lymph normally react to

1. infections
2. dirt
3. cancer

they may also enlarge because of abnormalities

1. benign
   1. sarcoid
   2. sinus histiocysis
2. malignant
   1. contain cancer that has spread
   2. tuberculosis
   3. lymphoma
      1. cells multiply and fail to mature properly
         1. dozens fo types
            1. go away
            2. life threatening

Pet CT

1. lymph nodes that are larger than normal
   1. over 1 cm diameter
      1. 1-2 cm borderline
2. lymph nodes that take up more glucose than normal
   1. Warburg effect
      1. correlates with malignancy
      2. node is unsually active

enlarged nodes that are deep inside are not easily accesible

therefore: surgeon

laporoscopy

tube inserted into the abdomen to get the biopsy

SUV: standard uptake value: relative amount of suugar in the hot nodes

very hot nodes have SUV 10 or more

?

serum protien electrophoresis

your pattern

immune system "stuck"

Normally the immune system produces antibodies

tags that identify foreign things like

germs

parasites

cancer cells

When the body comes in contact with one of these, it produces the matching tag

But normally, there is a constant improvement so there is never alot of one tag

Normally, no tag is present in high enough concentration to produce the spike

The spike means something is abnormal

This condition is called a monoclonal gammopathy

There are a number of potential ways that this can harm a person

1. break bones
1. a lump of these cells
   
2. decrease immunity
3. protein can mess up the kidneys
4. it can cause neuropathy

Emor: Flawless

the emphasis on flawlessness - for priests and sacrificial animals- in this weeks Parsha is unmodern. It is a violation of the Americans with Disabilities act. However, I think that the treatment of the flawed is far better than the Germanic tradition of eliminating them. In fact, recently we have had the Germanic tradition applied to us! Unfortunately, all Jews were defined as flawed.

I think this dovetails with the Mishna Yomi. Today's Mishna describes the " burnt" sacrifices, the most holy of the sacrifices ( Yom Kippur, errors of the Sanhedrin or High Priest). An interesting aspect of these sacrifices was that the carcases were burnt not on the alter but in the trash dump. The blood, the place of the nefesh, was used; but the body, so subject to flaws, whose fundamental use is the propagation of the species, is of no importance when the expiation is so lofty.

Needless to say, the daf yomi discussion of congealed, melted, human corpse material is evocative.

Emor: Flawless

the emphasis on flawlessness - for priests and sacrificial animals- in this weeks Parsha is unmodern. It is a violation of the Americans with Disabilities act. However, I think that the treatment of the flawed is far better than the Germanic tradition of eliminating them. In fact, recently we have had the Germanic tradition applied to us! Unfortunately, all Jews were defined as flawed.

I think this dovetails with the Mishna Yomi. Today's Mishna describes the " burnt" sacrifices, the most holy of the sacrifices ( Yom Kippur, errors of the Sanhedrin or High Priest). An interesting aspect of these sacrifices was that the carcases were burnt not on the alter but in the trash dump. The blood, the place of the nefesh, was used; but the body, so subject to flaws, whose fundamental use is the propagation of the species, is of no importance when the expiation is so lofty.

Needless to say, the daf yomi discussion of congealed, melted, human corpse material is evocative.

Kodoshim: Shoah

This weeks parsha i is Kodoshim; what we call the victims of persecution, the victims of the Holocaust. The Mishnah Yomi program was established as a Memorial to the victims of the Holocaust. In that program, we recently completed Nezikin.

The parsha contains the verse (19:16):לֹא-תֵלֵךְ רָכִיל בְּעַמֶּיךָ לֹא תַעֲמֹד עַל-דַּם רֵעֶךָ. The idea of standing by the blood of your friend has always reminds me of the American reaction to the Holocaust.

This year, I am struck by the juxtaposition of the idea of commerce to the idea of standing impotently as millions of relatives were slaughtered, sanctified. It was probably commerce that brought many from Europe to America. It is hard to know how much standing idly by was motivated by the desire not to interrupt commerce. Thus, the simultaneous completion of the section of the Mishnah dealing with commerce at this time of year strikes me as ironic. Furthermore, the section ends with laws pertaining to judicial error. It raises the question of whether there were errors of judgment on the part of our leadership at that time.