I also should mention - They used MRI, not CT. Which doesn't change most of the arguments of the above post (3d reconstruction can be done on either modality, and can still be viewed with any imaging software, and is still pretty useless in clinical practice) and it also means that it would all be out of the question there was any question about if someone had gotten shot.
With regards to post mortems, as far as I know, there is no centre in the world doing routine MRIs for all post mortems. It's still a research tool, and there are even fewer people around able to report post mortem MRIs.
Don't forget how a CT scanner works: it effectively takes thousands of xrays in a 360 degree plane around the body at different slices through the body. Start at the head, 360 degrees around the area. Move the body down a bit, do the thorax, 360 degrees, etc. http://en.wikipedia.org/wiki/CT_scanner Actually, most of the tech you see on the screen has been available for years - as in, a lot of ct scanners can do a 3d reconstruction anyway. The images you see on that vid have been done for years, it's just the setup which is pretty slick and neat. You can pan and scan and manipulate the images like that using any radiology imaging software. In clinical practice, most people don't bother with fancy reconstructions, not because it's memory intensive, but because there's no point. It looks nice, but most of the answers you can get without doing a silly reconstruction. You'll often see it done for fractures. And, as someone has already mentioned, scans aren't without their risk. As that wikipedia points out, you get about 3x your yearly dose of radiation in that one scan. And as for coupling it with other scans, again, kinda done anyway. But if you suspect someone has some pathology that needs a scan, you normally just pick the right scan for the job instead of taking a shotgun approach to the whole thing. It's cost and time intensive.
And as for replacing the autopsy, hmmm. For about 10 years the Swiss have been trying to come out with virtual autopsies, heralding it as the way of the future http://www.virtopsy.com/ The guy offers courses on how to use a CT scanner instead of an autopsy. The storage and memory problems not withstanding, there's also the cost of the systems, and the fact that there are very few radiologists worldwide who would be willing to take a 300k a year paycut to report on a bunch of corpses when pathologists have been doing the job for about 1/10th the cost for years. It's shown to be useful in very limited situations, including identification of remains in mass disasters... but again as a day to day tool, it's pretty hard to justify the cost. As far as I know, there are less than 10 forensic centres performing routine CT autopsies, none of which are based in the States. Albuquerque will probably be the first. Melbourne, Victoria does it, and probably has the highest throughput of any institute I've seen, but it really doesn't affect outcomes very much (ie, the person's still dead).
What this is basically is a really nice teaching tool that can help people learn a bit about human anatomy. It would be great in museums and the odd medical library.
You laugh, but they've actually done experiments like this on pigs:
Taser dart-to-heart distance that causes ventricular fibrillation in pigs.
IEEE Trans Biomed Eng. 2007 Mar;54(3):503-8.
With "These results suggest[ing] that the probability of a dart on the body landing in 1 cm2 over the ventricle and causing VF is 0.000172."
Completely sponsored by Taser, in all likelihood...
And yeah, it is absurd, but Tasers being contributory to death rarely makes it on the certificate. It usually gets left off becaue of all that legal pressure. This was the only case where it really happened and shit really hit the fan: Scott Denton is probably one of the more reknowned Pathologists in the USA too... http://www.azcentral.com/arizonarepublic/news/articles/0730taser30.html?&wired
Well, that is and isn't true. "Adrenal rush" as you put it is pretty much the mechanism of action of cocaine and methamphetamine. What that "adrenal rush" makes people do varies. Some people take it very well and some people go nuts. It is independant of the volume ingested and any tolerance that you might have. It's poorly understood. And as I said before, people die because of it. Now in addition to whatever problems are being caused by the drugs, add on 4 guys tackling you, being sat on, running a marathon, and (probably though good luck proving it with a Taser lobby) Tasers, and it's a recipe for potential sudden death. In a classic sense and in answer to your question, no, being tasered doesn't qualify as excitation delirium. It gives you an electric shock. Again. Excitation delerium is the man running down the street screaming without his shirt on breaking glass and screaming with no idea who he is or how he got there.
But with specific regards to being tased: You can't predict the path the electricity takes but it's safe to say that it probably zaps the whole body. So yeah, it'll follow the path of least resistance through the body just like lightning would, and on the way yeah, it will probably come into contact with muscle, and nerve (that includes spinal cord) and everything else. I don't know where the current goes after it hits you, does it return to the unit or does it go into the ground? I have no idea but it's largely irrelevant.
The argument that the Taser company makes, and again, is true, is that the mechanism of death in any electrocution is ventricular fibrillation. Something anaesthetists and executioners have known for a long time is that a frequency of about 50-60 Hz can cause the heart to go into VF, which is bad. It's also incidentally the frequency of household electricity as well which is why throwing a hairdryer in the bathtub will kill you if the ground fault interrupters don't get triggered.
But the argument Taser makes is that the frequency they use, which I can't remember off the top of my head, causes skeletal muscle contraction but doesn't cause VF. And that is probably true. But what we don't know is if all that skeletal muscle contraction does other things, like increases blood return to the heart which can cause increased stress on an already stressed (due to drugs or underlying cardiac disease or the situation, etc etc) and throw the heart into VF anyways, or releases all sorts of enzymes into the blood or what. But there's no way to know.
I'm trying to avoid an argument on whether it's right or wrong to use Tasers and in what situations. I'm just answering the OP's question on what Taser was referring to by excitation delirium and why they think their devices aren't causing death.
What usually happens is that these people are in such an agitated state that when approached by law enforcement (or a security guard, or some shopkeeper who is trying to get them out of the store, or some passerby trying to get them out of running down the middle of the road in heavy traffic) tend to get even more aggressive and attack, and don't respond to the usual methods of being subdued like pepper spray or threat of arrest or being shot or anything. It can and and often does take 4 or 5 heavily trained policemen to get these guys out of danger. What has happened in the past is that these people continue to fight even when restrained in handcuffs, and then die of a sudden cardiac event most likely due to all the excitement and inability to calm down due to whatever drugs they are on. Over the years this has been well recognized and most sensible jurisdictions have rules such as "once handcuffed do not place in prone position" due to higher chances of these people dying from positional asphyxia.
Anyways, back to the Taser thing. Taser for years and years have been saying that since these deaths can happen WITHOUT the use of a Taser, then it's reasonable to assume that their use had no bearing on whether or not the guy lived or died and he probably woulda died anyways because documented causes of people with excited delirium have and will continue to die under these circumstances. And what they are saying is true to a certain extent: If people die without it, then why would you expect its use specifically to be the sole cause of their death? This guy in this most recent case most certainly was in a crazed state and very well could have died without the use of the Taser: http://www.cbc.ca/canada/story/2007/11/24/custody-death.html. But that doesn't mean that the use of the Taser even in these cases wasn't contributory in some way. That recent Vancouver airport case had negative toxicology as far as I know, so we can't blame drugs on that guy's death, though he was clearly agitated. But it's just very difficult to prove, even with this video evidence, that the death was caused directly by the taser. It's electrical current. It doesn't leave any pathology.
Two jurisdictions in the States (Ohio and Chicago) have both attempted to certify deaths with "due to Taser" in the death certificate and both have been sued into submission. Taser has a huge lobby and has hired a number of physicists (not doctors) including this guy http://www.andcor.com/page/1/news_032206.jsp to go around the country giving lectures on how Tasers won't cause death and certifying them otherwise will land you a big fat lawsuit.
Anyways, it's a complicated issue, but in reference to your original question, excitation delirium is a state of agitation and occasionally extreme violence and paranoia usually brought on by stimulants and can commonly cause death in a mechanism not yet completely understood. Taser has been using it as an explanation for why people who have been Tasered go on to die for years. Hope that helps. The issue is extremely contentious and and very political at the moment.
OT but not really since it's about the fact that we get like 2 of these stupid Roland submissions a day. Do you notice how occasionally the link to the actual article, despite not going through Roland's page has one of those "=id_XXXX" identifiers at the end of the link? Does that mean that when we click on the link the article records that it is coming from a referral supplied from Roland, meaning that despite linking directly to the article, he is still getting credit for directing traffic that way? I'm new to this whole intarweb advertising scam nonsense, so can someone clue me in as to whether or not I'm crazy?
Yeah. Never thought I'd completely disagree, but I completely disagree. Patients get admitted to hospitals when they get sick. They don't have the choice on going to one where doctors may or may not speak their language. A heart attack happens when a heart attack happens and a patient will be sent to a hospital, where doctors will all of the sudden be forced to make minute to minute decisions based on the answers a patient gives. Where's the pain? What's the character of the pain? Does it radiate? What makes it better? We need to know these things and need to know em quick. Multilingual doctors? Say you have a hospital in an English speaking country with 200 doctors. how many do you expect to speak Tagalog/Gujarat/Bahasa/Japanese/Italian/Arabic? 1? 2? What if he's with a patient/in theatre/in consult rooms/sick?
Hospitals (mine included) have translators on call for over 30 languages. When someone presents acutely, and we don't have time to get someone in, there's a hotline with translators on the other end we can use. It's an antiquated system but it works well. If this computer thingo works just as well, then yes, it's useful.
This is true. Now ask yourself why cells which undergo more frequent mitotic divisions are the ones that develop cancer more commonly: your colorectals, your prostates, your lungs (in smokers, where there's constant damage).... the more replications a cell does, the more your errors you are likely to accumulate. This includes, but is not limited to, the examples you mentioned above. Take a cell and extend its lifespan, allow the DNA damage to increase and the DNA mismatch repair to fail, and voila, instant neoplasm.
For the record, mosquitos aren't immune to Plasmodium. If I recall undergraduate biology correctly, Plasmodium shortens the life cycle of mosquitos as well, and some have in fact theorized that the way to eliminate malaria would be to create a defense mechanism in the mosquito itself, that would prevent transmission to humans.
Eyes of the Dragon isn't a bad book. Thoroughly enjoyed it. I found The Stand to be the closest tie-in to The Dark Tower, though. There are chapters in the Dark Tower series devoted to Roland and his Ka-Tet walking through the world in which The Stand takes place. I might be mistaken, but isn't Flagg sorta the main evil baddie in The Stand as well?
If you read TFA you'd have read that the original publication is due to be released in JCI, a peer reviwed journal that is quite high impact. Not Nature or Science, but not the Ulan Bator Journal of Basket Weaving Medicine either.
Hmm. You sorta opened a can of worms here. A couple of issues here.
First: Does H. pylori eradication lead to increased incidence of Barrett's esophagitis and esophageal cancer? Maybe. The jury is still out. The Japanese have just published a pretty comprehensive review (Japanese Journal of Clinical Medicine. 63(8):1383-6, 2005 Aug)on the subject. The increase in one may be more common with the eradication of the other. Fine. Are they casually related? That's a more complex question that I think the research is sorta investigating. I dont think Scientific American really has the answer.
But that's not the major issue. Stomach ulcer is a condition that PRIOR to the triple treatment (bismuth + antibiotics + acid inhibitors) would take months to years to heal. Some anecdotal stories as long as 6 years. More. Sometimes never. Leading to serious, serious complications that have even worse prognoses. You see what I'm getting at here. Quality of life years lost are huge, affecting huge chunks of the population. Known risk of causing stomach cancer, perforation of your guts (think your guts spilling into your abdominal cavity) and iron deficiency due to chronic bleeding just for a start. Now we're saying... OK. It MAY result in reflux, eosophageal cancer and Barrett's (cells in your eosophagus changing morphology).
Hardly the "eliminating H. pylori is worse than the symptoms created by too much of it." If anything, what this might suggest is that there might be some unwanted complications to altering the internal milieu of the stomach, and they should be addressed. Full stop. Sky's not falling yet, pal.
Inflammation isn't really the CAUSE, per se. Peptic ulcer is due to a hypersecretion of stomach acid. H. pylori attacks the D cells in the stomach that normally turn off acid secretion in the parietal cells. It probably directly affects ECL cells (they release histamine, a potent mediator for the release of acid) and also directly stimulates the HCl producing parietal cells as well. The acid doesn't really cause inflammation, it erodes the mucous protective layer in the stomach, which can either perforate through into your abdominal cavity, penetrate your intestines and create a fistula, or erode your stomach wall causing bleeding. The only way you'd really get inflammation is if you get irritation of your abdominal cavity, but then it's not just an ulcer, it's peritonitis due to your ulcer. So the problem with the ulcer per se isn't the inflammation. It's the erosion of the gastric lining leading to perforation or penetration.
As for inflammation being involved in heart disease, rheumatoid and diabetes... Yes. Sorta. Heart disease slightly, depending on what heart disease you mean. Rheumatoid for sure. Type 1 diabetes is caused by an autoimmune attack on your pancreatic beta cells. Might cause a little inflammation but the attack is specific to the beta cells. (inflammation is a non-specific response to a foreign antigen) Type 2 diabetes... the kind fat people get.... not inflammatory at all. It's due to your peripheral body no longer responding to insulin (look up GLUT4 receptors if you want)
Didn't so much inspire it. SHH is actually the 4th or the 5th Hedgehog protein that they found. The first couple they discovered were named after real hedgehogs, and then they ran out of real ones, and picked Sonic, which ultimately ended up being the important protein. I'm not a molecular biologist anymore, so don't quote me on it. (It aint an antibody, either)
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I also should mention - They used MRI, not CT. Which doesn't change most of the arguments of the above post (3d reconstruction can be done on either modality, and can still be viewed with any imaging software, and is still pretty useless in clinical practice) and it also means that it would all be out of the question there was any question about if someone had gotten shot.
With regards to post mortems, as far as I know, there is no centre in the world doing routine MRIs for all post mortems. It's still a research tool, and there are even fewer people around able to report post mortem MRIs.
Don't forget how a CT scanner works: it effectively takes thousands of xrays in a 360 degree plane around the body at different slices through the body. Start at the head, 360 degrees around the area. Move the body down a bit, do the thorax, 360 degrees, etc. http://en.wikipedia.org/wiki/CT_scanner Actually, most of the tech you see on the screen has been available for years - as in, a lot of ct scanners can do a 3d reconstruction anyway. The images you see on that vid have been done for years, it's just the setup which is pretty slick and neat. You can pan and scan and manipulate the images like that using any radiology imaging software. In clinical practice, most people don't bother with fancy reconstructions, not because it's memory intensive, but because there's no point. It looks nice, but most of the answers you can get without doing a silly reconstruction. You'll often see it done for fractures. And, as someone has already mentioned, scans aren't without their risk. As that wikipedia points out, you get about 3x your yearly dose of radiation in that one scan. And as for coupling it with other scans, again, kinda done anyway. But if you suspect someone has some pathology that needs a scan, you normally just pick the right scan for the job instead of taking a shotgun approach to the whole thing. It's cost and time intensive.
And as for replacing the autopsy, hmmm. For about 10 years the Swiss have been trying to come out with virtual autopsies, heralding it as the way of the future http://www.virtopsy.com/ The guy offers courses on how to use a CT scanner instead of an autopsy. The storage and memory problems not withstanding, there's also the cost of the systems, and the fact that there are very few radiologists worldwide who would be willing to take a 300k a year paycut to report on a bunch of corpses when pathologists have been doing the job for about 1/10th the cost for years. It's shown to be useful in very limited situations, including identification of remains in mass disasters... but again as a day to day tool, it's pretty hard to justify the cost. As far as I know, there are less than 10 forensic centres performing routine CT autopsies, none of which are based in the States. Albuquerque will probably be the first. Melbourne, Victoria does it, and probably has the highest throughput of any institute I've seen, but it really doesn't affect outcomes very much (ie, the person's still dead).
What this is basically is a really nice teaching tool that can help people learn a bit about human anatomy. It would be great in museums and the odd medical library.
Taser dart-to-heart distance that causes ventricular fibrillation in pigs.
IEEE Trans Biomed Eng. 2007 Mar;54(3):503-8.
With "These results suggest[ing] that the probability of a dart on the body landing in 1 cm2 over the ventricle and causing VF is 0.000172."
Completely sponsored by Taser, in all likelihood...
And yeah, it is absurd, but Tasers being contributory to death rarely makes it on the certificate. It usually gets left off becaue of all that legal pressure. This was the only case where it really happened and shit really hit the fan: Scott Denton is probably one of the more reknowned Pathologists in the USA too... http://www.azcentral.com/arizonarepublic/news/articles/0730taser30.html?&wired
Well, that is and isn't true. "Adrenal rush" as you put it is pretty much the mechanism of action of cocaine and methamphetamine. What that "adrenal rush" makes people do varies. Some people take it very well and some people go nuts. It is independant of the volume ingested and any tolerance that you might have. It's poorly understood. And as I said before, people die because of it. Now in addition to whatever problems are being caused by the drugs, add on 4 guys tackling you, being sat on, running a marathon, and (probably though good luck proving it with a Taser lobby) Tasers, and it's a recipe for potential sudden death. In a classic sense and in answer to your question, no, being tasered doesn't qualify as excitation delirium. It gives you an electric shock. Again. Excitation delerium is the man running down the street screaming without his shirt on breaking glass and screaming with no idea who he is or how he got there.
But with specific regards to being tased: You can't predict the path the electricity takes but it's safe to say that it probably zaps the whole body. So yeah, it'll follow the path of least resistance through the body just like lightning would, and on the way yeah, it will probably come into contact with muscle, and nerve (that includes spinal cord) and everything else. I don't know where the current goes after it hits you, does it return to the unit or does it go into the ground? I have no idea but it's largely irrelevant.
The argument that the Taser company makes, and again, is true, is that the mechanism of death in any electrocution is ventricular fibrillation. Something anaesthetists and executioners have known for a long time is that a frequency of about 50-60 Hz can cause the heart to go into VF, which is bad. It's also incidentally the frequency of household electricity as well which is why throwing a hairdryer in the bathtub will kill you if the ground fault interrupters don't get triggered.
But the argument Taser makes is that the frequency they use, which I can't remember off the top of my head, causes skeletal muscle contraction but doesn't cause VF. And that is probably true. But what we don't know is if all that skeletal muscle contraction does other things, like increases blood return to the heart which can cause increased stress on an already stressed (due to drugs or underlying cardiac disease or the situation, etc etc) and throw the heart into VF anyways, or releases all sorts of enzymes into the blood or what. But there's no way to know.
I'm trying to avoid an argument on whether it's right or wrong to use Tasers and in what situations. I'm just answering the OP's question on what Taser was referring to by excitation delirium and why they think their devices aren't causing death.
What usually happens is that these people are in such an agitated state that when approached by law enforcement (or a security guard, or some shopkeeper who is trying to get them out of the store, or some passerby trying to get them out of running down the middle of the road in heavy traffic) tend to get even more aggressive and attack, and don't respond to the usual methods of being subdued like pepper spray or threat of arrest or being shot or anything. It can and and often does take 4 or 5 heavily trained policemen to get these guys out of danger. What has happened in the past is that these people continue to fight even when restrained in handcuffs, and then die of a sudden cardiac event most likely due to all the excitement and inability to calm down due to whatever drugs they are on. Over the years this has been well recognized and most sensible jurisdictions have rules such as "once handcuffed do not place in prone position" due to higher chances of these people dying from positional asphyxia.
Anyways, back to the Taser thing. Taser for years and years have been saying that since these deaths can happen WITHOUT the use of a Taser, then it's reasonable to assume that their use had no bearing on whether or not the guy lived or died and he probably woulda died anyways because documented causes of people with excited delirium have and will continue to die under these circumstances. And what they are saying is true to a certain extent: If people die without it, then why would you expect its use specifically to be the sole cause of their death? This guy in this most recent case most certainly was in a crazed state and very well could have died without the use of the Taser: http://www.cbc.ca/canada/story/2007/11/24/custody-death.html. But that doesn't mean that the use of the Taser even in these cases wasn't contributory in some way. That recent Vancouver airport case had negative toxicology as far as I know, so we can't blame drugs on that guy's death, though he was clearly agitated. But it's just very difficult to prove, even with this video evidence, that the death was caused directly by the taser. It's electrical current. It doesn't leave any pathology.
Two jurisdictions in the States (Ohio and Chicago) have both attempted to certify deaths with "due to Taser" in the death certificate and both have been sued into submission. Taser has a huge lobby and has hired a number of physicists (not doctors) including this guy http://www.andcor.com/page/1/news_032206.jsp to go around the country giving lectures on how Tasers won't cause death and certifying them otherwise will land you a big fat lawsuit.
Anyways, it's a complicated issue, but in reference to your original question, excitation delirium is a state of agitation and occasionally extreme violence and paranoia usually brought on by stimulants and can commonly cause death in a mechanism not yet completely understood. Taser has been using it as an explanation for why people who have been Tasered go on to die for years. Hope that helps. The issue is extremely contentious and and very political at the moment.
OT but not really since it's about the fact that we get like 2 of these stupid Roland submissions a day. Do you notice how occasionally the link to the actual article, despite not going through Roland's page has one of those "=id_XXXX" identifiers at the end of the link? Does that mean that when we click on the link the article records that it is coming from a referral supplied from Roland, meaning that despite linking directly to the article, he is still getting credit for directing traffic that way? I'm new to this whole intarweb advertising scam nonsense, so can someone clue me in as to whether or not I'm crazy?
Yeah. Never thought I'd completely disagree, but I completely disagree. Patients get admitted to hospitals when they get sick. They don't have the choice on going to one where doctors may or may not speak their language. A heart attack happens when a heart attack happens and a patient will be sent to a hospital, where doctors will all of the sudden be forced to make minute to minute decisions based on the answers a patient gives. Where's the pain? What's the character of the pain? Does it radiate? What makes it better? We need to know these things and need to know em quick. Multilingual doctors? Say you have a hospital in an English speaking country with 200 doctors. how many do you expect to speak Tagalog/Gujarat/Bahasa/Japanese/Italian/Arabic? 1? 2? What if he's with a patient/in theatre/in consult rooms/sick? Hospitals (mine included) have translators on call for over 30 languages. When someone presents acutely, and we don't have time to get someone in, there's a hotline with translators on the other end we can use. It's an antiquated system but it works well. If this computer thingo works just as well, then yes, it's useful.
This is true. Now ask yourself why cells which undergo more frequent mitotic divisions are the ones that develop cancer more commonly: your colorectals, your prostates, your lungs (in smokers, where there's constant damage).... the more replications a cell does, the more your errors you are likely to accumulate. This includes, but is not limited to, the examples you mentioned above. Take a cell and extend its lifespan, allow the DNA damage to increase and the DNA mismatch repair to fail, and voila, instant neoplasm.
For the record, mosquitos aren't immune to Plasmodium. If I recall undergraduate biology correctly, Plasmodium shortens the life cycle of mosquitos as well, and some have in fact theorized that the way to eliminate malaria would be to create a defense mechanism in the mosquito itself, that would prevent transmission to humans.
Eyes of the Dragon isn't a bad book. Thoroughly enjoyed it. I found The Stand to be the closest tie-in to The Dark Tower, though. There are chapters in the Dark Tower series devoted to Roland and his Ka-Tet walking through the world in which The Stand takes place. I might be mistaken, but isn't Flagg sorta the main evil baddie in The Stand as well?
If you read TFA you'd have read that the original publication is due to be released in JCI, a peer reviwed journal that is quite high impact. Not Nature or Science, but not the Ulan Bator Journal of Basket Weaving Medicine either.
First: Does H. pylori eradication lead to increased incidence of Barrett's esophagitis and esophageal cancer? Maybe. The jury is still out. The Japanese have just published a pretty comprehensive review (Japanese Journal of Clinical Medicine. 63(8):1383-6, 2005 Aug)on the subject. The increase in one may be more common with the eradication of the other. Fine. Are they casually related? That's a more complex question that I think the research is sorta investigating. I dont think Scientific American really has the answer.
But that's not the major issue. Stomach ulcer is a condition that PRIOR to the triple treatment (bismuth + antibiotics + acid inhibitors) would take months to years to heal. Some anecdotal stories as long as 6 years. More. Sometimes never. Leading to serious, serious complications that have even worse prognoses. You see what I'm getting at here. Quality of life years lost are huge, affecting huge chunks of the population. Known risk of causing stomach cancer, perforation of your guts (think your guts spilling into your abdominal cavity) and iron deficiency due to chronic bleeding just for a start. Now we're saying... OK. It MAY result in reflux, eosophageal cancer and Barrett's (cells in your eosophagus changing morphology).
Hardly the "eliminating H. pylori is worse than the symptoms created by too much of it." If anything, what this might suggest is that there might be some unwanted complications to altering the internal milieu of the stomach, and they should be addressed. Full stop. Sky's not falling yet, pal.
Inflammation isn't really the CAUSE, per se. Peptic ulcer is due to a hypersecretion of stomach acid. H. pylori attacks the D cells in the stomach that normally turn off acid secretion in the parietal cells. It probably directly affects ECL cells (they release histamine, a potent mediator for the release of acid) and also directly stimulates the HCl producing parietal cells as well. The acid doesn't really cause inflammation, it erodes the mucous protective layer in the stomach, which can either perforate through into your abdominal cavity, penetrate your intestines and create a fistula, or erode your stomach wall causing bleeding. The only way you'd really get inflammation is if you get irritation of your abdominal cavity, but then it's not just an ulcer, it's peritonitis due to your ulcer. So the problem with the ulcer per se isn't the inflammation. It's the erosion of the gastric lining leading to perforation or penetration.
As for inflammation being involved in heart disease, rheumatoid and diabetes... Yes. Sorta. Heart disease slightly, depending on what heart disease you mean. Rheumatoid for sure. Type 1 diabetes is caused by an autoimmune attack on your pancreatic beta cells. Might cause a little inflammation but the attack is specific to the beta cells. (inflammation is a non-specific response to a foreign antigen) Type 2 diabetes... the kind fat people get.... not inflammatory at all. It's due to your peripheral body no longer responding to insulin (look up GLUT4 receptors if you want)
Hope that cleared things up.Didn't so much inspire it. SHH is actually the 4th or the 5th Hedgehog protein that they found. The first couple they discovered were named after real hedgehogs, and then they ran out of real ones, and picked Sonic, which ultimately ended up being the important protein. I'm not a molecular biologist anymore, so don't quote me on it. (It aint an antibody, either)