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	<title>Comments on: House &#8211; Episode 2 (Season 2): &#8220;Autopsy&#8221;</title>
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	<link>http://www.politedissent.com/archives/914</link>
	<description>a blog of medicine, comics, television, science and other fun stuff</description>
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		<title>By: alexey petrovsky</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-425094</link>
		<dc:creator>alexey petrovsky</dc:creator>
		<pubDate>Sat, 04 Oct 2008 17:35:16 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-425094</guid>
		<description>I an NOT a doctor at all but here are some clues that I can expect from myself to recognize. (I am kind of monitoring fanatic and like to detect slight disturbance in different kind of stuff, like networks or relationships.)

It&#039;s way too hard to scan and regocnize all the scene from MRI, so the doctors have to watch &#039;their&#039; zones they are paying high attention. They claim which one of the zone are clear or not.

So Foreman was &#039;lucky&#039; to look exactly where the clot is and &#039;lucky&#039;. Others should to monitor their sectors. House could look at another trouble-free sector and see nothing. It&#039;s kind of induced tunnel vision that drivers have in high speed (and the final cut is just to approve my guess).

As I understand, the blood was used as a contrast agent in this case. As I see usual scans and graphs (like in MRI section in Wikipedia) they are all the scans of static planes but in this case MRI was used as controlling device that shows ONE plane but on a time scale.

So, there maybe an interest in dynamic time-spatial picture on a choosen plan but the spatial snapshots of different planes.

So, House did use MRI as a hacker and bear a respect for this.

This Ep is attractive to myself, so I can get an brain atlas and TRY to figure myself.</description>
		<content:encoded><![CDATA[<p>I an NOT a doctor at all but here are some clues that I can expect from myself to recognize. (I am kind of monitoring fanatic and like to detect slight disturbance in different kind of stuff, like networks or relationships.)</p>
<p>It&#8217;s way too hard to scan and regocnize all the scene from MRI, so the doctors have to watch &#8216;their&#8217; zones they are paying high attention. They claim which one of the zone are clear or not.</p>
<p>So Foreman was &#8216;lucky&#8217; to look exactly where the clot is and &#8216;lucky&#8217;. Others should to monitor their sectors. House could look at another trouble-free sector and see nothing. It&#8217;s kind of induced tunnel vision that drivers have in high speed (and the final cut is just to approve my guess).</p>
<p>As I understand, the blood was used as a contrast agent in this case. As I see usual scans and graphs (like in MRI section in Wikipedia) they are all the scans of static planes but in this case MRI was used as controlling device that shows ONE plane but on a time scale.</p>
<p>So, there maybe an interest in dynamic time-spatial picture on a choosen plan but the spatial snapshots of different planes.</p>
<p>So, House did use MRI as a hacker and bear a respect for this.</p>
<p>This Ep is attractive to myself, so I can get an brain atlas and TRY to figure myself.</p>
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		<title>By: Lisa</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-403809</link>
		<dc:creator>Lisa</dc:creator>
		<pubDate>Tue, 05 Aug 2008 02:02:18 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-403809</guid>
		<description>As stated earlier, the MRI, is a PoleStar N20 IntraOperative (low-field, 0.15 Tesla) MRI.  These were originally manufactured by a company named Odin, purchased by Medtronic Navigation approximately two years ago.  The head holder and pins are made of titanium.  The magnet is relatively weak compared to full-strength magnets.  Rooms with intra-operative MRIs are specifically designed to ensure the noise is low and the instruments are compatable, namely titanium.  However, the magnet is often moved out of the surgical field during surgery and items like retractors do not remain in place during scans.
I hope this helps.</description>
		<content:encoded><![CDATA[<p>As stated earlier, the MRI, is a PoleStar N20 IntraOperative (low-field, 0.15 Tesla) MRI.  These were originally manufactured by a company named Odin, purchased by Medtronic Navigation approximately two years ago.  The head holder and pins are made of titanium.  The magnet is relatively weak compared to full-strength magnets.  Rooms with intra-operative MRIs are specifically designed to ensure the noise is low and the instruments are compatable, namely titanium.  However, the magnet is often moved out of the surgical field during surgery and items like retractors do not remain in place during scans.<br />
I hope this helps.</p>
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		<title>By: Nimby</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-353357</link>
		<dc:creator>Nimby</dc:creator>
		<pubDate>Thu, 12 Jun 2008 00:46:32 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-353357</guid>
		<description>And, Anonymous, I believe the reason given was that if the brain was &quot;alive&quot;, it would shut down--once there was lowered activity, it didn&#039;t realize anything was going on--I&#039;m not explaining it very well, and I&#039;m not entirely sure that I understood it, but I think I&#039;m close, at least.

To explain the reasoning (or, at least, my understanding of it, that is):
Let&#039;s say that the patient is, instead, a computer with a worn power cord. Let&#039;s say you need to replace that cord. If you turn the computer on, and have programs running, and you&#039;ve just finished typing up your resume (let&#039;s pretend the word processor doesn&#039;t auto-save), and you&#039;re painting something by hand in Adobe Photoshop, and you cut through that power cord, you will lose all of that data. And your computer might suffer hard drive damage, etc. (You&#039;d also get electrocuted, but that&#039;s not really applicable to a patient and doctor). Now, if you shut your computer down properly, then cut off the power cord and replace it or whatever, and then turn it back on, everything is fine.

Something like that, I think.

Can someone back me up/correct me?</description>
		<content:encoded><![CDATA[<p>And, Anonymous, I believe the reason given was that if the brain was &#8220;alive&#8221;, it would shut down&#8211;once there was lowered activity, it didn&#8217;t realize anything was going on&#8211;I&#8217;m not explaining it very well, and I&#8217;m not entirely sure that I understood it, but I think I&#8217;m close, at least.</p>
<p>To explain the reasoning (or, at least, my understanding of it, that is):<br />
Let&#8217;s say that the patient is, instead, a computer with a worn power cord. Let&#8217;s say you need to replace that cord. If you turn the computer on, and have programs running, and you&#8217;ve just finished typing up your resume (let&#8217;s pretend the word processor doesn&#8217;t auto-save), and you&#8217;re painting something by hand in Adobe Photoshop, and you cut through that power cord, you will lose all of that data. And your computer might suffer hard drive damage, etc. (You&#8217;d also get electrocuted, but that&#8217;s not really applicable to a patient and doctor). Now, if you shut your computer down properly, then cut off the power cord and replace it or whatever, and then turn it back on, everything is fine.</p>
<p>Something like that, I think.</p>
<p>Can someone back me up/correct me?</p>
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		<title>By: Nimby</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-353355</link>
		<dc:creator>Nimby</dc:creator>
		<pubDate>Thu, 12 Jun 2008 00:21:29 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-353355</guid>
		<description>It is highly possible that House was exaggerating about the Benadryl dosage. As in, &quot;Man, I told you a million times...&quot; or &quot;That&#039;s a thousand to one chance!&quot;.</description>
		<content:encoded><![CDATA[<p>It is highly possible that House was exaggerating about the Benadryl dosage. As in, &#8220;Man, I told you a million times&#8230;&#8221; or &#8220;That&#8217;s a thousand to one chance!&#8221;.</p>
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		<title>By: Anonymous</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-277755</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Sat, 15 Mar 2008 06:57:12 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-277755</guid>
		<description>Do you really get brain damage after 60 seconds without blood and while being cooled?  I&#039;m no doctor but I always thought that the whole point of chilling the body was to preserve the tissue during longer procedures.  As someone else pointed out strokes have to be reversed within hours to avoid damage, so why the need to cool someone for such a short procedure?

Also doesn&#039;t it take longer to cool someone down that much?  Or did they just speed it up?</description>
		<content:encoded><![CDATA[<p>Do you really get brain damage after 60 seconds without blood and while being cooled?  I&#8217;m no doctor but I always thought that the whole point of chilling the body was to preserve the tissue during longer procedures.  As someone else pointed out strokes have to be reversed within hours to avoid damage, so why the need to cool someone for such a short procedure?</p>
<p>Also doesn&#8217;t it take longer to cool someone down that much?  Or did they just speed it up?</p>
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		<title>By: Johnny</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-270543</link>
		<dc:creator>Johnny</dc:creator>
		<pubDate>Thu, 28 Feb 2008 21:43:13 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-270543</guid>
		<description>There&#039;s no way that House took 1000mg of Benadryl like he said at the beginning. That high of a dosage causes some freaky, freaky hallucinations.</description>
		<content:encoded><![CDATA[<p>There&#8217;s no way that House took 1000mg of Benadryl like he said at the beginning. That high of a dosage causes some freaky, freaky hallucinations.</p>
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		<title>By: Jeff H</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-263158</link>
		<dc:creator>Jeff H</dc:creator>
		<pubDate>Sat, 09 Feb 2008 00:37:48 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-263158</guid>
		<description>You say &quot;House decides that the only way to find this clot is to chill her body to 21° Celsius (about 70° Fahrenheit) , stop her heart, remove two liters of blood, add the 2 liters of blood back while performing an MRI to find the clot, and then restart the heart.&quot;  If a clot doesn&#039;t show up on standard scans (CT, MRI, etc.) what else do you do?  I&#039;m no doctor, but I seem to recall the blood-brain barrier presents some extra challenges in getting good pictures of the brain?  I&#039;m just curious as to what other options were available.  I&#039;ll agree the procedure was fishy, but then, Cuddy did call it experimental to the point she felt they needed FDA approval - clearly this is not a routine thing the hospital does.

Likewise for the heart tumor - does the explanation that it was growing along the heart wall carry any merit?

Finally, I&#039;m interested in Peter&#039;s comment above...  would removing the clot have actually made things better?  What if it was only a partial clot, so some blood was getting through?

(As for the magnets, I just assumed the bolt was made of titanium or something.)</description>
		<content:encoded><![CDATA[<p>You say &#8220;House decides that the only way to find this clot is to chill her body to 21° Celsius (about 70° Fahrenheit) , stop her heart, remove two liters of blood, add the 2 liters of blood back while performing an MRI to find the clot, and then restart the heart.&#8221;  If a clot doesn&#8217;t show up on standard scans (CT, MRI, etc.) what else do you do?  I&#8217;m no doctor, but I seem to recall the blood-brain barrier presents some extra challenges in getting good pictures of the brain?  I&#8217;m just curious as to what other options were available.  I&#8217;ll agree the procedure was fishy, but then, Cuddy did call it experimental to the point she felt they needed FDA approval &#8211; clearly this is not a routine thing the hospital does.</p>
<p>Likewise for the heart tumor &#8211; does the explanation that it was growing along the heart wall carry any merit?</p>
<p>Finally, I&#8217;m interested in Peter&#8217;s comment above&#8230;  would removing the clot have actually made things better?  What if it was only a partial clot, so some blood was getting through?</p>
<p>(As for the magnets, I just assumed the bolt was made of titanium or something.)</p>
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		<title>By: Rob Haswell</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-238515</link>
		<dc:creator>Rob Haswell</dc:creator>
		<pubDate>Fri, 18 Jan 2008 15:51:47 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-238515</guid>
		<description>Some trivia for you:

At the end of the Episode, House is seen chopping up some pills with a razor blade, and making lines, as if to snort them. Wilson asks if he&#039;s treating his blocked nose with cocaine, yet House claims it&#039;s Benadryl with a new delivery system.

Wilson&#039;s next line goes something like &quot;It&#039;s all about speed, isn&#039;t it? You like doing things quickly.&quot;

Amphetamine (speed) is a powerful decongestant, one of the most potent available. That is almost certainly what House was preparing.</description>
		<content:encoded><![CDATA[<p>Some trivia for you:</p>
<p>At the end of the Episode, House is seen chopping up some pills with a razor blade, and making lines, as if to snort them. Wilson asks if he&#8217;s treating his blocked nose with cocaine, yet House claims it&#8217;s Benadryl with a new delivery system.</p>
<p>Wilson&#8217;s next line goes something like &#8220;It&#8217;s all about speed, isn&#8217;t it? You like doing things quickly.&#8221;</p>
<p>Amphetamine (speed) is a powerful decongestant, one of the most potent available. That is almost certainly what House was preparing.</p>
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		<title>By: Peter</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-201134</link>
		<dc:creator>Peter</dc:creator>
		<pubDate>Tue, 20 Nov 2007 16:12:25 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-201134</guid>
		<description>What is medically definitely wrong is the notion that removing the clot would restore function to the brain. If this were the case, strokes wouldn&#039;t be a problem. In reality, clots have to be removed within a few hours in order to restore function. After several days it&#039;s no use. Anyway, a clot large enough to obstruct flow would show up on contrast MRI or angio CAT scan without the complicated procedure.</description>
		<content:encoded><![CDATA[<p>What is medically definitely wrong is the notion that removing the clot would restore function to the brain. If this were the case, strokes wouldn&#8217;t be a problem. In reality, clots have to be removed within a few hours in order to restore function. After several days it&#8217;s no use. Anyway, a clot large enough to obstruct flow would show up on contrast MRI or angio CAT scan without the complicated procedure.</p>
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		<title>By: Scott</title>
		<link>http://www.politedissent.com/archives/914/comment-page-1#comment-190434</link>
		<dc:creator>Scott</dc:creator>
		<pubDate>Thu, 25 Oct 2007 13:32:45 +0000</pubDate>
		<guid isPermaLink="false">http://politedissent.com/archives/914#comment-190434</guid>
		<description>It&#039;s not that simple.  A small amount of metal -- even if it is equal and oppositely arranged -- warps the magnetic field and distorts the image.  Look at the lower cuts of an MRI of someone&#039;s head -- the minuscule amount of metal in amalgam fillings is enough to cause artifacts on the image.</description>
		<content:encoded><![CDATA[<p>It&#8217;s not that simple.  A small amount of metal &#8212; even if it is equal and oppositely arranged &#8212; warps the magnetic field and distorts the image.  Look at the lower cuts of an MRI of someone&#8217;s head &#8212; the minuscule amount of metal in amalgam fillings is enough to cause artifacts on the image.</p>
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