Medical News

WHO experts confirmed the link between the use of cell phones and brain tumors

2009-10-27T10:04:00.000-07:00

Communication between mobile use and the development of brain tumors exist. To such conclusion experts of the World Health Organization (WHO), who studied the safety of mobile devices. On the preliminary results of studies reported The Daily Telegraph.
The project called "Interphone" included several WHO-supported research, funding of which was spent about 20 million pounds sterling. The aim was to establish a link between mobile phone use and development of three types of brain tumors and tumors of salivary glands.
In studies conducted in 13 countries in the period from 2000 to 2004, was attended by 12,800 people, among whom were as healthy citizens and people with cancer.
It is reported that six of the eight studies project "Interphone" found an association between increased risk of glioma - the most common tumors of the brain - and using mobile. According to one of these studies, the risk of glioma increased by 39 percent.
Two of the seven studies of benign tumor of the auditory nerve (neuromas), confirmed the increased risk of its development in people who use phones for more than 10 years. According to scientists from Sweden, with such long-term use of these devices, the likelihood of neurinomas has increased almost fourfold.
According to a study conducted in Israel, the risk of developing tumors of the salivary glands increased by 50 per cent of those who too actively use the services of mobile communication.
It is reported that the official results of the research will be published in a scientific journal before the end of 2009.

Nerve cells restored

2009-10-27T09:48:00.000-07:00

Scientists have identified an enzyme whose activation in vivo leads to an accelerated regeneration of damaged nerve fibers, otherwise damaged fibers almost restored. The finding could form the basis of therapeutic methods for recovery of damaged nerve tissue.
The impact of an enzyme, called Mst3b, leads to the restoration of damaged axons in the central nervous system and in the periphery, which scientists believe could be used for recovery of patients after stroke, spinal cord injuries or head injuries.
Currently, such techniques recovery does not exist, and patients with severe spinal cord or brain are not always able to return to normal life after the trauma.
Discovery, which made the group Nina Irwin from the Children's Hospital in Boston, was made possible by studies of past years, held since 2002.
In the course of these studies, scientists have identified several molecules of different chemical nature that have the ability to stimulate the growth of nerve fibers in the living organism.
Studying the mechanisms of these molecules, scientists have concluded that they all work through the activation of the enzyme Mst3b. This protein, to interact with other proteins, activates the work of several genes required for growth of axons (neuronal processes).
In their experiments with rats, scientists have shown that even under the influence of known molecules that enhance the growth of axons, but in the absence Mst3b regeneration of nerve fibers in the animal organism does not occur.
In the future, scientists are going to find out whether the stimulation Mst3b the best method of enhancing the growth of nerve fibers, and to develop methods of gene therapy, allowing to activate the enzyme and to overcome some natural barriers that prevent the body in its normal "run" the full restoration of nerve tissue with Mst3b .

AIDS prevention has become more accessible and more efficient

2009-10-02T23:42:00.000-07:00

On Wednesday in Geneva published a joint report by the World Health Organization (WHO), UN Foundation, UNICEF and United Nations Program on HIV / AIDS (UNAIDS), under which over the past five years of antiretroviral therapy became available in 10 times.
The reduction in drug prices and timely medical examination contributed to the fact that since 2007 in developing countries, the number of patients receiving HIV treatment has increased by more than a million people, the report said.
However, despite notable progress, the treatment is still less than half of all infected.
Most HIV-infected pregnant women do not receive the necessary treatment, resulting in children born to infected by the so-called "vertical transmission".
The doctors insist that the early survey - the main way to treatment, and in many regions of significantly increased level of technical equipment necessary for the successful inspection of patients.
According to the report, HIV prevention and treatment of AIDS patients around the world covering 35% more patients compared to the previous year.
"A generation without AIDS - is no longer an illusion, we are drawing closer to the complete elimination of the danger of" vertical transmission ", - said Jimmy Kolker, head of UNICEF on AIDS and HIV.

Cheap and toxic
Prices of antiretroviral drugs have fallen by 10-40%, thanks to the cooperation of various pharmaceutical companies and the wide dissemination of low-cost generic drugs.
Today, various international organizations are considering establishing a common patent "pool", which enables to produce more and cheaper drugs to help people in developing countries to obtain more modern and effective treatment.
Particular attention is paid to the record accessibility of antiretroviral treatment: the majority of people undergoing treatment in developing countries, issue a mixture of lower-cost older drugs, which are in Western countries are hardly used because of serious side effects.
Three years ago, WHO recommended to switch to less toxic medications on the basis of zidovudine or tenofovir.
While these drugs are much more expensive. For example, the cost of the drug on the basis of tenovira twice the price of old medicines.

Infected - fast cure - slowly
According to recent estimates, at least 5 million HIV-infected people can not get even the most primitive of treatment.
In addition, the rate of infection continues to outpace the introduction of new methods of therapy: one person undergoing treatment, have three infected.
The report highlights the concern about low prevalence therapy among high-risk groups - homosexuals and sex workers. According to the report, the number of infected drug users worldwide reaches 6 million people, while only 40% of them are covered by HIV / AIDS.
Experts fear causes and negative effects of economic recession, which could undermine the financial capacity of international organizations, directing funds to the neediest countries.
"The current report shows the incredible progress in the global fight against HIV / AIDS - said WHO Director General Margaret Chan. - But much more remains to be done. At least five million people lack access to treatment that could prolong their lives. Preventive measures include not all in need. Governments and international partner organizations need to join efforts and to ensure that antiretroviral therapy became available everywhere. "

New way to treat skin defects.

2009-09-24T05:12:00.000-07:00

Found that the effective elimination of defects of the skin must be revitalized special cells - peritsitov.

All living organisms on our planet during its existence repeatedly exposed to adverse external influences: the mechanical, thermal, chemical, radiation, etc. Sometimes they may violate the integrity of the epithelium (surface layer) of the skin, and in some cases completely destroy it.

Leather - a special cloth body. She not only performs the function of the external protective barrier, but also actively participates in the physiological and biochemical processes that support homeostasis (constancy of internal environment). The skin takes part in thermoregulation, water-salt metabolism, acid-base balance, immune processes, etc. Therefore, damage to the skin extremely negative impact on the general condition of the organism. Just remember that with extensive damage to the skin with hot liquids may develop burn disease, often ending fatally.

If there is a violation of the integrity of skin pathogenic factor, it immediately begins a local inflammatory reaction, which can be seen three consecutive phases: 1) alteration (damage), 2) exudation (local reaction vessels with the formation of inflammatory fluid), 3) proliferation (multiplication of elements connective tissue) with the formation of scar patterns. That is why, after most of the lesions on his life are "traces". You can treat them philosophically, they say, scars adorn men, but the vast majority of the population, especially its fine half, believes the scars on the skin of the phenomenon is very undesirable. Some patients are ready by all means get rid of them and, preferably, in the shortest time.

The ideal solution of this problem should be considered as regeneration, that is, full recovery of tissue to replace the lost part of it. For example, very well restored epithelium of the mucous membranes. However, this ability is expressed in the skin rather weak. Therefore, before physicians and cosmetology is pressing question: how to stimulate regeneration of the skin, after the completion of the pathological process in it.

Recently attracted the attention of scientists peritsity. These particular cells with branches located inside the walls of microvessels (capillaries). Each Pericyte receives impulses from neurons of the autonomic nervous system. In turn, processes peritsitov contact with endothelial cells (the inner lining of the capillary), transfer them to nerve impulses, regulating the amount of internal diameter of vessels. The biological role of peritsitov not yet fully understood, but it is known that these cells do not only affect the lumen of the capillaries, but also help them rebuild their wall after mechanical injury or injury to the pathological process.

Group of scientists from Australia led by Sophie Paquet-Fifield was carried out complex investigation of the influence peritsitov the mechanisms of cell proliferation and regeneration of the skin tissue. For this purpose the genes microanalysis of cells responsible for stimulating recovery processes of the skin. Simultaneously analyze the activity of these gene products - biologically active substances that can affect cell division and differentiation (maturation).

Scientists have found that peritsity significantly increase the intensity of regeneration of the skin. They synthesize and release into the fabric of a group of important substances, primarily a special protein molecules - laminin, which is responsible for the products of gene LAMA5. Recently, it was found that laminin can enhance the formation of new tissue components, ie to stimulate cell proliferation, regeneration and reconstruction of damaged tissues. Also identified was an interesting fact - peritsity be relatively easy to differentiate into several cells (bone, cartilage, fat, etc.). Obviously, they can be compared with the well-known stem cells.

Thus, the discovery of new properties peritsitov: they are important regulators of processes of reconstructing the structure of the skin after injury. This will develop new therapeutic and cosmetic treatment of skin defects by stimulating the activity of these cells.

2009-09-14T10:15:00.001-07:00

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Protein transfer colesteril-ester

2009-09-14T04:45:00.000-07:00

Protein transfer colesteril-ester, coronary calcium and carotid artery intima-media thickness in a sample of middle-aged Japanese men
The relation between cholesteryl ester transfer protein (CETP) levels and atherosclerosis is controversial. Whether we examined the serum CETP levels were associated with subclinical atherosclerosis, independent of its most common gene variant in a sample of Japanese men. A population-based cross-sectional study of 250 Japanese men aged 40 to 49 years was conducted to Assess the intima-media thickness of the carotid artery, coronary artery calcium, serum CETP levels, and the CETP D442G gene variant. Compared with the lowest CETP quartile, the multivariate adjusted odds ratio for coronary artery calcium was 0.77 (95% confidence interval 0:18 to 3.36), 0.96 (95% confidence interval 0:27 to 3.40), and 3.49 (95% confidence interval 1:05 to 11.6) With increasing CETP quartiles. The serum CETP quartiles were also positively associated with the intima-media thickness of the carotid artery (adjusted mean 602, 616, 615, and 646 μm for the lowest quartile to top, respectively). The findings Remained unchanged after additional adjustment for the D442G CETP gene variant. No significant difference was found in the prevalence of coronary artery calcium or in the mean intima-media thickness of the carotid artery between participants with and without the D442G CETP gene variant.

Red wine Contain polyphenols which prevents the development of Alzheimer's disease - U.S. researchers

2009-09-11T06:18:00.000-07:00

Polyphenols, organic compounds of plant origin, contained in a red grape wine, helps prevent the development of Alzheimer's disease. This is evidenced by the results of new research published in the publication Journal of Alzheimer's disease.
Researchers from Purdue University and the School of Medicine, Mount Sinai found that after a guinea mice for ten days gave bioactive polyphenols extracted from grape seeds and skin, and their penetration into the brain tissue increased by 200% compared to the one-day dose . Many studies conducted before the penetration level of polyphenols in the brain is usually measured after a one-day dose, and, as a rule, was very low.
"All this points to the fact that only long-term consumption of these substances may have a therapeutic effect," - said Purdue University professor Mario Ferrutstsi who participated in the study.
As scientists believe, the bioactive polyphenols prevent the appearance in brain tissue concentrations of beta-amyloid protein, forming plaques in the brain, which leads to the development of Alzheimer's disease. Now that researchers have found, as polyphenols are absorbed and distributed in the brain tissue, they can determine the amount of product from grapes or the amount of red wine to be consumed within a certain period of time for more effective prevention of Alzheimer's disease.
Alzheimer's disease - one of the most severe disease, developing in elderly or old age. It is characterized by slowly progressive deterioration of memory and other intellectual functions and eventually leads to the destruction of all mental functions. Average life expectancy after diagnosis is about seven years, less than three percent of patients live more than 14 years.
According to statistics, only in the United States suffer from Alzheimer's disease more than 5 million people.

American Donated more than 151 liters of blood

2009-09-11T06:07:00.000-07:00

In the United States got a second donor-record holder, Donated 40 gallons of blood / 151.4 liters. Tuesday 8, 75-year-old resident of Long Island's Al Fisker donated 320-th pint of blood / 1 pint - 0,473 l /. For this achievement an American, was awarded the "hemoglobin hero.
"Some people donate money but I hand over the blood. This case, which I have devoted many years", - said Fisker. According to him, first time donor, he was back in 1951 during a visit with his parents Blood Center at the Baptist church in South Carolina. Since then, the American visitor to points transfusion of six to eight times a year.
During his adult life Fisker has thus a real aid to nearly Thousands of peoples. These data confirmed the executive director of the blood donation service on Long Island, Harvey Schaffler. "Al is a great representative and ambassador" - summed up President Blood Center of New York Christopher Hiller.
In the first place for the volume of donation in the United States is 83-year-old Maurice Wood, of St. Louis / Missouri. He is ahead Fisker to 2.8 liters. According to the national donor "number two", it is a friendly competition whose outcome is not yet clear. "I have spoken with him before. I do not think I could ever beat him, unless he ceases to donate blood," - admitted inhabitant of Long Island.
By the way, his car was a special "donor" brand. The license plate had been on "O BLOOD", which corresponds to the individual blood group owner. On system ABO group O / letters of the Latin / corresponds to our first and is considered to be universal in the West.

Pfizer will pay 2.3 billion dollars for the illegal promotion of drugs

2009-09-04T05:16:00.000-07:00

Pharmaceutical company Pfizer has agreed to pay 2.3 billion dollars for the termination of criminal and administrative investigations into the illegal marketing of a number of drugs, in particular - pain Bextra. Agreement with the pharmaceutical giant, providing for a record penalty payments, said Tuesday the U.S. Department of Justice.
Investigation of illegal methods of promotion of medicines used by Pfizer and its units, was launched four years ago on claims of several individuals. Manual Pfizer accused of systematically bribing doctors in the dissemination of false information about their products, as well as in stimulating the use of drugs for indications not approved by the supervisory agencies. Representatives of Pfizer denies the majority of alleged violations of the company.
The most significant charges related to the illegal promotion of anesthetic Bextra (valdekoksib), placed on the market in 2001 and subsequently withdrawn by the manufacturer in connection with serious side effects. Similar charges put forward by a number of other drugs Pfizer: the antibiotic Zyvox (linezolid), anticonvulsant drug, Lyrica (pregabalin), antipsychotic Geodon (ziprasidone).
Payments under the pretrial agreement amount will be divided among the budgets of the federal health insurance programs and health departments, 42 U.S. states, appeared as a complainant in the case.
The case of unfair promotion of drugs Pfizet, culminating in the largest fine in U.S. history - the fourth trial on similar charges against the pharmaceutical company for the past 7 years. Previous courts have ended for Pfizer penalty payments totaling more than $ 500 million.
Pfizer revenues for 2008 totaled 48.3 billion dollars.

Vitamin D may protect against dementia

2009-09-04T04:55:00.000-07:00

American and British scientists concluded that with the help of vitamin D can be prevented by prevention of dementia in elders. This vitamin can be found in fish, or the body produces its own after a long exposure to the sun. During the study took two thousand people.
On contents of the report is well known that people in the body of vitamin D which is contained in the normal amount, half as likely may be a violation of intellectual activity. If vitamin D is insufficient, the organism is exposed to what may worsen attention and memory disorders appear.
Countries where the winter is long, vitamin D, produced after the sun, to get more complicated. This particularly affects the elderly.

Health and safety of drivers

2009-08-31T04:33:00.000-07:00

Living in cities spend behind the wheel more and more time, then leaving for work, then cruising for, then returning home, then rushing to give a tight flow and picnics ... Life without an iron horse is transformed into a deep retro. Meanwhile, the car can be dangerous to the health of drivers! - This is not a sensation, the doctors came to similar conclusions a long time, and do car owners had to feel all the inconveniences associated with the faulty design of the seats and forced to pose behind the wheel, and on his own neck in the literal sense of the word!

Chronic diseases of the spine where drivers often cause is the construction of automobile seats. These conclusions were British scientists. Classics - expresses his opinion, Andrei Kozlov, head of the restorative therapy of pathology of the nervous system . fail, as in the pit, it is difficult to choose a comfortable position. Of course, a healthy person would find the optimal position, but the question is: for how long?
However, in the troubles of those who are forced to hold the wheel for many hours, it turns out, the culprit is not only inconvenient form of seats, but incorrectly adjusted the distance to the pedals and the back angle. It turns out that the driver takes his position, which experts dubbed pose a banana he stretches his legs to the pedals, and raises his hands to the steering wheel. In such a situation takes uncharacteristic bending of the spine, and this in turn leads to strain on back muscles. The result is very sad: prolonged pain in the back and neck.

main rule - you must be comfortable, continues to expert - in no matter what brand your car . Of course, Mercedes more opportunities to vary, but to any model should be adapted individually to solve the problem helps orthopedic pillow under your back or under his head. Ignoring the problem is not worth it the constant back pain as an uncomfortable posture while driving distract the driver from control of the vehicle and the road, and hence the risk of accidents in such a situation increases several times. Also do not forget that this forced posture, often tense, multiplied by the stress, especially if your driving experience is small, leads to an aggravation of degenerative disc disease. Appears pain, its range is very wide from mild discomfort to burning, tearing pain, which can be compared with open fractures. The main thing in this situation do not panic, do not panic. Pain - is primarily a bell, a signal that the body that something is wrong. And always try to change the posture. Of course, you will not be able to quickly jump out of the stream or to stop and get out of the car, but your task - to remove this maximum stress factors .

Next, you still get to the doctor. Of course, there are pharmacies warming ointment, there are a number of common exercises, but better yet, if this course specialists will work for you. And add in the elements of manual therapy, acupuncture, massage and teach to correct pose.
Incidentally, such a correct and posture can reduce the risk of spinal injury, if the driver gets in an accident. Doctors do not advise either cling to the helm, nor hold back hard-line. If possible, you need to relax the body and try to maximize lean back.

Secrets of security ...

By the way, except for seat designs and material scientists interested in upholstery. Optimum health was recognized as an ordinary cloth, not vinyl or leather, they are declared too slippery.
But the corset belt, especially if you know that you have back problems, wear a long journey to be sure.

Color machines also plays a role in the rules of safe driving: for statistics, the low level of accidents recorded at the iron horses of bright colors-red, yellow, blue, on the road it is difficult not to notice. If you gravitate to the lighter shades, it is better to stay on a gray or a metallic, these vehicles safer whites, who in the twilight on the road to becoming a blur. But the most dangerous, according to the same statistics, recognized auto black, brown and green colors.

Awful distract drivers and telephone conversations even if you use a headset hands free, your account is reduced. Scientists found that 90% of drivers weakening control of the situation on the road, but by the end of the first minute, they switched to the conversation almost entirely. Especially if the conversation requires emotional engagement: you tell the good news or roll their scandal, does not matter.

By the way, psychologists have been advised to get behind the wheel in the ruffled feelings, better to get to places by public transport or a taxi than to risk their health and lives of others!

Another serious danger of sleep-driving, in fact threatens not only to those who go on a long journey. If you suffer from insomnia constantly feel tired, sleepy and irritable, then you are at risk! The main advice in this situation - to treat insomnia and sleep, and just before going to sleep at least 20 minutes, then drink a cup of coffee.Doctors promise for 3 hours.

The fact that the health of urban residents did not improve from year to year, alas, not secret! And many are the different courses of treatment, but few with the peeps in the annotation to medication in the section of side effects. Yes, and lifestyles at the time of treatment, we try not to change. And it is quite wrong: the fact is that many drugs depress the central nervous system, causing lethargy and drowsiness, violate the coordination of movements. If it is such a person takes drugs while driving, the risk of accidents increases again repeatedly.
Acquaintance with a dangerous list .... Its lead products, which belong to the group of neuroleptics and lithium, antidepressants, tranquilizers, sedatives or hypnotics. Also traditionally not recommended to drive while taking antihistamines, drugs, prescribers and colds, and for the treatment of allergy. Exceptions, according to doctors, drugs account for 2 and 3 generation. But on these drugs in doubt: Many doctors argue that there can be no antihistamine, which would not oppress the nervous system.

Insidious extended summer this year, the common cold season,We habitually grasps the , forgetting that they also include medicines used to treat allergies, which can also cause retardation. Before the road it is better not to take. However, usually these drugs should not drink more than 3-5 days, so do without a car for this period is possible in principle.

Of the antihypertensive drugs that reduce blood pressure, drivers should be especially wary of drugs that act on the central nervous system. They are also a lot, and each has its own side effects. Even harmless soothing drops cease to be harmless, if we take them just before the trip.

The list basically goes on and on. So if you are poorly informed about the side effects of any medication, consult with your doctor: Is it possible after taking the drug get behind the wheel. If consultation with a specialist is not possible, then better to postpone the trip.

Another important rule - to use drugs a look at annotation: if it is written, for example, «should not engage in activities that require more attention, and reputable companies, drug manufacturers must indicate any potential hazards, Treat such a warning seriously.

Fears can be treated by tablets

2009-08-28T07:36:00.000-07:00

The drug, which had previously been used to treat people with heart disease, showed new results. It turned out that this tool can help people forget the acquired phobia and overpower stress after trauma.

Scientists have for some time been in search of drugs that could help people with neurological disorders to overcome old fears.
Today, doctors use a technique which is based on the fact that everything that causes a person fits unpleasant emotions, show patients in a calm and relaxed atmosphere. After some time a person removes from the memory connection and association, reminiscent of the unpleasant events in his life. But this method does not help everyone, because over the years, fears are back.

Ropranolol - a drug that scientists have discovered. He first tested on animals, and then it was proved that the same effect, it can produce on the people.

Siberian surgeons removed a bullet from the boy's head through the nose

2009-08-28T07:27:00.000-07:00

Surgeons from the Novosibirsk Regional Clinical Hospital removed a bullet from the head of three year old child through the nose, said Tass, Siberia.
Boy accidentally shot himself in the face of the air pistol, was taken to Children's Hospital emergency room number 3 Novosibirsk on August 19. The bullet diameter of three millimeters is stuck at the base of the skull of the child, passing through the nose.
Children's Hospital, doctors did not want to go to the trepanation of the skull, because access to its base without damaging the brain, blood vessels and nerves, is very difficult. Pediatricians have checked with the chief otolaryngologist of Professor Mikhail Melnikov. The specialist decided to perform endoscopic surgery, for which the patient was transferred to the regional clinical hospital.
August 26 bullet removed without touching the vital structures of the head. The operation lasted about an hour. Now the boy is feeling well, the development of complications is unlikely.
Such cases occur in the medical practice. Thus, for Professor Melnikov this patient was the fifth with a similar injury in the past 11 years.

Obesity leads to atrophy of the brain

2009-08-25T05:33:00.000-07:00

The brain of people suffering from obesity, looks 16 years older than their peers with normal weight, reports New Scientist. Such a conclusion was a group of employees of the University of California in Los Angeles (University of California in Los Angeles) led by Professor of Neurology, Paul Thompson (Paul Thompson).
Having tomogram of the brain 94 people aged about 70 years, researchers have made on their basis of detailed three-dimensional maps of body. They found that people with high body mass index (the ratio of a person's weight to its growth) of the brain, on average less than people with normal weight.
Scientists have found that reducing the size of the brain occurs mainly at the expense of the frontal and temporal lobes - these departments are responsible for the cognitive abilities of man. In addition, researchers found that the brain of patients with excess weight is less than in lean people, six per cent, and the obese - at eight percent.
According to Paul Thompson, the brain obesity looks for 8 years older than overweight people, and 16 years older than their normal-weight people. Reducing the size of the brain in obese people, Thompson is connected with the fact that these patients may breach the blood flow, resulting in brain does not receive the necessary amount of oxygen for life, which leads to the death of its cells.

Michael Jackson died from a lethal dose of propofol

2009-08-25T05:30:00.000-07:00

The cause of death was overdose of Michael Jackson potent anesthetic propofol. They began to know the first official results of toxicological tests carried out after the death of the king of pop music.
An investigation into the death of Jackson's testimony gave his personal physician Conrad Murray. He said that Jackson was suffering from insomnia and to combat it, he gave him the potent medications, including propofol. LAPD is considering the death of the singer as manslaughter.

Discovered a gene associated with hereditary kidney disease

2009-08-25T05:25:00.000-07:00

Researchers from the Medical School at Wake Forestskogo University (USA) have identified a genetic mutation associated with hereditary kidney disease.
The mutation occurs in a gene that encodes a protein renin (angiotenzinogenaza) - a component of the renin-angiotensin system, regulating blood pressure.
Holders of such a genetic mutation in a child suffering from anemia and progressive renal disease, resulting in they have a vital need for hemodialysis. During this process the patient's blood passes through a filter (dialyzer), which removes waste substances from the blood, excess fluid and salt. To connect to «artificial kidney» patient implanted external shunt or impose subcutaneous fistula between the artery and vein.
If researchers can learn more about the impact of gene mutations in families with hereditary kidney disease, they will be able to understand how the renin acts in the body of healthy people. Already, researchers are aware that this protein plays an important role in maintaining normal blood pressure and preventing anemia in children.

Fresh Juice rides obesity

2009-08-24T03:52:00.000-07:00

Study Group of the University of Minnesota found that any just squeezed fruit juice helps to prevent obesity in humans, while still significantly reduces the risk of such diseases as diabetes mellitus.

The data are obtained on the basis of years of research, which was attended by more than 14 thousand Americans, both men and women aged 19 years. All the results were published in the journal Experimental Biology.

In the course of the study, researchers concluded that daily consumption of fresh fruit juice (cup = 250 ml) at 38% and reduces the potential for obesity and 52% - diabetes. These data have high reliability.

Also available from the authors of scientific work, argue that people who use daily fruit juice does not suffer from lack of vitamins, much less suffer from various colds and physically more sturdy than those who every day do not drink fruit juice.

Oral Sex Cause of Throat Cancer Rise

2009-08-19T04:20:00.000-07:00

July 29, 2009 -- Changing sexual practices have led to a dramatic rise in throat cancer in the United States over the past two decades, and experts say they fear an epidemic of the disease.

The comments were made Wednesday at a news conference held by the American Association for Cancer Research to discuss research into the role of the sexually transmitted human papilloma virus (HPV) in head and neck cancer.

Increasing rates of HPV infection, spread through oral sex, is largely driving the rapid rise in oropharyngeal cancers, which include tumors of the throat, tonsils, and base of the tongue, said Scott Lippman, MD, who chairs the thoracic department at the University of Texas M.D. Anderson Cancer Center.

Studies of oropharyngeal tumor tissue stored 20 years ago show that only around 20% are HPV positive, Lippman said. Today it is estimated that 60% of patients are infected with the virus.

"The percentage of oropharyngeal cancers that are HPV positive is much higher now than it was 20 years ago," he said. "This is a real trend, and that is why there is concern of an epidemic given that fact that oropharyngeal cancer is increasing at an alarming rate."
Changing Face of Throat Cancer

Smoking and alcohol abuse were once considered the only major risk factors for these cancers, but this is no longer the case.

American Cancer Society Chief Medical Officer Otis Brawley, MD, said as many as half of the oropharyngeal cancers diagnosed today appear to be caused by HPV infection.

"Changing sexual practices over the last 20 years, especially as they relate to oral sex, are increasing the rate of head and neck cancers and may be increasing the rates of other cancers as well," he said.

He added that there is some evidence that oral HPV infection is also a risk factor for a type of cancer of the esophagus.

"The paradigm is changing," Lippman said. "The types of patients we are seeing now with oropharyngeal cancers are not the patients we have classically seen who were older, smokers, and have lots of other problems. These are young people, executives, a whole different population."
Oral Sex Not Safe Sex

The experts agreed that it is critical for the public to understand that oral sex doesn't equal safe sex.

The message was unofficially promoted in the early days of the HIV epidemic and it is still widely believed by many, especially teens.

Studies suggest that teens are often unaware of the risks associated with unprotected oral sex, including the transmission of HPV, chlamydia, and gonorrhea.

"There is a huge public health message here," Brawley said.

SOURCES: News conference, American Association for Cancer Research. Otis Brawley, MD, chief medical officer, American Cancer Society, Atlanta. Scott Lippman, MD, chair, department of thoracic head and neck medical oncology, University of Texas M.D. Anderson Cancer Center.

A (adenine)

2009-08-19T03:59:00.000-07:00

A (adenine): In genetics, A stands for adenine, one member of the A-T (adenine-thymine) base pair in DNA. The other base pair in DNA is G-C (guanine-cytosine).

Each base pair forms a "rung of the DNA ladder." A DNA nucleotide is made of a molecule of sugar, a molecule of phosphoric acid, and a molecule called a base. The bases are the "letters" that spell out the genetic code. In DNA, the code letters are A, T, G, and C, which stand for the chemicals adenine, thymine, guanine, and cytosine, respectively. In DNA base pairing, adenine always pairs with thymine, and guanine always pairs with cytosine.

Adenine is also one of the bases in RNA. There it always pairs with uracil (U). The base pairs in RNA are therefore A-U and G-C.

The tradition of innovation

2009-08-17T05:52:00.000-07:00

With new ideas can be good or better.

The effect of the classical acupuncture combined with the positive biological effects of laser light: the era of painless Acupuncture began with the Webern ® system, the latest generation of laser needle acupuncture system.

Weber Medical also offers the world's first device to an intravenous blood laser treatment and acupuncture on blood. This procedure comes from the former Soviet Union, which is why studies on sensational successes in treating internal diseases in the West never could penetrate. Meanwhile, many doctors and naturalists in Europe with this method and confirm all the excellent effect.

Kentucky Health Officials Join National HIV Testing Effort

2009-08-13T03:20:00.000-07:00

Health officials in Kentucky are participating in a nationwide effort called the "Test 1 Million Campaign," with the hopes of "encouraging everyone to get tested for HIV, particularly African-Americans and Hispanics," WKYT.com reports. Officials from the Department for Public Health held a news conference on Monday to announce the effort. HIV Activist Bobby Edelen said, "If we get one million people tested and find a percentage of those people who have it are positive, those people can make a positive change in their lives." While health officials are targeting blacks and Hispanics, they "are hoping [their] message reaches everyone," according to WKYT (Evans, 8/11).

This information was reprinted from dailyreports.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily U.S. HIV/AIDS Report, search the archives and sign up for email delivery at dailyreports.kff.org.

Medical diagnosis: Leaks proposed combination with "a major global group"

2009-08-12T05:42:00.000-07:00

The Diagnostic Medical Systems flies by 34% to 0.67 euro in mid-session, under the effect of leakage on a proposed combination of specialist medical imaging devices with a large global group.

Rabaste Antoine, who was CEO of the group not long ago, and led the development of the company for over 18 years, was suddenly off the board of the group at the general meeting of shareholders July 28. He was dismissed from his post at the Council that followed the meeting.

In a statement, the former boss today denounced the change in corporate governance following the action in concert between several minority shareholders entered in the capital when the capital increase of September 2008 and Jean-Luc Dumas, dismissed from his post as Director General on 19 June 2009 and has just been renamed to the post.

He stressed that "the new management team lacks the skills or knowledge of the sector to carry out the development of the Group," recalling that "two members of this new management including chairman of the board of directors and the Deputy CEO, gentlemen Daguise and Dumas were in the past officers of MDS, but were dismissed for misconduct or incompetence and, in both cases, the endorsement of the executive committee. "

Antoine Rabaste stresses that "this sudden change of governance comes as the prospects of the DMS were favorable to the products available in line with market needs."

Above all, it occurs "when, in my capacity as CEO and principal shareholder of MDS I led the negotiations well advanced since the beginning of the year to implement a proposed combination with a large industrial group in the world "Antoine Labaste reveals. However, he says, "the group said shareholders who act
concert was informed of these negotiations and was thus initiated.

The former boss of the company leaves and hear that "the only real goal [of the new management] [is] an ongoing negotiation to bring ... . Meanwhile, given the circumstances and the fact that since that meeting other third parties in society have also been initiated without special precautions in terms of confidentiality, the former leader said to have informed the AMF that it also " requested the suspension of listing to avoid any insider trading. "

In conclusion, Antoine Rabaste said, "it is surprising therefore that at the end of trading a group of 2 former agents dismissed for lack of jurisdiction and individuals who have recently expressed their wish to realize capital gains to short term decides to take control of a listed company knowingly cause considerable risk to derail this project. "

Structural Changes In Tourette's Revealed By New Imaging Technique

2009-05-12T21:04:00.000-07:00

Magnetization Transfer Imaging, MTI, has been used to visualize previously unknown alterations in the cerebral architecture of patients with Tourette's syndrome. The researchers, writing in the open access journal BMC Neuroscience, also found a correlation between the extent of some of the structural changes and symptom severity.

Kirsten Müller-Vahl, from Hanover Medical School, led a team of researchers who used normal MRI scanning and the new MTI technique to investigate the brains of 19 Tourette's patients and 20 controls. They identified alterations in the frontal lobe of the Tourette's group that they suggest may be responsible for the pathology of the syndrome. Müller-Vahl said, "Our in vivo findings, using two sensitive and unbiased techniques, support the hypothesis that alterations in frontostriatal circuitries underlie Tourette's pathology".

The MTI technique used by the researchers has never before been applied to the study of Tourette's. It is a refinement of the nuclear magnetic resonance technique and allows for the detection of changes invisible to conventional MRI scanners. Tissue alterations in comparison to controls were detected in brain areas involved in the selection, programming, initiation, and control of movement. The authors conclude, "We suggest that Tourette's is primarily caused by a dysfunction in prefrontal cortex areas rather than the basal ganglia, as has been previously thought".

Tourette's syndrome is estimated to affect between 1-10 children per 1000 and, although the severity of a person's tics tends to decline with age, as many as 1% of the adult population may have some form of tic disorder. Symptoms include various facial, phonic and other motor tics - the well-known propensity for 'un-voluntary' swearing is in fact relatively uncommon, only affecting about 10% of Tourette's patients.

Testosterone Gel Safety Concerns Prompt FDA To Require Label Changes, Medication Guide

2009-05-10T10:22:00.000-07:00

The U.S. Food and Drug Administration announced that it is requiring manufacturers of two prescription topical testosterone gel products, AndroGel 1% and Testim 1%, to include a boxed warning on the products' labels. The agency is requiring this action after receiving reports of adverse effects in children who were inadvertently exposed to testosterone through contact with another person being treated with these products (secondary exposure).

The gels are approved for use in men who either no longer produce testosterone or produce it in very low amounts. Both products are applied once daily, to the shoulders or upper arms. Only AndroGel 1% is approved for application to the abdomen. Precautions in the current labels instruct users to wash their hands after using the product and to cover the treated skin with clothing.

"These drugs are approved for an important medical need, but can have serious, unintended side effects if not used properly," said Janet Woodcock, M.D., director of the FDA's Center for Drug Evaluation and Research. "We must ensure that the adults using them are well-informed about the precautions needed to protect children from secondary exposure."

In 2007, 1.4 million prescriptions for AndroGel-the most commonly dispensed gel form of testosterone-were dispensed by U.S. retail pharmacies. Approximately 25,000 of those were dispensed for off-label use in women. During the same period, some 370,000 prescriptions were dispensed for Testim, according to data from SDI: Vector One National.

Despite the currently labeled precautions, as of Dec. 1, 2008, the FDA has received reports of eight cases of secondary exposure to testosterone in children ranging in age from nine months to five years. Since that time, additional reports of secondary exposure have been received by the agency and are presently under review.

Of the fully reviewed cases, adverse events reported in these children included inappropriate enlargement of the genitalia (penis or clitoris), premature development of pubic hair, advanced bone age, increased libido, and aggressive behavior.

In most cases, the signs and symptoms regressed when the child no longer was exposed to the product. However, in a few cases, enlarged genitalia did not fully return to age-appropriate size and bone age remained modestly greater than the child's chronological age.

In some cases, children had to undergo invasive diagnostic procedures and, in at least one case, a child was hospitalized and underwent surgery due to a delay in recognizing the underlying cause of the signs and symptoms.

Signs of inappropriate virilization (development of male secondary sexual characteristics) in children and the possibility of secondary testosterone exposure should be brought to a health care provider's attention.

In most of the cases, users of these products failed to follow appropriate use instructions, resulting in direct contact between treated skin and the child.

The required label changes will provide additional information about the risk of secondary exposure and the steps that should be taken to reduce this risk. The FDA also is requiring that the manufacturers of these products develop a Medication Guide as part of a Risk Evaluation and Mitigation Strategy to ensure that the benefits of these products continue to outweigh their potential risks.

The FDA recommends the following precautions be taken to minimize the potential for secondary exposure:

- Adults who use testosterone gels should wash their hands with soap and warm water after every application;

- Adults should cover the application site with clothing once the gel has dried;

- Adults should wash the application site thoroughly with soap and warm water prior to any situation where skin-to-skin contact with another person is anticipated;

- Children and women should avoid contact with testosterone application sites on the skin of men who use these products; and

- Adults should note that use of any similar, but unapproved, products from the marketplace -including the Internet- that can result in the same serious adverse effects should be avoided.

Tuberculosis: a discovery encouraged to improve treatment

2009-05-08T09:29:00.001-07:00

France - A team of Franco-Belgian researchers has developed a drug that makes TB hyper-sensitive to antibiotics. Ultimately, this strategy aims to reduce the amount of antibiotics used and therefore, eliminate some toxic side effects of treatment.

According to WHO figures, nearly 10 million people contract TB and more than half a million die each year. This millennium scourge affecting all countries around the world. China and India are hosting a two-thirds of patients, and Africa is most affected because AIDS promotes the development of tuberculosis. The poor in western countries are not spared and for some time, several European Union countries are experiencing significant growth in the number of cases.

This disease requires a long and tedious, often made more difficult by the many adverse drug reactions. These difficulties and lead many patients to poor monitoring of their medication, or even drop it. This episode may emerge when bacteria become resistant to treatment: relapse is rapid and the person must then be treated by a second-line antibiotics are difficult to quantify because even more toxic. The chances of success are diminishing strongly, this time with no other outcome than death. Currently, half a million cases of MDR-TB are reported each year, resulting in the death of a quarter of the patients concerned.

Therapeutic innovation in the fight against tuberculosis has been proposed this month by the teams of Lille A. Baulard, N. Willand, V. Villeret Brussels and the group of P. Bifani. Their work began there nearly 10 years with the discovery of a gene of Mycobacterium tuberculosis (TB, NB) controlling the level of sensitivity of bacteria to several antibiotics used in cases of MDR-TB. The researchers then sought to develop a drug capable of removing this control, which would make the bacteria more sensitive to treatment. The objective was, in fact, once those antibiotics become more efficient to use lower dose to cause fewer toxic effects and encourage a good therapeutic monitoring by patients, a factor critical to the success of treatment.

By combining different techniques, researchers have designed, synthesized and tested a molecule capable of modifying the sensitivity of Mycobacterium tuberculosis to several antibiotics used to treat MDR-TB. After an optimization in vitro, the administration of this molecule in mice with tuberculosis has decreased by three doses of one of the products necessary for their healing, to a level where the antibiotic no longer effective toxic.

This is the first time such a strategy is proposed to fight against infectious disease. Although many steps remain to be overcome before allowing the first trials in humans, they could be considered for 2012.

PROVENGE Cancer Vaccine Heralds New Dawn In Cancer Therapy

2009-04-30T08:03:00.001-07:00

With the news of Dendreon Corporation's announcement yesterday at the annual meeting in Chicago of the American Urological Association that its investigational active cellular immunotherapy for advanced prostate cancer, PROVENGE (sipuleucel-T), extended patient survival by 4.1 months and increased 3-year survival by 38 percent compared to placebo, the field of tumor immunology has taken a significant leap forward as this, the first active cellular immunotherapy shown in a phase III clinical trial to benefit patients, moves closer to FDA approval.

According to experts in the field of tumor immunology, this is an important milestone achievement--within the scope of the history of tumor immunology and the decades of effort to bring effective cancer immunotherapies to patients, the impact of PROVENGE specifically on prostate cancer therapy today, and the broader import this has and as it bears on cancer vaccine discovery and development efforts currently underway within academic and industry domains.

The Cancer Research Institute, a non-profit organization the supports and coordinates laboratory and clinical efforts leading to the immunological treatment, control, and prevention of cancer, is a global leader in cancer vaccine development. The CRI/LICR Cancer Vaccine Collaborative--a centralized network of more than 20 top academic clinical trial sites with immunological monitoring capability engaged in single-variable, first-in-man cancer vaccine studies, formed in partnership with the Ludwig Institute for Cancer Research Ltd--and its Cancer Vaccine Consortium--a membership association of more than 60 pharmaceutical and biotechnology companies and academic institutions who share a common goal of making cancer vaccines part of the standard-of-care for cancer patients--together comprise the world's leading experts in cancer vaccine discovery and development from both academia and industry.

Cancer Research Institute can provide expert commentary on the importance of the PROVENGE study results and what they mean for the field of tumor immunology, for cancer patients, and for the future of cancer therapy, as well as key challenges still facing the field, including vaccine reagent access, intellectual property concerns, regulatory issues, protocol design, RECIST criteria, and strategies that work to bridge the divide between academic and industry interests.

Major Breakthrough In Transplantation Immunity.

2009-04-07T06:16:00.000-07:00

Australian scientists have made a discovery that may one day eradicate the poverty for a time of poisonous immunosuppressive drugs after organ transplants.

Professor Jonathan Sprent and Dr Kylie Webster from Sydney's Garvan Institute of Medical Research, in collaboration with colleagues, Dr Shane Grey and Stacey Walters, have successfully hardened a practice, in experimental mice, of adjusting the immune method for just long enough to catch a bandanna transplant and accept it as 'self'. At no rostrum, during, or after the practice, is there any should for immunosuppressive drugs.

The fallout was now online in the tide version of the prestigious Journal of Experimental Medicine.

"Under common circumstances, the body would damage a transplanted organ unless immunosuppressive drugs such as cyclosporin were given," said Sprent. "In this propel, mice were given a substance, or 'compound', that untouched their immune systems, so that they accepted transplanted cells as their own."

Sprent urbanized the 'obsession' with Professor Charles Surh from California's Scripps Research Institute and Dr Onur Boyman, surgeon and Head of the Basic Immunology Unit at the University Hospital of Lausanne in Switzerland.

The multipart combines a molecule, interleukin-2 (IL-2), with an antibody to stimulate immune cells known as T regulatory cells.

"In broad terms, IL-2 is an evolution issue for T cells," explained Sprent. "My colleague Onur Boyman discovered that by combining IL-2 with different antibodies you can rule its action, boosting definite populations of T cells, while subduing others. For this foresee we desirable to boost the facts of T regulatory cells."

"T regulatory cells soothe the immune system, subduing the body's killer T cells when it's time to cease fighting an infection."

"The other elevation of the coin is that superabundance of T regulatory cells prevents killer T cells from functioning. And you wouldn't want to be lacking killer T cells for long because they brawl infections and cancers."

"For this plan, we boosted T regulatory cells temporarily, in a route that we deem might be very expedient clinically, particularly for preventing rejection."

It was the errand of postdoctoral researcher Kylie Webster, working with Stacey Walters, to see if she could make the T regulatory booth reply work in a clinically realistic locale.

"We took natural, strong mice, injected them for three consecutive living with the involved, then transplanted insulin-producing cells on the fourth day," said Kylie. "By the time of transplant there were titanic figures of T regulatory cells in their systems, making attach-destroying T cells ineffective."

"The numbers of T regulatory cells dropped over time, and the immune systems returned to normal in about two weeks. By that time 80% of the mice had accepted the grafts of insulin producing cells as their own."

"This acceptance price is very high for transplantation, with mice typically rejecting grafts within 2-3 weeks."

"A join is considered accepted if it's tolerated after 100 being. We took some mice out to 200-300 time, and not one of them abandoned."

While careful, Professor Sprent is very encouraged by the outcome.

"We have yet to determine just how the neurosis mechanism. Once we do, I trust a clinical tryout of this very non-toxic agent would be worthwhile."

"Our style plant well with pancreatic islets, or insulin-producing cells, but we have yet to try other clinically-pertinent grafts such as kidneys and hearts, which are technically very trying in mice," he said.

"I am also attentive that effective approaches in mice do not necessarily give good results in humans because of faint differences in the immune systems of mouse and man."

"Those provisos given, if we were able to duplicate this experiment in humans, it would fulfil the desire of each in the transplant ground."

Study Finds New Evidence Of Periodontal Disease Leading To Gestational Diabetes

2009-04-07T06:14:00.000-07:00

A new consider by NYU dental researchers has uncovered prove the pregnant women with periodontal (gum) disease face an amplified gamble of developing gestational diabetes even if they don't smoke or gulp, a sentence that underscores how important it is for all eager mothers - even those lacking other attempt factors - to argue good oral fitness.

The lessons, led by Dr. Ananda P. Dasanayake, Professor of Epidemiology & Health Promotion at New York University College of Dentistry in collaboration with the Faculty of Dental Sciences at the University of Peradeniya, Sri Lanka, eliminated smoking and alcohol use among a group of 190 pregnant women in the South Asian island nation of Sri Lanka, where a combination of cultural taboos and poverty deter the lead of women from smoking and drinking. The findings back an earlier reading led by Dr. Dasanayake that found mark the pregnant women with periodontal disease are more likely to expand gestational diabetes than pregnant women with vigorous gums.

That review, which followed 256 women at New York's Bellevue Hospital Center through their first six months of pregnancy, showed that 22 of the women urbanized gestational diabetes. Those women had significantly upper levels of periodontal bacteria and inflammation than the other women in the examine. The findings were available in the April 2008 spring of the Journal of Dental Research.

More than one-third of the women in the new examine, which was conducted over the course of one year, reported having flow gums when they brushed their teeth. The women were givens a dental examination and a glucose challenge test, which is worn specifically to conceal for gestational diabetes. According to Dr. Dasanayake, those women found to have the peak total of bleeding in their gums also had the supreme levels of glucose in their blood. Dr. Dasanayake, who vacant the findings nowadays at the yearly encounter of the International Association for Dental Research in Miami, said that he expected the decisive data to show that between 20 and 30 of the women had developed gestational diabetes.

An failure characterized gestational diabetes to transfer glucose -- the chief source of fuel for the body -- to the cells during pregnancy. The state typically disappears when the pregnancy tops, but women who have had gestational diabetes are at a greater attempt of developing the most ordinary form of diabetes, known as Type 2 diabetes, later in life. Asians, Hispanics, and Native Americans are at the highest expose for developing gestational diabetes. All the women in the Sri Lanka revise were of Asian cause, while 80 percent of the New York study subjects were Hispanic.

"Besides its aptitude character in preterm mode, mark that gum disease may also contribute to gestational diabetes suggests the women should see a dentist if they sketch to get pregnant, and after fetching pregnant," Dr. Dasanayake said. "Treating gum disease during pregnancy has been exposed to be sound and helpful in improving women's oral wellbeing and minimizing possible risks."

Yale Stem Cell Researchers Awarded $4 Million In State Grants

2009-04-02T08:02:00.000-07:00

A team of scientists led by Dr. Timm Schroeder of Helmholtz Zentrum Muenchen has proved the existence of hemogenic endothelial cells. The findings answer the question unsolved until now of how blood cells are generated during embryonic development and will enable scientists in the future to produce blood cells in the laboratory in a more target-specific manner. These new insights represent an important contribution to future clinical therapeutic approaches. The study was published in the prestigious science journal Nature and will be a central topic of the international symposium on the molecular mechanisms of hematopoiesis, which will take place in Munich from April 2nd to 4th.

The findings on the molecular mechanisms of blood formation (hematopoiesis) will be presented in Munich at the international symposium "Molecular Mechanisms of Normal and Malignant Hematopoiesis" from April 2nd to 4th. A question that has puzzled researchers for decades could now be solved: How are the first blood cells generated in the embryo?

In particular, Dr. Timm Schroeder, research group leader at the Institute of Stem Cell Research of Helmholtz Zentrum Muenchen and his team found out that a special type of endothelial cells exists that can transform themselves into blood cells. Endothelial cells line the interior surface of blood vessels.

Dr. Timm Schroeder explained: "It is extremely difficult to investigate the blood cell generation process. It occurs only very briefly, hidden from view in the embryo within the mother's uterus."

The scientists first had to create the technical means to continually observe the transformation process of endothelial cells into blood cells on the single-cell level over a longer period of time. Dr. Schroeder and his colleagues developed novel bioimaging techniques with which the behavior of large numbers of individual cells can be recorded and tracked. They combined optimized microscopy, incubation and imaging technology as well as novel software programs to track individual cells in time-lapse videos with sophisticated cell purification and cell culture techniques. Thus, the scientists could observe the behavior of many differentiating mesodermal cells over a period of up to one week.

By carefully analyzing thousands of cells and the molecules expressed by them, Dr. Schroeder and PhD student Hanna Eilken were able to detect several very rare endothelial cells that indeed transformed themselves into blood cells.

"As a next step, we will focus on the identification of molecules that regulate the specification of blood cells," Dr. Schroeder went on to say. "Ultimately, our objective is to understand the precise molecular mechanisms. Identifying the exact cell type generating blood cells is an important prerequisite for understanding what combination of molecules makes a cell a blood cell."

Besides giving more insight into the mechanisms of blood formation, the findings of this just-published study are important for improving production of blood cells in the laboratory for clinical therapies. A possible in vitro production of unlimited numbers of blood cells from embryonic stem cells holds great promise for new therapy approaches. However, to enable targeted, efficient and pure production of specific blood cells that are safe for clinical therapy, it is essential to precisely understand the necessary differentiation steps. Dr. Schroeder concluded: "Our study has now elucidated the last of these steps."

Enzyme And Vitamin Define The Yin And Yang Of Asthma

2009-04-01T09:17:00.000-07:00

The allergen breathed in by a person with asthma triggers a proteinase or enzyme called MMP7 that activates a cascade of events to prompt an allergic reaction, said a consortium of researchers led by Baylor College of Medicine in Houston in a report that appears online in the journal Nature Immunology.

In particular, MMP7 activates interleukin 25, a key mediator of the allergic response in the lung said Drs. Farrah Kheradmand and David B. Corry, associate professors of medicine-pulmonary at BCM, and senior authors of the report.

In the same report, the researchers report that they have identified a form of vitamin A made in the lung that is critical for dampening the inflammatory effect. Mice that lack MMP7 were found to have higher production of retinal dehydrogenase, an enzyme that is responsible for synthesizing vitamin A in the lung. MMP7 deficient mice showed less lung inflammation when they are exposed to allergens than did mice who had enough MMP7. Suppressing the production of vitamin A restored the asthmatic symptoms in the MMP7 deficient mice.

"It is important to know which mediators in the airway may be setting off the initial cascade of events that result in the asthmatic reaction in the lung; it would be like getting to the top of the food chain," they said.

In the future, they said, they hope to identify the relationship between the synthesis of vitamin A in the body and the repression of MMP7.

Anesthesiology Remains At The Forefront Of Modern Medicine

2009-03-31T07:14:00.000-07:00

Given the wide range of procedures in which anesthesia is required and the role it plays in making modern medicine possible, it is of little surprise that interest in this medical specialty continues to grow.

For example, anesthesiologists play a vital role from perioperative and postoperative care of newborn infants to elderly patients, from minor procedures, to complex organ transplants and heart surgery.

Duties range from deciding if a patient is fit for surgery to treating postoperative pain and determining if one is fit for discharge. Anesthesiologists also provide pain relief for women in labor, are involved in resuscitation, can be first responders to traumas and treat patients with chronic pain.

In addition to the operating room, work sites include the delivery room, emergency room, the intensive care unit and even the military battlefield. In addition, anesthesiologists sometimes provide sedation for procedures in the X-ray department, the endoscopy suite and elsewhere in the hospital.

Given the critical care performed, the profession requires a high level of technological savvy and extended education.

Anesthesiologists must remain cool and confident in situations of enormous stress and provide relief for patients who often are hurting, anxious or seriously upset. As a result, anesthesiologists enjoy tremendous satisfaction helping those they serve.

According to Mary Dale Peterson, M.D., chair of the ASA Committee on Physician Resources, "The practice of anesthesiology is both challenging and rewarding. As physicians we are very proud of our specialty and its positive impact on the lives of our patients and their families. The American discovery of ether anesthesia over 150 years ago has alleviated human suffering and led to the modern medical miracles we expect today."

Anesthesiologists: Physicians providing the lifeline of modern medicine. Founded in 1905, the American Society of Anesthesiologists is an educational, research and scientific association with 43,000 members organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.

Gene Linked To Lupus Might Explain Gender Difference In Disease Risk

2009-03-31T05:38:00.000-07:00

In an international human genetic study, researchers at UT Southwestern Medical Center have identified a gene linked to the autoimmune disease lupus, and its location on the X chromosome might help explain why females are 10 times more susceptible to the disease than males.

Identifying this gene, IRAK1, as a disease gene may also have therapeutic implications, said Dr. Chandra Mohan, professor of internal medicine and senior author of the study. "Our work also shows that blocking IRAK1 action shuts down lupus in an animal model. Though many genes may be involved in lupus, we only have very limited information on them," he said.

The study appears online this week in the Proceedings of the National Academy of Sciences.

Locating IRAK1 on the X chromosome also represents a breakthrough in explaining why lupus seems to be sex-linked, Dr. Mohan said. For decades, researchers have focused on hormonal differences between males and females as a cause of the gender difference, he pointed out.

"This first demonstration of an X chromosome gene as a disease susceptibility factor in human lupus raises the possibility that the gender difference in rates may in part be attributed to sex chromosome genes," Dr. Mohan said.

Systemic lupus erythematosus, or lupus for short, causes a wide range of symptoms such as rashes, fever or fatigue that make it difficult to diagnose.

The multicenter study involved 759 people who developed lupus as children, 5,337 patients who developed it as adults, and 5,317 healthy controls. Each group comprised four ethnicities: European-Americans, African-Americans, Asian-Americans and Hispanic-Americans.

In previous genetic studies, the researchers had found an association but not a definite link between lupus and IRAK1.

For the current study, the researchers studied five variations of the IRAK1 gene in the subjects, and found that three of the five variants were common in people with either childhood-onset or adult-onset lupus.

To further test the link, the researchers then took mice of a strain that normally is prone to developing lupus and engineered them to lack the IRAK1 gene. In the absence of IRAK1, the animals lacked symptoms associated with lupus, including kidney malfunction, production of autoimmune antibodies and activation of white blood cells.

"The extensive involvement of IRAK1 in the regulation of the immune response renders its association with lupus a prime candidate for careful genetic and functional analysis," Dr. Mohan said.

Future research will investigate the role that X-linked genes, versus hormonal differences, play in the gender susceptibility rates of lupus.

Other UT Southwestern researchers involved in the study were Dr. Jiankun Zhu, assistant instructor in medicine; Mei Yan, research associate; Jie Han, research assistant; Dr. Joseph Zhou, professor of pathology; and Dr. James Thomas, associate professor of pediatrics.

Investigators from the University of Southern California; the University of California, Riverside; Children's Hospital of Los Angeles; Texas Children's Hospital and Baylor College of Medicine in Houston; Oklahoma Medical Research Foundation; Children's Memorial Hospital and Northwestern University in Chicago; University of California, Los Angeles; LaRabida Hospital and University of Chicago; Wake Forest University; and Medical University of South Carolina also participated, as did international researchers from the Hospital for Sick Children in Toronto; the University of Puerto Rico; Hanyang University in the Republic of Korea; and Imperial College London.

The study was funded by the National Institutes of Health, the Alliance for Lupus Research and the Republic of Korea Ministry for Health.

Cholesterol Crystals Linked To Cardiovascular Attacks

2009-03-28T20:29:00.000-07:00

For the first time ever, a Michigan State University researcher has shown cholesterol crystals can disrupt plaque in a patient's cardiovascular system, causing a heart attack or stroke.

The findings by a team led by George Abela, chief of the cardiology division in MSU's College of Human Medicine, could dramatically shift the way doctors and researchers approach cardiovascular attacks. Abela's findings appear in the April issue of the American Journal of Cardiology.

"Any time there is something completely new or unique in medical research, it is met with healthy skepticism," said Abela, who has been working with cholesterol crystals since 2001. "But we have found something that can help dramatically change how we treat heart disease."

What Abela and his team found is that as cholesterol builds up along the wall of an artery, it crystallizes from a liquid to a solid state and then expands.

"As the cholesterol crystallizes, two things can happen," Abela said. "If it's a big pool of cholesterol, it will expand, causing the 'cap' of the deposit to tear off in the arterial wall. Or the crystals, which are sharp, needle-like structures, poke their way through the cap covering the cholesterol deposit, like nails through wood."

The crystals then work their way into the bloodstream. It is the presence of this material, as well as damage to an artery, that disrupts plaque and puts the body's natural defense mechanism - clotting - into action, which can lead to dangerous, if not fatal, clots.

Abela and his team studied coronary arteries and carotid plaques from patients who died of cardiovascular attacks. When comparing their findings against a control group, they found evidence of cholesterol crystals disrupting plaque.

The breakthrough in discovering the crystals' impact came after Abela and colleagues found a new way to preserve tissue after an autopsy, using a vacuum dry method instead of an alcohol solution. The previous method would dissolve the crystals and prevent researchers and doctors from seeing the impact.

Abela also has found that cholesterol crystals released in the bloodstream during a cardiac attack or stroke can damage artery linings much further away from the site of the attack, leaving survivors at even greater risk. The research means health care providers now have another weapon in their arsenal against cardiovascular diseases.

"So far, treatments have not been focused on this process," Abela said. "Now we have a target to attack with the various novel approaches. In the past, we've treated the various stages that lead to this final stage, rather than preventing or treating this final stage of the condition."

In separate research published in the March edition of medical journal Atherosclerosis, Abela and colleagues looked at the physical triggers that can cause cholesterol crystallization. They found that physical conditions such as temperature can play a role in how quickly cholesterol crystallizes and potentially causes a rupture.

Mechanism That Regulates Cancer-Causing Gene, Revealed By URI Scientists

2009-03-28T20:28:00.000-07:00

Two University of Rhode Island scientists have revealed how a cancer causing protein is regulated by reactive oxygen species (ROS) -- a type of stress signal. Their findings provide new insight into how this protein normally behaves in human cells and may help in the design of drugs targeting specific cancers.

Doctoral student David J. Kemble and Professor Gongqin Sun in the URI Department of Cell and Molecular Biology are the first to provide a biochemical mechanism describing how certain protein tyrosine kinases sense and respond to oxidation. This sensing system was found to uniquely apply to two families of proteins implicated in numerous cancers: the Src and Fibroblast Growth Factor Receptor families of tyrosine kinases.

Their results were published online March 9 in the Proceedings of the National Academy of Sciences.

Src was the first enzyme identified as a cancer-causing gene in the early 1900's. For years scientists have been studying how the enzymes are expressed in cancer cells - what do they do and what controls them.

According to Kemble and Sun, Src is a master regulator of cell function, controlling cell metabolism, division, and death. In normal cells, the function of Src is turned off, and it is turned on only when certain stimulatory signals activate it. When the regulatory mechanisms that control Src activity are disrupted, Src may be turned on all the time, which turns the host cell into a cancer cell. Thus, it is crucial to understand how Src function is controlled.

Reactive oxygen species have long been viewed as damaging byproducts of oxygen-based metabolism. However, it is now recognized that ROS are produced when the cells are under growth stimulation, and they in turn regulate other cellular events. Accumulating evidence indicates that ROS can directly regulate the function of Src function, and thus indirectly control many cellular processes. Yet how Src responds to this regulation has remained elusive.

The URI scientists took a systematic approach, examined all the potential mechanisms, and identified the sensor that enables Src to respond to ROS regulation. They further found that the sensor is also present in several other similar enzymes, mostly in the FGFR family.

"Our results were surprising at first, given that the results contradict some reports in the literature," Kemble said. "But there was always a very clear answer to each question we asked. It was both unusual and exciting to see things progress as smoothly as it did."

According to Sun, this mechanism of regulation represents just a small piece of the large puzzle of how Src is controlled in the cells. "Src function is under the control of several different mechanisms; each one needs to fit in with the others to form a seamless regulatory system." Sun said.

Drinking Hot Tea Strongly Linked To Higher Risk Of Oesophagal Cancer

2009-03-28T20:26:00.000-07:00

A study carried out in a province of northern Iran where people drink lots of hot tea every day found there was a strong link between drinking very hot tea and a higher risk of cancer of the oesophagus, the tube of muscle that carries food from the throat to the stomach.

The study was the work of Dr Reza Malekzadeh, professor and director of the Digestive Disease Research Center of Shariati Hospital at the Tehran University of Medical Sciences, and colleagues, and was published online on 26 March in the British Medical Journal, BMJ.

The researchers suggest people wait a few minutes before drinking tea made with boiling water, since they concluded that drinking very hot tea (that is at or above 70 degrees C or 158 degrees Fahrenheit) can raise a person's risk of developing cancer of the oesophagus.

However, in an accompanying editorial, David Whiteman of the Queensland Institute of Medical Research in Australia said there was no cause for alarm and advised people always to let hot food and drinks cool a little before swallowing them.

Oesophagal cancers, of which OSCC (oesophageal squamous cell carcinoma) is the most common, kill half a million people worldwide every year. Tobacco and alcohol use is the most common cause in Europe and America and is more likely to affect men than women, however, a tendency to consume hot drinks is also thought to play a role.

For the study, researchers went to Golestan Province in northern Iran because it has one of the highest rates of OSCC in the world, but women are just as likely to get it as men, and the numbers of people who smoke and drink alcohol are quite low. On the other hand, lots of people drink hot tea.

Malekzadeh and colleagues recruited 300 patients diagnosed with OSCC and matched them with 571 healthy people from the same area (the controls). Nearly all the participants in both groups were regular tea drinkers, consuming on average over a litre a day.

They asked them questions about how hot they drank their tea and how long they waited after pouring it before starting to drink it.

The researchers then measured the actual temperature that nearly 50,000 people from the same area drank their tea at and compared it to the participants' description. The temperature ranged from under 60 to over 70 degrees C, and the researchers found that what the participants described as the temperature agreed moderately with actual measurements.

The results showed that:

Compared with drinking warm or lukewarm tea (65 deg C or less), drinking hot tea (65 to 69 deg C) was linked to a doubling of the risk of OSCC.
Drinking very hot tea (70 deg C or more) however, was linked to an eight-fold increased risk of OSCC.
Drinking tea within two minutes of pouring it was linked with a five-fold higher risk of OSCC compared to drinking it after four minutes.
There was no link between how much tea people drank and risk of OSCC.

The authors concluded that:

"Drinking hot tea, a habit common in Golestan province, was strongly associated with a higher risk of oesophageal cancer."

UK studies show that healthy people tend to report drinking tea at around 56 to 60 deg C.

The researchers said it was probably worth telling the people of Golestan and other high risk populations with similar drinking habits about the health risk of having very hot drinks.

These findings are consistent with the idea that thermal injury may cause epithelial cancers, said Whiteman, though he pointed out that the underlying mechanism is not clear and should be studied further.

However, Whiteman said people should not alarm themselves about these findings and hopes public enthusiasm for drinking tea is not diminished: just let food and drinks cool from "scalding" to "tolerable" before swallowing them, he said.

"Tea drinking habits and oesophageal cancer in a high risk area in northern Iran: population based case-control study."

Farhad Islami, Akram Pourshams, Dariush Nasrollahzadeh, Farin Kamangar, Saman Fahimi, Ramin Shakeri, Behnoush Abedi-Ardekani, Shahin Merat, Homayoon Vahedi, Shahryar Semnani, Christian C Abnet, Paul Brennan, Henrik Møller, Farrokh Saidi, Sanford M Dawsey, Reza Malekzadeh, Paolo Boffetta.

BMJ 2009, 338:b929
Published online 26 March 2009

Gene Changes May Stunt Lung Development In Children

2009-03-28T20:19:00.000-07:00

Mutations in a gene may cause poor lung development in children, making them more vulnerable to diseases such as chronic obstructive pulmonary disease (COPD) later in life, say researchers at the University of Pittsburgh Graduate School of Public Health and the German Research Center for Environmental Health. Their study, published online in Physiological Genomics, measured expression levels of the gene and its variants in both mouse lungs and children ages 9 to 11.

Study authors, led by George Leikauf, Ph.D., professor of occupational and environmental health at the University of Pittsburgh Graduate School of Public Health, and Holger Schulz, M.D., professor of medicine at the Institute of Lung Biology and Disease, German Research Center for Environmental Health, Munich, focused on a gene called superoxide dismutase 3 (SOD3), previously shown to protect the lungs from the effects of asbestos and oxidative stress.

"People lose lung function as they age, so it's important to identify possible genetic targets that control healthy development of the lungs during childhood," said Dr. Leikauf.

Drs. Leikauf, Schulz and colleagues compared SOD3 expression levels in strains of mice with poor lung function to one with more efficient airways and lungs two times the size. As with people, the lungs of mice fully form as they mature to adulthood. The better-functioning strain maintained higher levels of SOD3 - levels in these mice were four times higher at the final stage of lung development. They also found the presence of single nucleotide polymorphisms, or SNPs, variations in DNA sequences, in SOD3 that were linked to lung function in mice.

The researchers went on to assess SOD3 mutations in children ages 9 to 11 by testing for SNPs linked to lung function. After analyzing DNA from 1,555 children in Munich and Dresden who were part of the International Study of Asthma and Allergy in Children, they discovered two common SNPs associated with poorer lung function. One of these SNPs likely alters the expression levels of SOD3. Lung function was tested with spirometry, which measures the amount and speed of exhaled air.

Previously, genetic variants in SOD3 have been associated with loss of lung function in COPD, which is mainly caused by cigarette smoking. "We know SOD3 protects the lung against injury caused by chemicals in cigarette smoke, and it could be a link between childhood exposure to environmental tobacco smoke and poor lung development," said Dr. Leikaf. In the future it might be possible to identify at-risk children and to develop a medication that would foster optimal lung development, he added. The researchers also are exploring sex differences in SOD3 gene expression and lung development, and girls appear to be at greater risk than boys.

COPD is the fourth leading cause of death in the United States, accounting for more than 120,000 deaths annually and costing more than $30 billion per year. It is estimated that more than 16 million Americans have COPD.

Bio-engineered Proteins: Trial Confirms New Way To Tackle Cancer

2009-03-26T10:20:00.000-07:00

Re-engineering a protein that helps prevent tumours spreading and growing has created a potentially powerful therapy for people with many different types of cancer. In a study published in the first issue of EMBO Molecular Medicine, Canadian researchers modified the tumour inhibiting protein, von Hippel-Lindau (VHL), and demonstrated that it could suppress tumour growth in mice.

When solid tumours grow they often have relatively poor and disorganised blood supplies. As a result, various regions including the centre of the tumour have low levels of oxygen and are said to be hypoxic. Cells in these hypoxic areas produce hypoxia-inducible factor (HIF) that helps them carry on growing. Consequently HIF is associated with aggressiveness in some of the most common types of cancer, including prostate, breast, colon and lung cancer. Under normal conditions VHL degrades HIF, but VHL is deactivated when oxygen levels are low. So, in hypoxic regions of a tumour, just where VHL is needed to inhibit cancer, it is ineffective.

The researchers, therefore, created a new version of VHL that does not stop working when oxygen is scarce. Introducing this newly engineered version of VHL into mice that had kidney tumours dramatically reduced levels of HIF, caused tumours to regress and limited the formation of new blood vessels within the tumours.

"We have genetically removed the Achilles' heel of VHL to permit unrestricted destruction of HIF," says lead researcher Professor Michael Ohh, who works in the Faculty of Medicine at the University of Toronto. "The level of HIF is usually very high under conditions of low oxygen, but when we put in our bioengineered VHL its levels go right down to a level that would be comparable to that in normal oxygen levels."

Their findings could have implications for any type of cancer in which HIF plays a role. "We used kidney cancer as a model because it is one of the most resistant tumours to conventional radiation and chemotherapy, but our findings provide a novel concept that could potentially serve as a foundation for smarter anti-cancer strategy for a wide variety of cancers," says Ohh.

Pericardial Fat Correlates With Heart Disease Risk In Adults With No Weight Problems

2009-03-26T09:52:00.000-07:00

Adults may be fat, thin, or carry normal body weight, but if a specific kind of fat has accumulated around their hearts, they probably have atherosclerosis.

Based on multislice cardiac CT studies of 558 chest pain patients, Dr. Hwan Seok Yong and colleagues at Korea University Guro Hospital in Seoul established a correlation for the first time between the presence of pericardial adipose tissue and coronary atherosclerosis in patients with a normal body mass.

The team's recent assessment of 558 patients with chest pain found that pericardial fat is closely linked to coronary artery plaque, even in patients who are not overweight. After excluding patients with a BMI (body mass index) of over 30 the study group was reduced to 165 patients.

Gene Variation Found To Help Predict Surgical Outcomes Of Coronary Artery Bypass Graft Surgery Patients

2009-03-25T10:46:00.001-07:00

A study with far-reaching implications for patients undergoing coronary artery bypass graft (CABG) surgery has identified human genetic variants that could help doctors predict the potential for certain patients to suffer poor heart function.

Amanda A. Fox, M.D., and her co-investigators from the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital and the Division of Cardiovascular Anesthesiology at the Texas Heart Institute, identified variants in two sets of genes that, when added into a clinical model for predicting heart function, offer significant improvement in the ability to anticipate heart problems after surgery.

"The gene variants we studied have been associated with cardiovascular disease states such as hypertension, stroke and myocardial infarction," said Dr. Fox. "However, to date, the association between these genes and development of heart failure after cardiac surgery with cardiopulmonary bypass has not been examined."

Dr. Fox's research focused on a group of protein hormones called natriuretic peptides, which are secreted by heart muscle cells. These natriuretic peptides help to stabilize the body by controlling such things as the amount of water, sodium, potassium and fats in the bloodstream.

Dr. Fox hypothesized that gene variants in natriuretic peptides could independently predict which patients might have poor heart muscle function after heart surgery. Such knowledge would lead to a better understanding of molecular mechanisms underlying postoperative heart failure.

In a companion editorial to the study, John H. Eisenach, M.D., stated that Dr. Fox's research could be an important next step in clinical genomics.

"The magnitude of this modern collaborative clinical trial is remarkable," said Dr. Eisenach, Mayo Clinic, Rochester. "This study has potential implications for the prediction of postoperative morbidity, development of disease prevention strategies and personalized pharmacological interventions that pertain to the natriuretic pathway."

Dr. Fox said that future research needs to broaden the scope of genetic associations in other cardiac surgical patients. Her study included 697 Caucasian subjects.

"The gene variants we studied differ in frequency between people depending upon ethnic backgrounds, requiring that analysis of these variants be stratified by race," she said.

Dr. Eisenach sees studies such as the one by Dr. Fox and her group as signaling new directions in clinical genomics, a formative field in anesthesiology research.

"The mind-bending speed of genomic technology and discovery has outpaced genomic education in medical school and anesthesiology residency," he said. "Eventually, education in genomics will be essential for practitioners to translate genomic discoveries into clinical practice."

Xenomics Presents New Diagnostics Platform: Detection Of In Vivo Cell Death By Analysis Of Cell-Free Tissue-Specific MiRNA In Urine Or Blood

2009-03-25T07:10:00.000-07:00

Xenomics, Inc. (XNOM.PK), a developer of non-invasive, next-generation molecular diagnostics, announces that Dr. Samuil Umansky, Chief Scientific Officer, is scheduled to give a talk today at the "microRNA in Human Disease and Development" conference in Boston, MA. Dr. Umansky will present a new platform technology developed by the company for detection of in vivo cell death by quantitative analysis of miRNA from urine and other bodily fluids.

The excessive apoptotic, or more rarely necrotic, cell death causes or accompanies numerous acute and chronic diseases and conditions, including brain stroke, acute myocardial infarction, Alzheimer's disease and other forms of dementia, as well as body reaction to various toxic causes and infections. Thus, a molecular technique enabling detection of in vivo cell death could be applied to many diagnostic areas and be used as companion diagnostics for the acceleration of drug development in clinical trials.

Xenomics recently developed a new technique that allows isolation of very short nucleic acids and oligonucleotides from urine and other bodily fluids. Using this method, the Xenomics team has demonstrated that urine contains various miRNA, including those specific for or overexpressed in placenta, liver, brain, and other tissues located outside of urinary system. This finding opens the possibility for non-invasive detection of cell death occurring in various tissues and organs.

Quantitative analysis of brain-specific miRNA isolated from urine and serum of patients with brain stroke or Alzheimer's disease demonstrated that the amount of neuron-specific miRNA was significantly higher both in urine and serum of those patients compared with matched controls, based on the analysis of samples from 100 human subjects completed to date. This data presents the first indication that the excessive cell death can be reliably detected in patients with acute and chronic diseases. The finding may lead to the development of non-invasive diagnostic tests based on analysis of cell-free miRNA from urine or serum. Such tests would be of particular importance for Alzheimer's disease, a devastating illness for which no molecular diagnostic or monitoring test exists. Over five million people in the United States are living with Alzheimer's disease; costs of Alzheimer's and other dementias to Medicare, Medicaid and businesses amount to more than $148 billion each year.

The possibility of detecting in vivo cell death by analysis of tissue-specific miRNA in bodily fluids complements Xenomics' original Transrenal DNA technology, which is based on analysis of "non-self" DNA sequences, including fetal DNA in the urine of pregnant women, DNA of various pathogens, and tumor-specific mutant DNA sequences.

Intensive Insulin Therapy Risks For Critically ill Patients

2009-03-24T10:51:00.001-07:00

A new study in CMAJ indicates that intensive insulin therapy considerably increases the risk of hypoglycemia in critically ill patients. http://www.cmaj.ca/press/cmaj.090206.pdf

Numerous intensive care units worldwide use rigorous insulin therapy to control blood sugar. A range of organizations, such as the American Diabetes Association and the American Association of Clinical Endocrinologists, recommend it as a standard care for critically ill patients.

In 2001, a randomized trial found that intensive insulin therapy considerably reduced hospital mortality. However, later trials have reported conflicting results on mortality and higher rates of severe hypoglycemia.

Information from twenty six trials is taken into account in the CMAJ study. It includes the NICE-SUGAR Study on intensive insulin therapy which is an international, multicentre randomized trial, and is the leading intensive insulin therapy trial to date. The New England Journal of Medicine issues online the NICE -SUGAR study on March 24, 2009 and publishes it in the print edition on March 26, 2009.

Dr. Donald Griesdale, anesthesiologist and critical care physician, Vancouver General Hospital and clinical instructor, University of British Columbia and his team write: "By including the largest trial on intensive insulin therapy published to date, we provide the most current and precise estimate of the effect of intensive insulin therapy on vital status and hypoglycemia in the ICU setting."

The twenty six trials analyzed in the CMAJ study included 13,567 patients. Results showed that the risk of hypoglycemia increased six times more than the control treatment.

The study was carried out by researchers from the University of British Columbia and Vancouver General Hospital, Vancouver, BC; Harvard School of Public Health, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Boston, Mass; Queen's University and Kingston General Hospital, Kingston, Ontario; McMaster University, Hamilton, Ontario; Royal North Shore Hospital and the University of Sydney, Australia.

The researchers write, "We suggest that policy makers reconsider recommendations promoting the use of intensive insulin therapy in all critically ill patients." However, as the study incorporated data from trials in diverse populations with a wide range of illness severity, they "cannot exclude the possibility that some patients may benefit from intensive insulin therapy and be at less risk of hypoglycemic events."

Dr. Greet Van Den Berghe and his team note in a related observation that the variations in how the therapy was given explain the different results of each separate study. One single guideline for intensive insulin therapy suitable for all patients is not a valid proposal.

Potential New Disease-Detection Method

2009-03-24T10:44:00.000-07:00

Relying on principles similar to those that cause Jell-O to congeal into that familiar, wiggly treat, University of Michigan researchers are devising a new method of detecting nitric oxide in exhaled breath.

Because elevated concentrations of nitric oxide in breath are a telltale sign of many diseases, including lung cancer and tuberculosis, this development could prove useful in diagnosing illness and monitoring the effects of treatment.

Assistant professor of chemistry Anne McNeil and graduate student Jing Chen will discuss the work at the spring meeting of the American Chemical Society in Salt Lake City, Utah.

McNeil and Chen work with molecular gels, which differ from Jell-O in being made up of small molecules, rather than proteins. But there are also key similarities, McNeil said.

"In both Jell-O and molecular gels, you can use heat to dissolve the material, which then precipitates out into a gel structure. This gel structure is basically a fibrous network that entraps solvent in little pockets," she said.

The researchers wanted to design a material made up of molecules that would organize themselves into a gel when prompted by particular cue - in this case, the presence of nitric oxide and oxygen. Other research groups have achieved similar feats with materials whose solubility changes when exposed to triggers (for example, a change in pH). But McNeil had the idea of promoting the process, known as stimuli-induced gelation, by changing the stackability of the molecules that make up the material.

"We took the approach of designing a molecule that has a shape that won't pack together with other, identical molecules very well, but will change into a more stackable shape on exposure to nitric oxide," McNeil said. When the molecules stack together, gelation occurs.

Because it's easy to see when the material stops flowing and turns into a gel, this method of nitric oxide detection is simpler and less subject to interpretation than other detection methods such as colorimetry and spectroscopy.

"I like the simplicity of not needing an instrument and just being able to flip the sample vial over and see if a gel has formed," McNeil said. At this point, the new technique isn't sensitive enough for clinical use, but McNeil and Chen are working to improve its sensitivity. They're also extending the approach to design materials that would use stimuli-induced gelation to detect hazardous materials, such as explosives.

Drug Como Tolerated In Lung And Breast Cancer Patients Shows Positive Response For Hodgkin's Disease In Young Adults

2009-03-23T10:32:00.000-07:00

New research published in the latest print edition of the Journal of Clinical Oncology (Vol. 27, No. 9) shows a treatment combination used in breast and lung cancers to be effective against Hodgkin's disease in pre-teens and young adults. Richard Drachtman, MD, the interim chief and medical director of the Division of Pediatric Hematology/Oncology at The Cancer Institute of New Jersey (CINJ) is a member of the author team. CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School.

Hodgkin's disease is a type of lymphoma, which compromises the body's immune system by affecting lymph nodes, lymph tissues, and other entities in the body responsible for fighting infection. According to the American Cancer Society, 8,200 new cases of the disease were diagnosed in the United States last year, with about 1,300 deaths. It is most common in people aged 15 to 40 and in those older than 55. Between 10 and 15 percent of all cases are found in children and teens.

At focus in the study, Phase II Study of Weekly Gemcitabine and Vinorelbine for Children with Recurrent or Refractory Hodgkin's Disease: A Children's Oncology Group Report, was a drug combination known as GV (Gemcitabine and Vinorelbine). Previous studies have shown that GV has been well tolerated by adults with breast cancer and non-small cell lung cancer. Investigators found that when children and young adults with Hodgkin's disease that was recurrent or treatment resistant were administered GV, the response was greater than reported for either drug by itself. Predominant side effects were hematologic in nature and primarily consisted of decreased bone marrow activity, which results in fewer platelets and red and white blood cells.

The research looked at 30 patients with a median age of 17, who were heavily treated in their initial stage of Hodgkin's disease. A median of five, 21-day cycles of GV was administered to each patient. Results showed 19 of 25 patients had measurable responses, with six having complete response, 11 having a very good partial response and two had a partial response. And while the one-year, event-free and overall survival rates measured 59.5 percent and 86 percent respectively, the study team notes that further evaluation of GV for this population of patients is warranted.

Dr. Drachtman, who is also a professor of pediatrics at UMDNJ-Robert Wood Johnson Medical School, and his study colleagues are part of the Children's Oncology Group, which is the world's largest cooperative pediatric cancer research organization.

Along with Drachtman, the author team consists of Peter D. Cole, MD, Albert Einstein College of Medicine, Montefiore Medical Center; Cindy L. Schwartz, MD, Brown Medical School, Hasbro Children's Hospital; Pedro A. de Alarcon, MD, University of Illinois College of Medicine at Peoria, St. Jude Children's Research Hospital; Lu Chen, PhD, Children's Oncology Group; and Tanya M. Trippett, MD, Memorial Sloan-Kettering Cancer Center.

The research, which was presented in part as a poster presentation at the American Society of Hematology Annual Meeting in December 2007, was supported in part by a National Cancer Institute Grant (CA98543) and the Damon Runyon Cancer Research Foundation (CI-16-03).

Motor Proteins May Be Vehicles For Drug Delivery

2009-03-23T06:19:00.000-07:00

Specialized motor proteins that transport cargo within cells could be turned into nanoscale machines for drug delivery, according to bioengineers. Chemical alteration of the proteins' function could also help inhibit the growth of cancerous tumors.

Each cell in the body contains motor proteins that ferry cargo such as chromosomes, mitochondria or bundles of proteins, either from the center of the cell to its outskirts or from the periphery toward the nucleus. Most motor proteins contain two motor domains, or heads, that are attached to a shared cargo-binding domain, or tail.

"Think of it as a freight train at the molecular level," said William Hancock, associate professor of bioengineering, Penn State. "And it runs on cylindrical tracks -- or microtubules -- made of many protein subunits meshed together into a long polymer that is one ten thousandth the diameter of hair."

Hancock and his colleagues are studying a particular motor protein known as kinesin-2. They are trying to understand the molecular mechanics of how these nanometer-scale proteins move within the cell.

"Kinesin motor proteins move by changing their shape," explains Hancock. "The two motor domains alternately bind to the microtubule, generate force and then detach, and the resulting displacement drags the cargo forward."

To power this hand-over-hand motion, the proteins convert the chemical energy of ATP molecules -- a common energy source in cells -- into mechanical work. But there is a problem if the proteins fall off their tracks.

"When a motor binds to the microtubule, it 'walks' about 100 steps -- each step being eight nanometers -- before detaching," said Hancock, whose findings appeared in a recent issue of Current Biology. "And the proteins are so small that if both motor domains let go, the proteins and their cargo would diffuse away within a few milliseconds. This profound effect of diffusion is one of the places where the nanoscale world fundamentally differs from the macro-scale world we normally live in."

The key to successfully hauling the cargo from one point to another lies in perfect coordination between the two motor domains. At any given time, one of the motor domains always needs to be bound to the track.

"Each motor domain is by itself an enzyme that continually alters the mechanics and the biochemistry of the other," explained Hancock, whose work is funded by the National Institutes of Health. "And we are trying to understand the mechanical coordination between the two domains. You can think of it like walking on two feet, but there's no brain to control when a step is taken, only a mechanical connection between the two feet."

The researchers have found that the tether that links the motor domains to the rest of the molecule is longer in kinesin-2 motors than in other kinesin proteins, which prevents efficient mechanical coordination between the two motor domains.

"If you think of this linker domain as a taut bungee cord, any force at one end will be communicated very efficiently to the other end. So the two motors can communicate very efficiently and the timing of their steps is tightly coordinated," Hancock said. "But if the cord is very loose, the forces from one motor domain are poorly communicated to the other and the precise timing of their steps is disrupted. This is a big effect and it reduces the performance of kinesin-2."

To confirm their findings, the researchers artificially lengthened the tethers on kinesin-1 motor proteins. These motors ferry chemicals over much greater distances -- such as in neurons that can be a meter long -- and the coordination between their two motor domains is very efficient.

The researchers found that when the tethers on kinesin-1 motors were lengthened, the communication between the two heads was diminished.

Hancock believes that the insight into the relationship between the length of the tether and the communication between the motor domains could offer new targets for drugs that inhibit kinesins.

"There are a lot of kinesins involved in cell division, and cancer is uncontrolled cell division," said Hancock. "Our hope is that this knowledge will help in the design of new drugs that block the motors during cell division and thereby slow the growth of tumors."

The researchers also believe that the kinesin transport system could in the future be engineered onto microchips.

"Our idea is that you can hook up cargo -- drugs, antibodies, sequences of DNA or RNA -- and the motors would carry them through microchannels on a lab-on-a-chip type of device," added Hancock. "We have already had success with incorporating these proteins into microengineered channels and achieving transport in these systems."

Cambridge-based researchers provide new evidence that the human brain lives "on the edge of chaos", at a critical transition point between randomness

2009-03-22T10:41:00.000-07:00

Recognition of the benefits of cooling strategies to protect the brain and spinal cord after traumatic injury has led to a wealth of cutting edge research, prime examples of which are featured in a special hypothermia issue of Journal of Neurotrauma, a peer-reviewed journal published by Mary Ann Liebert, Inc. The issue will be available free online at http://www.liebertpub.com/neu

The issue includes a series of original articles presenting experimental and clinical evidence to support the use of modest hypothermia in specific conditions. These reports emanated from presentations at the 2nd International Brain Hypothermia Symposium and were selected for publication in the Journal by Guest Editors W. Dalton Dietrich, PhD, and M. Ross Bullock, MD, PhD, both from the University of Miami Miller School of Medicine and Patrick M. Kochanek, MD, from the University of Pittsburgh.

In his Introduction, Dr. Dietrich points out that many factors determine whether hypothermic therapy will be beneficial, including "how early hypothermic therapy is initiated after the insult, the duration of the hypothermic period, the degree of hypothermia, as well as the rewarming protocol. Thus, it is important that basic research studies are continuing in clinical relevant animal models to address these important questions."

The issue explores several aspects of hypothermia, including studies in animal models, its use in the operating room, and its role in the treatment of cardiac arrest, stroke and subarachnoid hemorrhage, traumatic brain (TBI) and spinal cord injury, and pediatric TBI and asphyxia.

Mackensen et al. focus on "Perioperative Hypothermia: Use and Therapeutic Implications," and Kim et al. describe "The Use of Pre-Hospital Mild Hypothermia After Resuscitation from Out-of-Hospital Cardiac Arrest." Kochanek et al. collaborate on two articles on therapeutic hypothermia in pediatric populations, one describing the Safar Vision, and the other focusing on applications in pediatric cardiac arrest. Shankaran presents "Neonatal Encephalopathy: Treatment with Hypothermia," and Bullock et al. provides an overview of "Current and Future Role of Therapeutic Hypothermia."

The Human Brain Is On The Edge Of Chaos

2009-03-22T09:54:00.000-07:00

Cambridge-based researchers provide new evidence that the human brain lives "on the edge of chaos", at a critical transition point between randomness and order. The study, published March 20 in the open-access journal PLoS Computational Biology, provides experimental data on an idea previously fraught with theoretical speculation.

Self-organized criticality (where systems spontaneously organize themselves to operate at a critical point between order and randomness), can emerge from complex interactions in many different physical systems, including avalanches, forest fires, earthquakes, and heartbeat rhythms. According to this study, conducted by a team from the University of Cambridge, the Medical Research Council Cognition & Brain Sciences Unit, and the GlaxoSmithKline Clinical Unit Cambridge, the dynamics of human brain networks have something important in common with some superficially very different systems in nature. Computational networks showing these characteristics have also been shown to have optimal memory (data storage) and information-processing capacity. In particular, critical systems are able to respond very rapidly and extensively to minor changes in their inputs.

"Due to these characteristics, self-organized criticality is intuitively attractive as a model for brain functions such as perception and action, because it would allow us to switch quickly between mental states in order to respond to changing environmental conditions," says co-author Manfred Kitzbichler.

The researchers used state-of-the-art brain imaging techniques to measure dynamic changes in the synchronization of activity between different regions of the functional network in the human brain. Their results suggest that the brain operates in a self-organized critical state. To support this conclusion, they also investigated the synchronization of activity in computational models, and demonstrated that the dynamic profile they had found in the brain was exactly reflected in the models. Collectively, these results amount to strong evidence in favour of the idea that human brain dynamics exist at a critical point on the edge of chaos.

According to Kitzbichler, this new evidence is only a starting point. "A natural next question we plan to address in future research will be: How do measures of critical dynamics relate to cognitive performance or neuropsychiatric disorders and their treatments?"

Lab Grown Nerves Promote Nerve Regeneration After Injury

2009-03-20T23:45:00.000-07:00

Researchers at the University of Pennsylvania School of Medicine have engineered transplantable living nerve tissue that encourages and guides regeneration in an animal model. Results were published this month in Tissue Engineering.

About 300,000 Americans suffer peripheral nerve injuries every year, in many cases resulting in permanent loss of motor function, sensory function, or both. These injuries are a common consequence of trauma or surgery, but there are insufficient means for repair, according to neurosurgeons. In particular, surgeons need improved methods to coax nerve fibers known as axons to regrow across major nerve injuries to reconnect healthy targets, for instance muscle or skin.

"We have created a three-dimensional neural network, a living conduit in culture, which can be transplanted en masse to an injury site," explains senior author Douglas H. Smith, MD, Professor, Department of Neurosurgery and Director of the Center for Brain Injury and Repair at Penn. Smith and colleagues have successfully grown, transplanted, and integrated axon bundles that act as 'jumper cables' to the host tissue in order to bridge a damaged section of nerve."

Previously, Smith and colleagues have "stretch-grown" axons by placing neurons from rat dorsal root ganglia (clusters of nerves just outside the spinal cord) on nutrient-filled plastic plates. Axons sprouted from the neurons on each plate and connected with neurons on the other plate. The plates were then slowly pulled apart over a series of days, aided by a precise computer-controlled motor system.

These nerves were elongated to over 1 cm over seven days, after which they were embedded in a protein matrix (with growth factors), rolled into a tube, and then implanted to bridge a section of nerve that was removed in a rat.

"That creates what we call a 'nervous-tissue construct'," says Smith. "We have designed a cylinder that looks similar to the longitudinal arrangement of the nerve axon bundles before it was damaged. The long bundles of axons span two populations of neurons, and these neurons can have axons growing in two directions - toward each other and into the host tissue at each side.

The constructs were transplanted to bridge an excised segment of the sciatic nerve in rats. Up to 16 weeks post-transplantation, the constructs still had their pre-transplant shape, with surviving transplanted neurons at the extremities of the constructs spanned by tracts of axons.

Remarkably, the host axons appeared to use the transplanted axons as a living scaffold to regenerate across the injury. The authors found host and graft axons intertwined throughout the transplant region, suggesting a new form of axon-mediated axonal regeneration. "Regenerating axons grew across the transplant bridge and became totally intertwined with the transplanted axons," says Smith

Axons throughout the transplant region showed extensive myelination, the fatty layer surrounding axons. What's more, graft neurons had extended axons beyond the margins of the transplanted region, penetrating deep into the host nerve.

Remarkably, the constructs survived and integrated without the use of immunosuppressive drugs, challenging the conventional wisdom regarding immune tolerance in the peripheral nervous system.

The researchers suspect that the living nerve-tissue construct encourages the survival of the supporting cells left in the nerve sheath away from the injury site. These are cells that further guide regeneration and provide the overall structure of the nerve.

"This may be a new way to promote nerve regeneration where it may not have been possible before," says co-first author D. Kacy Cullen, PhD, a post doctoral fellow in the Smith lab. "It's a race against time - if nerve regeneration happens too slowly, as may be the case for major injuries, the support cells in the extremities can degenerate, blunting complete repair. Because our living axonal constructs actually grow into the host nerve sheath, they may 'babysit' these support cells to give the host more time to regenerate."

The other co-first author is Jason Huang, MD, Assistant Professor of Neurosurgery at Rochester University, who participated in the study during his Neurosurgical residency at Penn.

This work was funded by the National Institutes of Neurological Disorders and Stroke and the Sharpe Trust.

PENN Medicine is a $3.6 billion enterprise dedicated to the related missions of medical education, biomedical research, and excellence in patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System.

Penn's School of Medicine is currently ranked #4 in the nation in U.S.News & World Report's survey of top research-oriented medical schools; and, according to most recent data from the National Institutes of Health, received over $379 million in NIH research funds in the 2006 fiscal year. Supporting 1,700 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System (UPHS) includes its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nation's top ten "Honor Roll" hospitals by U.S.News & World Report; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center. In addition UPHS includes a primary-care provider network; a faculty practice plan; home care, hospice, and nursing home; three multispecialty satellite facilities; as well as the Penn Medicine at Rittenhouse campus, which offers comprehensive inpatient rehabilitation facilities and outpatient services in multiple specialties.

Prostate Cancer: Men Deserve Better

2009-03-20T23:23:00.000-07:00

Vast improvements in prostate cancer recognition, management and treatment are needed, according to major prostate cancer groups speaking at the European Association of Urology's 24th Annual Congress

The prostate cancer charter for change from 13 influential European and US prostate cancer patient groups, calls for the disease to be treated with the same level of priority as breast cancer is in women. The charter covers unmet needs in all areas of care from increasing awareness of the importance of screening to highlighting the impact of prostate cancer on love lives.

The group's overarching concern is a lack of clear and consistent information, particularly in areas that affect a man's quality of life and that of his family. Prostate cancer and its treatments impact on all elements of a man's life and not just his physical being. Many men experience urinary incontinence and impotence which can severely compromise their sense of masculinity and day-to-day quality of life, affecting their work, social activity and love life. The charter asks for practices to be put into place to better inform and educate men, their families and all those involved in prostate cancer care of the far reaching effects of the disease and to encourage a more open, communicative and holistic approach to its treatment and management.

Tom Hudson, Chairman of Europa Uomo, explains, "Prostate cancer is the most common cancer among men, yet it attracts far less attention than breast cancer in women. Our charter highlights the shortcomings in the current management of men with this condition but from a very practical viewpoint. For example, maintaining key relationships, love life and intimacy throughout prostate cancer is incredibly important but can often be overlooked. Many men feel uncomfortable discussing these issues and avoid them altogether. It is an area which is absolutely key to men's quality of life and there needs to be a cultural shift in the way it is approached and managed"

Men are living longer than ever before, reaching ages at which prostate cancer risk is highest. Prostate cancer is a disease predominantly affecting elderly men and the number of deaths from prostate cancer in Europe has increased by around 16% since 19951. Worldwide, more than 670,000 men are diagnosed with prostate cancer each year2 and there are approximately 2 million men living with this condition in Europe3. Incidence and prevalence rates vary widely around the world, with by far the highest rates in North America and Northern and Western Europe4.

Louis Denis, Secretary of Europa Uomo, adds "There is still much room for improvement in the management of prostate cancer and the fight against the disease is far from over. Prostate cancer does not receive anywhere near the level of interest and funding it warrants and this must be addressed. With the right holistic approach, men diagnosed with prostate cancer can live long and fulfilled lives. This approach has been taken very successfully to women with breast cancer and we believe that men deserve to be treated in the same way. At the moment, quality of life for men with prostate cancer can be very low, and steps must be taken to recognise and treat the whole person behind the disease, not just the disease itself.

Semafore Achieves A Preclinical Milestone With SF2626, A PI3K-MEK Dual Pathway Kinase Inhibitor

2009-03-18T08:04:00.000-07:00

Semafore Pharmaceuticals, Inc. announced that it has achieved proof of concept in its CRIMP (Control Resulting from Inhibiting Multiple Pathways) kinase platform by designing a small molecule that was demonstrated to inhibit members of both the PI3K (Phosphoinositide-3-kinase) pathway and the Ras-MAPK (Ras-mitogen activated protein kinase) pathway. Specifically, SF2626 has demonstrated the ability to inhibit both PI3K and MEK, the key component of the RAS/RAF/MEK/ERK pathway. Both PI3K and MEK are frequently activated in human tumors and are thus considered high value targets in treating cancer. SF2626 is the first combination PI3K and MEK kinase inhibitor that, in preclinical studies, blocks both pathways simultaneously.

There is clear rationale for inhibiting both pathways in treating cancer. Both the PI3K pathway and the Ras-MAPK pathways have emerged as central conduits of cell signaling networks that regulate cell growth and survival. Recent scientific studies demonstrate that the Ras-MAPK pathway has the ability to cross-talk to the PI3K pathway thereby activating it and that in some cancers both pathways require inhibition to induce programmed cell death.

Additionally, clinical studies in cancer patients with KRAS mutations show that EGFR inhibitors alone are not sufficient to block the downstream activation of the Ras-MAPK pathway. In these patients, it may also be necessary to block both pathways to inhibit cancer cell growth.

With the evolving knowledge of cancer biology and further understanding of the mechanisms of drug resistance Semafore's CRIMP platform technology offers a distinctive approach to rational drug design for combination pathway kinase inhibitors.

Semafore's dual PI3K-MEK kinase inhibitor, SF2626, is a promising lead for targeting cancer. The Company is actively seeking a partner for the continued development of SF2626 and other pipeline inhibitors.

About Semafore

Semafore is a clinical stage drug discovery and development company focused on small molecule modulators of the PI3 kinase and PTEN cell signaling pathway, a promising target pathway for multiple disorders, including the company's focus - cancer. Semafore is a leader in the development of PI3K inhibitors and one of the first biopharmaceutical companies to focus on both PI3K and PTEN. The Company has successfully discovered and is developing a portfolio of drug candidates addressing these targets. Semafore is also leveraging its experience in the PI3K arena to identify and design inhibitors that block multiple pathways.

Immune Tolerance Ensured By Dendritic Cells

2009-03-17T09:54:00.000-07:00

One of the most important tasks of the immune system is to identify what is foreign and what is self. If this distinction fails, then the body's own structures will be attacked, the result of which could be an autoimmune disease such as diabetes mellitus type 1 or multiple sclerosis. The only way to protect against these afflictions is to destroy all immune factors that turn against the body's own tissue - in other words: immune tolerance. A team working with LMU researcher Dr. David Vöhringer has now investigated exactly what role dendritic cells play in this process. There has long been suspicion that these cells, which are important for the body's defenses, are also essential for the establishment and maintenance of immune tolerance. "We investigated mice that lacked this cell type from birth," reports Vöhringer. "It turned out that immune cells that attack the body's own tissue survive in these animals, and thereby trigger an autoimmune response. It follows that dendritic cells play a major part in protecting against autoimmune disease."

T cells are a type of white blood cell that are key actors in the body's immune defenses. Each T cell has a receptor on its surface for recognizing just one single antigen. Antigens are molecular structures, mostly fragments of proteins. T cells do not dock onto free antigens, however: they rely on other cells which can present antigens to them. It is the dendritic cells that are primarily responsible for this job. They present the T cells with various antigens, and if an antigen matches a receptor, then that T cell will trigger an immune response from the body.

This is how the body defends itself against pathogens and other intruders. But behind this tactic lies an element of danger to the organism: what happens if the antigen is not foreign, but originates from the body's own tissue instead? A wrongly induced immune response can lead to a severe autoimmune disease that, if left untreated, could lead to destruction of organs or even death. So-called autoreactive T cells, which recognize the body's own structures, must be eradicated or pacified to avoid that they can cause harm. A T cell screening process therefore takes place in the thymus, the bilobular organ in the upper thorax, to distinguish the good from the bad of these dangerous lone mavericks. Each individual T cell is tested, and the autoreactive ones destroyed.

The remaining T cells are checked a second time in the peripheral lymphatic organs of the body. This constant quality control goes on mostly in the lymph nodes and the spleen. As has been known for a while now, dendritic cells can induce peripheral tolerance although it remained unclear whether they are essential for this process. Dendritic cells migrate continuously out of tissues and organs into the lymph nodes, bringing tissue material with them and present it to T cells. Any T cell that reacts to the body's own proteins is then deactivated or killed off.

Most recent findings have shown that dendritic cells are essential to generate and maintain immunological tolerance. "Our work on mice has proven that without dendritic cells, even the first, central screening of autoreactive T cells in the thymus runs only at reduced efficiency," reports Vöhringer. "In these animals, the thymus releases T cells that react to the body's own material. These are then activated in the peripheral organs - and trigger autoimmunity."

In light of the crucial role these cells play, it is a logical question as to how autoimmunity can be triggered at all without dendritic cells. After all, it is the dendritic cells that undertake certain critical tasks during an immune response. "Among other things, they are specialized in presenting antigens to T cells, which is what makes an immune response at all possible in the first place," says Vöhringer. "So we are left with the question as to what type of cell activates the autoreactive T cells if the supposedly most important antigen-presenting cells - the dendritic cells - are missing. We already have a few candidates for this, and are studying their function more closely now." (suwe)

American Physical Society Presents Biomedical News March 16-20

2009-03-17T08:50:00.000-07:00

Many of the leading scientists working at the interface of physics and medicine will present their latest research at the March Meeting of American Physical Society (APS), which takes place from March 16-20, 2009 at the David L. Lawrence Convention Center in Pittsburgh.

For more than a century, some of the greatest advances in medicine have been born at the intersection of biology and physics. Perhaps many of the most interesting discoveries of tomorrow are being investigated at this crossroads today. Potential examples include: designing advanced imaging and therapeutic techniques for confronting cancer and other diseases deep within the body, inventing advanced materials that help alleviate the suffering of people with particular diseases, creating new materials with useful biomedical properties, and discovering ways of delivering lifesaving drugs to specific parts of the body. Highlights of a few of these discoveries are described below.

HIGHLIGHTS OF BIOMEDICAL NEWS

Immune Cells Shoulder Microscopic Backpacks
New Polymer Material Helps Accelerate Bones Growth
Imaging Neuronal Activity Directly with MRI
Measuring the Flexibility of Human Eye Lenses as we Age
Unraveling the Proteins at the Heart of Parkinson's Disease

1) IMMUNE CELLS SHOULDER MICROSCOPIC BACKPACKS

The most obvious advantage of wearing a backpack over briefcases or most other types of book bags, according to Massachusetts Institute of Technology graduate student Al Swiston, is that they free up your hands and do not interfere with your ability to walk around. Now Swiston, with his advisor MIT Professor Michael Rubner and their colleagues, has designed a way to give tiny cells of the immune system the same advantage -- microscopic backpacks that enable these cells to carry loads of foreign materials without interfering with the cell's ability to interact with their movement.

The packs are actually flexible polymer disks that attach to the membrane of cells. They can carry a wide variety of useful cargo. Swiston and his colleagues envision that the backpacks would enable cells to carry functional molecules that would enhance their action -- antivirals, new vaccines, cancer drugs, contrast agents that show up in MRI scans, fluorescent particles that glow under a microscope, and just about anything that will fit inside.

The idea is to give the immune system new tools for such applications as detecting and imaging cancer cells, delivering drugs to particular sites in the body, and perhaps even delivering particles that can help engineer new tissues. In preliminary tests, which Swiston will describe at the March Meeting, they loaded the backpacks with magnetic and fluorescent particles and traced their movements across a surface. (Talk Y20.3, http://meetings.aps.org/Meeting/MAR09/Event/100256).

2) NEW POLYMER MATERIAL HELPS ACCELERATE BONE GROWTH

As far as materials go, human bones can be both remarkable and frustrating. Their properties are an evolutionary miracle -- steel-like strength, light weight, and the ability to grow continually. But by the same token, these properties can be a medical curse. When treating certain types of severe fractures, for instance, orthopedic surgeons often need to apply grafts that closely mimic real bones. Finding materials that are strong, light, or have the ability to grow is one thing, but finding materials that are all three is a tall order. Titanium, for instance, is terrific for its ability to support heavy loads, but titanium bone grafts may not grow along with healing bones. Once in, these grafts may need to be removed at a later date.

Seeking to design a new type of bone graft, Yizhi Meng of Stony Brook University and her colleagues have been studying the very early stages of bone formation, when a proliferation of cells produce a "matrix" of collagen and other proteins that fits them together tightly. Last year, Meng teamed up with Elaine DiMasi of Brookhaven National Laboratory to probe the mechanical properties of live mouse bone cells as they are laying down a matrix. Over the course of several weeks, calcium and other minerals are deposited into this matrix, which hardens into bones.

What they found was that when cells first lay down their matrix, it needs to be in the correct form in order for mineral deposition to take place. The surface properties are key to this process. On glass, the matrix proteins do not spread out. However, on a specially charged polymer surface designed by a different group of scientists at SUNY Stony Brook and the City University of New York, the proteins unfurl and spread out nicely into a matrix. Meng and her colleagues have found that this special polymer can accelerate bone formation, and they are working on adapting this polymer for making advanced bone grafts. (Talk X39.5, http://meetings.aps.org/Meeting/MAR09/Event/95469).

3) IMAGING NEURONAL ACTIVITY DIRECTLY WITH MRI

The technique of functional Magnetic Resonance Imaging (fMRI) has changed the field of neuroscience because it allows scientists to image living brains in action, revealing which distinct regions of the brain control particular mental processes. Typically fMRI studies are done using the big, expensive high-field MRI instruments you might find in a large urban hospital (they are called "high-field" because of the large 1.5 or 3.0 Tesla superconducting electromagnets they employ). High-field MRI studies do not measure neuronal activity directly, however. Instead they measure the effect of the local blood flow on the MRI signal -- a good but inexact proxy of neuronal activity.

Scientists have tried for years to directly measure the signal from firing neurons, since doing so would allow more precise mapping of brain function. Using high-field MRI to do this seems impossible, however, partially because neuronal activity produces an extremely weak signal that gets completely masked by the overwhelmingly strong MRI signal change generated by the blood flow. Detecting the weaker signal would be like trying to hear a whisper above a roaring jet engine.

Karlene Maskaly and her colleagues at Los Alamos National Laboratory are taking a different approach towards directly measuring the signal from firing neurons. Using a technique called ultra-low field MRI, they employ a small, inexpensive magnet that is 10,000 times weaker than a typical hospital MRI. They hypothesize that this less powerful magnet will cause the roaring signal from the blood flow to be 10,000 times smaller, which will reveal the comparatively whispering signal of the neuronal activity. The use of a small magnet may also allow for the possibility of a resonant interaction between the neural currents and the MRI signals that would act to amplify the whisper as well. They have tested their technique in various settings, including the activation of nerve cells in a human arm placed in the apparatus. Although these results have been inconclusive thus far, they are looking to achieve more definitive results through detection of the neuronal currents in the brain of an epileptic rat. This work was funded by the National Institute of Biomedical Imaging and BioEngineering, and the National Eye Institute, both components of the NIH. (Talk Y40.5, http://meetings.aps.org/Meeting/MAR09/Event/100510).

4) MEASURING THE FLEXIBILITY OF HUMAN EYE LENSES AS WE AGE

The lens of the human eye serves a purpose much like the lens on the front of a digital camera-they both bring light coming from distant objects into focus. Unlike the hard glass lens on the front of your digital camera, the lens of a young human eye is soft and deformable. Attached to a sphincter muscle by tiny ligaments around its edge, human lenses dynamically adjust their focus on objects at different distances by changing its shape. As we age, the ability of our eye lenses to change shape decreases, which is one of the reasons why so many people over the age of 40 wear glasses for reading.

There is no clear scientific consensus as to why the lens' ability to change shape diminishes with age. One theory is that the muscles attached to it grow weaker. Another is that the material properties of the lens itself change, stiffening with age. Now Professor Sooryakumar and his colleagues at Ohio State University and the University of Houston have done light scattering studies on human and bovine eye lenses in order to measure their elasticity. By observing tiny changes in the frequency of light scattered off the lenses, they can calculate variations in lens elasticity. What they found, both in cow eyes and in a group of human lenses obtained from OSU's organ donor program, was consistency. While there was some variation in the elastic properties of the lenses with age, the stiffness of the lenses did not significantly change. This contradicts earlier data (obtained using a different technique) that suggests lenses stiffen dramatically as we age. More studies are needed, says graduate student Sheldon Bailey, but for now the question of how time affects our eye lenses is wide open. (Talk A39.14, http://meetings.aps.org/Meeting/MAR09/Event/93636).

5) UNRAVELING THE PROTEINS AT THE HEART OF PARKINSON'S DISEASE

Parkinson's Disease, which affects some 1.5 million people in the United States, is a progressive brain disorder for which there is currently no cure. One of the leading theories about what causes Parkinson's is that it arises due to the toxic accumulation of protein plaques within certain neurons in the brain. The plaques inhibit neurotransmitter uptake and release in neurons necessary to control movement, and the loss of this neuronal function leads to the characteristic movement disorders and other symptoms that are hallmarks of this disease.

Francis Rose and Miroslav Hodak of North Carolina State University are investigating the early events that may lead to the formation of these plaques -- beginning with the misfolding of a mysterious protein called alpha-synuclein, which is the key component of the toxic plaques. Based on computations they performed, they are proposing a mechanism that explains the early misfolding events that lead to plaque formation. Understanding this initial process is critical for drug development, they say, and their proposed mechanism may help in the design of drugs to stop, slow, or reverse Parkinson's. (Talk X39.9, http://meetings.aps.org/Meeting/MAR09/Event/100013).

Acute Myocardial Infarction (AMI) Successfully Treated With Stentys Self-expanding Platform, Solving Stent-malapposition

2009-03-16T10:47:00.000-07:00

Medical device pioneer Stentys announced that it has extended its 'self-expanding' and 'disconnectable' technology platform to include a second major indication-acute myocardial infarction (AMI). Two patients were successfully treated during acute myocardial infarction procedures last week by Drs. S. Verheye (Antwerp, Belgium) and K. E. Hauptmann (Trier, Germany).

The versatile Stentys platform has two features- self-expansion and disconnectability-that are designed to be unrivaled in the stent industry. The self-expanding feature insures optimal apposition in the critical initial hours and days after the procedure by being constantly applied to the vessel surface during thrombus and vessel spasm relief, therefore avoiding malapposition, a significant concern to cardiologists. The disconnectability feature is designed to treat lesions close to a bifurcation, by ensuring safe main branch provisional stenting and optimal side branch access when needed. Equally important, the Stentys platform is implanted by usual stenting techniques requiring no additional training.

"The Stentys device was simple to implant, conformed snugly to the treated vessel, and created minimal vessel injury since no high-pressure inflation was required," said Dr. Verheye. "When comparing immediate and five days post-procedure results using IVUS (intravascular ultrasound), the coronary vessel expanded slightly, and Stentys followed intimately the vessel remodeling with perfect apposition."

"We are extremely pleased with these preliminary results which suggest that AMI patients may be better treated. This adds a second indication to the Stentys self-expandable platform and consequently doubles the Company's market opportunities," added Jacques Séguin, M.D., Ph.D., Chairman of Stentys.

About Stentys

Based in Paris, France, and Princeton, N.J., Stentys, a privately held company, has developed a self-expanding platform aimed at enhancing the treatment of complex coronary lesions such as acute coronary syndromes or lesions close to coronary bifurcations.

Ipsogen Announces The CE Marking Of Its "ProfileQuant(R) WT1" Kit

2009-03-16T09:59:00.000-07:00

IPSOGEN SA (Alternext - FR0010626028 - ALIPS), a molecular diagnostic company specialized in the development, manufacturing and commercialization of diagnostic assays for breast cancer and leukemias, announces the CE marking of its ProfileQuant(R) WT1 kit.

The WT1 (for "Wilms' tumor gene") biomarker is used in the prognosis and follow-up of normal karyotype AML patients, who account for nearly half of AML adult patients. Quantification of WT1 expression level helps predict disease aggressiveness and determine patient response to treatment. In a recent large European study, WT1 proved to be a reliable indicator that can be used for Minimal Residual Disease monitoring distinguishing patients at differing risk of relapse.

The WT1 assay has been developed in the context of a collaborative project coordinated by the ELN consortium, systematically evaluating 9 different available assays to identify the best performing one.

"The WT1 gene has been reported to be switched on in the majority of cases of AML making it an attractive target for novel treatment approaches and monitoring response to therapy" says David Grimwade, leader of the Minimal Residual Disease working group of ELN. "Therefore, there was a pressing need to develop a highly reproducible and reliable assay that quantifies WT1 transcript levels. IPSOGEN's collaboration and industrial support were key to the success of this international collaborative study coordinated by ELN."

The CE marking obtained by Ipsogen for the ProfileQuant(R)WT1 kit, confirms the quality of its validation and manufacturing processes. With this kit, Ipsogen continues to contribute to the standardisation efforts in place in Europe in order to reduce inter-laboratory variability and provide consistent results over time.

"The CE marking of our ProfileQuant(R) WT1 will further increase the adoption of this marker by European laboratories" says Vincent Fert, founder and CEO of Ipsogen. "This test provides oncologists and hematologists with a more precise picture of pathological processes and disease evolution, and will help them to tailor their treatment strategy for each individual AML patient, a critical need in a disease where only 60% of normal karyotype AML patients survive on the long term".

About IPSOGEN

Ipsogen, Cancer Profiler, develops and markets molecular diagnostic tests designed to map diseases in order to guide patients and oncologists decisions along their complex therapeutic path.

With more than 70 tests already used routinely worldwide for the diagnosis, prognosis and follow-up of thousands of patients with leukemia, Ipsogen is now also targeting breast cancer. Its initial goal will be to provide diagnostic information that remained unavailable until now.

Strengthened by its first-rate scientific, clinical and technological partnerships, in addition to its highly skilled multidisciplinary team in France and the USA, Ipsogen is striving to become the leader in the molecular profiling of cancers. It is pursuing its development and promotion of diagnostic standards that have a significant impact on patients, medical professionals and society.

Ipsogen employed 48 people as of December 31, 2008. Its headquarters are located in Marseille, France. The company has also a subsidiary, Ipsogen Inc., in New Haven, CT, USA.

Hypos Linked To Cognitive Decline In People With Diabetes

2009-03-15T10:35:00.000-07:00

Severe hypoglycaemic episodes or 'hypos', where blood glucose levels drop dangerously low, may lead to poorer memory and diminished brain power in people with Type 2 diabetes, according to new research announced at Diabetes UK's Annual Professional Conference.

The study

The study looked at 1,066 people with Type 2 diabetes aged between 60 and 75 years. Participants completed seven tests looking at memory, logic and concentration to establish their level of brain function. The 113 people who had previously experienced severe hypos scored lower than the rest of the group.

At-risk group

There are at least 670,000 people in England aged between 60 and 75 years old who have Type 2 diabetes and around a third of them could be at risk of a hypo.

Reinforcing previous evidence

"This study reinforces previous evidence which suggests that poorly controlled diabetes affects the functioning of the brain," said Dr Iain Frame, Director of Research at Diabetes UK.

"Cognitive decline is the decline of brain functions such as memory, attention, vocabulary and planning. It can be a predictor of dementia although this is only in some cases.

Complex jigsaw puzzle

"We already know that Type 2 diabetes increases the risk of developing Alzheimer's disease, which is a type of dementia, and this research adds another piece to a very complex jigsaw puzzle.

More research needed

"However, more research is needed before we can come to any firm conclusions. If anyone with diabetes is concerned about their treatment they should consult their GP or diabetes healthcare professional."

Accounting for other factors

The study found that the group who experienced previous severe hypos scored lower on general cognitive ability and vocabulary than the group who had not, even after the results took into account the participants' age, gender and 'pre-morbid cognitive ability' (the cognitive ability that does not naturally decline with age).

Possible explanations

Dr Jackie Price from the University of Edinburgh, who led the research, said: "These findings suggest that exposure to severe hypoglycaemia is associated with cognitive decline in people with Type 2 diabetes aged between 60 and 75 years old.

"This can mean either that hypos lead to cognitive decline, or that cognitive decline makes it more difficult for people to manage their diabetes, which in turn causes more hypos.

"A third explanation could be that a third unidentified factor is causing both the hypos and the cognitive decline. We are carrying out more research to establish which explanation is the most likely."

The seven tests used

The seven neuropsychological tests assessed people's memory for faces, recollection of linear stories, vocabulary, the ability to re-organise a sequence of letters as well as some other cognitive functions.

Is It Really Only Our Kidneys That Control Blood Pressure?

2009-03-15T09:48:00.000-07:00

The problem of high blood pressure has reached pandemic proportions, causing premature death through heart attacks, strokes and kidney disease in a third of the UK population. For decades, scientists have battled at length over its cause yet still cannot agree; is the kidney or the brain to blame?

This month, Experimental Physiology hosts a lively debate between two groups of world-leading experts. In the first ever published dialogue on the topic, Drs Montani & Vliet and Drs Osborn, Averina & Fink share their opinions with us and criticise each-others theories. Their frank exchange of views provides an interesting and informative summary of the latest research into how blood pressure is controlled.

When blood pressure increases the kidneys respond by extracting extra water and salts into the urine, causing blood volume - and hence pressure - to fall. But special nerve pathways mean the brain can also regulate urine production and hence influence blood pressure. So which organ is really in charge?

Montani & Vliet argue that controlling blood volume is the key, as the kidney automatically makes more urine as blood pressure increases.

However, Osborn and colleagues remind us that the cardiovascular system is controlled by multiple mechanisms including the automatic part of the nervous system, which directly controls the kidney. They also update us on a plethora of new findings supporting a role of the nervous system in controlling blood pressure long term.

But both groups acknowledge that new mathematical models are needed that incorporate both the kidney and the brain control systems. So the question of whether it is the kidney or the brain that has a firmer grip on the reins for controlling blood pressure may have to wait for a mathematician to answer.

Professor David Paterson, the Chief Editor of Experimental Physiology and instigator of the debate, said: "This frank exchange of views was needed as it highlights major issues that remain with blood pressure control and will undoubtedly guide future studies to reveal fundamental new knowledge that will inform the future treatment of high blood pressure."

One Virus Particle Is Enough To Cause Infectious Disease

2009-03-14T09:53:00.000-07:00

Can exposure to a single virus particle lead to infection or disease? Until now, solid proof has been lacking. Experimental research with insect larvae at Wageningen University and Simon Fraser University in Canada has shown that one virus particle is theoretically enough to cause infection and subsequent disease. The researchers are publishing this finding in this week's edition of the Proceedings of the Royal Society B.

A virus population is usually composed of a collection of variants of virus particles. In order to investigate whether virus particles (virions) can cause an infection independently from each other, and therefore individually, the researchers set up an experiment with two 'marked' virus variants. They exposed a population of hosts (caterpillars) to both variants.

The experiment showed that exposure to a low dosage of virus particles resulted in a small number host infections (20%). The majority of these hosts (86%) turned out to be infected by a single virus genotype. In contrast, exposure to a high dosage of virus particles resulted in virtually all the hosts (99%) becoming infected, where most of the hosts were infected by both types of virus. Only 14% were infected by only one of the two variants.

Based on the assumption that every virus particle operates independently from all other virus particles, the researchers set up a probability model. This model predicts how many virus particles have caused an infection and how many different virus genotypes are present in infected hosts, such as plants, insects or people. The results of the infection experiment with the susceptible insects are in agreement with the model predictions. From this it can be derived that the virus particles have an independent effect, and that a single virus particle can indeed cause infection and/or disease.

If there are few virus particles that lead to an infection, the number of virus particles determines the degree of diversity that can be present within the host. This is an important finding because the interactions between virus variants, such as competition and exchanging genetic information, determine the progression of disease and the evolution of the virus.

Until now, it was unclear whether a virus must be seen as an individual that can infect a host independently, or whether a cloud of viruses 'cooperates' to cause an infection. It is not yet known if the viruses that affect people can also act individually, but this research shows that it is possible.

Mark P. Zwart et al.: An experimental test of the independent action hypothesis in virus-insect pathosystems. Proc. R. Soc. B, 2009.

Bioabsorbable Stents Show Promise

2009-03-14T09:43:00.000-07:00

A study published online in The Lancet presented two year data for the bioabsorbable everolimus coronary stent. Commenting on the results, interventional cardiology specialist, Professor Franz Eberli from the University Hospital Zurich (Switzerland) and official spokesperson for the European Society of Cardiology, said:

"In addition to the ABSORB study presenting the longest ever follow up data for a bioabsorbable stent, the investigators used multiple imaging systems, including Optical Coherence Tomography. This technical advance has allowed them to get really detailed images of the intra coronary structures for the first time. What really impressed me was the smoothness of the vessel wall at two years, and images showing the stents had disappeared to a great extent, which was a very promising finding.

The study showed an overall 19 % loss in luminal diameter at 18 months and an angiographic in- stent late loss of 0.48mm at two years. These results fall intermediate between those commonly seen for bare metal stents (which typically have an in stent late loss of 1.0 mm), and drug eluting stents (which typically have an in-stent late loss of 0.15 to 0.3 mm). But the upside of this bioabsorbable stent data is that patients don't appear to be getting any in-stent thrombosis here.

Since in-stent late loss increased by only 0.05 mm between 6 months and two years, the most probable explanation for the in-stent late loss is early recoil after stent implantation. This indicates that this bioabsorbable stent initially is not exerting enough radial force to keep the vessels perfectly open. The challenge facing stent designers is to achieve a balance between sufficient radial strength, and a structure that can be reabsorbed in a reasonable time period. Industry is already acting on this data and looking to produce stronger second generation bioabsorbable stents by developing novel stent designs that retain integrity and radial strength for a longer time period.

The fact that vasomotion (the ability to undergo vasodilation and vasoconstriction) was restored in response to vasoactive agents in the stented vessel segment was a really good sign. It shows that after two years the physiological function of the stented part of the vessel has been almost completely restored, and that patients will not get any symptoms of angina or limitations in physical activity. In contrast, for first generation drug eluting stents, studies have shown "paradoxical vasoconstriction" in the area of the stent, where the vessel constricts instead of opening during exercise.

This is a proof of principle study that teaches us a lot about the way bioabsorbable stents work and affect remodelling of the stented vessel segment. But with only 30 patients included in the study, numbers are too small to show us if the technology is safe. Furthermore the study was only performed in patients with single de novo coronary lesions, who are considered by far the most straight forward cases. The study doesn't show us if the new stent will work in real world situations of patients with long lesions, calcification or bifurcations."

A bioabsorbable everolimus-eluting coronary stent system(ABSORB): 2-year outcomes and results from multiple imaging methods. P W Serruys, J A Ormiston, V Onuma, et al. Lancet 2009;373: 897-910.

Success Of Pfizer Pancreatic Cancer Drug Stops Trial

2009-03-13T10:32:00.000-07:00

Global drug company Pfizer Inc announced yesterday, 12 March, that a phase 3 clinical trial of its pancreatic cancer drug Sutent (sunitinib malate) stopped early because the drug showed significant benefits in patients.

Sutent is designed to treat patients with advanced pancreatic islet cell tumors, also known as pancreatic neuroendocrine tumors.

It is an oral multi-kinase inhibitor (blocks the action of molecules that help the cancer to spread) and is already approved for the treatment of both advanced renal cell carcinoma (RCC) and second-line gastrointestinal stromal tumor (GIST). More than 38,000 patients with these diseases have been treated with the drug, both in clinical settings and in trials.

The independent Data Monitoring Committee (DMC) that was overseeing this trial recommended it stop after finding that the drug had shown greater progression-free survival compared to placebo (patients lived longer without the cancer spreading), and best supportive care in patients with pancreatic islet cell tumors, said Pfizer in a press statement. Once the trial data is fully analyzed, it will be presented at a scientific meeting, they added.

Pancreatic islet cell tumors are rare, with an incidence of 5 to 10 per million worldwide annually. Such tumors include insulinomas, glucagonomas and gastrinomas, and current treatment options are limited.

The participating centers have now been informed of the decision, so all the patients taking part in the trial can choose to continue on Sutent or switch from placebo to the drug.

Dr Mace Rothenberg, senior vice president of medical development and clinical affairs for Pfizer's Oncology Business Unit told the press:

"We are delighted by these findings which demonstrate that Sutent provides a benefit for patients with advanced, well-differentiated pancreatic islet cell tumors -- a rare cancer with limited treatment options."

"These and previously reported phase 2 data contribute to the growing body of evidence indicating activity with sunitinib in patients with pancreatic islet cell tumors," he added.

The phase 3 trial followed the successful completion of the phase 2 trial which was reported in the July 2008 issue of the Journal of Clinical Oncology.

Pfizer reported that this is the second phase 3 trial of Sutent that has stopped early on the recommendation of the trial's DMC because it has shown benefits to patients. In January 2005, when Sutent was being trialled for use with GIST patients, the trial was unblinded early when results showed the drug delayed tumor progression compared to placebo.

The company is also looking to test the drug in phase 3 trials for the treatment of other solid tumors, including advanced breast cancer, advanced non-small cell lung cancer, advanced colorectal cancer, advanced hepatocellular carcinoma and advanced hormone-refractory prostate cancer.

According to the Associated Press, the news sent Pfizer shares up by nearly 10 per cent on Thursday. Sutent is already the New-York based company's best-selling cancer drug, earning 847 million dollars in sales in 2008, of which 254 million was in the US, said the AP announcement.

Nano Particles Loaded With Anti-Tumor Genes Zap Cancer Cells

2009-03-12T07:05:00.000-07:00

Scientists from Cancer Research UK have developed a new treatment that they successfully tested on mice whereby tiny nano particles carried anti-tumor genes into cancer cells and "zapped" them by causing them to make proteins that killed the cancer.

The research was done by Cancer Research UK's Dr Andreas Schatzlein, who is based at the School of Pharmacy in London, and colleagues, and was published online on 10 March in the journal Cancer Research.

Previous studies have shown that this type of gene therapy can shrink tumors, and even cure about 80 per cent of the mice, and the hope is that treatments based on this method can save lives by helping people with inoperable tumors, such as those that are close to vital organs like the brain or lungs.

Gene therapy doesn't kill cells indiscriminately, unlike chemotherapy, which is more of a scattergun approach that kills all cells in the affected area, including healthy ones. This is why chemo patients often have side effects like fatigue, hair loss and nausea. By targeting cancer cells only, the hope is that gene therapy won't have such side effects.

The missing link supplied by this study is that the researchers found not only a way to get anti-tumor genes into nanoparticles and remain stable, but they also found a way to make them seek and target only the cancer cells and leave healthy cells untouched. This means the method could potentially be developed to treat cancer that has spread.

As Schatzlein explained:

"We hope this therapy will be used to treat cancer patients in clinical trials in a couple of years."

" This is the first time that nanoparticles have been shown to target tumours in such a selective way, and this is an exciting step forward in the field," he added.

Once inside the cell, the genes inside the particle switch on in response to the cancerous environment, and start issuing instructions to make proteins that are only toxic to the cancer cells, leaving healthy cells unaffected, explained Schatzlein.

For the study, Schatzlein and colleagues were able to produce "colloidally stable" nanoparticles ranging from 33 to 286 nm that were capable of carrying evenly distrubuted DNA molecules and diffusing in experimental tumors in live mice.

They deployed "whole-body nuclear imaging using small-animal nano-single-photon emission computed tomography/computer tomography scanner and the human Na/I symporter (NIS) as reporter gene" to show that the nanoparticles had targeted and entered only the cancer cells and none of the genes had transferred to any of the healthy tissue of the tumor-bearing mice.

They also performed post-mortem tests on the mice to confirm that the nanoparticles had accumulated at tumor sites and that "tumor-selective transgene expression" had taken place.

The researchers concluded that:

"Considering that NIS imaging of transgene expression has been recently validated in humans, our data highlight the potential of these nanoparticles as a new formulation for cancer gene therapy."

Director of cancer information for Cancer Research UK, Dr Lesley Walker who has a PhD in immunology and is an experienced research scientist herself, said in a press statement that these results were encouraging and they were looking forward to seeing if the approach developed by Schatzlein and colleagues will work in humans.

"Gene therapy is an exciting area of research, but targeting genetic changes to cancer cells has been a major challenge, said Walker.

"This is the first time a solution has been proposed, so it's exciting news," she added.

"Cancer-Specific Transgene Expression Mediated by Systemic Injection of Nanoparticles."

Edward J. Chisholm, Georges Vassaux, Pilar Martin-Duque, Raphael Chevre, Olivier Lambert, Bruno Pitard, Andrew Merron, Mark Weeks, Jerome Burnet, Inge Peerlinck, Ming-Shen Dai, Ghassan Alusi, Stephen J. Mather, Katherine Bolton, Ijeoma F. Uchegbu, Andreas G. Schatzlein, and Patrick Baril.

Cancer Research first published on March 3, 2009.
doi:10.1158/0008-5472.CAN-08-2657

Spiritual Kids Are Healthier, Researcher Says

2009-03-12T07:02:00.000-07:00

Like adults, kids who are more spiritual or religious tend to be healthier.

That's the conclusion of Dr. Barry Nierenberg, Ph.D., ABPP, associate professor of psychology at Nova Southeastern University in Fort Lauderdale, Florida, who has been studying the relationship between faith and health. He presented on the topic at the American Psychological Association's Division of Rehabilitation Psychology national conference on February 27, in Jackson, Fla.

"A number of studies have shown a positive relationship between participatory prayer and lower rates of heart disease, cirrhosis, emphysema and stroke in adults," he says. "Prayer has been shown to correlate to lower blood pressure, cortisol levels, rates of depression, as well as increased rates of self-described well being."

"But very few studies have attempted to examine how children's spiritual beliefs impact their health," he says. Initially, Nierenberg conducted a study of HIV positive pediatric patients (ages seven to 17), comparing religious development, church attendance and prayer to health measures such as symptoms, T-cell counts and number of hospitalizations.

"One significant finding was that children who attended church were more likely to have higher T-cell counts than non churchgoing children," he says, "but that finding is difficult to interpret. It's likely that the more ill a child is, the less ability they have to attend church."

"We needed a second study to more precisely examine religious faith and behavior," he says.

So they examined 16 children (ages six to 20) who were undergoing hemodialysis due to End-Stage Renal Disease (ESRD). The patients were questioned on a scale of spirituality behaviors and attitudes, and responses were correlated to dialysis-related blood levels, including: blood urea nitrogen (BUN), lymphocytes, albumin, phosphorus, parathyroid hormone (PTH), and urea reduction ratio.

"There was a significant negative correlation between spiritual attitudes and BUN levels," he says. "As children reported more agreement with statements like, 'I am sure that God cares about me,' and 'God has a plan for me," their average BUN levels over the past year were lower."

"We have a deeper understanding of why there is so little in the literature exploring the relationship between health spirituality in children and adolescents," he says. "It's challenging to measure in this population. It can be difficult getting all the necessary permission. The pool of children is limited, and the interviews can be time consuming. But it's important it's done for the same reason we study it in adults."

Do Junk Food Ads Weigh Heavily On Kids?

2009-03-12T07:01:00.000-07:00

For more than 25 years, Quebec has had one of the world's toughest policies on the marketing of products to children. Section 248 of the province's Consumer Protect Act prohibits companies from directing their advertising to anyone under the age of 13, effectively preventing sellers of high-fat or super-sweet junk foods from pitching these foods to kids.

According to 2004 StatsCan data, the prevalence of obese and overweight children in Quebec is lower than in the rest of Canada. Children in Quebec also eat more fruits and vegetables and less fast food than children in provinces where industry essentially polices itself when it comes to advertising to children.

Dr. Dubois is leading a three-year study - funded in large part by the Canadian Institutes of Health Research - of Francophone and Anglophone schoolchildren in Quebec and Ontario to gauge the impact of television and Internet advertising on food consumption and obesity.

The project could not be timelier.

"Many governments are talking about legislation that might ban junk food advertising. But not much work has been done on the reception of ads by the children who are watching. And as for the Internet, there is almost no research," says Dr. Dubois.

While television advertising of junk foods has long been suspected of contributing to childhood obesity, the stakes have been raised by food companies' use of "advergame" Internet sites where children play games while being exposed to promotional messages.

"A commercial on TV is just 30 seconds long, but if you can extend a child's play time on an advergame to half an hour, they will be immersed in the brand," says Monique Potvin Kent, a doctoral candidate working closely with Dr. Dubois on the project.

The obesity epidemic in Canada, which affects more than 500,000 children, obviously involves more than exposure to junk food ads.

"It's a complex problem," says Dr. Dubois. "In the past, children went outside and played with their friends more. Now food portions are bigger. Children have more pocket money and can buy what they like. They eat in restaurants more and parents buy a lot of prepared foods with higher calorie, fat and salt content."

Advertising, however, has a powerful impact on what children want. "You can't underestimate the influence of advertising on children. Our research will show just how much exposure children have to junk food advertising," says Ms. Potvin Kent.

The Study

The three-year project will capture the TV-viewing and Internet-surfing habits of 1,600 10-12 year-old schoolchildren in Quebec and Ontario over a one-week period in the spring of 2009.

The children will be studied in four groups of 400: French-speaking Quebeckers, English-speaking Quebecers, French-speaking Ontarians and English-speaking Ontarians.

Kids will record their TV and Internet habits over a one-week period in a journal. Researchers will record TV broadcasts over that week and check website content to analyze the amount of junk food advertising the children are receiving.

The children and their parents also will fill out questionnaires about their usual TV watching and Internet habits and the foods they usually eat. The kids' height and weight will be measured.

Multiple Sclerosis In Children

2009-03-12T06:27:00.000-07:00

Helen Yates, Chief Executive of MSRC, commenting on this paper said; "Whilst we are always saddened to hear of MS in the very young, it is very important that the medical profession is becoming increasingly aware that the condition DOES exist in children. MSRC is working to provide as many resources as possible for young people with MS and their families"

Introduction

Multiple sclerosis (MS) in children is being recognized with increasing frequency. The first descriptions of MS in children were published by Charcot between 1829 and 1849, though it was not for another 50 years that MS in children was again described in the literature (Hanefeld, 2007). There are now several national programs focused on the research and clinical management of children with MS. Recently, an International Pediatric Multiple Sclerosis Study group was constituted with the goal of fostering collaborative efforts (for more information, email: info@ipmssg.org).

Demographics and Epidemiology of Pediatric Multiple Sclerosis
How common is MS in children?

Analysis suggests that 2% to 5% of all patients with MS are diagnosed before their 16th birthday (Ness et al., 2007). These estimates, however, are based on retrospective review of established adult MS populations and may underestimate the true prevalence of the disease in the pediatric population. The annual average incidence of a first demyelinating event in Canadian children is 0.9/100,000, but has been reported as lower in other parts of the world (Banwell et al., 2007; Pohl, 2008). The incidence of MS diagnosis following an acute demyelinating event is the subject of ongoing research.

Genetics of MS

Genetic factors clearly influence the risk of developing MS, as MS can "run" in families. The risk of developing MS is approximately 30% if you have an identical twin with MS, 5% if you have a first degree relative (parent or non-twin) with MS, but only 0.1% if no one in the family has MS (Sadovnick, Dircks, & Ebers, 1999). Furthermore, carefully documented family histories reveal that approximately 20% of people with MS will have at least one first degree or distant relative with MS (Sadnovnick, Baird, & Ward, 1988). Family history data obtained from a large international study of MS demonstrated that 6% to 8% have a positive history of MS (Banwell et al., 2007). It is important to remember that the first degree relatives of pediatric patients with MS are still young, and may still be at risk to develop MS in the future.

A female preponderance in MS is well-established in the adult MS population. In children, however, the F:M ratio varies depending on age at first presentation. Males outnumber females when MS onset occurs prior to 10 years of age (F:M ratio, 0.7) (Simone et al., 2002; Ruggieri, Polizzi, Pavone, & Grimaldi, 1999). A female preponderance is pronounced in adolescence-onset MS (F:M ratio, 2.7 - 4.7) (Ghezzi et al., 2002). Hormonal contributions to pediatric MS risk in females after puberty require further study.

Immunological Studies

In order for the immune system to "attack", it must first recognize the "target." Scientists are very interested in learning what is initially targeted in MS. Complicating this search, however, is the fact that once the immune system is active, it will not only attack the initial target, but over time will also attack the injured tissue in the brain/spinal cord as well.

We found that children with MS harbor T-cell populations that proliferate when exposed to myelin proteins (Banwell et al., 2008). These T-cell findings may reflect the injured tissue response, rather than a primary immune aspect of MS and they represent one of several abnormalities in immune cell regulation in MS (Bar-Or, 2008).

Environmental Triggers

Infectious Triggers

Children with MS have been shown to have a significantly increased likelihood, relative to healthy age-matched peers, of being previously infected with Epstein-Barr virus (EBV) (Alotaibi et al., 2004). EBV infection leads to persistent B-cell infection, and B-cells are known to play a role in MS. Study of children enrolled from geographical regions has confirmed that the association of EBV with MS, suggesting that the association of EBV with MS is common among multiple world regions (Banwell, Krupp et al., 2007). Immunological studies specifically exploring T- and B-cell behavior in EBV-positive MS patients, may provide insights into how EBV infection influences the immune system in people with MS (Ascherio et al., 2007).

Sunlight Exposure, Vitamin D, and MS

The increased prevalence of MS in temperate regions has prompted consideration of the role of vitamin D and sunlight exposure as potential non-infectious environmental risk factors for MS. Exposure to sunlight is the primary source of vitamin D, and as such, in the winter months very little, if any, cutaneous vitamin D synthesis occurs. Individuals with MS have been shown to have lower vitamin D levels as compared to age-matched healthy controls (Nieves et al., 1994), although this finding is confounded by the potential limit in outdoor activity of patients with MS. An inverse relationship has also been demonstrated between serum concentrations of 25-hydroxyvitamin D obtained from young adults entering the military and their risk of MS diagnosis in mid-adulthood (Munger et al., 2006). The potential role for vitamin D supplementation in the primary prevention, or amelioration, of MS is an exciting area of ongoing research.

Clinical Features of Acute Demyelination in Children

The First Attack

MS in both children and adults is characterized by multiple episodes of neurological dysfunction secondary to inflammatory demyelination of the central nervous system (CNS). Just as in adults, however, not all children who experience an initial acute demyelinating syndrome (ADS) will develop MS. The term "clinically isolated syndrome or CIS" has also been applied to persons experiencing a first demyelinating event, although many authors restrict the term CIS to patients with an initial demyelinating event at high risk for future diagnosis of MS. As such, the term "CIS" is not universally applied across the entire spectrum of ADS events, particularly those considered to have a low risk of relapses.

An ADS is classified as "monofocal" if the clinical features were referable to a single CNS lesion, such as optic neuritis, transverse myelitis, or brainstem, cerebellar, or hemispheric dysfunction; and as polyfocal if the clinical features are localized to more than one CNS location. This is based on the physician's clinical examination, rather than MRI findings (which could show asymptomatic lesions). "Polyfocal" features refer to more than one CNS lesion and when accompanied by problems with thinking, is termed, acute disseminated encephalomyelitis (ADEM) (Krupp, Banwell, & Tenembaum, 2007).

Specific ADS presentations include:

Transverse Myelitis: Transverse myelitis (TM), or attack of the immune cells on the spinal cord, leads to loss of strength and sensation of the limbs and difficulty with bowel and bladder control. TM was the presenting feature of MS in only 14% of children enrolled in a multinational pediatric MS Study (Banwell, Teller et al., 2005).

Optic Neuritis: Optic neuritis (ON), an attack of the immune system on the optic nerve from the eye, results in reduced vision, pain with eye movements, and difficulty seeing color. It has been thought that bilateral ON is more common in children and unilateral ON more common in adults. This may simply reflect, however, that young children may not notice or report loss of vision in one eye. In one study of childhood ON, in which some patients were followed for 40 years, 26% were ultimately diagnosed with MS (Lucchinetti et al. 1997). In a review of ON at SickKids (www.sickkidsfoundation.com), bilateral ON was more common than monocular ON, and was associated with a greater likelihood of MS diagnosis (Wilejto et al., 2006). Of the 36 children enrolled, 13 (36%) were diagnosed with MS within the two years of ON, an outcome that was highly correlated with MRI evidence of white matter lesions in the brain.

Acute Disseminated Encephalomyelitis (ADEM): For a diagnosis of ADEM, there must be a multiple neurological symptoms plus trouble thinking (encephalopathy). The demyelinating event in some children may be accompanied by fever, drowsiness or even coma, and neck stiffness.

What happens to children with ADS:

In a review of 296 children with acquired demyelination in France, 57% were diagnosed with MS, while the remaining 43% appeared to have a monophasic illness (Mikaeloff, Suissa et al., 2004). The children in this study were followed for a mean of 2.9 years (range 0.5- 14.9 years). Since patients can develop their second MS-defining attack years after their first attack, it is possible that the percentage of children in the French study ultimately diagnosed with MS will increase as the duration of follow-up lengthens.

Recurrent Attacks: Diagnosis of MS

Pediatric MS requires multiple episodes of CNS demyelination separated in time (by four weeks or more) and space (involving new areas of the CNS) just as is specified for adults. MRI evidence of new lesions in new CNS locations can be used to meet the requirement for disease dissemination in time (Polman et al., 2005).

Approximately 95% of pediatric patients with MS have recurrent attacks followed by periods of clinical recovery or stability (Banwell, Ghezzi et al., 2007; Boiko et al., 2002). This form of MS is known as relapsing-remitting MS (RRMS). Over time, children with RRMS may enter a phase of the disease in which they show increasing physical disability even in the absence of attacks (secondary progressive MS, SPMS). Primary progressive MS (PPMS), in which neurological disability worsens over time in the absence of clear attacks, appears to be exceptionally rare in children. Figure 1 illustrates the typical MRI features of MS in children.

How do children with MS do?

The time from the initial acute attack to the second, MS-defining event is highly variable. Younger children tend to have a longer interval from first to second attack (median 6 years), in contrast to most adolescent patients with MS who typically have their second attack within 12 months. The annual relapse rate reported in retrospective studies with long observation periods range from 0.38 per year to 1.0 per year (Simone et al., 2002).

In a multinational study of 137 children with MS, 13% of children with MS showed fixed neurological deficits that limited their ambulation (EDSS >4.0) after a mean disease duration of 5 years. Mikaeloff and colleagues, (Mikaeloff et al., 2006) documented EDSS scores of 4 or higher in 15% of children with MS enrolled in the French KIDSEP study after a median observation of 4.8 years (from second demyelinating event).

While physical disability may occur relatively infrequently in the first decade in pediatric-onset MS, cognitive impairment may be a significant clinical concern (Banwell & Anderson, 2005). Formal neurocognitive assessments are required to fairly appreciate the breadth of cognitive impairments, as review of academic performance, however, many underestimate the deleterious effects of MS on cognitive capacity and academic potential. Cognitive impairments in attention and memory have been reported in approximately 60% of adults with MS (Rao, 1986), and emerging evidence suggests that impaired cognitive performance occurs in at least 30% to 40% of pediatric patients with MS. Deficits are most notable in attention, working memory, information processing, speed, and understanding of more complex sequential tasks.

MS Disease Course

In a study reviewing the disease course of 116 patients with MS onset under age 16 years, 53% of the 116 patients ultimately progressed to SPMS at 23 years post-MS diagnosis. In comparison to studies in adult MS, pediatric-onset MS patients progress more slowly and take a longer period of time to develop disability (Boiko et al., 2002). It is important to consider, however, that a 10 year-old child with MS will only be about 30 to 40 years of age when he/she is at risk for SPMS-and thus, actually younger than the typical age of onset of disability in adult-onset patients with MS. Children with more disability early in the disease are at greater risk of severe disability over time.

Symptoms of MS in Children

Many symptoms may accompany an MS relapse, which by definition, lasts at least 24 hours.

Sensory symptoms: The most common sensory symptoms are numbness and paresthesias (tingling) in one or more limbs. The sensory symptoms can be due to a myelopathy, which can produce a spinal sensory level. Sensory deficits that arise from lesions in the sensory cortex or the supraspinal pathways lead to numbness. Patients may also have radicular symptoms due to a lesion at the dorsal root entry zone of the spinal cord or the brainstem, although this is very rare. Patients with sensory deficits involving the dorsal column pathways subserving vibration and propioception, can experience a "useless hand syndrome" in which motor movement is preserved, but the ability to manipulate the arm in space is impaired (El-Moslimany & Lublin, 2008).

Motor symptoms: Weakness can occur in any extremity, singly or in combination. The most dramatic of the acute motor syndromes is an acute transverse myelitis. In most children with MS, TM manifests as a partial cord syndrome. Longitudinally extensive lesions that traverse the cross-sectional diameter of the cord are more typical of isolated TM or NMO (Pidcock et al., 2007).

Spasticity: Spasticity or stiffness of the limbs during attempted limb movement occurs in patients following severe relapses associated with residual damage to motor pathways, and occurs as a core component of the progressive disability seen in the secondary progressive phase of MS. As such, it is relatively rare as a major symptom in children with RRMS. When present, spasticity is disabling, causes disruption of sleep, and contributes to pain.

Bladder and sexual function: Lesions of the distal spinal cord can impair both bladder and sexual function. While such deficits are rarely reported in children and adolescents with MS, recognition of these issues is critical. Impaired bladder emptying can lead to retention of urine, infection, and potential life-threatening sepsis. Impaired sexual function is a socially and psychologically devastating issue for sexually-active adolescents--and an issue that few are comfortable discussing unless a strong rapport and level of trust have been established between the pediatric MS care provider and the patient. Clinical interviews with parents out of the room are essential for these discussions.

Bladder impairment most commonly results from overactivity of the detrusor muscle of the bladder. This produces the sensation or urgency despite low bladder volume. Urge incontinence occurs if high intravesical pressure results in the loss of some urine.

Detrusor-sphincter dyssynergia is characterized by contraction of the internal urethral sphincter during an involuntary detrusor contraction. This is due to the loss of synchronization between the detrusor and internal urethral sphincter leading to incomplete bladder emptying and hesitancy (El-Moslimany et al., 2008).

Fatigue: Fatigue or a "sense of physical tiredness and lack of energy, distinct from sadness or weakness," is reported by approximately 40% of children and adolescents with MS. (Banwell, Ghezzi et al., 2007). Fatigue of sufficient severity to compromise participation normal activities, such as sports, social events, or completion of academic tasks is considered worthy of treatment.

Dysarthria: Children with MS can have different forms of dysarthria or impaired speech production. Dysarthria of the cerebellar type results in scanning speech which is characterized as monotonous speech interspersed with explosive consonants, resulting in irregular volume and indistinct articulation tremor of the voice. As cerebellar involvement occurs relatively commonly in pediatric-onset MS, speech impairment is also a notable feature of some children. Pseudobulbar dysarthria is caused by spastic vocal cords, which causes a high-pitched low-volume speech with slurred consonants- this is rarely seen in children. The precise frequency and severity of speech disorders in pediatric MS have not been described.

Tremors and other movement disorders: Tremors in MS are usually most notable when the child is reaching for an object or attempting to perform purposeful movements of the upper limbs. Tremor in MS is associated with greater impairment and functional disability due to impairments in hand-writing, self-care, and fine motor tasks. Transient tremor is a common feature of corticosteroid therapy, and patients and parents should be made aware of this in order to avoid concern over what they may perceive to be a new neurological deficit.

Pain: A significant number of adults with MS, and a lesser proportion of pediatric patients with MS, experience pain, which may be due to many factors. Patients can have musculoskeletal pain due to weakness, spasticity, imbalance, osteoporosis, compression fractures or osteoarthritis. All these processes are due to the disease or to immobility secondary to MS. Pain, and particularly back pain, reported by any child that has been exposed to prolonged or repeated corticosteroid therapy should prompt a careful evaluation for pathological fractures of the spine, ribs, or long bones associated with osteopenia.

Burning pain or " dysesthetic pain" is reported in some patients with MS. While the cause of this type of pain is not entirely clear, the mechanism could be spontaneous activity in the deafferented neurons, ephaptic transmission, or sympathetic activation (El-Moslimany & Lublin, 2008). Transmission of abnormal electrical discharges laterally across a demyelinated plaque might produce painful symptoms.

L'Hermitte's phenomeno: This is a specific sensory symptom seen in patients with spinal cord lesions. It is defined as a sensation of electric shock in the back and legs of patients brought on by neck flexion. The symptom usually remits quickly, but also can persist. Younger children describe this as "an elastic band feeling" or a "cell phone going off my spine." The presence of L'Hermitte's symptom should prompt imaging of the spinal cord.

Depression: Mood disturbances are a common feature of MS, and depression is a significant health issue that warrants recognition in pediatric patients with MS. Reactive depression, initiated often by diagnosis or by a severe relapse, is not surprising in children and adolescents facing an uncertain future with an unpredictable illness. Counseling sessions with a mental health care professional may be sufficient to address the issue.

Paroxysmal symptoms: While an attack has been defined as a period of neurological dysfunction lasting for 24 hours, patients with MS can have brief episodes of numbness, tingling, visual loss, sensory, speech or balance problems , occur frequently (from 1-2 times per day to hundreds of times a day).

Seizures: Seizures occur in about 5% of children with MS (Boiko et al., 2002). Seizures and headache are particularly prominent features in children with tumefactive demyelination, a demyelinating phenotype characterized by one or more large areas of demyelination, perilesional edema with mass effect, and often ring-enhancement (McAdam, Blaser, & Banwell, 2002).

MRI Findings in MS

Magnetic resonance imaging (MRI) is a useful tool for supporting the diagnosis of MS in adults and children. The MRI appearance of pediatric MS, however, is not entirely similar to that of adult-onset MS, particularly in younger children. The increasing recognition and treatment with MS underscores the urgent need for pediatric-specific MRI diagnostic criteria. Mikaeloff and colleagues have demonstrated that the sole presence of well-defined lesions, as well as lesions perpendicular to the corpus callosum are highly specific for MS in children, although these criteria are only met by approximately 30% of pediatric MS patients (Mikaeloff et al., 2004). Using standardized scoring methods, Callen and colleagues have proposed pediatric-specific modifications to the currently accepted MRI criteria that are more sensitive and specific for the diagnosis of MS in children. (Callen et al, Neurology in press) These criteria required two of the following: (1) 5 or more lesions; (2) 2 or more periventricular lesions; and (3) 1 brainstem lesion. The validity of these proposed criteria predictive of MS outcome in children experiencing an initial demyelinating attack is currently being evaluated.

Figure 2 depicts the varied appearance of MS in children, including the diffuse, ill-defined lesion appearance that may be seen early in the MS disease course of very young children. In children with ADEM, despite a rather dramatic MRI appearance, MRI resolution of initial lesions typically occurs. The capacity for lesion resolution suggests either that the neuroimaging features represent a greater contribution of swelling (edema) rather than demyelination or tissue injury, or that children have an enhanced capacity for rapid lesion repair. More advanced imaging techniques, such as magnetization transfer imaging, are required to explore this possibility. Longitudinal MRI studies are required to evaluate the rate of lesion accrual, and the progression of brain shrinkage or atrophy, and to determine whether these measures correlate with physical and cognitive outcomes of MS in children.

Laboratory Studies

More than 90% of children with MS will have oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) - obtained by performing a lumbar puncture or spinal tap- provided that sensitive techniques such as isoelectric focusing are used (Pohl et al., 2007). Although OCBs may be present transiently in children with monophasic ADEM, CNS lupus, and in patients with primary CNS infections, the presence of OCBs is strongly supportive of MS. Electrical tests called evoked potential testing can confirm the involvement of or detect clinically silent problems in the visual system, the auditory system, or in the sensory system.

Differential Diagnosis of Pediatric MS

The diagnosis of MS requires that other possible diagnoses be excluded. Acute infections of the brain (i.e., viral, lyme, West Nile virus), deficiency of vitamin B12, inflammation of the brain with other autoimmune diseases (i.e., systemic lupus erythematosus, vasculitis, sarcoidosis), acute stroke or trauma, tumors, and metabolic diseases (i.e., mitochondrial or leukodystrophies) must be considered.

Treatment of Pediatric MS

The care of children with MS is optimized by a multidisciplinary team comprised of pediatric or adult neurologists with expertise in pediatric MS, nurses, physiotherapists, occupational therapists, social workers, psychologists, and psychiatrists. Compliance with medication, especially among adolescent patients, rests on a strong relationship between medical teams, patients, and parents.

Treatment of pediatric MS can be divided into: (1) treatment of acute attacks; (2) treatments to reduce the number of attacks and attack severity; (3) treatment of intermittent or persistent MS symptoms. Most care models for pediatric MS are based on protocols optimized in adults. Randomized control trials in pediatric MS are challenged by the relative rarity of MS in children, and by the fact that pivotal studies of MS therapies are restricted to patients over age 18 years of age.

Acute MS Relapses

Corticosteroids. These agents are very effective at reducing the inflammation (swelling, brain irritation) associated with acute MS attack, and are associated with a more rapid recovery from an acute MS relapse. While it remains to be proven that therapy for acute relapses alters the long-term course of MS, hastening of recovery from an attack leads to reduced school absenteeism and enhanced quality of life. Acute MS attacks in our pediatric MS population are managed with intravenous methylprednisolone (Solumedrol) 20 to 30 mg/kg/day (maximum of 1 gram) as a single dose for 3 to 5 days. Children with complete resolution of symptoms receive no further corticosteroids. Children with incomplete clinical recovery following the intravenous treatment are prescribed oral prednisone tablets starting at 1 mg/kg/day, followed by a tapering schedule with reduction by 5 mg every 2 to 3 days.

The most frequent side effects of high dose glucocorticoids are facial flushing, sleep difficulties, irritability, mild tremor, and increased appetite. In children, growth retardation is an additional concern, and is related to the cumulative dose. Every effort should be made to keep the total duration of corticosteroid exposure to a minimum. In our program, the total duration of tapering dosing is restricted to 21 days. Hypertension and hyperglycemia are rare, but important corticosteroid related toxicities, and thus all patients should be monitored closely with regular evaluation of blood pressure, glucose, and electrolytes. Many patients experience gastrointestinal irritation during corticosteroid therapy, and administration of gastric protection is suggested.

Intravenous Immunoglobulins. Some children do not experience sufficient clinical recovery with corticosteroids (steroid-resistant) or develop recurrent symptoms during the prednisone taper (steroid-dependent). Treatment with intravenous immunoglobulin (IVIg) can be helpful in these patients. Case-report level evidence supports efficacy for IVIg (in a dose of 2 gms/kg over 2-5 days) in children with acute demyelinating attacks (Nishikawa et al., 1999).

Plasma Exchange. Level 1 evidence exists for plasma exchange to treat severe relapses in adult patients with MS when they fail to recover after treatment with high-dose glucocorticoids (Keegan et al., 2002). Five exchanges over 8 to 10 days is generally recommended.

Treatment to Reduce Number of Attacks

Immunomodulatory therapy. Both glatiramer acetate (GA) and interferon beta (IFNB) are immunomodulators, and decrease the relapse rate and MRI accrual of new lesions in adults with MS (IFNB Multiple Sclerosis Study Group 1993; Jacobs et al., 1996; PRISMS 2000; Comi, Filippi, & Wolinsky, 2001). Overall, these medications reduce the frequency of clinical relapse by 29% to 34%.

Interferon beta - 1b (Betaseron/Betaferon®). A retrospective review of safety and tolerability in a cohort of 43 children and adolescents with MS was reported by an international working group (Banwell et al., 2006). Given the variable size and weight of children, many pediatric MS specialists initiate therapy at one quarter of the adult dose, and increase monthly by quarter dose increments provided that tolerability is acceptable. In particular, it is critical to observe liver function, as some younger patients may demonstrate elevation in liver transaminases. Typically, the elevation in transaminases resolves if the interferon dose is reduced, and the escalation phase is performed over a longer period of months. Most common adverse effects (AE) included flu-like symptoms (35%), abnormal liver function test (LFT) (26%), and injection site reactions (21%) (Pohl et al., 2007).

Interferon beta - 1a IM (Avonex®). Data on the tolerability of weekly IM IFNB - 1a for treatment of RRMS in 9 children younger than 16 years of age was reported in a retrospective study (Pohl et al., 2007). Adverse effects included flu-like symptoms (44%), headaches (44%), fever (22%), and injection site soreness (11%). A reduction of annualized relapse rate from 3.1 (pre-treatment) to 0.3 and stable EDSS were reported. However, in the absence of a randomized double-blind control design, efficacy data must be considered with caution.

Interferon beta - 1a (Rebif®). In a cohort of 46 patients with pediatric MS, 22 µg SC of IFNB - 1a treatment was initiated three times weekly (Pohl et al., 2005). In five additional patients with very active disease, treatment was started at 44 µg three times weekly. Side effects were similar to those described for adult patients: injection site reaction (71%); flu-like symptoms (65%); gastrointestinal symptoms (10%); and blood count (39%) and liver function abnormalities (35%).

Glatiramer acetate (Copaxone®). Glatiramer acetate appeared to be safe and well-tolerated in seven children with RRMS at the daily dose of 20 mg daily administered SQ for 24 months (Kornek et al., 2003). Reported adverse reactions included injection site pain or induration and a short lived whole body reactions such as facial flushing and fast heart rate. After a mean treatment duration of 14.7 months, there was a reduced relapse rate from a baseline of 2.5 to 0.1 on drug and stable EDSS were reported. Again, efficacy cannot truly be evaluated in retrospective reviews of small groups of children.

Immunosuppressive therapy. Oral azathioprine has been used in MS to prevent exacerbations by some clinicians, although little has been reported regarding safety or efficacy. Azathioprine is not used commonly in adults with MS, as efficacy is considered limited. Side effects include cytopenia, gastrointestinal intolerance, liver toxicity, and skin rashes. The cost of azathioprine makes it an attractive therapy for patients or countries unable to afford the high cost of the immunomodulatory therapies. Efficacy, however, requires evaluation. Close monitoring of the complete blood count (CBC) and LFTs is recommended.

Disease-modifying Therapy

Initiation. The International Pediatric MS Study Group agreed that immunomodulatory treatment should be started in children and adolescents with active relapsing-remitting disease (defined clinically or by MRI scans) after MS diagnosis. In patients with a recent clinical exacerbation, any MRI change or enhancement on a follow-up brain MRI 3 to 6 months after the exacerbation would suggest disease activity.

Choice of medication. Treatment selection should occur after discussions with the child and parents focused on issues related to compliance, efficacy, and tolerability. The initial IFNB therapy is often initiated at 25% to 50% of the recommended full dose for adults with MS, followed by a stepwise escalation every 2 to 4 weeks up to full or highest tolerated dose. Use of acetaminophen or ibuprofen at the time of injections and, if necessary, 4 to 6 hours thereafter will lessen frequency and severity of flu-like symptoms during the first months of therapy. Glatiramer acetate regimen in children and adolescents is similar to adult regimen. No dose escalation is necessary.

Interferon therapy requires laboratory monitoring, monthly for six months and then three-to six-monthly thereafter.

One approach to evaluate treatment efficacy in an individual patient is to perform neurological examinations at treatment initiation and at 1, 3, and 6 months, and every 6 months thereafter. A repeat brain MRI scan with gadolinium should be obtained around the time of treatment initiation, and again after a period of therapy (typically at 6 or 12 months). These suggestions are based on the clinical model followed in our pediatric MS clinic - formal protocols have not been evaluated.

Change of DMT should be considered in the presence of severe side effects, poor compliance, or in patients who appear to be poor responders. Again, while a standardized definition of treatment failure has yet to be adopted, most clinicians consider a patient to be failing a specific therapy if the child experiences more than two relapses in 12 months, or it the MRI demonstrates accrual of numerous lesions.

Symptomatic Therapy

Spasticity. The goal of spasticity treatment is to improve mobility, reduce pain, and control painful muscle spasms. In severely affected patients, care involves positioning in order to prevent contractures and pressure sores. The treatments offered to reduce spasticity in children with MS are very similar to methods used in children with severe spastic cerebral palsy. Initial management utilizes daily stretching and physical therapy, with particular focus on range-of-motion exercises. If these are insufficient, baclofen, a GABA agonist, is the drug of choice for monotherapy. Tizanadine, a central alpha-adrenergic agonist, can be considered as monotherapy for patients who do not tolerate baclofen. Selective botolinum toxin type A injections can be considered if the above-mentioned therapies are not effective. It has successfully relieved severe leg adductor spasticity in some patients.

Fatigue. Many patients with MS complain of fatigue that is sufficiently severe to interfere with school performance or social activities. Amantidine is an NMDA receptor antagonist with antiviral, neuroprotective, and anti-parkinsonian effects. If amantidine is not effective, modafinil, should be considered. Modafinil (Provigil®) has been shown to be efficacious in adults with MS.

Tremor and ataxia. Occupational therapy and physical therapy can be helpful in providing adaptive equipment for safe walking and other daily activities. Clonazepam (Rivotril®) is one of the most effective treatments for MS intention tremor. Primidone can also be considered.

Urologic and bowel disorders. A urinary tract infection should be excluded in all patients with bladder dysfunction and treated accordingly with appropriate antibiotics. Detrusor-sphincter dyssynergia responds to combination of anticholinergic agents with intermittent straight catheterization. Formal urological assessment is highly recommended.

Coping With the Diagnosis of MS

The diagnosis of a chronic illness such as MS leads to significant impact not only on the child, but on the entire family. Some children/teenagers will require psychiatric support, and we recommend that all children/teenagers be offered a psychiatry or social work referral. Many pediatric MS patients adopt an "invincible" attitude, a common coping mechanism for this age (Boyd et al., 2005). Psychiatric support for these patients may be delayed until such time as they are willing to participate in these discussions. Parents of pediatric MS patients, on the other hand, typically seek support immediately. The Canadian and US National MS Societies provide several resources for children with MS and their families, including a parent handbook.

Conclusion

Although recognition of pediatric MS is increasing, there remains a great deal to learn. Optimal care paradigms remain to be decided, and collaborative efforts are required to meaningfully develop such care plans. Research initiatives are also critical as understanding gained through the exploration of MS in the youngest patients may unveil clues involved in the beginning of the MS disease process.

Jean Marie B. Ahorro, MD-The Hospital for Sick Children, Toronto, Ontario Canada; Brenda L. Banwell, MD-Director, Pediatric Multiple Sclerosis Clinic The Hospital for Sick Children, Toronto, Ontario Canada

The Role Of The Omentum In Regenerating The Liver

2009-03-10T11:03:00.000-07:00

In their recent work, published on March 7, 2009 in the World Journal of Gastroenterology, Dr. Singh and his colleagues from the Cook County Hospital in Chicago (USA) first activated the omentum using a foreign body to increase its content of stem cells and growth factors and then used the activated omentum to regenerate the liver. They cut and removed a small piece of the liver tissue and let the omentum, pre-activated by foreign body, adhere to the wound in order to supply stem cells to the injured liver. They found that the liver of these rats treated with activated omentum expanded to a size 50% greater than the original, an outcome never reported before. They stained the liver sections to understand the mechanism of this result and found that there was an interlying tissue present between the wounded liver and the activated omentum in which bile ducts, containing cytokeratin-19 positive oval cells (liver stem cells), extended from the wound edge. In this interlying tissue oval cells were abundant and appeared to multiply to form new liver tissue. In rats pre-treated with drugs which inhibited hepatocyte growth, liver proliferation was ongoing, indicating that liver regeneration by the omental intervention was the result of oval cell expansion and not multiplication of existing hepatocytes. Further support for the involvement of stem cells was shown by the up-regulation of genes associated with pluripotent stem cells (Nanog and Oct-4) and other genes that play a part in fetal liver development (Wnt-4 and α-fetoprotein).

The present study is the first to demonstrate the unique role of the omentum in regenerating the liver. It may be noted that although Singh and his group have demonstrated the power of the omentum in regenerating a normal liver in this study it remains to be investigated whether this methodology can result in regeneration in a chronically diseased liver.

Dr. Singh and his group have been publishing their work on the omentum and its use to regenerate diseased organs for the last 3 years from the Cook County Hospital in Chicago, USA and its sister research institution, the Hektoen Institute of Medicine. The present work is an extension of their work in the use of adult stem cells derived from the omentum.

The use of embryonic stem cells to regenerate organs is controversial as it is hampered by ethical, political and safety concerns. In that regard, the use of the patient's own tissue (omentum) as a source of stem cells to regenerate the liver (and possibly other organs), as shown by Singh and his group, will be free of such concerns and therefore of great public good.

Skull Base Brain Surgery Course Presents Latest Techniques - 3D Visualization Technology Helps Teach Surgeons Complex Approaches

2009-03-09T10:28:00.000-07:00

The skull base is not just a simple platform for the brain but an anatomically intricate area with an array of connections necessary to the body's essential functions. Traditionally, a tumor or aneurysm in this area was either inoperable or involved significant risk. Now, new surgical techniques -- including procedures done through the patient's eye orbit, ear and nose -- are greatly improving patient outcomes. However, the skills necessary for it require intensive training.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center recently organized a medical education course called "Surgical Approaches to the Skull Base," to train neurosurgeons and ENT surgeons in the subspecialty. Notably, course participants used a custom 3-D visualization tool to learn about the complex surgical techniques. There were 30 attendees representing 10 countries across five continents. It was the third such course organized by the Department of Neurological Surgery at Weill Cornell.

"With rapidly emerging advances in imaging, instrumentation and techniques, we are now able to access the skull base in ways never before thought possible," said Dr. Philip E. Stieg, course director, chairman of the Department of Neurological Surgery at Weill Cornell Medical College and neurosurgeon-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "Mastering these is an integral part of providing patients with the best available treatment options and outcomes."

"In the old method, a lesion in the skull base could only be accessed from above by pushing aside the brain, something that risked neurological damage," said Dr. Antonio Bernardo, course director, assistant research professor of neurological surgery at Weill Cornell Medical College, and director of the microneurosurgery skull base laboratory at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "New skull base surgery techniques reduce this risk and improve recovery for patients. However, they require that the surgeon have a high degree of dexterity with surgical instrumentation, and a deep knowledge of the skull's complex anatomy -- something our course was designed to impart."

To this end, Drs. Stieg and Bernardo offered a custom 3-D virtual-reality environment called IVD (interactive virtual dissection). Participants wore 3-D goggles during lectures and demonstrations. According to Dr. Bernardo, who developed the technology, the IVD system allows them much more time to familiarize themselves with the techniques before they perform actual dissections and surgeries.

Also participating in the event was Dr. Samuel H. Selesnick, professor and vice chairman of the Department of Otorhinolaryngology at Weill Cornell Medical College, and otorhinolaryngologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

The course took place Feb. 6-8 at the Palm Beach Gardens, Fla., campus of the Anspach Companies, a surgical device maker, which also sponsored the course. Additional sponsors included Zeiss AMT, Integra BrainLAB, Bracco TruVision and Stryker.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances -- from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial for gene therapy for Parkinson's disease, the first indication of bone marrow's critical role in tumor growth, and, most recently, the world's first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. NewYork-Presbyterian, which is ranked sixth on the U.S.News & World Report list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar.

Protein Helps Immune Cells To Divide And Conquer

2009-03-09T09:26:00.000-07:00

Researchers at the University of California, San Diego School of Medicine have identified a key protein that is required for immune cells called B lymphocytes to divide and replicate themselves. The rapid generation of large numbers of these immune cells is critical to the body's antibody defense mechanism. However, when B cells grow unchecked, it can lead to immune cell cancers such as multiple myeloma or, when they grow to attack the wrong targets, to autoimmune disease. By discovering the role of the CD98hc protein, scientists may find new therapy targets for such diseases.

The study from the laboratory of Mark H. Ginsberg, MD., professor of medicine, will be published online March 8 in advance of print in Nature Immunology. It describes why CD98hc is essential in order for B lymphocytes to transition into antibody-secreting cells. It also describes how this relates to the protein's role in the signaling ability of integrins - a large family of adhesion molecules that transfer information between the inside and outside of a cell.

According to first author Joseph Cantor, PhD, UC San Diego School of Medicine, scientists have known for nearly 25 years that CD98hc, common to all vertebrates, probably played a role in their adaptive immune system, but it wasn't known how this protein functioned.

"This protein was used as a marker of activation because it was found in low levels on resting lymphocytes," said Cantor. "But when B or T lymphocytes were stimulated by antigens - for instance, to protect the body against bacteria - levels of CD98hc went up 20 fold."

The scientists generated a mouse model lacking the CD98hc protein in B lymphocytes. When vaccinated, these mice were unable to mount a normal antibody response to the pathogen. Cantor says this was the first clue to the researchers of the protein's importance.

"In purifying B lymphocytes without the CD98hc protein, we discovered that the lymphocytes couldn't divide rapidly," Cantor said, adding that this proved the protein was essential to expanding the number of immune cells, a necessary step in the immune response. While deletion of the protein didn't impair early B cell activation, it did inhibit later activation of elements along the signaling pathway that push the cell forward to divide.

"Since B cells can't rapidly divide and replicate without CD98hc, perhaps by blocking this protein we could stop the unchecked growth of B lymphocyte cells that can result in cancer or block misdirected B cell attacks that can cause certain autoimmune diseases," said Ginsberg.

The CD98hc protein functions in cells by helping to transmit integrin signals, as well as transporting amino acids - the building blocks of proteins - into the cell. But the scientists didn't know which, if either, of these functions was related to the protein's role in the rapid division of immune cells. By replacing normal CD98hc in B cells with a version that lacked one or the other of these two functions, they discovered that the integrin-binding domain of this protein is required, but the amino acid transport function is dispensable for B cell proliferation.

"CD98hc interacts with certain integrin subunits to prompt signaling events that control cell migration, survival and proliferation. Our study shows that the rapid proliferation of B cells, necessary for the body to fight infection, is aided by the CD98hc protein's support of integrin signaling," Cantor said.

Notes:

Additional contributors to this paper include Cecille D. Brown and Robert C. Rickert of the Burnham Institute; Raphael Ruppert and Reinhard Fässler of the Max Planck Institutte, Germany; and Chloé C. Féral, Nice-Sophia Antipolis University, France.

This work was supported by National Institutes of Health grants; Joseph Cantor is a post-doctoral fellow of the National Multiple Sclerosis Society.

IntraOp Debuts DermaBeam™ Radiotherapy Solution For Dermatologists

2009-03-08T09:50:00.000-07:00

IntraOp Medical Corporation (OTCBB: IOPM) announces the launch of DermaBeam™, a ground-breaking new paradigm in radiation therapy for office-based dermatology applications and the first implementation at Dermrad, LLC in Ft. Myers, FL.

DermaBeam™ is the first ever office-based electron beam radiation therapy solution. It is based on IntraOp's Mobetron, a mobile and affordable linear accelerator that eliminates the need for the tons of costly and cumbersome shielding and equipment siting required by traditional linear accelerators. While radiation therapy has long been the preferred standard-of-care for many types of skin cancers, the logistics of radiation delivery have made its benefits impractical and inaccessible for most dermatologists and their patients. DermaBeam™ delivers precise, highly effective radiation therapy fine-tuned for the needs of dermatologists and related office-based practices.

Andrew Jaffe, MD, a longtime Florida-based dermatologist, co-founded Dermrad, LLC to utilize the DermaBeam treatment at his Florida dermatology office. Dermrad, LLC is the first medical group to offer the pioneering DermaBeam™ External Beam Radiation Therapy and is excited to have begun treatments earlier this year.

"For patients with cancer in cosmetically sensitive areas and patients that have trouble healing, like diabetics, DermaBeam™ offers an alternative that provides superior cosmetic results," Dr. Jaffe said. "By using DermaBeam™, we are now able to offer a safe, effective, non-surgical alternative for skin cancer treatment."

"In addition to the patient benefits," said Albert DeNittis MD MS, another Dermrad co-founder, "DermaBeam™ offers an impressive economic benefit to my dermatology practice. We think as many as 25 percent of our skin cancer patients will choose the DermaBeam™ treatment because of its cosmetic benefits. DermaBeam™ RT treatments are fully covered and paid by insurance carriers and will allow dermatologists to treat more patients and further increase the size of their practice."

External Beam Radiation Therapy (EBRT) is one of the most common forms of radiation therapy delivered to treat a full range of internal tumors in radiation therapy centers nationwide. The technique uses a linear accelerator, a high energy electron machine, to direct radiation to the cancer site. Typically, patients receive a course of five or six weekly treatments five to six times each week. In skin cancer therapy, EBRT potentially may be used independently or as a complement to surgery, chemotherapy and a variety of other treatments. However, because of the logistics of traveling to radiation therapy centers and the administrative difficulties of this multi-specialty approach, today radiation therapy for skin cancers is uncommon.

Yet, this highly effective non-invasive treatment, as an alternative to surgery, offers particular benefits to patients with lesions in cosmetically sensitive areas such as the face and scalp. It also may be preferable for patients suffering from diabetes or blood-clotting disorders. DermaBeam™ takes advantage of the proven performance of IntraOp Mobetron technology, to bring electron beam radiation therapy to a flexible, easily accessible medical office environment. It allows doctors to deliver high-dose radiation treatment more precisely than traditional large-scale linear accelerators, helping to minimize damage to healthy skin tissue surrounding a tumor. With the specialized DermaBeam™ treatment, dermatologists are able to provide offer a multi-disciplinary approach to skin cancer therapy and provide patients a range of treatment options.

"We are very excited to introduce the power of DermaBeam™ to the dermatology market and to work with dermatologists to reintroduce the benefits of a multi-disciplinary approach to treating skin cancer," said John Powers, CEO of IntraOp, adding, "With strong reimbursement, superior cosmesis and proven clinical effectiveness, we are confident DermaBeam™ will be widely adopted by dermatologists in the United States."

About IntraOp

IntraOp Medical Corporation provides innovative technology solutions for the treatment and eradication of cancer. Founded in 1993, IntraOp is committed to providing the tools doctors need to administer intraoperative radiation therapy safely and effectively - for all cancer patients. The company's flagship product, the Mobetron, is the first fully portable, self-shielding intraoperative electron radiation therapy device designed for use in any operating room. Key Mobetron benefits include: increased survival rates, better local tumor control, shorter treatment cycles, and fewer side effects. Leading hospitals, from university research centers to specialized cancer clinics in North America, Europe and Asia, use the Mobetron as a vital part of their comprehensive cancer program.

Surgeons Perform Minimally Invasive Spine Surgery With US Spine's Lock-Tight™ Device

2009-03-08T09:48:00.000-07:00

Spine surgeons at Middlesex Hospital in Middlesex Connecticut have performed a minimally invasive, posterior spinal fixation procedure on a 70-year-old patient using the Lock-Tight™ Facet System, a groundbreaking new technology that enables surgeons to fixate the facet joint without needing to perform an open procedure.

The surgeons, Jeffrey A. Bash, M.D. of the Connecticut Spine Institute and Joseph Aferzon, M.D. of the Center for Advanced Neuro & Spine in New Britain, utilized Lock-Tight technology, a minimally invasive, percutaneous implant and delivery system. Lock-Tight features a cannulated, partially-threaded, titanium screw, which is inserted through a unique locking washer which, when fully seated against the underside of the screw head, prevents the screw from rotating out of the bone. This feature is unique to the system, and eliminates rotational loosening of the implants post-operatively.

"Our existing Facet Fixation technology has already been ushering in a new type of posterior fixation that allows surgeons to create a rigid posterior construct in a fraction of the time required by conventional devices," said Doris Blake, President and CEO of Boca Raton-based US Spine, makers of Facet Fixation Systems, including Lock-Tight. "Now, with Lock-Tight, we can provide surgeons with a reliable locking implant technology that can be delivered to patients during MIS fusions and decompressions. It is a complimentary solution to our Facet Gun™ and Facet Bolt™ technology, which is inserted in a mini-open, midline approach, and solidifies our position as the market leader in Facet Fixation. We're very excited that the technology is being embraced by leading surgeons such as Dr's Bash and Aferzon in Middlesex."

About US Spine

US Spine is a privately held, middle-stage medical device company focused on the development and commercialization of advanced spinal implant systems with breakthrough technology to address the rapidly increasing spine implant market. US Spine's development efforts focus on motion and tissue preservation through the use of advanced biomaterials and expert surgeon designers. More information about the Company can be found at http://www.us-spine.com.

The Making Of An Intestinal Stem Cell

2009-03-07T09:10:00.000-08:00

Researchers have found the factor that makes the difference between a stem cell in the intestine and any other cell. The discovery reported in the March 6th issue of the journal Cell, a Cell Press publication, is an essential step toward understanding the biology of the stem cells, which are responsible for replenishing all other cells in the most rapidly self-renewing tissue in mammals. It may also have implications for colon cancer, according to the researchers.

The report finds evidence that a transcription factor called Achaete scute-like 2 (Ascl2) switches on the stem cell program in intestinal cells. Transcription factors are genes that control other genes.

"This transcription factor makes these stem cells tick," said Hans Clevers of Hubrecht Institute-KNAW & University Medical Center Utrecht, The Netherlands. "It activates a small program of genes essential to gut stem cells." In other words, if the Ascl2 gene turns on, any dividing cell in the intestine would turn into a stem cell capable of producing any other cell type in that tissue, he added.

The lining of the intestine is made up of peaks known as villi and valleys called crypts. The crypts contain stem cells and so-called Paneth cells, which serve to protect those stem cells.

Intestinal stem cells are rather unique among adult stem cells, Clevers said. In most tissues of the body, stem cells divide only rarely -- perhaps once a month. That's not true of the rapidly dividing stem cells of the intestine.

"Their entire life, intestinal stem cells make tissue every day," he said. That's because approximately every five days, the intestinal lining is replaced in its entirety, leaving only the stem cells and their Paneth cell defenders constant. The stem cells produce an impressive 200 to 300 grams of new cells every day, Clevers added.

"That's an enormous buildup of tissue. These stem cells are responsible."

While there has been some controversy in the field over the identity of intestinal stem cells, Clevers team earlier showed that tiny cells intermingled with the Paneth cells of the intestine do have the characteristics of stem cells. Each crypt bottom harbors around six of those cells, which divide daily to produce every other type of cell in the intestinal linings of mice over the course of their lifetimes. These cells are defined by the expression of a gene called Lgr5.

In the new study, the researchers wanted to further explore the genes that distinguish the Lgr5 stem cells from other intestinal cells. After examining 200 or so genes, they landed on a handful that differed between stem cells and all other cells. Of those, Clevers said Ascl2 was the only transcription factor, a class of genes that are generally important to setting the fates of cells.

When they induced the activity of the Ascl2 transcription factor throughout the intestinal lining of mice, it caused the overgrowth of crypts and the development of additional crypts on surfaces of the villi, they report. In intestines of adult mice lacking Ascl2, the Lgr5 stem cells disappeared within days. All together, those findings led the researchers to conclude that Ascl2 is the key to intestinal stem cell fate.

While he said the findings may not have any immediate practical implications, they could yet yield some insight into the cancer stem cells that give rise to other colon cancer cells.

"In colon cancer tumors, there are a very limited number of cells that express this transcription factor," Clevers said. "It's likely that the same gene turns cancer cells into cancer stem cells."

Fact Sheet: The Thyroid And Pregnancy

2009-03-07T09:08:00.000-08:00

The thyroid gland is located in the middle of the lower neck. Although the thyroid gland is relatively small, it produces a hormone that influences every cell, tissue and organ in the body. The thyroid is a hormone-producing gland that regulates the body's metabolism the rate at which the body produces energy from nutrients and oxygen and affects critical body functions, such as energy level and heart rate. Pregnancy has a great impact on the thyroid.

-- During pregnancy, the thyroid gland produces 50 percent more thyroid hormone as compared to when a woman is not pregnant

-- During pregnancy, the thyroid may increase in size by 10-15 percent.

-- The normal range for thyroid function tests is different during pregnancy as compared to when a woman is not pregnant.

-- The chance of developing hypothyroidism during pregnancy is increased as compared to when a woman is not pregnant.

Thyroid, mothers and babies

For the first 10 to 12 weeks of pregnancy, the baby is completely dependent on the mother for the production of the thyroid hormone

-- By the end of the first trimester or pregnancy, the baby's thyroid begins to produce the thyroid hormone.

-- The baby remains dependent on the mother to ingest adequate amounts of iodine, essential for making the thyroid hormone.

-- During pregnancy, adequate iodine intake is critical for the normal development of the fetal brain.

-- During pregnancy, the mother must increase her intake of iodine to produce more thyroid hormone and have iodine available for the fetus

-- During pregnancy the American Thyroid Association recommends that all pregnant women take a daily prenatal vitamin with 150 µg of iodine in the form of potassium iodide

Hypothyroidism

Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone, is the most common form of thyroid disease. Symptoms include fatigue, depression, forgetfulness, irregular menses and weight gain.

-- Treatment for hypothyroidism during pregnancy is the same as for non-pregnant women a synthetic form of thyroid hormone called levothyroxine.

-- Prior to becoming pregnant, women on levothyroxine should see their doctor to make sure that they are on an appropriate dose.

-- Women who are on levothyroxine prior to becoming pregnant typically need to increase the dose early in the first trimester by approximately 50 percent.

-- Untreated, or inadequately treated, hypothyroidism is linked to spontaneous miscarriage, preterm delivery, and decreased IQ in the unborn child.

-- Children born with congenital hypothyroidism (no thyroid function at birth) may have severe developmental abnormalities if not appropriately identified and treated.

-- In the U.S., ALL newborns are screened for congenital hypothyroidism.

-- Mandatory screening of newborns for congenital hypothyroidism and early treatment has prevented mental retardation.

-- Eight percent of all women develop postpartum thyroiditis. Postpartum thyroiditis occurs in the first year after delivery and consists of hyperthyroidism followed by hypothyroidism.

Hyperthyroidism

Hyperthyroidism is a condition causing the gland to produce too much thyroid hormone. Symptoms include irritability, nervousness, muscle weakness, unexplained weight loss, sleep disturbances, vision problems and eye irritation.

-- Hyperthyroidism may be difficult to diagnose during pregnancy because the symptoms are difficult to distinguish from normal pregnancy.

-- Graves' disease is a type of hyperthyroidism; it is an autoimmune disorder that is genetic.

-- Women treated for Graves' disease typically have their medicine decreased during pregnancy.

-- Women with pre-existing Graves' disease frequently have a flare of the disease postpartum.

-- The chance of developing new onset Graves's disease is increased during the first year postpartum.

-- Inadequately treated hyperthyroidism can result in early labor and a serious complication called "pre-clampsia."

Screening for Thyroid Disease During Pregnancy

The American Thyroid Association recommends that the following high-risk women be screened for thyroid disease either prior to becoming pregnant, or as soon as feasible once a woman becomes pregnant:

-- Women with a history of thyroid disease or thyroid surgery.

-- Women with a family history of thyroid disease.

-- Women with a goiter.

-- Women with known thyroid antibodies.

-- Women with symptoms or clinical signs of hyperthyroidism or hypothyroidism.

-- Women with Type I diabetes mellitus.

-- Women with other autoimmune disorders.

-- Women with infertility.

-- Women with previous therapeutic head or neck irradiation.

-- Women with a history of miscarriage or preterm delivery.

Researchers Use 454 Sequencing System For Rapid Sequencing Of Avian Influenzas

2009-03-07T09:07:00.001-08:00

A team of researchers at the Institute of Diagnostic Virology, Friedrich-Loeffler-Institute Insel Riems, in Germany has developed a simple and rapid method for preparing Avian Influenza samples of infected individuals for sequencing with the Genome Sequencer FLX system.

The highly pathogenic avian influenza A virus (HPAIV) of subtype H5N1 has caused global concern as a potential pandemic threat, killing millions of poultry and fatally crossing over to humans in a number of documented cases. The risk of sequence mutations which cause an increase in pathogenicity, meaning an escalation in the health threat of the virus, demands fast and reliable methods for in-depth full-length sequence analysis to prevent spread of the disease. Höper et al. (1) designed a simple and sensitive method for the preparation of sequencing libraries from HPAIV H5N1 RNA samples for sequencing with the Genome Sequencer FLX instrument. The presented method seamlessly integrates high-throughput 454 sequencing into analysis without necessitating additional equipment or molecular biological techniques besides standard PCR and the Genome Sequencer FLX sample preparation and sequencing pipeline.

According to the authors, their approach is the first published method enabling sequencing of complete HPAIV H5N1 genomes directly from individual human samples using the Genome Sequencer FLX. Massively parallel sequencing of shotgun libraries with the GS FLX System with standard series reagents generated up to 500 Mb of raw sequence data in a single instrument run. The tremendous depth of coverage provided by the sequencing data enabled representation of every nucleotide in multiple independent reads.

"This method is simply not comparable with conventional sequencing and by far surpasses the single reads of 'diagnostic'-relevant sites of the hemagglutinin gene of avian influenza as generated in former studies," explains Dirk Höper. "Our method allows for sequencing of complete HPAIV H5N1 genomes from routine samples, neither requiring previous virus propagation in eggs or cell culture nor cloning and amplification of cDNA in vectors. Our approach permits sequencing of up to 8 complete viral genomes within only 3 days at an unprecedented depth and consequently, reliability of the sequence. The procedure has the potential to seamlessly integrate into the normal diagnostic routine." The described procedure can be easily adapted to different HPAIV subtypes, allowing sequencing of full length genomes immediately after identification of the subtype by routine diagnostics.

"The high accuracy and quick run-time make 454 Sequencing ideal for medical applications. This study demonstrates the tremendous potential our technology has for future diagnostic applications in the field of virology," says Chris McLeod, President and CEO of 454 Life Sciences.

454 Life Sciences, a center of excellence of Roche Applied Science, develops and commercializes the innovative 454 Sequencing system for ultra-high-throughput DNA sequencing. Specific applications include de novo sequencing and re-sequencing of genomes, metagenomics, RNA analysis, and targeted sequencing of DNA regions of interest. The hallmarks of the 454 Sequencing system are its simple, unbiased sample preparation and long, highly accurate sequence reads, including paired-end reads. The technology of the 454 Sequencing system has enabled hundreds of peer-reviewed studies in diverse research fields, such as cancer and infectious disease research, drug discovery, marine biology, anthropology, paleontology and many more.

Powder Free Gloves In Hospitals Decreases Allergy Risk

2009-03-07T08:48:00.000-08:00

Using powder-free latex gloves rather than those with cornstarch powder greatly reduced the number of workers' compensation claims related to latex-related illness, a recent Geisinger study found.

Healthcare workers use latex gloves to reduce the spread of infection and disease when caring for patients. The gloves also protect workers from exposure to chemicals, bodily fluids and other potentially dangerous substances.

Often, a powder such as cornstarch is added to make it easier to slip on or remove the gloves. The powder provides a dry grip for contact with moist hands. The powder also makes it more difficult for gloves to tear. But, powder can aggravate latex allergies. Allergic reactions caused by latex exposure range from simple itching to anaphylactic shock.

In 2001, Geisinger Health System clinicians stopped using powdered latex gloves. A study in a recent edition of the medical journal Dermatitis examined what happened after Geisinger made the change:

-- The number of workers' compensation claims for latex illness among Geisinger employees fell from 12 per year in the five years before the transition to four-and-a-half claims per year in the four years after the transition.

-- The average workers' compensation payment to employees fell from $34,789 to $2,505.

While Geisinger's cost increased initially with the new gloves, most of that increase was offset by decreased workers' compensation claims as well as spending on water and soap to clean the powder, the study noted.

"The transition away from powdered latex gloves should decrease the chance of sensitization to the latex protein in healthcare workers," said Patricia Malerich, M.D., primary study author and Geisinger dermatologist. "Although we examined the effects on healthcare workers, we hope that this decreased exposure to latex proteins carried in powdered gloves will also lead to fewer allergic reactions in latex-sensitive patients."

About Geisinger Health System

Founded in 1915, Geisinger Health System is one of the nations largest integrated health services organizations. Serving more than 2.6 million residents throughout central and northeastern Pennsylvania, the physician-led organization is a nationally recognized leader in the use of electronic health records, patient access and engagement in their healthcare, and in medical education for the next generation. Geisinger is comprised of three medical center campuses, a 740-member group practice, a not-for-profit health insurance company and research that extends across our large system- all dedicated to creating new models for scientific discovery, quality patient care, and successful clinical outcomes. Geisinger's Weis Center, Center for Health Research and Center for Clinical Studies include basic science, population-based and clinical trials research, complemented by collaborative relationships with top academic centers. Geisinger Ventures, the system's for profit entrepreneurial arm, seeks and promotes opportunities to speed the delivery of medical innovation to benefit patients. For more information, visit http://www.geisinger.org.

Prostate adenoma

2009-03-06T05:43:00.000-08:00

Prostate (Prostate) - this man's internal organs (in the form resembling chestnut), which is located below the bladder and urethra thoroughly permeated.

Adenoma of the prostate is characterized by the growth of benign tumors of glands surrounding the urethra, and pushed part of the normal prostate to the periphery, the way of the pinch the urethra at the point where it passes through the tissue of the gland. The prevalence of the disease to 50% of men after 50 years and older than 70 years of 75%. However, the disease «younger», and already there are patients younger than 40 years.

The causes of the disease are manifold and are not sufficiently clear. The most accurate theory of the prostate adenoma - are age-related changes in the endocrine system with the development of benign tumors. The disease occurs in people with different sexual activity, including from clergy celibate.

With the growth of prostate adenoma causing problems with urination and bladder may not empty completely. Such a regular delay of urine in the bladder cavity leads to the formation of stones in the kidney and the bladder itself, the development of infections in the urinary system, the progressive degeneration of kidney tissue.

Symptoms of disease is that at an early stage there are difficulties at the beginning of urination. In the future, with the growth of prostate adenoma there are rapid, irresistible urge to urination, increasing the duration of an act of urination, the urge at night to help increase the duration of urination, vyalaya stream of urine, and finally possible Acute delayed urination, which often are not allowed to conservative methods, and requires the installation tsistostomy (drainage into the bladder through the front puncture abdominal wall). Found at these symptoms need immediate medical treatment because they are fully similar to the more menacing male disease - cancer of the prostate.

Methods of treatment of prostate adenoma are divided into: medical, no medical or surgical. If conservative treatment does not bring the desired effect, it appointed more radical methods of treatment. Modern medicine has learned to perform surgical treatment of prostate adenoma with minimal stress to the body.

Laser irradiation of blood

2009-03-06T05:36:00.000-08:00

Intravascular laser irradiation of blood (VLOK) - one of the methods of quantum therapy blood. Widely used by domestic and foreign practice medicine over the past 20 years.

The method - a direct irradiation of blood in the vascular bed through the optical waveguide, typically entered into any easily accessible vein. The source of radiation is a laser therapeutic device, which gives light with a wavelength of 630 nm (red). By the light of the length of highly sensitive photoreceptor, located on the surface of blood cells. Initiation and activation of these photoreceptors resulted in a number of biochemical reactions, and then the general reactions of the organism, with the development of therapeutic effect.

The following will describe the effects VLOK having no analogs in the pharmacological treatment methods, or exceed it, as well as treatment of disease not accessible to local treatment with laser, because this method of treatment effect develops in the whole body.

Cardiovascular effects - the removal of vascular spasm and expansion of small and medium diameter. Increased network of capillaries in the pathological focus. The restriction zone of necrosis (gangrene) of tissues. Reducing the viscosity of blood. Reducing elevated blood coagulability. Rassasyvanie mikrotrombov. Withdrawal of the most dangerous forms of violations of the rhythm of the heart, as well as preventing their occurrence. Increased contractile heart. Stimulation of the exchange and increase the level of oxygen in the tissues. Reduce blood cholesterol.

Antivirus, antibacterial effect - through the rapid and persistent strengthening of the immune system, increasing the sensitivity of microorganisms to antibiotics, increasing the stability of tissue to damaging effects of micro-organisms.

Antiinflammatory effect - the rapid and effective removal of all signs of inflammation (swelling of tissues, pain syndrome, etc.), much higher than on the pharmacological action of all known drugs. Softening of and rassasyvanie spaek with spaechno-cicatrices processes. Ulcerous wound healing and tissue defects without gross scars. The rapid recovery of bone, cartilage, liver, lung and nervous tissue.

Antifermentny effect - decreased secretion of the gastrointestinal tract, pancreas.

Pulmonary effect - improvement of respiratory function. Bronhorasshiryayuschy effect.

Gormonostimuliruyuschy effect - a tonic effect on the ovaries, thyroid, adrenals, mammary gland (stimulation of lactation).

Increased sensitivity to drugs, to reduce their dosage (antibiotics, hormones, nitrates, psychotropic, etc.).

Detoxification effect - with the strong gravity of the disease.

Antiallergic effect.

Applications VLOK

Therapeutic illness - acute and chronic bronchitis, pneumonia. Asthmatic bronchitis, bronchial asthma. Ischemic heart disease, angina at rest and stress. Breach rhythm of the heart. Stomach ulcer, and 12-p. Intestines. Acute and chronic gastroduodenitis, gastritis, holetsistopankreatity. Cirrhosis of the liver. Inflammatory diseases of the joints.

Endocrinological diseases - diabetes and diabetic vascular lesion, the nervous system. Purulent complications in patients with diabetes. Decreased function of the thyroid gland caused by autoimmune thyroiditis and partial resection of the thyroid gland. Reduced function of the ovaries, adrenal glands.

Surgical disease - accelerating the healing of wounds, long an open ulcer, burn surface sores without serious scarring. Reducing pain syndrome in the trauma and the postoperative period, as well as in vascular diseases of lower extremities. Postoperative infiltration, phlegmon, abscesses, purulent mastitis, paraproktit, hemorrhoids, chronic anal fissures. Chronic and periartrit. The turning of bones. Trophic ulcers. Acute throm. Obliterating atherosclerosis of vessels of lower extremities. Diabetic nerve tissue lesion. Burn injury. Acute and chronic holetsistopankreatit. Ulcerative lesions of gastrointestinal tract. Complications after gastric resection.

Gynecological diseases - inflammatory diseases of the uterus and appendages. Infiltativnye education in the uterus and appendages. Infertility associated with both the spaechnym process, and infectious diseases. Diseases of the mammary glands in lactating mothers, to stimulate lactation. Sexual disorders - a tonic effect on the ovaries, adrenal glands, thyroid gland and milk.

Urologic diseases - acute and chronic prostatitis, pyelonephritis, cystitis, urethritis. Neurogenic bladder dysfunction with enuresis. Stricture urethra. Glomerulonephritis. Chronic renal failure. Sexual disorders in men.

Neurological disease - astenizatsiya, neuroses. Pain syndrome, with migraine, facial nerve neuritis, radicular syndrome, etc. Neurogenic bladder dysfunction with enuresis. The states associated with spasm and narrowing of brain vessels. Spinal cord injuries. The defeat of the peripheral nervous system.

Psychiatric illness - neuroses, depression, epilepsy and episindromy. Withdrawal symptoms when alcohol and drug abuse. Can substantially reduce the need for psychotropic substances.

ENT diseases - acute and chronic ear and upper respiratory tract, sinuses: sinuity, tonsillitis, pharyngitis, vasomotor rhinitis, and external otitis media. ARI. Neurosensory hearing loss.

Dental diseases - acute and chronic focal stomatitis (prosthetic). Stryi and chronic pulpitis and periodontitis. Paradontity. Osteomyelitis.

Skin diseases - atopic dermatitis. Psoriasis. Hemorrhagic vasculitis. Red flat lichen. Vitiligo. Allergodermatozy. Herpes. Furunculosis. Pyoderma and other skin lesions of viral and bacterial nature.

Eye disease - fibrinous iridocyclitis. Acute and chronic konyuktivity.

The clinical effect occurs by the end of treatment, consisting of 5 - 10 sessions of up to 20 - 30 min, and steadily maintained for a period of several months. If you need to repeat courses of treatment in 2 - 3 months, with considerable severity of the disease.

Contraindications

Malignant disease.

In the treatment method VLOK no restrictions on age of patients. During pregnancy and lactation is not a contraindication. Easy by patients and requires no special training in the treatment period.

All of 3D ultrasound (Ultrasound)

2009-03-06T05:34:00.000-08:00

All of the ultrasound Ultrasound - a crucial step in a comprehensive survey of pregnant women and on how precisely and accurately, using appropriate techniques of high-level survey will be done, without exaggeration, depends the health and, consequently, the happiness and the mother, and it is in the womb of a child - because the early detection of potential problems - a guarantee that they will be resolved in time.
How many times do ultrasound?

It is no coincidence that during pregnancy is considered to be the most rational conduct at least three ultrasound examinations, and the rest - for the testimony. The point is that the different timing of ultrasound is its purpose, which is directly linked to the physiological development of the embryo.

First time ultrasound is recommended to do for a period of 10-12 weeks of pregnancy. What are its objectives? At this stage confirmed the existence of pregnancy, its duration is determined by the place of attachment of the embryo, the number of children in this time period you can see the gross vices of the fetus, as well as the formation of the placenta.

A second ultrasound is conducted for a period of 20-24 weeks. It is now feasible to consider the quantity and quality of amniotic fluid, placenta development, all parts of the body of a child, so at the second ultrasound often determine sex of the child.

The third ultrasound done at 32-34 weeks. During the study, determine the size of a baby with her pregnancy, his position in the uterus, conduct Doppler - an assessment of blood flow in the system of «mother-placenta - fetus».

Accordingly, each stage ultrasound helps physicians to monitor the health of mother and child, consistently observing their condition. What kinds of ultrasound machines? Unfortunately, not every medical facility park vehicles in line with modern requirements for diagnostics. The most common spelling of ultrasound-device is a conventional two-dimensional ultrasound: a method based on the reflection of ultrasonic waves from the body tissues, capture device, and receiving the reflected signal on the screen of planar images, which are passed through the ultrasound. But already in 1996 thanks to new computer technologies has a scanner with the possibility of a three-dimensional reconstruction in real time, with the intensity of ultrasonic waves remains the same, but in terms of diagnosis gives a much better position to diagnose due to the three-dimensional volumetric images.

These three-dimensional ultrasound provides additional information, it is very important for the diagnosis of malformations of the fetus - the extremities, spine, face. Last word of ultrasound technology - it is a universal ultrasonic scanner with a color 3D image - Sono Ace 8000 LIVE. Among its components - power doppler, pulse doppler, tissue doppler, doppler statistical constant, allowing for different levels, with maximum accuracy to investigate the blood vessels in the uterus, placenta, fetus. The unit has 512 digital channels of forming an ultrasonic signal, based on Microsoft Windows 2000 operating system.

Used for creating high-tech guarantee 100% success in ultrasound studies of any bodies, as well as the identification of pathology in the development of pregnancy, as well as three-dimensional anatomical scan gives the best results in terms of diagnosis. Therefore, selecting the center to maintain pregnancy, ask in advance exactly how it is equipped with ultrasound machine.

Advantages of 3D and 4D Ultrasound diagnosis to two: - With the help of three-dimensional ultrasound future mom can see a picture of her child, close to the photos and a videotape of his movements in real time, as physicians, supervise pregnancy - an image of a full range of pathology. - Ideal identify effects of fetal anomalies.

Thanks to the three-dimensional Ultrasound, doctors can assess the various parts of the body the fetus in three projections simultaneously, which is very important to identify the effects of fetal anomalies.

The simultaneous detailed survey of the parent organism.

A retrospective show of images, analysis and consultation with patients in the process of scanning.

You can record data in a digital ultrasound image, as well as on VHS tape, CD or DVD in 3D

The first image of your child's volumetric images of three-dimensional ultrasound allows parents at the time of the birth of a child not only have digital photos, but also a video that was recorded on the tape, where the main role - your unborn baby.

Start a family chronicle of three-dimensional ultrasound!

Safety of ultrasound machines

Safety studies of the method was studied by scientists around the world, and to date their conclusion was straightforward: ultrasound is a safe and reliable method. Recent scientific evidence suggests that new medical technologies such as 3D ultrasound and 4D, will not cause even with frequent use of the slightest harm to the body.

Electroencephalography (EEG)

2009-03-06T05:29:00.000-08:00

Electroencephalography (of electricity ..., gr. Enkephalos - the brain and ... grafia) method for studying the brain activity of animals and humans, based on the total registration of bioelectric activity of individual zones, areas that share a brain. EEG. used in modern neurophysiology, as well as in neyropatologii and psychiatry.

Electrical activity of the brain is small and is expressed in millions of shares of volts, it can be registered only with the help of highly specialized instruments and amplifiers, called electroencephalography.

EEG being overlaid on the surface of the skull of metal plates (electrodes), which connect the wires from the input device. The output is a graphic representation of the difference between the oscillations of bioelectric potentials of living brain, called the electroencephalogram (EEG). EEG reflects the complex dynamics of the functioning of brain structures, ie, synaptic processes developing in the body and dendrites of neurons cortex. EEG - a complex curve, consisting of waves of different frequencies (periods), with varying phase relationships and different amplitudes. Depending on the amplitude and frequency to distinguish the EEG waves, referred to by Greek letters "alpha, beta, delta, etc.

A healthy person may vary depending on the EEG in the physiological state (sleep and wake, the perception of visual or auditory signals, a variety of emotions, etc.). EEG of healthy adults in a state of the case, rest, reveals two main types of rhythms: a-rhythm, characterized by the frequency of oscillations at 8-13 Hz with an amplitude of 25-55 mV, and b-rhythm is manifested in the frequency of 14-30 Hz with amplitude of 15-20 mV. In various brain diseases occur more or less serious violations of the normal EEG picture, which you can determine severity and localization of lesions, for example, to identify the location of a tumor or hemorrhage.

Mathematical, quantitative methods of description of EEG recordings, spectral, correlation and other methods of statistical analysis of topographic maps of potential fields of the brain make a simple visual assessment of EEG and allow extraction of the EEG is a new, previously hidden information to the researcher.

Doctor-neurologist, the highest qualification category, candidate of medical sciences, a doctor with clinical experience, Galina Mikhailovna Dzhanumova, invites you to take with us "the diagnosis and correction of disorders of the nervous system."

Mesotherapy - a new tool in the treatment of cellulite

2009-03-06T05:26:00.000-08:00

Mesotherapy - method based on the promotion of recovery processes mezodermy (middle layer of dermis) by introducing organopreparatov.

ORGANOPREPARATY - drugs are made of biomolecules and biofaktorov of organs and tissues of healthy animals and their embryos.

Organopreparaty have pharmacological effects on the accuracy of the functions of an organ or tissue. For organopreparatov also characterized the effect of filling. Filled the deficit of cellular biomolecules, disposed at the biochemical level, the cellular defects. Thus, in homologous organs are optimized processes physiological recovery of tissues by increasing its reserves and the restoration of functional activity, which contributes to rejuvenate, restore the young tissue, withdrawal effects of inflammation, slow down aging, atrophy, etc.

Biokosmetika based organopreparatov is a good breeding ground and support the protective skin, and injection forms organopreparatov - the basis of the guaranteed effect of treatment of cellulite, and with bioliftinge.

Mesotherapy - method based on stimulating mezodermy (middle layer of dermis) by introducing organopreparatov.

In medicine used 2 mesotherapy method: manual (hand) and hardware techniques.

The advantages of manual method are:

It is more precise, accurate work of a doctor, but it allows the manipulation of sensitive areas (eyelids, face, neck);

It enables the implementation of a linear technology vkola - the most effective method of correction of wrinkles;

It reduces traumatic injury of small vessels of the skin.

Accordingly, the manual method of introduction and use of highly organopreparatov in aesthetic medicine - the best solution to resolve problems such as cellulite, excess fat deposits (general and local), atony and flabbiness skin, reducing its turgora, wrinkled, etc.

We use a manual method of introducing homeopathic organopreparatov company HEEL. It is highly hypoallergenic cocktails used to solve aesthetic problems.

More often than not, use the following products:

MADE - Ready Homeopathic cocktail, which stimulates cellular respiration, peripheral circulation and microcirculation, but also activates the production of collagen, has protivootechnym and antifibroznym effect prevents the enzymatic destruction of collagen. Effect: biolifting face and body, eliminating wrinkles.
Gomeoformula - line drugs for the treatment of cellulite and excess fat deposits.

GOMEOFORMULA 1 - contains 21 of the active ingredient. Has lipoliticheskim effect, activates the metabolism, displays the products of splitting of fats and toxins, rapidly reduces the volume of the body, reduces hypertrophy and hyperplasia of fat deposits.

GOMEOFORMULA 2 - contains 24 active ingredients. Stimulates metabolism, enhances lipolysis, blocks the formation of new fat, has a pronounced effect of drainage, improves tone walls of capillaries and veins, strengthens skin collagen framework, v. Fr. reduces the effects of cellulite.

There are many homeopathic cocktails, which are used to address any aesthetic concerns. We're finding drugs and treatments tailored to each patient, which guarantees high efficiency and good results.

Glioblastoma

2008-12-30T03:27:00.000-08:00

A Glioblastoma is a type of a primary brain tumor. Primary brain tumors are those that arise from the brain itself rather than traveling or metastasizing from another location in the body. Approximately 17,000 new cases of primary brain tumors are treated each year in the United States.

Primary brain tumors can either be benign or malignant. Benign brain tumors (eg. meningiomas, acoustic neuromas, pituitary gland tumors) usually grow slowly and can often be removed by surgery depending upon their specific location in the brain. Malignant brain tumors, such as glioblastomas and anaplastic astrocytomas, among others, tend to grow rapidly spreading into the surrounding brain tissue and often cannot be entirely removed surgically.

Primary brain tumors can occur in both children as well as adults. The most common age groups are children 3 to 12 and adults ages 40-70. Metastatic brain tumors, such as glioblastomas, are much more common in adults than in children.

There are many different types of brain tumors. One type, know as astrocytomas, are tumors that arise from astrocyte cells - part of the supportive (neuroglial) tissue of the brain. Astrocytomas account for about half of all primary brain and spinal cord tumors.
Glioblastomas are fast growing astrocytomas that contain areas of dead (necrotic) tumor cells. In adults, glioblastoma occurs most often in the cerebrum, especially in the frontal and temporal lobes of the brain. They rarely occur in the cerebellum or brain stem.
Glioblastoma can be difficult to treat although surgery, radiation therapy, steroids, and chemotherapy have shown the ability to prolong survival.

Nuclear medicine now safer than ever

2008-12-28T09:45:00.000-08:00

Hospitals are now able to ensure that the correct dose is administered to the 670,000 patients that undergo nuclear medicine procedures every year due to a new device developed by scientists at the National Physical Laboratory (NPL).

The number of nuclear medicine procedures has increased by 36% over the last 10 years. 240 NHS sites around the country now use nuclear medicine, mostly for diagnostic scans on areas such as bone, lung perfusion, myocardium and the kidneys. Nuclear medicine is also used in cancer and thyroid therapy.

For most diagnostic procedures, radioactive compounds are injected into the body so that physiological images can be made with gamma cameras. Of course, the exact radioactivity of the dose is crucial, not only to the ultimate safety of the patient but also to the quality of the procedure. A low dose can result in inconclusive images whereas a high dose could cause harm to the patient.

A new instrument, called 'Fidelis', allows medical physicists to check their in-house instruments against the UK national standards for radioactivity. Once confident that their own instruments are measuring activity correctly, the right dose should always be given to the patient.

The instrument is comprised of an ionisation chamber designed by the National Physical Laboratory (NPL), the UK's national measurement institute and a brand new computer-controlled electrometer module from Southern Scientific Ltd (which manufactures and sells the instrument). An ionisation chamber is a gas filled enclosure between two conducting electrodes. When a radioactive source is placed near to the enclosure, gamma-rays emitted by the source ionise the gas - thus creating a current that can be measured by the electrometer.

Previously hospitals have used off-the-shelf Radionuclide Calibrators which needed re-calibrating every time new applications for nuclear medicine or a new design of vial came on stream. With Fidelis, this problem is solved.

'The ionisation chamber is an identical version of the master chamber here,' says Piers de Lavison, the Head of Radionuclide Metrology at NPL. 'It's like having NPL in a box - it is a great example of how our work contributes to quality assurance in healthcare, something that touches all our lives.'

Strategies to Control TB Outdated, Inadequate

2008-12-28T09:44:00.000-08:00

The standard regimens to treat tuberculosis (TB) are inadequate in countries with high rates of multi-drug resistant (MDR) TB. In countries with high rates of MDR-TB, patients are nearly twice as likely to fail their initial treatment than those in countries with low rates, according to a new analysis of World Health Organization (WHO) data. This finding suggests strongly that current TB treatment regimens need to updated and revised to address the shifting landscape of public health in the face of MDR-TB.

“In countries with low prevalence of initial multi-drug resistance, the standardized treatment regimens for new case appear to be adequate, wrote Dick Menzies, M.D., lead author of the study and director of the respiratory division at McGill University. “However, in countries where the prevalence of initial drug resistance exceeds three percent, we believe it is urgent to strengthen capacity to perform drug sensitivity testing, or to reevaluate these standard treatment regimens, given the unacceptably high rates of failure and relapse.”

The study appeared in the first issue for August of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

When the current public health strategies to contain TB were conceived, MDR-TB was much less common. “We hypothesized that, in countries using standardized initial and retreatment regimens, the proportion of patients with poor treatment outcomes would be correlated with prevalence of initial and acquired multi-drug resistance,” wrote Dr. Menzies.

To determine if that were the case, Dr. Menzies and co-investigators reviewed the WHO’s data from 2003 and 2004 for a total of 155 countries, 121 of which reported at least 250 cases annually. They assessed dropout, failure, relapse and death rates with initial treatment, as well as dropout, failure and death rates for retreatment. All rates were analyzed with respect to the prevalence of MDR-TB in each country.

They were right: rates of failed treatment were dramatically higherwith increasing prevalence of MDR-TB (p<0.0001). In fact, after accounting for age, HIV prevalence, per capita income and treatment regimen, for every one-percent increase in MDR TB prevalence, they saw a 0.30 percent rise in treatment failure among new cases, a 1.1 percent increase in failure rate among RE-treatment cases, and a one percent increase in relapse. “This is striking evidence that MDR-TB is directly linked to the increased failure rates of our current treatment regimens,” said Dr. Menzies.

Overall, the proportion of patients requiring retreatment nearly doubled between countries with low and high prevalence of MDR-TB, from 11.9 percent in countries with initial MDR prevalence of less than one percent, to 21.4 percent in countries with MDR prevalence of more than three percent. “In the short term, the higher the failure and relapse rates mean greater morbidity and mortality for patients, with greater social and economic harm for their families and communities. In the long term, these standardized regimens may be contributing to amplification of multi-drug resistance in these countries,” wrote Dr. Menzies.

The concern is that with current treatment regimens, manypatients fail treatmentor relapse later, andby continuing to usethose regimens, researchers and public health officials may be unwittingly increasing the problem of drug resistance andmultiplying the problem for other future patients. “Unless those with the responsibility to boost control and research efforts increase their commitments and their financial investments by several fold, we may never see elimination of this major scourge in the decades to come,” wrote Marcos Espinal, M.D., and Mario C. Raviglione, M.D., both of the WHO, in an accompanying editorial in the same issue of the journal.

Flu shot does not reduce risk of death

2008-12-28T09:41:00.000-08:00

The widely-held perception that the influenza vaccination reduces overall mortality risk in the elderly does not withstand careful scrutiny, according to researchers in Alberta. The vaccine does confer protection against specific strains of influenza, but its overall benefit appears to have been exaggerated by a number of observational studies that found a very large reduction in all-cause mortality among elderly patients who had been vaccinated.

The results will appear in the first issue for September of the American Journal of Respiratory Medicine, a publication of the American Thoracic Society.

The study included more than 700 matched elderly subjects, half of whom had taken the vaccine and half of whom had not. After controlling for a wealth of variables that were largely not considered or simply not available in previous studies that reported the mortality benefit, the researchers concluded that any such benefit “if present at all, was very small and statistically non-significant and may simply be a healthy-user artifact that they were unable to identify.”

“While such a reduction in all-cause mortality would have been impressive, these mortality benefits are likely implausible. Previous studies were likely measuring a benefit not directly attributable to the vaccine itself, but something specific to the individuals who were vaccinated—a healthy-user benefit or frailty bias,” said Dean T. Eurich,Ph.D. clinical epidemiologist and assistant professor at the School of Public Health at the University of Alberta. “Over the last two decades in the United Sates, even while vaccination rates among the elderly have increased from 15 to 65 percent, there has been no commensurate decrease in hospital admissions or all-cause mortality. Further, only about 10 percent of winter-time deaths in the United States are attributable to influenza, thus to suggest that the vaccine can reduce 50 percent of deaths from all causes is implausible in our opinion.”

Dr. Eurich and colleagues hypothesized that if the healthy-user effect was responsible for the mortality benefit associated with influenza vaccination seen in observational studies, there should also be a significant mortality benefit present during the “off-season”.

To determine whether the observed mortality benefits were actually an effect of the flu vaccine, therefore, they analyzed clinical data from records of all six hospitals in the Capital Health region in Alberta. In total, they analyzed data from 704 patients 65 years of age and older who were admitted to the hospital for community-acquired pneumonia during non-flu season, half of whom had been vaccinated, and half of whom had not. Each vaccinated patient was matched to a non-vaccinated patient with similar demographics, medical conditions, functional status, smoking status and current prescription medications.

In examining in-hospital mortality, they found that 12 percent of the patients died overall, with a median length of stay of approximately eight days. While analysis with a model similar to that employed by past observational studies indeed showed that patients who were vaccinated were about half as likely to die as unvaccinated patients, a finding consistent with other studies, they found a striking difference after adjusting for detailed clinical information, such as the need for an advanced directive, pneumococcal immunizations, socioeconomic status, as well as sex, smoking, functional status and severity of disease. Controlling for those variables reduced the relative risk of death to a statistically non-significant 19 percent.

Further analyses that included more than 3,400 patients from the same cohort did not significantly alter the relative risk. The researchers concluded that there was adifficult to capture healthy-user effect among vaccinated patients.

“The healthy-user effect is seen in what doctors often refer to as their ‘good’ patients— patients who are well-informed about their health, who exercise regularly, do not smoke or have quit, drink only in moderation, watch what they eat, come in regularly for health maintenance visits and disease screenings, take their medications exactly as prescribed— and quite religiously get vaccinated each year so as to stay healthy. Such attributes are almost impossible to capture in large scale studies using administrative databases,” said principal investigator Sumit Majumdar, M.D., M.P.H., associate professor in the Faculty of Medicine & Dentistry at the University of Alberta.

The finding has broad implications:

* For patients: People with chronic respiratory diseases such as chronic obstructive pulmonary disease, immuno-compromised patients, healthcare workers, family members or friends who take care of elderly patients and others with greater exposure or susceptibility to the influenza virus should still be vaccinated. “But you also need to take care of yourself. Everyone can reduce their risk by taking simple precautions,” says Dr. Majumdar. “Wash your hands, avoid sick kids and hospitals during flu season, consider antiviral agents for prophylaxis and tell your doctor as soon as you feel unwell because there is still a chance to decrease symptoms and prevent hospitalization if you get sick— because flu vaccine is not as effective as people have been thinking it is.”

* For vaccine developers: Previously reported mortality reductions are clearly inflated and erroneous–this may have stifled efforts at developing newer and better vaccines especially for use in the elderly.

* For policy makers: Efforts directed at “improving quality of care” are better directed at where the evidence is, such as hand-washing, vaccinating children and vaccinating healthcare workers.

Finally, Dr. Majumder said, the findings are a reminder to researchers that “the healthy-user effect is everywhere you don’t want it to be.”

Marijuana ingredients show promise in battling superbugs

2008-12-28T09:40:00.000-08:00

Substances in marijuana show promise for fighting deadly drug-resistant bacterial infections, including so-called “superbugs,” without causing the drug’s mood-altering effects, scientists in Italy and the United Kingdom are reporting. Besides serving as infection-fighting drugs, the substances also could provide a more environmentally-friendly alternative to synthetic antibacterial substances now widely used in personal care items, including soaps and cosmetics, they say. Their study is scheduled for the Sept. 26 issue of ACS’ monthly Journal of Natural Products.

In the new study, Giovanni Appendino and colleagues point out that scientists have known for years that marijuana contains antibacterial substances. However, little research has been done on those ingredients, including studies on their ability to fight antibiotic resistant infections, the scientists say.

To close that gap, researchers tested five major marijuana ingredients termed cannabinoids on different strains of methicillin-resistant Staphylococcus aureus (MRSA), a “superbug” increasingly resistant to antibiotics. All five substances showed potent germ-killing activity against these drug-resistant strains, as did some synthetic non-natural cannabinoids, they say. The scientists also showed that these substances appear to kill bacteria by different mechanisms than conventional antibiotics, making them more likely to avoid bacterial resistance, the scientists note. At least two of the substances have no known mood-altering effects, suggesting that they could be developed into marijuana-based drugs without causing a “high.”

Potential new drug for cocaine addiction and overdose

2008-12-28T09:38:00.000-08:00

Chemists are reporting development of what they term the most powerful substance ever discovered for eliminating cocaine from the body, an advance that could lead to the world’s first effective medicine for fighting overdoses and addictions of the illicit drug. Their findings are scheduled for the Sept. 24 issue of the Journal of the American Chemical Society, a weekly publication.

In the new study, Chang-Guo Zhan and colleagues point out no effective anti-cocaine medication currently exists for cocaine abuse. One of the most promising approaches focuses on substances that mimic butyrylcholinesterase (BChE), a natural blood protein that helps break down and inactivate the drug, researchers say. However, natural BChE is too weak and ineffective for medical use, the researchers note.

The researchers describe design and produce the most potent, stable BChE structure ever produced. In lab studies, that form of BChE broke down, or metabolized, cocaine 2,000 times faster than the body’s natural version of BChE, the scientists say, noting that reducing levels of the drug in the blood is a key to fighting overdose in humans. The substance also prevented convulsions and death when injected into mice that were given overdoses of cocaine, they note. — MTS

New medications for schizophrenia

2008-12-28T09:37:00.000-08:00

New scientific insights into schizophrenia are pointing toward new drugs that offer hope for millions of individuals with the disease — the most serious form of mental illness, according to an article scheduled for the Sept. 15 issue of Chemical & Engineering News, ACS’ weekly newsmagazine. Schizophrenia affects about 25 million people, or about one percent of adults, worldwide.

In the article, C&EN Assistant Editor Carmen Drahl notes that existing medications for schizophrenia, so-called antipsychotics, help ease some symptoms, such as hallucinations and disorganized speech. However, they do not deal with all of the disease’s symptoms, such as lack of motivation and impairments to decision-making.

Researchers are now moving beyond traditional drugs, which generally target dopamine neurotransmission, and focusing on new targets that might tackle a wider range of symptoms. The article describes animal and human trials of several potential new drugs that focus on new disease targets, including the glutamate neurotransmitter system, a nicotinic acetylcholine receptor, and a signaling pathway mediated by cyclic nucleotides. These substances appear to help relieve a wider range of symptoms while causing fewer side effects, the researchers note. “We’re still trying to understand the basic mechanisms of schizophrenia, which will hopefully lead to more effective treatments that target core features of the illness,” notes an outside expert.

Natural Viagra? “Horny goat weed” shows promise in lab studies

2008-12-28T09:29:00.002-08:00

Scientists tested herbal extracts that could possibly improve sexual performance and found that "horny goat weed," pictured below, could be an alternative to Viagra.

Move over, Viagra! Researchers in Italy report that an ancient Chinese herbal remedy known as “horny goat weed” shows potential in lab studies as source for new future drugs to treat erectile dysfunction (ED). The study, which provides scientific evidence supporting the herb’s well-known use as a natural aphrodisiac, is scheduled for the October 24 issue of ACS’ Journal of Natural Products, a monthly publication.

In the new study, Mario Dell’Agli and colleagues point out that Viagra (sildenafil) and several other prescription drugs are now available for ED, or male impotence. ED affects an estimated 18 million men in the United States alone. Studies show, however, that these drugs may cause side effects such as headache, facial flushing, stomach upset, and visual disturbances.

To find better treatments, the scientists studied herbal extracts reputed to improve sexual performance. Scientists exposed the substances to an enzyme that controls blood flow to the penis and whose inhibition results in an erection. Of the extracts tested, “horny goat weed” was the most potent inhibitor of the enzyme. By chemical modification of icariin, the active ingredient purified from the extract, the scientists obtained a derivative with activity similar to Viagra and a potential for fewer side effects because it targeted the protein more precisely than sildenafil.

Goatweed

Facet Joint Effusion and Interspinal Ligament Edema: Major Sources of Lower Back Pain

2008-12-28T09:29:00.001-08:00

New MR techniques show that facet joint effusion (the collection of fluid in the spinal joints) and interspinal ligament edema (swelling of the interspinal ligaments) are major sources of lower back pain, according to a study performed at Baskent University Hospital in Ankara, Turkey and Alanya Research Center in Antalya, Turkey.

During the study 372 patients with lower back pain and 249 healthy patients underwent MRI accompanied by STIR (short inversion time inversion recovery) sequences. "The most common imaging findings in patients with lower back pain were soft tissue changes, mainly facet joint effusion, 85.5%, and interspinal ligament swelling, 80.6%," according to Nefise Cagla Tarhan, MD, lead author of the study.

"Soft tissue changes are important in the understanding of lower back pain and prevention and treatment options should focus more on these changes. A lot of patients (mostly younger) come to me with complaints of bad, lower back pain; it is a very common community problem," said Dr. Tarhan. "With this new MR technique, prevention and treatment options for lower back pain can focus more on soft tissue degenerative changes that cause facet joint effusion and interspinal ligament swelling," said Dr. Tarhan.

3D CT Scans Lead to More Successful Treatment of Varicose Veins in the Lower Extremities

2008-12-28T09:28:00.001-08:00

3D CT scans provide a more comprehensive view of complex varicose veins (one of the most common diseases in the world) in the lower extremities, according to a study performed at the Seoul National University Hospital in Seoul, Republic of Korea. This technique aids surgeons to more effectively treat varicose veins.

One hundred patients with varicose veins in their lower extremities underwent 3D CT scans and "images attained were excellent in 76% of patients," said Jin Wook Chung, MD, and Whal Lee, MD, lead authors of the study. 3D CT scans also gave doctors a closer look at the great saphenous vein (the large superficial vein of the leg and thigh) in 99.5% of all lower extremities being examined.

Varicose veins sit deeply inside fat and 3-D CT allows doctors to have an overview of them. With 3D CT, "the patient and surgeon have a more comprehensive way to see the disease. It shows all aspects of the varicose veins that are important to detect before surgery to prevent recurrence," according to Drs. Chung and Lee.

"3-D CT makes it easy to understand the disease and make a surgical plan," said Drs. Chung and Lee.

Core Needle Breast Biopsy Safe for Patients Taking Blood Thinners

2008-12-28T09:27:00.000-08:00

It is safe to take anticoagulants (blood thinners) before core needle breast biopsies, according to a study performed at the Elizabeth Wende Breast Clinic in Rochester, NY. Core needle biopsies are offered as an alternative to surgical biopsy when a tissue sample of an irregular area in the breast is found by mammogram or sonogram. "They are safer than surgical procedures, require fewer anesthetics, and are accurate," according to Patricia Somerville, MD, lead author of the study.

The study included 200 women who were taking anticoagulants (blood thinners) and 855 women who were not. Adverse reactions, lumps and bruises, after a woman's core needle biopsy were recorded. Results showed that lumps or bruising occurred in 34% of women who were taking blood thinners and 26.5% of women who were not taking them.

"Our study demonstrates that it is safe to perform core needle biopsies on patients taking aspirin and warfarin (another name for coumadin). Patients can remain on their medications and avoid surgical biopsy if the lesion is benign," said Dr. Somerville.

Multidetector CT: Non-Invasive Alternative to Bronchoscopy in Patients with Airway Stent Complications

2008-12-28T09:25:00.000-08:00

Multidetector CT (MDCT) scans are highly accurate in detecting airway stent complications according to a recent study performed at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, MA.

MDCT correctly identified 29 (97%) of 30 complications in 21 patients, including all cases of intraluminal narrowing, migration, invasion by neoplasm and tracheal perforation; MDCT also identified three of four cases of stent fracture," according to Vandana Dialani, MD, lead author of the study.

"Our results show that MDCT is a promising alternative to bronchoscopy for surveillance of stents for complications and has the potential to assist early detection of complications while they are most amenable to treatment. MDCT has the potential to replace bronchoscopy for the routine surveillance of patients with airway stents," said Dr. Dialani.

Patient complications from airway stents are common. "Bronchoscopy is currently the reference standard for detection and treatment of stent complications, but it is an invasive test. MDCT is a non-invasive imaging alternative for the detection of airway stent complications," said Dr. Dialani.

Although the results of this study are very promising, Dr. Dialani emphasized the need for additional, larger studies in order to determine whether a negative CT result effectively excludes a stent complication and to better assess the accuracy of MDCT for detecting rare complications.

Surgical Removal of Small Colon Polyps is Costly and Unnecessary

2008-12-28T09:21:00.000-08:00

Polypectomy (the surgical removal of polyps by colonoscopy) of small polyps found during CT colonography is costly and unnecessary according to a study performed at the University of Wisconsin School of Medicine and Public Health in Madison, WI.

A decision analysis model was constructed to represent the clinical and economic consequences of performing three year colorectal cancer surveillance, immediate colonoscopy with polypectomy, or neither on patients who have 6-9 mm polyps found on CT colonography (CTC). The analysis model was accompanied by a hypothetical population of 100,000 60-year-old adults with 6- to 9-mm polyps detected at CTC screening. Results showed that, "by excluding large polyps and masses, CTC screening can place a patient in a very low risk category making colonoscopy for small polyps probably not warranted," said Perry J. Pickhardt, MD, lead author of the study. "Approximately 10,000 colonoscopy referrals would be needed for each theoretical cancer death prevented at a cost of nearly $400,000 per life-year gained. We would also expect an additional 10 perforations and probably one death related to these extra colonoscopies. There may be no net gain in terms of lives-just extra costs," said Dr. Pickhardt.

"The clinical management of small polyps detected at colorectal cancer screening has provoked controversy between radiologists and gastroenterologists. Patients should be allowed to have the choice between immediate colonoscopy and imaging surveillance for one or two isolated small polyps detected at colorectal cancer screening," said Dr. Pickhardt.

CT colonography is now a recommended test for colorectal cancer screening by the American Cancer Society. "If patients with small polyps are monitored, only five percent of adults undergoing CTC screening will need to undergo immediate invasive colonoscopy," said Dr. Pickhardt.

Aarskog-Scott syndrome

2008-12-23T03:57:00.000-08:00

Aarskog-Scott syndrome is a genetic disorder that affects the development of many parts of the body. This condition mainly affects males, although females may have mild features of the syndrome.

People with Aarskog-Scott syndrome often have distinctive facial features, such as widely spaced eyes (hypertelorism), a small nose, a long area between the nose and mouth (philtrum), and a widow's peak hairline. They frequently have mild to moderate short stature during childhood, but their growth usually catches up during puberty. Hand abnormalities are common in this syndrome and include short fingers (brachydactyly), curved pinky fingers (fifth finger clinodactyly), webbing of the skin between some fingers (syndactyly), and a single crease across the palm. Some people with Aarskog-Scott syndrome are born with more serious abnormalities, such as heart defects or a cleft lip with or without an opening in the roof of the mouth (cleft palate).

Most males with Aarskog-Scott syndrome have a shawl scrotum, in which the scrotum surrounds the penis. Less often, they have undescended testes (cryptorchidism) or a soft out-pouching around the belly-button (umbilical hernia) or in the lower abdomen (inguinal hernia).

The intellectual development of people with Aarskog-Scott syndrome varies widely among affected individuals. Some may have mild learning and behavior problems, while others have normal intelligence. In rare cases, severe mental retardation has been reported.

Symptoms

Belly button that sticks out
Bulge in the groin or scrotum (inguinal hernia)
Delayed sexual maturation
Delayed teeth
Downward palpebral slant to eyes
Hairline with a "widow's peak"
Mildly sunken chest (pectus excavatum)
Mild to moderate mental problems
Mild to moderate short stature which may not be obvious until the child is 1 - 3 years old
Poorly developed midportion of the face
Rounded face
"Shawl" scrotum, testicles that have not come down (undescended)
Short fingers and toes with mild webbing
Single crease in palm of hand
Small, broad hands and feet with short fingers and curved-in 5th finger
Small nose with nostrils tipped forward
Top portion of the ear folded over slightly
Wide groove above the upper lip, crease below the lower lip
Wide-set eyes with droopy eyelids

Treatment

Moving the teeth (orthodontic treatment) may be done for some of the abnormal facial features.

Possible Complications
Cystic changes in the brain
Difficulty growing in the first year of life
Poorly aligned teeth
Seizures
Undescended testicle

Chymotrypsinogen

2008-11-09T07:57:00.000-08:00

Chymotrypsinogen is a precursor of the digestive enzyme chymotrypsin (zymogen).
This molecule is inactive and must be cleaved by trypsin, and then by other chymotrypsin molecules before it can reach its full activity. Its activity is the conversion of proteins to amino acids. The active site of the chymotrypsinogen is covered by a six amino acid long mask. It is only when this mask is removed - when it enters the lumen of the intestine and comes into contact with chymotrypsin molecules - that the enzyme becomes active. This is a very useful safety feature for a protein digesting enzyme. If it wasn't inactivated in this way it would digest the pancreas where it is produced.

RELATED INFO

Molecular Cloning of the Atlantic Cod Chymotrypsinogen B

The cDNA encoding Atlantic cod (Gadus morhua) chymotrypsinogen B has been isolated and sequenced. Its deduced amino acid sequence consists of a 16-residue signal sequence and a mature polypeptide of 247 residues, being two residues longer than its vertebrate analogs. This mature polypeptide corresponds to a calculated molecular mass of 26.5 kDa and shares 70% sequence identity with cod chymotrypsinogen A. However, the identity between cod chymotrypsinogen B and its other vertebrate analogues is 63-66%. In common with most fish serine proteases, cod chymotrypsinogen B contains a high number of methionine residues. The presence of a threonine instead of a highly conserved serine residue at position 189 is a novel characteristic of this enzyme. Cod chymotrypsin B, as its type B vertebrate analogs, has an alanine at position 226, whereas a glycine is most commonly found at this position in the type A chymotrypsins.

Dacryoadenitis

2008-11-04T04:54:00.000-08:00

Dacryoadenitis is an inflammation of the tear-producing gland (lacrimal gland).

Causes: Acute dacryoadenitis is most commonly due to viral or bacterial infection. Common causes include mumps, Epstein-Barr virus, staphylococcus, and gonococcus.

Chronic dacryoadenitis is usually due to noninfectious inflammatory disorders. Examples include sarcoidosis, thyroid eye disease, and orbital pseudotumor.

Symptoms

* Swelling of the outer portion of the upper lid, with possible redness and tenderness
* Pain in the area of swelling
* Excess tearing or discharge
* Swelling of lymph nodes in front of the ear

Diagnosis: Dacryoadenitis can be diagnosed by examination of the eyes and lids. Special tests such as a CT scan may be required to search for the cause. Sometimes biopsy will be needed to be sure that a tumor of the lacrimal gland is not present.

Treatment: If the cause of dacryoadenitis is a viral condition such as mumps, simple rest and warm compresses may be all that is needed. For other causes, the treatment is specific to the causative disease.

Prevention: Mumps can be prevented by immunization. Infection with gonococcus, the bacteria causing gonorrhea, can be avoided by the use of condoms. Most other causes cannot be prevented.

C-reactive protein

2008-11-04T04:12:00.000-08:00

A plasma protein that rises in the blood with the inflammation from certain conditions.

C-reactive protein (CRP) is one of the plasma proteins known as acute- phase proteins: proteins whose plasma concentrations increase (or decrease) by 25% or more during inflammatory disorders.

CRP can rise as high as 1000-fold with inflammation. Conditions that commonly lead to marked changes in CRP include infection, trauma, surgery, burns, inflammatory conditions, and advanced cancer. Moderate changes occur after strenuous exercise, heatstroke, and childbirth. Small changes occur after psychological stress and in several psychiatric illnesses.

CRP is therefore a test of value in medicine, reflecting the presence and intensity of inflammation, although an elevation in C-reactive protein is not the telltale diagnostic sign of any one condition.

Since inflammation is believed to play a major role in the development of coronary artery disease, markers of inflammation have been tested in respect to heart health. CRP was found to be the only marker of inflammation that independently predicts the risk of a heart attack. The CRP test may therefore be added to the screening battery of cholesterol and other lipid tests to detect people at risk for a heart attack.

Genetics and Biochemistry: The CRP gene is located on the first chromosome (1q21-q23). CRP is a 224 residue protein with a monomer molar mass of 25106 Da. The protein is an annular pentameric disc in shape. Proteins with this type of configuration are known as pentraxins. Native CRP is a bit different as it has 10-subunits making two pentameric discs, with an overall molecular mass of 251060 Da.

Babesiosis

2008-11-04T04:03:00.000-08:00

Babesiosis: An illness caused by the parasite Babesia which is transmitted from animals to humans by ticks. In the US, it is typically contracted in the Northeast or Midwest -- in southern New England or New York State and in Wisconsin or Minnesota. The signs and symptoms include fever, chills, sweating, myalgias (muscle aches), fatigue, hepatosplenomegaly (enlargement of the liver and spleen) and hemolytic anemia (anemia due to break-up of red cells). Symptoms typically occur after an incubation period of 1 to 4 weeks and can last several weeks. The disease is more severe in patients who are immunosuppressed, splenectomized (lack their spleen), or elderly. It can cause death. Treatment involves antibiotics, usually clindamycin and quinine.

The parasite: While more than 100 species of Babesia have been reported, only a few have been identified as causing human infections. Babesia microti and Babesia divergens have been identified in most human cases, but variants (considered different species) have been recently identified. Little is known about the occurrence of Babesia species in malarial areas where Babesia can easily be misdiagnosed as Plasmodium (the agent of malaria).

The diagnosis: Diagnosis can be made by microscopic examination of thick and thin blood smears stained with Giemsa. Repeated blood smears may need to be examined to make the diagnosis. Antibody detection by indirect fluorescent antibody (IFA) test is a complementary diagnostic test. Isolation of Babesia by inoculation of the patient's blood into hamsters or gerbils may also assist in diagnosis. Animals inoculated with infective blood typically develop parasitemia (parasites circulating in their bloodstream) within 1 to 4 weeks.

Treatment: The current drug treatment options (in 2002) are clindamycin plus quinine or with atovaquone plus azithromycin. Exchange transfusions have been used in severely ill patients with high parasitemia (high levels of the parasite in the blood).

Aarskog-Scott syndrome

2008-11-04T03:53:00.000-08:00

Aarskog-Scott syndrome: A syndrome of wide spaced eyes (ocular hypertelorism), front-facing (anteverted) nostrils, a broad upper lip, a malformed ("saddle-bag") scrotum, and laxity of the ligaments resulting in bending back of the knees (genu recurvatum), flat feet, and overly extensible fingers. There are X-linked and autosomal forms of the disease. The gene for the X-linked form has been mapped to chromosome band Xp11.21 and identified as the FGD1 gene.

The disease is named for DJ Aarskog (1928-) and CI Scott, Jr. (1934-), Norwegian and American pediatricians, who described it in 1970 and 1971. It is also known as Aarskog syndrome, faciodigitogenital dysplasia, and faciogenital dysplasia.

Genetics: Aarskog-Scott syndrome is transmitted in an X-linked recessive manner. The sons of female carriers are at 50% risk of being affected with the syndrome. The daughters of female carriers are at 50% risk of being carriers themselves. Females may have mild manifestations of the syndrome. The syndrome is caused by mutation in a gene called FGDY1 in band p11.21 on the X chromosome.

Diagnosis: Genetic testing may be available for mutations in the FGDY1 gene. Genetic counseling is indicated for individuals or families who may carry this condition, as there are overlapping features with Fetal alcohol syndrome.

Treatment: Surgery may be required to correct some of the anomalies, and orthodontic treatment may be used to correct some of the facial abnormalities. Trials of growth hormone have not been effective to treat short stature in this disorder.

Prognosis: Mild degrees of mental slowness may be present, but affected children usually have good social skills. Some males may exhibit reduced fertility.

Complications: Some recent findings have included cystic changes in the brain and generalized seizures[citation needed] . There may be difficulty growing in the first year of life in up to one-third of cases. Misaligned teeth may require orthodontic correction. An undescended testicle will require surgery.

Molecular Biology: The Aarskog-Scott syndrome is due to mutation in the FGD1 gene. FGD1 encodes a guanine nucleotide exchange factor (GEF) that specifically activates Cdc42, a member of the Rho (Ras homology) family of the p21 GTPases. By activating Cdc42, FGD1 protein stimulates fibroblasts to form filopodia, cytoskeletal elements involved in cellular signaling, adhesion, and migration. Through Cdc42, FGD1 protein also activates the c-Jun N-terminal kinase (JNK) signaling cascade, a pathway that regulates cell growth, apoptosis, and cellular differentiation.

Within the developing mouse skeleton, FGD1 protein is expressed in precartilaginous mesenchymal condensations, the perichondrium and periosteum, proliferating chondrocytes, and osteoblasts. These results suggest that FGD1 signaling may play a role in the biology of several different skeletal cell types including mesenchymal prechondrocytes, chondrocytes, and osteoblasts. The characterization of the spatiotemporal pattern of FGD1 expression in mouse embryos has provided important clues to the understanding of the pathogenesis of Aarskog-Scott syndrome.

It appears likely that the primary defect in Aarskog-Scott syndrome is an abnormality of FGD1/Cdc42 signaling resulting in anomalous embryonic development and abnormal endochondral and intramembranous bone formation.