Recently in Medicine Category

Eight weeks ago, I hosted Dr. Aubrey de Grey for his second talk at Google in Mountain View, California, a follow-up to his earlier Google talk in the SENS series, "WILT: taking cancer seriously enough to really cure it":

ABSTRACT

The intrinsic genetic instability of cancer cells makes age-related cancers harder to ... all » postpone or treat than any other aspect of aging. Any therapy that a cancer can resist by activating or inactivating specific genes is unlikely to succeed long-term, because pre-existing cancer cells with the necessary gene expression pattern will withstand the therapy and proliferate. WILT (Whole-body Interdiction of Lengthening of Telomeres) seeks to pre-empt this problem by deleting from as many of our cells as possible the genes needed for telomere elongation. Cancers lacking these genes can never reach a life-threatening stage by altering gene expression, only by acquiring new genes, which is far more unlikely. Continuously-renewing tissues can be maintained by periodic reseeding with telomere elongation-incompetent stem cells that have had their telomeres lengthened in vitro with exogenous telomerase. I will describe why WILT may become a uniquely comprehensive anti-cancer modality, and the practicalities of performing it and avoiding side-effects.

Some weeks back, my (now) friend Dr. Daniel Kraft, a physician scientist at Stanford, came to Google at my invitation to give a talk, "Everything You Wanted To Know About Stem Cells... But Were Afraid To Ask":


ABSTRACT

Stem cell technology and the debate surrounding it has generated a great deal of excitement ... all » and controversy in recent years. The field is surrounded by misconceptions, hype and yet very significant potential. In this talk we'll cover: defining what are stem cells really and where do they come from... the differences between embryonic stem cells and 'adult stem cells' (i.e. derived from our own bone marrow, fat, umbilical cord blood, placentas and even our kids teeth) and emerging technologies to utilize these cells in powerful and novel ways. We'll cover current clinical uses of stem cells, ongoing clinical trials in regenerative medicine (i.e. using marrow derived cells to treat heart attacks, vascular disease, stroke and even diabetes), upcoming trials utilizing embryonic stem cells, and some of the likely near term and future applications as well as challenges remaining in order for this field to reach its full potential.

Aubrey de Grey gave a Tech Talk at Google's Mountain View campus this week, and I was privileged to attend. I've seen him give a longer, earlier version of this presentation before - at Stanford in June 2005 - and was impressed more than ever. Enjoy:



ABSTRACT

It may seem premature to be discussing approaches to the effective elimination of human ... all » aging as a cause of death at a time when essentially no progress has yet been made in even postponing it. However, two aspects of human aging combine to undermine this assessment. The first is that aging is happening to us throughout our lives but only results in appreciable functional decline after four or more decades of life: this shows that we can postpone the functional decline caused by aging arbitrarily well without knowing how to prevent aging completely, but instead by increasingly thorough molecular and cellular repair. The second is that the typical rate of refinement of dramatic technological breakthroughs is rather reliable (so long as public enthusiasm for them is abundant) and is fast enough to change such technologies (be they in medicine, transport, or computing) almost beyond recognition within a natural human lifespan. In this talk I will explain, first, why (presuming adequate funding for the initial preclinical work) therapies that can add 30 healthy years to the remaining lifespan of healthy 55-year-olds may arrive within the next few decades, and, second, why those who benefit from those therapies will very probably continue to benefit from progressively improved therapies indefinitely and thus avoid debilitation or death from age-related causes at any age.

What a day! Just as I'm getting ready to attend Aubrey de Grey's talk at Google, I find out that a martial arts training buddy of mine, Dr. Pete Lohstroh, recently left his research position at UC Davis to take a senior scientist position at Telomolecular Nanotechnologies, specializing in the application of nanocircles to telomere extension therapy (one of several approaches they're taking). Congratulations Pete!

Nanomedicine opens the way for nerve cell regeneration


"The ability to regenerate nerve cells in the body could reduce the effects of trauma and disease in a dramatic way. In two presentations at the NSTI Nanotech 2007 Conference, researchers describe the use of nanotechnology to enhance the regeneration of nerve cells. In the first method, developed at the University of Miami, researchers show how magnetic nanoparticles (MNPs) may be used to create mechanical tension that stimulates the growth and elongation of axons of the central nervous system neurons. The second method from the University of California, Berkeley uses aligned nanofibers containing one or more growth factors to provide a bioactive matrix where nerve cells can regrow..."

Nanoparticles Delivery of 'Suicide DNA' Kills Prostate Tumors


"...using nanoparticles developed by members of the Alliance for Nanotechnology in Cancer, a team of investigators at the Lankenau Institute for Medical Research, in Philadelphia, has developed a DNA-based therapeutic agent that has the potential to treat both enlarged prostates and localized prostate tumors. When tested in mice, this new agent specifically targeted prostate tissue, producing no toxic effects in surrounding tissues..."

I'm about a month late in actually publishing a mention of my friend (and Reuters reporter) Tom Burroughes' interview with Cambridge University gerontologist Aubrey De Grey, "Lifespans soon to be decades longer", which, interestingly, seems to have been syndicated on the Indian version of Yahoo! News.

Forwarded to me by Perry Metzger, and independently brought to my attention by Tom Burroughes, published in Science as "Cancer Regression in Patients After Transfer of Genetically Engineered Lymphocytes":

Using adoptive transfer of lymphocytes given after host immunodepletion it is possible to mediate objective cancer regression in patients with metastatic melanoma. However, the generation of tumor-specific T cells in this mode of immunotherapy is often limiting. Using a retrovirus encoding a T cell receptor, we report here the ability to specifically confer tumor recognition by autologous lymphocytes from peripheral blood. Adoptive transfer of these transduced cells in fifteen patients resulted in durable engraftment at levels exceeding ten percent of peripheral blood lymphocytes for at least two months post infusion. We observed high sustained levels of circulating, engineered cells at one year post-infusion in two patients, that both demonstrated objective regression of metastatic melanoma lesions. This study suggests the therapeutic potential of genetically engineered cells for the biologic therapy of cancer.

I have the full paper, forwarded to me by a friend, which I'm reading slowly.

A gift from my training partner last night, and proof that padded training weapons are a good idea for some types of waza:


Russell with a black eye from training

That's from the end of a 6-foot hickory pole, received during a sword evasion drill (sword in my hand, bo in his.) I was fortunate: my training partner had enough sensitivity to have placed the tip of the hickory right down across that eyelid into the left zygomatic arch. Pretty cool, actually.

An interesting blog article about the use of dendrimers in targetted drug delivery systems, sent me by Tom Burroughes in London.

University of Michigan scientists have created the nanotechnology equivalent of a Trojan horse to smuggle a powerful chemotherapeutic drug inside tumor cells – increasing the drug's cancer-killing activity and reducing its toxic side effects.
Previous studies in cell cultures have suggested that attaching anticancer drugs to nanoparticles for targeted delivery to tumor cells could increase the therapeutic response. Now, U-M scientists have shown that this nanotechnology-based treatment is effective in living animals.

This type of news carries a special type of urgency for me, as I've recently been informed that my good friend Chris Tame, in London, has been diagnosed with epithelioid angiosarcoma of the bones (spine & hip so far.) His oncologists are working hard to find the primary source of the cancer. In the meantime, any new developments in the effectiveness of chemotherapy with short & medium term time horizons are of great personal interest to me and my friends.

...the digital (PDF) version I'm reading now, but Charlie Stross tells his readers not to do so. I will, however, be buying several copies from Amazon as gifts to friends. Damn it's good!

Cambridge biogerontologist Aubrey de Grey will be speaking next week at Stanford University, on "Why the prospect of dramatic life extension matters now." Talk will occur Wednesday evening 7:00-8:30 PM, 8 June 2005, at the Clark Center Auditorium. Thanks to Tyler Emerson for forwarding this to me; I do plan to attend.

I am really, really enjoying my biology class, a concentrated term of cell & molecular biology. Students in this program spend about four times as much time in lab, learning industrially useful techniques, as do students in comparable programs in the University of California system. In the last three weeks, I've had hands-on time doing protein electrophoresis, conjugation (bacterial DNA transfer), and DNA electrophoresis. Here's an image of our team's first DNA gel:

dna electrophoresis gel image

The DNA is from purified coliphage Lambda virus, 48,502 Kb (kilobases) in length. Lane 1 is pure, uncut DNA. Lane 2 is DNA restricted (cut) by Eco RI enzyme, Lane 3 restricted by Hind III, and Lane 4 by both (the restriction sites are different, resulting in more, smaller DNA fragments.)

Lanes 5 through 7 are subsamples taken from 2 through 4, subjected slowly and thoroughly to the action of the enzyme DNA ligase, resulting in outrageously long, randomly recombinant strands.

The gel is purified agarose treated with ethidium bromide. The image above is a high-contrast Polaroid of the gel UV-transilluminated to fluoresce in the visible spectrum (reddish orange, here shown in black and white).

This stuff is outrageously fun.

Monica, you can take my blog off the "Missing in Action" list on your blogroll: I'm out of school for three weeks, concentrating on work but taking a few minutes a day to blog.

Speaking of school, the last few weeks of organic chemistry were split between the standard track material (in this case reactions of alkynes) and a series of lectures on NMR (nuclear magnetic resonance) in depth. When I return to school, our department's new NMR machines will be in place, so this preparation is essential to actually using these machines productively. I'm really looking forward to adding NMR to my toolkit.

Quote of the Day

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In science, 'fact' can only mean 'confirmed to such a degree that it would be perverse to withhold provisional assent.' I suppose that apples might start to rise tomorrow, but the possibility does not merit equal time in physics classrooms.

Stephen Jay Gould

Cosmetic Neurology?

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Here's a term I'd not expected to hear: "cosmetic neurology" (via John Venlet).

We finally started into dissections in biology lab tonight. My own specimen was this rather stout, well-endowed female Ascaris lumbricoides, an intestinal parasite of humans:

Ascaris, laid out after dissection

I'd suspected that although our college's brand-new science center was state of the art in facilities, our gear would be knackered, so I brought my own gear (probes, pins, scalpels, various forceps, etc.) just in case. I was correct in my assessment: all the school-supplied gear was thrashed. One other guy in the lab, an Air Force PJ (USAF Pararescue) who's med-school bound, brought his own gear too; it was interesting to compare kits.

Since this specimen was pseudocoelomate in its body plan, there was no mesentary tissue to complicate the incision process. I was able to do really well with a #15T surgical blade: small enough, with a fine tip for starting an incision, but a sufficiently curved blade belly to continue incisions without nicking the viscera.

One gets the impression after laying this open and spreading its innards with a blunt probe that it is all uterus, wrapped in oviduct... two strands of Top Ramen cloaked in angel hair pasta. This thing is even more dedicated to reproduction than it is to feeding. Brrrrrr.

Perry Metzger reports a fantastic bit of news about the reconstruction of a man's jaw using a fusion of prosthesis and a novel bone re-growth technique.

I'm answering email just now, with a local Mandarin-language cable TV channel playing in the background (2 years of Mandarin in college, gotta keep it up... besides, I admit to a silly fascination with "Pawnshop No. 8"), when I see an advert for my dentist - a part-time semiretiree who's also a professor at a local dental college - and glanced a white guy with black hair leaning back in The Chair. What the hell? Wonder if that was me... don't remember consenting to filming. I did spend an inordinate number of visits recently getting my dentition reconstructed from the effects of "overlarge crown placement... aiyah!" from a few years ago.

This reminds me... every dentist I've ever had - American, English, Filipino, Persian, Japanese, Taiwanese - seems to have been drilled in The Dark Art of Attempting Dialogue With a Patient Pinned Helpless with Cheek Retractors.

Thanks to Chris Tame for passing along this article: "Scientists Identify Compounds That Mimic Calorie Restriction."

Quote of the Day

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Most of America's health care is private, so many assume it operates as a free market. In truth, it is dominated by the government, resulting in high costs and stifling bureaucracy.

The federal government effectively socializes 86% of all health spending, a greater share than in 17 other industrialized countries, including Canada (though other features make these systems less free).

By discouraging individual responsibility, the government guarantees irresponsibility. We pay less attention to our health and demand more care — with little regard to the costs we impose on others or the rising prices that result. (Should it surprise us that health insurance is unaffordable for millions?) Those footing the bill — employers, insurers and the government — try to impose responsibility in ways both offensive and harmful (read: managed care).

Michael F. Cannon

Perry Metzger reports in "Immunotherapy Halts Alzheimer's in Mice" that:


...the injection of antibodies targeting the beta amyloid plaques into the brains of mice with a close analog of Alzheimer's disease managed to trigger a response in which the immune system cleared the plaques. Neurofibrillary tangles associated with the disease cleared spontaneously shortly after the amyloid plaques vanished.

Perry Metzger reports that Francis Crick has died. He will be missed.

Courtesy of Perry Metzger today: "New Technique for Imaging May Improve Study of Proteins" and its related story direct from IBM, "IBM Scientists Make Breakthrough in Nanoscale Imaging."


IBM scientists have achieved a breakthrough in nanoscale magnetic resonance imaging (MRI) by directly detecting the faint magnetic signal from a single electron buried inside a solid sample.

Quote of the Day

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A biophysicist talks physics to the biologists and biology to the physicists, but when he meets another biophysicist, they just discuss women.

Unknown

A big thanks to James and Steph for their gift of the Springer title Name Reactions by Jie Jack Li, a compact atlas of 331 reactions in organic chemistry, from "Abnormal Claisen rearrangement" to "Zenin benzine rearrangement." This should be truly useful from the fall term onwards; thanks guys!

Bizarre Science

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Recommended by Monica White: the blog "Bizarre Science."

I never hear good news emanating from that cesspit of a state, New Jersey. Apparently, they're proposing yet another outrageous law, in this case the first tax on a medical procedure in American history:


The bill, sponsored by Democratic Sen. Wayne R. Bryant and Democratic Assemblyman Joseph Cryan, imposes a 6 percent tax on certain cosmetic medical procedures that are directed at improving the patient's appearance and that do not promote the proper function of the body or prevent or treat illness or disease.

The New Scientist reported yesterday that experimental progress in growing replacement teeth in situ has been made... yet another reason to pressure the federal government into repealing all its vile, stupid laws against stem cell research.

Bear in mind this was written in the 1930's, a time when the role of medicine was far more profoundly focussed on service to the individual, rather than as a tool of social engineering (a path we've been headed down for a few decades):


Hygiene is the corruption of medicine by morality. It is impossible to find a hygienist who does not debase his theory of the healthful with a theory of the virtuous. The whole hygienic art, indeed, resolves itself into an ethical exhortation. This brings it, in the end, into diametrical conflict with medicine proper. The true aim of medicine is not to make men virtuous, it is to safeguard and rescue them from the consequences of their vices. The physician does not preach repentance; he offers absolution.
H. L. Mencken

Quote of the Day

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When the war finally came to an end, I was at a loss as to what to do... I took stock of my qualifications. A not-very-good degree, redeemed somewhat by my achievements at the Admiralty. A knowledge of certain restricted parts of magnetism and hydrodynamics, neither of them subjects for which I felt the least bit of enthusiasm. No published papers at all... Only gradually did I realize that this lack of qualification could be an advantage. By the time most scientists have reached age thirty they are trapped by their own expertise. They have invested so much effort in one particular field that it is often extremely difficult, at that time in their careers, to make a radical change. I, on the other hand, knew nothing, except for a basic training in somewhat old-fashioned physics and mathematics and an ability to turn my hand to new things... Since I essentially knew nothing, I had an almost completely free choice...

Francis Crick
What Mad Pursuit, Basic Books, New York, 1988, pp 15-16.

L. Neil Smith passes on this amusing bit of reportage about a possible consequence of the American habit of wearing the silk snot rag with the white coat.

Men, if you can't see your penis when you stand up, you need some serious lifestyle change, starting with diet and exercise. Maybe a look at this might provide an impetus to change.

Here's an interesting short article by Ralph Merkle written when he was working for Zyvex (before he moved on to Georgia Tech): "Nanotechnology and Medicine".

Another source of concise information on the respirocyte concept.

My thanks to my longtime friend (I avoid the term "old friend" for such a young woman) Kennita Watson for alerting me to this lecture at Stanford on 23 June 2004: "The Artificial Synapse Chip: Towards an Electronic Prosthetic Retina" by Harvey A. Fishman, M.D., Ph.D, Stanford University School of Medicine, the Director of Ophthalmic Tissue Engineering and Chief Ophthalmology Resident in the department of Ophthalmology.


Age-related macular degeneration (AMD) is the most common form of severe and irreversible blindness in the U.S. Our research program consists of a highly interdisciplinary effort between physicians, engineers, and scientists to develop a neural interface that will connect the output from a digital camera to individual retinal cells in patients with AMD, thus bypassing injured cells.

I really wish I could make this lecture, but I have a bioanthropology final exam during the very time slot this lecture occurs (6:15pm for dinner at the hospital cafeteria, 7:30-8:30pm for the lecture). If you, the reader, can attend I'd love to hear your impressions of the event.

By the way, this sounds like a skillset for the type of research physician I find really interesting:


Dr. Fishman's area of expertise is translational research that uses a multidisciplinary approach to develop novel therapies for blinding diseases in the eye – in particular, Age-Related Macular Degeneration. His research bridges the gaps between tissue engineering, surface science, nanofabrication, chemistry, neuroscience and retinal transplantation biology in Ophthalmology. His background in new technologies and medical science is diverse including bioMEMS, chip-based microfluidics and confocal and time-lapse microscopy, neuroscience/nerve cell regeneration and macular diseases in Ophthalmology. He has made contributions in the fields of microfluidics, laser-induced fluorescence detection, separation science, and biosensors.

My friend Steve Pegram passed this on to me a few days ago with the comment "First I've heard of these. Handy, if they work as advertised." I agree.

"The Only EPA Registered Purification Tablets on the Market - effective against Cryptosporidium, Giardia, bacteria, and viruses."


The only disinfection system effective against viruses, bacteria, cryptosporidium, and Giardia
Fresh tasting water - no unpleasant taste
Easy to use tablets
The same proven technology that is used in municipal water supplies
Lightweight and compact - ideal for traveling, lightweight backpacking, and emergency use
Purification Method: Chlorine Dioxide Tablets

Output: 1 tablet treats 1 quart (1 liter) of water

Capacity: 30 tablets

An old friend of mine, whose judgment I strongly respect, recently stated that the services he received at Kronos Optimal Health Centre were "...worth every penny!" Eventually, I plan to avail myself of those services too.

...especially when it involves bad things happening perilously close to me.

There's a phenomenon well known in its universality among martial artists, pilots, and laboratory investigators (and many others, though these are categories to which I can personally claim memberhip): beginners can be dangerous!

For fledgling pilots, safety comes first in collision avoidance and minimal aptitude in takeoff and landing (especially landing). Student pilots at this point truly have to be watched carefully.

For martial artists, dealing with beginners means being aware that the beginner is often not aware of how easy it is to hurt your training partner, and hence how important it is to learn how to train properly so that you don't get hurt "when it's your turn to lose" in practice. Genuinely dangerous!

Today, I had a reminder of how easily late-first-year chemistry students can be genuinely dangerous too. I'm a stickler for thorough preparation for lab investigation, which includes adequately understanding any reaction schema involved in the labwork. Today's labwork involved the generation of noticable volumes of chlorine and nitrogen dioxide gasses, the latter of which was to be generated by heating of reagents including concentrated nitric acid under a fume hood.

Well, today a couple of giggly Chinese girls (otherwise sharp but who are treating chemistry as a checklist item, a waypoint on the way to medical school) who didn't fully understand the reaction schema, were heating the nitric acid solutions at their bench! Before any of us had time to react, they'd already generated a visible cloud of white, toxic smoke. The hell of it was, they simply stood rooted where they were standing, looking embarassed. They were not embarassed that they stood a risk of death or injury, but that they'd been caught not having prepped their lab notebooks with the proper procedure! A couple of other students managed to shake them from their (not yet literal) mortification and pull them away from the danger, while my instructor and I started hitting the buttons on the emergency fume hood evacuation systems, hoping we could clear the cloud quickly and safely by drawing it across the room into the hood system (and upwards from there into the Great Dilution of the atmosphere... note that our lab building is gratifyingly free of pigeon poop for a very good reason.)

Later, I did what the instructor later noted was probably more effective and shocking coming from a fellow student rather than from him: I dressed down the girls in front of everyone else, telling them they must come into the lab prepared next time, rather than faking their way through an experiment. Funny thing was, just a few minutes before the incident I'd commented to my instructor that many of my classmates didn't seem to have any grasp of the difference between real laboratory science and ritual magic.

Oh, and several minutes later I witnessed another girl come up to the instructor asking if the open centrifuge tubes she was holding - which were continuously generating chlorine gas as a side reaction - were hazardous! Argh!

At least our labwork on Thursday of last week went without incident. You see, there was a reaction on that day which required careful control of pH in one of the test solutions containing thiocyanate ions (SCN-). We needed to maintain a particular weakly acidic environment in order to favor a certain desired product. You see, a more acidic pH would have tilted the reaction strongly to the production of HCN, hydrogen cyanide gas...

I'll be attending all 3 days of the 14-16 May 2004 Foresight Senior Associates Gathering in Palo Alto, California. I very highly recommend this event to anyone interested in molecular nanotechnology. If you're not intimately familiar with nanotechnology, but want to learn, I enthusiastically recommend the 8-hour "Fundamentals of Nanotechnology" tutorial session on Friday: I'll be attending myself to dust off and deepen my own understanding.

Quote of the Day

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There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.

Hippocrates, in "Law"

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The mind likes a strange idea as little as the body likes a strange protein and resists it with similar energy. It would not perhaps be too fanciful to say that a new idea is the most quickly acting antigen known to science. If we watch ourselves honestly we shall often find that we have begun to argue against a new idea even before it has been completely stated.

Wilfred Batten Lewis Trotter, English surgeon (1872-1939)

Penn & Teller are back for another season of the excellent BULLSHIT! debunking series on Showtime. Set your PVRs: there's an episode tonight.

Anton asks this medical question, to which my answer is: "yes."

I'd post it as a comment on his blog, but he's using primitive blogging software that's not set up for it.

Quote of the Day

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The thinking physician identifies AOIs [areas of ignorance] daily.

Professor Elliot Wolfe, MD
Stanford University Medical Center, 5 April 2004

Quote of the Day

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The juvenile sea squirt wanders through the sea searching for a suitable rock or hunk of coral to cling to and make its home for life. For this task it has a rudimentary nervous system. When it finds its spot and takes root, it doesn't need its brain any more so it eats it. It's rather like getting tenure.

Daniel Dennett
Consciousness Explained