delivery of oxygen results in irreversible brain injury after about 4 minutes and irreversible cardiac muscle injury after 10-15 minutes. Most othe tissues are slightly more forgiving for the lack of oxygen but the time is usually counted in terms of minutes before irreversible change and death occurs. The oxygen from our atmosphere is mostly produced by photosynthesis, a process which occurs in plant life and which breaks down carbon dioxide and water to produce oxygen and sugars. Oxygen is thus part of environment to the same extent that the interstitial space surrounds and is part of the environment of the cells. Respiratory System This image represents a 3D rendered image of the airways and lungs with the heart whose function in transporting oxygen and carbon dioxide is vital to survival. The lungs and airways represent the organ that brings the most basic of elements essential to life – oxygen. The airways and lungs are in turn surrounded by a capsular fence called the pleura that protects and separates them from other structures. The pump station -aka the heart is seen centrally which is also protected and separated from the other organs by the pericardium. Courtesy of Ashley Davidoff M.D. 45819 chest cardiac heart trachea right and left bronchus lungs cardiomegaly enlarged CTscan surface rendering Courtesy Ashley Davidoff MD 45815 45816 45818 45819 45820 45821 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Alveoli of the Lung – Factory Workers This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing The Lung – Order and Disorder These two anatomic specimens represent the left lung in health and disease. The right specimen is one of a hemorrhagic pneumonia with the alveoli drowned in blood and pus. Courtesy Ashley Davidoff MD. a87-68 32228b code lungs pulmonary lymphatics distended grosspathology anatomy fissure left Chest X-Ray – Normal and Abnormal 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 47100.800 chest lung bronchus fx air bronchogram dx pneumonia CXR plain film Davidoff MD Therapeutic Intervention Before and After Antibiotic Therapy Images a and b show a pneumonia in the right middle lobe in both the A-P and lateral examination as an almost rectangular white patch, which resolved with treatment shown as a normal CXR in images c and d. 41819c02 Courtesy Ashley Davidoff MD medical students code chest CXR imaging lung plain film pneumonia radiology resolution There are many factors that are prerequisites for the sustenance of life. Sometimes it is the energy itself that we are concerned with (ATP) and sometimes it is the facilitators (oxygen, enzymes, cofactors, coenzymes, hormones). Electricity, oil, gas, propane, solar , and nuclear energy are some of the more commonly used forms. The failure of delivery of any one of these may bring significantt discomfort and inconvenience but will not usually lead to death and irreversible injury. Cardiovascular System The cardiovascular system consisting of the heart, arteries, veins, and capillaries functions as one of the many tubular transport systems of the body. It represents the roads and highways, railways and airways, seaways and riverways of the transport systems as we know them in our towns and cities. The cardiovascular system enables the delivery of essential raw and refined products, and the removal and transport of waste to the appropriate dumps. Disease of the vessels is commonly due to obstruction and a consequent inability of supply to meet demand. In the case of arterial obstruction to the coronary arteries the consequent myocardial infarction can and often results in death. The event of a highway accident results in a mere inconvenience – but imagine the devastation if the water supply were suddenly cut off as is seen when a city is under siege, or when main water spplies are lost. Survival is of course threatened. Highways Byways and Waterways for the City 32165 code RS pulmonary lung alveolus arteriole venule epithelium drawing gas exchange anatomy physiology histology 83557.800 highways waterways reservoirs storage stations factories homes transport systems bus cars Davidoff photography Cardiovascular System 32368b05.800 cardiovascular system heart cardiac artery arteries capillary capillaries arterioles venules veins negative firces positive forces road highway TCV the common vein applied biology Davidoff art Davidoff MD In the cardiovascular system the relatively positive pressure in the left sided systemic circulation created by the left ventricle, enables flow throught the capillary circulation, perfusion of the cells tissues and organs, and subsequent return of the blood to the relatively low pressure of the right side of the heart. The pulmonary circulation on the other hand is serviced by the pumping action of the right ventricle, which creates a positive force and flow to the capillaries of the lung and subsequent return to the low pressure of the left atrium. Congestion Open Highway and Congestion 57693b01 road highway clear open city electricity street lights Johannesburg South Africa Davidoff photography Davidoff MD Open Highway and Congestion 51187 Vehicles jam the Spanish highway leading to France after French authorities prevented Spanish Basque protesters from entering the country Saturday, March 11, 2000, in Irun, northern Spain. Photo by Bob Edme (AP) Normal Chest and Pulmonary Congestion 42076c04 Courtesy Ashley Davidoff MD medical students code batwing distribution congestion heart lung Rupture Intact River and Rupture and Flooding 83567.800 Charles river Boston Massachusetts Salt and Pepper Bridge order TCV The Common VEin Davidoff photography 50755 MAPUTO:MOZAMBIQUE – Houses on the outskirts of Mozambique’s capital Maputo are flooded after heavy rains drenched southern Africa, February 12. Flooding has forced an estimated 250,000 Mozambicans to find temporary refugee and left at least 50 dead across southern Africa. In Mozambique, flooding threatened the fertile farming land of the Limpopo Valley and regional capitals and waterborne disease loomed. Photo by Red Cross (Reuters) Order and Disorder Caused by Environmental Change 57677 before and after Kalutara Sri Lanka Courtesy DigitalGlobe.com Normal and Ruptured Aorta 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA Interruption of Flow and Repair A Bridge Broken and a Bridge Repaired 13227 bridge obstruction break disease disorder Davidoff photography 02340p bridge repaired Potomac Washington DC water TCV the common vein Davidoff photography The Normal Coronary Artery This is an anterior view of the heart showing the long LAD travelling within the expected course of the interventricular septum. Courtesy of Ashley Davidoff M.D. 32134 code cardiac heart coronary artery LAD diagonal conal infundibulum RVOT anatomy normal A Narrowed Artery and a Repaired Artery The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD Ruptured Aneurysm and Repair by Embolization 22521 22524 Courtesy Ashley Davidoff MD code spleen + artery + dx ruptured splenic artery aneurysm pseudoaneurysm + cystic fibrosis biliary cirrhosis portal hypertension angiography emergency Gastrointestinal System The gastrointestinal system is the food basket and the garbage removal service of the body. It is responsible for taking in, pocessing, transporting, absorbing, and excreting food and water, the raw products of metabolism. The gastrointestinal system is the breadbasket of our bodies. It receives the food, processes, absorbs, stores, and transports the food, and helps either to recycle needed products, or eliminate unwanted products. It thus functions as the equivalent of our farms, food processing plants, grocery, food delivery systems, water and sewerage works, and recycling plants. Food and the Community – Road from Farm to the Cell A Farm in Peru 0175.800 farm vegetables road transport units on the farmland oxygen sunlight clouds water TCV the common vein Peru Davidoff photography Mountain Farms in Peru 0178.800 Peru farm wall units to unity mountains vertical agriculture food the common vein applied biology Davidoff photography Davidoff MD Gathering on a farm in Pennsylvania 02512p food farm gathering receiving packing transporting TCV the common vein Davidoff photography Packing Red Peppers on a farm in South Arica 57984.800 farm red peppers vegetables South Africa gather picking transport work Davidoff photography Transport 0072.800 0010.800 Peru cane transport woman old barefoot bare feet hat storage Davidoff photography Davidoff MD Storage in Peru 0074.800 Peru corn storage drying in the sun food carbohydrate Davidoff photography Davidoff MD Storage 02387p USA New Hampshire storage food store farm water phone wires electricity electrical TCV the common vein Davidoff photography Davidoff MD Market in PEru 62923.800 community market produce Peru people Davidoff photography Davidoff Oneness Fish Workers in Portugal Columnar Epithelium in the Gut 56889 fishprocessors in Portugal young women uniform gum boots 70043cD08.800 cells columnar epithelium food processing packing packaging digestion absorbtion excretion Davidoff art Davidoff MD TCV the common Vein Davidoff photography Davidoff MD Selling or “Exchanging” in a Market in Jerusalem 02837p bananas selling Arab market Old Jerusalem Israel TCV the common vein Davidoff photography Garlic in Greece 02977p Athens Greece food seller garlic TCV The Common Vein Davidoff photography Chicks in Greece 02976p chickens chicks Greece food roadside seller young woman TCV the common vein Davidoff photography Davidoff MD Food Distribution in New York City – Liver Metabolic Warehouse Elegant foods through the window of Balducci’s New York Courtesy Ashley Davidoff MD 02128p code interesting accessory Davidoff photography Buying in Boshoek South Africa – Tel # 1 10150 Boshoek South Africa food buying distributing telephone women baby woman TCV the common vein Davidoff photography Eating in Peru 0063.800 Peru food eating restaurant Davidoff photography Davidoff MD Gathering Food and Transporting 39562c esophagus stomach hiatus hernia normal HH Stomach – Storage Cleansing 00410 stomach body areae gastrica mucosa contrast barium upper GI UGI X-Ray imaging radiology normal anatomy histology Healthy Brothers in South Africa and Malnourished Child in Ethiopa 02348p01 boy youth health nutrition physiology anatomy Davidoff photography 51954 51955 DANAN, ETHIOPIA – Malnourished children at a camp in the town of Danan some six hundred kilometers South East of Addis Ababa April 7. Ethiopia has appealed for over 800,000 tonnes of food aid to feed eight million people faced with starvation around the country this year. Photo by Peter Andrews (Reuters) Devastating Effects of Diabetes – aberrant glucose metabolism This image reveals the devastating manifestations of aberrant glucose metabolism as a result of insulin insufficiency, with consequent effects on the small vessels throughout the body. In this instance the diabetic arteriopathy is characterised by calcific atherosclerotic diease seen as calcification of the digital artery in b with subsequent ischemia to the foot. The poor nutrition has resulted in infection and ulceration of skin and bone, with poor healing and a need to amputate irrecovarable tissues. 48471c01 foot phalanx phalanges toes digital artery bone fx amputation calcified calcification of arteries dx diabetic arteriopathy chronic ischemia complicated by ulceration infection osteomyelitis treated with amputation diabetes mellitus metabolic disorder plain X-Ray of the foot Courtesy Ashley Davidoff MD Poverty – Poor Nutrition 57955 children third world South Africa tin shanty protective barb wire povert poor nutrition Davidoff photography – functionality the stroke that may result in paralysis of the person.A similar event where vital supply to the controlling institutions may be seen in the oft used tactic of yesteryear of a siege of a city. In this instance it is a lack of supply to the whole city, but the term paralysed city would be appropriate brainis related to permanent affecting the verbal function, results in an inability to communicate needs – such as hunger and thirst – survival needs. A coup of a government, or in the case of the curent realtively leaderless situation in Iraq, gives a sense of The respiratory system brings fuel to the fire by providing oxygen for all metabolic events. This oxygen is required not only for the maintenance and sustenance of life but is also required for every specialised and productive function. The community requires sustained supplies of adequate and clean air, food and water for sustenance. The clean air comes to our cities and as long as we are vigilant As our industrial world evolved, the machines that we built required alternate sources of energy in the form of electricity and fuel. The factories that process, package and store our food for example are dependant on these alternate and costly sources of energy that are not freely available like the air we breathe. Thus the viability of our factories in general, and our food factories specifically, are dependant on these alternate sources of energy and hence our viability and survival to some extent is dependant on them too. This was not the case when we livee the hunter gatherer lifestyle.valuable and sourceswithout these energy sources and they have become the sources of our food, and to lesser The most frequently used fuel is electricity which is often used in conjunction with oil and or gas. Unlike the oxygen which is freely available to our bodies the energies that are vital to the function of the factories of our city come with a price which closes for the night, the fuel requirement of oxygen is always needed. Factory on the Shore 83879b01.800 Boston MAssachusetts from the airplane factory sunrise chimney stacks storage tanks water sea energy sky light electricity the common vein applied biology concepts interstitium 3rd space extracellular space Davidoff photography Davidoff MD The Liver Factory 44426b01 liver hepatic clockwork purple anatomy Courtesy Ashley Davidoff Davidoff art Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography The genitourinary system Urination 82001p.800 Bruge Belgium interesting accessory urine urinary system genitourinary tract urine out put Courtesy of Ashley Davidoff MD Davidoff photo Factories are an essential component of our community. They manufacture and process critical items such as food, clothing, and building materials, – all essential for our survival. We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a The Portal System Courtesy Ashley Davidoff MD 01217 code esophagus + vein + ;liver portal vein spleen splenic vein left gastric vein coronary vein IMV inferior mesenteric vein fx short gastric varices + angiography transhepatic venogram anatomy The needs of human biology include survival, growth, and fulfilment. Consider the city in which you live and you will find that in general, the core of the city contains components in some form of these three elements. The cell in its turn has to have similar elements. While it is easy to recognise the survival, and to some extent growth in the life of a cell, the fulfilment aspect is not as obvious. As human conciousness emerges as a result of the power of the units to unity of cellular accumulation, the needs for individual fulfilment at many levels becomes comprehensible. On the other hand as one moves beyond the individual to the family and then to communities of progressively enlarging sizes, the aspects of survival and growth are fairly easy to see and understand while the element of fulfilment becomes even a more difficult concept. We are going to look at the city (or the village or town for that matter and we are going to look at its survival, growth and fulfilment as best we can to expose how the biology in the person translates into the city. The makeup of the city. The city has elements that include resources for survival, resources for growth, and resources for fulfilment. Resources for survival include sources for food ,water, protectionclothing, and housing, and the provision of an environment that has safety institutions of public safety Departments Shopping centre – food Water departmentEnvironment/building/police Survival: Neither the cell nor the city can survive without air water and food. Students of biology understand the acquisition of air and oxygen through the breathing mechanisms championed by the respiratory system, while the acquisition, processing and use of food and water is understood by the study of the gastrointestinal system. The pattern of acquisition, transport, processing, and exportation are repeating principles in all of biology. It is therefore not surprising that a city, which an extension of the biology that resides within it, functions along the same principles. The air we breathe is as natural a form of the environment of the city, as the interstitial fluids that bathe our cells. It comes free and is key to our survival – every second of it – the difference between life and death of a city and a cell, is totally dependant on this entity – air and oxygen – and fortunately for the city – it coms relatively easy. Air and Oxygen: Free and Fresh Air for the City New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting Our need for oxygen is so essential to life, that for most – it is packaged with life itself and we have no struggle to obtain it except under exceptional circumstances. While the person and city are naturally exposed to the oxygen source, the cell is dependant on transport mechanisms to bring the oxygen to it. Thus the upper powers of the hiearchy (the body and its systems) are in control of this essential element of life for the cell. If they, for whatever reason lose control of oxygen supply to the cells in the form of airway obstruction or occlusion of a coronary or cerebral artery, the overall survival of the biological unit becomes threatened. In this example we see and start to understand the interdependancy of biological units. In the case of the city (town or village) and the person air and oxygen is a given and oft unappreciated gift, while in the case of the tissues and cells, it is a commodity that has to be earned to some extent and has to be delivered. The cell is at the mercy of others in the team to deliver air regulalrly and efficiently. In the same way that we have to “earn’ our food by working, earning, positioning ourselvs to receive and transporting our food, the cells and tissues have to earn their supply of oxygen. Thus for example the heart cell has to position itself in its place of employment (cardiac tissue in the borough of the thoracic cavity) It holds hands in syncitial format with the other cells in its production line which has positioned itself near the rivers of the arterial system in order to efficiently receive the oxygen (and other metabolic products) necessary for its function. Its work starts early in the morning of its original birth, and it practices its trade of contraction and relaxation which it learned from the school housed in the genetics of contractile evolutionary lessons. Its work consists a pumping action and as a result it can “earn” reactive vasodilation (brokered by the Nobel winning nitrous oxide mechanism). If it works harder based on physiological need (perhaps a run in the park by the CEO) it will earn and receive more food. Thus the pattern of earn by positioning a biological unit in a work environment, doing the work, earning the reward, is for the myocardial cell in its use of oxygen and food what it is for the individual who earns money for food. The city receives as a gift the oxygen from the environment. It has to ensure that this gift remains untainted and is kept free of pollutants. Water and Food When it comes to food and water, the concepts are the same but the story is a little different. Both the cell, and the individual become slave to the larger community to provide the essential units, while they retain masterhood for eventual survival. A healthy city will have mechanisms in place to acquire and deliver food and water regularly and efficiently. We start to talk of relative scarcity of the commodity, and a need to “earn” the food and water. While clean water through the evolution of the sciences comes to most cities through a tubular systems, it comes with a cost albeit relatively small, and we therefore have to earn iour water Our ability to position ourselves to “earn” our food and water for survival seems to me to be no different from the myocardial or liver cell that has learned a skill that is valuable for the community. “If you give you get ” I tell my children – this is so fundamental in all of biology. The delivery of water to biological units has a larger latitude in terms of the time when compared to the delivery of oxygen. Whereas the need for oxygen delivery is measured in seconds and minutes the delivery and use of food and water can be measured in multiples of minutes and hours. Water and food to the cell is delivered in the same way as air is delivered – via tubular systems. The tissues keep themselves bathed in just the right amount of water, at the right temperature. Water to the person and city comes from reservoirs and water plants via tubular systems. Whereas water is almost as The food to the person has to be earned. there is an order in the world that is beyond our comprin order and ouThe biological world in general tends to be hostile with each biological unit fighting for survival. The need for food, fluid, oxygen, is obvious, and the need for a a safe and clean environment is a large part of the survival.SuWhen we look at biological units, including the cell, organs, persons or communities we take in things, process them and give them out. The cell mostly has no choice about where it is positioned in life. It is slave to its circumstance Raw materials Hospitals Supermarkets :aw and Order Walled City of Porto 83936 city wall safety protection Porto Portugal Davidoff photography Walled Body 49640 bone rib thoracic spine spinous processes scapula protection support CTscan volume rendering Davidoff MD Walled City of Porto 83937.800 city wall safety protection Porto Portugal Davidoff photography Law and Order 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography Rules of the Road An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography Ridding Waste Garbage Garbage A trash can with styrofoam boxes from McDonalds, diet coke cans and Kit Kat wrappers. Does our garbage tell a story of the way we live? Courtesy Ashley Davidoff MD. 02013p code accessory interesting garbage waste radiologists and detectives Davidoff photography Chimney from the Underground Smoke in New York city Courtesy Ashley Davidoff code accessory interesting chimney tube smoke New York 2001p Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Garbage Eater – Macrophage 02308p.800 monkey baboon garbage South Africa Cape Town Davidoff photography Bridge Intact 62639.800 bridge water intact white arch shape connection reflection TCV the common vein Davidoff photography References Chase Dunn and Jorgensen Regions and Interaction Networks. a World-Systems Perspective [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => table [baseURI] => [textContent] => The Body as a Community (in progress) The Common Vein Copyright 2007 Introduction This chapter is intended to draw the parallels that exist between the functional units in the body, and their equivalents in a community of people, and introduce the consequences to the system when there is disorder. There are also some examples of what may be needed to convert the disorder to order. The module is lacking from the point of view of detail and depth, since the intention is to provide breadth and context. In keeping with the philosophy of this work, we start learning with the most basic of concepts and attempt to give context and an infrastructure to the information. We progress thereafter in stepwise fashion to greater detail and complexity. (inverted pyramid concept – see approach to learning) As we build the community of people into the village, town or city we observe the units to unity effect of a larger unit that is more powerful than the individual parts. In the body, the little people, or the cells, are located and organized in a variety of functional patterns. There are doctors, lawyers, butchers, bakers, and candlestickmakers. There are garbage collectors, water and sewerage workers, government workers, policemen, teachers, emergency medical responders, and long term care specialists. They are all there as we know them in our town and city experience- we just have to identify them. Within each of these levels is a community that has a structural and functional organization that is remarkably similar to the units that make them up and each depends on the other for its health. The country has no value if it has no people and the body no body if it has no cells. This chapter however focuses on the functional and collaborative organizational system of the organs, resulting in a series of systems that in conjunction, enable the person to survive, grow and be fulfilled. These systems have two relative states – order and disorder, or health and disease, or survivability and lack of it. There exists a continued and continual process that is required to maintain health and homeostasis because time is moving, conditions are changing, and adaptation is essential for survival. The two states – which can also be viewed as relatively positive and relatively negative can be reversed with appropriate resources and adaptation. The healers of the world, sometimes the government, sometimes the people, sometimes the police force and sometimes the doctors, sometimes the street sweepers, and sometimes the lawyers and often the teachers – in fact the functioon of most of us – our function is to to try and and change the world from a state of relative negativity to a world of relative positivity. Functionality of Systems The institutions of the organs and body systems have the following major role Maintenance of life – the coordinated process of the systems that keep things alive and moving Fulfilment of life – the effects of a healthy system that allows the parts of the system to thrive and grow In order to accomplish these roles there are systems in place in both the healthy body and the healthy city that work in unison Controlling Systems Production systems- the factories Transport systems Protective systems Systems for growth and reproduction. The Central Nervous System The central nervous system is the government of our body. It ensures minute to minute survival as well as survival from week to week, month to month and year to year. It coordinates body function including the functions of production, transport, and protection, while it enables the organism to grow toward fulfilment. The Gold Dome of the State House of Massachusetts – Central Control Brain – Central Control 83562.800 city Boston skyline gold dome government centre state house control law Davidoff photography 14798b08.800 brain anatomy physiology cerebrum cerebral autonomic nervous system central nervous system peripheral nervous system eyes ears mouth nose taste sight heart cardiovascular system respiratoty system lungs gastrointestinal system liver pancreas kidney spleen adrenals gentourinary system genitalia normal anatomy davidoff art TCV the common vein Malfunction of any the controlling functions of the nervous system brings disorder to the system. A stroke for example, is caused by the loss of blood supply to part of the brain caused by thrombosis of the artery. After about 4 minutes of lack of supply there will be death of the brain tissue supplied by that artery. The final functional outcome depends on the vessel involved and the extent of the damage, and will range from transient malfunction (also called a transient ischemic attack and abbreviated as TIA), through recoverable disease, to permanent impairment and in the extreme – death. Psychiatric disease is another dramatic example of loss of control of the brain over the body with resulting devaststing effects not only of the person but on the community. Normal and Global Ischemia after Cardiac Arrest The two images represent a diffusion weighted MRI image which measures Brownian motion of molecules. In acute infarction there is restricted Brownian motion of the affected area and the image can be manipulated to present this a s a bright region. In this case the acute infarction or ischemia (b) is relatively bright compared to the white and gray matter of the normal (a) 49433c02.800 brain cerebral cerebrum white matter gray matter basal ganglia fx increase intensity in gray matter relative decrease in intensity in white matter dx global ischemia question brain death probable irreversible brain death cerebral infarction s/p arrest MRI DWI diffusion weighted imaging normal and abnormal Courtesy Ashley Davidoff MD Stroke – Chronic impairment In this unfortunate 60 year old a stroke which is seen in the high superior and anterior frontal lobe as a low density abnormality in a, overlaid in green in b, resulted in a significant functional defect including spastic deformity and functional loss of the left arm and hand. 48641c01.800 60 year old male brain area of decreased attenuation in the superior anterior frontal laobe fx encephalomalacia dx chronic infarction CTscan 3 D resurface rendering Courtesy Ashley Davidoff MD A “paralysed” city has broad implications but is one in which the day to day function is halted for one of many reasons. The word “paralysed” draws the parallel with implied paralysis of a stroke discussed above in which functionality is lost because one of the control systems has become impaired. While the asassination of John Kennedy brought an emtional paralysis to our country, the democratic organization with systems in place allowed full and ongoing functionality. On the other hand with the fall of the relative autocracy of Saddam Hussein in Iraq, a true paralysis resulted with loss of life and loss of maintenance of services more akin to the devastating effects of a cerebral stroke. The chaos of Iraq persists at this writing – 2 years after autocratic control of the country was lost and as the coutry tries through democratic process to regain control of its component people. Either way, the point of discussion is to reveal the importance of control systems in the body and in the towns, cities, and country, and the dramatic and terrible consequences when control systems are in disarray. Endocrine System The nervous system works in conjunction and is helped by the endocrine system which controls metabolic activity, as well as promoting growth and reproduction. It also contributes to water and salt maintenance. Its functional tools are the hormones produced by the specialised cellular workers in its factories which are scattered throughout the body. The endocrine system controls the supply and demand of the metabolic economy of the body. It ensures appropriate distribution and use of metabolic resources. The departments of economic affairs and their equivalents in the towns and cities formulate policies and programs relating to internal and external use of resources. The annual budget enables appropriate use of resources to ensure maintenance of life and optimise growth and fulfilment for the members of the society. The pituitary gland is the master gland of the endocrine system. One of the hormones it produces from the anterior pituitary gland is called growth hormone or somatotropin, which if produced in excess will result in acromegaly, (aka gigantism) while dwarfism is caused by lack of production. The apartheid government of South Africa did not apportion economic resources fairly to its citizens, resulting in poverty for a large proportion of its citizens (economic and social dwarfism)and excessive wealth for priviliged others. (economic and social gigantism) The resulting disproportionate use of resources led to excessive growth for one section of the society and stunted growth for the other. A Single Abnormal Gigantic Floret – Gigantism a Quirk of Nature Variations in Size in Humans 61229p flower allium size large elongated greater than the 90th percentile abnormally enlarged Davidoff photography Former Olympian Olga Korbut (C) stands between Manute Bol (L) and William “The Refrigerator” Perry (R) during the weigh-in for Celebrity Boxing 2 in Los Angeles, California Tuesday, May 14, 2002. Korbut will face Darva Conger and Bol will face Perry during the boxing event which will air May 22 on Fox. REUTERS/John Hayes 54916.800 Olga 5feet 1 inch Manut Bol 7foot 7 inches William Perry 6’2” 370lbs The function of the Federal Reserve in the USA parallels to some extent the function of the thyroid gland in that setting the prime rate enables some control of the basic economic activity for the country, much in the way that the thyroid controls the basic metabolic rate for the body. Thyroxine does not stand alone and it needs substrate (products) and use for the products to execute a balanced and healthy situation. In thyrotoxicosis there is an excess of of thyroxine (and a relative paucity of substrate) and the resulting overactivity is a patient who is at a high level of unnecessary activity. A paucity of thyroxine results in underactivity and is called myxedema. In this instance there is too little thyroxine, a relative excess of substrate that does not get used. In the community, the parallels relate to a state of health when the supply of materials and goods is in balance with the demands of the community. Overproduction of goods (without appropriate need and use) or unerproduction with insufficient products below the needs of the community are unhealthy situations. Inflation is defined as an economic situation when too much money chases too few goods (almost like too much thyroxine chasing relatively little substrate) and this results in a rise of cost for the goods. Recession is defined as a slowing of the economy and usually follows a boom and may precede a depression. The brain is assisted by the autonomic nervous system and peripheral nervous system which represent the lines of communication between the central governing body and the people. The autonomic nervous system maintains the automaticity of body function, increasing the activity when necessary and slowing it down during sleep hours. It controls the respiratory centre for example and the rate and rhythm of breathing is under its direct control. Again breathing is so essential to life that the process is a seamless event with no thought nor concious effort. System of Wires Nerves and Autonomic Ganglia In this scene of Johannesburg taken from the highway, we can view the vital lines of electrical energy that are essential to maintain the city. In the distance we see the city that the electrical lines serves. We also see other elements that have biological equivalents. – the fence that protects and prevents and forms a border between the highway and the property of the homes that reside on the other side. An old goldmine dump to the left of the picture – the tall post office tower for communication and a host of office buildings for collaborative effort. 57692 city electricity air energy essential community need Johannesburg South Africa fence capsule tcv the common vein Davidoff photography 83925 elctricity node ganglion nerve control telephone cable box connections communication control systems nerves Davidoff photography Normal CXR and one with Pacemaker needed for Complete Heart Block Secondary to Involvement of the Conduction System of the Heart by Sarcoidosis 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 49740b03.800 hx 34 male heart cardiac pacemaker lung chronic interstitial lung disease fibrosis inflammation dx sarcoidosis of the heart with complicated by involvement of the A-V atrioventricular node with complete heart block necessitating an urgent pacemaker placement TCV applied biology complete heart block Davidoff MD The Respiratory System The respiratory system has the life sustaining role of bringing oxygen to the body. Oxygen is needed to regenerate ATP from ADP through a process called oxidative phosphorylation. ATP is the only source of chemical energy that the body can use (bioenergy)) Failure of delivery of oxygen results in irreversible brain injury after about 4 minutes and irreversible cardiac muscle injury after 10-15 minutes. Most othe tissues are slightly more forgiving for the lack of oxygen but the time is usually counted in terms of minutes before irreversible change and death occurs. The oxygen from our atmosphere is mostly produced by photosynthesis, a process which occurs in plant life and which breaks down carbon dioxide and water to produce oxygen and sugars. Oxygen is thus part of environment to the same extent that the interstitial space surrounds and is part of the environment of the cells. Respiratory System This image represents a 3D rendered image of the airways and lungs with the heart whose function in transporting oxygen and carbon dioxide is vital to survival. The lungs and airways represent the organ that brings the most basic of elements essential to life – oxygen. The airways and lungs are in turn surrounded by a capsular fence called the pleura that protects and separates them from other structures. The pump station -aka the heart is seen centrally which is also protected and separated from the other organs by the pericardium. Courtesy of Ashley Davidoff M.D. 45819 chest cardiac heart trachea right and left bronchus lungs cardiomegaly enlarged CTscan surface rendering Courtesy Ashley Davidoff MD 45815 45816 45818 45819 45820 45821 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Alveoli of the Lung – Factory Workers This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing The Lung – Order and Disorder These two anatomic specimens represent the left lung in health and disease. The right specimen is one of a hemorrhagic pneumonia with the alveoli drowned in blood and pus. Courtesy Ashley Davidoff MD. a87-68 32228b code lungs pulmonary lymphatics distended grosspathology anatomy fissure left Chest X-Ray – Normal and Abnormal 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 47100.800 chest lung bronchus fx air bronchogram dx pneumonia CXR plain film Davidoff MD Therapeutic Intervention Before and After Antibiotic Therapy Images a and b show a pneumonia in the right middle lobe in both the A-P and lateral examination as an almost rectangular white patch, which resolved with treatment shown as a normal CXR in images c and d. 41819c02 Courtesy Ashley Davidoff MD medical students code chest CXR imaging lung plain film pneumonia radiology resolution There are many factors that are prerequisites for the sustenance of life. Sometimes it is the energy itself that we are concerned with (ATP) and sometimes it is the facilitators (oxygen, enzymes, cofactors, coenzymes, hormones). Electricity, oil, gas, propane, solar , and nuclear energy are some of the more commonly used forms. The failure of delivery of any one of these may bring significantt discomfort and inconvenience but will not usually lead to death and irreversible injury. Cardiovascular System The cardiovascular system consisting of the heart, arteries, veins, and capillaries functions as one of the many tubular transport systems of the body. It represents the roads and highways, railways and airways, seaways and riverways of the transport systems as we know them in our towns and cities. The cardiovascular system enables the delivery of essential raw and refined products, and the removal and transport of waste to the appropriate dumps. Disease of the vessels is commonly due to obstruction and a consequent inability of supply to meet demand. In the case of arterial obstruction to the coronary arteries the consequent myocardial infarction can and often results in death. The event of a highway accident results in a mere inconvenience – but imagine the devastation if the water supply were suddenly cut off as is seen when a city is under siege, or when main water spplies are lost. Survival is of course threatened. Highways Byways and Waterways for the City 32165 code RS pulmonary lung alveolus arteriole venule epithelium drawing gas exchange anatomy physiology histology 83557.800 highways waterways reservoirs storage stations factories homes transport systems bus cars Davidoff photography Cardiovascular System 32368b05.800 cardiovascular system heart cardiac artery arteries capillary capillaries arterioles venules veins negative firces positive forces road highway TCV the common vein applied biology Davidoff art Davidoff MD In the cardiovascular system the relatively positive pressure in the left sided systemic circulation created by the left ventricle, enables flow throught the capillary circulation, perfusion of the cells tissues and organs, and subsequent return of the blood to the relatively low pressure of the right side of the heart. The pulmonary circulation on the other hand is serviced by the pumping action of the right ventricle, which creates a positive force and flow to the capillaries of the lung and subsequent return to the low pressure of the left atrium. Congestion Open Highway and Congestion 57693b01 road highway clear open city electricity street lights Johannesburg South Africa Davidoff photography Davidoff MD Open Highway and Congestion 51187 Vehicles jam the Spanish highway leading to France after French authorities prevented Spanish Basque protesters from entering the country Saturday, March 11, 2000, in Irun, northern Spain. Photo by Bob Edme (AP) Normal Chest and Pulmonary Congestion 42076c04 Courtesy Ashley Davidoff MD medical students code batwing distribution congestion heart lung Rupture Intact River and Rupture and Flooding 83567.800 Charles river Boston Massachusetts Salt and Pepper Bridge order TCV The Common VEin Davidoff photography 50755 MAPUTO:MOZAMBIQUE – Houses on the outskirts of Mozambique’s capital Maputo are flooded after heavy rains drenched southern Africa, February 12. Flooding has forced an estimated 250,000 Mozambicans to find temporary refugee and left at least 50 dead across southern Africa. In Mozambique, flooding threatened the fertile farming land of the Limpopo Valley and regional capitals and waterborne disease loomed. Photo by Red Cross (Reuters) Order and Disorder Caused by Environmental Change 57677 before and after Kalutara Sri Lanka Courtesy DigitalGlobe.com Normal and Ruptured Aorta 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA Interruption of Flow and Repair A Bridge Broken and a Bridge Repaired 13227 bridge obstruction break disease disorder Davidoff photography 02340p bridge repaired Potomac Washington DC water TCV the common vein Davidoff photography The Normal Coronary Artery This is an anterior view of the heart showing the long LAD travelling within the expected course of the interventricular septum. Courtesy of Ashley Davidoff M.D. 32134 code cardiac heart coronary artery LAD diagonal conal infundibulum RVOT anatomy normal A Narrowed Artery and a Repaired Artery The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD Ruptured Aneurysm and Repair by Embolization 22521 22524 Courtesy Ashley Davidoff MD code spleen + artery + dx ruptured splenic artery aneurysm pseudoaneurysm + cystic fibrosis biliary cirrhosis portal hypertension angiography emergency Gastrointestinal System The gastrointestinal system is the food basket and the garbage removal service of the body. It is responsible for taking in, pocessing, transporting, absorbing, and excreting food and water, the raw products of metabolism. The gastrointestinal system is the breadbasket of our bodies. It receives the food, processes, absorbs, stores, and transports the food, and helps either to recycle needed products, or eliminate unwanted products. It thus functions as the equivalent of our farms, food processing plants, grocery, food delivery systems, water and sewerage works, and recycling plants. Food and the Community – Road from Farm to the Cell A Farm in Peru 0175.800 farm vegetables road transport units on the farmland oxygen sunlight clouds water TCV the common vein Peru Davidoff photography Mountain Farms in Peru 0178.800 Peru farm wall units to unity mountains vertical agriculture food the common vein applied biology Davidoff photography Davidoff MD Gathering on a farm in Pennsylvania 02512p food farm gathering receiving packing transporting TCV the common vein Davidoff photography Packing Red Peppers on a farm in South Arica 57984.800 farm red peppers vegetables South Africa gather picking transport work Davidoff photography Transport 0072.800 0010.800 Peru cane transport woman old barefoot bare feet hat storage Davidoff photography Davidoff MD Storage in Peru 0074.800 Peru corn storage drying in the sun food carbohydrate Davidoff photography Davidoff MD Storage 02387p USA New Hampshire storage food store farm water phone wires electricity electrical TCV the common vein Davidoff photography Davidoff MD Market in PEru 62923.800 community market produce Peru people Davidoff photography Davidoff Oneness Fish Workers in Portugal Columnar Epithelium in the Gut 56889 fishprocessors in Portugal young women uniform gum boots 70043cD08.800 cells columnar epithelium food processing packing packaging digestion absorbtion excretion Davidoff art Davidoff MD TCV the common Vein Davidoff photography Davidoff MD Selling or “Exchanging” in a Market in Jerusalem 02837p bananas selling Arab market Old Jerusalem Israel TCV the common vein Davidoff photography Garlic in Greece 02977p Athens Greece food seller garlic TCV The Common Vein Davidoff photography Chicks in Greece 02976p chickens chicks Greece food roadside seller young woman TCV the common vein Davidoff photography Davidoff MD Food Distribution in New York City – Liver Metabolic Warehouse Elegant foods through the window of Balducci’s New York Courtesy Ashley Davidoff MD 02128p code interesting accessory Davidoff photography Buying in Boshoek South Africa – Tel # 1 10150 Boshoek South Africa food buying distributing telephone women baby woman TCV the common vein Davidoff photography Eating in Peru 0063.800 Peru food eating restaurant Davidoff photography Davidoff MD Gathering Food and Transporting 39562c esophagus stomach hiatus hernia normal HH Stomach – Storage Cleansing 00410 stomach body areae gastrica mucosa contrast barium upper GI UGI X-Ray imaging radiology normal anatomy histology Healthy Brothers in South Africa and Malnourished Child in Ethiopa 02348p01 boy youth health nutrition physiology anatomy Davidoff photography 51954 51955 DANAN, ETHIOPIA – Malnourished children at a camp in the town of Danan some six hundred kilometers South East of Addis Ababa April 7. Ethiopia has appealed for over 800,000 tonnes of food aid to feed eight million people faced with starvation around the country this year. Photo by Peter Andrews (Reuters) Devastating Effects of Diabetes – aberrant glucose metabolism This image reveals the devastating manifestations of aberrant glucose metabolism as a result of insulin insufficiency, with consequent effects on the small vessels throughout the body. In this instance the diabetic arteriopathy is characterised by calcific atherosclerotic diease seen as calcification of the digital artery in b with subsequent ischemia to the foot. The poor nutrition has resulted in infection and ulceration of skin and bone, with poor healing and a need to amputate irrecovarable tissues. 48471c01 foot phalanx phalanges toes digital artery bone fx amputation calcified calcification of arteries dx diabetic arteriopathy chronic ischemia complicated by ulceration infection osteomyelitis treated with amputation diabetes mellitus metabolic disorder plain X-Ray of the foot Courtesy Ashley Davidoff MD Poverty – Poor Nutrition 57955 children third world South Africa tin shanty protective barb wire povert poor nutrition Davidoff photography – functionality the stroke that may result in paralysis of the person.A similar event where vital supply to the controlling institutions may be seen in the oft used tactic of yesteryear of a siege of a city. In this instance it is a lack of supply to the whole city, but the term paralysed city would be appropriate brainis related to permanent affecting the verbal function, results in an inability to communicate needs – such as hunger and thirst – survival needs. A coup of a government, or in the case of the curent realtively leaderless situation in Iraq, gives a sense of The respiratory system brings fuel to the fire by providing oxygen for all metabolic events. This oxygen is required not only for the maintenance and sustenance of life but is also required for every specialised and productive function. The community requires sustained supplies of adequate and clean air, food and water for sustenance. The clean air comes to our cities and as long as we are vigilant As our industrial world evolved, the machines that we built required alternate sources of energy in the form of electricity and fuel. The factories that process, package and store our food for example are dependant on these alternate and costly sources of energy that are not freely available like the air we breathe. Thus the viability of our factories in general, and our food factories specifically, are dependant on these alternate sources of energy and hence our viability and survival to some extent is dependant on them too. This was not the case when we livee the hunter gatherer lifestyle.valuable and sourceswithout these energy sources and they have become the sources of our food, and to lesser The most frequently used fuel is electricity which is often used in conjunction with oil and or gas. Unlike the oxygen which is freely available to our bodies the energies that are vital to the function of the factories of our city come with a price which closes for the night, the fuel requirement of oxygen is always needed. Factory on the Shore 83879b01.800 Boston MAssachusetts from the airplane factory sunrise chimney stacks storage tanks water sea energy sky light electricity the common vein applied biology concepts interstitium 3rd space extracellular space Davidoff photography Davidoff MD The Liver Factory 44426b01 liver hepatic clockwork purple anatomy Courtesy Ashley Davidoff Davidoff art Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography The genitourinary system Urination 82001p.800 Bruge Belgium interesting accessory urine urinary system genitourinary tract urine out put Courtesy of Ashley Davidoff MD Davidoff photo Factories are an essential component of our community. They manufacture and process critical items such as food, clothing, and building materials, – all essential for our survival. We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a The Portal System Courtesy Ashley Davidoff MD 01217 code esophagus + vein + ;liver portal vein spleen splenic vein left gastric vein coronary vein IMV inferior mesenteric vein fx short gastric varices + angiography transhepatic venogram anatomy The needs of human biology include survival, growth, and fulfilment. Consider the city in which you live and you will find that in general, the core of the city contains components in some form of these three elements. The cell in its turn has to have similar elements. While it is easy to recognise the survival, and to some extent growth in the life of a cell, the fulfilment aspect is not as obvious. As human conciousness emerges as a result of the power of the units to unity of cellular accumulation, the needs for individual fulfilment at many levels becomes comprehensible. On the other hand as one moves beyond the individual to the family and then to communities of progressively enlarging sizes, the aspects of survival and growth are fairly easy to see and understand while the element of fulfilment becomes even a more difficult concept. We are going to look at the city (or the village or town for that matter and we are going to look at its survival, growth and fulfilment as best we can to expose how the biology in the person translates into the city. The makeup of the city. The city has elements that include resources for survival, resources for growth, and resources for fulfilment. Resources for survival include sources for food ,water, protectionclothing, and housing, and the provision of an environment that has safety institutions of public safety Departments Shopping centre – food Water departmentEnvironment/building/police Survival: Neither the cell nor the city can survive without air water and food. Students of biology understand the acquisition of air and oxygen through the breathing mechanisms championed by the respiratory system, while the acquisition, processing and use of food and water is understood by the study of the gastrointestinal system. The pattern of acquisition, transport, processing, and exportation are repeating principles in all of biology. It is therefore not surprising that a city, which an extension of the biology that resides within it, functions along the same principles. The air we breathe is as natural a form of the environment of the city, as the interstitial fluids that bathe our cells. It comes free and is key to our survival – every second of it – the difference between life and death of a city and a cell, is totally dependant on this entity – air and oxygen – and fortunately for the city – it coms relatively easy. Air and Oxygen: Free and Fresh Air for the City New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting Our need for oxygen is so essential to life, that for most – it is packaged with life itself and we have no struggle to obtain it except under exceptional circumstances. While the person and city are naturally exposed to the oxygen source, the cell is dependant on transport mechanisms to bring the oxygen to it. Thus the upper powers of the hiearchy (the body and its systems) are in control of this essential element of life for the cell. If they, for whatever reason lose control of oxygen supply to the cells in the form of airway obstruction or occlusion of a coronary or cerebral artery, the overall survival of the biological unit becomes threatened. In this example we see and start to understand the interdependancy of biological units. In the case of the city (town or village) and the person air and oxygen is a given and oft unappreciated gift, while in the case of the tissues and cells, it is a commodity that has to be earned to some extent and has to be delivered. The cell is at the mercy of others in the team to deliver air regulalrly and efficiently. In the same way that we have to “earn’ our food by working, earning, positioning ourselvs to receive and transporting our food, the cells and tissues have to earn their supply of oxygen. Thus for example the heart cell has to position itself in its place of employment (cardiac tissue in the borough of the thoracic cavity) It holds hands in syncitial format with the other cells in its production line which has positioned itself near the rivers of the arterial system in order to efficiently receive the oxygen (and other metabolic products) necessary for its function. Its work starts early in the morning of its original birth, and it practices its trade of contraction and relaxation which it learned from the school housed in the genetics of contractile evolutionary lessons. Its work consists a pumping action and as a result it can “earn” reactive vasodilation (brokered by the Nobel winning nitrous oxide mechanism). If it works harder based on physiological need (perhaps a run in the park by the CEO) it will earn and receive more food. Thus the pattern of earn by positioning a biological unit in a work environment, doing the work, earning the reward, is for the myocardial cell in its use of oxygen and food what it is for the individual who earns money for food. The city receives as a gift the oxygen from the environment. It has to ensure that this gift remains untainted and is kept free of pollutants. Water and Food When it comes to food and water, the concepts are the same but the story is a little different. Both the cell, and the individual become slave to the larger community to provide the essential units, while they retain masterhood for eventual survival. A healthy city will have mechanisms in place to acquire and deliver food and water regularly and efficiently. We start to talk of relative scarcity of the commodity, and a need to “earn” the food and water. While clean water through the evolution of the sciences comes to most cities through a tubular systems, it comes with a cost albeit relatively small, and we therefore have to earn iour water Our ability to position ourselves to “earn” our food and water for survival seems to me to be no different from the myocardial or liver cell that has learned a skill that is valuable for the community. “If you give you get ” I tell my children – this is so fundamental in all of biology. The delivery of water to biological units has a larger latitude in terms of the time when compared to the delivery of oxygen. Whereas the need for oxygen delivery is measured in seconds and minutes the delivery and use of food and water can be measured in multiples of minutes and hours. Water and food to the cell is delivered in the same way as air is delivered – via tubular systems. The tissues keep themselves bathed in just the right amount of water, at the right temperature. Water to the person and city comes from reservoirs and water plants via tubular systems. Whereas water is almost as The food to the person has to be earned. there is an order in the world that is beyond our comprin order and ouThe biological world in general tends to be hostile with each biological unit fighting for survival. The need for food, fluid, oxygen, is obvious, and the need for a a safe and clean environment is a large part of the survival.SuWhen we look at biological units, including the cell, organs, persons or communities we take in things, process them and give them out. The cell mostly has no choice about where it is positioned in life. It is slave to its circumstance Raw materials Hospitals Supermarkets :aw and Order Walled City of Porto 83936 city wall safety protection Porto Portugal Davidoff photography Walled Body 49640 bone rib thoracic spine spinous processes scapula protection support CTscan volume rendering Davidoff MD Walled City of Porto 83937.800 city wall safety protection Porto Portugal Davidoff photography Law and Order 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography Rules of the Road An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography Ridding Waste Garbage Garbage A trash can with styrofoam boxes from McDonalds, diet coke cans and Kit Kat wrappers. Does our garbage tell a story of the way we live? Courtesy Ashley Davidoff MD. 02013p code accessory interesting garbage waste radiologists and detectives Davidoff photography Chimney from the Underground Smoke in New York city Courtesy Ashley Davidoff code accessory interesting chimney tube smoke New York 2001p Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Garbage Eater – Macrophage 02308p.800 monkey baboon garbage South Africa Cape Town Davidoff photography Bridge Intact 62639.800 bridge water intact white arch shape connection reflection TCV the common vein Davidoff photography References Chase Dunn and Jorgensen Regions and Interaction Networks. a World-Systems Perspective )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 4 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 4 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => This image represents a 3D rendered image of the airways and lungs with the heart whose function in transporting oxygen and carbon dioxide is vital to survival. The lungs and airways represent the organ that brings the most basic of elements essential to life – oxygen. The airways and lungs are in turn surrounded by a capsular fence called the pleura that protects and separates them from other structures. The pump station -aka the heart is seen centrally which is also protected and separated from the other organs by the pericardium. Courtesy of Ashley Davidoff M.D. 45819 chest cardiac heart trachea right and left bronchus lungs cardiomegaly enlarged CTscan surface rendering Courtesy Ashley Davidoff MD 45815 45816 45818 45819 45820 45821 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => This image represents a 3D rendered image of the airways and lungs with the heart whose function in transporting oxygen and carbon dioxide is vital to survival. The lungs and airways represent the organ that brings the most basic of elements essential to life – oxygen. The airways and lungs are in turn surrounded by a capsular fence called the pleura that protects and separates them from other structures. The pump station -aka the heart is seen centrally which is also protected and separated from the other organs by the pericardium. Courtesy of Ashley Davidoff M.D. 45819 chest cardiac heart trachea right and left bronchus lungs cardiomegaly enlarged CTscan surface rendering Courtesy Ashley Davidoff MD 45815 45816 45818 45819 45820 45821 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 3 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => In this scene of Johannesburg taken from the highway, we can view the vital lines of electrical energy that are essential to maintain the city. In the distance we see the city that the electrical lines serves. We also see other elements that have biological equivalents. – the fence that protects and prevents and forms a border between the highway and the property of the homes that reside on the other side. An old goldmine dump to the left of the picture – the tall post office tower for communication and a host of office buildings for collaborative effort. 57692 city electricity air energy essential community need Johannesburg South Africa fence capsule tcv the common vein Davidoff photography 83925 elctricity node ganglion nerve control telephone cable box connections communication control systems nerves Davidoff photography [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => In this scene of Johannesburg taken from the highway, we can view the vital lines of electrical energy that are essential to maintain the city. In the distance we see the city that the electrical lines serves. We also see other elements that have biological equivalents. – the fence that protects and prevents and forms a border between the highway and the property of the homes that reside on the other side. An old goldmine dump to the left of the picture – the tall post office tower for communication and a host of office buildings for collaborative effort. 57692 city electricity air energy essential community need Johannesburg South Africa fence capsule tcv the common vein Davidoff photography 83925 elctricity node ganglion nerve control telephone cable box connections communication control systems nerves Davidoff photography )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => In this unfortunate 60 year old a stroke which is seen in the high superior and anterior frontal lobe as a low density abnormality in a, overlaid in green in b, resulted in a significant functional defect including spastic deformity and functional loss of the left arm and hand. 48641c01.800 60 year old male brain area of decreased attenuation in the superior anterior frontal laobe fx encephalomalacia dx chronic infarction CTscan 3 D resurface rendering Courtesy Ashley Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => In this unfortunate 60 year old a stroke which is seen in the high superior and anterior frontal lobe as a low density abnormality in a, overlaid in green in b, resulted in a significant functional defect including spastic deformity and functional loss of the left arm and hand. 48641c01.800 60 year old male brain area of decreased attenuation in the superior anterior frontal laobe fx encephalomalacia dx chronic infarction CTscan 3 D resurface rendering Courtesy Ashley Davidoff MD )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 2 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => The two images represent a diffusion weighted MRI image which measures Brownian motion of molecules. In acute infarction there is restricted Brownian motion of the affected area and the image can be manipulated to present this a s a bright region. In this case the acute infarction or ischemia (b) is relatively bright compared to the white and gray matter of the normal (a) 49433c02.800 brain cerebral cerebrum white matter gray matter basal ganglia fx increase intensity in gray matter relative decrease in intensity in white matter dx global ischemia question brain death probable irreversible brain death cerebral infarction s/p arrest MRI DWI diffusion weighted imaging normal and abnormal Courtesy Ashley Davidoff MD [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => The two images represent a diffusion weighted MRI image which measures Brownian motion of molecules. In acute infarction there is restricted Brownian motion of the affected area and the image can be manipulated to present this a s a bright region. In this case the acute infarction or ischemia (b) is relatively bright compared to the white and gray matter of the normal (a) 49433c02.800 brain cerebral cerebrum white matter gray matter basal ganglia fx increase intensity in gray matter relative decrease in intensity in white matter dx global ischemia question brain death probable irreversible brain death cerebral infarction s/p arrest MRI DWI diffusion weighted imaging normal and abnormal Courtesy Ashley Davidoff MD )
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DOMElement Object ( [schemaTypeInfo] => [tagName] => td [firstElementChild] => (object value omitted) [lastElementChild] => (object value omitted) [childElementCount] => 129 [previousElementSibling] => [nextElementSibling] => [nodeName] => td [nodeValue] => The Body as a Community (in progress) The Common Vein Copyright 2007 Introduction This chapter is intended to draw the parallels that exist between the functional units in the body, and their equivalents in a community of people, and introduce the consequences to the system when there is disorder. There are also some examples of what may be needed to convert the disorder to order. The module is lacking from the point of view of detail and depth, since the intention is to provide breadth and context. In keeping with the philosophy of this work, we start learning with the most basic of concepts and attempt to give context and an infrastructure to the information. We progress thereafter in stepwise fashion to greater detail and complexity. (inverted pyramid concept – see approach to learning) As we build the community of people into the village, town or city we observe the units to unity effect of a larger unit that is more powerful than the individual parts. In the body, the little people, or the cells, are located and organized in a variety of functional patterns. There are doctors, lawyers, butchers, bakers, and candlestickmakers. There are garbage collectors, water and sewerage workers, government workers, policemen, teachers, emergency medical responders, and long term care specialists. They are all there as we know them in our town and city experience- we just have to identify them. Within each of these levels is a community that has a structural and functional organization that is remarkably similar to the units that make them up and each depends on the other for its health. The country has no value if it has no people and the body no body if it has no cells. This chapter however focuses on the functional and collaborative organizational system of the organs, resulting in a series of systems that in conjunction, enable the person to survive, grow and be fulfilled. These systems have two relative states – order and disorder, or health and disease, or survivability and lack of it. There exists a continued and continual process that is required to maintain health and homeostasis because time is moving, conditions are changing, and adaptation is essential for survival. The two states – which can also be viewed as relatively positive and relatively negative can be reversed with appropriate resources and adaptation. The healers of the world, sometimes the government, sometimes the people, sometimes the police force and sometimes the doctors, sometimes the street sweepers, and sometimes the lawyers and often the teachers – in fact the functioon of most of us – our function is to to try and and change the world from a state of relative negativity to a world of relative positivity. Functionality of Systems The institutions of the organs and body systems have the following major role Maintenance of life – the coordinated process of the systems that keep things alive and moving Fulfilment of life – the effects of a healthy system that allows the parts of the system to thrive and grow In order to accomplish these roles there are systems in place in both the healthy body and the healthy city that work in unison Controlling Systems Production systems- the factories Transport systems Protective systems Systems for growth and reproduction. The Central Nervous System The central nervous system is the government of our body. It ensures minute to minute survival as well as survival from week to week, month to month and year to year. It coordinates body function including the functions of production, transport, and protection, while it enables the organism to grow toward fulfilment. The Gold Dome of the State House of Massachusetts – Central Control Brain – Central Control 83562.800 city Boston skyline gold dome government centre state house control law Davidoff photography 14798b08.800 brain anatomy physiology cerebrum cerebral autonomic nervous system central nervous system peripheral nervous system eyes ears mouth nose taste sight heart cardiovascular system respiratoty system lungs gastrointestinal system liver pancreas kidney spleen adrenals gentourinary system genitalia normal anatomy davidoff art TCV the common vein Malfunction of any the controlling functions of the nervous system brings disorder to the system. A stroke for example, is caused by the loss of blood supply to part of the brain caused by thrombosis of the artery. After about 4 minutes of lack of supply there will be death of the brain tissue supplied by that artery. The final functional outcome depends on the vessel involved and the extent of the damage, and will range from transient malfunction (also called a transient ischemic attack and abbreviated as TIA), through recoverable disease, to permanent impairment and in the extreme – death. Psychiatric disease is another dramatic example of loss of control of the brain over the body with resulting devaststing effects not only of the person but on the community. Normal and Global Ischemia after Cardiac Arrest The two images represent a diffusion weighted MRI image which measures Brownian motion of molecules. In acute infarction there is restricted Brownian motion of the affected area and the image can be manipulated to present this a s a bright region. In this case the acute infarction or ischemia (b) is relatively bright compared to the white and gray matter of the normal (a) 49433c02.800 brain cerebral cerebrum white matter gray matter basal ganglia fx increase intensity in gray matter relative decrease in intensity in white matter dx global ischemia question brain death probable irreversible brain death cerebral infarction s/p arrest MRI DWI diffusion weighted imaging normal and abnormal Courtesy Ashley Davidoff MD Stroke – Chronic impairment In this unfortunate 60 year old a stroke which is seen in the high superior and anterior frontal lobe as a low density abnormality in a, overlaid in green in b, resulted in a significant functional defect including spastic deformity and functional loss of the left arm and hand. 48641c01.800 60 year old male brain area of decreased attenuation in the superior anterior frontal laobe fx encephalomalacia dx chronic infarction CTscan 3 D resurface rendering Courtesy Ashley Davidoff MD A “paralysed” city has broad implications but is one in which the day to day function is halted for one of many reasons. The word “paralysed” draws the parallel with implied paralysis of a stroke discussed above in which functionality is lost because one of the control systems has become impaired. While the asassination of John Kennedy brought an emtional paralysis to our country, the democratic organization with systems in place allowed full and ongoing functionality. On the other hand with the fall of the relative autocracy of Saddam Hussein in Iraq, a true paralysis resulted with loss of life and loss of maintenance of services more akin to the devastating effects of a cerebral stroke. The chaos of Iraq persists at this writing – 2 years after autocratic control of the country was lost and as the coutry tries through democratic process to regain control of its component people. Either way, the point of discussion is to reveal the importance of control systems in the body and in the towns, cities, and country, and the dramatic and terrible consequences when control systems are in disarray. Endocrine System The nervous system works in conjunction and is helped by the endocrine system which controls metabolic activity, as well as promoting growth and reproduction. It also contributes to water and salt maintenance. Its functional tools are the hormones produced by the specialised cellular workers in its factories which are scattered throughout the body. The endocrine system controls the supply and demand of the metabolic economy of the body. It ensures appropriate distribution and use of metabolic resources. The departments of economic affairs and their equivalents in the towns and cities formulate policies and programs relating to internal and external use of resources. The annual budget enables appropriate use of resources to ensure maintenance of life and optimise growth and fulfilment for the members of the society. The pituitary gland is the master gland of the endocrine system. One of the hormones it produces from the anterior pituitary gland is called growth hormone or somatotropin, which if produced in excess will result in acromegaly, (aka gigantism) while dwarfism is caused by lack of production. The apartheid government of South Africa did not apportion economic resources fairly to its citizens, resulting in poverty for a large proportion of its citizens (economic and social dwarfism)and excessive wealth for priviliged others. (economic and social gigantism) The resulting disproportionate use of resources led to excessive growth for one section of the society and stunted growth for the other. A Single Abnormal Gigantic Floret – Gigantism a Quirk of Nature Variations in Size in Humans 61229p flower allium size large elongated greater than the 90th percentile abnormally enlarged Davidoff photography Former Olympian Olga Korbut (C) stands between Manute Bol (L) and William “The Refrigerator” Perry (R) during the weigh-in for Celebrity Boxing 2 in Los Angeles, California Tuesday, May 14, 2002. Korbut will face Darva Conger and Bol will face Perry during the boxing event which will air May 22 on Fox. REUTERS/John Hayes 54916.800 Olga 5feet 1 inch Manut Bol 7foot 7 inches William Perry 6’2” 370lbs The function of the Federal Reserve in the USA parallels to some extent the function of the thyroid gland in that setting the prime rate enables some control of the basic economic activity for the country, much in the way that the thyroid controls the basic metabolic rate for the body. Thyroxine does not stand alone and it needs substrate (products) and use for the products to execute a balanced and healthy situation. In thyrotoxicosis there is an excess of of thyroxine (and a relative paucity of substrate) and the resulting overactivity is a patient who is at a high level of unnecessary activity. A paucity of thyroxine results in underactivity and is called myxedema. In this instance there is too little thyroxine, a relative excess of substrate that does not get used. In the community, the parallels relate to a state of health when the supply of materials and goods is in balance with the demands of the community. Overproduction of goods (without appropriate need and use) or unerproduction with insufficient products below the needs of the community are unhealthy situations. Inflation is defined as an economic situation when too much money chases too few goods (almost like too much thyroxine chasing relatively little substrate) and this results in a rise of cost for the goods. Recession is defined as a slowing of the economy and usually follows a boom and may precede a depression. The brain is assisted by the autonomic nervous system and peripheral nervous system which represent the lines of communication between the central governing body and the people. The autonomic nervous system maintains the automaticity of body function, increasing the activity when necessary and slowing it down during sleep hours. It controls the respiratory centre for example and the rate and rhythm of breathing is under its direct control. Again breathing is so essential to life that the process is a seamless event with no thought nor concious effort. System of Wires Nerves and Autonomic Ganglia In this scene of Johannesburg taken from the highway, we can view the vital lines of electrical energy that are essential to maintain the city. In the distance we see the city that the electrical lines serves. We also see other elements that have biological equivalents. – the fence that protects and prevents and forms a border between the highway and the property of the homes that reside on the other side. An old goldmine dump to the left of the picture – the tall post office tower for communication and a host of office buildings for collaborative effort. 57692 city electricity air energy essential community need Johannesburg South Africa fence capsule tcv the common vein Davidoff photography 83925 elctricity node ganglion nerve control telephone cable box connections communication control systems nerves Davidoff photography Normal CXR and one with Pacemaker needed for Complete Heart Block Secondary to Involvement of the Conduction System of the Heart by Sarcoidosis 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 49740b03.800 hx 34 male heart cardiac pacemaker lung chronic interstitial lung disease fibrosis inflammation dx sarcoidosis of the heart with complicated by involvement of the A-V atrioventricular node with complete heart block necessitating an urgent pacemaker placement TCV applied biology complete heart block Davidoff MD The Respiratory System The respiratory system has the life sustaining role of bringing oxygen to the body. Oxygen is needed to regenerate ATP from ADP through a process called oxidative phosphorylation. ATP is the only source of chemical energy that the body can use (bioenergy)) Failure of delivery of oxygen results in irreversible brain injury after about 4 minutes and irreversible cardiac muscle injury after 10-15 minutes. Most othe tissues are slightly more forgiving for the lack of oxygen but the time is usually counted in terms of minutes before irreversible change and death occurs. The oxygen from our atmosphere is mostly produced by photosynthesis, a process which occurs in plant life and which breaks down carbon dioxide and water to produce oxygen and sugars. Oxygen is thus part of environment to the same extent that the interstitial space surrounds and is part of the environment of the cells. Respiratory System This image represents a 3D rendered image of the airways and lungs with the heart whose function in transporting oxygen and carbon dioxide is vital to survival. The lungs and airways represent the organ that brings the most basic of elements essential to life – oxygen. The airways and lungs are in turn surrounded by a capsular fence called the pleura that protects and separates them from other structures. The pump station -aka the heart is seen centrally which is also protected and separated from the other organs by the pericardium. Courtesy of Ashley Davidoff M.D. 45819 chest cardiac heart trachea right and left bronchus lungs cardiomegaly enlarged CTscan surface rendering Courtesy Ashley Davidoff MD 45815 45816 45818 45819 45820 45821 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Alveoli of the Lung – Factory Workers This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing The Lung – Order and Disorder These two anatomic specimens represent the left lung in health and disease. The right specimen is one of a hemorrhagic pneumonia with the alveoli drowned in blood and pus. Courtesy Ashley Davidoff MD. a87-68 32228b code lungs pulmonary lymphatics distended grosspathology anatomy fissure left Chest X-Ray – Normal and Abnormal 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 47100.800 chest lung bronchus fx air bronchogram dx pneumonia CXR plain film Davidoff MD Therapeutic Intervention Before and After Antibiotic Therapy Images a and b show a pneumonia in the right middle lobe in both the A-P and lateral examination as an almost rectangular white patch, which resolved with treatment shown as a normal CXR in images c and d. 41819c02 Courtesy Ashley Davidoff MD medical students code chest CXR imaging lung plain film pneumonia radiology resolution There are many factors that are prerequisites for the sustenance of life. Sometimes it is the energy itself that we are concerned with (ATP) and sometimes it is the facilitators (oxygen, enzymes, cofactors, coenzymes, hormones). Electricity, oil, gas, propane, solar , and nuclear energy are some of the more commonly used forms. The failure of delivery of any one of these may bring significantt discomfort and inconvenience but will not usually lead to death and irreversible injury. Cardiovascular System The cardiovascular system consisting of the heart, arteries, veins, and capillaries functions as one of the many tubular transport systems of the body. It represents the roads and highways, railways and airways, seaways and riverways of the transport systems as we know them in our towns and cities. The cardiovascular system enables the delivery of essential raw and refined products, and the removal and transport of waste to the appropriate dumps. Disease of the vessels is commonly due to obstruction and a consequent inability of supply to meet demand. In the case of arterial obstruction to the coronary arteries the consequent myocardial infarction can and often results in death. The event of a highway accident results in a mere inconvenience – but imagine the devastation if the water supply were suddenly cut off as is seen when a city is under siege, or when main water spplies are lost. Survival is of course threatened. Highways Byways and Waterways for the City 32165 code RS pulmonary lung alveolus arteriole venule epithelium drawing gas exchange anatomy physiology histology 83557.800 highways waterways reservoirs storage stations factories homes transport systems bus cars Davidoff photography Cardiovascular System 32368b05.800 cardiovascular system heart cardiac artery arteries capillary capillaries arterioles venules veins negative firces positive forces road highway TCV the common vein applied biology Davidoff art Davidoff MD In the cardiovascular system the relatively positive pressure in the left sided systemic circulation created by the left ventricle, enables flow throught the capillary circulation, perfusion of the cells tissues and organs, and subsequent return of the blood to the relatively low pressure of the right side of the heart. The pulmonary circulation on the other hand is serviced by the pumping action of the right ventricle, which creates a positive force and flow to the capillaries of the lung and subsequent return to the low pressure of the left atrium. Congestion Open Highway and Congestion 57693b01 road highway clear open city electricity street lights Johannesburg South Africa Davidoff photography Davidoff MD Open Highway and Congestion 51187 Vehicles jam the Spanish highway leading to France after French authorities prevented Spanish Basque protesters from entering the country Saturday, March 11, 2000, in Irun, northern Spain. Photo by Bob Edme (AP) Normal Chest and Pulmonary Congestion 42076c04 Courtesy Ashley Davidoff MD medical students code batwing distribution congestion heart lung Rupture Intact River and Rupture and Flooding 83567.800 Charles river Boston Massachusetts Salt and Pepper Bridge order TCV The Common VEin Davidoff photography 50755 MAPUTO:MOZAMBIQUE – Houses on the outskirts of Mozambique’s capital Maputo are flooded after heavy rains drenched southern Africa, February 12. Flooding has forced an estimated 250,000 Mozambicans to find temporary refugee and left at least 50 dead across southern Africa. In Mozambique, flooding threatened the fertile farming land of the Limpopo Valley and regional capitals and waterborne disease loomed. Photo by Red Cross (Reuters) Order and Disorder Caused by Environmental Change 57677 before and after Kalutara Sri Lanka Courtesy DigitalGlobe.com Normal and Ruptured Aorta 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA Interruption of Flow and Repair A Bridge Broken and a Bridge Repaired 13227 bridge obstruction break disease disorder Davidoff photography 02340p bridge repaired Potomac Washington DC water TCV the common vein Davidoff photography The Normal Coronary Artery This is an anterior view of the heart showing the long LAD travelling within the expected course of the interventricular septum. Courtesy of Ashley Davidoff M.D. 32134 code cardiac heart coronary artery LAD diagonal conal infundibulum RVOT anatomy normal A Narrowed Artery and a Repaired Artery The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD Ruptured Aneurysm and Repair by Embolization 22521 22524 Courtesy Ashley Davidoff MD code spleen + artery + dx ruptured splenic artery aneurysm pseudoaneurysm + cystic fibrosis biliary cirrhosis portal hypertension angiography emergency Gastrointestinal System The gastrointestinal system is the food basket and the garbage removal service of the body. It is responsible for taking in, pocessing, transporting, absorbing, and excreting food and water, the raw products of metabolism. The gastrointestinal system is the breadbasket of our bodies. It receives the food, processes, absorbs, stores, and transports the food, and helps either to recycle needed products, or eliminate unwanted products. It thus functions as the equivalent of our farms, food processing plants, grocery, food delivery systems, water and sewerage works, and recycling plants. Food and the Community – Road from Farm to the Cell A Farm in Peru 0175.800 farm vegetables road transport units on the farmland oxygen sunlight clouds water TCV the common vein Peru Davidoff photography Mountain Farms in Peru 0178.800 Peru farm wall units to unity mountains vertical agriculture food the common vein applied biology Davidoff photography Davidoff MD Gathering on a farm in Pennsylvania 02512p food farm gathering receiving packing transporting TCV the common vein Davidoff photography Packing Red Peppers on a farm in South Arica 57984.800 farm red peppers vegetables South Africa gather picking transport work Davidoff photography Transport 0072.800 0010.800 Peru cane transport woman old barefoot bare feet hat storage Davidoff photography Davidoff MD Storage in Peru 0074.800 Peru corn storage drying in the sun food carbohydrate Davidoff photography Davidoff MD Storage 02387p USA New Hampshire storage food store farm water phone wires electricity electrical TCV the common vein Davidoff photography Davidoff MD Market in PEru 62923.800 community market produce Peru people Davidoff photography Davidoff Oneness Fish Workers in Portugal Columnar Epithelium in the Gut 56889 fishprocessors in Portugal young women uniform gum boots 70043cD08.800 cells columnar epithelium food processing packing packaging digestion absorbtion excretion Davidoff art Davidoff MD TCV the common Vein Davidoff photography Davidoff MD Selling or “Exchanging” in a Market in Jerusalem 02837p bananas selling Arab market Old Jerusalem Israel TCV the common vein Davidoff photography Garlic in Greece 02977p Athens Greece food seller garlic TCV The Common Vein Davidoff photography Chicks in Greece 02976p chickens chicks Greece food roadside seller young woman TCV the common vein Davidoff photography Davidoff MD Food Distribution in New York City – Liver Metabolic Warehouse Elegant foods through the window of Balducci’s New York Courtesy Ashley Davidoff MD 02128p code interesting accessory Davidoff photography Buying in Boshoek South Africa – Tel # 1 10150 Boshoek South Africa food buying distributing telephone women baby woman TCV the common vein Davidoff photography Eating in Peru 0063.800 Peru food eating restaurant Davidoff photography Davidoff MD Gathering Food and Transporting 39562c esophagus stomach hiatus hernia normal HH Stomach – Storage Cleansing 00410 stomach body areae gastrica mucosa contrast barium upper GI UGI X-Ray imaging radiology normal anatomy histology Healthy Brothers in South Africa and Malnourished Child in Ethiopa 02348p01 boy youth health nutrition physiology anatomy Davidoff photography 51954 51955 DANAN, ETHIOPIA – Malnourished children at a camp in the town of Danan some six hundred kilometers South East of Addis Ababa April 7. Ethiopia has appealed for over 800,000 tonnes of food aid to feed eight million people faced with starvation around the country this year. Photo by Peter Andrews (Reuters) Devastating Effects of Diabetes – aberrant glucose metabolism This image reveals the devastating manifestations of aberrant glucose metabolism as a result of insulin insufficiency, with consequent effects on the small vessels throughout the body. In this instance the diabetic arteriopathy is characterised by calcific atherosclerotic diease seen as calcification of the digital artery in b with subsequent ischemia to the foot. The poor nutrition has resulted in infection and ulceration of skin and bone, with poor healing and a need to amputate irrecovarable tissues. 48471c01 foot phalanx phalanges toes digital artery bone fx amputation calcified calcification of arteries dx diabetic arteriopathy chronic ischemia complicated by ulceration infection osteomyelitis treated with amputation diabetes mellitus metabolic disorder plain X-Ray of the foot Courtesy Ashley Davidoff MD Poverty – Poor Nutrition 57955 children third world South Africa tin shanty protective barb wire povert poor nutrition Davidoff photography – functionality the stroke that may result in paralysis of the person.A similar event where vital supply to the controlling institutions may be seen in the oft used tactic of yesteryear of a siege of a city. In this instance it is a lack of supply to the whole city, but the term paralysed city would be appropriate brainis related to permanent affecting the verbal function, results in an inability to communicate needs – such as hunger and thirst – survival needs. A coup of a government, or in the case of the curent realtively leaderless situation in Iraq, gives a sense of The respiratory system brings fuel to the fire by providing oxygen for all metabolic events. This oxygen is required not only for the maintenance and sustenance of life but is also required for every specialised and productive function. The community requires sustained supplies of adequate and clean air, food and water for sustenance. The clean air comes to our cities and as long as we are vigilant As our industrial world evolved, the machines that we built required alternate sources of energy in the form of electricity and fuel. The factories that process, package and store our food for example are dependant on these alternate and costly sources of energy that are not freely available like the air we breathe. Thus the viability of our factories in general, and our food factories specifically, are dependant on these alternate sources of energy and hence our viability and survival to some extent is dependant on them too. This was not the case when we livee the hunter gatherer lifestyle.valuable and sourceswithout these energy sources and they have become the sources of our food, and to lesser The most frequently used fuel is electricity which is often used in conjunction with oil and or gas. Unlike the oxygen which is freely available to our bodies the energies that are vital to the function of the factories of our city come with a price which closes for the night, the fuel requirement of oxygen is always needed. Factory on the Shore 83879b01.800 Boston MAssachusetts from the airplane factory sunrise chimney stacks storage tanks water sea energy sky light electricity the common vein applied biology concepts interstitium 3rd space extracellular space Davidoff photography Davidoff MD The Liver Factory 44426b01 liver hepatic clockwork purple anatomy Courtesy Ashley Davidoff Davidoff art Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography The genitourinary system Urination 82001p.800 Bruge Belgium interesting accessory urine urinary system genitourinary tract urine out put Courtesy of Ashley Davidoff MD Davidoff photo Factories are an essential component of our community. They manufacture and process critical items such as food, clothing, and building materials, – all essential for our survival. We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a The Portal System Courtesy Ashley Davidoff MD 01217 code esophagus + vein + ;liver portal vein spleen splenic vein left gastric vein coronary vein IMV inferior mesenteric vein fx short gastric varices + angiography transhepatic venogram anatomy The needs of human biology include survival, growth, and fulfilment. Consider the city in which you live and you will find that in general, the core of the city contains components in some form of these three elements. The cell in its turn has to have similar elements. While it is easy to recognise the survival, and to some extent growth in the life of a cell, the fulfilment aspect is not as obvious. As human conciousness emerges as a result of the power of the units to unity of cellular accumulation, the needs for individual fulfilment at many levels becomes comprehensible. On the other hand as one moves beyond the individual to the family and then to communities of progressively enlarging sizes, the aspects of survival and growth are fairly easy to see and understand while the element of fulfilment becomes even a more difficult concept. We are going to look at the city (or the village or town for that matter and we are going to look at its survival, growth and fulfilment as best we can to expose how the biology in the person translates into the city. The makeup of the city. The city has elements that include resources for survival, resources for growth, and resources for fulfilment. Resources for survival include sources for food ,water, protectionclothing, and housing, and the provision of an environment that has safety institutions of public safety Departments Shopping centre – food Water departmentEnvironment/building/police Survival: Neither the cell nor the city can survive without air water and food. Students of biology understand the acquisition of air and oxygen through the breathing mechanisms championed by the respiratory system, while the acquisition, processing and use of food and water is understood by the study of the gastrointestinal system. The pattern of acquisition, transport, processing, and exportation are repeating principles in all of biology. It is therefore not surprising that a city, which an extension of the biology that resides within it, functions along the same principles. The air we breathe is as natural a form of the environment of the city, as the interstitial fluids that bathe our cells. It comes free and is key to our survival – every second of it – the difference between life and death of a city and a cell, is totally dependant on this entity – air and oxygen – and fortunately for the city – it coms relatively easy. Air and Oxygen: Free and Fresh Air for the City New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting Our need for oxygen is so essential to life, that for most – it is packaged with life itself and we have no struggle to obtain it except under exceptional circumstances. While the person and city are naturally exposed to the oxygen source, the cell is dependant on transport mechanisms to bring the oxygen to it. Thus the upper powers of the hiearchy (the body and its systems) are in control of this essential element of life for the cell. If they, for whatever reason lose control of oxygen supply to the cells in the form of airway obstruction or occlusion of a coronary or cerebral artery, the overall survival of the biological unit becomes threatened. In this example we see and start to understand the interdependancy of biological units. In the case of the city (town or village) and the person air and oxygen is a given and oft unappreciated gift, while in the case of the tissues and cells, it is a commodity that has to be earned to some extent and has to be delivered. The cell is at the mercy of others in the team to deliver air regulalrly and efficiently. In the same way that we have to “earn’ our food by working, earning, positioning ourselvs to receive and transporting our food, the cells and tissues have to earn their supply of oxygen. Thus for example the heart cell has to position itself in its place of employment (cardiac tissue in the borough of the thoracic cavity) It holds hands in syncitial format with the other cells in its production line which has positioned itself near the rivers of the arterial system in order to efficiently receive the oxygen (and other metabolic products) necessary for its function. Its work starts early in the morning of its original birth, and it practices its trade of contraction and relaxation which it learned from the school housed in the genetics of contractile evolutionary lessons. Its work consists a pumping action and as a result it can “earn” reactive vasodilation (brokered by the Nobel winning nitrous oxide mechanism). If it works harder based on physiological need (perhaps a run in the park by the CEO) it will earn and receive more food. Thus the pattern of earn by positioning a biological unit in a work environment, doing the work, earning the reward, is for the myocardial cell in its use of oxygen and food what it is for the individual who earns money for food. The city receives as a gift the oxygen from the environment. It has to ensure that this gift remains untainted and is kept free of pollutants. Water and Food When it comes to food and water, the concepts are the same but the story is a little different. Both the cell, and the individual become slave to the larger community to provide the essential units, while they retain masterhood for eventual survival. A healthy city will have mechanisms in place to acquire and deliver food and water regularly and efficiently. We start to talk of relative scarcity of the commodity, and a need to “earn” the food and water. While clean water through the evolution of the sciences comes to most cities through a tubular systems, it comes with a cost albeit relatively small, and we therefore have to earn iour water Our ability to position ourselves to “earn” our food and water for survival seems to me to be no different from the myocardial or liver cell that has learned a skill that is valuable for the community. “If you give you get ” I tell my children – this is so fundamental in all of biology. The delivery of water to biological units has a larger latitude in terms of the time when compared to the delivery of oxygen. Whereas the need for oxygen delivery is measured in seconds and minutes the delivery and use of food and water can be measured in multiples of minutes and hours. Water and food to the cell is delivered in the same way as air is delivered – via tubular systems. The tissues keep themselves bathed in just the right amount of water, at the right temperature. Water to the person and city comes from reservoirs and water plants via tubular systems. Whereas water is almost as The food to the person has to be earned. there is an order in the world that is beyond our comprin order and ouThe biological world in general tends to be hostile with each biological unit fighting for survival. The need for food, fluid, oxygen, is obvious, and the need for a a safe and clean environment is a large part of the survival.SuWhen we look at biological units, including the cell, organs, persons or communities we take in things, process them and give them out. The cell mostly has no choice about where it is positioned in life. It is slave to its circumstance Raw materials Hospitals Supermarkets :aw and Order Walled City of Porto 83936 city wall safety protection Porto Portugal Davidoff photography Walled Body 49640 bone rib thoracic spine spinous processes scapula protection support CTscan volume rendering Davidoff MD Walled City of Porto 83937.800 city wall safety protection Porto Portugal Davidoff photography Law and Order 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography Rules of the Road An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography Ridding Waste Garbage Garbage A trash can with styrofoam boxes from McDonalds, diet coke cans and Kit Kat wrappers. Does our garbage tell a story of the way we live? Courtesy Ashley Davidoff MD. 02013p code accessory interesting garbage waste radiologists and detectives Davidoff photography Chimney from the Underground Smoke in New York city Courtesy Ashley Davidoff code accessory interesting chimney tube smoke New York 2001p Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Garbage Eater – Macrophage 02308p.800 monkey baboon garbage South Africa Cape Town Davidoff photography Bridge Intact 62639.800 bridge water intact white arch shape connection reflection TCV the common vein Davidoff photography References Chase Dunn and Jorgensen Regions and Interaction Networks. a World-Systems Perspective [nodeType] => 1 [parentNode] => (object value omitted) [childNodes] => (object value omitted) [firstChild] => (object value omitted) [lastChild] => (object value omitted) [previousSibling] => (object value omitted) [nextSibling] => (object value omitted) [attributes] => (object value omitted) [ownerDocument] => (object value omitted) [namespaceURI] => [prefix] => [localName] => td [baseURI] => [textContent] => The Body as a Community (in progress) The Common Vein Copyright 2007 Introduction This chapter is intended to draw the parallels that exist between the functional units in the body, and their equivalents in a community of people, and introduce the consequences to the system when there is disorder. There are also some examples of what may be needed to convert the disorder to order. The module is lacking from the point of view of detail and depth, since the intention is to provide breadth and context. In keeping with the philosophy of this work, we start learning with the most basic of concepts and attempt to give context and an infrastructure to the information. We progress thereafter in stepwise fashion to greater detail and complexity. (inverted pyramid concept – see approach to learning) As we build the community of people into the village, town or city we observe the units to unity effect of a larger unit that is more powerful than the individual parts. In the body, the little people, or the cells, are located and organized in a variety of functional patterns. There are doctors, lawyers, butchers, bakers, and candlestickmakers. There are garbage collectors, water and sewerage workers, government workers, policemen, teachers, emergency medical responders, and long term care specialists. They are all there as we know them in our town and city experience- we just have to identify them. Within each of these levels is a community that has a structural and functional organization that is remarkably similar to the units that make them up and each depends on the other for its health. The country has no value if it has no people and the body no body if it has no cells. This chapter however focuses on the functional and collaborative organizational system of the organs, resulting in a series of systems that in conjunction, enable the person to survive, grow and be fulfilled. These systems have two relative states – order and disorder, or health and disease, or survivability and lack of it. There exists a continued and continual process that is required to maintain health and homeostasis because time is moving, conditions are changing, and adaptation is essential for survival. The two states – which can also be viewed as relatively positive and relatively negative can be reversed with appropriate resources and adaptation. The healers of the world, sometimes the government, sometimes the people, sometimes the police force and sometimes the doctors, sometimes the street sweepers, and sometimes the lawyers and often the teachers – in fact the functioon of most of us – our function is to to try and and change the world from a state of relative negativity to a world of relative positivity. Functionality of Systems The institutions of the organs and body systems have the following major role Maintenance of life – the coordinated process of the systems that keep things alive and moving Fulfilment of life – the effects of a healthy system that allows the parts of the system to thrive and grow In order to accomplish these roles there are systems in place in both the healthy body and the healthy city that work in unison Controlling Systems Production systems- the factories Transport systems Protective systems Systems for growth and reproduction. The Central Nervous System The central nervous system is the government of our body. It ensures minute to minute survival as well as survival from week to week, month to month and year to year. It coordinates body function including the functions of production, transport, and protection, while it enables the organism to grow toward fulfilment. The Gold Dome of the State House of Massachusetts – Central Control Brain – Central Control 83562.800 city Boston skyline gold dome government centre state house control law Davidoff photography 14798b08.800 brain anatomy physiology cerebrum cerebral autonomic nervous system central nervous system peripheral nervous system eyes ears mouth nose taste sight heart cardiovascular system respiratoty system lungs gastrointestinal system liver pancreas kidney spleen adrenals gentourinary system genitalia normal anatomy davidoff art TCV the common vein Malfunction of any the controlling functions of the nervous system brings disorder to the system. A stroke for example, is caused by the loss of blood supply to part of the brain caused by thrombosis of the artery. After about 4 minutes of lack of supply there will be death of the brain tissue supplied by that artery. The final functional outcome depends on the vessel involved and the extent of the damage, and will range from transient malfunction (also called a transient ischemic attack and abbreviated as TIA), through recoverable disease, to permanent impairment and in the extreme – death. Psychiatric disease is another dramatic example of loss of control of the brain over the body with resulting devaststing effects not only of the person but on the community. Normal and Global Ischemia after Cardiac Arrest The two images represent a diffusion weighted MRI image which measures Brownian motion of molecules. In acute infarction there is restricted Brownian motion of the affected area and the image can be manipulated to present this a s a bright region. In this case the acute infarction or ischemia (b) is relatively bright compared to the white and gray matter of the normal (a) 49433c02.800 brain cerebral cerebrum white matter gray matter basal ganglia fx increase intensity in gray matter relative decrease in intensity in white matter dx global ischemia question brain death probable irreversible brain death cerebral infarction s/p arrest MRI DWI diffusion weighted imaging normal and abnormal Courtesy Ashley Davidoff MD Stroke – Chronic impairment In this unfortunate 60 year old a stroke which is seen in the high superior and anterior frontal lobe as a low density abnormality in a, overlaid in green in b, resulted in a significant functional defect including spastic deformity and functional loss of the left arm and hand. 48641c01.800 60 year old male brain area of decreased attenuation in the superior anterior frontal laobe fx encephalomalacia dx chronic infarction CTscan 3 D resurface rendering Courtesy Ashley Davidoff MD A “paralysed” city has broad implications but is one in which the day to day function is halted for one of many reasons. The word “paralysed” draws the parallel with implied paralysis of a stroke discussed above in which functionality is lost because one of the control systems has become impaired. While the asassination of John Kennedy brought an emtional paralysis to our country, the democratic organization with systems in place allowed full and ongoing functionality. On the other hand with the fall of the relative autocracy of Saddam Hussein in Iraq, a true paralysis resulted with loss of life and loss of maintenance of services more akin to the devastating effects of a cerebral stroke. The chaos of Iraq persists at this writing – 2 years after autocratic control of the country was lost and as the coutry tries through democratic process to regain control of its component people. Either way, the point of discussion is to reveal the importance of control systems in the body and in the towns, cities, and country, and the dramatic and terrible consequences when control systems are in disarray. Endocrine System The nervous system works in conjunction and is helped by the endocrine system which controls metabolic activity, as well as promoting growth and reproduction. It also contributes to water and salt maintenance. Its functional tools are the hormones produced by the specialised cellular workers in its factories which are scattered throughout the body. The endocrine system controls the supply and demand of the metabolic economy of the body. It ensures appropriate distribution and use of metabolic resources. The departments of economic affairs and their equivalents in the towns and cities formulate policies and programs relating to internal and external use of resources. The annual budget enables appropriate use of resources to ensure maintenance of life and optimise growth and fulfilment for the members of the society. The pituitary gland is the master gland of the endocrine system. One of the hormones it produces from the anterior pituitary gland is called growth hormone or somatotropin, which if produced in excess will result in acromegaly, (aka gigantism) while dwarfism is caused by lack of production. The apartheid government of South Africa did not apportion economic resources fairly to its citizens, resulting in poverty for a large proportion of its citizens (economic and social dwarfism)and excessive wealth for priviliged others. (economic and social gigantism) The resulting disproportionate use of resources led to excessive growth for one section of the society and stunted growth for the other. A Single Abnormal Gigantic Floret – Gigantism a Quirk of Nature Variations in Size in Humans 61229p flower allium size large elongated greater than the 90th percentile abnormally enlarged Davidoff photography Former Olympian Olga Korbut (C) stands between Manute Bol (L) and William “The Refrigerator” Perry (R) during the weigh-in for Celebrity Boxing 2 in Los Angeles, California Tuesday, May 14, 2002. Korbut will face Darva Conger and Bol will face Perry during the boxing event which will air May 22 on Fox. REUTERS/John Hayes 54916.800 Olga 5feet 1 inch Manut Bol 7foot 7 inches William Perry 6’2” 370lbs The function of the Federal Reserve in the USA parallels to some extent the function of the thyroid gland in that setting the prime rate enables some control of the basic economic activity for the country, much in the way that the thyroid controls the basic metabolic rate for the body. Thyroxine does not stand alone and it needs substrate (products) and use for the products to execute a balanced and healthy situation. In thyrotoxicosis there is an excess of of thyroxine (and a relative paucity of substrate) and the resulting overactivity is a patient who is at a high level of unnecessary activity. A paucity of thyroxine results in underactivity and is called myxedema. In this instance there is too little thyroxine, a relative excess of substrate that does not get used. In the community, the parallels relate to a state of health when the supply of materials and goods is in balance with the demands of the community. Overproduction of goods (without appropriate need and use) or unerproduction with insufficient products below the needs of the community are unhealthy situations. Inflation is defined as an economic situation when too much money chases too few goods (almost like too much thyroxine chasing relatively little substrate) and this results in a rise of cost for the goods. Recession is defined as a slowing of the economy and usually follows a boom and may precede a depression. The brain is assisted by the autonomic nervous system and peripheral nervous system which represent the lines of communication between the central governing body and the people. The autonomic nervous system maintains the automaticity of body function, increasing the activity when necessary and slowing it down during sleep hours. It controls the respiratory centre for example and the rate and rhythm of breathing is under its direct control. Again breathing is so essential to life that the process is a seamless event with no thought nor concious effort. System of Wires Nerves and Autonomic Ganglia In this scene of Johannesburg taken from the highway, we can view the vital lines of electrical energy that are essential to maintain the city. In the distance we see the city that the electrical lines serves. We also see other elements that have biological equivalents. – the fence that protects and prevents and forms a border between the highway and the property of the homes that reside on the other side. An old goldmine dump to the left of the picture – the tall post office tower for communication and a host of office buildings for collaborative effort. 57692 city electricity air energy essential community need Johannesburg South Africa fence capsule tcv the common vein Davidoff photography 83925 elctricity node ganglion nerve control telephone cable box connections communication control systems nerves Davidoff photography Normal CXR and one with Pacemaker needed for Complete Heart Block Secondary to Involvement of the Conduction System of the Heart by Sarcoidosis 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 49740b03.800 hx 34 male heart cardiac pacemaker lung chronic interstitial lung disease fibrosis inflammation dx sarcoidosis of the heart with complicated by involvement of the A-V atrioventricular node with complete heart block necessitating an urgent pacemaker placement TCV applied biology complete heart block Davidoff MD The Respiratory System The respiratory system has the life sustaining role of bringing oxygen to the body. Oxygen is needed to regenerate ATP from ADP through a process called oxidative phosphorylation. ATP is the only source of chemical energy that the body can use (bioenergy)) Failure of delivery of oxygen results in irreversible brain injury after about 4 minutes and irreversible cardiac muscle injury after 10-15 minutes. Most othe tissues are slightly more forgiving for the lack of oxygen but the time is usually counted in terms of minutes before irreversible change and death occurs. The oxygen from our atmosphere is mostly produced by photosynthesis, a process which occurs in plant life and which breaks down carbon dioxide and water to produce oxygen and sugars. Oxygen is thus part of environment to the same extent that the interstitial space surrounds and is part of the environment of the cells. Respiratory System This image represents a 3D rendered image of the airways and lungs with the heart whose function in transporting oxygen and carbon dioxide is vital to survival. The lungs and airways represent the organ that brings the most basic of elements essential to life – oxygen. The airways and lungs are in turn surrounded by a capsular fence called the pleura that protects and separates them from other structures. The pump station -aka the heart is seen centrally which is also protected and separated from the other organs by the pericardium. Courtesy of Ashley Davidoff M.D. 45819 chest cardiac heart trachea right and left bronchus lungs cardiomegaly enlarged CTscan surface rendering Courtesy Ashley Davidoff MD 45815 45816 45818 45819 45820 45821 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Alveoli of the Lung – Factory Workers This is a drawing of a cluster of alveoli surrounded by the capillary network, fed by an arteriole in blue, and drained by a venule in red. The second image shows the exchange of life giving oxygen for the by product of metabolic activity – carbon dioxide Courtesy of Ashley Davidoff M.D. 32164 32165 code RS lung alveolus respiratory bronchiole artery vein pulmonary capillary normal anatomy histology drawing The Lung – Order and Disorder These two anatomic specimens represent the left lung in health and disease. The right specimen is one of a hemorrhagic pneumonia with the alveoli drowned in blood and pus. Courtesy Ashley Davidoff MD. a87-68 32228b code lungs pulmonary lymphatics distended grosspathology anatomy fissure left Chest X-Ray – Normal and Abnormal 41818b chest lung CXR normal imaging radiology Courtesy Ashley Davidoff MD 47100.800 chest lung bronchus fx air bronchogram dx pneumonia CXR plain film Davidoff MD Therapeutic Intervention Before and After Antibiotic Therapy Images a and b show a pneumonia in the right middle lobe in both the A-P and lateral examination as an almost rectangular white patch, which resolved with treatment shown as a normal CXR in images c and d. 41819c02 Courtesy Ashley Davidoff MD medical students code chest CXR imaging lung plain film pneumonia radiology resolution There are many factors that are prerequisites for the sustenance of life. Sometimes it is the energy itself that we are concerned with (ATP) and sometimes it is the facilitators (oxygen, enzymes, cofactors, coenzymes, hormones). Electricity, oil, gas, propane, solar , and nuclear energy are some of the more commonly used forms. The failure of delivery of any one of these may bring significantt discomfort and inconvenience but will not usually lead to death and irreversible injury. Cardiovascular System The cardiovascular system consisting of the heart, arteries, veins, and capillaries functions as one of the many tubular transport systems of the body. It represents the roads and highways, railways and airways, seaways and riverways of the transport systems as we know them in our towns and cities. The cardiovascular system enables the delivery of essential raw and refined products, and the removal and transport of waste to the appropriate dumps. Disease of the vessels is commonly due to obstruction and a consequent inability of supply to meet demand. In the case of arterial obstruction to the coronary arteries the consequent myocardial infarction can and often results in death. The event of a highway accident results in a mere inconvenience – but imagine the devastation if the water supply were suddenly cut off as is seen when a city is under siege, or when main water spplies are lost. Survival is of course threatened. Highways Byways and Waterways for the City 32165 code RS pulmonary lung alveolus arteriole venule epithelium drawing gas exchange anatomy physiology histology 83557.800 highways waterways reservoirs storage stations factories homes transport systems bus cars Davidoff photography Cardiovascular System 32368b05.800 cardiovascular system heart cardiac artery arteries capillary capillaries arterioles venules veins negative firces positive forces road highway TCV the common vein applied biology Davidoff art Davidoff MD In the cardiovascular system the relatively positive pressure in the left sided systemic circulation created by the left ventricle, enables flow throught the capillary circulation, perfusion of the cells tissues and organs, and subsequent return of the blood to the relatively low pressure of the right side of the heart. The pulmonary circulation on the other hand is serviced by the pumping action of the right ventricle, which creates a positive force and flow to the capillaries of the lung and subsequent return to the low pressure of the left atrium. Congestion Open Highway and Congestion 57693b01 road highway clear open city electricity street lights Johannesburg South Africa Davidoff photography Davidoff MD Open Highway and Congestion 51187 Vehicles jam the Spanish highway leading to France after French authorities prevented Spanish Basque protesters from entering the country Saturday, March 11, 2000, in Irun, northern Spain. Photo by Bob Edme (AP) Normal Chest and Pulmonary Congestion 42076c04 Courtesy Ashley Davidoff MD medical students code batwing distribution congestion heart lung Rupture Intact River and Rupture and Flooding 83567.800 Charles river Boston Massachusetts Salt and Pepper Bridge order TCV The Common VEin Davidoff photography 50755 MAPUTO:MOZAMBIQUE – Houses on the outskirts of Mozambique’s capital Maputo are flooded after heavy rains drenched southern Africa, February 12. Flooding has forced an estimated 250,000 Mozambicans to find temporary refugee and left at least 50 dead across southern Africa. In Mozambique, flooding threatened the fertile farming land of the Limpopo Valley and regional capitals and waterborne disease loomed. Photo by Red Cross (Reuters) Order and Disorder Caused by Environmental Change 57677 before and after Kalutara Sri Lanka Courtesy DigitalGlobe.com Normal and Ruptured Aorta 37004 abdomen aorta kidneys cortical phase subcurtaneous fat adipose tissue normal anatomy gallsones cholelthiasis CT scan Davidoff MD 18269 aorta abdomen AAA aortic aneurysm abdominal aorta retroperitoneum fx retroperitoneal hematoma fx active hemorrhage fx perinephric hematoma anterior pararenal space perirenal space posterior pararenal space hemorrhage dx rupture abdominal aortic aneurysm CTscan Davidoff MD fx ruptured AAA Interruption of Flow and Repair A Bridge Broken and a Bridge Repaired 13227 bridge obstruction break disease disorder Davidoff photography 02340p bridge repaired Potomac Washington DC water TCV the common vein Davidoff photography The Normal Coronary Artery This is an anterior view of the heart showing the long LAD travelling within the expected course of the interventricular septum. Courtesy of Ashley Davidoff M.D. 32134 code cardiac heart coronary artery LAD diagonal conal infundibulum RVOT anatomy normal A Narrowed Artery and a Repaired Artery The coronary angiogram in the LAO projection shows a severe proximal stenosis (about 70%) of the circumflex with some post stenotic dilatation. The second image has a green overlay indicating the region of disease with the post stenotic dilatation. The third image on the right is a 3D CTscan where the heart and coronary areries have been rendered and reconstructed from the axial images. It shows a metallic stent in the circumflex artery that has been used to dilate and maintain the patency of the circumfex arteryCourtesy Ashley Davidoff MD. 07023c code heart artery coronary circumflex stenosis atherosclerosis imaging radiology angiography overlay 44250 heart cardiac artery coronary artery LAD left anterior descending artery fx dilated fx aneurysm circumflex fx stent imaging radiology CTscan Courtesy Ashley Davidoff MD Jeffrey Mendel MD Ruptured Aneurysm and Repair by Embolization 22521 22524 Courtesy Ashley Davidoff MD code spleen + artery + dx ruptured splenic artery aneurysm pseudoaneurysm + cystic fibrosis biliary cirrhosis portal hypertension angiography emergency Gastrointestinal System The gastrointestinal system is the food basket and the garbage removal service of the body. It is responsible for taking in, pocessing, transporting, absorbing, and excreting food and water, the raw products of metabolism. The gastrointestinal system is the breadbasket of our bodies. It receives the food, processes, absorbs, stores, and transports the food, and helps either to recycle needed products, or eliminate unwanted products. It thus functions as the equivalent of our farms, food processing plants, grocery, food delivery systems, water and sewerage works, and recycling plants. Food and the Community – Road from Farm to the Cell A Farm in Peru 0175.800 farm vegetables road transport units on the farmland oxygen sunlight clouds water TCV the common vein Peru Davidoff photography Mountain Farms in Peru 0178.800 Peru farm wall units to unity mountains vertical agriculture food the common vein applied biology Davidoff photography Davidoff MD Gathering on a farm in Pennsylvania 02512p food farm gathering receiving packing transporting TCV the common vein Davidoff photography Packing Red Peppers on a farm in South Arica 57984.800 farm red peppers vegetables South Africa gather picking transport work Davidoff photography Transport 0072.800 0010.800 Peru cane transport woman old barefoot bare feet hat storage Davidoff photography Davidoff MD Storage in Peru 0074.800 Peru corn storage drying in the sun food carbohydrate Davidoff photography Davidoff MD Storage 02387p USA New Hampshire storage food store farm water phone wires electricity electrical TCV the common vein Davidoff photography Davidoff MD Market in PEru 62923.800 community market produce Peru people Davidoff photography Davidoff Oneness Fish Workers in Portugal Columnar Epithelium in the Gut 56889 fishprocessors in Portugal young women uniform gum boots 70043cD08.800 cells columnar epithelium food processing packing packaging digestion absorbtion excretion Davidoff art Davidoff MD TCV the common Vein Davidoff photography Davidoff MD Selling or “Exchanging” in a Market in Jerusalem 02837p bananas selling Arab market Old Jerusalem Israel TCV the common vein Davidoff photography Garlic in Greece 02977p Athens Greece food seller garlic TCV The Common Vein Davidoff photography Chicks in Greece 02976p chickens chicks Greece food roadside seller young woman TCV the common vein Davidoff photography Davidoff MD Food Distribution in New York City – Liver Metabolic Warehouse Elegant foods through the window of Balducci’s New York Courtesy Ashley Davidoff MD 02128p code interesting accessory Davidoff photography Buying in Boshoek South Africa – Tel # 1 10150 Boshoek South Africa food buying distributing telephone women baby woman TCV the common vein Davidoff photography Eating in Peru 0063.800 Peru food eating restaurant Davidoff photography Davidoff MD Gathering Food and Transporting 39562c esophagus stomach hiatus hernia normal HH Stomach – Storage Cleansing 00410 stomach body areae gastrica mucosa contrast barium upper GI UGI X-Ray imaging radiology normal anatomy histology Healthy Brothers in South Africa and Malnourished Child in Ethiopa 02348p01 boy youth health nutrition physiology anatomy Davidoff photography 51954 51955 DANAN, ETHIOPIA – Malnourished children at a camp in the town of Danan some six hundred kilometers South East of Addis Ababa April 7. Ethiopia has appealed for over 800,000 tonnes of food aid to feed eight million people faced with starvation around the country this year. Photo by Peter Andrews (Reuters) Devastating Effects of Diabetes – aberrant glucose metabolism This image reveals the devastating manifestations of aberrant glucose metabolism as a result of insulin insufficiency, with consequent effects on the small vessels throughout the body. In this instance the diabetic arteriopathy is characterised by calcific atherosclerotic diease seen as calcification of the digital artery in b with subsequent ischemia to the foot. The poor nutrition has resulted in infection and ulceration of skin and bone, with poor healing and a need to amputate irrecovarable tissues. 48471c01 foot phalanx phalanges toes digital artery bone fx amputation calcified calcification of arteries dx diabetic arteriopathy chronic ischemia complicated by ulceration infection osteomyelitis treated with amputation diabetes mellitus metabolic disorder plain X-Ray of the foot Courtesy Ashley Davidoff MD Poverty – Poor Nutrition 57955 children third world South Africa tin shanty protective barb wire povert poor nutrition Davidoff photography – functionality the stroke that may result in paralysis of the person.A similar event where vital supply to the controlling institutions may be seen in the oft used tactic of yesteryear of a siege of a city. In this instance it is a lack of supply to the whole city, but the term paralysed city would be appropriate brainis related to permanent affecting the verbal function, results in an inability to communicate needs – such as hunger and thirst – survival needs. A coup of a government, or in the case of the curent realtively leaderless situation in Iraq, gives a sense of The respiratory system brings fuel to the fire by providing oxygen for all metabolic events. This oxygen is required not only for the maintenance and sustenance of life but is also required for every specialised and productive function. The community requires sustained supplies of adequate and clean air, food and water for sustenance. The clean air comes to our cities and as long as we are vigilant As our industrial world evolved, the machines that we built required alternate sources of energy in the form of electricity and fuel. The factories that process, package and store our food for example are dependant on these alternate and costly sources of energy that are not freely available like the air we breathe. Thus the viability of our factories in general, and our food factories specifically, are dependant on these alternate sources of energy and hence our viability and survival to some extent is dependant on them too. This was not the case when we livee the hunter gatherer lifestyle.valuable and sourceswithout these energy sources and they have become the sources of our food, and to lesser The most frequently used fuel is electricity which is often used in conjunction with oil and or gas. Unlike the oxygen which is freely available to our bodies the energies that are vital to the function of the factories of our city come with a price which closes for the night, the fuel requirement of oxygen is always needed. Factory on the Shore 83879b01.800 Boston MAssachusetts from the airplane factory sunrise chimney stacks storage tanks water sea energy sky light electricity the common vein applied biology concepts interstitium 3rd space extracellular space Davidoff photography Davidoff MD The Liver Factory 44426b01 liver hepatic clockwork purple anatomy Courtesy Ashley Davidoff Davidoff art Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography The genitourinary system Urination 82001p.800 Bruge Belgium interesting accessory urine urinary system genitourinary tract urine out put Courtesy of Ashley Davidoff MD Davidoff photo Factories are an essential component of our community. They manufacture and process critical items such as food, clothing, and building materials, – all essential for our survival. We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a We can observe many of the equivalent factories in the liver which has, among other roles, a major manufacturing and processing function in the body. to the extent it is called the “metabolic warehouse”of the body – and in tems of the city would be equivalent to an industrial and manufacturing area of the body that receive process package items such as food, raw materials such as proteins that act as the building blocks for our body structures as well as other esential items such as vitamins and biliary lubricant. The liver is the true metabolic warehouse of the body. It manufactures some of the more basic building blocks of structure including certain proteins such as albumin, fibrinogen, globulin and other plasma proteins, as well as some amino acids. It is also responsible for the production of about 80% of the cholesterol of the body that is an important part of membranes and is also a precursor for many of the steroid based hormones of the adrenals, testes and ovaries while it is also a precursor for the bile acids which have important function in the processing of and digestion of fats.The efficient transport system of the portal system from the breadbaskets of the gastrointestinal tract to the liver factory are key to survival. The need to ensure a clean environment of the liver in order to provide a quality product for the community is ensured by the local Kuppfer police system. The splenic recycling plant breaks down old and defunctioninbg red cells and recycles the bilirubin that requires further refnement in the factories of the liver. The spleen also has a policing function to ensure that unwanted organisms are cleared from the circulation. provides a protective fence from the community at large. and medicationsand transport food and of a The Portal System Courtesy Ashley Davidoff MD 01217 code esophagus + vein + ;liver portal vein spleen splenic vein left gastric vein coronary vein IMV inferior mesenteric vein fx short gastric varices + angiography transhepatic venogram anatomy The needs of human biology include survival, growth, and fulfilment. Consider the city in which you live and you will find that in general, the core of the city contains components in some form of these three elements. The cell in its turn has to have similar elements. While it is easy to recognise the survival, and to some extent growth in the life of a cell, the fulfilment aspect is not as obvious. As human conciousness emerges as a result of the power of the units to unity of cellular accumulation, the needs for individual fulfilment at many levels becomes comprehensible. On the other hand as one moves beyond the individual to the family and then to communities of progressively enlarging sizes, the aspects of survival and growth are fairly easy to see and understand while the element of fulfilment becomes even a more difficult concept. We are going to look at the city (or the village or town for that matter and we are going to look at its survival, growth and fulfilment as best we can to expose how the biology in the person translates into the city. The makeup of the city. The city has elements that include resources for survival, resources for growth, and resources for fulfilment. Resources for survival include sources for food ,water, protectionclothing, and housing, and the provision of an environment that has safety institutions of public safety Departments Shopping centre – food Water departmentEnvironment/building/police Survival: Neither the cell nor the city can survive without air water and food. Students of biology understand the acquisition of air and oxygen through the breathing mechanisms championed by the respiratory system, while the acquisition, processing and use of food and water is understood by the study of the gastrointestinal system. The pattern of acquisition, transport, processing, and exportation are repeating principles in all of biology. It is therefore not surprising that a city, which an extension of the biology that resides within it, functions along the same principles. The air we breathe is as natural a form of the environment of the city, as the interstitial fluids that bathe our cells. It comes free and is key to our survival – every second of it – the difference between life and death of a city and a cell, is totally dependant on this entity – air and oxygen – and fortunately for the city – it coms relatively easy. Air and Oxygen: Free and Fresh Air for the City New York city – a combination of horizontals and verticals – glass mirrors and cement. Courtesy Ashley Davidoff MD. 02165p code accessory interesting Our need for oxygen is so essential to life, that for most – it is packaged with life itself and we have no struggle to obtain it except under exceptional circumstances. While the person and city are naturally exposed to the oxygen source, the cell is dependant on transport mechanisms to bring the oxygen to it. Thus the upper powers of the hiearchy (the body and its systems) are in control of this essential element of life for the cell. If they, for whatever reason lose control of oxygen supply to the cells in the form of airway obstruction or occlusion of a coronary or cerebral artery, the overall survival of the biological unit becomes threatened. In this example we see and start to understand the interdependancy of biological units. In the case of the city (town or village) and the person air and oxygen is a given and oft unappreciated gift, while in the case of the tissues and cells, it is a commodity that has to be earned to some extent and has to be delivered. The cell is at the mercy of others in the team to deliver air regulalrly and efficiently. In the same way that we have to “earn’ our food by working, earning, positioning ourselvs to receive and transporting our food, the cells and tissues have to earn their supply of oxygen. Thus for example the heart cell has to position itself in its place of employment (cardiac tissue in the borough of the thoracic cavity) It holds hands in syncitial format with the other cells in its production line which has positioned itself near the rivers of the arterial system in order to efficiently receive the oxygen (and other metabolic products) necessary for its function. Its work starts early in the morning of its original birth, and it practices its trade of contraction and relaxation which it learned from the school housed in the genetics of contractile evolutionary lessons. Its work consists a pumping action and as a result it can “earn” reactive vasodilation (brokered by the Nobel winning nitrous oxide mechanism). If it works harder based on physiological need (perhaps a run in the park by the CEO) it will earn and receive more food. Thus the pattern of earn by positioning a biological unit in a work environment, doing the work, earning the reward, is for the myocardial cell in its use of oxygen and food what it is for the individual who earns money for food. The city receives as a gift the oxygen from the environment. It has to ensure that this gift remains untainted and is kept free of pollutants. Water and Food When it comes to food and water, the concepts are the same but the story is a little different. Both the cell, and the individual become slave to the larger community to provide the essential units, while they retain masterhood for eventual survival. A healthy city will have mechanisms in place to acquire and deliver food and water regularly and efficiently. We start to talk of relative scarcity of the commodity, and a need to “earn” the food and water. While clean water through the evolution of the sciences comes to most cities through a tubular systems, it comes with a cost albeit relatively small, and we therefore have to earn iour water Our ability to position ourselves to “earn” our food and water for survival seems to me to be no different from the myocardial or liver cell that has learned a skill that is valuable for the community. “If you give you get ” I tell my children – this is so fundamental in all of biology. The delivery of water to biological units has a larger latitude in terms of the time when compared to the delivery of oxygen. Whereas the need for oxygen delivery is measured in seconds and minutes the delivery and use of food and water can be measured in multiples of minutes and hours. Water and food to the cell is delivered in the same way as air is delivered – via tubular systems. The tissues keep themselves bathed in just the right amount of water, at the right temperature. Water to the person and city comes from reservoirs and water plants via tubular systems. Whereas water is almost as The food to the person has to be earned. there is an order in the world that is beyond our comprin order and ouThe biological world in general tends to be hostile with each biological unit fighting for survival. The need for food, fluid, oxygen, is obvious, and the need for a a safe and clean environment is a large part of the survival.SuWhen we look at biological units, including the cell, organs, persons or communities we take in things, process them and give them out. The cell mostly has no choice about where it is positioned in life. It is slave to its circumstance Raw materials Hospitals Supermarkets :aw and Order Walled City of Porto 83936 city wall safety protection Porto Portugal Davidoff photography Walled Body 49640 bone rib thoracic spine spinous processes scapula protection support CTscan volume rendering Davidoff MD Walled City of Porto 83937.800 city wall safety protection Porto Portugal Davidoff photography Law and Order 81752p interesting accessory police protection defence defense Brussels Belgium Courtesy of Ashley Davidoff MD Davidoff photography Rules of the Road An car and a police cruiser on a country road. CAn you date the event. Courtesy Ashley Davidoff MD 02009p code accessory interesting Radiologists and Detectives Davidoff photography Ridding Waste Garbage Garbage A trash can with styrofoam boxes from McDonalds, diet coke cans and Kit Kat wrappers. Does our garbage tell a story of the way we live? Courtesy Ashley Davidoff MD. 02013p code accessory interesting garbage waste radiologists and detectives Davidoff photography Chimney from the Underground Smoke in New York city Courtesy Ashley Davidoff code accessory interesting chimney tube smoke New York 2001p Factory Waste 84311p.800 chimney brick factory Cambridge MAssachusetts tube waste Davidoff MD Davidoff photography Garbage Eater – Macrophage 02308p.800 monkey baboon garbage South Africa Cape Town Davidoff photography Bridge Intact 62639.800 bridge water intact white arch shape connection reflection TCV the common vein Davidoff photography References Chase Dunn and Jorgensen Regions and Interaction Networks. a World-Systems Perspective )