Docinthemachine Guest Blogging at Medgadget!

Posted on March 30, 2007 by Steven F. Palter, MD

I am very excited to begin guest blogging over at Medgadget! I am sure many of you are familiar with the site. Medgadget is a hugely popular site that reviews new medical devices. My first post is Bionic Implants Available Today: Docinthemachine Guest Post and reviews the state of the art of current human bionics; technology and ethics.

Medgadget is edited by Michael Ostrovsky, M.D. & Nicholas Genes, M.D., Ph.D. (of blogborygmi and grand rounds fame) & Timothy Odell along with webmaster Gene Ostrovsky. After admiring their work from when I began blogging, I was honored to be one of their finalists for best medical technology blog 2006. Then the real suprise cam when I received an email from Nich & Michael asking if I would consider guest blogging on medgagdet as a regular feature.

They wrote:

I was also talking this over with my colleagues at Medgadget.com, we’re grateful for your comments to the site and were wondering if you’d like to formalize your relationship, which is to say, write for Medgadget. As we talked about it, you could post about your research, other technology that catches your eye, your expectations for future development.

Since I have ideas galore and love their site I quickly wrote back – YES!

Thank you so much for the kind words and your support. As far as medgadget, I know the site well and greatly respect and enjoy it. I am honored by your request.

After we got this arranged I found out Nick and Gene were both invited to the J&J Blogging Summiit in NYC along with me. We had a great discussion and exchange of ideas and made arrangements for me to start guest blogging.

Gene, myself, and Nick at the Medical Blogging Dinner

I hope you will all go check out my gest blogging. Please send comments to me here or the medgadget people over on their site and let us know if you enjoy my visit over there. I plan on posting on their site very other week or so.

Human-Animal Mutant Animal Developed: It’s Not the First!

Posted on March 27, 2007 by Steven F. Palter, MD

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Many reports on-line are coming out about chimeric man-sheep creatures developed.

Scientists have created the world’s first human-sheep chimera – which has the body of a sheep and half-human organs. The sheep have 15 per cent human cells and 85 per cent animal cells – and their evolution brings the prospect of animal organs being transplanted into humans one step closer. Professor Esmail Zanjani, of the University of Nevada, has spent seven years and £5million perfecting the technique, which involves injecting adult human cells into a sheep’s fetus.

What is the promise:

He has already created a sheep liver which has a large proportion of human cells and eventually hopes to precisely match a sheep to a transplant patient, using their own stem cells to create their own flock of sheep.

The process would involve extracting stem cells from the donor’s bone marrow and injecting them into the peritoneum of a sheep’s foetus. When the lamb is born, two months later, it would have a liver, heart, lungs and brain that are partly human and available for transplant.

What many don’t realize is that chimeric, transgenic, and xenograpted human-animal research has been going on for some time. THe genetic research focuses on placing the genes of one species inthe cells of another. Xenograft research has not gotten much press. This is what I was extensively involved in. Here we actually graft human tissue into animals (usually mice) that lack an immune system

My research involved grafting human ovarian tissue into immunodeficient mice and then allowing it to grow, develop, and function. This ia called a xenograft and the technique has now been developed by several groups. The hope was to develop techniques to preserve fertility in cancer patients. There has now been a case reported where human ovarian tissue was frozen, reimplanted (into the woman not a mouse) and resulted in a pregnancy.

The biggest controversies

1. this could potentially lead to a mouse ovulating a human egg that gets fertilized and become a person
2. there is unknown potential for interactive effects between the species
3. there is possibility for new animal viral contamination of the human cells that can be transmitted

When I did xenograft research the animals were locked down as if they has Ebola. Made Alcatraz look like a Holiday Inn.

The top photo is NOT MY RESEARCH —it is a human ear growing on the back of an immunodeficient mouse by a group working on growing human organs for replacement. This is part of the emerging field of tissue engineering where human tissue and even organs are gorwn in lab dishes. Read more on that subject ere: Creating tissues that can augment or replace injured, defective, or diseased body parts.

Yes, it is real…

Bionic Friday Posts

Posted on March 23, 2007 by Steven F. Palter, MD

For your enjoyment today – a collection of forward thinking docinthemachine posts about robotics and bionic humans. Take a minute today to push your mind a decade into the future. Ponder with me roboic amoeba rovers inthe body, bionic retinal implants, and humanoid androids.

Finish the day with a post on the singularity and mind transfer into a computer.

What makes a human human? While you may think you know, the distinction is blurring as a result of medical technology advances.

Better Retinal Implants for Blindness Cure Coming

Posted on March 23, 2007 by Steven F. Palter, MD

I previously wrote about retinal implants that might cure blindness. This idea is yet another in the line of machine-human implants that will first replace natural abilities – aqnd ultimately augment human abilities. Look here for a video fest and link fest of bionic human implants in development.

Researchers now claim to have developed another retinal implant to cure blindness now with four times the resolution of previous implantable chips

Scientists at the University of Southern California (USC) announced their plans to test an improved retinal implant in blind patients. The new implant, which scientists hope will improve patients’ vision even more, has four times the resolution of the previous version.

Details of the chip and it’s challenges:

The device, developed by Mark Humayun and colleagues at USC, consists of a tiny chip dotted with hair-thin electrodes. When implanted in the retina, the electrodes transmit electrical signals from the chip to neural cells in the eye, which then send the message to the brain. A wireless camera mounted on glasses and a video processing unit worn on the belt capture and process visual information from the wearer’s surroundings and wirelessly transmit those signals to the chip.

The new version of the implant… has quadrupled the number of electrodes–from 16 to 60.l. The researchers recently received permission from the Food and Drug Administration to start human tests.

It is just a matter of time until night vision and superhuman quality vision chips will be available for elective implantation. Would you get one?

If You Transfer Your Mind to Robot Which One of You is “You”?

Posted on March 23, 2007 by Steven F. Palter, MD

Kurzweil and others have been forecasting the coming of the technological singularity for some time. The term, coined by Vernor Vinge, describes the creation of “humans 2.0″ when man and machine become connected in the creation of a new type of being. For more background information on this concept and predictions for it s coming in the future read here. As Vinge writes:

The acceleration of technological progress has been the central feature of this century. We are on the edge of change comparable to the rise of human life on Earth. The precise cause of this change is the imminent creation by technology of entities with greater-than-human intelligence.

Potential ways this may happen

Computers that are “awake” and superhumanly intelligent.

Large computer networks become superhumanly intelligent entities.

Computer/human interfaces blur distinction between man and machine.

Biological science may provide means to improve natural human intellect.

Betterhumans ponders a technological question which really delves into a metaphysical question of what makes a human human and where is the seat of the soul. If you download increasing amounts of your memory and consciousness into a machine at what point does it become human and “you”

(If) we have the technology to constantly back up our brains onto a computer through some wireless connection so that at any one time the computer has a snapshot of your brain in its current state. Now lets say that you get in an accident and 50% of your brain is damaged, so they take that backup and use it to replace 50% of your brain. Would you still consider yourself to be you and not some copy? what about 40% or 20%? What about 5%? Are you still you?

If you get in an accident and need 95% of your brain replaced and you use the backup image of your brain, are you still the original? Lets say that you get in an accident and are killed and lose 100% of your brain. But doctors take the image of your brain and put it into a new body that is exactly like your old body with all your memories right up to and including the accident which caused your death, are you still you? What if they replaced your brain while you were still healthy?

Consider now a future technology which allows for the slow conversion of your brain from flesh and blood to hardware. It’s a slow process taking up to 3 years, no one really knows when the process is entirely finished. You notice no difference in your daily life as the process occurs but at some point in the future your brain goes from being 100% natural to being 100% artificial. Are you still you? Are you still the original? You obviously feel like the original but your brain is no longer original it’s just a pattern of your old brain running on hardware.

Generally speaking a person would be far more accepting of the slow replacement that isn’t noticeable over a complete replacement at one time but the two processes give the exact same result. It’s a pattern of your flesh and blood brain in hardware. So why is it that people have such a difficult time with the idea of mind uploading? It seems like the issue in the end is that people want a sense of being original. That is to say when you go to sleep and then wake up in the morning you believe that you are the same person that went to sleep in the same bed last night, but what if you aren’t? Would it really make any difference as long as you thought that you were the original?

Image that when you die you wake up in a new body right after you die and you say, oh shit I just died. But you are on a bed in some room in a building with a new body but all your memories including every memory up until the moment of death are in your mind and you start thinking about how much it sucked to die but how happy you are that you woke up in this bed and are alive and well. How is that any different than the idea of a soul being transfered at the moment of death from one body to another? Your soul if there is such as thing is nothing more than the sum total of who you are so it would be essentially the same thing? Your are just transferring the essence of yourself.

If you have brain damage you are no longer yourself, it’s your mind not your body that makes up the essence of who you are, so why fight mind uploading when it makes so much sense?

The Most Life-Like Android Ever Made: Video

Posted on March 23, 2007 by Steven F. Palter, MD

Meet Jules, the most life-like robot you have ever seen. The robot is programmed with the most sophisticated artificial intelligence features. It can recognize babies vs. adults, its creator and people he has ‘met’.

video of “intelligent” android

Is Technology Good, Evil, or Neutral?

Posted on March 14, 2007 by Steven F. Palter, MD

Is the TechDoc Evil?

Technology is neither good nor evil, it’s the use that crosses the moral boundaries.

As technology is leaping forward an unprecedented pace, this old question is more pressing now than ever. (If you’re short on time skip to the last paragraph for my conclusions)

A review of this debate can be found here including this question:

As we have seen, technology can be neutral, and … “can act as a catalyst to engender trust” … It is also clear that in many situations, technology is certainly not neutral; technology can marginalize people, incite divisiveness, block knowledge flow… Is technology a neutral “tool” that is designed to carry out the will of the user?

Ars technica in a post ipods at war related this debate to the Myth of Icarus. Unfortunately, their conclusion is so far off the mark. They claim we are victims of technology that we have become addicted to. War ravages as the American Army is shaped by video games and movies to kill. Sorry, folks, the Ozzy Osbourne made me kill myself lawsuit just didn’t hold up.

I really like the inference they make that the Icarus myth is really a story about technology; “when father Daedalus creates the artificial wings for himself and his son, he makes it possible for them to experience something new, but the technology also makes it easy for Icarus to destroy himself.”

ICtforpeace goes on to argue that technology is not morally neutral (and the military is inherently evil).

A Walther PPK would make, I am sure, a pretty good paper-weight, but it was made for a specific purpose and it is rather good when used for its intended purpose, and less elegant when used for others.

They mistakenly suggest

many technologies can be used for both good and bad purposes. But usually neutrality is taken to have a stronger meaning, such as that technologies are equally easy to use for different purposes, which is not helpful when comparing compact disks and cruise missiles.

Philosophical theories on this point can be found on this webpage

Those who believe that technology is neutral argue that “guns don’t kill people, people do”, or that a knife can be used to “cook, kill, or cure.” Those who believe the opposite counter with evidence that technology cannot be evaluated in a vacuum and that there are traits common to all technological developments: (1) technological objects are unique; they are designed to function in a particular and limited way, and (2) technological objects are intertwined with their environment; they interact in unique ways with the rest of reality.

More philosophical musings on the neutrality question can be found here.

I believe in technological neutrality. While it seems that in some scenarios (such as weapons) technology is clearly more likely to be used in one way rather than another, it is just that particular application of the technology that sets off our reaction. There is no better example than the work of DARPA which I have written about. Nuclear technology did not just lead to the bomb it also can be used for medicine and energy. The knowledge of the technology is not that is evil.

While many lament the development of expensive military technology I see the beneficial medical applications inherent in these projects. While one person might see evil and death I can see good and life come from the exact same technologies. Read about the medical uses of military technology here, here, and here.

As my friend Dr. Rick Satava (surgeon, colonel, and Program Manager at DARPA) said:

Technology is Neutral – it is neither good or evil

It is up to us to breathe the moral and ethical life into these technologies

And then apply them with empathy and compassion for each and every patient

Grand Rounds Vol. 3.25 is Up!

Posted on March 13, 2007 by Steven F. Palter, MD

Grand Rounds 3.25 is up over at Scienceroll. A gret blog I have mentioned before it is run by Bertalan Meskó, a Hungarian Medical Student wit a passion for genetics. Definitely worth checking out there are about 60 posts but excellently organized in categories to make the reading clear and quick. A nice variety.

I am honored that he chose two submissions from docinthemachine (one I submitted and one submitted by somemone else!). There are links to my posts on :

docinthemachine’s first podcast on the coming technological revolution in surgery (in a new web 2.0 section of grand rounds )and also on new regulations to spread information and increase post marketing surveillance of drugs from the FDA

New Drugs Enhance Performance, Eliminate Need to Sleep

Posted on March 9, 2007 by Steven F. Palter, MD

this stuff makes crank look like candy

Gizmag reports on the further evolution of no-sleep performance enhancing drugs.

The original version of these substances was the “time-shifting” drug, Modafinil that enables you to stay awake for 40+ hours with close to full mental capacity and with few side effects. (produced by Cephalon as PROVIGIL®, MODIODAL® in France and VIGIL® in Germany, for excessive sleepiness associated with narcolepsy and for “shift work sleep disorder” – hear that you medical interns?- web site advertises free 7 day trial supply).

This is precisely the substance the the former chief medical director of the olympic committee spoke to me of. He asked – once this stuff hits the street don’t you think a majority of college students would use it to perform better on exams? The military sure thinks its a god idea for soldiers and pilots. You can read my thoughts on how far people will go in the future to enhance their bodies here. If you think plastic surgery is the rage of body enhancement – wait until we get performance enhancing bionics and cognitive enhancing drugs and implants!

The drug is a eugeroic and offers improved memory, mood enhancement, improved alertness and cognitive powers without any of the nasty side effects and mass murder of speed and crank.

What’s a Eugeroic you ask? - Literally the term means “Good Arousal” . They are a class of novel stimulants that produce long-lasting mental arousal. They are unique in producing hypervigilence and alertness without peripheral effects or addidition of usual stimulants. Strangely, they have minimal effect on sleep structure, and do not cause rebound hypersomnolence (crashing).

You might also be interested in Ampakines are similar but also cause memory enhancement (just a bit of abuse potential there). One of these – a drug code-named CX717 from Cortex – reportedly enabled sleep deprived rhesus monkeys to outperform rested normal monkeys on memory tasks.

Under carefully controlled conditions and constant medical monitoring, the monkeys were individually sleep-deprived for 30-36 hours and re-tested at that time. When monkeys are sleep deprived their performance accuracy is reduced by 15-25%, and their reaction times slow by at least 50%. A dose of 0.8 mg/kg of CX717 completely reversed the performance deficits associated with sleep-deprivation. In addition, specific brain EEG changes that occur after sleep deprivation were returned to the non-sleep-deprived state in the CX717 group, but not in the control group. Thus, CX717 counteracted the effects of periods of prolonged sleep deprivation when given immediately before testing

Not surprisingly, DARPA had a hand in these experiments.

Man, I remember as an intern a 43 hour shift I once did (Friday AM straight to Monday afternoon). By Sunday I was practically hallucinating, everthing was in slow motion , and there was a constant sound of running water… I predict these drugs have an abuse potential greater than any drug since alcohol.

I hear there is a new super eugeroic called armodafinil coming down the pike with even more potent effects.