New Test May Mean Faster Breast Cancer Treatment

Well there is a new test that has led to the conclusion of a quicker detection of breast cancer in breast cancer victims. This will be unlike the previous method that involves the use of a genome test that would apply to lymph-node negative and estrogen receptor positive breast cancer. It is applicable to all women diagnosed with breast cancer. The research was done by Dr. Matthew Ellis of the Siteman Cancer Center at Washington University in St. Louis and Barnes Jewish Hospital. They tested over 1000 breast cancer tumors and found 50 genes to would help identify the 4 different types of breast cancer tumors known. Which are Luminal A, Luminal B, HER2-enriched, and basal-like tumors. The genetic test performed was called an OncotypeDx however it doesn’t identify all of the types. The first type they decided to incorporate was basal-like tumors and they did so by molecular profile basis. This is believed to be important because basal-like tumors have shown to have caused the most severe and aggressive types of cancer yet they are the most sensitive to chemotherapy. A 5th type of breast cancer tumor can be seen at times called the normal-like which is actually an indicator as it is really an insufficient amount of tumor cells to make a diagnosis. The 50 gene treatment was very accurate when predicting how the cancer patients would react to chemotherapy. Luminal A was not sensitive to chemotherapy; Luminal B was the least sensitive and Basal-like was the most sensitive. This is very important because breast cancer is very treatable when discovered early and now with this new information the cancer will be found sooner therefore treatment will begin right away. It also gives a good idea of what type of treatment will be most efficient and which will most likely fail.

http://doctorslounge.e-healthsource.com/?p=news1id=623982

Microfracture Knee Surgery.

Microfracture surgery is a procedure that treats damage in the knee by actually creating tiny fractures in the bone. After first going in and cleaning out calcified cartilage the surgeon creates tiny fractures in bone. These fractures cause a cascade that lead to the creation of new cartilage. This procedure is considered an intermediate step in treatment of the knee. It is also used in order to avoid having to have a partial knee replacement or total knee replacement. This procedure is used to treat pain in the knee from arthritis, cartilage damage, and lesions in the knee.
The downside to this procedure is that the new cartilage created is not as durable as the original cartilage.

This procedure has been most notably performed on athletes in the NBA. The results however have been mixed. Some players return have a full recovery and return to level of play they were at before the procedure. Others however, are not as lucky. Some return to the game and are different player while others never fully recovered and were forced to retire. Due to the high stress on the knees in basketball it is tough to predict how any one player will recover.

I chose to research this article because recently a player on the Houston Rockets elected to undergo this procedure and I was curious to what it was. I thought it was a procedure to actually repair microfractures in the bone, not create them. After learning about this procedure I feel that can be improved in the future by biomedical research. Stem cell research could make this procedure more effective as it could improve the cartilage that is made to where it resembles the original knee cartilage.

High Altitude Sickness

I am writing this article about the cause and treatment of high altitude sickness for those who hold the hobby of mountain hiking and desire to stand atop Mount Everest.

Atmospheric pressure results due to the pulling of gas molecules by earth’s gravity. Air at a certain level is compressed by the weight of air above it. Therefore, the air pressure at high altitude has less pressure because less air is pushed down from above that leads to a lowering in air density. There are fewer oxygen molecules available even though the air has still 21% oxygen by composition

While climbing high altitudes, the availability of oxygen falls and body responds the condition by increasing the blood flow to the brain. It can overcompensate and the fluid leaks from the blood vessel into the brain causing it to swell which results in Acute Mountain Sickness to severe swelling condition called High Altitude Cerebral Edema. In some bad cases, the brain gets squeezed out down the spinal cord and then one dies. This is called as “Herniation syndrome”. Acute Mountain Sickness can be treated by using diuretics and a plenty of water.

Mountaineer may get flu like symptoms at high point and surprisingly get better after head down. This illness is caused by building up of fluids in the lungs a condition known as Pulmonary Edema. It is a result of increase in the flow of blood through the lungs as the body tries to get as much oxygen as possible to fulfill high oxygen demand. Heart increases the flow by increasing the pressure causing leakage from the blood vessels into the air sacs. In bad cases, one can hear gurgling of fluid in the lungs, and the victim brings up bloody sputum, which may kill patient within an hour. Treatment is immediate descent by several thousand feet and oxygen if available.

Body responds to the lower oxygen by increasing the demand of RBC in the blood which results in the thickening of the blood. At excess condition, the blood becomes thick and prone to clotting that results in heart attacks, strokes, and pulmonary embolisms.
Common complaint of most climbers is a persistent dry cough that may result even in broken ribs. This condition results from a drying out of the bronchi caused by breathing cold air. The best treatment is to avoid over exertion and thereby lowering the breath rate.

Sundeep Sharma

VTPP 435

Doodling could improve memory

Now there is a valid excuse for drawing in the margins of your notebook during class! A study from Plymouth University in England shows that doodling, though it may seem a distracting task during a dull speech or presentation, is much less distracting than daydreaming, and may actually improve memory recall. This study, published in the journal of Applied Cognitive Psychology, was headed by Professor Jackie Andrade, PhD, of the School of Psychology at Plymouth and involved 40 adult volunteers. Professor Andrade stated that: "tests of memory or attention will often use a second task to selectively block a particular mental process. If that process is important for the main cognitive task then performance will be impaired. My research shows that beneficial effects of secondary tasks, such as doodling, on concentration may offset the effects of selective blockade". During an experiment with, participants were asked to listen to an intentionally boring phone message and recall specific names of people mentioned in the message that were to attend a party. Half were given shapes to shade(without attention to detail) in while listening, and the other half were left to their own devices. After listening, participants were asked to recall names and places mentioned (they were not aware they should remember places); the doodling participants performed 29% better than the control group, recalling an average of 7.5 person/place details correctly, as opposed to the control group's average of 5.8. This suggests that doodling could help people remember pieces of important information presented, even if during a dull, mundane task. It may even be useful at keeping people alert better than letting their minds escape to such things as holidays and other common daydreaming topics. So, the next time you find yourself nodding off or daydreaming during an uninteresting task, go ahead and let yourself doodle on your paper, you might remember more than you expect!

Robotic Surgery on the Battlefield

Robotic Surgery has been around for a few years. The surgeries are normally very successful, being more precise and less invasive. However, there are also many other downsides associated with with robots. For one, they usually take up a lot of space, nearly filling a whole operating room. Sterilizing such a large piece of equipment is also extremely time consuming and the cost for the whole system is very high (around $1 million). For this reason, Peter Berkelman, an professor of engineering at the University of Hawaii has been developing a much smaller, lower cost robot capable of performing quick surgery for the last 4 year .

The robot, which can fit into a backpack, would be ideal for battlefields. A medic could easily carry and sterilize the robot on site, allowing for quick and clean removal of shrapnel. Two joysticks control the system with an "advanced" camera that helps the operator see. Three arms are available to the user, allowing one doctor to hold the camera while working with two arms.

Other benefits include the fact that this robot is made from "off-the-shelf parts," which keeps the cost down to $75,000. The device has yet to gain FDA approval, which means that it will be several years before this becomes a real product. While this device will be able to perform quick surgeries, it is unlikely that any big operations (like open heart surgery) could take place. This is a very exciting development that should lead to improved increased surgical precision.

Wired

Hawaii Business

Adaptive Lenses

Eyesight is something that we in the developed world take for granted, but what if we didn't have the luxury of seeing in perfect vision? Didn't have glasses or contacts? Unfortunately, around 1 billion people in the world would benefit from corrective lenses but lack the money to buy conventional lenses.

This is where Joshua Silver comes in. A physicist by trade but a philanthropist at heart, Dr. Silver developed adaptive spectacles. These are specially made lenses that work by injecting silicon in into the “lens” thereby increasing or decreasing their strength from -6 to 6 Dioptres. This range represents 90% of all peoples needing corrective vision. Because the strength of the lenses can be easily modulated by injecting more silicon, people in the developing countries of the world, without access to regular health care, can correct their own vision simply and easily without having to see a doctor.

Dr. Silver had been reported being offered millions of dollars for his design but has refused the money because he believes that the corporations wouldn’t put the technology in the hands of the people that need it most, the poor in developing countries.


http://www.guardian.co.uk/society/2008/dec/22/diy-adjustable-glasses-josh-silver

Pollution-Related Asthma May Start in the Womb

It has been somewhat assumed that children living in cities with high air pollution are at a greater risk of developing asthma, but it was unknown when the exposure was causing the genetic change. The University of Cincinnati and Columbia University Mailman School of Public Health have recently conducted the first study to determine whether the effects of exposure to prenatal ambient air pollution can be linked to changes associated with asthma. The study was conducted using umbilical cord blood of New York City children whose mothers wore backpack air monitors to determine the level of pollutant exposure.

In the white blood cells of the blood samples, it was discovered that a new biomarker may be associated with prenatal exposure to polycyclic aromatic hydrocarbons common in air pollution caused by the burning of car fuels. This marker is an epigenetic alteration in the gene ACSL3 expressed in the lung meaning that the gene expression is changed due to a cause other than to changes in the DNA itself. It was found that there is a strong relationship between changes in ACSL3 methylation and maternal exposure to polycyclic aromatic hydrocarbons. ACSL3 is also associated with asthma symptoms seen in children before the age of five. Knowing a potential marker for asthma allows early treatment to hopefully prevent any complications later from the disease.

Columbia Center for Children's Environmental Health has been studying the effects of prenatal exposure to pollutants since 1998 in children of non-smoking African-American and Dominican women.

Link to Article: http://www.sciencedaily.com/releases/2009/02/090214082110.htm

Engineering with Out Borders

Engineering without borders is a non-profit organization that focuses on taking the engineering disciplines to the ends of the earth. The mission is really one of bettering the quality of life of people without education or means to otherwise. This non-profit humanitarian effort involves partnerships to implement sustainable engineering projects and train internationally responsible engineers.

There is a without borders section in a variety of fields such as doctors, vets and nurses with out borders. Engineering without borders is further broken down into projects ranging from the construction of sustainable energy systems (that developing communities can operate without external assistance) to equipping such communities with local, technical, managerial, and entrepreneurial skills. These communities get hands on training and participate in seeing these projects through. It was said you can feed a man a fish or you can teach a man to fish. EWB sees the need and implements the strategy for overcoming some of the devastating situations impoverished communities around the world face.

Below is the flow chart for projects in EWB:


Huge corporations donate millions of dollars in medical devices and equipment to third world countries. This is a step in the right direction. However, if you have ever been to a hospital in say Ethiopia, you could find a $250,000 machine sitting unplugged in a corner because a twenty dollar part that broke on it. To couple the great effort put forth by these donors, we need engineers and medical professionals who can repair these devices. An integrated effort of experts in their fields is needed.

Another interesting program that engineers with out borders provides a year long stent traveling to hospitals repairing these devices. In this program, the engineer stays for 3 months in Tanzania or Costa Rica learning Swahili in the morning and learning to fix medical equipment in the afternoon. After this cultural and hands on crash course the engineer is launched into the far reaches of ethiopia traveling around to various hospitals fixing the medical equipment. This program goes on for a year. Not only is this amazing skill building but also an awesome opportunity to make a real difference in peoples lives.


--Andrew Stewart

Can an Artificial Heart Replace the Real Thing?

I found an interesting article about a new design for an artificial heart in a November issue of Time. I thought this very pertinent to our physiology class, considering we just finished a unit on cardiology and the cardiovascular system. Also, over Christmas break, in Germany I had the opportunity to learn about Ventricular Assist Devices and artificial hearts, which I found to be extremely fascinating. (I think I am most intrigued by these devices is for reasons beyond medicine and science, because the heart is often synonymous with the human sole, and associated with the capacity to love as well as having a spiritual dimension. I am completely comfortable with the idea of using a device to assist in heart function while the heart remains in the body, but I have mixed feelings about the heart being completely removed from the body. )
Regardless, I was excited to read that French researchers have developed a pioneering new artificial heart. The developers of this design say that it is the closest things yet to the human body’s natural heart. There are several new improvements to the design including two pumps, instead of one, more accurately mimicking the function of a real heart's two ventricles. As well as a system of miniature sensors that react to physical activity and automatically increase or decrease the heart rate and blood pressure, like a human heart, as we learned in class. The prosthesis also uses new composite bio-tech materials, which are made from animal tissue and chemically treated to eliminate the risk of blood clots, which is a problem that has plagued earlier alternatives. The new design also has an improved battery life in comparison to other VADs and artificial hearts on the market.
Most of the earlier Ventricular Assist Devices were designed to assist impaired function and bridge heart patients to transplant, but not to replace the heart entirely. Current artificial hearts have proved unsuccessful in modulating beating and pulse according to the physical needs of the patient.
If this new French design proves to be successful it will be a huge advancement in the field of medicine, by dramatically reducing the need for heart transplants. Currently there is an estimated 20,000 people worldwide who are in urgent need of a heart transplant each year for survival, but only about a quarter of those patients receive transplanted hearts from donors.
The project is currently in the animal testing phase, and researchers hope to begin human testing with in the next two years.

http://www.time.com/time/health/article/0,8599,1857216,00.html

Excessive Fat Diet Causes 300 Percent Increase in Tumor Cell Metastasis in Animal Models

It has been widely accepted that a healthy lifestyle leads to a lower risk of cancer; however, nobody has actually demonstrated a study that concretely shows this as it relates to tumor cell metastasis. Researchers at Purdue University used a technique to measure how increasing fat causes tumor cells to transform into cells that have all the properties that lead to metastasis. They used another imaging technique to count the number of tumor cells that were in the blood stream, something called coherent anti-Stokes Raman scattering and sum frequency generation imaging. You can see two cancer cells bound to collagen fibrils before they spread to the blood in the picture above.

The researchers conducted their research on two different samples of mice, those who were fed a lean low fat diet, and those who were fed an extremely high fat diet. All of the mice had a cancerous lung implanted at the start of the experiment. The results that they found were astounding; the mice who were fed the high fat diet had a 300 percent more tumor cell metastasis relative to the other mice. The researchers have theorized that in order for a tumor cell to metastasize, it has increased metabolic demands, or their must be an excess of energy. In a high lipid diet, fat can be stored very efficiently in the lipids. The cells can use this excess energy to modify themselves appropriately for metastasis.

These modifications include what is called membrane rounding, where the plasma membranes of the cells begin to round off slightly, and something else called membrane phase separation, which have both already been proven to be key in metastasis. One researcher said, “If the cancer cells don't have excess lipids they stick together and form very tight junctions in tumors, but increasing lipids causes them to take on a rounded shape and separate from each other." Obviously, this increase in lipids provides the energy necessary to break up the tight and dense tumor cells and allow them to begin to move towards the bloodstream.

I found this article very interesting because cancer metastasis is essentially when cancer begins to kill people. If the cancer can be kept very locally, almost always the cancer is treatable to a certain extent. However, as soon as the cancer starts to rapidly metastasize the prognosis becomes much worse. With these cancerous cells in the bloodstream they can affect other essential organs very quickly, which will ultimately lead to multi-organ failure and certain death. I also found this article interesting because of the fact that high fat diets basically give the body more glucose stores than it needs which can allow cells to complete processes that they would not normally do like membrane rounding and membrane phase separation. I also thought that the results were very dramatic, a 300% difference is quite a bit. Diet is often overlooked in these situations, but it is clearly critical.

http://www.sciencedaily.com/releases/2009/02/090225172639.htm

New Asthma Research Opposes Current Drug Treatment, Says UH ProfThe article is about a professor’s theory and research to purport that perhaps “beta-2 adrenoreceptor antagonist drugs (or beta blockers) ultimately might be a safer, more effective strategy for long-term asthma management than the currently used beta-2 adrenoreceptor agonists.” The theory is based on studies that show a mouse that lacks a key gene that produces the beta-2 adrenoreceptors, and the mouse also happens have an “absence of asthma-like symptoms.”This research is important especially now, because the FDA is considering new approaches that deal with the long term control medicines that asthma patients are currently using. The main purpose of these long term drugs is to reduce inflammation of the airways. The reason the FDA is currently thinking about altering the approach of these long term control methods is because “several studies have shown chronic use of the beta-2 agonists (or stimulants) can negatively affect asthma control and airway hyperresponsiveness by desensitizing the beta-2 adrenoreceptor through regular stimulation.” Basically, the mouse is better off without the beta-2 receptor at all. The professor’s research shows fundamentally that “blocking…the receptor with antagonists, instead of stimulating it with agonists, reduces the asthma-like features of the mouse model."



http://www.medicalnewstoday.com/articles/136807.php

Drugs Just as Good and Much Cheaper than Stents for Delayed Treatment of Heart Attacks

A heart attack is a very severe occurrence, and should be treated as soon as possible, ideally within hours of the attack. However, some people are not diagnosed or treated in nonfatal heart attacks for days or even a couple weeks after their attack. The normal approach to treatment in these patients upon discovering a completely blocked artery has been to put in a stent to open up the occlusion, and follow up with a subsequent drug treatment. However, a new study has shown that the stent might be completely unnecessary, a large waste of money.

In a study of about 2000 patients, Dr Judith Hochman from New York University concluded that a drug only treatment was just as effective as placing a stent. All of these patients had had a heart attack at least three days before being treated, and were found to have a completely blocked artery but they were otherwise stable. This seems very counterintuitive, that one would be able to do just as well letting drugs slowly break up a clogged artery when it could be instantly fixed by a stent, but Dr. Hochman found the drugs only to be just as effective. The absence of a stent placement would be more convenient for the patient as they would not have to undergo an invasive operation, and it would be much cheaper as well. This would also help cut down on the costs of medical treatment as a whole, if needless operations were reduced.

In the comparison of subjects with a stent to those without, those getting a stent did report slightly less chest pain and had a better cardiac assessment score after four months. However, in subsequent results, after 8 months or a year, these differences had vanished. Both sets of patients were leading equal lifestyles with no problems. The patients without stents were just as healthy, but they had saved up to $10,000 by receiving drugs only. If this turns out to become a reliable method of safe treatment for heart attack victims, with about a million attacks happening each year in the U.S., the savings could be astronomical.

Author: Catharine Paddock

http://www.medicalnewstoday.com/articles/139837.php

Posted By Brian Bass, Section 502

Artificial Arm Listens to Brain

Losing an arm typically means losing the many functions associated with that arm until now. With a technique called target muscle reinnervation the remaining nerves in the arm after amputation are connected to another muscle in the body and essentially "rerouted" for continuance of nerve-brain relations. These nerves are often placed in the chest so that the nerves and the brain can continue to communicate; the brain sends signals to the nerves causing the muscles of the chest to contract, which sends an electrical signal to the prosthetic arm for movement. The control techniques involved in moving the arm are the same for any other part of the body providing the amputee with the functions associated with an arm that is no longer there.

Mind control of prosthetics is not a new technology but scientists claim that this new method provides the patient with the ability to perform 10 different hand, wrist and elbow movements versus just being able to weakly bend the elbow or wrist. This reinnervation method allows the patient to have more control with less effort and although it sounds amazing, creators make it known that this technology is expensive and does take months for nerves to grow, a necessary part of the process. Other similar technologies include researchers working with monkeys to move a mechanical arm and a paralyzed man being able to control a cursor on a computer screen with his mind. The drive of such technologies are said to be both incidence of diabetes and military injuries making this research vital to more patients each year. Desiring to obtain functions as close to normal arm function as possible, researchers believe that reinnervation is just a step in the right direction but say that there is still plenty to accomplish with these technologies.

http://www.nytimes.com/2009/02/11/health/research/11arm.html?pagewanted=1&_r=1&ref=research

Brittany Sanchez

VTPP 435-502

Beta-Blockers Erase Emotion of Fearful Memories

Have you ever had a memory that keeps coming back to haunt you? A recent study by clinical psychologist Merel Kindt shows that beta-blockers have the potential to take away emotions associated with scary memories. After taking the drugs, a person who recalls a traumatic event would have dulled emotions associated with that memory.

Published in Nature Neuroscience, Kindt’s research follows a clinical study published in the Journal of Psychiatric Research that suggested beta-blockers helped patients who suffered from PTSD, post-traumatic stress disorder. Subjects were shown a photograph of a spider accompanied by an electric shock, conditioning them to associate fear with that memory. Some subjects were given the beta-blocking drug propanolol and others were given a placebo. Twenty four hours later, the subjects were shown the same photograph of the spider. The fear associated with the image was erased for those who had taken propanolol.

The scientists believe that the beta-blockers affect how the frightening memories are stored. When you recall a memory, it changes a little, and the new version is recorded in long-term memory by chemical fluctuations (called reconsolidation). The beta-blockers are thought to interfere with these chemical fluctuations, blocking reconsolidation of the emotional components of your memories. The rest of the memory is still there, so people remember going through trauma, but the emotional intensity is dulled.

The negative side to this finding is that beta-blockers would affect reconsolidation of all memories, whether happy or sad. However, patients with anxiety disorders based on fear would most likely choose to lose some of the happier moments in order to avoid reliving the fearful ones. Thus, beta-blockers are a widespread treatment for anxiety orders but the long-term effects on memory still must be assessed. Since they are already widely prescribed for other conditions such as various heart problems, researchers believe overall the drugs are benign and useful for these anxiety patients.

http://www.sciencenews.org/view/generic/id/40928/title/Beta-blockers_erase_emotion_of_fearful_memories

Bioengineering Bacteria for Drug Delivery

Osel (http://www.oselinc.com/) in Santa Clara, CA, works in the emerging field of bacterial therapeutics, focusing on the development of live bacterial products for the prevention and treatment of urogenital and gastrointestinal diseases.
The term bacterial therapeutics distinguishes Osel’s approach from probiotics. “People think of probiotics as health-food store products,” says co-founder Peter P. Lee, M.D., an immunologist at Stanford University and acting CEO at Osel. “We apply a tremendous amount of science to our products and want to shift the mindset.”
Osel’s newest product uses a bio-engineered bacterium that lives in the vaginal tract of healthy women to deliver a potent drug to block HIV. “It’s a novel way to think about drug delivery,” Dr. Lee says.
Dr. Lee co-founded Osel in 1998 with Gary Schoolnik, M.D., an infectious disease expert at Stanford University; David Ho, M.D., director of the Aaron Diamond AIDS Research Center in New York City; and Peter Kim, Ph.D., president of Merck Research Laboratory in West Point, PA.


By creating a bacteria that could help aid in blocking HIV, urogenital and gastrointestinal diseases. By further supporting this research, it can help prevent HIV or even treat it as further research goes. Since thousands of people are vulnerable to HIV, by stopping or preventing the spread or even the interaction with it, it can help succumb the development of AIDS and aid thousands of humans.




Source:http://www.genengnews.com/articles/chitem.aspx?aid=2011&chid=0

-Perryl Libardo

section 501

New Pulseless Total Artificial Heart

Two University of Houston mechanical engineering professors (Matt Franchek and Ralph Metcalfe) have received a $2.8 million federal grant from the National Institutes of Health (NIH) to develop a new artificial heart technology. In order to create a pulseless total artificial heart (TAH), they 'are focusing on developing a control system that emulates how the natural heart responds to physiological conditions within the body.' According to the scientists, this TAH device will be smaller, lighter and more reliable than existing pulsating artificial hearts.

“The proposed TAH replaces the pulsatile feature with two pulseless continuous flow pumps, each about the size of a C battery. The pumps also are unique in that their cardiac output automatically adjusts to physiological needs. To ensure proper integration of the TAH on a patient-to-patient basis, the UH team will be adding onboard intelligence to the TAH using automatic controls. One pump would be dedicated to the pulmonary loop, carrying oxygen-depleted blood away from the heart to the lungs and returning oxygenated blood back to the heart. The other pump would drive the systemic loop, carrying oxygenated blood away from the heart to the body and returning deoxygenated blood back to the heart."

This artificial heart will not only be less costly, but the goal is to create a robust continuous-flow ventricular assist device that is smaller and more reliable than the current pulsating pumps that mimic the natural heart. The implanted intelligence controllers will also provide current conditions of the blood, including viscosity, which is critical to maintaining patient health. Don’t get your hopes up though, for this won’t be hitting the medical markets for at least 4 more years.

http://www.primidi.com/2008/10/14.html

Hieu Tran

Section 502