The important discovery here is not that the spleen has monocytes in it, because you do in fact see a ton of them when you look at splenic tissue under the microscope. The interesting thing about this discovery is that the spleen can (evidently) release a bunch of those cells in response to an injury. The bone marrow does this too, but the WBCs it releases are immature, and we know that there are changes in the way WBCs function as they age. It would appear that "spleen" WBCs are optimized for their tissue repair properties, while "bone marrow" WBCs are better for fighting infection.
It will be interesting to see if this holds true in humans. Lots of animals have spleens that seem more functional than ours. Cats and dogs, for example, can "transfuse" themselves with the blood from their spleen in response to bleeding, but this does not hold true for humans.
The technique is interesting. The normal body reaction to a new antigen is to form antibodies, which bind to and mark the antigen for destruction (in this case, transplanted pancreatic islet cells, which would cure diabetes). Currently in transplant medicine, that response is dampened by large doses of steroids at the time of transplant, followed by lifelong immunosuppression.
The authors hypothesized that all of those circulating antibody-antigen complexes might shut down further antibody production for a short period of time, as a normal protective mechanism (too many complexes are known to be toxic to lung and kidney). They induced this condition and then performed the transplant. Eighty percent graft survival with no further immunosuppression is pretty remarkable, especially since they demonstrate that the host immune response seems to return to normal quite quickly.
As you say, a bunch of ifs, but this technique as described is readily reproducible in any medical school immunology lab.
There is a common belief that embryonic stem cells, because they have the potential to differentiate into any cell line instead of just one or two, are somehow "better" than the other myriad types of cells. This ignores the fact that it's much harder to stop ESCs from continuing to differentiate, which is why you get tumors at an alarming rate.
This is in turn rooted in another common incorrect notion, namely that stem cells repair injury by differentiating into new cells and tissue. The first decade of research in this field has largely disproved this notion. Instead, stem cells seem to alter the host response to injury, such that normal repair mechanisms function much more effectively. Stem cells tend to get stuck in the lungs when given intravenously, but still result in improved repair at remote sites; conversely, after direct injection of cells into a site of injury, most of those cells are someplace else in the body after 24 hours.
This is why the Geron trial is limited to spinal cord injuries that are less than two weeks old. Once scar formation has occurred, this therapeutic target is gone, and there is currently no notion of how to truly "reconstruct" a spinal cord in a long-standing paraplegic patient.
Not sure which number you consider bogus, but if it's the reference for the >100,000 dead Iraqis, you want, look no further than the New England Journal of Medicine, January 31, 2008 issue, pages 484-493. The article is entitled "Violence-Related Mortality in Iraq from 2002-2006".
This is the first war that has had a careful statistical study of civilian deaths. Since the entire world knew this war was going to happen well in advance, the WHO sent researchers to perform what's called cluster analysis- they identified 10,000 households and then visited them repeatedly over the next three years to determine actual mortality. They then extrapolated to the population of the country as a whole.
There is no captioning provided, although copies of the translation are distributed the day before commencement. The student radio station broadcasts the English translation in real time. For most of the attendees it's a weird, archaic diversion.
While there is a typical foreign language requirement, Latin is not required. Even the degree certificates are now in English.
What haven't been available for decades are things like CT/PET and functional MRI. These techniques allow one to map increases in metabolic activity to specific regions of the brain in response to stimuli. Eventually advertisers might be able to choose visual patterns which excite both emotions (limbic region) and memory (prefrontal cortex).
Let's say Madison Avenue discovers a combination of embedded images which increase favorable memory retention in five percent of subjects, but induce seizures in 1 out of 10,000 people. My opinion is that a large portion of advertisers would ask, "What's the down side?"
Your Stanford geneticist recommended a Stanford surgeon because they work for the same company. It was a business decision, period, and it has become the norm in American medicine. You might remember that when Sen. Clinton comes asking for your vote.
Academic medical centers are good for uncommon problems because researchers can establish expertise over long periods of time. Stanford, however, "suffers" from being in Palo Alto-- the debt load after finishing training makes most people move elsewhere to establish their careers. Some stick around and handle the clinical load for a year or two while adding the Stanford handle to their CV. No knock on Stanford, since members of my own family get medical care there, but they've had to look elsewhere for their own off-the-bell-curve medical issues.
After so long it must have been a major decision for you to seek this consultation in the first place; please don't let this discouraging experience stop you from at least talking to someone who can give you sound advice.
Tom DeLay was the rep for TX-22 (Sugar Land). Tom DeLay is currently under indictment in Travis County, Texas. He stayed on the ballot to win the primary, then transferred his residence to Virginia and quit Congress, thinking that the Texas Republican party would pick his replacement for the general election.
That person is Shelley Sekula-Gibbs. Unfortunately for this excellent plan, TX Supreme Court said that DeLay's name has to stay on the ballot, since he won the primary. So Republican voters have to write her name in on a track-ball voting machine. With no hyphen.
I agree with you, and it makes me wonder why the Administration admitted anything at all. It's clear from the long string of precedents cited in the judge's opinion that absent such an admission, the State Secrets privilege would have ended this lawsuit.
Is this some sort of weird exit strategy? "If we were guilty of anything we wouldn't be dumb enough to admit it in the press?"
The judge's opinion, incidentally, brought tears to my eyes. It is definitely worth the read.
Surgical instruments are kept in prepackaged sets for anticipated needs. A "major abdominal" set has different instruments than a "major vascular" set or a "GYN" set. The situation arises in emergencies, however, where you need an instrument from another set than the one initially opened, and if the surgeon has achieved that sublime state known as "audible bleeding", sure as hell no one stops to count out the set. Repeat enough times and it happens, and it's a big deal when it does.
It's pretty easy to make sure the sponge, needle, and instrument "counts are correct" during routine, elective surgery, and that ritual phrase is spoken to me by every circulating nurse I work with to let me know that it's okay to close. I don't see anything wrong with this invention, except that everything allowed on the field is already radioopaque (that's why surgical sponges have that blue thread sewn in, or the blue tag hanging off). If there's any question at all, you get an x-ray.
As a physician, but not a neurosurgeon, I had to do a quick Pubmed search to refresh some things I haven't thought about since med school. Most environment-related brain tumors come from organic chemical exposure (pesticides, benzene, vinyl chloride, etc) or exposure to other known bad actors like asbestos. TFA says that the building used to be an old theater, so there's no telling what might be in there; the clustering of cases on the top floor might imply a lighter-than-air causative agent.
The fact is, the human brain is surprisingly tolerant of radiation exposure. Radiation oncologists take advantage of this characteristic to treat cancers that have metastasized to the brain. Whole-brain external beam radiation therapy uses ionizing radiation, many orders of magnitude more energetic than any cell phone tower, but the occurrence of de novo brain tumors after brain XRT is actually pretty rare.
A good idea that has actually been looked at repeatedly in large studies, even though in the USA "blood" is transfused as one of its constituent parts (red cells, plasma, or platelets).
Transfused blood turns out to suppress, not enhance, the human immune system. This effect has actually been shown statistically to increase mortality in colon cancer (by increased tumor recurrence) and after major traumatic injury (by increasing rates of pneumonia and other infections). The increase in mortality after trauma is the ethical basis for the controversial, nearly-complete blood substitute trial recently in the news.
It's called the "harmonic" scalpel. It uses ultrasonic frequency mechanical energy to denature the hydrogen bonds that hold proteins together, while generating enough heat to seal blood vessels. You can seal medium-sized arteries with one of these (unlike electrocautery). They're very cool and now quite common, but 5-10x more expensive than electrocautery.
Whilst I agree that drug companies (like all companies) are money-driven, the reasons for the lengthy acceptance time for this particular discovery are complex and rooted in the medicine:
1) H. pylori is very common in the general population (not just people with ulcers). If it's a causative agent, why do comparatively few people with H. pylori get ulcers?
2) The inflammation that makes un ulcer hurt also destroys H. pylori. Ergo, no bacteria in the ulcer under a microscope, and no bacteria on cultures.
The drugs you mention were so successful because they, along with the work recognized by the Nobel committee, have largely eliminated the need for ulcer surgery, which used to be among the most common operations performed. In retrospect it seems obvious to look for an infectious etiology, but that's why they've been awarded the prize, I guess.
Actually, M-16s are designed to shoot whatever ammunition you load into them. "Dum-dum" (fragmenting) bullets are designed to maim, and are outlawed. Full metal jacket bullets create an incapacitating wound which may kill you, but (with modern medical care) is unlikely to result in loss of a limb.
Most amputations in the current conflict are the result of blast injury.
First, red blood cells, which carry oxygen, have nothing to do with hemostasis (the cessation of bleeding). That job is done by platelets and clotting factors, which act synergistically with fibrin to form a "plug" which stops blood flow.
Platelets are activated by exposure to injured tissue. In massive bleeding, the plug gets washed out before it can fully form. Chitosan biochemically activates platelets all along its surface (by binding to the gp2b/IIIa receptor, if you care). Also, chitosan becomes extremely sticky when mixed with blood. Another poster mentioned that these bandages must be difficult to get off. This is actually true, particularly with the powdered variant that hardens into a concrete-like mass that has to be surgically removed from the wound bed. The reaction is also exothermic, which leads to the occasional burn.
You are correct that charge has little to do with it. There are many important interactions at the cell surface, however, that are dominated by charge; the cellular environment is in aqueous solution, not a solid, and so is the bandage once it gets bled on.
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It will be interesting to see if this holds true in humans. Lots of animals have spleens that seem more functional than ours. Cats and dogs, for example, can "transfuse" themselves with the blood from their spleen in response to bleeding, but this does not hold true for humans.
The authors hypothesized that all of those circulating antibody-antigen complexes might shut down further antibody production for a short period of time, as a normal protective mechanism (too many complexes are known to be toxic to lung and kidney). They induced this condition and then performed the transplant. Eighty percent graft survival with no further immunosuppression is pretty remarkable, especially since they demonstrate that the host immune response seems to return to normal quite quickly.
As you say, a bunch of ifs, but this technique as described is readily reproducible in any medical school immunology lab.
I don't mind the bubble so much. If I close my eyes it goes away!
There is a common belief that embryonic stem cells, because they have the potential to differentiate into any cell line instead of just one or two, are somehow "better" than the other myriad types of cells. This ignores the fact that it's much harder to stop ESCs from continuing to differentiate, which is why you get tumors at an alarming rate.
This is in turn rooted in another common incorrect notion, namely that stem cells repair injury by differentiating into new cells and tissue. The first decade of research in this field has largely disproved this notion. Instead, stem cells seem to alter the host response to injury, such that normal repair mechanisms function much more effectively. Stem cells tend to get stuck in the lungs when given intravenously, but still result in improved repair at remote sites; conversely, after direct injection of cells into a site of injury, most of those cells are someplace else in the body after 24 hours.
This is why the Geron trial is limited to spinal cord injuries that are less than two weeks old. Once scar formation has occurred, this therapeutic target is gone, and there is currently no notion of how to truly "reconstruct" a spinal cord in a long-standing paraplegic patient.
This is the first war that has had a careful statistical study of civilian deaths. Since the entire world knew this war was going to happen well in advance, the WHO sent researchers to perform what's called cluster analysis- they identified 10,000 households and then visited them repeatedly over the next three years to determine actual mortality. They then extrapolated to the population of the country as a whole.
Result: 151,000 excess violent deaths (95% CI, 104000-233000).
This is a heat engine with gaseous hydrogen as the working fluid? What part of the "membrane-electrode assemblies" is different from this?
At least you can't say he's hiding.
Fine. As long as he's not singing. Ick.
While there is a typical foreign language requirement, Latin is not required. Even the degree certificates are now in English.
Your population goes to 11.
Not in Windows cause you would have to reboot after each one
Let's say Madison Avenue discovers a combination of embedded images which increase favorable memory retention in five percent of subjects, but induce seizures in 1 out of 10,000 people. My opinion is that a large portion of advertisers would ask, "What's the down side?"
Academic medical centers are good for uncommon problems because researchers can establish expertise over long periods of time. Stanford, however, "suffers" from being in Palo Alto-- the debt load after finishing training makes most people move elsewhere to establish their careers. Some stick around and handle the clinical load for a year or two while adding the Stanford handle to their CV. No knock on Stanford, since members of my own family get medical care there, but they've had to look elsewhere for their own off-the-bell-curve medical issues.
After so long it must have been a major decision for you to seek this consultation in the first place; please don't let this discouraging experience stop you from at least talking to someone who can give you sound advice.
That person is Shelley Sekula-Gibbs. Unfortunately for this excellent plan, TX Supreme Court said that DeLay's name has to stay on the ballot, since he won the primary. So Republican voters have to write her name in on a track-ball voting machine. With no hyphen.
Is this some sort of weird exit strategy? "If we were guilty of anything we wouldn't be dumb enough to admit it in the press?"
The judge's opinion, incidentally, brought tears to my eyes. It is definitely worth the read.
Surgical instruments are kept in prepackaged sets for anticipated needs. A "major abdominal" set has different instruments than a "major vascular" set or a "GYN" set. The situation arises in emergencies, however, where you need an instrument from another set than the one initially opened, and if the surgeon has achieved that sublime state known as "audible bleeding", sure as hell no one stops to count out the set. Repeat enough times and it happens, and it's a big deal when it does.
It's pretty easy to make sure the sponge, needle, and instrument "counts are correct" during routine, elective surgery, and that ritual phrase is spoken to me by every circulating nurse I work with to let me know that it's okay to close. I don't see anything wrong with this invention, except that everything allowed on the field is already radioopaque (that's why surgical sponges have that blue thread sewn in, or the blue tag hanging off). If there's any question at all, you get an x-ray.
The fact is, the human brain is surprisingly tolerant of radiation exposure. Radiation oncologists take advantage of this characteristic to treat cancers that have metastasized to the brain. Whole-brain external beam radiation therapy uses ionizing radiation, many orders of magnitude more energetic than any cell phone tower, but the occurrence of de novo brain tumors after brain XRT is actually pretty rare.
6
Transfused blood turns out to suppress, not enhance, the human immune system. This effect has actually been shown statistically to increase mortality in colon cancer (by increased tumor recurrence) and after major traumatic injury (by increasing rates of pneumonia and other infections). The increase in mortality after trauma is the ethical basis for the controversial, nearly-complete blood substitute trial recently in the news.
6
I'd feel better if it weren't Friday night.
1) H. pylori is very common in the general population (not just people with ulcers). If it's a causative agent, why do comparatively few people with H. pylori get ulcers?
2) The inflammation that makes un ulcer hurt also destroys H. pylori. Ergo, no bacteria in the ulcer under a microscope, and no bacteria on cultures.
The drugs you mention were so successful because they, along with the work recognized by the Nobel committee, have largely eliminated the need for ulcer surgery, which used to be among the most common operations performed. In retrospect it seems obvious to look for an infectious etiology, but that's why they've been awarded the prize, I guess.
Actually, M-16s are designed to shoot whatever ammunition you load into them. "Dum-dum" (fragmenting) bullets are designed to maim, and are outlawed. Full metal jacket bullets create an incapacitating wound which may kill you, but (with modern medical care) is unlikely to result in loss of a limb.
Most amputations in the current conflict are the result of blast injury.
Platelets are activated by exposure to injured tissue. In massive bleeding, the plug gets washed out before it can fully form. Chitosan biochemically activates platelets all along its surface (by binding to the gp2b/IIIa receptor, if you care). Also, chitosan becomes extremely sticky when mixed with blood. Another poster mentioned that these bandages must be difficult to get off. This is actually true, particularly with the powdered variant that hardens into a concrete-like mass that has to be surgically removed from the wound bed. The reaction is also exothermic, which leads to the occasional burn.
You are correct that charge has little to do with it. There are many important interactions at the cell surface, however, that are dominated by charge; the cellular environment is in aqueous solution, not a solid, and so is the bandage once it gets bled on.