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Tag Archives: medicine

199. Fighting Tuberculosis and Embarassment

Listening to a patient for tuberculosis

Near the dawn of the 19th century medicine advanced inwards. Doctors began once more to diagnose problems with the heart and lungs by placing their ears against the bodies of patients and listening intently. This practice had been used since the time of the Greeks but recent advances had returned to frequent usage. This new body of science was in its infancy and doctors had great trouble listening to internal problems and keeping abreast of developments in the understanding of the human interior. Then it was improved by chance and embarrassment.

The Doctor René Theophile-Hyacinthe Laënnec was busy at work in the nineteenth century, doing nineteenth century things when he was presented with a chest problems. It was a young and rather plump lady, who was followed by her family. They lined the room as the young lady told of her suffering. For a decent diagnosis, he needed to listen to her lungs.

Under the watchful gaze of the family and the pressure of nineteenth century sensibilities he felt suddenly aware of how uncomfortably close he would have to place his head to her bosom, so he improvised. He grabbed a nearby piece of paper and rolled it up into a tube and placing the paper purposefully on her skin. To his shock when he listened, the sounds were much clearer. The lazy lungs breathing and the nervous heart beating.

That day, in 1816, the stethoscope was invented. Over time they became less papery and more trumpet-like. So it was until 1851 when a binaural stethoscope, one allowing the use of both ears, was introduced. Designs similar to the ones still used today, or so I hear.

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Posted by on January 30, 2012 in Articles

 

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181. Life Without A Pulse

It is commonly held notion that without a pulse, one cannot survive. In fact before the advent of open-heart surgery a lack of a pulse was, medically speaking, death. The definition has changed of course. Now in fact, it seems that a pulse is not required.

Dr Billy Cohn and Bud Frazier at the Texas Heart Institute believed that trying to copy the heart was a waste of resources, instead they have used an existing device, a VAD which provides blood flow via the means of rotating blades and doubled it. Leaving a final contraption that they believe can fully replace the heart. “What we’ve kind of done is taken two motorcycles, strapped them together, and called it a car,” said Cohn. VADs or vascular assist devices have been around since 1994 and constantly been getting smaller and more efficient, making them the ideal technology to make a heart out of.

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141. Soviet Self Surgery

In a frontier Soviet Antarctic base, 1961 there was an incident, one Leonid Rogozov became ill with acute appendicitis, he needed an operation. Unfortunately the 12 men at the base were as remote as was possible at the time, and Leonid Rogozov was the only Physician. So to stay alive, he performed the operation on himself.

From March 1961 the polar winter had cut the base off completely from the outside world, in April Leonid Rogozov developed those symptoms. He knew what it was and tried to cope with it. The pain soon became unmanageable. There was the option of flying out, but then Antarctic blizzards quickly struck off that option. The pain was too much, he described it in his journal as :

A snowstorm whipping through my soul, wailing like a hundred jackals.

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Posted by on June 10, 2011 in Articles, Trivia

 

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97. The Immortal Henrietta Lacks

The Immortal Henrietta Lacks

In life Henrietta was a not particularly special person, she lived a fairly full and standard life as an African American woman in the 20th Century. Then in 1951 she was diagnosed with and died of, cervical cancer at the age of 31. Then came her claim to fame.

In her case, as in almost all cases of cancer there were tumours formed, and without any kind of knowledge or consent given by her, cells from these tumours was taken from her dead body and sent to a lab. This illicit taking of samples was an unfortunately common practice in the 20th Century, but in this case it was very fortunate, or at least interesting. The cells performed a task that the researcher tasked with them, George Gey, had never seen before. They stayed alive.

In fact they could be kept alive and grow, not dependent on a human body to provide their sustenance. They were grown and formed into more cells and they were still alive. It was a breakthrough, these cells were ‘immortal’ – this ability to produce unlimited amounts of itself meant that many tests and  experiments could be performed on the same genetic material. So they got growing; starting from the sample of cells they established the ‘immortal line’ of cells that came off of it, name ‘HeLa’ to protect the identity of Henrietta.

Now there is now almost no biomedical research clinic in the world that doesn’t contain something of Henrietta Lacks. You see, once the immortal cell line became available the demand was huge. The cells represented the opportunity for constant access to human cell cultures that had no defects. The demand was met and Henrietta Lacks has done much since her death.

The first thing was fighting polio, her cells were the testing ground for the effectiveness of the polio vaccine. From that start point she has been used to study cancer, AIDS and the effects of radiation on the human body amongst other things.

HeLa cells are involved in over 11,000 patents and she is heavier in death than in life. Estimates suggest that well over 20 tons of Henrietta Lacks have been grown in labs, a considerable amount more than her living weight.

There are additionally, problems. Thanks to her cells being ‘immortal’ they are quite good at surviving and reproducing, so good in fact that they are a pain to control and contain. So widespread are they that they now contaminate hundreds of experiments; in all actual fact her cells are contaminating as much as 20 percent of other, alternate cell lines. The effects of such widespread contamination?

Unknown. Long live Henrietta Lacks, now lacking in life, but not in substance.

 
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Posted by on April 27, 2011 in Articles, Trivia

 

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73. The Crab and the Vampire

Horseshoe Crabs, odd little creatures indeed. They wander around in shallow ocean waters, surrounded by clouds of dirt and silt. It has been around for over 250 million years. Now it has something new to worry about… vampires.

The Horseshoe Crab has blue blood; and we want it. We are their vampires.

So why? What on earth has possessed us to make us want to harvest the precious blue blood of this harmless relic from many years past. The simple answer is to sustain us. Simply, their blue blood is a bona fide medical marvel.

In 1971 some scientists decided to introduce E. coli bacteria to some of the blood. The blood reacted, it clotted and stuck around the bacteria, preventing further spread. This was great news for the scientists, it showed a reaction to endotoxins produce by many types of bacteria that can cause humans to get fevers or haemorrhagic strokes.

Filled with delicious blood!

The simple clotting mechanism was very useful indeed. For the crabs it is their whole immune system, living in an environment where there can be billions of bacteria per millilitre they hang under the constant threat of infection, and the clotting mechanism is their way of fighting it. The secret is a compound in the blood called LAL (Limulus Amebocyte Lysate) which performs all of the clotting action, neutralising threats from fungi, viruses and bacterial endotoxins.

That is good for the crab and good for us. The clotting happens in under an hour and Horseshoe crabs were plentiful, as well as easy to catch. The Biomedical industry saw its opportunity and once the FDA approved the blood clotting test the blood frenzy began. These days the crab-blood test is the worldwide standard screening for bacterial contamination. A worldwide standard requires resources.

A $50,000,000 industry sprung up, harvesting the crabs along American coasts and selling them. How many? 250,000 crabs a year. Each of which are carted off to LAL laboratories wherein they are washed and examined for any signs of ill health or wounds, we are conscientious vampires after all. If they pass muster we then get about the blood business, draining each crab of up to one third of their blood with a large gauge needle. The blood is then carefully bottled and sent around the world at a handsome profit. One quart (just under a litre) of the blood fetches $15,000, such is our desire for it.

Now, we are not vampires in reality. We don’t really want the blood, just the LAL inside it, and unfortunately the only way to get that compound is to get that precious blood. You see, we need it for just about everything medical. For any drug to be approved, it has to pass trial by blue blood. Any surgical implant such as a pacemaker or prosthetic limb, trial by blue blood and so on. There is a demand and it puts strain on the species.

After harvesting the crabs are placed back in the ocean and take several months to recuperate and build up their blood levels, unfortunately they can go through it all again. The excessive trawling means that it is possible for crabs to be harvested up to four times a ear, an amount that can certainly result in some sick crabs.

The practice of draining their blood is not so safe either, recent surveys suggest that between 20,000 and 38,000 crabs die after bleeding. That’s a death rate of 10 – 15%. Populations then dropped in size and now we are finally taking steps to protect these creatures. Regulations have been put into place so as to prevent over-harvesting. These are all steps in the right direction, however an alternative may be needed. Scientists are working hard to try and produce LAL on its own in the lab, or at least find another source. Until then, humanity shall be medicinal vampires.

Think on that for moment the next time you have any pill or medicine. Think ‘I am a crab vampire’. Even if it makes no sense, at least it’s an interesting thought.

Further reading : detailed article

 
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Posted by on April 3, 2011 in Articles, Trivia

 

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