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giuliaratti · 5 years

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SOME EXCERPTS FROM   Sensual Culture: The Socio-Sensual Practices of Clubbing. Philip Gordon Jackson University College London In Fulfilment of PhD in Social Anthropology Submitted in June 2001  

_core crowd

people become core crowd members by simply becoming regulars and partying hard, so that they get noticed and invited to other nights; they make an effort to add to the party by participating in it to a high degree; they will dress up, dance hard, socialize and play a role in "kneading" the party out of the more reserved clubbers.

over the course of the night, we don't spend a lot of time with each other, because we're circulating and chatting and dancing and trying to get other people to let their hair down and join in, that's the most important job of the core crowd.

The core crowd are the people who produce a party more than they consume it darkness holds an unknown quality about it that is a combination of both promise and threat. It is a time of invisibility or transformation where, shielded from the clarity of Foucault's gaze, people can become slippery in terms of the activities they seek out and the personas they present to the world. Night in the city is time out [...] For people who hold down boring or unsatisfactory jobs, night is the time when they feel they lead their real lives.

"Night is the final frontier because it's the only space and time, in the current system, that can be given over to things that won't necessarily make money. During the day you have to do things that will allow you to survive financially. Whereas the night you don't." (Male 28; 11 years experience.)

anonimity

darkness "covers", "penetrates" and "touches"

"It's hard to dance when a club's too light, you feel too vulnerable; it's like dancing during the daytime I find that a bit odd too, though once I've got going I don't mind as much, but there's something about really dark rooms that makes it easier to dance and go a bit wilder; it feels more natural." (Female 29; 7 years experience.)

Dancing in the dark is easier than dancing in broad daylight where the movements of the dancer are revealed to the world and open to scrutiny. You often see people closing their eyes, when they dance, enveloping themselves in their own darkness and allowing themselves to experience their own body in motion more intensely by cutting out the distraction of the crowd.

Out on the dancefloor, shrouded in this cimmerian world, the tyranny of vision is abandoned in favor of the delights of invisibility and the physical closeness of bodies getting serpentine on the beat. What you can't see you can't judge and can't be judged by. 

Shrouded by the darkness bodies became liquid, emotions rose to the surface, faces were hyper-expressive revealing joy, confusion, contemplation and sheer unadulterated bliss.

Some of these crowds may have difficult lives outside of the club space, others don't, but regardless of where they have come from the experience of clubbing itself adds something they value to their lives. I believe this sense of value arises from this point of sensual tension; it is an emotional and experiential value, rather than an ideological position; clubbing is about creating worlds that feel right.

"I get to be sexy; it seems silly but I really enjoy it, when I'm in a club dancing my whole body feels hot and horny and alive. I can dress up in a way that I could never do on the street or in pubs, because I think in clubs people will accept that you're doing it for yourself; they can watch you and enjoy you, but that's as far as it goes; it's playful rather than serious; It feels safe much safer than other places where it might cause hassle; I feel more in charge of the situation, less threatened by people watching me. You know that some guy might be getting turned on by the way you dance, but m a club that feels less dangerous because you expect the men to not behave like arseholes. If they're just smiling at you and watching you and enjoying or dancing along with you then they understand that It doesn’t necessarily mean you want to fuck them; it's just part of the might, part of the fun of clubbing." (Female 41; 19 years experience.) 

"I was dancing on my own and this group of women were on the floor with me; it was pretty empty, but they kept crowding in on me like there was no room and giving me horrible nasty looks and whispering to each other, then staring at me. It wasn't very nice; they seemed to resent me dancing on my own, like they were threatened by it or something. It hasn't happened very often at all, but when it does you just think, 'Oh you sad bastards just leave me alone and enjoy yourself, that's what we're all here for.' " (Female 42; 5 years experience.)

_The Dynamics of Dance

Stage 1 is the pre-dance stage, where punters begin to embody the practice of clubbing. They congregate at the peripheries of the space, around bars, at the edge of the dancefloor. Standing with their mates, scanning the crowd to see who's there, they drink, giggle, watch. Some are waiting for their drugs to "come on" and at this stage the crowd is still anxious about the night.

Club crowds must be hospitable and welcoming and this is again communicated physically: it is a bodily attitude that is relaxed, passionate and, most importantly, friendly.

Stage 2 is the point where a dancefloor tentatively begins. DJ drops a club favourite or a confident party posse arrives in force. people surreptitiously start to dance at the periphery, move into the visible space and then retire back to the edge.

This is a period where people feel particularly self conscious, by beginning to dance they must move from the safety and anonymity of the crowd, to the visibility of the floor. People at the edges often start dancing, while chatting with friends or facing away from the floor itself, as they attempt to conceal themselves and their movements by pretending that they're not actually dancing, more just moving about while talking.

Stage 3 is a warm-up periodThe temperature rises, muscles warm up, bodies start to relax

You become hyper-aware of your own self within the crowd. The joy of dancing in a club is that there is no wrong way to dance, as long as you're getting otT on it, lapping it up, lovin' it, then you can dance. The only bad dancer is a miserable one.

Stage 4 is the point where the dancefloor reaches a critical mass of bodies; it is the hottest and most intense stage in terms of being amongst others. Full dancefloors can become static, they reduce the range of potential movement, this is the hands in the air stage when you have to focus your movement vertically, rather than horizontally, to avoid collisions. As one informant explained:

"Dancing on a really packed floor, that's really going for it, can feel like leaping into a bucket full of eels; it's great, hot, bodies everywhere, all just squirming and getting sweaty; it's great." (Male)

The sweat which pours from your skin seems to cleanse you, draining out the toxic residue of frustrated plans, niggling worries, stupid arguments and petty insecurities. Nothing matters but the beat, the crowd, the dance.

Glorious. Some clubbers themselves see this experience in terms of escapism, but to the outside eye, it seems so social and physically creative, that it forces you to re-think the meaning of the term escapism itself.

The crowd has worked together to create this moment. They have put time, energy and hard cash into the night, but most importantly they have generated a sense of social camaraderie, within the club, that underpins their ability to cut loose and feel good amongst the people who surround them. The dance is one way in which that sensation manifests itself, in both individuals and groups, by allowing them to possess a different physicality in the world, one that is strong and fervent, relaxed yet powerful, one that has shed, even if only for a night, the physicality of the drudge.

"I was trained as a dancer; I worked as a dancer; I have always danced; I've always enjoyed dancing, but I never really felt like a dancer until I started taking drugs and dancing in clubs. That taught me more about dancing than any other experience of dancing ever has." (Female 41; 19 years experience)

The easiest way to describe it is that it feels like vertical fucking, but this fuck has a sense of humour, it is playful and intense simultaneously.

"I haven't had sex for almost two years and dancing allows me to enter a wonderful sensual place; it's almost as good as sex in terms of making your body feel fabulous" (Female 42; 5 years experience.)

The aches and pains of the week begin to evaporate through movement.

grey flees the building to be replaced by vivid reds, burning oranges, iridescent blues and a slither of topaz. You ain't in Kansas no more. You're on a dancefloor and it is fearsome fine.

You can literally feel these changes deep in the flesh, your posture becomes liquid, you can sense the energy pumping through your veins, as this sensorial realm begins to dominate consciousness. Your kinaesthetic sense is firing on all fronts, all that matters is the dance. The sensual residue of the week, your weaknesses, anxieties and strengths are channelled into the dance and so transmuted into movement, energy and heat. They are not simply forgotten, their form is altered, their shadows are expunged from the flesh. Those knots of tension, that are the physical manifestation of problems at work, the heaviness of depression, the stooped form of anxiety, are all cast-off and replaced with a body in lithe, supple motion.

At times this can feel transcendent; it is a physicality that takes you so far beyond the everyday experience of your own social body, that it felt as a sublime manifestation of self in world.

'I've never felt like that, because I've never moved like that'

the experience of dancing becomes a form of sensual knowledge in itself; it teaches you about your own body, how you can make that body feel and how you can intensify those feelings.

you don't have to look good, when you dance, it is enough to simply dance and express your passion for dancing and this freedom is one of the most important qualities of the club space.

once my body started to loosen up then I could look at people, catch their eyes and smile and feed off their energy, because I had space my dancing could get pretty wild.

“[…] It's not showing off; it's trying to provoke and tempt people to go further. It's not about performance; I don't want people to look at me; I want them to interact with me; to be with me; not stare at me. The display thing is all very silly really; it's a game”

dancing in a crowded room is very different from dancing alone, because you're immersed within and energized by the sociality of the space.

safe social space

What they actually communicate, when they're wrapped within the full force of the dance, is the feeling of being exquisitely and sensually ALIVE, more alive than they feel in many other areas of their lives. That sense of aliveness arises from a repossessing and re- sensualizing your own body through the practice of dancing.

Dressing up is a sensual practice […] it is fun in itself and people enjoy playing with the way they look.

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lupine-publishers-acr · 4 years

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Lupine Publishers | Troubleshooting in Upgrading Procedure: Intraprocedural Percutaneous Transluminal Angioplasty of Great Vessels

Lupine Publishers | Journal of Cardiology & Clinical Research

Abstract

Upgrading procedure is relatively common since indications to cardiac resynchronization therapy (CRT) and implantable defibrillator are increasing. A relatively frequent phenomenon that the operator may encounter is some degree of venous obstruction around the previously implanted leads, which may become completely occlusive. In these situations, upgrading procedure may be challenging and various manoeuvers have been described. We describe a case of intraprocedural percutaneous transluminal angioplasty (PTA) of occlusive stenosis of the innominate vein, performed during an upgrading procedure from bicameral cardiac implantable defibrillator (ICD) to CRT-D.

Keywords: Upgrading; Cardiac resynchronization therapy; Percutaneous transluminal angioplasty; Venous occlusion

Introduction

Cardiac resynchronization therapy is a well-established therapy for patients with severe systolic dysfunction, wide QRS and heart failure despite optimal medical therapy [1]. Moreover, since indications for cardiac resynchronization devices continue to expand, the number of upgrading procedures from previously implanted single- or dual-chamber systems is increasing. In these cases, some degree of venous obstruction is a relatively frequent phenomenon (up to 50%), which may become completely occlusive in 12% of cases [2]. Chronic venous occlusion, mostly asymptomatic, can involve the coronary sinus and its branches as well as central veins, such as the axillary-subclavian or innominate veins. Angioplasty of the coronary sinus is well described in the literature to allow the placement of a left ventricular lead (LV) [3,4]. By contrast, not many data are available on the intra-procedural safety and efficacy of central vessel angioplasty [5,6]. We describe a successful case of angioplasty of a total central venous occlusion to allow LV lead placement during an upgrading procedure to a CRT system.

Case Report

A 69-year-old patient with a clinical history of hypertension, diabetes, prior myocardial infarction, poor EF (30%), and previous percutaneous transluminal coronary angioplasty (PTCA) on the circumflex coronary artery, was referred to our institution for elective replacement of a dual-chamber ICD implanted in July 2008 (ICD Lumos DRT, atrial lead Selox JT 53 and ventricular lead Linox SD 65/16, Biotronik SE. Berlin Germany). On admission, the patient was symptomatic for dyspnea, with a poor functional class (NYHA III), the echocardiogram showed a severely depressed ejection fraction (20%) and the electrocardiogram confirmed a wide QRS duration of 130msec with left bundle branch block. A coronary angiography confirmed the indication to medical therapy in the absence of any target vessel for revascularization. We consequently decided to perform an upgrading procedure to a CRT system. In accordance with our clinical practice, angiography of the axillary and subclavian veins through the ante cubital venous access was performed before the procedure to assess patency of the central veins. The angiogram documented severe stenosis of the axillary vein at the insertion point of the right atrial and ventricular leads into the vessel. The subclavian vein was then directly punctured distally to the sub-occlusive stenosis (behind first rib), to obtain a venous access for the LV lead. Unfortunately, subsequent advancing on the 0.035” guidewire through a sealed 9 Fr introduction sheath (Safe Sheath HLS 1009, Pressure Product, San Pedro, USA) proved unsuccessful owing to another occlusion at the junction between the superior vena cava (SVC) and the innominate vein, where the second shocking coil lead was located. Selective injection of contrast media into the subclavian vein through the introducer confirmed total occlusion of the main vessel and a wide collateral vicarious circulation draining blood into the SVC (Figure 1).

Figure 1: Vein angioplasty procedure. A. Angiography from the subclavian venous access, revealing occlusive venous stenosis of the anonimous trunk. B. Balloon inflated up to 8-10 atm. across the stenosis. C. Restoration of venous patency after angioplasty.

A 0.014” angioplasty guidewire (TERUMO Corporation, Tokyo, Japan) was threaded through the occlusion and then left in the right atrium. An angioplasty balloon (Sterling 6mm x 20mm, Boston Scientific Inc. Natick, USA) was then advanced over the wire to the occlusion and inflated to 6 atm. In order to progressively open the occlusion, we removed the balloon and advanced over the 0.014” wire a multipurpose catheter (Cordis Corporation, Miami, USA) which, thanks to the dotter effect, enabled us to pass through the stenotic tract and to replace the 0.014” with a 0.35” x 200 cm guidewire. Once we had retrieved the MP catheter, a larger angioplasty balloon (Sterling 8 mm x 40 mm, Boston scientific Inc. Natick, USA) was advanced over the 0.35” wire and repeatedly inflated to 10 atm to obtain satisfactory dilation of the subclavian and innominate veins (Figure 1B). A 5-10 cc injection of contrast medium confirmed the re-establishment of flow within the subclavian vein and SVC, with a residual stenosis of 30-40% (Figure 1C). Implantation of the CRT device was then successfully carried out, without complications, by cannulating the coronary sinus through a dedicated delivery system (Attain Command Straight, Medtronic Inc. Minneapolis, USA), placing a 4 Fr dual-unipolar LV lead (Attain Ability 4196- 88 cm, Medtronic Inc. Minneapolis, USA) into a lateral coronary vein and, finally, by connecting the three leads to a CRT-D device (Consulta CRT-D, Medtronic Inc. Minneapolis, USA). The acute LV lead threshold was 1.1 V at 0.5 msec, with no diaphragmatic capture at 10V. The electrical parameters of the right atrial and right ventricular leads were also stable. The additional time required to perform PTA was 15 minutes, plus 3 minutes of fluoroscopy time with an additional 30 cc injection of contrast medium injection. At the 3-month follow-up examination, electrical parameters of atrial, right ventricle and left ventricle leads were stable, and no adverse event was observed.

Discussion

Chronic venous occlusion is not an infrequent finding in patients undergoing implantation procedures. This issue may involve both the coronary sinus and the central venous system. Recognized risk factors for venous obstruction include blood stasis due to venous angulation or kinking, the presence of a central venous line for long-term infusion therapy, hemodialysis, trauma, infection and the presence of pacemaker leads. Heart failure and poor systolic function may facilitate the process [7,8]. The most likely pathogenesis seems to be due to thrombosis, beginning with fibrin deposition over the lead surface and progressive fibrous reaction, with a ring-like fibrosis development around the lead, causing severe stenosis or even total occlusion of the vein [5]. The presence of a second ICD shocking coil, usually located in the superior vena cava, has been associated with increased incidence of venous obstruction [9]. In our case, the occlusion was localized at the junction of the innominate vein with the superior vena cava, where the second shocking coil lead lays for anatomical reasons. Thrombosis and fibrotic reaction were probably favored by the close contact of the heavy coil with the vessel wall at a point where, for hemodynamic reasons, there may be turbulence, thereby predisposing the vessel to occlusive stenosis.

As the stenotic process is usually gradual, a collateral venous network can develop to compensate for the occlusion. Consequently, symptoms or physical signs are rare, and partial or total venous occlusion may be totally asymptomatically, becoming an unexpected finding at the time of implantation. If a new lead needs to be added to the implanted system, the operative strategy may differ considerably according to the physician’s familiarity with the available technical options. The physician can choose among various approaches: an opposite-side approach with subsequent lead tunneling across the thorax [10], an ipsilateral approach performed by means of jugular system cannulation [11], and epicardial placement of the leads through thoracotomy or vein angioplasty [5]. The first option carries several risks, including the development of complete occlusion of both subclavian veins over time, damage to the leads — particularly deleterious in the case of ICD leads - or higher defibrillation threshold in the case of rightside placement of the active can. The jugular system approach may expose the patient to the risk of worsened blood drainage or, in the case of the internal jugular cannulation, even acute serious damage to this important vessel of the neck [12]. Epicardial placement of the leads through thoracotomy has the disadvantage of requiring surgery and general anesthesia.

Our experience showed that angioplasty of the central venous system can be performed in the same session of the upgrading procedure without excessively prolonging the procedural time, thereby avoiding postponing the procedure. We observed no complications, damage or dislocations of the existing leads. Moreover, this approach is less invasive than other alternatives and allows the patency of the contralateral venous system to be preserved. This case also shows that in certain clinical conditions at higher risk of venous occlusion, it is advisable to perform an angiography from ante cubital vein before the procedure, in order to assess the patency and exact location of the great veins. We can hypothesize that incomplete location of the second shocking coil inside the superior vena cava and the lying of the coil across the junction between the innominate vein and superior vena cava may contribute, for hemodynamic reasons, to the development of a marked fibrotic reaction. Eventually, in case of occlusive stenosis of central veins, intraprocedural venoplasty of great vessel seem to be feasible, without postponing the upgrading procedure.

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thenikhilniks-blog · 5 years

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we-kumar-niks2019-blog · 5 years

Text

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The support work of corporation M&A and Due diligence in Turkey

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we-kumar-niks2019-blog · 5 years

Text

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***We could provide the service to establish and registrar a corporation in Turkey.

The completion for establish a corporation in Turkey

***We could introduce an office or company house by the real estate, which cooperated with our company.

The forms of business to establish in Turkey

Corporation

Limited Liability Company

Branch in Turkey

Representative office

1. Corporation (Anonim Şirket)

2. Limited Liability Company (Limited Şirketi)

3. Branch in Turkey (Şube)

4. Representative Office

The support work of corporation M&A and Due diligence in Turkey

>>The discovery of risk in management and financial

>>The calculation of value of corporation

>>The price negotiation with target company

>>To correspond to financial due diligence by project team

The procedure to establish a business in Turkey

❶ preparation of necessary documents

❷ translation and certification

❸ application

❹ registration and permission of business

❺ notification to tax office

❻ business starting

To establish a representative office in Turkey

To learn more about our incorporation assistance and a range of other services related to establish company

0 notes

we-kumar-niks2019-blog · 5 years

Text

We provide the consulting service related to company setup in turkey

The consultation to establish a company or a local corporation in Turkey

***We could provide the service of consulting.

The consultation related to the procedure to establish and budget in Turkey

***We could provide the necessary information, such as the research of marketing, the decision of form to establish.

To decide to investment in Turkey and establish a company in Turkey

***We could help you make a decision which form should be established

The registration of your corporation in Turkey

***We could provide the service to establish and registrar a corporation in Turkey.

The completion for establish a corporation in Turkey

***We could introduce an office or company house by the real estate, which cooperated with our company.

The forms of business to establish in Turkey

Corporation

Limited Liability Company

Branch in Turkey

Representative office

1. Corporation (Anonim Şirket)

2. Limited Liability Company (Limited Şirketi)

3. Branch in Turkey (Şube)

4. Representative Office

The support work of corporation M&A and Due diligence in Turkey

>>The discovery of risk in management and financial

>>The calculation of value of corporation

>>The price negotiation with target company

>>To correspond to financial due diligence by project team

The procedure to establish a business in Turkey

❶ preparation of necessary documents

❷ translation and certification

❸ application

❹ registration and permission of business

❺ notification to tax office

❻ business starting

To establish a representative office in Turkey

To learn more about our incorporation assistance and a range of other services related to establish company

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