New Generation of Performance Enhancing Drugs

Posted on February 12, 2008 by Steven F. Palter, MD

NatureNews has just reported on a new drug that plugs calcium leaks in muscles and boosts stamina (in mice). I have previously written of the next wave of what I call “designer drug abuse” coming- performance enhancing drugs. The first batch are called eugeroics 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. This new class is a physical performance enhancer. 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 and congnitive enhancing bionics, drugs, and implants!

Nature writes of the published in the online edition of the Proceedings of the National Academy of Sciences today (Bellinger, A. M. et al. Proc. Natl Acad. Sci. USA 105, 2198-2202 (2008).

Researchers have shown how intense exercise can damage muscles, and developed a drug that can hinder the effect in mice. Mice on a taxing work-out schedule were stronger and had more endurance when given the drug.

The drug, called S107, prevents calcium from leaking into muscle cells. Calcium causes muscles to contract, but calcium leaks can reduce the force of contraction and activate an enzyme that chews up muscle protein.

They go on to say that “leaky calcium channels have been associated with the fatigue and soreness that follows intense, sustained exertion, such as running a marathon or long-distance cycling. This weakness can last for days or weeks, and is not the same as the brief discomfort that follows a typical work-out.”

As expected there is a start-up ARMGO Pharma, that plans to develop S107 and others like it for clinical use in patients with chronic tiredness from disease.

Nature hits upon the potential for abuse just as I predicted. “Don Catlin, director of the Olympic Laboratory drug-testing centre at the University of California, Los Angeles, says that a drug such as S107 could also become prime fodder for athletes looking to improve their stamina.

I myself had dinner with the former chief medical director of the olympic committee (the guy in charge of thesting if the women really are women and vice versa). He told me he is very concerned about athletes and students using performance enhancing drugs. Imagine a high school athlete or student offered a pill that could makethem run faster or longer or increase memory without adverse effects. How many do you think would take them. I recall his worry- your child saying daddy I want to be a track star- can you amputate my legs so I can get the new bionic ones.

Next Gen Mini-PS3 Cell Chips -Next Medicine Imaging Revolution?

Posted on February 8, 2008 by Steven F. Palter, MD

“ Though sold as a game console, what will in fact enter the home is a Cell-based computer. ” – Ken Kutaragi

“Cell-based computers will revolutionize medical imaging” – Docinthemachine

The IBM Cell graphics processor at the heart of the PS3 is a remarkable chip. Cell is shorthand for Cell Broadband Engine Architecture. It has been described as “seemingly obscene computing capabilities for what will rapidly become a very low price.”

A newer miniaturized lower power version has just been announced by ars technica that I predict will make it to medical video and VR processing. I recently led a session on the use of VR in medicine where Andy Van Dam (VR pioneer , professor of computer science at Brown, and founder of Siggraph) and I spoke about the future of VR processing. He predicted that the video grame industry hardware innovations will make the most dramatic strides and that this technology will then trickle down to VR due to its sheer massive computational power- beyond that of the old CAVEs of DARPA.

You may be unaware that this represent a new form of computer processing:

The Cell concept was originally thought up by Sony Computer Entertainment inc. of Japan, for the PlayStation 3. The genesis of the idea was in 1999 when Sony’s Ken Kutaragi “Father of the PlayStation” was thinking about a computer which acted like Cells in a biological system. A patent was applied for listing Masakazu Suzuoki and Takeshi Yamazaki as the inventors in 2002

The architecture as it exists today was the work of three companies: Sony, Toshiba and IBM. Sony and Toshiba previously co-operated on the PlayStation 2 but this time the plan was more ambitious and went beyond chips for video games consoles. The aim was to build a new general purpose processor for a computer.

In lay terms here is the muscle behind the processor:

The setup of the Cell processor is like having a team of processors all working together on one chip to handle the large computational workload needed to run next-generation video games. In order to understand how the Cell processor works, it helps to look at each of the major parts that comprise this processor.

The “Processing Element” of the Cell is a 3.2-GHz PowerPC core equipped with 512 KB of L2 cache. The PowerPC core is a type of microprocessor similar to the one you would find running the Apple G5. It’s a powerful processor on its own and could easily run a computer by itself; but in the Cell, the PowerPC core is not the sole processor. Instead, it’s more of a “managing processor.” It delegates processing to the eight other processors on the chip, the Synergistic Processing Elements.

The computational workload comes in through the PowerPC core. The core then assesses the work that needs to be done, looks at what the SPEs are currently processing and decides how.

Watch out for our robot PS3 overloards. This Chip has the potential to expand itself and distribute workloads over networks. Don’t worry this is not some Singularity scenario where the chips start to think on their own. Here is a review of the potnetial of the chip:

Chip giants such as Intel have already started working on dual-core chips, but Cell goes several steps further by giving processing units a measure of independence. Current multicore chips typically chop a single computing task into parts, which are distributed among processing units. Cell’s processing units–called “software cells”–can handle completely separate jobs.

“The software cells are designed to be kind of self-contained–they can kind of roam around,” Halfhill said.

Cells can even roam over a network, allowing the processor to perform a type of distributed or grid computing, an increasingly popular enterprise technique in which demanding tasks are divvied up among a gang of networked computers. A PlayStation 3 could borrow unused processing power from other consoles on a network, for example, to complete a demanding task such as delivering streaming video.

“The Cell architecture is designed to make grid computing almost universal,” Halfhill said. “It makes distributed processing part of the design. If you have several of these machines on a network, the work can be spread across a network.”

The cell design can allow cooperation between video devices: “This architecture is not fixed, if you have a computer, PS3 and HDTV which have Cell processors they can co-operate on problems. They’ve been talking about this sort of thing for years of course but the Cell is actually designed to do it. According to IBM the Cell performs 10x faster than existing CPUs on many applications. This may sound ludicrous but GPUs (Graphical Processors Units) already deliver similar or even higher sustained performance in many non-graphical applications.”

Medical uses: We are at the cusp of a revolution due to the integration of computer video processing and surgical and radiological imaging. Details of this concept of mine are here and a podcast here. As we move ahead with virtual imaging and newer forms of optical processing it is the computational power of these kinds of chips that will be enabling.

Disclosure: As I previously wrote, I was chosen to be a Sony Medical HD Luminary Site. I receive no financial payment for this relationship which is only with Sony’s Medical division and is part of my medical research work on surgical tools and imaging. Heck- I had to buy my PS3 at Best Buy just like anybody else.

Docinthemachine is Back!

Posted on January 29, 2008 by Steven F. Palter, MD

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Hello again all my friends, supporters, and loyal readers! After far too long of an absence I am back. So much time has passed and so much has happened that I wanted to fill you all in and welcome you back to my regular schedule of postings on all new in medical technology.

So you may ask- what the heck happened to you? We thought you were dead? Here is my free form list of all that has happened to tie me up and take me (temporarily) off-line. Here is a list of just some of things that took my attention in the last few months.

1) First and foremost my wife gave birth to our son the babyinthemachine. Despite being old pros at this a newborn really takes a hit to your free time! Happily she did awesome in pregnancy and labor and all went perfectly. It is always a bit of an event when an Ob Gyn’s wife gives birth we have really seen it all before, but that gets mixed up with the knowledge of every little thing that could go wrong at every step and trying to stay at the correct end of the bed (the head) ! The little guy came home and has been a delight. This led to the quick realization that these kids no way fit in our car we had to buy some new transportation. Thanks to Edmunds – remember never pay over invoice I won’t say what we got but I am sure you can guess…

Here’s the little guy in utero

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2) All of my research of the use of High Definition video for Surgery got picked up by the medical and lay press and I was doing a fair bit of lecturing and speaking. This was a real pleasure for me having worked on the development of these tools since 1999.

3) National Geographic featured footage from my high def surgery on their special Inside the living body. This led to a series of interviews and lectures including the peculiar thing that is morning drive FM radio shock jocks. No need to go any further. I’ll post some excerpts coming soon.

4) 20/20 did a piece on my research on visualization in surgery including high def and future vision autofluorescent laparoscopy. What a delight that was to do. Bob Brown and crew were great to work with and they then invited me back onto ABC News for a show about innovators. I’ll be posting video clips from this too.

5) DITM – this blog- hit its one year anniversary and I celebrated all that the experience has brought to me and allowed me to share.

6) My wifeinthemachine Michele Lang sold and published a major future tech-sci fi-romance Netherwood which included dozens of examples of current and future med tech from the pages of this blog in the Shomi Line from Dorchester Publishing. All this is woven into a story of a technological future world where computers become sentient and the local sheriff must destroy the man set out to destroy the network but learns he is her virtual reality lover who holds the secret to the survival of mankind. The book can be ordered at Amazon now and has gotten amazing reviews. She be posting some updates and interviews here to come!

7) I was honored to be chosen to be a High Definition Visionary Site by Sony Medical. As one of the few MD’d chosen for this distinction I have access to their wealth of electronic knowledge and product engineering. For full disclosure I do not receive any financial payments for this relationship. They are helping me with a demo research project for HD surgery education on the internet and on improving visualization and archiving of surgery. I’ll be posting more from this to come.

I was involved in the keynote general session at the 38th Annual International Congress of Gynecologic Endoscopy (The AAGL). A true honor, this was the third time I led a session on new technology in medicine and the second year in a row. This year I focused the session on NOTES – or natural orifice surgery. This amazing new technology still in development is where physicians pass special flexible never before seen endoscopes through natural body openings (mouth, anus, vagina, etc) to reach any part of the body without any incisions at all. Needless the say the audience was in awe of the video of an appendectomy removed without external incisions and pulled out the patient’s mouth! More from this session will be posted with updates and excerpts on this technology.

9) As part of this session I presented new research of mine on the transformation of medical technological research and mathematical modeling that shows we are on the cusp of unparalleled explosive growth in med tech innovation. Of course more to come on this!

10) I was elected vice-president of the ACGE (Council for Gynecologic Endoscopy) – established to elevate standards in operative endoscopic procedures performed by gynecologists. We will be continuing our efforts on surgeon and facility standards and review including the validation of simulator based evaluations. More to come!

11) I was chosen by the AAGL as well on a special ongoing press conference panel on the future of gynecologic endoscopy. I have to say it was a real honor and validation of years of work when The President of the society Dr Charles Miller introduced me as the visionary of the society. Videos and transcripts will be posted.

12) Related to this I began an advisory role for a company developing a gyn NOTES procedure which will likely begin clinical trials for infertility very soon.

13) We had the Annual meeting of the American Society for Reproductive Medicine (ASRM) – the largest infertility meeting where I serve on the program committee and chair the video program. I’ll be posting updates of new research including a dinner I had with the world’s expert on human pheromones.

14) The Society of Reproductive Surgeons (SRS) of the ASRM invited me to chair their postgraduate course on fertility surgery at next year’s meeting. Of course the topic I chose is “New Technology in Fertility and Reproductive Surgery”. I’ll run the course as a lecture and hands on lab and we will include robotic surgery, alternatives to hysterectomy, surgical simulators, Natural Orifice Surgery, Autofluorescence, Office Surgery, High Definition, High Intensity Ultrasound surgey and many others. I’ll post updates as we go along.

15) I continued my usual lecturing, research, publications, and the development of a new innovative DITM podcast series.

16) Had some minor surgery- I am really an expert on edoscopes and the entire GI track as well now.

17) My clinical practice Gold Coast IVF had our busiest and most fertile year ever! Countless pregnancies in my usual mix of complex cases left me grateful and delighted to be a part of this specialty. Using all the tools in my armamentarium (drugs, surgery, IVF, egg and sperm donation, etc) allowed me to help create more families than ever. I treated local patients and those who traveled from around the country and from Nations as distant as Russia, China, and Nigeria.

OK – it has been a busy few months here but I am ready for 2008 to do even more! Welcome back to docinthemachine!

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.

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?