Scientific Advances for 2008 That Will Affect the Practice of Medicine in the Near Future

Transcription

1 Scientific Advances for 2008 That Will Affect the Practice of Medicine in the Near Future Richard E. Ya Deau MD John Donoghue Cyberkinetics or Brain- Machine interfaces. Implants a 4mm amplifier in the brain in order to direct a robotic arm directly. Quadriplegics would have some level of independence. Cell Phones magazine.com/ storydetail.cfm?id=370 Miguel Nicolelis Implanted electrodes in two monkeys brains, connected them to a robot. The monkeys themselves found they could move the robotic arm without the joy-stick to which they had been trained. news/article.php?id=7100

2 Deciphering the electrical signals from the brain to command robotic hand movement. Liam Paninski Columbia University neurotheory.columbia.edu/liam.html Liam s work is an initial step towards direct downloading of memory from the brain to computers, and in turn uploading from the computer to the brain. Liam Paninski Columbia University neurotheory.columbia.edu/liam.html USA 1/10/2008

3 Japan Sepsis With many short and long term implantable devices, as well as infusion lines, in our therapeutic quiver, infection continues to be a significant concern. Sepsis Christopher Loose has developed a coating of antimicrobial peptides that puncture bacteria like balloons. This coating (SteriCoat) does not release from the implanted surface but remains active on the surface of the device. MIT TR10 Award, Hertz Foundation Capital Award

4 Infections Drug resistant bacteria thrive in biofilm communities. Viral agents have been engineered that are active against both the bacteria and the carbohydrates in the biofilm. These viruses have been genetically modified to maximize their effectiveness against selective bacterium. James Collins, Boston University, Proceedings of the National Academy of Sciences, Jul Infections Pathogens have shown a remarkable ability to transform themselves, when assailed by antibiotics, into drug resistant organisms. This is enabled by a gene LexA for which a molecular OFF Switch has been engineered. Floyd Romesberg, Scripps Research Institute. Genetics Utilizing synthetically manufactured DNA to bioengineer bacteria, Amyris is inexpensively producing the chemical precursors of the drug Artemisinin for use by the Gates Foundation to eradicate malaria in third world countries. This creates a model for other drugs as well as biofuels. Neil Renninger, Amyris Biotechnologies

5 Cancer Lili Yang is reprogramming the patient s immune system to recognize and kill malignant cells. Initial therapeutic trials: within 6 months for malignant melanoma. Current research is focused on extending this to AIDS therapy. Lili Yang, Project Manager CalTech s Engineering Immunity Program Cancer Mobilizing the endogenous immune response to selectively destroy cancer cells has been successfully mediated by the patient s own immune reaction using tumor markers. Coby Carlson PhD University of Wisconsin, Madison Cancer As early as 1930 biologist John Bittner speculated that breast cancer in mice was viral based. Today we still have little understanding of the cause of those non-genetically determined breast cancers. Some postulate cancer is related to the Mouse Mammary Tumor Virus or MMTV.

6 Cancer Sequences of this MMTV virus, as well as viral remnants, have been found in human breast tissue. Of interest, in mice this MMTV virus can be permanently integrated into the mouse genome and passed down generationally. Cancer In July of 2007 the Federal Government awarded a grant to Dr. Stephen Johnson to direct a collaborative project between the Mayo Clinic and Arizona State University to identify of the unique protein fragments of breast cancer. Using these fragments to create a vaccine, they will try to trigger an immune response against breast cancer. Cancer This is our first attempt to create a vaccine that prevents breast cancer. They are working toward a vaccine and first human trials within 3 years.

7 Analgesia A new class of pain-arresting drugs has been developed; they are activated by a patient s tissue ph. There is no effect on normal tissue, at normal ph, but they provide significant pain relief at a site of injury where the ph drops significantly. A drop in ph from 7.4 to 6.9 increases the potency of the pain medicine 62 fold. Ray Dingledine Emory University School of Medicine Proceedings Biotechnology Industry Organization, May 2007 Robots NeuroArm is an MRI compatible robot designed to work within the brain as the neurosurgeon works from a console. Depth perception combines a stereoscopic viewer and MRI views to enable extraordinarily fine and anatomically specific surgical intervention. Dr. Garnette Sutherland, University of Calgary Robots The HeartLander is a miniature mobile robot that facilitates minimally invasive, beating-heart, intrapericardial therapies. The robot enters the chest through an incision below the sternum, adheres to the epicardial surface of the heart, and can be navigated to any location on the epicardium.

8 Avatars Avatars in medicine: ASME (Anatomic and Symbolic Mapping Engine) IBM introduced a 3-D representation of the body allowing physicians to visualize medical records in an entirely new manner. Imagine Google Earth for the human body! September 26, 2007, Avatars Perhaps one will reside as your Avatar in Second Life ,496 more

9 Avatars Designed to navigate a computerized medical records system, the Avatar will find every piece of evidence in the record for a given organ system. Sources can include texts, lab results, medical images like MRIs and any other digitalized material. September 26, 2007, Avatars They integrate and rationalize heterogeneous data sources from otherwise unstructured data in various databases. All relevant data around a single problem, from anywhere in the system, is summarized and presented as a whole. September 26, 2007, Obesity (an animal model study) In mice a GIP (gastric inhibiter polypeptide) blockade using a daily injection of a GIP antagonist (Pro3)GIP: reverses established type 2 Diabetes. reversed insulin resistance lowered cholesterol and triglyceride levels Human Hormone Blocker to help prevent diabetes The American Physiological Society, JANUARY

10 Gee-Wiz Obesity may be endemic as well as epidemic. Gee-Wiz Adenovirus-36 and a similar virus AMAM-1 make animals gain weight. 30% of obese people, but less than 10% of non-obese, have antibodies against these viruses. Exposure of human adult stem cells to these viruses creates very fat cells. Nikhil Dhurandhar & Magdalene Pasarica, Louisiana State University, Baton Rouge International Journal of Obesity Vol 31, p87, August 2007 Gee-Wiz Natural Orifice Transluminal Endosurgery (NOTES) 3 surgical teams have used this approach. Ohio State surgeons have trans-gastrically explored 10 people for possible pancreatic cancer. In New York and France women have had trans-vaginal cholecystectomy!

11 Gee-Wiz The Hype: Pain-free, convalescencefree, scar-free surgery. C Rolanda Gastrointestinal Endoscopy, Your Turn What medical advance do you think is, or ought to be, imminent from your readings, insights or thoughtful speculation?