Tiny Animal Becomes An Organ- Can We Engineer This?

Posted on October 12, 2006 by Steven F. Palter, MD

Scientific American: Tiny Genome May Reflect Organelle in the Making

Scientific Amrican is reporting on an organism with the smallest known genome. So small in fact, that it lacks half the genes thought necessary for life. This type of mini-creature only exists as a parasite inside th body of a host. What’s so amazing is the possibility that this is a symbionic relationship and that the tiny creature is evolving into a new form of organelle.

For the non-biology majors here organelles are microscopic structures in a cell that have specialized functions (eg, mitochondria and the nucleus). The mitochondria are structures that made this evolutionary transformation millions of years ago and which live in every cell in our body. Mitochondria are rod-shaped organelles that can be considered the power generators of the cell, converting oxygen and nutrients into energy. This process is called aerobic respiration and is the reason animals breathe oxygen. Without mitochondria higher animals would likely not exist because their cells would only be able to obtain energy from anaerobic respiration (in the absence of oxygen), a process much less efficient.

The mitochondrion is different from most other organelles because it has its own circular DNA (similar to the DNA of bacteria not mammals) and reproduces independently of the cell in which it is found; an apparent case of endosymbiosis. Scientists hypothesize that millions of years ago small, free-living bacteria were engulfed, but not consumed, by larger bacteria, perhaps because they were able to resist the digestive enzymes of the host organism. The two organisms developed a symbiotic relationship over time, the larger organism providing the smaller with ample nutrients and the smaller organism providing energy molecules (ATP) to the larger one. Eventually, according to this view, the larger organism developed into the cells like we have (eukaryotes) and the smaller organism into the mitochondrion.

In humans all mitochondria with their separate DNA are inherited from the mother. They do not share our DNA. In fact, the infertility treatment of nuclear transfer was designed to try to give an egg from an older woman the energy production of a young egg (before the FDA outlawed it).

Maybe someday we will be able to engineer this type of transformation and create organelles that will provide additional functions to our cells.

Teenager Plays Mind-Controlled Video Game

Posted on October 11, 2006 by Steven F. Palter, MD

I previously reported on BrainGate-the neural interface that connected a paraplegic’s brain to a computer for cursor control. Researchers at Wash U have reported a sytem that uses surface electrodes to provide similar function.

“With approval of the patient and his parents and the Washington University School of Medicine Institutional Review Board, Leuthardt and Moran connected the patient to a sophisticated computer running a special program known as BCI2000 (developed by their collaborator Gerwin Schalk at the Wadsworth Center, New York State Department of Health in Albany) which involves a video game that is linked to the ECoG grid. They then asked the boy to do various motor and speech tasks, moving his hands various ways, talking, and imagining. The team could see from the data which parts of the brain and what brain signals correlate to these movements. They then asked the boy to play a simple, two-dimensional Space Invaders game by actually moving his tongue and hand. He was then asked to imagine the same movements, but not to actually perform them with his hands or tongue. When he saw the cursor in the video game, he then controlled it with his brain.”

The boy, a 14-year-old who suffers from epilepsy, is the first teenager to play a two-dimensional video game, Space Invaders, using only the signals from his brain to make movements. Getting subjects to move objects using only their brains has implications toward someday building biomedical devices that can control artificial limbs, for instance, enabling the disabled to move a prosthetic arm or leg by thinking about it.

I also reported on the monkey with a direct link info here.

In the big picture this is another variation of alternative control systems. I often speak of “gesture controled surgery” where gestures are converted by video to task controls for surgery. This another way to potentially control surgical taks without traditional hands or instruments.

World’s Largest Seamless Display- Coming to the OR Someday

Posted on October 11, 2006 by Steven F. Palter, MD

Engadget reports

Are you ready to finally assemble your home theater? You’ve got all the elements picked out: the screen, the sound system — and a big projector. Well, if you really want the most awesome projector out there, you may want to head on down to Kentucky, where two university engineers, Christopher Jaynes and Stephen Webb have just built a 27 foot x 15 foot projected seamless display that shows 60 million pixels. As The Courier-Journal reported: “Building such a high-resolution display would normally cost millions of dollars, but Jaynes and Webb crafted the device from $100,000 in computers and projectors available at Best Buy and Circuit City.” The alleged “world’s highest resolution seamless display” is currently on public exhibition at the Galt House Conservatory in Louisville, Kentucky through Saturday (it’s free, so bring the kids), where there will be a rotating collection of images. These will include photographs from inside the space shuttle cockpit (you’ll be able to read the instruments), to snaps from the Hubble Space Telescope, to even extremely high-resolution imagery from the National Weather Service. Jaynes and Webb will also be on hand taking questions from visitors, so if you want to proposition them to see if they can incorporate one of these screens into your home — just remember to bring as much cash as you can carry.

REminds me of the military cave- I envision some version of this in the OR in the future instead of the myriad scattered displays we now have for endoscopy. True immersion.

FDA Starts to Take on Claims of Bogus Drugs

Posted on October 11, 2006 by Steven F. Palter, MD

FDA reports that The U.S. Food and Drug Administration (FDA) has negotiated an agreement with one manufacturer of unapproved drugs and sent warning letters to four others. The FDA document, “Marketed Unapproved Drugs — Compliance Policy Guide” (CPG). This CPG makes clear that firms marketing drugs requiring FDA approval must submit applications showing that their products are safe and effective before marketing those products.

Anyone who listens to the ads on TV or radio or walks through a drug store hears and sees the endless non-drug products. The claims of these things are outrageous but all carry the disclaimer that their statements have not been evaluated by the FDA and that the product is not intended to diagnose or treat any illness.

Its amazing- a drug requires millions of dollars of development and research proving safety and efficacy. An herbal supplement requires nothing of the sort.

I canonly hope the FDA steps up and take more action against these awful products.

Lifesaver from Nextfest

Posted on October 11, 2006 by Steven F. Palter, MD

The single most important product shown at Nextfest in NYC was not a high tech electrnic gizmo at it. It was Lifestraw profiled today in the NY times. This $3 tube contains carbon filtration and a resin and is effective as a personal water purification system for up to 1 year (700 liters).It filters bacteria such as Shigella, Salmonella, Enterrococus, Staphylococcus Aureus and E .Coli which cause the diseases diarrhea, dysentery, typhoid, and cholera- #1 killers in the developing world. Amazing it was at a tiny quiet booth with little traffic or fanfare. Most people just did not appreciate how this little thing will save countless lives. Kudos to the company – more info here

More posts to follow on their new fly mosquito and malaria prevention tarps.

Male Contraception- They Just Copied Us Gynecologists

Posted on October 10, 2006 by Steven F. Palter, MD

prototype for boy parts for girl parts (available now)

Medgadget reports on a potential new male contraceptive technology today following a press release from Shepherd Medical Company. They write:

“Shepherd Medical Company is gearing up to conduct a clinical trial for the IVD, or Intra Vas Device, a long-term male contraceptive that works by plugging the vas deferens, allowing for a potential “return to duty,” at least compared to the very-permanent vasectomy.”

Q:Where did this come from? (A: gynecology) Q: Is this new? (A: no) Q:Why now? (A: the potential to make $ piggybacking a major gynecologic product. Plugs of this sort were developed decades ago. Initial studies did not work very well. Most studies were in the human fallopian tube (by my Friend the Late Jay Cooper, MD). Unfortunately, they did not seal the human tube well enough. Fast forward to the 1990′s – Conceptus ( a fertility enhancing company who I did some work with in looking inside the human fallopian tube) decides to go the other way and make a tubal blockage device. What they did differently was construct the plug from a filamentous material with a surrounding metal coil (called Essure). The coil holds it in place and the filaments promote the growth of the scar plug.

The newest version of this is called Adiana where a radiofrquency device heats the tube opening and then applies a polymer plug. The combo promotes the scar formation. Many of my colleagues are excited about these and the results I have seen look very promising. If the info from gyn applies to urology as well the simple plug without permanent scarring won’t work.

First A Spider-Goat Next a Spider-Man

Posted on October 10, 2006 by Steven F. Palter, MD

My last post was on Nexia Biotechnologies tranfection of a goat with a gene to produce spider silk. I wanted to elaborate on the technology behind the process. A complete description is available from the company.

As a fertility specialist I know this technology well since it involves in vitro fertilization (IVF) and is the basis of what will become human gene therapy. As they write:

The first method uses microinjection of the genetic construct into a fertilized egg. This traditional method of pronuclear microinjection involves literally injecting the genetic construct into the pronucles of a one-celled fertilized egg with an extra-fine needle. The genetic construct will merge itself with the fertilized egg’s native DNA and once this is achieved, the egg is transferred to a recipient goat and the pregnancy follows its normal course. The second method uses nuclear transfer technology. In this method, the nucleus of a cell containing the genetic construct of interest is fused to a recipient fertilized egg whose native DNA has been previously removed and the resulting egg is transferred to a recipient goat.

Ok folks- both these methods already exist in humans! The first method is the basis of how gene therapy is planned to be done in humans. . This single cell is then analyzed quickly for signs of genetic diseases and I can pick the healthy embryos (without the disease) to implant into the mother’s womb. This is called PGD or preimplantation genetic diagnosis. The current human research is trying to refine the process (and safety) of inserting genes like was done with the goat. Step one: fix sickle cell anemia or Tay Sach’s Disease. Potentially eliminate it from the gene pool as well. There are dangers however- genes for genetic diseases in some cases have potential beneficial effects that would be eliminated (like sickle cell carriers having resistance to malaria). More ominous is potential “down-stream effects” where changing one gene may have ripple-like effects on other seemingly unrelated genes. Most researchers I know in this field are looking at somatic cell gene therapies (only affects the non reproductive tissues) so “problems” are not passed on to offspring as would be with germ-cell (egg and sperm affected) techniques.

The second technique was a promising technique to deal with age related infertility. There is a high level of egg dysfunction from the eggs of older women. Researchers in infertility took eggs from an older woman and removed the gene-containing nuclei and used it to replace the nuclei of the egg from a young donor. In theory, if the old egg was genetically normal but had poor supporting stuff then placing it in a young egg host would lead to increased fertility. This technique has essentially been banned by the FDA. I was present at a meeting of the ASRM in SAn Antonio where researchers I know with collaborators in China reported on results doing this on humans. The pregnancies did not survive. The legal and ethical ramifications are huge and reviewed here.

Spider Silk Uses Reported- Mutant GoatSpider They Missed

Posted on October 10, 2006 by Steven F. Palter, MD

This sucker spins webs.

Med gadget reports on a review of uses of spider silk. All kinds of neat potential spider-tech uses are mentioned in the article they quote.

“Dr. Randolph V. Lewis from the Department of Molecular Biology, University of Wyoming, wrote a great review article about spider silk and its multiple possible uses for biomed industry. From the press release that features an interview he gave to the American Chemical Society”

This article does not mention my favorite scary mutant spider product “biosteel”. I origially heard about this from a talk I attended at a medical meeting by a rep from DARPA (who have a hand in all things amazing and terrifying). Biosteel is a product made with transgenic technology by Nexia Biotechnologies. In short, the gene for spider-dragline-silk (the long toughest but non-sticky thread they use to drop to the ground in emergencies) has been transfected into goats. Yes goats. Then these mutant genetic chimera animals excrete the spider silk protein by the bucketful in their milk. Yes its true.

The company reportedly has been having difficulties spinning the stuff into usable forms and progress as been behind schedule. You can imagine where this (and the DARPA connection) is going – flexible wearable armor made of the strongest fabric even known. Spiderman did not need Kevlar.

In medicine, there are many potential uses I can imagine- all kinds of joint and tendon replacements, ligaments, heart valves, cut-proof surgeon gloves, etc. See my follow-up post on the technology behind this and how it can be used to make a spider-man.

Grand Rounds 3.3 Are Up

Posted on October 10, 2006 by Steven F. Palter, MD

Grand Rounds 3.3 are up hosted by Jon Mikel at Unbounded Medicine. I really like this site which is on our DITM blogroll. He is a student in MExico studying to be a surgeon and somehow finds time to blog on medicine and society. I am honored that my post on what I call “gesture controlled surgery”, Nextfest, and Tom Cruise in Minority Report is included. Thanks and welcome all grand rounds visitors!

World’s Thinnest LCD for Cell-Phones Also Good for Surgeon

Posted on October 7, 2006 by Steven F. Palter, MD

Engadget reports of the world’s thinnest LCD for cell-phones from Toshiba. In the OR we have been limited by the use of traditional display technologies. One potential liberating technology is head mounted displays (HMD’s). I have done research on these and used them in the OR. Current technology is limited by weight, thickness, and resolution. This is a new light weight LCD and I forsee similar systems trickling down to surgeon’s displays. This one is just 240×320 QVGA resolution but that will change. Small size is handles with magnification lenses so that part’s ok!