For example, Michael J Fox had an ablative procedure (thalamotomy) to treat his parkinson's disease. We don't really do that procedure anymore because deep brain stimulation has gotten better, but this article is extremely light on details and the write up (particularly by the OP) is needlessly sensationalized.
This was not an act of "terrorism". The shooter was caucasian and does not have a foreign sounding name, so, by definition, this cannot be called terrorism. Apparently.
The disorder in ALS is of the corticospinal tract, not the NMJ, but both points are irrelevant in this case. The researchers are decoding cortical signals and translating them drive a mechanical prosthesis. Theoretically, anyone with an intact motor cortex (spinal cord injured patient, as you point out, but also for ALS) should be able to manipulate one of these things.
Pretty cool stuff, but we're years away from anything clinically useful coming out of this because compared to other medical conditions, the research dollars just aren't there (the number of people with diabetes dwarfs all the SCI and amputees easily). Also, we need to figure out a way to use these non-invasively (i.e. outside the head) to avoid the problems with infection and the ethics of justifying an experimental brain surgery on a human...
first of all, a complete resection of a infiltrative glioma is not possible, because frequently by the time they're diagnosed, they've already crossed the corpus callosum into the contralateral hemisphere (google butterfly glioma. and those are just the cells we can see with MRI. we already know there are micrometastases that are not visible by/any/ currently available clinical imaging modality)
theoretically, you could do a gross total resection (we do these all the time) and irradiate the surrounding parenchyma with white light to reduce the tumor burden due to micrometastases. of course, we could just find a slightly different form of EM radiation (like x-rays) that penetrate better than visible light and activate the nanoparticles that way.
As a neurosurgeon, I have been involved in procedures like this (although not with a banjo player). To evaluate the efficacy of the tremor suppression, we frequently ask the patient to sip a glass of water.
The analogy of a surgeon as a glorified human body mechanic has been used on me in the past, too. I will accept the comparison with the following conditions:
Next time you take your car in, tell your mechanic that 1. You only plan on having one car for the rest of your life and 2. When they work on your car, they have to leave the engine running.
This device appears to be measuring electical potentials generated by muscle groups in the face firing. I would think that a "brain interface" (or mind-machine interface or direct neural interface or brain-computer interface) at the very least should be driven directly by cortical neuronal activity (i.e. EEG, MEG), not the end muscle group.
This seems like more of a gamer's application of electromyography
Have your doctor talk to the speech therapist or occupational therapist. They have are professionally-trained to deal with this stuff and have lots of resources to help overcome this problem.
High Tech High is alive and well in San Diego County. They're now up to 6 campuses, I believe with one elementary middle school, one middle school, three high schools in south county and a new middle school and high school opening in North county this fall.
Their robotics team is very well respected and consistently performs well at national competitions. Their college placement rates are substantially higher than other local high schools. The failure of the SV HTH actually had more to do with administrative and personnel issues that were unique to the San Francisco campus. HTH continues to thrive and grow in California.
...in San Diego. They have three high school campuses and one middle school that are up an running, and they just opened two more in the north part of the county for the coming school year. Their robotics team is one of the top in the country. I think the problem with the San Francisco campus was more of an administrative one (i.e. the administrators were not in line with the institution's philosophy or something along those lines)
OK he's not that bad, but he evidently chose to continue to post links to his blog on the slashdot main page despite numerous complaints from the community. If I accidentally click on a link to his blog one more time, my head is going to explode.
I remember that I changed some parameter when Katz was crapping up our message boards so I wouldn't have to even see his posts. Is that possible under the current incarnation of the site? How do I do it?
First of all, it sounds like from the article that we're talking about high-grade gliomas (like glioblastoma multiforme) here. Typical survival is 5% after 5 years. Median survival time with best available treatment was 14 months 50 years ago. Now it's about 19 months and many people argue that it's because we're diagnosing gliomas earlier.
In short, this looks very promising but we're a long way from any sort of clinically relavent treatment.
actually, the real reason that urine sterile is because, under normal circumstances, the kidneys are filtering a sterile fluid (blood).
there are five normally sterile fluids in the body: blood, urine, cerebrospinal fluid, pleural fluid (on the outside of the lungs) and peritoneal fluid (on the outside of your intestines). your mouth and gut are full of bacteria which makes fluid that comes out of them (spit, sputum, mucous, feces) contaminated.
<speculation> i would think that urine is an extremely poor vector for disease transmission. for one thing, it's pH is low enough that it is an unfavorable environment for bacterial or viral growth. it's relatively acellular and is loaded with osmotically active molecules (urea). certian viruses and bacteria could i suppose slip through the glomeruli or more likely catch a ride on the end of the urethra as the pee squirts by, but i doubt that it could concentrate into a fluid with a clinically significant viral load.</speculation>
the idea of urine accumulating on porcelain posing a disease risk doesn't ring true to me.
are the plumbers going to lose money on this by having fewer moving parts to maintain?
1. peripheral nerves regenerate at the rate of about 1mm per day after an acute injury (assuming no other medical comorbidities that impair healing, inflammation, etc). that's about an inch a month. this article deals with central nervous system repair/regeneration so that information is not applicable.
2. are you arguing that all umbilical stem cells will ultimately return to the bone marrow regardless of which nerve growth factors they are given and irrespective of their site of implantation? you're assuming a lot about the technique used here and i don't think you can be so dismissive of the paper without reading it (my institution doesn't have access to that particular journal).
this is promising research, but i too am troubled by the fact that it was published in a relatively minor journal. animal models suggest that stem cells can be used to facilitate central nervous system (CNS_ regrowth. i'd like to know more about the woman's initial injury and resulting defecits. was it a cord transection or just a bad contusion? i'll also point out that the lower thoracic cord and cauda equina tolerate injury better than any other part of the CNS.
we're talking about two different things here. the OP (who is describing a discectomy, rather than a laminectomy) presumably did not have a spinal cord injury, rather a disease of the vertebral column (i.e. the bony support around the spinal cord and spinal nerve roots). in the case the OP describes, the nucleus pulposis of the intervertebral disc herniates out (either by mechanical stress or simply by aging) and impinges the exiting nerve root of a spinal peripheral nerve. we have been able to repair peripheral nerves for some time now. in the case of the research presented here, we're talking about growth/repair in the central nervous system. this type of repair was not thought to be possible throughout much of the 20th century. turns out we were mostly wrong.
while the cited article in this posting is a little light on details, this research is potentially novel for the reason that these researchers appear to have recovered function in an animal with a complete spinal cord transection. incomplete spinal cord injury (aka "crush") injuries are a different beast. for some time now, some degree of functional rehabilitation has been possible. the hope is that in humans, we will be able to culture the appropriate stem cell, provide the correct growth factors and achieve connection between the motor/sensory cortex and the peripheral nerve(s).
the problem is that until this point, we have not had very much success getting neurons in the central nervous system to grow across scar tissue and make appropriate connections to regain function.
in anticipation of a heated debate in this forum regarding stem cells etc, it's worth noting that the cells used in this study probably fall into the category of "adult stem cells" and not embryonic stem cells (the more contriversial of the two).
yikes. having personally seen the effects of HIV infection and AIDS in people who subscribe to the AIDS Denialist school of thought, i felt compelled to reply to this posting.
bottom line:
1. CD4+ T-lymhocyte counts and HIV viral loads have been negatively and positively (respectively) correlated with survival in virtually every patient population ever studied.
2.highly active anti-retroviral therapy (HAART) has been shown to significantly reduce mortality in HIV-infected individuals.
we practice evidence-based medicine in the united states. you can try to poke holes in the virology if you want to (i'm not a virologist) but you can't argue with epidemiology.
the theory that HIV is the causative pathogen in AIDS has not been disproven in any peer-reviewed publication that i have ever seen.
we know how to treat these patients and turn AIDS into a chronic rather than a fatal illness.
my neurology professor gave a lecutre about neurologic disorders in star wars. the most interesting part was the observation that yoda may have suffered from William's Syndrome
Please mod parent down
on
HIV Vaccine
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· Score: 1
There is no such thing as a dendritic cell in the CNS. Dendrites components of a neuron that extend from the cell body to communicate with neighboring neurons. A previous poster has already given an accurate definition and resource discussing the dendritic cell as a part of the cell-mediated immune system.
Re:What's a dead virus?
on
HIV Vaccine
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· Score: 1
Depends on what your definition of "alive" or "dead" means. Certainly one of the criteria of being alive involves some acknowledgement of reproduction. An intact virus (alive, if you will) in the setting of a compatible host will replicate at the expense of the host's well-being. It may or may not induce an effective immune response (HIV, many strains of HPV).
There are several methods of preparing vaccines with the intent of priming the body's immune system to fight a future exposure to a virus (or, as appears to be the case here, and existing infection). Whole killed vaccines are just what you would expect from the name: whole virii (or bacteria) that have had all of their genetic and reproductive material denatured and renedered ineffective). Sometimes, we just take some proteins from the virus (or bacteria) that are particularly good at stimulating a long-term host response and conjugate those with some delivery vector.
In either case, the reproductive and genetic material are removed from the pathogen preventing (theoretically) any reproduction and therefore any detrimental effects on the host and simulating infection from the standpoint of the immune system. That way, when you're infected for real, you have antibodies at the ready to swarm the actual pathogen and overwhelm it before it can cause any real damage.
I was a software engineer for about 3 years during and after college here in the States. I decided to go back to school and become a physician. I'd be lying if I said I hadn't second-guessed myself along the way (especially when I look at my student debt), but I truly believe this was the right decision for me.
On the plus side, I can't think of another field that tickles my science itch as well as giving me a sense that I have accomplished something concrete and meaningful at the end of the day (usually not a cure, but at least alleviation).
Also, I should point out that diagnosis (especially localization of neurological problems) calls on many of the same faculties as debugging, which I liked quite a bit.
Of course, there are sacrifices. I miss the design and construction aspects of software engineering. I'm putting in longer hours (particularly early in the morning) than I did as an engineer. Anything worthwhile requires work and dedication.
I am a third year medical student at a state medical school in the United States
This is a multifactoral problem. The average medical student graduates with about $180,000 debt (closer to $220,000 by the time it's paid off). Monthly payments can be about $1,000 per month.
Secondly, technology has largely supplanted physical diagnosis. Doctors have gotten sloppy in the past due to reliance on expensive diagnostic tests rather than relying on patient's history and their 5 senses (Greeks used to taste urine to diagnose diabetes). This problem is being addressed. Medical students are trained more like engineers in that cost to the patient (and by extension the system as a whole) is an important consideration in ordering tests. Of course, the health of the patient is paramount. For example, a good abdominal exam can obviate the need for an expensive CT scan.
The legal system in the US contributes in no small way to the cost of health care. Professional liabilty insurance ("malpractice insurance" to the laypublic) premiums can range upwards of $100,000 per year for high-risk specialty. An OB/GYN I know in Florida was recently offered $250,000 of coverage at a $216,000 premium. He is now practicing without coverage. Doctors pass these increased costs onto patients.
Lastly, medical equipment is held to tremendously high quality control standards. From my software engineering classes, I seem to recall that the importance of reliability testing was consistently invoked by mentioning areospace and healthcare equipment. If your $4 EKG misses one MI, you've got a big assed lawsuit on your hands (which we all pay for through increased costs).
Slashdot Mirror
My guess is BoB and NDT are trolling us. Funny stuff.
This.
For example, Michael J Fox had an ablative procedure (thalamotomy) to treat his parkinson's disease. We don't really do that procedure anymore because deep brain stimulation has gotten better, but this article is extremely light on details and the write up (particularly by the OP) is needlessly sensationalized.
This was not an act of "terrorism". The shooter was caucasian and does not have a foreign sounding name, so, by definition, this cannot be called terrorism. Apparently.
Not quite true.
The disorder in ALS is of the corticospinal tract, not the NMJ, but both points are irrelevant in this case. The researchers are decoding cortical signals and translating them drive a mechanical prosthesis. Theoretically, anyone with an intact motor cortex (spinal cord injured patient, as you point out, but also for ALS) should be able to manipulate one of these things.
Pretty cool stuff, but we're years away from anything clinically useful coming out of this because compared to other medical conditions, the research dollars just aren't there (the number of people with diabetes dwarfs all the SCI and amputees easily). Also, we need to figure out a way to use these non-invasively (i.e. outside the head) to avoid the problems with infection and the ethics of justifying an experimental brain surgery on a human...
first of all, a complete resection of a infiltrative glioma is not possible, because frequently by the time they're diagnosed, they've already crossed the corpus callosum into the contralateral hemisphere (google butterfly glioma. and those are just the cells we can see with MRI. we already know there are micrometastases that are not visible by /any/ currently available clinical imaging modality)
theoretically, you could do a gross total resection (we do these all the time) and irradiate the surrounding parenchyma with white light to reduce the tumor burden due to micrometastases. of course, we could just find a slightly different form of EM radiation (like x-rays) that penetrate better than visible light and activate the nanoparticles that way.
interesting stuff.
As a neurosurgeon, I have been involved in procedures like this (although not with a banjo player). To evaluate the efficacy of the tremor suppression, we frequently ask the patient to sip a glass of water.
The analogy of a surgeon as a glorified human body mechanic has been used on me in the past, too. I will accept the comparison with the following conditions:
Next time you take your car in, tell your mechanic that
1. You only plan on having one car for the rest of your life and
2. When they work on your car, they have to leave the engine running.
This device appears to be measuring electical potentials generated by muscle groups in the face firing. I would think that a "brain interface" (or mind-machine interface or direct neural interface or brain-computer interface) at the very least should be driven directly by cortical neuronal activity (i.e. EEG, MEG), not the end muscle group.
This seems like more of a gamer's application of electromyography
Have your doctor talk to the speech therapist or occupational therapist. They have are professionally-trained to deal with this stuff and have lots of resources to help overcome this problem.
High Tech High is alive and well in San Diego County. They're now up to 6 campuses, I believe with one elementary middle school, one middle school, three high schools in south county and a new middle school and high school opening in North county this fall.
Their robotics team is very well respected and consistently performs well at national competitions. Their college placement rates are substantially higher than other local high schools. The failure of the SV HTH actually had more to do with administrative and personnel issues that were unique to the San Francisco campus. HTH continues to thrive and grow in California.
...in San Diego. They have three high school campuses and one middle school that are up an running, and they just opened two more in the north part of the county for the coming school year. Their robotics team is one of the top in the country. I think the problem with the San Francisco campus was more of an administrative one (i.e. the administrators were not in line with the institution's philosophy or something along those lines)
OK he's not that bad, but he evidently chose to continue to post links to his blog on the slashdot main page despite numerous complaints from the community. If I accidentally click on a link to his blog one more time, my head is going to explode.
I remember that I changed some parameter when Katz was crapping up our message boards so I wouldn't have to even see his posts. Is that possible under the current incarnation of the site? How do I do it?
We have an opening in our brain tumor biology lab. When can you start?
First of all, it sounds like from the article that we're talking about high-grade gliomas (like glioblastoma multiforme) here. Typical survival is 5% after 5 years. Median survival time with best available treatment was 14 months 50 years ago. Now it's about 19 months and many people argue that it's because we're diagnosing gliomas earlier.
In short, this looks very promising but we're a long way from any sort of clinically relavent treatment.
also, lisa is playing a tenor sax in the live action version, whereas she plays a baritone sax in the animated version.
it was a nice touch to see homer's ass crack as he's running into the garage.
actually, the real reason that urine sterile is because, under normal circumstances, the kidneys are filtering a sterile fluid (blood).
there are five normally sterile fluids in the body: blood, urine, cerebrospinal fluid, pleural fluid (on the outside of the lungs) and peritoneal fluid (on the outside of your intestines). your mouth and gut are full of bacteria which makes fluid that comes out of them (spit, sputum, mucous, feces) contaminated.
<speculation> i would think that urine is an extremely poor vector for disease transmission. for one thing, it's pH is low enough that it is an unfavorable environment for bacterial or viral growth. it's relatively acellular and is loaded with osmotically active molecules (urea). certian viruses and bacteria could i suppose slip through the glomeruli or more likely catch a ride on the end of the urethra as the pee squirts by, but i doubt that it could concentrate into a fluid with a clinically significant viral load.</speculation>
the idea of urine accumulating on porcelain posing a disease risk doesn't ring true to me. are the plumbers going to lose money on this by having fewer moving parts to maintain?
a lot of misinformation here.
1. peripheral nerves regenerate at the rate of about 1mm per day after an acute injury (assuming no other medical comorbidities that impair healing, inflammation, etc). that's about an inch a month. this article deals with central nervous system repair/regeneration so that information is not applicable.
2. are you arguing that all umbilical stem cells will ultimately return to the bone marrow regardless of which nerve growth factors they are given and irrespective of their site of implantation? you're assuming a lot about the technique used here and i don't think you can be so dismissive of the paper without reading it (my institution doesn't have access to that particular journal).
this is promising research, but i too am troubled by the fact that it was published in a relatively minor journal. animal models suggest that stem cells can be used to facilitate central nervous system (CNS_ regrowth. i'd like to know more about the woman's initial injury and resulting defecits. was it a cord transection or just a bad contusion? i'll also point out that the lower thoracic cord and cauda equina tolerate injury better than any other part of the CNS.
we're talking about two different things here. the OP (who is describing a discectomy, rather than a laminectomy) presumably did not have a spinal cord injury, rather a disease of the vertebral column (i.e. the bony support around the spinal cord and spinal nerve roots). in the case the OP describes, the nucleus pulposis of the intervertebral disc herniates out (either by mechanical stress or simply by aging) and impinges the exiting nerve root of a spinal peripheral nerve. we have been able to repair peripheral nerves for some time now. in the case of the research presented here, we're talking about growth/repair in the central nervous system. this type of repair was not thought to be possible throughout much of the 20th century. turns out we were mostly wrong.
while the cited article in this posting is a little light on details, this research is potentially novel for the reason that these researchers appear to have recovered function in an animal with a complete spinal cord transection. incomplete spinal cord injury (aka "crush") injuries are a different beast. for some time now, some degree of functional rehabilitation has been possible. the hope is that in humans, we will be able to culture the appropriate stem cell, provide the correct growth factors and achieve connection between the motor/sensory cortex and the peripheral nerve(s).
the problem is that until this point, we have not had very much success getting neurons in the central nervous system to grow across scar tissue and make appropriate connections to regain function.
in anticipation of a heated debate in this forum regarding stem cells etc, it's worth noting that the cells used in this study probably fall into the category of "adult stem cells" and not embryonic stem cells (the more contriversial of the two).
Once cleaner diesel fuel starts rolling in look out!
you mean like biodiesel?
yikes. having personally seen the effects of HIV infection and AIDS in people who subscribe to the AIDS Denialist school of thought, i felt compelled to reply to this posting.
bottom line:
1. CD4+ T-lymhocyte counts and HIV viral loads have been negatively and positively (respectively) correlated with survival in virtually every patient population ever studied.
2.highly active anti-retroviral therapy (HAART) has been shown to significantly reduce mortality in HIV-infected individuals.
we practice evidence-based medicine in the united states. you can try to poke holes in the virology if you want to (i'm not a virologist) but you can't argue with epidemiology.
the theory that HIV is the causative pathogen in AIDS has not been disproven in any peer-reviewed publication that i have ever seen.
we know how to treat these patients and turn AIDS into a chronic rather than a fatal illness.
here is a more complete resource on the debate.
my neurology professor gave a lecutre about neurologic disorders in star wars. the most interesting part was the observation that yoda may have suffered from William's Syndrome
There is no such thing as a dendritic cell in the CNS. Dendrites components of a neuron that extend from the cell body to communicate with neighboring neurons. A previous poster has already given an accurate definition and resource discussing the dendritic cell as a part of the cell-mediated immune system.
Depends on what your definition of "alive" or "dead" means. Certainly one of the criteria of being alive involves some acknowledgement of reproduction. An intact virus (alive, if you will) in the setting of a compatible host will replicate at the expense of the host's well-being. It may or may not induce an effective immune response (HIV, many strains of HPV).
There are several methods of preparing vaccines with the intent of priming the body's immune system to fight a future exposure to a virus (or, as appears to be the case here, and existing infection). Whole killed vaccines are just what you would expect from the name: whole virii (or bacteria) that have had all of their genetic and reproductive material denatured and renedered ineffective). Sometimes, we just take some proteins from the virus (or bacteria) that are particularly good at stimulating a long-term host response and conjugate those with some delivery vector.
In either case, the reproductive and genetic material are removed from the pathogen preventing (theoretically) any reproduction and therefore any detrimental effects on the host and simulating infection from the standpoint of the immune system. That way, when you're infected for real, you have antibodies at the ready to swarm the actual pathogen and overwhelm it before it can cause any real damage.
Since when do US Supreme Court Justices monitor Slashdot? Please cruise on over to YRO when you're done in here...
I was a software engineer for about 3 years during and after college here in the States. I decided to go back to school and become a physician. I'd be lying if I said I hadn't second-guessed myself along the way (especially when I look at my student debt), but I truly believe this was the right decision for me.
On the plus side, I can't think of another field that tickles my science itch as well as giving me a sense that I have accomplished something concrete and meaningful at the end of the day (usually not a cure, but at least alleviation).
Also, I should point out that diagnosis (especially localization of neurological problems) calls on many of the same faculties as debugging, which I liked quite a bit.
Of course, there are sacrifices. I miss the design and construction aspects of software engineering. I'm putting in longer hours (particularly early in the morning) than I did as an engineer. Anything worthwhile requires work and dedication.
--b
I am a third year medical student at a state medical school in the United States
This is a multifactoral problem. The average medical student graduates with about $180,000 debt (closer to $220,000 by the time it's paid off). Monthly payments can be about $1,000 per month.
Secondly, technology has largely supplanted physical diagnosis. Doctors have gotten sloppy in the past due to reliance on expensive diagnostic tests rather than relying on patient's history and their 5 senses (Greeks used to taste urine to diagnose diabetes). This problem is being addressed. Medical students are trained more like engineers in that cost to the patient (and by extension the system as a whole) is an important consideration in ordering tests. Of course, the health of the patient is paramount. For example, a good abdominal exam can obviate the need for an expensive CT scan.
The legal system in the US contributes in no small way to the cost of health care. Professional liabilty insurance ("malpractice insurance" to the laypublic) premiums can range upwards of $100,000 per year for high-risk specialty. An OB/GYN I know in Florida was recently offered $250,000 of coverage at a $216,000 premium. He is now practicing without coverage. Doctors pass these increased costs onto patients.
Lastly, medical equipment is held to tremendously high quality control standards. From my software engineering classes, I seem to recall that the importance of reliability testing was consistently invoked by mentioning areospace and healthcare equipment. If your $4 EKG misses one MI, you've got a big assed lawsuit on your hands (which we all pay for through increased costs).
My $0.02
--b