Radioiodine Therapy for Hyperthyroidism

Radioiodine Therapy for Hyperthyroidism RESULTS AND DISCUSSION Radioiodine therapy is now a day increasingly used for treatment for hyperthyroidism. The response to this treatment is unpredictable and the factors postulated to predict outcome have not generally proven clinically useful or is not widely accepted in clinical practice. So this retrospective study was carried out to determine whether the demographic, clinical and laboratory characteristics at presentation had any influence on the recurrence and the success of the radioiodine therapy. This study was carried out in the Nuclear Medicine Department of Kovai Medical Center And Hospital during the inclusive period of Jan 2014 to July 2014. At the beginning of the study 70 patients were included, but only 62 completed follow up. In this study, the records of 70 hyperthyroid patients were reviewed. Among those 70 patients, 23 (32.9%) males and 47 (67.1%) females were enrolled. The female to male ratio was 2.1:1, showing a higher incidence of hyperthyroidism in females than in males. Even though females are more prone to hyperthyroidism, this had no influence on the outcome of therapy (p=0.2330). Similar studies conducted by Antony Lewis et al also could not find any association between gender and outcome of therapy. (Table: 1 Graph: 1) As hyperthyroidism is relatively more common in adult population, for convenient analysis patients were categorized based on the age limit into 2 groups i.e. less than 35 years and above 35 years . The mean age of study patients was found to be 42.56Â ±13.44 years (range 15 to 72 years). 21 patients came under the category of less than 35 years with females and males with mean age of 27.42Â ±5.81 and 26.57Â ±7.45 years respectively. The remaining 49 patients comes under the age limit of above 35 years, the mean age of male patients was 49.06Â ±9.05 and 49.21Â ±10.21 years in females. This indicated a higher incidence of hyperthyroid conditions in subjects above 35 years. According to this study, there was no significant tendency for proportion cured to change with age (p=0.899). Studies done by Robert A.Nordyke et al also could not find any association with age and cure rate and also the mean age of the study population was also similar.(Table:2,3 Graph 2,3) The patients in this study received a fixed dose of 10 mCi for Graves’ disease and relatively higher doses for toxic multinodular goiters based on the size of thyroid gland determined by physical examination and thyroid uptake scan. Of the total of 70 patients who received radioactive iodine 52 (74.3%) patients were treated with an average dose of 5 mCi, range (0-10 mCi) and 18 patients received an average dose of 15 mCi, range (11-20 mCi) of radioactive iodine. The optimal method for determining the appropriate iodine-131 treatment dose remains controversial. Techniques vary from fixed dose to more elaborate calculations based on the gland size and iodine uptake. In calculated dose method, a dose of RAI is administered which is proportional to the size of the gland, this theoretically increases the chances of cure. But studies done by satzal-Mazer et al and Y.Khalid et al have failed to demonstrate any improvement in cure rate with calculated dose compared to fixed dose regim en. In this study ,a good result was seen in 90.9% of patient who received a dose of RAI in the range of 0-10 mCi and 83.3% of patients receiving a dose of 11-20 mCi, but this correlation was not significant.(p=0.403)(Table :4 Figure:4) Studies done by Funda Utsun et al revealed that majority of the patients was treated for Graves’ disease followed by toxic multinodular goiter. In this study also among the patients who received radioactive iodine, the largest group was diagnosed with Graves’ disease (54 patients, 77.2%), followed by toxic multinodular goiter (11 patients, 15.7%). The relatively smaller groups include those with thyrotoxicosis (4 patients, 5.7%) and solitary thyroid nodule (1patient, 1.4%). (Table: 5 Figure: 5) Clinical Graves’ ophthalmopathy was noted in 8 patients (11.4%) in which except one all others were female. 62 patients (88.6%) were free from ophthalmopathy. Of the 8 patients who had ophthalmopathy, 5 patients was treated successfully and hence there was no significant correlation between ophthalmopathy and outcome of the treatment in this study (p=1.00). Studies done by Wisam.K.Ghadban et al found out that there was no significant worsening or new development of ophthalmopathy post RAI treatment. In contrast, a systematic review done by Shamasunder H.Acharya et al concluded that radioiodine therapy is associated with increased risk of progression of ophthalmopathy compared with antithyroid drugs and hence pretreatment with steroids is necessary.(Table:6 Figure: 6) Presence of goiter was assessed clinically by endocrinologists and was documented as either present or absent at the time of radioiodine administration. About 58 patients (82.9%) showed the presence of goiter and in 12 patients (17.1%) the signs of goiter were not present. No significant association was seen in this study on goiter and treatment success. (p=0.326). In contrast, previous studies done by Anthony Lewis et al revealed that patients with small or no goiter were more likely to be successfully treated by a single dose.(Table: 7 Figure: 7) Prior use of antithyroid medication occurred in 63 patients (90%). Of these, 68.57% (48 patients) received treatment for more than one year whereas 21.43% (15) of patients received for a period of less than one year.10% (7) of patients had no pre-treatment with antithyroid medication before RAI administration. Previous studies done by Joyce S Y Yau et al demonstrated that there was no significant association between anti-thyroid medication and radioiodine treatment within one year. (Table: 8 Figure: 8) Among the study subjects who received pre-treatment, majority of the patients were treated with carbimazole (40%, 28 patients), followed by neomercazole (19 patients, 27.2%) and methimazole (15 patients, 21.4%). Only 1 patient among the 63 patients was treated with propylthiouracil (1.4%). All were advised to stop the drugs 7 days before radioiodine administration. A significant correlation was not observed between pretreatment with antithyroid drugs and treatment success (1.00). In a prior study done by Edward Prinat et al ,treatment success was obtained in patients with no pre-treatment and those who have stopped ATD seven days before 131I admnistration, while in the group of patients who received MMI until 131I application,success was significantly lower.(Table: 9 Figure:9) The primary objective of radioactive iodine therapy is to eliminate hyperthyroidism, but what is important to patients is the quickness of therapeutic effect. Graph 10 shows change in mean concentrations of TSH and T4 before and after I131 administration. The result revealed an increase in TSH concentration after the RAI treatment whereas the T4 levels showed a decrease in the concentration which indicates that therapeutic effect is achieved in the hyperthyroid patients. Piotr Szumowski et al came up with a study which showed similar results. (Table: 10 Graph: 10). Thyroid hormone concentrations before and after administration of radioiodine was analysed. A significant difference was found in the concentration of TSH and T4 before and after radioiodine therapy in patients who are on thyoxine replacement therapy after RAI administration (p=0.000 p=0.003 resp.). Whereas on comparing the concentration of TSH and T4 prior and post therapy on who were not on drugs, there was no significant difference (p=0.533 0.057) (Table: 14). As the time after radioiodine administration elapses,the percentage of hypothyroid patients increases. The incidence of hypothyroidism was 38.5 %( 27) in first trimester, 12.8 %( 9) in second trimester and 2.8 %( 2) in the third trimester. A prior study done by Ajith S Shinto et al also similar incidence of hypothyroidism after therapy. (Table: 12 Graph: 12) The assessment of overall efficacy of treatment at one year after I131 administration showed that a euthyroid status was achieved in 24.3% (17) of patients, hypothyroidism was observed in 54.3% (38 patients), while persistence or recurrence of hyperthyroidism was seen in 10% of patients , which revealed that a second dose of radioiodine is required in these patients. This outcome meant that 75.7% of patients require further treatment. In that 38 patients requires further hormone replacement therapy and 7 patients requires a second dose of radioactive iodine. The achievement of euthyroid and hypothyroid status is considered as good result. Studies done by Mosako Tsuruta et al and Sirianong Namwongprom et al also showed similar results.(Table:11 Graph 11)

Russian Reform And Economics: The Last Quarter Of The 20th Century :: essays research papers fc

Russian Reform and Economics: The Last Quarter of the 20th Century Outline Thesis: As the reformation of the USSR was becoming a reality, Russia's economy was crumbling beneath it. Russia began its economic challenge of perestroika in the 1980's. The Russian people wanted economic security and freedom, while the government was trying to obtain democracy. The previous management styles needed to be changed along with the way that most businesses in Russia operated. I. Reformation of USSR A. The change from communism to democracy. B. The change in government has had a great effect on the Russian people and workers. C. The reformation left the Russian economy upside down. II. Post-Reform economy versus Pre-Reform economy. A. There were many steps in the reformation of the economy. B. What are some of the effects of a reforming economy? C. There are many changes that are still needed in order for the Russian economy to grow. III. What will be the future of Russia's Economy? Main Body As the reformation of the USSR was becoming a reality, Russia's economy was crumbling beneath it. Russia began its economic challenge of perestroika in the 1980's. The Russian people wanted economic security and freedom, while the government was trying to obtain democracy. The previous management styles needed to be changed along with the way that most businesses in Russia operated. The Russian Federation consists of 17,075,400 square km, which is roughly 76.2 percent of the former USSR, and covers about 12 percent of the earth's land surface. The Russian Federation's population in 1991 was 147.3 million (Smith, A., 7). During the 1980's the Russian government started a reformation process called "perestroika," meaning restructuring (Aganbegyan, 1). Perestroika signifies qualitative changes and transformation in the government and in the economy. The four stages of perestroika are the "Preliminary stage (March 1985- February 1986)," the "Stabilizing stage (March 1986 - January 1987)," the "Expansive stage (January - November 1987)," and the "Regrouping stage (November 1987 onwards)" (Hill & Dellenbrant, 140). The government also identified two other processes. "Glasnost," which means openness, supported the strong economic reform (Aganbegyan, 1; Hill & Dellenbrant, 54). The acceleration of economic reform was called "uskorenie" (Aganbegyan, 1). Many changes took place during the years contained in each of the stages of perestroika. This changes ranged from government policies and structure to industrial production procedures to economic policies. The major change came in 1991 with the breakup of USSR. This freed the individual states and allowed them to become independent countries. All of these new countries went through radical government changes. Many of them, including Russia, chose to implement democracy. This change from a central military based structure into democracy

William Wordsworth :: essays research papers

One of the most famous poets in literary history is that of William Wordsworth. He lived between the years of 1770-1850. He was a very strong poet and many of his works have some degree of a pessimistic view to them. They could be understood after the hard life he led. He saw the French Revolution at its height and wrote several poems about it. He had an illegitimate daughter with a woman in France. When he returned back to England he married Mary Hutchinson, who gave him two sons and another daughter.   Ã‚  Ã‚  Ã‚  Ã‚  Till this day we can read the famous poems and ballads of Wordsworth. One poem that caught my attention was that of Scorn not the sonnet. The poem is rather interesting and brings up other poets before his time. It also talks about the form and the meaning of a sonnet. He talks of the sonnet as a delicate work of art. Wordsworth describes each part of the sonnet by talking of another poet. He describes how one of the other poets helped shape the form of sonnet writing.   Ã‚  Ã‚  Ã‚  Ã‚  In the first two lines of the poem he is writing of a critic. Wordsworth writes â€Å"Scorn not the sonnet; Critic, you have frowned, mindless of its just honors;† These two lines state the critic or the audience is not able to understand what is being written in the sonnet. Wordsworth from the beginning says that the sonnets hold honor in their form of literary writing. This style of writing was very popular among the sixteen hundreds and most well known writers are known because of their sonnets. The sonnets gave the writers honor as the sonnet took honor of its own.   Ã‚  Ã‚  Ã‚  Ã‚  Next he goes on to say, â€Å"with this key Shakespeare unlocked his heart;† Without going into great detail Shakespeare is none for his incredible sonnets as well as hi plays. Wordsworth here begins to show how each poet contributed to this writing still. He begins off with Shakespeare. Wordsworth explains that through these sonnets Shakespeare’s heart was opened so therefore he was able to write such meaning full sonnets with love and passion. By the honor that was bestowed by the sonnets Shakespeare was able to be more expressive and gain his own honor.   Ã‚  Ã‚  Ã‚  Ã‚  Petrarch, who was one of the early sonnet writers is also one of the great Italian poets. His sonnets dealt with his unrequited love for a woman by the name of Laura.

Important Symbols of Taoism

Throughout history, Taoism has been one of the most influential religions in the Eastern culture. It is one of the most unique of all religions. In fact, many Taoists do not even consider it as a religion, and in many ways it is not. They make no claim that Tao exists. Although very different from others, Taoism also has very important unique symbols. Yin yang diagram, the most important symbol of Taoist represents the movement of heaven or the Tao. The small dots represent the fact that there is good in the evil, as there is evil in the good. Another important symbol of Taoism is the eight trigrams or pakua.Last but not least the dragon is one of the yang symbols, which represents the power, sage and saint. The Yin Yang sign is an old symbol for the universe that has been combined. It shows the two opposing dimensions that give the world its dynamics. It’s used to describe how seemingly contrary forces are joined and dependent in the natural world, and how they give rise to e ach other in turn. Opposites thus only exist in relation to one another. Male and female, light and dark, hot and cold, are thought as demonstration of Yin Yang. The outer circle represents the universe to which all exists.There is a belief that Yin Yang link to good and evil. Taoism believes that even in the most innocent nice people there is evil within them, and even the devil has good inside of him. The eight trigrams of pakua is a group of symbols that hold profound meaning in Chinese philosophy. These symbols represent movement and change. Each of the trigrams is associated with a season, family member, animal, personality, etc. They are ordered into two different arrangements. Primary heaven and future heaven. The arrangements represent the four basic and four minor directions on the compass. South is first at the top.Whichever symbol is at the top represents South. The primary heaven arrangement is organized based on opposite forces. The primary Heaven arrangement is organiz ed on the cyclic nature of the world. The eight trigrams are Heaven-Sky-Air, Earth, Water, Fire, Wind, Thunder, Lake Valley, and Mountain. Lastly, the Yin Yang dragons combine really powerful ideas. The yang dragons radiate a bright, positive charge. This energy is really physical, and often, brave, and outgoing. The Yin dragon’s energy is totally the opposite. Influenced by the planet Venus, Yin dragons release a negative energy.This darker type of energy is usually in a female nature. No matter what the religion is, symbols play a big role. There is profound meaning into such insignificant objects. The Yin Yang diagram, the most important symbol of Taoism, the eight trigrams of pakua that represent movement and change, and the powerful Yin Yang dragons. Citations: . Center of Traditional Taos. . Cdot. org. 26 Nov. 2010. Zhou GuoXin. . Important Symbols of Taoism Throughout history, Taoism has been one of the most influential religions in the Eastern culture. It is one of the most unique of all religions. In fact, many Taoists do not even consider it as a religion, and in many ways it is not. They make no claim that Tao exists. Although very different from others, Taoism also has very important unique symbols. Yin yang diagram, the most important symbol of Taoist represents the movement of heaven or the Tao. The small dots represent the fact that there is good in the evil, as there is evil in the good. Another important symbol of Taoism is the eight trigrams or pakua.Last but not least the dragon is one of the yang symbols, which represents the power, sage and saint. The Yin Yang sign is an old symbol for the universe that has been combined. It shows the two opposing dimensions that give the world its dynamics. It’s used to describe how seemingly contrary forces are joined and dependent in the natural world, and how they give rise to e ach other in turn. Opposites thus only exist in relation to one another. Male and female, light and dark, hot and cold, are thought as demonstration of Yin Yang. The outer circle represents the universe to which all exists.There is a belief that Yin Yang link to good and evil. Taoism believes that even in the most innocent nice people there is evil within them, and even the devil has good inside of him. The eight trigrams of pakua is a group of symbols that hold profound meaning in Chinese philosophy. These symbols represent movement and change. Each of the trigrams is associated with a season, family member, animal, personality, etc. They are ordered into two different arrangements. Primary heaven and future heaven. The arrangements represent the four basic and four minor directions on the compass. South is first at the top.Whichever symbol is at the top represents South. The primary heaven arrangement is organized based on opposite forces. The primary Heaven arrangement is organiz ed on the cyclic nature of the world. The eight trigrams are Heaven-Sky-Air, Earth, Water, Fire, Wind, Thunder, Lake Valley, and Mountain. Lastly, the Yin Yang dragons combine really powerful ideas. The yang dragons radiate a bright, positive charge. This energy is really physical, and often, brave, and outgoing. The Yin dragon’s energy is totally the opposite. Influenced by the planet Venus, Yin dragons release a negative energy.This darker type of energy is usually in a female nature. No matter what the religion is, symbols play a big role. There is profound meaning into such insignificant objects. The Yin Yang diagram, the most important symbol of Taoism, the eight trigrams of pakua that represent movement and change, and the powerful Yin Yang dragons. Citations: . Center of Traditional Taos. . Cdot. org. 26 Nov. 2010. Zhou GuoXin. .

Dr. Victor Frankenstein †The True Monster Essay

The worst kind of monster there is in this world is the kind that totally dismisses the power of love and does everything to destroy believe in this great and wonderful virtue. In Mary Shelley’s ‘Frankenstein’ where Dr. Victor Frankenstein creates a creature from the parts of various corpses and gives it live, the matter of love becomes a central element and this love is what clearly distinguishes the human from the true monster. Mary Shelley’s â€Å"Frankenstein† explores the two levels of love and these two levels are what set apart Dr.Victor Frankenstein as the true monster from the creature that he created because albeit the monstrous external appearance of Frankenstein’s creation, the creature proves more capable of love than its creator. The novel begins with a letter written by Robert Walton to his sister where he describes witnessing a huge creature in the arctic pursued by Dr. Victor Frankenstein. â€Å"Walton records Frankenstein’s narrative, while Frankenstein in turn relays the monster’s narrative, so that there are layers of reality expressed through different characters’ points of view. † (Johnson) From this initial glimpse of the ‘so-called’ monster, the novel unfolds to eventually show that the true monster in the novel is in fact the doctor and not his creation. Apart from the expectations of readers, the creature of Dr. Victor Frankenstein eventually evolves into an individual who can think logically, prove to be more articulate, and more importantly, more capable of love compared to its creator. This alone is evidence that between the two characters who drive the novel, the creature is in fact the one that is presented as the symbol of intrinsic emotions apart from the superficiality that Dr. Frankenstein portrays. In exploring the personality of Dr. Frankenstein in the novel, his monstrosity inevitably emerges. For instance, in the lines, â€Å"Life and death appeared to me ideal bounds, which I should first break through, and pour a torrent of light into our dark world. † (Shelley, Ch. 4) the doctor proves to possess a distorted perception of the world at large. Here, he looks at the world as a place of darkness which needs his scientific prowess as it moves into the light. Aside from the fact that this puts too much weight on his shoulders, this quote also shows his conceit and bloated ego. These lines validate the doctor’s obsession with life and death and how he has the power to control it; only a few levels short of wanting to rule the world as is common with all villains. These lines also express the intentions of the doctor when he creates his ‘so-called’ monster. In this context, the doctor seeks to penetrate natural laws not in the interest of the evolution of science or the welfare of the public but because he would simply want to exercise his assumed power over natural laws. This, in effect, presents the doctor as a mad scientist who is guided by values that are way beyond the values of someone sincerely concerned with the plight of humanity. This initial presentation of Victor sets the tone for the audience and gives them a glimpse of what is to come. With the intentions and personality of this doctor exposed in the way he is characterized, one can easily see that the novel will definitely take a twist that would have the monster gaining the upper hand in terms of sanity and morality. This is validated by another quote from the doctor that states, â€Å"A new species would bless me as its creator and source; many happy and excellent natures would owe their being to me. † (Shelley, Ch. 4) where the doctor very clearly expresses his dark intentions which is to want to have other natures ‘owe their being’ to his work. Here, one sees that the doctor seems to be suffering from a God-complex which to most is the delusion of being someone who can create life and hence, derive power from this ability. Victor, therefore, becomes an individual of thwarted beliefs and one who does not respect the established laws of the universe; of course, the consequences of this are later expressed in the way his monster turns out to be. In comparison to the doctor, the monster as it has already been created presents or manifests critical thought and a deeper and more logical perception of things as opposed to how its master perceives it. This initially sets the stage for a diametrical opposition between the personalities of these two characters. The monster first begins to question his existence, hence, the line, â€Å"â€Å"God in pity made man beautiful and alluring, after his own image; but my form is a filthy type of yours†¦. † (Shelley, p. 154) Here, the monster demonstrates an understanding of natural laws in recognition of God as the creator of man and the circumstance by which man was created as being ‘after his own image’. In looking at his image, the monster concludes that his is a ‘filthy type’ of the image of his creator, Victor Frankenstein. In effect, the monster is now question how a creation can be a substandard version of its creator’s when natural law dictates that the creature has to be ‘beautiful and alluring’ like its creator. There is a deep philosophical insight in this statement by the monster which challenges the humanity of the doctor himself. The mere fact that the monster perceives itself as a ‘filthy’ version of the creator implies that the creator may in fact be human on the outside but a monster on the inside because if the matter of the likeness of God is applied to this supposition, man is created not in the physical likeness of God but in His spiritual likeness. The monster therefore, is an external reflection of the internal nature of the doctor. However, despite this superficial image, the monster develops its own volition and evolves into a thinking-feeling individual who is not restrained or enslaved by the distorted values of its creator. So, the monster begins to recognize this fact and is initially bound to its creator, hence, the lines, â€Å"â€Å"I learned from your papers that you were my father, my creator, and to whom could I apply with more fitness than to him who had given me life? † (Shelley, p. 165) The monster, in these lines expresses two values – the first, being his recognition of the importance of the acquisition of life as a basis for respect, and second, the recognition of the worth of the person who had given it life. For a monster, these realizations are quite distant, but in the case of Frankenstein’s monster, such realizations seemed to come naturally which all the more validates the clear and discriminating thought process of the creature. Another insight that could be derived from these lines is the presence of a deeper emotion than respect – love. The monster, upon referring to the doctor as its ‘father’ gives a deeper dimension to this statement because the word ‘father’ is different from creator; the word ‘father’ is not just a recognition of creation or pro-creation for that matter, but also a recognition of the nurturing nature of the individual. The monster, therefore, by referring to the doctor as ‘father’, is aware of the fact that whoever created it also had the task of nurturing it whether physically or emotionally. In another instance, one sees how the monster acquires its savage nature only as a reflection of the savage nature of the creator. This is seen in the lines, â€Å"â€Å"I am malicious because I am miserable†¦. You, my creator, would tear me to pieces, and triumph; remember that, and tell me why I should pity man more than he pities me? † (Shelley, p. 173) Here one sees that the reason why the monster had developed a hatred for man was because the creator had exercised a certain degree of hostility toward the monster. While in natural circumstances this may simply be construed as cruelty, in this particular instance, the monster is able to perceive the reasons for the hostility and manifest it in its own existence. Therefore, the monster is not savage; instead, it had become savage in response to the hostility of its creator. It will also be recalled from the novel that in the desperation of the monster for social acceptance it implored the doctor to create for it a wife, hence, the lines â€Å"â€Å"I am alone, and miserable; man will not associate with me, but one as deformed and horrible as myself would not deny herself to me. † (Shelley, p. 171) Now, in connection to this particular incident, the doctor did create another monster out of scrap female body parts and introduced it to the first monster as its wife, however, the more horrible thing in this particular instance is the fact that the doctor destroys the female monster and angers the male. In the earlier lines, one can easily glean that the male monster had perceived its appearance to be the reason for its isolation and hence, demonstrated it’s human nature which is in fact beyond the human nature of the doctor who is consumed by his own power and takes away from the male monster the only opportunity at acceptance and love. The incident where the monster kills the wife of Victor on the night of their wedding therefore becomes immaterial to whether the monster has human qualities or not, in fact, it validates its humanness as it demonstrates a significant response to the feeling of remorse and hatred for the inhumanity that was committed upon it by the doctor; and so, this particular incident changes the monsters point of view completely, but it should not be denied that this change of perception is not because of the volition of the monster but as a result of the savage and insensitive actions of Victor, its creator. So, the monster then states, â€Å"â€Å"[T]he human senses are insurmountable barriers to our union†¦. [I]f I cannot inspire love, I will cause fear†¦. † (Shelley, p. 173) Now, if one was to peruse this line as it is without considering the underlying circumstances, it would seem that the monster had become irrational and wild, but with the perusal of underlying circumstance, the monster becomes very logical in its responses. â€Å"It is therefore, plausibly suggested, that the Monster can be seen as a metaphor for the destructive power of unleashed passion. â€Å" (Pearce) This basically shows that the creature is not really the monster in the novel as demonstrated by its insights and responses, and the real monster is the doctor, who, apart from being obsessed with the power of being able to create life, relegates his creation as a monstrosity and totally dismisses the possibility that this creation also has the same degree of emotions and logical thought that he has as its creator. â€Å"Dr. Frankenstein continually underestimates the being’s malice and power. † (Thripp) This is the deadening mistake of Victor and this is what makes the distinction clear between him and his creation. Both seek love, as is shown in Victor’s desire for his wife and the monster’s need for a partner, but it is the way these two men act on the love that had been acquire that sets each other apart. Victor takes this love as if it is natural and ordinary, while the monster perceives it as something that is of great value because of his physical inadequacies; Victor, therefore, becomes more savage than the monster in this aspect, hence, â€Å"the secret is not that he created a monster; the secret is that he is the monster. This intensifies his guilt and seclusion, adds weight to his terrible illness and remorse,† (Thripp) It will be seen towards the end of the story that Victor grows insane and pursues the monster until they finally meet in the arctic. Here, the doctor dies and the creature mourns the loss of its master. This, again, is an expression of humanity, because the monster, despite being victim to the hostility and insensitivity of its creator still felt a certain degree of indebtedness and love for Victor, whom the monster fully recognized and respected to be its sole source of life. The monster, in these final scenes in the novel, validates its humanity over the humanity of the doctor by ignoring all past evils of its master and transcending hostile emotions to recognize the supremacy of love and compassion. In validation of this compassion of the monster, he says, ‘†I do know that for the sympathy of one living being, I would make peace with all. I have love in me the likes of which you can scarcely imagine and rage the likes of which you would not believe. If I cannot satisfy the one, I will indulge the other. † (Shelley) Here one sees that when said by a physically horrible creature these words might seem to be a threat but if the humanity of the creature is superimposed against the reasons for the creature’s existence, then a perfect and complete humanity emerges. â€Å"All the references to monstrousness are metaphors for Victor’s black heart, and that Shelley has created a work of art that is truly Romantic; the entire novel miserable and revolutionary, a battle of light versus dark, good versus evil, all wrapped up in one self-contradictory character. † (Thripp) In conclusion, it is not really the ability of the doctor to create life that is the meat and the matter in this novel; instead it is the conflict of morality that arises from his creation of life. While some argue that this novel alludes to the duality of the personality of Dr. Frankenstein, analyzing the novel deeper would tell one that over and above the dramatic circumstances in the tale, the author offers deep and surprising insights into the nature of humanity. The monster as a symbol of unbounded humanity succeeds in the author’s intention of relegating the real human, Dr. Frankenstein into a domain where readers might question his integrity as a human and as a sane individual. The saner element therefore becomes the monster and the doctor becomes a representation of the dark and savage nature of man which is only expressed in exaggeration in the monster only to highlight or reflect the evil and savageness that dwells in the heart of the true monster, Dr. Frankenstein. Finally, one has the line, â€Å"I may die; but first you, my tyrant and tormentor, shall curse the sun that gazes on your misery. Beware; for I am fearless, and therefore powerful. † (Shelley, Ch. 20) which seals the fate of the monster as one who is more human than its creator. This line expresses one other aspect of humanity that determines how one survives and that is the absence of fear. Victor Frankenstein, in the way he is portrayed in the novel did not fear dabbling with the laws of nature, but upon setting eyes on his creation began to fear what he saw. In effect, the doctor had developed not a fear for the unknown and what should be feared but a fear for his own reflection as portrayed in the monster. He feared the horrors that he saw of himself in the monster. The monster was a mirror of the darkness that pervaded his soul and the misplaced feat that manifested itself in his desire to create life despite traditional values that tell him to do otherwise. So, based on the textual evidence presented in the novel it is quite clear that while numerous philosophical implications can be attached to the text, Victor Frankenstein actually emerges as the monster over and above the superficial monstrosity of his creation. The monster therefore, proves to be more human than its creator in more aspects than one and proves its humanity in the end by showing a sincere and exceptionally deep sense of compassion and logical emotion. ? Works Cited Johnson, Diane. â€Å"Mary Wolstonecraft Shelley, Frankenstein . † Greenman Review. N. p. , 2008. Web. 15 Aug. 2010. . Pearce, Joseph. â€Å"The Misunderstood Monster. † Ignatius Critical Editions. N. p. , 2008. Web. 15 Aug. 2010. . Shelley, Mary W. â€Å"Frankenstein. † N. p. , n. d. Web. 15 Aug. 2010. . Thripp, Richard. â€Å"Victor Frankenstein: Trodden Hero or Veiled Villain?. † Scholarly Essays. N. p. , 2008. Web. 15 Aug. 2010.

Vacant Chapter 16 Emily

This has to be perfect. Ethan is the most amazing man, and I don't want to disappoint him. So everything has to be flawless. Margie has been a huge help, though, and I don't think I could have – or would have – done this without her. Sometimes I'm so out of my element with this whole love and relationship thing. I know Ethan has more experience, but still†¦ I want him to know how much he means to me. Margie had me over for a girl's night where we watched what she called â€Å"chick licks.† She insisted that the surest way to be able to pull off the perfect anniversary was to see examples of perfect love on the big screen, or a forty-two inch, anyway. We started brainstorming and came up with a plan; a pretty good one if I do say so myself. Now I just have to make sure I don't mess it up. So here I am, standing in the middle of our living room in a new black and pink lace lingerie set and enough lit candles that I may, in fact, set off a smoke alarm. Of course, Ethan has seen me in much less that bra and panties, but these seem†¦dirty somehow. Because of the purpose for which they are intended, the pink and black lace seems obscene. I hadn't wanted to get the â€Å"tonga† cut, but Margie insisted it was the look needed for the occasion. I'm more of a cotton brief kind of girl. All the panties we looked through were so small†¦ and in bright lacy colors, nor did they seem practical. I really hope Ethan doesn't expect fancy panties all the time because I cannot see the practicality of wearing this style on a daily basis. Particularly if one has to frequently bend or stoop I glance at the clock on the wall, which was purchased at Hobby Lobby, thank you very much, and know that Ethan will walk through the front door at any moment. I shouldn't be this nervous, but we have grown so much together in the last year, both in heart and mind. I know without a doubt I will be with this man forever, and I want to experience every last thing imaginable with him. When I hear the key in the door, I close my eyes and take a deep breath. Within seconds of the door opening and closing, I hear a loud gasp followed by, â€Å"Holy shhiiittt.† Ethan is in front of me, hands exploring my backside after only a few seconds. I wonder if he sprinted, even though the distance from the door is only a few steps. It makes me relax, realizing he appreciates my gift a great deal. â€Å"Baby, you smell so good,† he whispers. His lips– then teeth skim my neck and shoulder. The contrast in sensation takes my breath away. â€Å"Fuck. What did I do to deserve all this? And you?† I'm frozen for a second because I think he's forgotten what today is. He thinks this is just a random tryst. And while we are extraordinarily honest with each other, I can't bring myself to tell him what this is really about. A pang shoots from my heart down into my stomach. â€Å"Whoa, whoa†¦Ã¢â‚¬  Ethan pulls away and looks at me. I try to smile, but it's wholly unsuccessful. It makes my throat tighten more, and I need an escape to the bathroom to shed unwanted tears. This isn't how it's supposed to go! He's supposed to see me, sweep me off my feet, pledge undying devotion, and make love to me for hours. Damn you, Hollywood! You're a liar. â€Å"Emily, what's wrong? What did I say?† He turns away from me at the moment my lips quivers. He's fisting his hair, mumbling to himself. Even though I still have on a bra, panties, and stupid black heels Margie insisted made the look perfect, I've never felt more exposed. I want to sink into the carpet, wishing the last half hour hadn't ever happened. Stupid, Emily†¦why do you always have to do something different or fancy? Why not just make fried chicken for dinner and get him a nice card, I argue with myself. â€Å"Shit! Why did I have to say something stupid on our anniversary? I try, Emily. I want to be good for you, I do. I just can't get it right, ya know? God, please say something.† †¦stupid on our anniversary†¦ â€Å"You know it's our anniversary?† I could have heard incorrectly. â€Å"Well, yeah. How could I forget our anniversary? I can't forget a thing about you, Emily.† He starts to walk toward the couch and grabs my hand, pulling me behind him. He flops down then pulls me into his lap. His thumb graces the outer edges of my smile. He didn't forget. â€Å"I remember that you hate high heels.† His hand ghosts down my leg and then draws my leg up. He grasps my spiked heel and slips it off my foot. He tosses the shoe to the floor before he begins to rub my toes. After a few moments, his hand slides up my arm to my neck, landing on my earlobe. â€Å"I remember that you only wear stud earrings because you're afraid of getting them caught on something.† His tongue snakes out a lightly traces the tip of my ear. â€Å"I also remember that you don't wear necklaces†¦.† His hand floats to cup my neck and then draws a finger down my breastbone and into my enhanced cleavage. Ethan shifts on the sofa and pulls something from his pocket. He hands me a small black box with a red bow. â€Å"But I'm hoping to change that.† Ethan finishes. I open the box and see the most delicate, yet beautiful necklace. A small silver disc holds the date we pledged our love for each other. One year ago, today. I find that I can't resist this thoughtful man. Not only has he not forgotten our anniversary, but he has also purchased the perfect gift. I seductively maneuver myself so that I'm facing Ethan. I straddle his lap and then kiss him like my life depends on it. â€Å"It's perfect. You're perfect,† I mumble in between kisses. I always get this feeling when Ethan and I are about to do it. It's still a million tiny butterflies bouncing in my stomach trying to break free. Honestly, it's the best feeling. The greatest part, though, is that each time is better than the last. I'm not sure if Ethan has been swapping stories in the stock room – although I doubt it, it's not his style – or reading up on the internet, but things have really†¦exploded for us in the bedroom department. There was a Get-to-know-you period, which was followed by the Awkward-movements period. Then there was the This-works-so-let's-do-it-this-way-all-the-time period. Lately, we'd found the â€Å"Life is like a box of chocolates†¦Ã¢â‚¬  period. And let me tell you, I may not know what I'm â€Å"gonna get,† but that shit is good. â€Å"Chocolate† is never a bad thing. â€Å"And I remember,† Ethan pauses, breathing me in. â€Å"You love it when I kiss you here,† he finishes and then sucks my nipple into his mouth. The contrast in sensation of his soft, wet mouth and the lace fabric has me beyond aroused. â€Å"New rule: all panties must be like this.† His hands rub across the exposed flesh of my butt, grabbing a handful of cheek to accentuate his point. Ethan's kiss is now languid, his tongue reaching out and teasing my body. As he moves upward, our eyes connecting once again, he beckons my mouth to open and allow him inside. I'm totally lost to this man and would submit to anything he wanted but after a few moments, I remember I have a plan. â€Å"Let's move to the bedroom,† I say in my most seductive voice. â€Å"I have more surprises for you.† Before I even have a chance to stand, Ethan grabs me and stands, coaxing me to wrap my legs around him. He doesn't carry me like this often, but when he does, there is no safer feeling in this world. He is totally supporting me, exerting his masculinity. I feel small pressed against him – a protector and his charge. â€Å"I love you,† I whisper and rest my head on his shoulder. The journey down the hall to the bedroom is too short. I could stay wrapped up in Ethan this way forever, but I have a massage to render, so I regrettably pull myself from the security of his arms. â€Å"Clothes off and lie down,† I command. Ethan raises a brow at me, showing he's a little shocked by my demand. His smile, however, tells me he likes it. He quickly sheds his clothes and lies face down on the bed. â€Å"No peeking,† I say while removing my bra and panties. I grab the oil from the nightstand and pour a liberal amount in my palm then rub my hands together. I slide my hands over his back and down over his backside, eliciting a moan from Ethan before I move myself into position. I shift and sit on top of his butt, cautious about fully putting my weight on him. â€Å"Is this okay? I'm not too heavy, am I?† His barely intelligible grunt of no helps me relax a little more fully on top of him. Per Hollywood protocol, I've trimmed myself so that I'm mostly exposed. I can't help but grind against him, my bare skin seeking friction with his. â€Å"Emily, that feels so good, but I can't stand it. I gotta turn over and see you.† I rise up to allow Ethan to turn. His hands immediately glide up my legs, his thumbs moving inward. They brush against the smooth skin that hides my clit. â€Å"Say it for me.† I know what he wants, as it has been Ethan's new fascination. I turn red because no matter how many times I say it, I know it will embarrass me. â€Å"Come on, say pussy for me. Tell me how you want my tongue on your pussy, then your mouth on my cock.† I respond with a small yet nervous laugh. â€Å"Come on, my sweet baby girl,† Ethan coaxes. Anything for this man†¦ â€Å"First, Ethan,† I begin with a little attitude. I can do this, and possibly without giggling. â€Å"I want my mouth on your cock.† I make sure to punctuate the word cock. â€Å"Then I want your mouth on my†¦ pussy. And after I've screamed your name†¦I want your cock in my pussy,† I say wanting to add a little naughtiness. That should do it. â€Å"Holy – † Ethan doesn't finish his thought as his words are replaced with vowel sounds when my mouth takes him in. It took me a few tries to get used to the idea of his†¦cock†¦in my mouth, but now there are times I crave it. Ethan says the same thing about going down on me. â€Å"Bring that pussy up here. I need you in my mouth. God, Emily, I – â€Å" I know what he means, even though he doesn't finish saying it. It's always like this, and I hope it always will be. Sometimes, I think I could just come without him touching me; just thinking about his hands and mouth on me is enough. I feel like this level of obsession can't be healthy, though and I shouldn't want someone so much, so often. â€Å"Oh fuck†¦.fuck, fuck. Emily, stop.† Ethan lifts me off of him and lays me on my stomach. He licks down my spine and softly bites my ass. His hands grab at my flesh, separating my cheeks. â€Å"Push your ass up a little, baby. Let me see that perfect little pussy.† Unnnfff†¦ As soon as I comply, his tongue is back on me, tasting me. He's a master at this now. His thumbs rub at my clit while his tongue lavishes attention to my pussy. It only takes a minute before I'm panting and trying to grind my pelvis into the bed. â€Å"Nuh uhh. Keep those hips up,† Ethan reminds me. As much as I enjoy this, I really want the main event. â€Å"Ethan,† I moan. I hope my needy groan tells him I can't wait anymore. â€Å"Don't beg. Never beg, sweetheart.† Ethan pushes me forward, and my chest is now pressed into the mattress. He holds his cock and strokes me a few times before drawing back and sliding inside me. The description of fullness seems so trite, but it's the most accurate description. When Ethan enters me, we are connected, one in mind, body, and soul. â€Å"I wish you could see this, Emily; how my cock glides in and out of you†¦seeing your wetness on my dick.† Ethan stops and runs his hand down through my lips, gathering moisture. â€Å"Turn over.† He grasps his cock and begins to stroke himself. Within seconds, his lips are back on my breast, tugging at my nipple with his teeth. After a few more moments, he leans back, hooks my thighs with his forearms, and pulls me forward. He wastes no time in aligning himself and sliding home again. With my legs pushed back, he can get so much deeper and I feel him in my belly. His thrusts become aggressive and I know that he's close. â€Å"Do you want me to take you this way, or do you want to ride me, so I can see your tits bounce?† Ethan quickly adjusts himself so that he's sitting up. He pulls me into his lap. â€Å"Or maybe like this, so I can see your perfect face and the glisten of sweat that forms on your nose as you come?† All of Ethan's dirty talk is driving me crazy, and quite frankly, I don't care how we get the job done because I'm ready to burst. He lies back, pulling me with him. His hands knead the flesh of my breasts as I moan and writhe on top of him. â€Å"I want to come inside you, baby,† he pleads. I'll never deny him. As soon as we are connected again, we grasp hands, me using him for leverage. The first few times we did it this way, I felt self-conscious, but now I love the feeling of control and power I have to bring him to his end, to coax his lust and love from his body as it spills into mine. I meet my climax first, but Ethan soon follows. We collapse together, me still on top of him. I hug him like a child hugs her favorite teddy bear, and feel safe, warm, and satisfied. We lay together for a while, just caressing and kissing. It is always like this – the tenderness afterward. We'd never†¦ deep breath†¦ fucked. I adored our lovemaking, but also wanted to know what it felt like to be taken in the dressing room of Victoria Secret or the bathroom stall at a nightclub. But we had time, time to experience all of those things. This was the end of one year in a long line of many. Margie says that's love and I just need to go with it. She explained there is a natural progression and I won't always ache for him. She explained that– eventually, he'll just be a small pain in my ass. â€Å"I love you, Ethan.† â€Å"I love you, Emily. Happy anniversary.†

tories, fairytales and myths

Stories, fairytales and myths that were created thousand years ago are relevant today. These folklores have provided the basis for some cultures and in some cultures is a way of life. Stories and fairytales are relevant today, because they often have hidden meanings, which are often times used as examples in everyday life.Take for instance the story of the Tortoise and the Hare, this story shows that being big and strong does not help you to win, but using your wits and your brain is what helps you to overcome certain things. It also teaches us today, that slow and steady won the race and it never pays to be in a hurry and brag about how good you are.The story of Cinderella is relevant to today’s society as, you still have a lot of Cinderalla’s around. Especially the part about the wicked stepmother and how her siblings treated her. This story of Cinderella is all too real within our present day society, and it is up to us to rescue the Cinderalla’s of our time.G reek mythologies are very important and relevant to today’s society. From the story of Pandora we have the concept of beautiful evil, which is still prevalent in our society. Pandora was the image of a perfect, beautiful woman, she was created to please the eye and deceive mankind.This idea of a ‘beautiful evil' is still present in today's society. In the mass media viewers are constantly bombarded with images of beautiful women in sexual roles and evil roles.Women are often portrayed as gifts to men and then become detrimental to them. This ‘good girl gone bad' image has its roots in Pandora's myth. Pandora was a perfect, beautiful woman when Epimetheus took her as his wife. But Pandora was a little too curious. Her weakness and inferior mind led her to open the container and release all of the evils onto mankind.Stories today form the basis of many cultures, as stories in some cultures are handed down from generation to generation, to teach life lessons and illu strate the folly of mankind. Often time’s stories are used as references and examples, when disciplining a troublesome child or are used as a way to inform a person of the consequences of their actions. An example of this is the story of the Boy Who Cried Wolf. This little boy cried wolf so many times that he was not believed when the wolf actually came and took the sheep.This serves as a lesson to would be liars, children and even adults who like to play pranks. The moral of the story is that, sometimes when you lie or make things up a lot, it is very hard for anyone to believe you. In the end the young boy learned his lesson.Some people argue that stories, fairytales and myths are rubbish and have no relevance in today’s society, but in my opinion, they do give relevance to the meaning of life, and what it is to love and live. You can live and not be happy. Fairytales especially, the ones like Cinderella make you believe in happy endings. Happy endings still exist to day, regardless of what people think.The story of Hansel and Gretel has a moral to it, that appearances are deceiving. This is very true in today’s society. Appearances among people are very deceiving and often times, you get trapped by the very person that seems to want to help you, only to destroy or try to destroy you in the end.To me the fairytale of Hansel and Gretel speak of caution and cautions people to beware of who they are around. I also think that Hansel and Gretel is a great story for teaching children not to trust strangers and to be aware of the people they are around. In conclusion, stories, fairytales, and myths are just as relevant a today as they were thousands of years ago.Works CitedTyree, R. (1998). Pandora. Retrieved April 15, 2008, from http://www.arthistory.sbc.edu/imageswomen/papers/tyreepandora/pandora.html