Berger Seeing Is Believing Pdf Writer
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“A woman must continually watch herself. She is almost continually accompanied by her own image of herself. Whilst she is walking across a room or whilst she is weeping at the death of her father, she can scarcely avoid envisaging herself walking or weeping. From earliest childhood she has been taught and persuaded to survey herself continually. And so she comes to consider the surveyor and the surveyed within her as the two constituent yet always distinct elements of her identity as a woman. She has to survey everything she is and everything she does because how she appears to men, is of crucial importance for what is normally thought of as the success of her life.
Her own sense of being in herself is supplanted by a sense of being appreciated as herself by another.One might simplify this by saying: men act and women appear. Men look at women.
Women watch themselves being looked at. This determines not only most relations between men and women but also the relation of women to themselves. The surveyor of woman in herself is male: the surveyed female. Thus she turns herself into an object - and most particularly an object of vision: a sight.”―John Berger. “What reconciles me to my own death more than anything else is the image of a place: a place where your bones and mine are buried, thrown, uncovered, together. They are strewn there pell-mell.
One of your ribs leans against my skull. A metacarpal of my left hand lies inside your pelvis. (Against my broken ribs your breast like a flower.) The hundred bones of our feet are scattered like gravel.
It is strange that this image of our proximity, concerning as it does mere phosphate of calcium, should bestow a sense of peace. With you I can imagine a place where to be phosphate of calcium is enough.”―John Berger. “To be naked is to be oneself.To be nude is to be seen naked by others and yet not recognized for oneself. A naked body has to be seen as an object in order to become a nude. ( The sight of it as an object stimulates the use of it as an object.) Nakedness reveals itself. Nudity is placed on display.To be naked is to be without disguise.To be on display is to have the surface of one's own skin, the hairs of one's own body, turned into a disguise which, in that situation, can never be discarded. The nude is condemned to never being naked.
Nudity is a form of dress.”―John Berger. “The happiness of being envied is glamour.Being envied is a solitary form of reassurance. It depends precisely upon not sharing your experience with those who envy you. You are observed with interest but you do not observe with interest - if you do, you will become less enviable. In this respect the envied are like bureaucrats; the more impersonal they are, the greater the illusion (for themselves and for others) of their power. The power of the glamorous resides in their supposed happiness: the power of the bureaucrat in his supposed authority.”―John Berger. “I can't tell you what art does and how it does it, but I know that art has often judged the judges, pleaded revenge to the innocent and shown to the future what the past has suffered, so that it has never been forgotten.I know too that the powerful fear art, whatever its form, when it does this, and that amongst the people such art sometimes runs like a rumour and a legend because it makes sense of what life's brutalities cannot, a sense that unites us, for it is inseparable from a justice at last.
Metin2 yang hack 2013 download free. Art, when it functions like this, becomes a meeting-place of the invisible, the irreducible, the enduring, guts and honour.”―John Berger.
Cancerous skeletal lesions, which resemble pits in the bone, are a hallmark of multiple myeloma. A skeletal survey using an X-ray machine has long been the gold standard for spotting these lesions, and the International Myeloma Working Group still recommends that doctors conduct such a survey once the disease is suspected.
Radiography machines are inexpensive and widely available, but the process can be slow and uncomfortable for patients. To ensure that the radiologist gets images of the entire skeleton, patients must reposition themselves frequently. “You have to lie on your side and then stand up — there's a huge amount of moving around,” says Ciaran Healy, a radiologist at Mater Misericordiae University Hospital in Dublin, Ireland. For patients who are frail or already in pain, the process can be agonizing. And X-rays tend to miss small lesions. Many medical centres, including Mater Misericordiae, also use magnetic resonance imaging (MRI) to spot multiple myeloma. X-rays and low-dose CT scans can find lesions in the bone, but MRI is better at detecting cancer in the soft marrow inside the bones.
“It can identify not only very small lesions, but lesions which spread around the spinal cord,” says Homer Macapinlac, chair of the nuclear-medicine department at the M. Anderson Cancer Center in Houston, Texas. Spotting these lesions is particularly important because they can press against the spinal cord and cause paralysis. Studying MRI images can also help doctors decide where to biopsy. In some patients, cancer cells are concentrated in clusters, or hotspots, in the bone marrow.
If the biopsy misses those lesions, “you might miss a diagnosis”, says Ronald Walker, a radiologist and nuclear-medicine physician at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. Also, because MRI relies on radio waves and strong magnets, radiation exposure is not a concern. However, MRI is more expensive and time consuming than CT scans. And because the conventional MRI is “optimized for the marrow”, Walker says, scans may not detect cancer that has spread outside the bones into the surrounding soft tissue.
In the 1990s, oncologists working with multiple myeloma patients began combining CT with positron emission tomography (PET), which lets them visualize biological processes in the body. The radiologist injects a radioactive tracer and a scanner detects the gamma radiation it emits. The most widely used tracer, fluorodeoxyglucose (FDG), allows researchers to track the uptake of glucose. Cancer cells grow and divide faster than normal cells, so they usually use more glucose. Areas of high glucose uptake show up as bright spots on the PET image. Combining PET and CT locates these bright spots in the body. It was a PET–CT scan that alerted Raje to Ben's relapse.
Although whole-body MRI is better than PET–CT at picking up active cancer, PET–CT is more effective at determining whether a patient is responding to therapy. If treatment works, the cells stop proliferating, use less glucose and become dimmer on the image.
Berger Seeing Is Believing Pdf Writer Book
The largest and most comprehensive study of the use of imaging to detect treatment response in multiple myeloma found that the number and intensity of active cancer spots on a PET–CT scan was predictive of how patients respond to therapy. “The higher the number of hotspots and the greater their intensity, the poorer the outcome,” says Bart Barlogie, director of the Myeloma Institute for Research and Therapy at the University of Arkansas for Medical Sciences in Little Rock. Barlogie now relies on PET–CT scans to individualize treatment. “We do the scanning sometimes on a weekly basis,” he says. “And if the lights don't dim in a week, we know the drug is not active and we change course.”. First, a pump intravenously injects the agent, which travels through the blood vessels.
Multiple scans allow physicians to track the agent and quantify blood flow and vessel density in the bone marrow. The technique also helps doctors measure the leakiness of blood vessels, which is usually higher in areas of malignancy. This measurement could enable DCE-MRI to spot signs of progression in patients with 'smouldering myeloma' — an early form of the disease — sooner than other imaging techniques. “We are hoping that this would help to define patients at risk of going on to symptomatic myeloma,” Hillengass says. Another promising direction involves new tracers to identify lesions in PET imaging.
“A lot of the lesions in myeloma do not have increased glucose uptake,” says Ola Landgren, head of the multiple myeloma section at the National Cancer Institute in Bethesda, Maryland. A tracer known as 18F-FLT measures the rate of DNA synthesis, rather than glucose uptake. Because cancer cells cycle more rapidly than normal cells, they synthesize more DNA. However, the rate of DNA synthesis is also high in normal bone-marrow cells, minimizing the difference between cancer cells and normal bone-marrow cells. “It's like trying to identify chocolate chips in a chocolate cupcake,” Macapinlac says. “They kind of all blend in.” But 18F-FLT can detect a patient's response sooner than FDG.
“You don't have to wait for several cycles of therapy,” he says. Scientists are also investigating a PET tracer that is preferentially taken up by bone-forming cells. This tracer, 18F-sodium fluoride (NaF), was approved in the 1970s but was not widely adopted because for many years PET scanners were expensive and scarce.
Now they are widely available, researchers are investigating how the NaF tracer can help myeloma patients. There is evidence from a South Korean PET study that NaF is better than FDG at spotting bone lesions. Doctors used to think that “once you have a hole in the bone, it's not ever going to heal”, says Raje.
But new therapies that promote bone formation are challenging that wisdom. And tracers such as NaF might enable physicians to observe this healing process in real time. A machine that combines PET imaging with MRI could offer the most complete picture of multiple myeloma. The US Food and Drug Administration approved the first such system, manufactured by Siemens Medical Solutions of Malvern, Pennsylania, in June 2011.
It could provide all the benefits of PET–CT without exposure to radiation. This is especially useful for younger patients, who have a greater risk of developing CT-related cancers, Macapinlac says. Researchers are working to optimize the algorithms needed to reconstruct the PET images and to make it quicker to do scans, he adds.