Monthly Archives: June 2015

Pomplamoose – on making a living as 21st century artists

You have to wonder how anyone could think it is possible to make a living making music. Those at the top may as well have been born there – not because they didn’t have to work hard to get where they are, but because the number of artists who have ‘made it’ is so small that it may as well be limited to the winners of the PowerBall Lottery.

Pomplamoose is duo (Jack Conte and Nataly Dawn) making music and videos (I find it hard to imagine either one without the other) and doing the occasional tour. Last year (2014), Pomplamoose put together a 28 day tour around the US and then wrote up a summary of the accounting for the tour to illustrate how difficult it can be to make ends meet even for a relatively famous band (I admit that using the word ‘relatively’ could mean almost anything).

You can find Jack’s accounting of the tour and how their net loss of about $11,000 is just the price of doing business and building a fan base here. You can also check out Jack’s other project, Patreon, where normal people, like you and me, can be patrons of the arts.

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Posted by on June 25, 2015 in Uncategorized


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Decision Anticipated



The Supreme Court of the US is expected to release its decision on the case of Obergefell v. Hodges very soon. This case, as summarized on the SCOTUSBlog, asks:

1) Does the Fourteenth Amendment require a state to license a marriage between two people of the same sex? 2) Does the Fourteenth Amendment require a state to recognize a marriage between two people of the same sex when their marriage was lawfully licensed and performed out-of-state?

It does so in order to decide, specifically, if James Obergefell, who married his partner of 20 years, John Arthur, can be listed as a spouse on Mr. Arthur’s death certificate (Arthur died of ALS). The two were married in Maryland, but were residents of Ohio, where same sex marriage is not recognized.

For a description of the case in plain English, visit the SCOTUS Blog.

The decision is expected late this month.

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Posted by on June 23, 2015 in Uncategorized


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Hiatal Hernias

plate 391

plate 391

A Hiatus is a gap or hole. In the context of the diaphragm, there are hiati (?) for a number of structures including the Vena Cava, the Aorta, and the Esophagus. These can be seen as the three openings in this image (plate 391) of Gray’s Anatomy. The smaller gap in the center is the esophageal hiatus (recall that the esophagus is a collapsed structure except in the case when a bolus of food is moving through it.

Hiatal Hernias occur when part (or all) of the stomach moves up through this opening and into the thoracic cavity. In general, these hernias are classified as either sliding or para-esophageal (see below). In general, a sliding hernia is one in which part of the stomach (including the gastroesophageal junction) moves up and down through the hiatus and the axis of the stomach is aligned with the axis of the esophagus (i.e. symmetrical). Para-esophageal hernias occur when the gastroesophageal junction remains in the abdomen, but part of the fundus of the stomach moves into the thoracic cavity.

As stated in wikipedia, “In most cases however, a hiatal hernia does not cause any symptoms. The pain and discomfort that a patient experiences is due to the reflux of gastric acid, air, or bile.” As such, they are often treated with lifestyle changes rather than more invasive procedures.

These hernias are most common among obese persons, women, and in those over 50 years old.

2014.03.83.Hernia HiatalOf the two varieties of hiatal hernias, paraesophageal hernias are more often treated with surgery, which resolves symptoms in ~90% of patients. Outcomes are most favorable with laproscopic, rather than open, surgery.

I have a feeling I’ll ask something about this on tomorrow’s exam…

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Posted by on June 23, 2015 in Uncategorized


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Etymology: Oligouria

Screen Shot 2015-06-18 at 4.18.00 PMI think I misspoke in class the other day. I’m not positive, but I may have used the term Oligouria incorrectly.

Regardless of what I may have said, I want to clarify here…

Oligiouria is the condition of producing small amounts of urine. Oligo- meaning ‘small, little’ + -uria, from the Gr. Ouron = urine. Clinically, oligouria is defined as the production of 100-400 ml of urine per day as opposed to the typical 400 to 2,000 mL — from about 2 liters of fluid intake.

Less than that and you’re in the realm of Anuria (a- meaning ‘no’ + -uria).

Decreased urine production can be caused by a number of conditions, but most commonly, it is an indicator of dehydration or hypovolemic shock, which may also sequelae of  a variety of things. Hiking in the desert without water can do it, but so can kidney failure or a blockage – both of which can occur even with adequate hydration.

The other end of the spectrum is Polyuria, or the production of excessive urine ~more than 2.5 Liters over the course of a 24 hr day. This is essentially equivalent to Diuresis which is from the Gr. Diourein, meaning ‘to urinate’. polyuria

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Posted by on June 18, 2015 in Uncategorized


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pointer to spookie Renal Physiology

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Posted by on June 16, 2015 in Uncategorized


A Little Help from my Friends

Really, everyone should see the Woodstock movie at least once. This is a great clip, but the whole film is great. As a tie-in to my film blog, this movie also has a prominent placement in the 1971 film, The Omega Man.

I have not done so yet this semester, but I thought now was a good time to start…

I want to invite my Pathology students to write questions for the upcoming exams. Here are the rules:

1. Post your question as a comment on this post

2.Include four answers for multiple choice

3. Indicate the correct answer

4. Questions and answers must be high quality, i.e., not ‘gimmes’

5. You are encouraged to comment on one another’s questions – ask for or provide clarity, help with crafting the best question, or discussing the content.

High Quality Questions will be used in future exams. I think the benefit to you is apparent. So far, I have had no limit to the number of questions you may submit. I have definitely used multiple questions from a single contributing author in the past – however, as you will see, it isn’t simple to write good questions – and keep in mind that the exams are only 25 questions long.

I hope you take advantage of the opportunity here.

and Belushi’s blockbuster cover Cocker covering the same cover…

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Posted by on June 10, 2015 in Uncategorized


An Exam, tomorrow?!

They come so quickly.

tick tick tick

tick tick tick

Tomorrow we will be testing on the Circulatory System and then moving into the Respiratory System. I fell that that is so much to learn in each of these systems that I wish we had much more time to tumble down the Rabbit Hole and get to know them well.

The time has come,’ the Walrus said,
      To talk of many things:
Of shoes — and ships — and sealing-wax —
      Of cabbages — and kings —
And why the sea is boiling hot —
      And whether pigs have wings.’
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Posted by on June 10, 2015 in Uncategorized


EKG Basics

And, I mean really basics. We don’t spend much time talking about EKG reading in my Pathophysiology class because my own background is limited. However, I have asked that students be able to identify a normal EKG vs a ST elevated EKG; which signifies, along with other signs, such as cardiac enzymes in the blood; that a patient has had a heart attack.

(by the way, I would like to say right up front, that I happily accept comments that can improve this post)

Case Report:

A patient (65 yo male Caucasian) arrives in the ER after having severe chest pain radiating into the left arm, neck and jaw. The patient has a history of hypertension, some atherosclerosis, and spasms of the coronary arteries. Patient smokes 1/2 pack per day, and drinks approximately 1-2 beers a day. When symptoms set in, he took a Nitroglycerine tab under his tongue, but experienced no relief. His wife drove him in to the ER as he was experiencing nausea.

A blood test for cardiac proteins indicated that Troponins (Tn T and Tn I) were both present in serum at 10x the upper reference limits. His EKG appear as:

Screen Shot 2015-06-08 at 8.44.30 PM

Click image for live EKG

What is your diagnosis?

What do the elevated Troponins indicate?

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Posted by on June 8, 2015 in Uncategorized


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Measles and immune memory

memoryThere’s more than one reason to immunize your kids.

Even if just not getting measles was all you got for your immunization, it would still be worth it. But through some unknown mechanism, getting measles seems to erase prior immunological memory, by depleting B and T lymphocytes (so, we know the cause, but not how this happens).

Below, is a visualization of individuals’ lymphocyte numbers pre and post measles:


Apparently, naive cells are either not impacted, or only minimally so. Whereas all specific lymphocytes are completely depleted. Following resolution of the infection, the only antigen-specific lymphocytes that remain afterwards are those specific to measles. That is, you now have the immune system of a toddler, with the sole exception of having immunity to measles. Recovering that lost immunity takes approximately 2-3 years of being exposed to and contracting infection after infection to rebuild memory.

One of the reasons that investigators knew that there was something to investigate was that once measles vaccine became available, not only did deaths associated with measles decrease, but so did deaths associated with a number of other infections.

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Posted by on June 3, 2015 in Uncategorized


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Feeling Important? This’ll take you down a notch

Graphic decription of Venus phases (in Il saggiatore, In Roma, appresso Giacomo Mascardi, 1623) Istituto e Museo di Storia della Scienza, Library, Florence, Rari 153

Graphic decription of Venus phases (in Il saggiatore, In Roma, appresso Giacomo Mascardi, 1623)
Istituto e Museo di Storia della Scienza, Library, Florence, Rari 153

Like Galileo looking up to the heavens and Hooke looking down into the pond scum, the images in this essay still have the power to bend your mind regarding the scale of the universe.

In the 16th and early 17th centuries, everyone knew the Earth was the center of the universe and planets were odd wanderers in the sky.

Several men had suggested otherwise, but they didn’t always get rewarded for their scientific curiosities in ways that they appreciated.

The Athenian, Anaxagoras, of 5th century BC  had an idea that the Sun and stars were fiery stones. We were warmed by the Sun because of its proximity, while  the stars were too far away for their heat to be felt. For his ideas, he was  imprisoned for impiety.

Aristarchus of Samos, Greece in the 3rd century BC suggested that the Sun is much larger than the Earth and that the comparatively small Earth orbited around the larger Sun rather than the other way around. He also posited that the stars were so far away that there was no observable parallax. These ideas were not well accepted, and lacking the data required to prove such a hypothesis, it was difficult to sustain.

Giordano Bruno, a 16th century philosopher proposed the idea that the Earth is a planet just like the others orbiting the sun. To make matters worse, he added that the Universe is infinitely large containing many worlds. His ideas earned him the condemnation of both the Roman Catholic and Reformed Churches and was burnt alive at the stake in Rome in 1600 for his heresy.

It wasn’t until the early 20th century that new telescopes enabled Edwin Hubble and others to see beyond the scope of the Milky way and into the vast universe beyond. With these vast, new distances, another aspect of astronomy came into being – that of distance equating with time.

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Posted by on June 1, 2015 in Uncategorized