Stony Heart Research Articles

Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit.

The post-resuscitation period is recognized as the main predictor of cardiopulmonary resuscitation (CPR) outcomes. The first description of post-resuscitation syndrome and stony heart was published over 50 years ago. Major manifestations may include but are not limited to, persistent precipitating pathology, systemic ischemia/reperfusion response, post-cardiac arrest brain injury, and finally, post-cardiac arrest myocardial dysfunction (PAMD) after successful resuscitation. Why do some patients initially survive successful resuscitation, and others do not? Also, why does the myocardium response vary after resuscitation? These questions have kept scientists busy for several decades since the first successful resuscitation was described. By modifying the conventional modalities of resuscitation together with new promising agents, rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal, stony heart. Community awareness and staff education are crucial for shortening the resuscitation time and improving short- and long-term outcomes. Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes. This review extensively addresses the underlying pathophysiology, management, and outcomes of post-resuscitation syndrome. The pattern, management, and outcome of PAMD and post-cardiac arrest shock are different based on many factors, including in-hospital cardiac arrest vs out-of-hospital cardiac arrest (OHCA), witnessed vs unwitnessed cardiac arrest, the underlying cause of arrest, the duration, and protocol used for CPR. Although restoring spontaneous circulation is a vital sign, it should not be the end of the game or lone primary outcome; it calls for better understanding and aggressive multi-disciplinary interventions and care. The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.

Lee, Wendy Anne. Failures of Feeling: Insensibility and the Novel.

Lee, Wendy Anne. <i>Failures of Feeling: Insensibility and the Novel</i>.

Remote pharmacological preconditioning on median nerve territory increases Hsp32 expression and attenuates ischemia–reperfusion injury in rat heart

AimsThe aim of this study was to test the hypothesis that remote pharmacological preconditioning (RPP) induced myocardial heat shock protein (Hsp) 32 expression and attenuated the ischemia–reperfusion (I/R) injury of the heart in rats. Main methodsAnimals were injected at the left median nerve territory with chloralose and urethane mixture. At different time intervals, myocardial Hsp32 gene expression was analyzed. Primary heart cultures were used to investigate the direct effect of drug mixture on Hsp32 expression. Key findingsThe results showed that Hsp32 was time- and dose-dependently increased by in vivo drug mixture treatment, but not in primary cultures. RPP significantly decreased the duration of arrhythmia and incidence of stony heart in rats with subsequent I/R injury. SignificanceWe conclude that RPP on the left median nerve territory induced Hsp32 gene expression in the heart and attenuates myocardial damage functionally after subsequent I/R injury.

John Updike and the Waning of Mainline Protestantism

John Updike is known more for the perfection of his prose than the pacing of his plots. At least, that is an observation one might infer from his critics, who commonly complain that his stories have a surplus of style over substance--although even the most ardent among them admit that his style is sufficient to sustain interest in the most minimal of narrative actions. This backhanded praise of Updike's literary achievement is heard so often that it is worth pausing to ponder. The power of his prose comes, at least in part, from the way he applies his expansively metaphorical imagination to the most tapered slices of perception. In Updike's verbal economy, a maximally exuberant splurge of language is required for the most efficient animation of matters that are seemingly insignificant. This paradox of a style that is as demonstrable as its subject matter is restrained leaves some readers cold, as if Updike generates a lot of heat without producing any goods. Reading Updike in the context of contemporary popular culture highlights the virtues of his unapologetic literariness. The silver screen has cast its golden aura across the spectrum of media technologies, making movies the measure of our lives. We stare blankly at the speed by which movies flip through images like a pack of deftly dealt cards. Our eyes are so strained by the ocular imperative to lay reality bare that we almost forget how unknowable the world is when stripped of language's garment. From this perspective, the patience of Updike's focus on the delicacy of life's overlooked details constitutes a radical riposte to our image-soaked society. His signature sentences, which unwind slowly with a serpentine precision only to end, frequently, with surprising sharpness, taunt our dulled senses. Updike lights up the ordinary in order to discipline our desires for the immediacy of visual seduction. Nonetheless, Updike's critics always want more--more message and less of the means by which it is delivered. Such criticisms date early in Updike's career, beginning, famously, with Saul Bellow's diagnosis of Updike's stony heart (6) and continuing with lames Wood's accusation that many of Updike's narrators and characters are imperturbable because they speak not from their own predicaments but with Updike's own languid and ultimately complacent prose. The most perceptive of Updike's critics, perhaps following Updike's own frequent confessions to antinomian tendencies (the separation or even opposition of faith and common morality), have given this alleged imbalance between style and substance a theological significance. Thus Ralph Wood, intuiting the vice that virtue inevitably casts as its shadow, attributes Updike's descriptive generosity to a narratological sloth, arguing that Updike's polished aesthetic surfaces reflect a God that is none too deep. Frank G. Novak, Jr., in a brilliantly provocative reading of Roger's Version, pushes Woods' accusation of moral passivity to the point of suggesting that Updike has a proclivity, at least in this novel, for assigning his protagonist to the side of Satan. And Peter I. Bailey argues that the dialectic between faith and doubt that Updike deployed in his early work collapsed in the Rabbit Angstrom tetralogy and In the Beauty of the Lilies (1996), revealing Updike's journey as a voyage into increasing skepticism and even agnosticism regarding the consolations of belief. For a writer so steeped in religion, the charge that he has become (or perhaps always was) unsuccessful in adequately transferring the drama of faith to the written page would certainly account for qualms about the superfluity of his prose. Nonetheless, I want to argue that Updike is too invested in reality to permit his readers simply to revel in his roguish verbosity, just as he is too fine a craftsman to let them think they can penetrate the thicket of his words to a level moral clearing. In other words, his prose is neither diverting nor moralizing. …

The Resuscitation Outcome: Revisit the Story of the Stony Heart

Postresuscitation syndrome is a state of myocardial dysfunction after the restoration of circulation by successful resuscitation. Despite several advances in the field of resuscitation, the management of out-of-hospital cardiac arrest is still suboptimal. The high fatality rate shortly after successful resuscitation is mainly related to postresuscitation myocardial dysfunction. Postresuscitation myocardial stunning is reversible, while stony heart is irreversible due to prolonged unsuccessful resuscitation. This article reviews most of the published articles concerning the causes, mechanism, pathophysiology, and the updated trials for management of postresuscitation myocardial dysfunction. Further studies are warranted to highlight postresuscitation disease and its hemodynamic sequences and then to intervene according to the different phases of cardiac arrest. By modifying the conventional modalities of resuscitation together with new promising agents, the rescuers will be able to salvage the jeopardized postresuscitation myocardium and prevent its progression to the dismal stony heart. Community awareness and staff education are crucial to shorten resuscitation time and improve short-term and long-term outcomes. There is an urgent need to revise the guidelines for cardiopulmonary resuscitation in community setting, but how? It is a matter of where and when it is of enough value to be efficacious and cost-effective.

The response to the challenge of organ shortage in the middle east region: A summary

RANSPLANTATION probably started in the Middle East. In the Old Testament, we learn that God would “take the stony heart out of their flesh, and will give them a heart of flesh” (Ezekiel 11:19). And it is also in the Middle East that the legendary fathers of transplantation, the twin Arab brothers Cosmas and Damian lived, although the miracle claimed on their behalf occurred in Rome many years after their death. Religion and history have been both a blessing and a source of conflict in the Middle East, and it is understandable that both have an influence on transplantation today. Like most developing countries, a large proportion of kidney transplants are derived from living-related donors. Cadaveric donation has been rudimentary, transplants of other solid organs are rare, and the question of commerce in kidneys has been a frequent topic for discussion. Over the past decade there have been significant changes in all these areas.

The Machine in Tartarus: Melville's Inferno

T HE of Bachelors and the Tartarus of is Melville's title.1 He could have got separate if unequal pieces out of the material. Perhaps he should have, since relationship between the parts rests chiefly in dissimilarity, even opposition. Opposites attract, but here neither side is drawn to the other; sex is unexercised or atrophied. It is true that overfed or unfed Bachelors and Maids are equally sterile and that the segments do share an unnamed narrator. Melville is attempting what is called a diptych, after an ancient writing tablet having two hinged panels. Of his three tries with the form this is the best, though the hinge might be better oiled. And Tartarus of might command more attention if it stood alone. Paradise is set in the stony heart of stunning London, where a cool, deep shady glen is monastically cloistered from the careworn world. To appreciate the place you would have to dine there at the invitation of Templar. Templar? Knights Templars? We know indeed . . . that a moral blight tainted at last this sacred Brotherhood. . . . The genuine Templar is long since departed. But the ancient buildings and grounds and the nominal society remain. The Templar is a lawyer-also a bachelor and capital diner. The narrator's host is such. Nine men sat at dinner, which was hearty and heady with innumerable dishes, wines, and silver flagons of humming ale. State bumpers, impromptu glasses between, elaborate courtesies, convivial if formalized conversation, pleasant stories told betimes. No wives or children. At the end arrives an immense horn containing some choice Rappee . . . a mull of snuff.

The Economy of Praise in George Herbert's "The Church"

The Economy of Praise in George Herbert's "The Church" by Parker H. Johnson The first stanza of "Good Friday" brings together in its puns and its rhetorical stance two important elements in Herbert's poetry: the problem of an appropriate poetic response to Christ's suffering and the persistent turn toward economic imagery. The stanza is deceptively simple: O my chief good, How shall I measure out thy bloud? How shall I count what thee befell, And each grief tell?1 Addressing his "chief good," the Christ to whom he owes his salvation, Herbert asks how he can respond in his poetry to Christ's sacrifice. Within this rhetorical context, that of a speaker at a loss for words before the magnitude of another's act, the problem of response becomes a problem of economic transaction, as we can see from the puns on the words "measure," "count," and "tell." These are countinghouse terms; but they also belong to the technical vocabulary of poetry or refer to its intentions. The word "measure" means here to ascertain an amount or quantity; it also refers to a specific unit in prosody or music. The word "count" has three senses: to enumerate, to give an account of. or to scan a verse of poetry. The word "tell" can mean to enumerate or, simply, to speak. Herbert's "Lovely enchanting language" ("The Forerunners ,"!. 19), by means of catachresis, can make economics, in the sense of symbolic exchange, a metaphor for poetry, for Herbert another system of symbolic exchange. The un45 Parker H. Johnson predictable congruencies of language point to legal and mercantile imagery of exchange as a way to explore the difficulty of response to God and the problem of praise. The rhetoric of praise was a highly developed art in Herbert's time. As the Cambridge Orator, Herbert would have known and practiced the topics and figures of classical epideictic oratory.2 Puttenham had assigned the highest position to the praise of the gods on the basis of his classical sources.3 Biblical sources, particularly the Psalms, provided a tradition and rhetoric of praise for the Christian poet; translation, versification, and paraphrase of the Psalms were widespread practices in the period. Calvin'sdefinition ¡sail-encompassing: "Under the word pra/se, however, is comprehended . . . both faith and prayer. . . . Hence it follows, that the whole of spiritual worship is comprehended under what is either presupposed in the exercise of praise, or follows from it."4 Given this weighty tradition and the paramount importance of praise, it is surprising how little of it we actually find in Herbert. We find nothing like the paean of the last six psalms of David in which all creation is called upon to praise God. In these psalms, the preoccupations of complaint and petition are forgotten in a whole-hearted praise of God's glory. With the exception of "Antiphon" (I) and (II), and perhaps a few other poems, most of Herbert's verse is punctuated by the speaker's despair, soul-searching, self-condemnation, prayer, or rejoicing. What we find is a constant meditation on the possibilities and problems of praise, a struggle with the self, and a continual conflict with God over the terms of such praise. Praise of God is Herbert's announced intention at the outset of "The Church." In "The Altar" the speaker's heart is made the site for the sacrifice of praise: Wherefore each part Of my hard heart Meets in this frame, To praise thy Name: That, if I chance to hold my peace. These stones to praise thee may not cease. (11.9-14) 46 PRAISE IN "THE CHURCH" The heart, "Whose parts are as thy hand did frame" (I. 3), is fashioned by God; the heart is also constructed in the frame of the poem — it "Meets in this frame." In "The Altar" we find a reciprocity between God and the speaker: God frames the heart and the heart's frame — this poem — then serves as an altar from which ascends poetic praise. In a cycle of creation and praise, God fashions the stony heart into an altar-poem, and the poem then inevitably praises the greatness of its...

Notes on Some Physical Features in Iceland

In response to a request from the Council of this Society, I have endeavoured to put into the form of a short paper a few notes and recollections gathered during a visit to Iceland in August and September of the present year. Iceland just dips into the Arctic Circle in its northern parts, and is less than 250 miles from the coast of Greenland. It is a land of everlasting snow, with an area of 40,000 square miles, and a population of 70,000, with 20 active volcanoes, of which the principal are Orafa Jokull, 6,410 feet high, Hekla, 5,095, with Vatna Jokull, noted for the great eruption of 1875, and Skaptaa Jokull, which is said to have thrown out no less than 40,000 million tons of matter, to have killed over 1,300 human beings, 20,000 horses, 7,000 cattle, and 130,000 sheep in the awful eruption of 1783. The great lava streams that caused this havoc can readily be seen to-day. Iceland is a volcanic, treeless, mountainous land, wherein dwelleth Frost and Fire. It contains immense lava deserts arid drear wastes, with boiling mud and hot springs, with creeping glaciers and snow-covered jokulls. Its bleak and sterile grandeur, aided by a gloriously clear atmosphere, and wonderful sunsets, and brilliant Aurora Borealis, is surely sufficient to stir up enthusiasm and poetry even in the stony heart of a Geologist. This island is said to be the most extensive area of volcanic rock known. Dr. Thoroddsen, the Geological Surveyor of Iceland under the …