"When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov
''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.'' -Robert Ehrlich, drug advertising executive.
"Opinions are like sphincters, everyone has one." - Chris Rangel
Essentially, doctors first took biopsies of each patient's bladder tissue to obtain the bladder's two key cell types -- the urothelial cells lining the inside and the muscle cells on the outer surface. Over several weeks these cells were multiplied in the laboratory. Meanwhile, the doctors built a customized three-dimensional shell of biodegradable polymer in the shape of a bladder. Then they added the patient's cells to the shell -- first the inner layer, then the outer muscle layer -- mimicking the order in which the cells coexist in a real organ.
Once enough cells attached themselves, the new bladder was sutured into the patient's defective bladder. To nurture the new organ, the scientists wrapped some of the patients' bladders with a blood-rich tissue called the omentum, which is present in people's abdominal cavities.
They're working on other organs, including penises and vaginas. Now what do you suppose they're planning to do with those? posted by Sydney on
4/04/2006 10:45:00 PM
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We're also routinely told that we're "overdue" for a pandemic, with H5N1 the likeliest cause. Insert the search terms "avian flu," "pandemic," and "overdue" into Google and you'll get about 35,000 hits. The director of the National Institute of Allergy and Infectious Disease, Anthony Fauci, insists we're "overdue," explaining that there were 3 pandemics in the 20th century and the last was in 1968. It's been 38 years since the last pandemic . Yet the time between the second and third pandemics was only 11 years. There's no cycle. As risk communication experts Peter Sandman and Jody Lanard say, the "overdue pandemic" is mere superstition.
We do here that a lot. I've been hearing it for 20 years now in every lecture on influenza I've ever attended. Kind of like my grandmother who was always expecting another Great Depression any day now. If we only wait long enough, it's bound to happen. posted by Sydney on
4/04/2006 10:36:00 PM
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All Seasons for Thy Own: Here in Northeast Ohio you can feel the seasons turning from death to life. The breezes are warmer, the days longer. Daffodils are blooming, trees are budding. Birds are building their nests. But death surrounds me.
There is a definite uptick in mortality from January to March. By April, when spring finally shows its face, the weight of all those deaths begins to tell. Once again, my practice has seen its cluster reach a peak over the past several weeks. Most of them were expected in one way or another. They were old, they had cancer, they had bad lungs, bad hearts. Every day was a gift and we all knew it. Their loss is no less sad for that.
But yesterday, after signing what I hoped would be the last death certificate for a while, another loss came through the door. It wasn't my patient. I didn't know him, or his family, at least not in any tangible sort of way. I only knew him remotely from stories and pictures that one of my patients has shared at each of his visits. My patient called, distraught, to tell me of his death. It was his grandson. He was seven months old.
I remember the last photograph he had shown me, just a few weeks ago. A beautiful baby, happy, content. "See that smile," he had said, "When you see that smile, it's as if you are looking into the happy face of God." And so it is, a baby's smile.
Maybe it was a cumulative effect of so much death in such a short time, maybe it was a post-call lack of sleep, or maybe it was just the thought of that baby's smile, but this stranger's death was the final blow to that inner fortress called professionalism that keeps constant sorrow at bay through the bad times. I wanted to weep.
Of course, I couldn't. There were patients to see. Patients with bunions, and runny noses, and stressful jobs giving them headaches. Patients who pay me to attend to their sorrows. They should not be disappointed. So, pile those bricks of the inner fortress back up, and soldier on. The banality of life and of routine makes a pretty good mortar, but not a long lasting one. At the end of the day, when the phones are turned off, the last patient and the staff long gone, that fortress crumbles again.
There's a picture above my desk, put there by my son - a photograph of himself when he was about seven months old. Smiling, happy, innocent (although now with a caption balloon and funny phrase added, courtesy of his older goofy self.) I remembered what it felt like to hold him, to see his smile, to hear his laugh. To feel his joy of being. It was like looking at the happy face of God. And what it must be to lose that, even to lose the older goofy version. And I finally wept.
Dear readers, keep my patient and his family in your thoughts and prayers. Their burden is a heavy one. posted by Sydney on
4/04/2006 08:51:00 AM
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Monday, April 03, 2006
Like Pavarotti on Helium: The glories of the castrati:
In 17th and 18th Century Italy, about 4,000 boys were castrated each year, from the age of eight upwards, with the aim of making a fortune as opera singers and soloists with choirs in churches and royal palaces.
The castrato's voice was prized for its combination of high pitch and power - with the unbroken voice able to reach the high notes, but delivered with the strength of an adult male.
Composers were enthusiastic about the more complex musical possibilities of these voices - and music lovers turned these exotic figures into the pop idols of their day.
"The best castrati were superstars, adored by female fans. Their voices had a tremendous emotional impact on the audiences of the day"
....The last-ever performing castrato, and the only one recorded, was Alessandro Moreschi, who was supposedly applauded by crowds with the call "Eviva il coltello" ("Long live the knife!"). Yikes!
Cancer Sticks: Sometimes, people with lung cancer figure they might as well continue to smoke since the damage has already been done, anyway. But some new basic research indicates that continuing to smoke may put lung cancer patients at an even greater disadvantage - nicotine may inhibit chemotherapy:
Srikumar Chellappan and colleagues at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, tested three standard lung cancer drugs: gemcitabine, cisplatin and taxol, on several different batches, called cell lines, of cells taken from lung cancer tumors.
Adding a small amount of nicotine, equivalent to what would be found in the blood of an average smoker, interfered with the drugs' action against the tumor cells, they reported in the study, which was also presented to a meeting of the American Association for Cancer Research.
Nicotine protected the cancer cells by increasing the activity of two genes called XIAP and survivin, Chellappan's team found. The genes stopped a process called apoptosis, a kind of cell suicide.
When the two genes were suppressed, the cells died as they should have, they said.
The tests were done on cancer cells in a lab, not on cancer cells in the body, but there's no reason to expect the chemical to work differently in vivo. So not only can nicotine cause cancer (by damaging the DNA of cells), but it can aid and abet cancer, too. posted by Sydney on
4/03/2006 08:31:00 AM
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Saturday, April 01, 2006
Mumps on the March: There's a mumps outbreak in Iowa:
An outbreak of mumps is sweeping across Iowa, the first in nearly 20 years, and it's puzzling health officials and worrying parents.
``We have probably, at this point, what we would call an epidemic of mumps,'' said state epidemiologist Dr. Patricia Quinlisk.
As of Thursday, the latest report available, 245 confirmed, probable and suspected cases of mumps had been reported to the Iowa Department of Public Health this year.
One rarely sees mumps in this country. They don't yet know why or how the mumps got started in Iowa, but it's interesting that in most recent cases in the U.S., they were imported from the U.K., where many people have a mumps-shot phobia thanks largely to this doctor. Dr. Crippen has some things to say about that. posted by Sydney on
4/01/2006 09:01:00 PM
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