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Einstein and General Theory of Relativity

Larry H. Bernstein, MD, FCAP, Curator

LPBI

 

 

General Relativity And The ‘Lone Genius’ Model Of Science

Chad Orzel

http://www.forbes.com/sites/chadorzel/2015/11/24/general-relativity-and-the-lone-genius-model-of-science/

 

(Credit: AP)

 

One hundred years ago this Wednesday, Albert Einstein gave the last of a series of presentations to the Prussian Academy of Sciences, which marks the official completion of his General Theory of Relativity. This anniversary is generating a good deal of press and various celebratory events, such as the premiere of a new documentary special. If you prefer your physics explanations in the plainest language possible, there’s even an “Up Goer Five” version (personally, I don’t find these all that illuminating, but lots of people seem to love it).

Einstein is, of course, the most iconic scientist in history, and much of the attention to this week’s centennial will center on the idea of his singular genius. Honestly, general relativity is esoteric enough that were it not for Einstein’s personal fame, there probably wouldn’t be all that much attention paid to this outside of the specialist science audience.

But, of course, while the notion of Einstein as a lone, unrecognized genius is a big part of his myth, he didn’t create relativity entirely on his own, asthis article in Nature News makes clear. The genesis of relativity is a single simple idea, but even in the early stages, when he developed Special Relativity while working as a patent clerk, he honed his ideas through frequent discussions with friends and colleagues. Most notable among these was probably Michele Besso, who Einstein later referred to as “the best sounding board in Europe.”

And most of the work on General Relativity came not when Einstein was toiling in obscurity, but after he had begun to climb the academic ladder in Europe. In the ten years between the Special and General theories, he went through a series of faculty jobs of increasing prestige. He also laboriously learned a great deal of mathematics in order to reach the final form of the theory, largely with the assistance of his friend Marcel Grossmann. The path to General Relativity was neither simple nor solitary, and the Nature piece documents both the mis-steps along the way and the various people who helped out.

While Einstein wasn’t working alone, though, the Nature piece also makes an indirect case for his status as a genius worth celebrating. Not because of the way he solved the problem, but through the choice of problem to solve. Einstein pursued a theory that would incorporate gravitation into relativity with dogged determination through those years, but he was one of a very few people working on it. There were a couple of other theories kicking around, particularly Gunnar Nordström’s, but these didn’t generate all that much attention. The mathematician David Hilbert nearly scooped Einstein with the final form of the field equations in November of 1915 (some say he did get there first), but Hilbert was a latecomer who only got interested in the problem of gravitation after hearing about it from Einstein, and his success was a matter of greater familiarity with the necessary math. One of the books I used when I taught a relativity class last year quoted Hilbert as saying that “every child in the streets of Göttingen knows more about four-dimensional geometry than Einstein,” but that Einstein’s physical insight got him to the theory before superior mathematicians.

 

History: Einstein was no lone genius

Michel Janssen & Jürgen Renn   

16 November 2015 Corrected:   17 November 2015    Nature Nov 2015; 527(7578)

Lesser-known and junior colleagues helped the great physicist to piece together his general theory of relativity, explain Michel Janssen and Jürgen Renn.

http://www.nature.com/news/history-einstein-was-no-lone-genius-1.18793

 

http://www.nature.com/polopoly_fs/7.31357.1447429421!/image/Comment2.jpg_gen/derivatives/landscape_630/Comment2.jpg

Marcel Grossmann (left) and Michele Besso (right), university friends of Albert Einstein (centre), both made important contributions to general relativity.

 

A century ago, in November 1915, Albert Einstein published his general theory of relativity in four short papers in the proceedings of the Prussian Academy of Sciences in Berlin1. The landmark theory is often presented as the work of a lone genius. In fact, the physicist received a great deal of help from friends and colleagues, most of whom never rose to prominence and have been forgotten2, 3, 4, 5. (For full reference details of all Einstein texts mentioned in this piece, seeSupplementary Information.)

Here we tell the story of how their insights were woven into the final version of the theory. Two friends from Einstein’s student days — Marcel Grossmann and Michele Besso — were particularly important. Grossmann was a gifted mathematician and organized student who helped the more visionary and fanciful Einstein at crucial moments. Besso was an engineer, imaginative and somewhat disorganized, and a caring and lifelong friend to Einstein. A cast of others contributed too.

Einstein met Grossmann and Besso at the Swiss Federal Polytechnical School in Zurich6 — later renamed the Swiss Federal Institute of Technology (Eidgenössische Technische Hochschule; ETH) — where, between 1896 and 1900, he studied to become a school teacher in physics and mathematics. Einstein also met his future wife at the ETH, classmate Mileva Marić. Legend has it that Einstein often skipped class and relied on Grossmann’s notes to pass exams.

 

http://www.nature.com/polopoly_fs/7.31485.1447758022!/image/entanglement.jpg_gen/derivatives/fullsize/entanglement.jpg

 

Grossmann’s father helped Einstein to secure a position at the patent office in Berne in 1902, where Besso joined him two years later. Discussions between Besso and Einstein earned the former the sole acknowledgment in the most famous of Einstein’s 1905 papers, the one introducing the special theory of relativity. As well as publishing the papers that made 1905 his annus mirabilis, Einstein completed his dissertation that year to earn a PhD in physics from the University of Zurich.

In 1907, while still at the patent office, he started to think about extending the principle of relativity from uniform to arbitrary motion through a new theory of gravity. Presciently, Einstein wrote to his friend Conrad Habicht — whom he knew from a reading group in Berne mockingly called the Olympia Academy by its three members — saying that he hoped that this new theory would account for a discrepancy of about 43˝ (seconds of arc) per century between Newtonian predictions and observations of the motion of Mercury’s perihelion, the point of its orbit closest to the Sun.

Einstein started to work in earnest on this new theory only after he left the patent office in 1909, to take up professorships first at the University of Zurich and two years later at the Charles University in Prague. He realized that gravity must be incorporated into the structure of space-time, such that a particle subject to no other force would follow the straightest possible trajectory through a curved space-time.

In 1912, Einstein returned to Zurich and was reunited with Grossmann at the ETH. The pair joined forces to generate a fully fledged theory. The relevant mathematics was Gauss’s theory of curved surfaces, which Einstein probably learned from Grossmann’s notes. As we know from recollected conversations, Einstein told Grossmann7: “You must help me, or else I’ll go crazy.”

Their collaboration, recorded in Einstein’s ‘Zurich notebook‘, resulted in a joint paper published in June 1913, known as the Entwurf (‘outline’) paper. The main advance between this 1913 Entwurf theory and the general relativity theory of November 1915 are the field equations, which determine how matter curves space-time. The final field equations are ‘generally covariant’: they retain their form no matter what system of coordinates is chosen to express them. The covariance of the Entwurf field equations, by contrast, was severely limited.

 

http://www.nature.com/polopoly_fs/7.31488.1447759403!/image/einstein_lost.jpg_gen/derivatives/fullsize/einstein_lost.jpg

Einstein’s lost theory uncovered

 

Two Theories

In May 1913, as he and Grossmann put the finishing touches to their Entwurf paper, Einstein was asked to lecture at the annual meeting of the Society of German Natural Scientists and Physicians to be held that September in Vienna, an invitation that reflects the high esteem in which the 34-year-old was held by his peers.

In July 1913, Max Planck and Walther Nernst, two leading physicists from Berlin, came to Zurich to offer Einstein a well-paid and teaching-free position at the Prussian Academy of Sciences in Berlin, which he swiftly accepted and took up in March 1914. Gravity was not a pressing problem for Planck and Nernst; they were mainly interested in what Einstein could do for quantum physics.  (It was Walther Nernst who advised that Germany could not engage in WWI and win unless it was a short war).

Several new theories had been proposed in which gravity, like electromagnetism, was represented by a field in the flat space-time of special relativity. A particularly promising one came from the young Finnish physicist Gunnar Nordström. In his Vienna lecture, Einstein compared his own Entwurf theory to Nordström’s theory. Einstein worked on both theories between May and late August 1913, when he submitted the text of his lecture for publication in the proceedings of the 1913 Vienna meeting.

In the summer of 1913, Nordström visited Einstein in Zurich. Einstein convinced him that the source of the gravitational field in both their theories should be constructed out of the ‘energy–momentum tensor’: in pre-relativistic theories, the density and the flow of energy and momentum were represented by separate quantities; in relativity theory, they are combined into one quantity with ten different components.

 

http://www.nature.com/polopoly_fs/7.31358.1447420168!/image/Comment4.jpg_gen/derivatives/landscape_630/Comment4.jpg

ETH-Bibliothek Zürich, Bildarchiv

ETH Zurich, where Einstein met friends with whom he worked on general relativity.

 

This energy–momentum tensor made its first appearance in 1907–8 in the special-relativistic reformulation of the theory of electrodynamics of James Clerk Maxwell and Hendrik Antoon Lorentz by Hermann Minkowski. It soon became clear that an energy–momentum tensor could be defined for physical systems other than electromagnetic fields. The tensor took centre stage in the new relativistic mechanics presented in the first textbook on special relativity, Das Relativitätsprinzip, written by Max Laue in 1911. In 1912, a young Viennese physicist, Friedrich Kottler, generalized Laue’s formalism from flat to curved space-time. Einstein and Grossmann relied on this generalization in their formulation of the Entwurf theory. During his Vienna lecture, Einstein called for Kottler to stand up and be recognized for this work8.

Einstein also worked with Besso that summer to investigate whether the Entwurf theory could account for the missing 43˝ per century for Mercury’s perihelion. Unfortunately, they found that it could only explain 18˝. Nordström’s theory, Besso checked later, gave 7˝ in the wrong direction. These calculations are preserved in the ‘Einstein–Besso manuscript‘ of 1913.

Besso contributed significantly to the calculations and raised interesting questions. He wondered, for instance, whether the Entwurf field equations have an unambiguous solution that uniquely determines the gravitational field of the Sun. Historical analysis of extant manuscripts suggests that this query gave Einstein the idea for an argument that reconciled him with the restricted covariance of the Entwurf equations. This ‘hole argument’ seemed to show that generally covariant field equations cannot uniquely determine the gravitational field and are therefore inadmissible9.

Einstein and Besso also checked whether the Entwurf equations hold in a rotating coordinate system. In that case the inertial forces of rotation, such as the centrifugal force we experience on a merry-go-round, can be interpreted as gravitational forces. The theory seemed to pass this test. In August 1913, however, Besso warned him that it did not. Einstein did not heed the warning, which would come back to haunt him.

 

http://www.nature.com/polopoly_fs/7.31486.1447758069!/image/integrity.jpg_gen/derivatives/fullsize/integrity.jpg

Scientific method: Defend the integrity of physics

 

In his lecture in Vienna in September 1913, Einstein concluded his comparison of the two theories with a call for experiment to decide. The Entwurf theory predicts that gravity bends light, whereas Nordström’s does not. It would take another five years to find out. Erwin Finlay Freundlich, a junior astronomer in Berlin with whom Einstein had been in touch since his days in Prague, travelled to Crimea for the solar eclipse of August 1914 to determine whether gravity bends light but was interned by the Russians just as the First World War broke out. Finally, in 1919, English astronomer Arthur Eddington confirmed Einstein’s prediction of light bending by observing the deflection of distant stars seen close to the Sun’s edge during another eclipse, making Einstein a household name10.

Back in Zurich, after the Vienna lecture, Einstein teamed up with another young physicist, Adriaan Fokker, a student of Lorentz, to reformulate the Nordström theory using the same kind of mathematics that he and Grossmann had used to formulate the Entwurf theory. Einstein and Fokker showed that in both theories the gravitational field can be incorporated into the structure of a curved space-time. This work also gave Einstein a clearer picture of the structure of the Entwurf theory, which helped him and Grossmann in a second joint paper on the theory. By the time it was published in May 1914, Einstein had left for Berlin.

 

http://www.nature.com/polopoly_fs/7.31489.1447761264!/image/Einstein_frontal_small.jpg_gen/derivatives/fullsize/Einstein_frontal_small.jpg

Snapshots explore Einstein’s unusual brain

 

The Breakup

Turmoil erupted soon after the move. Einstein’s marriage fell apart and Mileva moved back to Zurich with their two young sons. Albert renewed the affair he had started and broken off two years before with his cousin Elsa Löwenthal (née Einstein). The First World War began. Berlin’s scientific elite showed no interest in the Entwurf theory, although renowned colleagues elsewhere did, such as Lorentz and Paul Ehrenfest in Leiden, the Netherlands. Einstein soldiered on.

By the end of 1914, his confidence had grown enough to write a long exposition of the theory. But in the summer of 1915, after a series of his lectures in Göttingen had piqued the interest of the great mathematician David Hilbert, Einstein started to have serious doubts. He discovered to his dismay that the Entwurf theory does not make rotational motion relative. Besso was right. Einstein wrote to Freundlich for help: his “mind was in a deep rut”, so he hoped that the young astronomer as “a fellow human being with unspoiled brain matter” could tell him what he was doing wrong. Freundlich could not help him.

“Worried that Hilbert might beat him to the punch, Einstein rushed new equations into print.”

The problem, Einstein soon realized, lay with the Entwurf field equations. Worried that Hilbert might beat him to the punch, Einstein rushed new equations into print in early November 1915, modifying them the following week and again two weeks later in subsequent papers submitted to the Prussian Academy. The field equations were generally covariant at last.

In the first November paper, Einstein wrote that the theory was “a real triumph” of the mathematics of Carl Friedrich Gauss and Bernhard Riemann. He recalled in this paper that he and Grossmann had considered the same equations before, and suggested that if only they had allowed themselves to be guided by pure mathematics rather than physics, they would never have accepted equations of limited covariance in the first place.

Other passages in the first November paper, however, as well as his other papers and correspondence in 1913–15, tell a different story. It was thanks to the elaboration of the Entwurf theory, with the help of Grossmann, Besso, Nordström and Fokker, that Einstein saw how to solve the problems with the physical interpretation of these equations that had previously defeated him.

In setting out the generally covariant field equations in the second and fourth papers, he made no mention of the hole argument. Only when Besso and Ehrenfest pressed him a few weeks after the final paper, dated 25 November, did Einstein find a way out of this bind — by realizing that only coincident events and not coordinates have physical meaning. Besso had suggested a similar escape two years earlier, which Einstein had brusquely rejected2.

In his third November paper, Einstein returned to the perihelion motion of Mercury. Inserting the astronomical data supplied by Freundlich into the formula he derived using his new theory, Einstein arrived at the result of 43″ per century and could thus fully account for the difference between Newtonian theory and observation. “Congratulations on conquering the perihelion motion,” Hilbert wrote to him on 19 November. “If I could calculate as fast as you can,” he quipped, “the hydrogen atom would have to bring a note from home to be excused for not radiating.”

Einstein kept quiet on why he had been able to do the calculations so fast. They were minor variations on the ones he had done with Besso in 1913. He probably enjoyed giving Hilbert a taste of his own medicine: in a letter to Ehrenfest written in May 1916, Einstein characterized Hilbert’s style as “creating the impression of being superhuman by obfuscating one’s methods”.

Einstein emphasized that his general theory of relativity built on the work of Gauss and Riemann, giants of the mathematical world. But it also built on the work of towering figures in physics, such as Maxwell and Lorentz, and on the work of researchers of lesser stature, notably Grossmann, Besso, Freundlich, Kottler, Nordström and Fokker. As with many other major breakthroughs in the history of science, Einstein was standing on the shoulders of many scientists, not just the proverbial giants4.

 

http://www.nature.com/polopoly_fs/7.31375.1447420557!/image/cartoon.jpg_gen/derivatives/landscape_630/cartoon.jpg

Berlin’s physics elite (Fritz Haber, Walther Nernst, Heinrich Rubens, Max Planck) and Einstein’s old and new family (Mileva Einstein-Marić and heir sons Eduard and Hans Albert; Elsa Einstein-Löwenthal and her daughters Ilse and Margot) are watching as Einstein is pursuing his new theory of gravity and his idée fixeof generalizing the relativity principle while carried by giants of both physics and mathematics (Isaac Newton, James Clerk Maxwell, Carl Friedrich Gauss, Bernhard Riemann) and scientists of lesser stature (Marcel Grossmann, Gunnar Nordström, Erwin Finlay Freundlich, Michele Besso).

Nature 527, 298–300 (19 Nov 2015)       http://dx.doi.org:/10.1038/527298a

 

 

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Abdominal Aortic Aneurysms (AAA): Albert Einstein’s Operation by Dr. Nissen

Reporter: Aviva Lev-Ari, PhD, RN

On June 11, 2013, I received the following comment by Dr. Miranda, to my article, an Interview with Dr. Richard Cambria, Chief Vascular Surgery, MGH, Boston

No Early Symptoms – An Aortic Aneurysm Before It Ruptures – Is There A Way To Know If I Have it?

Efrain Miranda, Ph.D. • It is true that abdominal aortic aneurysms (AAA) are mostly asymptomatic, until they rupture. By luck, some are identified. An example was a AAA found in Albert Einstein by Dr. Nissen when Einstein went for abdominal surgery for something completely unrelated! In my experience, I have found many AAA’s in individuals who had a totally different cause of death.
http://clinanat.com/mtd/153-aneurysm

I am presenting here the the CASE of an AAA found in Albert Einstein by Dr. Nissen when Einstein went for abdominal surgery for something completely unrelated!

A Moment in History

Dr. Rudolph Nissen
Dr. Rudolf Nissen
(1896 – 1981)

Dr Nissen’s life is extraordinary. Born in the city of Neisse, Germany in 1896, he was the son of a local surgeon. He studied medicine in the Universities of Munich, Marburg, and Breslau. He was the pupil of the famous pathologist Albert Aschoff (discoverer of the heart’s AV node, along with Sunao Tawara).

Nissen became a professor of surgery in Berlin, and in 1933 moved to Turkey where he was placed in charge of the Department of Surgery of the University of Istanbul. In 1939 he moved to the US, first to the Massachusetts General Hospital and later to the Jewish Hospital in Brooklyn, New York. After becoming a US citizen, he moved again in 1952 to Basel, Switzerland as Chief of the Department of Surgery, where he retired in 1967. He died in 1981.

His contributions to surgery are innumerable. He wrote over 30 books and 450 journal articles. Known for the development in 1956 of what is today known as the “Nissen fundoplication” for esophageal hiatus hernia surgery, Nissen also worked with his assistant, Dr. Mario Rossetti to develop the “floppy Nissen fundoplication”, also known as the “Nissen-Rossetti procedure”. This would be enough to honor this man, still, he (with Sauerbruch) performed the first lung lobectomy and the first pneumonectomy (called then a total pneumonectomy). In 1949 he performed the first esophagectomy with a gastroesophagostomy.

His personal life is even more interesting. Drafted at 20, he fought in WWI and was wounded several times. In 1933, under the Nazi regime,  he was ordered to fire all the Jewish-German assistants under his care. Being Jewish himself, he was told that he would keep his job, Nissen could not take this. He resigned his position and moved out of Germany.

Another little known fact is that he operated on Albert Einstein in 1948. He operated on Einstein because of intestinal cysts. Having found a developing abdominal aortic aneurysm, he reinforced it with cellophane, undoubtedly giving his patient a few extra years to live. Einstein died in 1955.

As a personal side note, our good friend Dr. Aaron Ruhalter scrubbed in with Dr. Nissen while serving as a surgical resident at the Brooklyn Jewish Hospital!

Sources:
1. “Rudolf Nissen: The man behind the fundoplication” Schein et al. Surgery 1999;125:347-53 
2. “Rudolf Nissen (1896–1981)-Perspective” Liebermann-Meffert, D. J Gastrointest Surg (2010) 14 (Suppl 1):S58–S61
3. “The Life of Rudolf Nissen: Advancing Surgery Through Science and Principle” Fults, DW; Taussky, P. World J Surg (2011) 35:1402–1408 
4. “Total Pneumonectomy” Nissen, R. Ann Thorac Surg 1980; 29:390-394 
5. “Historical Development of Pulmonary Surgery” Nissen, R. Am J Surg 80: Jan 1955 9- 15 áclav Treitz (1819-1872): Czechoslovakian Pathoanatomist and Patriot” Fox, RS; Fox, CG; Graham, WP. World J. Surg. 9, 361-366, 1985 
Original image courtesy of Universität Basel.

http://clinanat.com/mtd/153-aneurysm


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No Early Symptoms – An Aortic Aneurysm Before It Ruptures – Is There A Way To Know If I Have it?

Curator: Aviva Lev-Ari, PhD, RN

I shadowed Dr. Cambria in the Operating Room at MGH in January 2005 while he performed Carotid Endarterectomy following Aortic Valve Replacement performed by Dr. Jennifer D. Walker  in a sequence, first the Valve replacement, then the Endarterectomy.

Aneurysm

Published on Thursday, 15 November 2012 | Print | Email
This word has a Greek origin from the terms [aneurusma], composed of [ana] meaning “complete or throughout”, and [eurus] meaning “wide”, a “complete widening or dilation”. It is used to refer to the dilation of an artery. Aneurysms can be formed in any artery, although they have some preferred sites. The most common aneurysms are found in the aorta, arterial circle of Willis, the root of the cerebral arteries, and internal carotid arteries.Biomechanical studies suggest that once an aneurysm forms it will generally progress in its dilation until aneurysmal rupture. Because of turbulent flow within the aneurysm large clots are usually formed, which in turn can cause emboli.The image shows an excised infrarenal aortic abdominal aneurysm (AAA). The two common iliac arteries can be seen. If you click on the image you will be able to see the same aneurysm opened through its posterior wall and the clot that was contained inside.Photography by D.M.Klein  Abdominal Aortic Aneurysm

http://clinanat.com/mtd/153-aneurysm

On 6/11/2013, Efrain Miranda, Ph.D. commented on this article, as follows:

It is true that abdominal aortic aneurysms (AAA) are mostly asymptomatic, until they rupture. By luck, some are identified. An example was a AAA found in Albert Einstein by Dr. Nissen when Einstein went for abdominal surgery for something completely unrelated! In my experience, I have found many AAA’s in individuals who had a totally different cause of death.

Dr. Richard Cambria describes an Aortic Aneurysm and recalls the numerous risk factors associated with the condition.

VIEW VIDEO

http://www.empowher.com/aortic-aneurysm/content/there-are-no-early-symptoms-there-way-know-if-i-have-aortic-aneurysm-it-rupt

By Dr. Richard Cambria Expert April 12, 2011 – 10:08am

 

Dr. Cambria:
An aortic aneurysm can be most simply thoughts of as a weakening or ballooning of the aorta which is the body’s major and largest blood vessel. That’s important because this ballooning or weakening can eventually lead to the aneurysm bursting, which is usually a fatal event.

Aneurysms have been referred to as the ‘silent killer’ because in most cases these aortic aneurysms cause no symptoms or problems prior to bursting. Most aortic aneurysms occur in older patients, but there are a clearly defined set of risk factors which makes certain patients at higher risk of developing aortic aneurysms. These include, most importantly, a family history of aortic aneurysm disease, and by family history I mean, if your mother or father or a brother or sister had an aortic aneurysm, you are clearly at increased risk of developing an aneurysm.

20% of the patients that we treat for aortic aneurysms have a positive family history of aneurysm disease. You are also at higher risk for developing an aortic aneurysm if you are female, if you have a history of high blood pressure, if you have been a cigarette smoker, and if you have chronic obstructive pulmonary disease or emphysema, which is in turn related to long-term cigarette smoking.

If you are at risk for developing an aortic aneurysm there are simple diagnostic x-ray studies such as ultrasounds and CAT scans to accurately diagnose number one, whether or not an aneurysm is present, and more importantly, if it is present, to measure just how large it is because that’s the single most important factor in determining whether or not your aneurysm needs to be treated.

It’s important to detect and monitor aortic aneurysms before they reach the stage of bursting because treatment is then usually successful with an expected excellent recovery. Treatment of aortic aneurysms today is very effective and involves replacing the aneurysm with an artificial blood vessel.

There are a variety of different surgical treatments, some of them including minimally invasive operations known as stent grafts, which are applied today in many patients.

Mass General has been a leader in the northeast in the successful management of aortic aneurysms. More than a decade ago, we formed the Mass General Thoracic Aortic Center, which is a team-approach of vascular surgeons, cardiac or heart surgeons, and cardiologists to effectively manage thoracic aneurysms which are often the most challenging and clinically complex to treat.

About Dr. Richard Paul Cambria, M.D.:
Richard P. Cambria, M.D. is Professor of Surgery at Harvard Medical School and Chief, Division of Vascular/Endovascular Surgery at Massachusetts General Hospital. Dr. Cambria received his medical degree from the College of Physicians and Surgeons, Columbia University, in 1977. He trained in general and vascular surgery at Massachusetts General Hospital.

http://www.empowher.com/aortic-aneurysm/content/there-are-no-early-symptoms-there-way-know-if-i-have-aortic-aneurysm-it-rupt

Education & Awards

Dr. Cambria graduated from Columbia University, New York. He has 15 awards.

Awards
One of America’s Leading Experts on:
Abdominal Aortic Aneurysm
Aortic Aneurysm
Aortic Diseases
Aortic Rupture
Arterial Occlusive Diseases
Blood Vessel Prosthesis Implantation
Carotid Endarterectomy
Carotid Stenosis
Kidney Failure
Mesenteric Vascular Occlusion
Spinal Cord Ischemia
Thoracic Aortic Aneurysm
Vascular Surgical Procedures
Castle Connolly America’s Top Doctors® (2002 – 2012)
Top Ten Doctors (2012)
Vascular Surgery, Downtown, Boston, MA

http://www.vitals.com/doctors/Dr_Richard_Cambria.html#ixzz2VqxwIwMK

Publications & Research

Dr. Cambria has contributed to 164 publications.
Title Giant Cell Aortitis of the Ascending Aorta Without Signs or Symptoms of Systemic Vasculitis is Associated with Elevated Risk of Distal Aortic Events.
Date February 2012
Journal Arthritis and Rheumatism
Title Long-term Outcomes of Patients Undergoing Endovascular Infrainguinal Interventions with Single-vessel Peroneal Artery Runoff.
Date May 2011
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Management of Diseases of the Descending Thoracic Aorta in the Endovascular Era: a Medicare Population Study.
Date October 2010
Journal Annals of Surgery
Excerpt Read excerpt

Title The Effects of Systemic Hypothermia on a Murine Model of Thoracic Aortic Ischemia Reperfusion.
Date August 2010
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Long-term Outcomes of Diabetic Patients Undergoing Endovascular Infrainguinal Interventions.
Date August 2010
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Preoperative Variables Predict Persistent Type 2 Endoleak After Endovascular Aneurysm Repair.
Date August 2010
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Surgical Management of Descending Thoracic Aortic Disease: Open and Endovascular Approaches: a Scientific Statement from the American Heart Association.
Date August 2010
Journal Circulation
Title Balloon Expandable Stents Facilitate Right Renal Artery Reconstruction During Complex Open Aortic Aneurysm Repair.
Date March 2010
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Preoperative Functional Status Predicts Perioperative Outcomes After Infrainguinal Bypass Surgery.
Date March 2010
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Intermediate-term Outcomes of Endovascular Treatment for Symptomatic Chronic Mesenteric Ischemia.
Date February 2010
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title A Multicenter Clinical Trial of Endovascular Stent Graft Repair of Acute Catastrophes of the Descending Thoracic Aorta.
Date December 2009
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Effect of Pj34 on Spinal Cord Tissue Viability and Gene Expression in a Murine Model of Thoracic Aortic Reperfusion Injury.
Date December 2009
Journal Vascular and Endovascular Surgery
Excerpt Read excerpt

Title Secondary Intervention After Endovascular Abdominal Aortic Aneurysm Repair.
Date October 2009
Journal Annals of Surgery
Excerpt Read excerpt

Title Aortic Remodeling After Endovascular Repair of Acute Complicated Type B Aortic Dissection.
Date September 2009
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Significant Perioperative Morbidity Accompanies Contemporary Infrainguinal Bypass Surgery: an Nsqip Report.
Date September 2009
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Pj34, a Poly-adp-ribose Polymerase Inhibitor, Modulates Visceral Mitochondrial Activity and Cd14 Expression Following Thoracic Aortic Ischemia-reperfusion.
Date August 2009
Journal American Journal of Surgery
Excerpt Read excerpt

Title Thoracoabdominal Aneurysm Repair: Hybrid Versus Open Repair.
Date July 2009
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Successful Use of Bivalirudin for Combined Carotid Endarterectomy and Coronary Revascularization with the Use of Cardiopulmonary Bypass in a Patient with an Elevated Heparin-platelet Factor 4 Antibody Titer.
Date April 2009
Journal Anesthesia and Analgesia
Excerpt Read excerpt

Title Atherosclerotic Peripheral Vascular Disease Symposium Ii: Controversies in Carotid Artery Revascularization.
Date January 2009
Journal Circulation
Title Functional Outcome After Thoracoabdominal Aneurysm Repair.
Date December 2008
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Outcomes Following Endovascular Abdominal Aortic Aneurysm Repair (evar): an Anatomic and Device-specific Analysis.
Date August 2008
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Zenith Abdominal Aortic Aneurysm Endovascular Graft.
Date August 2008
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Spinal Cord Complications After Thoracic Aortic Surgery: Long-term Survival and Functional Status Varies with Deficit Severity.
Date August 2008
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Five-year Results of Endovascular Treatment with the Gore Tag Device Compared with Open Repair of Thoracic Aortic Aneurysms.
Date June 2008
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Aortic Aneurysms.
Date May 2008
Journal Journal of the American College of Radiology : Jacr
Title International Controlled Clinical Trial of Thoracic Endovascular Aneurysm Repair with the Zenith Tx2 Endovascular Graft: 1-year Results.
Date March 2008
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Contemporary Management of Descending Thoracic and Thoracoabdominal Aortic Aneurysms: Endovascular Versus Open.
Date February 2008
Journal Circulation
Title Contemporary Management of Carotid Stenosis: Carotid Endarterectomy is Here to Stay.
Date January 2008
Journal Perspectives in Vascular Surgery and Endovascular Therapy
Excerpt Read excerpt

Title Long-term Durability of Open Abdominal Aortic Aneurysm Repair.
Date November 2007
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Commentary On: Mas Jl, Chatellier G, Beyssen B, Et Al. Endarterectomy Versus Stenting in Patients with Symptomatic Severe Carotid Stenosis. N Engl J Med. 2006;355:1660-1671.
Date November 2007
Journal Perspectives in Vascular Surgery and Endovascular Therapy
Excerpt Read excerpt

Title Defining the High-risk Patient for Carotid Endarterectomy: an Analysis of the Prospective National Surgical Quality Improvement Program Database.
Date October 2007
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Persistent Type 2 Endoleak After Endovascular Repair of Abdominal Aortic Aneurysm is Associated with Adverse Late Outcomes.
Date July 2007
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Restenosis After Eversion Vs Patch Closure Carotid Endarterectomy.
Date July 2007
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Surgical Revascularization Versus Endovascular Therapy for Chronic Mesenteric Ischemia: a Comparative Experience.
Date July 2007
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Comparison of Risk-adjusted 30-day Postoperative Mortality and Morbidity in Department of Veterans Affairs Hospitals and Selected University Medical Centers: Vascular Surgical Operations in Men.
Date July 2007
Journal Journal of the American College of Surgeons
Excerpt Read excerpt

Title Thoracoabdominal Aneurysm Repair: a 20-year Perspective.
Date March 2007
Journal The Annals of Thoracic Surgery
Excerpt Read excerpt

Title Stent-graft Versus Open-surgical Repair of the Thoracic Aorta: Mid-term Results.
Date January 2007
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Intermediate Results of Percutaneous Endovascular Therapy of Femoropopliteal Occlusive Disease: a Contemporary Series.
Date October 2006
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Long-term Outcomes After Endovascular Abdominal Aortic Aneurysm Repair: the First Decade.
Date October 2006
Journal Annals of Surgery
Excerpt Read excerpt

Title Poly Adenosine Diphosphate-ribose Polymerase Inhibitor Pj34 Abolishes Systemic Proinflammatory Responses to Thoracic Aortic Ischemia and Reperfusion.
Date August 2006
Journal Journal of the American College of Surgeons
Excerpt Read excerpt

Title Contemporary Results of Open Surgical Repair of Descending Thoracic Aortic Aneurysms.
Date August 2006
Journal Seminars in Vascular Surgery
Excerpt Read excerpt

Title Commentary on “extra-anatomic Visceral Revascularization and Endovascular Stent-grafting for Complex Thoracoabdominal Aortic Lesions”.
Date May 2006
Journal Perspectives in Vascular Surgery and Endovascular Therapy
Title Multi-institutional Pivotal Trial of the Zenith Tx2 Thoracic Aortic Stent-graft for Treatment of Descending Thoracic Aortic Aneurysms: Clinical Study Design.
Date May 2006
Journal Perspectives in Vascular Surgery and Endovascular Therapy
Excerpt Read excerpt

Title Aortic Dissection: Perspectives in the Era of Stent-graft Repair.
Date March 2006
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Title Current Results of Open Surgical Repair of Descending Thoracic Aortic Aneurysms.
Date March 2006
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Title Late Results of Combined Carotid and Coronary Surgery Using Actual Versus Actuarial Methodology.
Date December 2005
Journal The Annals of Thoracic Surgery
Excerpt Read excerpt

Title Contemporary Results of Angioplasty-based Infrainguinal Percutaneous Interventions.
Date November 2005
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Pj34, a Poly-adp-ribose Polymerase Inhibitor, Modulates Renal Injury After Thoracic Aortic Ischemia/reperfusion.
Date October 2005
Journal Surgery
Excerpt Read excerpt

Title Safety and Efficacy of Reoperative Carotid Endarterectomy: a 14-year Experience.
Date July 2005
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Determinants of Carotid Endarterectomy Anatomic Durability: Effects of Serum Lipids and Lipid-lowering Drugs.
Date May 2005
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Early Outcomes of Endovascular Versus Open Abdominal Aortic Aneurysm Repair in the National Surgical Quality Improvement Program-private Sector (nsqip-ps).
Date May 2005
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Thoracoabdominal Aneurysm Repair: Anesthetic Management.
Date March 2005
Journal International Anesthesiology Clinics
Title Endovascular Treatment of Thoracic Aortic Aneurysms: Results of the Phase Ii Multicenter Trial of the Gore Tag Thoracic Endoprosthesis.
Date March 2005
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Poly(adenosine Diphosphate Ribose) Polymerase Inhibition Modulates Spinal Cord Dysfunction After Thoracoabdominal Aortic Ischemia-reperfusion.
Date March 2005
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Current Status of Thoracoabdominal Aneurysm Repair.
Date November 2004
Journal Advances in Surgery
Title Stenting for Carotid-artery Stenosis.
Date October 2004
Journal The New England Journal of Medicine
Title Carotid Endarterectomy at the Millennium: What Interventional Therapy Must Match.
Date September 2004
Journal Annals of Surgery
Excerpt Read excerpt

Title Surgical Management of Popliteal Artery Embolism at the Turn of the Millennium.
Date June 2004
Journal Annals of Vascular Surgery
Excerpt Read excerpt

Title Regional Hypothermia with Epidural Cooling for Prevention of Spinal Cord Ischemic Complications After Thoracoabdominal Aortic Surgery.
Date April 2004
Journal Seminars in Thoracic and Cardiovascular Surgery
Excerpt Read excerpt

Title Preservation of Renal Function with Surgical Revascularization in Patients with Atherosclerotic Renovascular Disease.
Date February 2004
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Durability of Aortouniiliac Endografting with Femorofemoral Crossover: 4-year Experience in the Evt/guidant Trials.
Date June 2003
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Late Aortic and Graft-related Events After Thoracoabdominal Aneurysm Repair.
Date February 2003
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Surgical Treatment of Complicated Distal Aortic Dissection.
Date October 2002
Journal Seminars in Vascular Surgery
Excerpt Read excerpt

Title Thoracoabdominal Aneurysm Repair: Results with 337 Operations Performed over a 15-year Interval.
Date October 2002
Journal Annals of Surgery
Excerpt Read excerpt

Title Clinical Outcome of Internal Iliac Artery Occlusions During Endovascular Treatment of Aortoiliac Aneurysmal Diseases.
Date October 2002
Journal Journal of Vascular and Interventional Radiology : Jvir
Excerpt Read excerpt

Title Evolving Experience with Thoracic Aortic Stent Graft Repair.
Date July 2002
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Clinical Failures of Endovascular Abdominal Aortic Aneurysm Repair: Incidence, Causes, and Management.
Date July 2002
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Regarding “analysis of Predictive Factors for Progression of Type B Aortic Intramural Hematoma with Computed Tomography”.
Date July 2002
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Title Contemporary Management of Aortic Branch Compromise Resulting from Acute Aortic Dissection.
Date July 2001
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Endovascular Stent-graft in Abdominal Aortic Aneurysms: the Relationship Between Patent Vessels That Arise from the Aneurysmal Sac and Early Endoleak.
Date June 2001
Journal Radiology
Excerpt Read excerpt

Title Regional Hypothermia with Epidural Cooling for Spinal Cord Protection During Thoracoabdominal Aneurysm Repair.
Date April 2001
Journal Seminars in Vascular Surgery
Excerpt Read excerpt

Title Endovascular Repair of Abdominal Aortic Aneurysms: Current Status and Future Directions.
Date August 2000
Journal Ajr. American Journal of Roentgenology
Title Epidural Cooling for Spinal Cord Protection During Thoracoabdominal Aneurysm Repair: A Five-year Experience.
Date July 2000
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Utility and Reliability of Endovascular Aortouniiliac with Femorofemoral Crossover Graft for Aortoiliac Aneurysmal Disease.
Date July 2000
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

Title Surgical Renal Artery Reconstruction Without Contrast Arteriography: the Role of Clinical Profiling and Magnetic Resonance Angiography.
Date January 2000
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt Read excerpt

http://www.vitals.com/doctors/Dr_Richard_Cambria/credentials
http://www.vitals.com/doctors/Dr_Richard_Cambria/credentials#ixzz2VqyhFZVd

Cambria RP, Brewster DC, Lauterbach SR, Kaufman JA, Geller SC, Fan CM, Greenfield A, Hilgenberg A, Clouse WD. Evolving experience with thoracic aortic stent-graft repair. J Vasc Surg 2002:35:1129-36.

Cambria, RP, Clouse WD, Davison JK, Dunn PF, Corey M, Dorer D. Thoracoabdominal aneurysm repair: Results with 337 operations performed over a 15 year interval. Ann Surg 2002;236-471-79.

Cambria RP, Lauterbach SR, Brewster DC, Gertler JP, LaMuraglia GM, Isselbacher EM, Hilgenberg AD, Moncure AC. Contemporary management of aortic branch compromise secondary to acute aortic dissections. J Vasc Surg 2001;331185-92.

Cambria RP and Black JH. Aortic dissection perspectives for the vascular/endovascular surgeon. In Rutherford (ed) Comprehensive Vascular and Endovascular Surgery 6 th , W. B. Saunders, Inc. (in press, 2004).

Cambria RP, Marone LK, Cloud WD, Dorer, DJ, Brewster, DC, LaMuraglia, GM, Watkins, MT, Kwolek, CJ. Preservation of renal functions with surgical revascularization in patients with atherosclerotic renovascular disease. J Vasc Surg 2004; 10.023.

Abdominal Aortic Aneurysm – Case Study

by

Angela Rodriguez-Wong, MD, RVT, RPVI

Lois Eliassi, BS, RVT

http://www.navixdiagnostix.com/downloads/Navix%20-%20Q1%20’13%20Ultrasound%20Solutions.pdf

An aneurysm is defined as a focally dilated segment of an artery that is 1.5 times its normal diameter and involves all three arterial walls (intima, media and adventitia). Aneurysms can be found in the common femoral and popliteal arteries in the lower extremities, the splenic, mesenteric, and renal arteries in the abdomen, and also in the intracranial vessels. However, the most common is an abdominal aortic aneurysm (AAA) involving the aorta and iliac arteries.

Abdominal aortic aneurysms are generally asymptomatic and are discovered accidentally either by physician palpation or by a radiologic examination such as a chest or abdominal X-ray. The risk factors that increase the probability of developing a AAA are primarily smoking and family history. An abdominal aortic aneurysm can rupture and, according to the Centers for Disease Control and Prevention, ruptured AAA was the 10th leading cause of death in males between the ages of 65-74 in the United States in 2000.

The preferred method of screening for AAA is diagnostic ultrasound. According to the Journal of Vascular Surgery, diagnostic ultrasound performed by a registered vascular technologist has a sensitivity of 100 percent and a specificity of 96 percent for the detection of an infrarenal AAA. The abdominal aorta is considered aneurysmal when it measures >3.0 cm.

Because of its accuracy, diagnostic ultrasound not only has become an integral part in diagnosing AAA but is also an integral part in the evaluation of disease progression, the preoperative AAA evaluation, and the follow-up of AAA surgical repair. It is important to note that a rupture of an AAA is a surgical emergency and is difficult to evaluate with ultrasound due to the inability to easily demonstrate abdominal free fluid. If a rupture is suspected, it is recommended that other imaging modalities such as CT be employed to better demonstrate the ruptured aneurysm and any intra-abdominal free fluid.

Case Study – 

Abdominal Aortic Aneurysm – A 77 year-old male

Angela Rodriguez-Wong, MD, RVT, RPVI

Lois Eliassi, BS, RVT

Figure 1 Distal abdominal aortic aneurysm with mural thrombus.

pic1

Figure 2 Bifurcation of the aorta.

pic2

Case Study: A 77 year-old male with a past medical history of diabetes, hypertension, arthritis, aortic valve disease and heavy smoking was referred to Eastern Vascular Diagnostic Center with a 4.2 centimeter aneurysm. The patient denied any family history of aneurysm and is allergic to intravenous contrast. A physical exam found the patient alert with a blood pressure of 100/60 mmHg, a pulse of 58 and respiration of 16. Auscultation found a bruit in the left carotid artery, clear lungs, and a regular heart rhythm with an aortic systolic murmur. The patient had a well healed sub-costal incision on his abdomen. The physician was unable to palpate the aneurysms. The patient had an aortic valve replacement in 2007 and also a cholecystectomy. On May 12, 2012, a magnetic resonance imaging (MRI) scan without contrast was performed on the patient’s abdomen. The MRI found an AAA measuring greater than 3 cm with extensive plaque near the bifurcation. The aneurysm extended into the right common iliac artery (CIA) measuring 4.2 cm and into the left CIA measuring 3.1 cm. The MRI exam did not include the pelvis, so the extent of the iliac aneurysms was not clear. On July 31, 2012, the ultrasound was performed, demonstrating normal ankle brachial index (right-1.2, left-1.1) and a AAA measuring 3.9 cm which extended into the right and left CIA. The maximum diameter of the right CIA measures 4.1 cm with mural thrombus creating a residual lumen of 2.0 cm. The maximum diameter of the left CIA measures 4.3 cm, there is also mural thrombus noted but without significant appreciable diameter reduction within the vessel. A computed tomography (CT) scan of the abdomen and pelvis without contrast was performed on July 18th confirming the infrarenal AAA with extension into the iliac arteries bilaterally.

Surgery is recommended when an AAA reaches 5.0-5.5 cm in a male and 4.5-5.0 cm in females. Surgery, depending on the aneurysm, can be an open repair or an endovascular repair. In this patient, despite the size of the AAA being 4.1 cm, the disease also involved the bilateral common iliacs prompting the need for surgical intervention. The patient was cleared by cardiology and on July 31st had an AAA and bilateral Iliac aneurysm resection with a re-implantation of the inferior mesenteric artery and an Aorta to right Hypogastric bypass to maintain pelvic perfusion.

The U.S. Preventive Services Task Force has released a statement summarizing recommendations for screening for AAA. It states that screening benefits patients who have a relatively high risk for dying from an aneurysm; major risk factors are age 65 years or older, male sex, and smoking at least 100 cigarettes in a lifetime. The guideline recommends one-time screening with ultrasound for AAA in men 65 to 75 years of age who have ever smoked. No recommendation was made for or against screening in men 65 to 75 years of age who have never smoked, and it recommended against screening women. Men with a strong family history of AAA should be counseled about the risks and benefits of screening as they approach 65 years of age.

Angela Rodriguez-Wong, MD, RVT, RPVI 

awong@navixdiagnostix.com

Lois Eliassi, BS, RVT

leliassi@navixdiagnostix.com

Figure 3 Sagittal image of the right common iliac artery demonstrating the measurement of the aneurysm and the true lumen.

pic3

Figure 4 Coronal view of the left common iliac artery.

pic4

REFERENCES 

1. Anderson RN. Deaths: Leading causes for 2000. Natl Vital Stat Rep. 2002;50:1–85.

2. Kent KC, Zwolak RM, Jaff MR, et al. Screening for abdominal aortic aneurysm. J Vasc Surg. 2004;39:267–9.

3. Upchurch G Jr, Schaub T. Abdominal aortic aneurysm. American Family Physician. 2006;73(7), 1198-1204. http://www.aafp.org/afp/2006/0401/p1198.html

http://www.navixdiagnostix.com/downloads/Navix%20-%20Q1%20’13%20Ultrasound%20Solutions.pdf

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Reporter and Curator: Aviva Lev-Ari, PhD, RN

Oldest picture

http://th.physik.uni-frankfurt.de/~jr/physpiceinstein.html

my favorite picture of Albert Eistein

http://www.google.com/search?q=albert+einstein+pictures&hl=en&tbo=u&tbm=isch&source=univ&sa=X&ei=sXKyUI6RJ4j-0gG7m4DIDA&sqi=2&ved=0CDUQsAQ&biw=779&bih=776

http://www.albert-einstein.org/

A new study on the neuroanatomy of Albert Einstein was

Released: 11/15/2012 10:00 AM EST
Embargo expired: 11/15/2012 7:00 PM EST
Source: Florida State University

Portions of Albert Einstein’s brain have been found to be unlike those of most people and could be related to his extraordinary cognitive abilities, according to a new study led by Florida State University evolutionary anthropologist Dean Falk.

Brain

Uncommon Features of Einstein’s Brain Might Explain His Remarkable Cognitive Abilities

Released: 11/15/2012 10:00 AM EST
Embargo expired: 11/15/2012 7:00 PM EST
Source: Florida State University

Newswise — TALLAHASSEE, Fla. ⎯ Portions of Albert Einstein’s brain have been found to be unlike those of most people and could be related to his extraordinary cognitive abilities, according to a new study led by Florida State University evolutionary anthropologist Dean Falk.

Falk, along with colleagues Frederick E. Lepore of the Robert Wood Johnson Medical School and Adrianne Noe, director of the National Museum of Health and Medicine, describe for the first time the entire cerebral cortex of Einstein’s brain from an examination of 14 recently discovered photographs. The researchers compared Einstein’s brain to 85 “normal” human brains and, in light of current functional imaging studies, interpreted its unusual features.

“Although the overall size and asymmetrical shape of Einstein’s brain were normal, the prefrontal, somatosensory, primary motor, parietal, temporal and occipital cortices were extraordinary,” said Falk, the Hale G. Smith Professor of Anthropology at Florida State. “These may have provided the neurological underpinnings for some of his visuospatial and mathematical abilities, for instance.”

The study, “The Cerebral Cortex of Albert Einstein: A Description and Preliminary Analysis of Unpublished Photographs,” will be published Nov. 16 in the journal Brain.

Upon Einstein’s death in 1955, his brain was removed and photographed from multiple angles with the permission of his family. Furthermore, it was sectioned into 240 blocks from which histological slides were prepared. Unfortunately, a great majority of the photographs, blocks and slides were lost from public sight for more than 55 years. The 14 photographs used by the researchers now are held by the National Museum of Health and Medicine.

The paper also publishes the “roadmap” to Einstein’s brain prepared in 1955 by Dr. Thomas Harvey to illustrate the locations within Einstein’s previously whole brain of 240 dissected blocks of tissue, which provides a key to locating the origins within the brain of the newly emerged histological slides.

SOURCE:

http://www.newswise.com/articles/uncommon-features-of-einstein-s-brain-might-explain-his-remarkable-cognitive-abilities

Albert Einstein died 50 years ago Monday. While that day marked the end of his life, it was only the beginning of a long, strange journey for his brain.

Thomas Harvey, a doctor at the hospital where Einstein died, removed the famous scientist’s brain and kept it with him over the next four decades. Harvey wanted to know what made Einstein a genius.

As Brian Burrell writes in his new book Postcards from the Brain Museum, Harvey wasn’t alone.

Scientists have long sought to understand the nature of genius and before computers and imaging technology, they had few options other than studying the actual brain.

Burrell discusses the long, strange journey of Einstein’s brain.

The Long, Strange Journey of Einstein’s Brain

April 18, 2005

Albert Einstein’s Brain May Provide Clues To His Genius, Study Says

By  Posted: 11/17/2012 12:08 am EST Updated: 11/19/2012 6:26 pm EST

http://www.huffingtonpost.com/2012/11/17/albert-einstein-brain-study-genius_n_2144865.html

ORIGINAL PAPER  in BRAIN, A JOURNAL OF NEUROLOGY, OCCASIONAL PAPER – November 16, 2012

The cerebral cortex of Albert Einstein: a description and preliminary analysis of unpublished

photographs

http://www.oxfordjournals.org/our_journals/brainj/press_releases/prpaper.pdf

Paper Authors’ Affiliations:

Dean Falk,1,2 Frederick E. Lepore3,4 and Adrianne Noe5

1 Department of Anthropology, Florida State University, Tallahassee, FL 32306-7772, USA

2 School for Advanced Research, Santa Fe, NM 87505, USA

3 Department of Neurology, Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA

4 Department of Ophthalmology, Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA

5 National Museum of Health and Medicine, Silver Spring, MD 20910, USA

Correspondence to:

Dean Falk,

School for Advanced Research,

660 Garcia Street,

Santa Fe, NM 87505, USA

E-mail: dfalk@fsu.edu or falk@sarsf.org

Summary and conclusions

Quote from Brain, 2012, November 16, 2012, green color added

Einstein’s brain is of unexceptional size and its combination of a relatively wide and forward-projecting right frontal lobe with a relatively wide and posteriorly protruding left occipital lobe is the most prevalent pattern seen in right-handed adult males.

We have identified the sulci that delimit expansions of cortex (gyri or convolutions) on the external surfaces of all of the lobes of the brain and on the medial surfaces of both hemispheres. The morphology 25 in some parts of Einstein’s cerebral cortex is highly unusual compared with 25 (Ono et al., 1990) and 60 (Connolly, 1950) human brains for which sulcal patterns have been thoroughly described. To the extent possible, the blocks of brain from particularly interesting areas are identified on the ‘roadmap’ that was prepared when Einstein’s brain was sectioned, as a guide for researchers who may wish to explore the histological correlates of Einstein’s gross cortical morphology.

Contrary to earlier reports, newly available photographs reveal that Einstein’s brain is not spherical in shape. The surface area of Einstein’s inferior parietal lobule is larger on the left than the right side, whereas that of his superior parietal lobule appears markedly larger in the right hemisphere. The photographs also suggest that the primary somatosensory and motor cortices representing the face and tongue are differentially expanded in the left hemisphere, that the posterior ascending limb of the Sylvian fissure is separate from (rather than confluent with) the postcentral inferior sulcus,and that parietal opercula are present. Nevertheless, our findings are concordant with the earlier suggestion that unusual morphology in Einstein’s parietal lobes may have provided neurological substrates for his visuospatial and mathematical abilities (Witelson  et al., 1999a, b).

Our results also suggest that Einstein had relatively expanded prefrontal cortices, which may have provided underpinnings for some of his extraordinary cognitive abilities, including his productive use of thought experiments. From an evolutionary perspective, the specific parts of Einstein’s prefrontal cortex that appear to be differentially expanded are of interest because recent findings indicate that these same areas increased differentially in size and became neurologically reorganized at microanatomical levels during hominin evolution in association with the emergence of higher cognitive abilities (Semendeferi et al., 2011).

It would be interesting therefore to investigate the histological correlates of these (as well as parietal) regions of Einstein’s brain from the newly available slides. We hope that future research on comparative primate neuroanatomy, paleoneurology and functional neuroanatomy will provide insight about some of the unusually convoluted parts of Einstein’s brain that we have described with little, if any, interpretation (e.g. the external neuroanatomy of the occipital lobes, posterolateral temporal cortex, and inferior temporal gyri). 

Figure 12 The remainder of the original ‘road map’ to the 240 blocks sectioned from Einstein’s brain. A–D correspond with Fig. 8.

The figure is reproduced with permission from the National Museum of Health and Medicine.

| Brain 2012: Page 22 of 24 D. Falk et al.

Acknowledgements

The authors thank the estate of Thomas S. Harvey, MD, for

donating the materials that form the basis for this article to the

National Museum of Health and Medicine, Elizabeth Lockett and

5 Emily Wilson for help in accessing materials, and Jessica Calzada

for preparation of figures. Kurt Rockenstein is thanked for extensive

technical support. We also received help from Eric Boyle, Tim

Clarke, Jr., Laura Cutter, Elizabeth Eubanks, Albert Galaburda, Lois

Hawkes, Sam Huckaba and Micah Vandegrift. The National

Museum of Health and Medicine is acknowledged for permission

to reproduce the 12 images that appear in this article. The views

expressed are those of the authors and do not reflect the official

policy or position of the Department of Defense or the United

States Government.

Individuals who are interested in studying the newly emerged

Harvey Collection should contact medicalmuseum@amedd

.army.mil.

Funding

Publication costs were provided by the College of Arts and

20 Sciences at Florida State University, and travel support for DF

was provided by the School for Advanced Research in Santa Fe,

New Mexico.

REFERENCES

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Allman JM, Tetreault NA, Hakeem AY, Manaye KF, Semendeferi K,

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Broca’s region revisited: cytoarchitecture and intersubject variability.

J Comp Neurol 1999; 412: 319–41.

Amunts K, Schleicher A, Ditterich A, Zilles K. Broca’s region: cytoarchitectonic

asymmetry and developmental changes. J Comp Neurol 2003;

465: 72–89.

Anderson B, Harvey T. Alterations in cortical thickness and neuronal

density in the frontal cortex of Albert Einstein. Neurosci Lett 1996;

210: 161–4.

Bailey P, Von Bonin G. The isocortex of man. Urbana, IL: University of

Illinois Press; 1951.

Bangert M, Schlaug G. Specialization of the specialized in features of

external human brain morphology. Eur J Neurosci 2006; 24: 1832–4.

Broca P. Remarques sur le sie´ ge de la faculte´ du langage articule´ , suivies

d’une observation d’aphe´ mie (Perte de la Parole). Bulletin de la Socie´ te´

Anatomique de Paris 1861; 6: 330–57.

Clark GM, Mackay CE, Davidson ME, Iversen SD, Collinson SL,

James AC, et al. Paracingulate sulcus asymmetry; sex difference, cor-

relation with semantic fluency and change over time in adolescent

onset psychosis. Psychiatry Res 2010; 184: 10–15.

Cole MW, Yeung N, Freiwald WA, Botvinick M. Conflict over cingulate

cortex: between-species differences in cingulate may support

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