New Non-invasive Surgery Technique

Yoav Medan, an Israeli doctor, has been working for the past 15 years on a new method of non-invasive surgery that combines two known technologies into one operating procedure.  

The idea of non-invasive surgery is not new.  Non-invasive surgery has been used in various treatments, in varying degrees of effectiveness for decades. The obstacle early pioneers had in this area was not being able to see what was happening during the surgery, and this resulted in surrounding tissue damage similar to the damage seen in invasive surgery.  Also, the non-invasive surgeries were not effective because they could not properly target the area on which to be operated.  Invasive surgery today is still risky and impacts patients for months with pain, physical therapy, and medications. The revolutionary technique would be finding a new effective treatment, without damaging surrounding tissues, therefore maximizing the percentage of success while minimizing recovery times. That’s exactly what this team of scientists has been able to accomplish.  The use of Magnetic Resonance Imagining (MRI) allows doctors to have real-time visual interaction during surgical procedures.  Focused ultrasound is used today in procedures such as ones to break up kidney stones. Combining the use of MRI and focused ultra sound, researchers at InSightec in Israel and partners around the world, have created the ability to treat such ailments as motor disorders, fibroid tumors, and metastases of the bone using this technique; to be able to operate without damaging surrounding tissue damage and no recovery time. 

Demonstration of focused ultrasound on mimicked issue (silicone)
Pictures from TED talk cited below

Simulated lesion in the silicone without damaging other tissue
Pictures from TED talk 

The operating room of the future could very well consist of a surgeon sitting behind a computer clicking nothing more than a mouse.  For example, a patient being treated for a brain condition would be placed in the MRI chamber with a transducer placed on their head.  The MRI would pinpoint the location and the transducer would project ultrasonic energy to the specific area targeted by the surgeon.  This procedure could be compared to the process done to break up kidney stones, doctors could change the amount of energy directed to an area from a brush of air to a smashing force. The surgeon first locates the affected area by sending a pulse that heats up the area a few degrees; this lets surgeons know if they are focused precisely.  Once the surgeon has correctly focused on the affected area, he or she then sends the ultrasonic pulse to that site.  Patients can literally walk away from this procedure in minutes, with proven relief. 

Simulation of procedure: transducer located around the head before being placed under the MRI
Picture from TED talk

John, a retired professor from Virginia suffered from neurological tremors.  Medicines were no longer effective and his quality of life was poor and he was totally dependent on others.  Many patients are reluctant to undergo traditional forms of surgery and physically cut into the brain.  John underwent this experimental surgery in early 2011, as approved by the FDAID at the University of Virginia.   Here is a sample of John’s handwriting on the morning of his surgery and hours after the procedure. 

"This is my handwriting John S. Watterson III 6-20-11"
Picture from TED talk

Many other patients have seen immediate relief with this type of treatment and their quality of life has been drastically improved.  John is able to live an independent life and enjoys an active retirement life.

This technique could revolutionize surgery and already shows promise in tackling different diseases, all while improving a patient’s quality of life.  

References:

Medan, Y. (2011, Oct). Yoav Medan: Ultrasound surgery-- healing without cuts. [video file]. Retrieved
           from http://www.ted.com/talks/yoav_medan_ultrasound_surgery_healing_without_cuts.html

Customized medicine

In June of 2012, Nina Tandon, a tissue engineer, spoke about her interesting field and its potential to revolutionize the field of medical diagnosis and testing.  Today method of creating new medicine is lengthy, expensive, and risky. To create a new drug it can cost as much as one billion dollars and take up to ten years before reaching the available market. Once a drug is formulated it hast to undergo laboratory testing, animal testing followed by human testing before being able to be approved by the FDA.  Even when a medicine has made it through testing and final approval many people don’t react the same way as the tests indicated causing more harm than good. Nina and her colleges have designed a new method in tissue engineering that they hope can pave the path for a new way of prescribing medicine and treating disease.

Stem cell research has been a controversial topic in headlines for years. The stem cells that cause the most controversy are: embryonic, fetal, and umbilical stem cells, which are harvested from the placenta or aborted fetuses. However, adult stem cells are taken from numerous cells in the body, blood cells or even skin cells. The problem with these types of stem cells are they are less flexible the sense they can not turn into as many types of cells as the embryonic or fetal stem cells. However, recently a new tactic was discovered that induced human cells back into their embryonic state. Scientists could then mold these cells into any type of tissue they desired, they called these induced pluripotent stem cells (iPSC). This is first time scientists have been able to grow tissues from their own cells.

Think about the possibilities that this new discovery could have in prescribing more precise medicine to patients. If a person came into the hospital with a certain disease, doctors could ideally take a sample of a person’s skin or blood and create an identical computerized model in which to test different drugs and gauge their effectiveness. Doctors could do hundreds or even thousands of different trials in a matter of hours compared to years that today’s medicine has taken. This breakthrough could lead to precise customized medicine that will be effective to that person’s chemistry.  Sound far-fetched? This could very well be the way future diseases are diagnosed and treated.

References:

Tandon, Nina. (2012, June). Nina Tandon: Could tissue engineering mean personalized medicine? [Video File]. Retrieved from http://www.ted.com/talks/nina_tandon_could_tissue_engineering_mean_personalized_medicine.html

New DNA strand discovered

When anyone hears the word “double helix” they tend to associate it with the shape of our DNA. Over sixty years ago colleagues at the University of Cambridge released a paper stating they had found the fundamental structure of DNA. Today researchers at the same university have discovered what they call quadruple helixes, two strands of DNA wrapped into one.

This isn’t however the first time scientists have contemplated the existence of quadruple helixes. Prior to this discovery, quadruple helixes were discovered in test tubes. Scientists found when they manipulated DNA a certain way they could make this replication occur, but this recent discovery was the first time that evidence appeared of this in human cells. 

Scientists believe the occurrence of quadruple helixes in human cells could signal an unhealthy state for DNA, which has lead researchers to believe that this replication only happens in cancerous cells or cells that have aberrant cell division. Researchers believe that a chemical found within DNA may be responsible for this abnormal replication and as well as division in cells.

Quadruple helix joining of two chomosomes (left and right)
Image from Google Images

Guanine is one of four chemicals within DNA that carries information for our genetic “code.” The bonding of four guanine molecules forms the quadruple helix.  This abnormality only seems to occur in DNA that is highly enriched in guanine. This discovery has led researchers to believe this chemical is linked with the replication of this abnormality.  If researchers would be able to pinpoint the areas of higher guanine concentration, a treatment could be used to form a prevention treatment for diseases such as Downs syndrome, Alzheimers or cancer.

References:

Amos, J. (2013). “Quadruple helix” DNA seen in human cells. Retrieved Feb 13,

            2013, from http://www.bbc.co.uk/news/science-environment-21091066

Lewsey, F (2013). Four-stranded “quadruple helix” DNA structure proven to exist

            In human cells. Retrieved Feb 13, 2012, from http://www.cam.ac.uk/research/news/four-stranded-quadruple-helix-dna-structure-proven-to-exist-in-human-cells/

Out with the old and in with the new

Psychology hasn't always been a field full of moral treatments for patients with depression. Many horrible tests as well as treatments have been done in the thought to help patients with mental disorders. In the early 1930's operations such as lobotomies and electoroconvulsive therapy (ECT) were used to help patients with psychotic behavior. The patients would be electrocuted using ECT until falling unconscious momentarily, then an icepick would be delivered through the nose and eye lids to "scramble" the brain. Fortunately, with the production of the first anti-psychotic medication, the use of lobotomies were no longer performed by the mid 1950's. Today ECT is only used in extreme cases and has progressed significantly compared to the more violent treatments, such as rendering the patient unconscious.  Scientists however have taken a new approach to this outdated therapy and put on the table a considerable treatment for depression.

Depression affects 15-17% of the US population and in some cases goes untreated.  A significant number of people who do undergo treatment however do not always benefit from the treatments they receive from psychiatrists and the medicine they prescribe, making it an epidemic in the adult population. Finding an option for these treatment-resistent patients is a question longed to be answered.

Researchers from the University of New South Wales tested 64 participants treatment-resistent patients to under go a new, less powerful form of electro therapy called transcranial Direct Current Stimulation (tDCS). The participants had electrodes placed on numerous parts of the scalp for twenty minutes, with nothing to feel but a slight tingling sensation under the electrodes. About 30 of the participants reported significant improvement with their depression symptoms. Another study in Brazil recorded similar data with their 120 person population test. Most of the participants stated there were very minimal side effects after treatment; just some slight redness and irritation from where the electrodes were placed.

I for one have never been an advocate for anti-depressant medications. Pharmaceutical companies release new drugs each year and most have too many side-effects that can do more harm than good. It's great to see another option for those who suffer from depression than a pill. Although this treatment has had promising results for those who are able to meet at the centers where this is available, its practicality gets called into question. What sounds more realistic? Taking a pill each day at your convenience or driving to the center each day to undergo treatment to help with your depression symptoms?

Although this treatment is a door that may lead to advances on electrical stimulation as a cure for many diseases, it does not lead to a cure for everyone. This type of stimulation would be most beneficial to those who are placed in a psychiatric hospital or those who suffer severely from other mental disorders and were placed under special supervision. If researchers could design an universal way for the treatment to be administered tDCS could be used at home and with more convenience to those who need it.

Works Cited:

Matta, C. (2013). Transcranial Direct Current Stimulation: A New     Electrical Treatment for Depression?. Psych Central. Retrieved on February 10, 2013, from http://psychcentral.com/blog/archives/2013/02/06/transcranial-direct-current-stimulation-a-new-electrical-treatment-for-depression/

Quadruple amputee receives new lease on life

In April 2009, Brendan Marrocco, a US Army infantryman stationed in Iraq, lost all four limbs when the armored vehicle he was traveling in hit an Improvised Explosive Device (IED).  He arrived back in the United States and awoke at Walter Reed Hospital, grateful to be alive.  For the past three years Brendan has been content with the prosthetic legs he received, but was anxious to get back the use of his arms. 

Image from dailymail.co.uk. 

In December 2012, the 26 year old underwent an extensive, 13-hour surgery to replace both of his missing arms.  He is first quadruple amputee to have survived the loss of all four limbs, according to physicians at Johns Hopkins.  The team of 16 orthopedic and micro vascular surgeons practiced this new surgical technique for 18 months on cadavers before beginning the operation. The operation consisted of replacing the entire right arm as well as his left forearm. Surgeons attached the muscles, arteries, veins, and nerve endings from the shoulder to the newly attached limbs. 

Transplants in general are a very dangerous operation. When a recipient receives a donated organ, the body may mistaken it as a threat and begin to attack and break it down. To put the odds in his favor, Brendan was given an injection of donated bone marrow to help his body recognize the organ and reduce the chance of rejection. Brendan was one of seven to ever have this new type of double arm transplant. Although Brendan doesn’t have feelings yet in his arms, surgeons expect that he will regain sensation in his limbs in 20-24 months. Doctors are hopeful that his operation can set the standard for future limb replacements. 


Work Cited:

CNN Wire. (2013).  Iraq vet Brendan Marrocco undergoes successful double-arm transplant. Retrieved
          Feb 2, 2013 from:http://www.abc15.com/dpp/news//iraq-vet.

Nye, J. (2013, Jan 29). the incredible scene inside operating theatre as surgeons carry out double arm
         transplant on US Iraq war veteran who lost all four limbs. Mailonline.

New method to fight addiciton

Nicotine is one of the most common and addictive substances found in today’s society. Close to half a million people die from smoking-related illnesses in the United States each year, accumulating more deaths from smoking than motor vehicle crashes, drug abuse, AIDS, suicide, and homicide combined (CDC, 2008).

This mild stimulant sends a jolt of adrenaline through the blood stream that provides the “buzz” that smokers experience.  Within two to three hours the subject will begin to have signs of cigarette withdraw.  Scientists have long known that certain areas of the brain are responsible for cravings and impulsive behavior. The orbitofrontal cortex of the brain is responsible for deciding a level of determination towards a behavior. In this case the brains appraisal of need for a cigarette. The prefrontal cortex is responsible for planning complex cognitive behavior and decision making.

Findings from the National Academy of Sciences, suggest that both the orbitofrontal cortex and the prefrontal cortex (PFC) were key respondents to cigarette cravings. The scientists focused on these two parts of the brain that could be manipulated to change the occurring behavior of cravings in smokers. They scanned the brains of ten participants that were heavy smokers using functional Magnetic Resonance Imaging (fMRI)(that track the amount of blood flow through the brain) to see how these spots reacted when the person watched videos of cigarette smoking. Their brains showed increased brain activity while watching videos of smokers than opposed to the neutral videos watched. Those who were allowed to smoke immediately after the demonstration recorded greater cravings and their brains showed more activity in the PFC than those who were told they had to wait four hours before they could have a cigarette.

Researchers have developed a method to try and reduce cravings in smokers. Scientists used Transcranial Magnetic Stimulation (TMS) to send a weak electrical current to certain areas of the brain. They were able to stimulate as well as suppress activity. When subjects watched the smoking videos again after TMS the reactions were identical to the neutral videos and showing less cravings in both groups.

As a smoker I experience cravings continuously throughout the day. Quitting is something very close to mind but with its easy accessibility and my frequent exposure, the habit is hard to kick. For years I’ve thought people who were trying to quit smoking cigarettes should be able to be hospitalized the same way a person would be helped with withdraw from alcohol and heroin. This research into non-invasive techniques and brain stimulation might be a practical way to help addicts break destructive habits.

Works Cited:

Centers for Disease Control and Prevention (CDC). (2008).

     Annual smoking attributable mortality, years of

     potential life lost, and economic costs- Untied

     States,2000-2004. Morbidity and Mortality Weekly

     Report, 57(45), 1226-1228

Lewis, T. (2013, Jan 28). Brain Chemistry Circuitry

behind cigarette craving revealed. Scientific American.