Archives: 3/2006

A fascinating article at the New York Times looks at a new theory of pregnancy as a basic conflict between organisms, an idea advocated by Dr. David Haig, an evolutionary biologist at Harvard.
Here’s a teaser:

Dr. Haig proposed that pre-eclampsia was just an extreme form of a strategy used by all fetuses. The fetuses somehow raised the blood pressure of their mothers so as to drive more blood into the relatively low-pressure placenta. Dr. Haig suggested that pre-eclampsia would be associated with some substance that fetuses injected into their mothers’ bloodstreams. Pre-eclampsia happened when fetuses injected too much of the stuff, perhaps if they were having trouble getting enough nourishment.
In the past few years, Ananth Karumanchi of Harvard Medical School and his colleagues have gathered evidence that suggests Dr. Haig was right. They have found that women with pre-eclampsia had unusually high levels of a protein called soluble fms-like tyrosine kinase 1, or sFlt1 for short.
Other labs have replicated their results. Dr. Karumanchi’s group has done additional work that indicates that this protein interferes with the mother’s ability to repair minor damage to her blood vessels. As that damage builds up, so does her blood pressure. And as Dr. Haig predicted, the protein is produced by the fetus, not the mother.

The article

The Engineer is reporting that a team of researchers from Edinburgh, Paisley and Birmingham Universities is working on a new higher frequency, and hence, higher resolution ultrasound technology.
Here’s the plan:

Existing ultra-high resolution systems are based on mechanically scanned, single-element transducers. These systems demonstrate the need for increased resolution, but at the same time limit progress because they cannot be used in real time.
The team will develop a technique to produce both ultra-high resolution and real-time images. Initially, the system will be based on single-element, mechanically- scanned transducers, but the project will move into a second phase and develop a multi-element, electronically scanned system, which will improve the uniformity of the scanning process. For this, ultrasound transducers are needed, which can operate at frequencies higher than the present maximum of 30MHz. The team propose to reach frequencies as high as 100MHz…
Ultrasound imaging is measured in millimetres and microns. Achieving 100MHZ frequencies should enable the team to reach the sub-millimetre range. McDicken [Dr. Norman McDicken from Edinburgh University -ed.] said: ‘When we look at the layers of a cavity wall we will be able to see much more detail at sub-millimetre range.
“Improved resolution helps with clarity of lines and boundary definitions. Users may be able to see boundaries they could not see before. We know these boundaries exist from looking at them histologically. If we can improve the imaging equipment we can start seeing these boundaries.”
To achieve ultra-high resolution, the team will reduce the size of piezocomposite material used in ultrasound transducers. Piezocomposites are widely used in underwater sonar and biomedical imaging, but the resolution of the images that can be obtained in medical applications is limited by the maximum frequency.
Usually, the higher the frequency the greater the attenuation. Where a high-resolution image is less important, attenuation is less of an issue. However, where an ultrahigh resolution is desirable – as it is in medical diagnostics – attenuation becomes a serious hurdle.
The maximum frequency is limited by the minimum size of piezocomposite, and the team is focusing on producing micron-scale components that have the dimensions of around 10 microns. To date, attempts to manufacture material with micron-scale dimensions have been unsuccessful. The smallest available is around 20 microns.
in the first instance the researchers will aim at halving the size of the piezocomposite dimensions. But they eventually hope to reduce the present size by a quarter, thus reaching ultra-high levels of frequency.
The three universities each have a discipline to develop. “Paisley translates Edinburgh’s clinical requirements into device design,” explained Paisley’s Prof Sandy Cochran. “Birmingham then works with Paisley to implement those designs and manufacture the piezocomposites. It is a very cohesive project,” she said.

Our guess is that if this technology makes it through, it will be only available for in vivo ultrasound: at such high frequencies, the ultrasound penetration is quite shallow. And it is a law of physics: hard to bypass that one!
More from The Engineer

rTMS Transcranial Magnetic Stimulation for Schizophrenia?Transcranial magnetic stimulation (TMS), an emerging technology that uses an alternating magnetic field to influence electrical activity of the brain through magnetic induction, is now being investigated for treatment of hallucinations in schizophrenia. From Yale School of Medicine:

“It appears that stimulating populations of neurons once per second with TMS over many minutes modestly reduces the capacity of these neurons to activate each other,” Hoffman said [Ralph Hoffman, M.D., a professor in the Department of Psychiatry and lead investigator of the study -ed.] “As a result, neural populations as a whole become less reactive or excitable. Our study findings suggest that hallucinations can be curtailed using this approach without interfering with normal brain function.”
Hoffman recently completed a study testing TMS in different areas of the brain and found that positioning the TMS over what is known as Wernicke’s region in the left temporal lobe, and a second region located on the opposite side of the brain, were optimal in reducing these hallucinations. He said these two brain areas, which ordinarily play key roles in perceiving words spoken by other persons, have also been found in other studies to be important in producing hallucinated “voices.”
For patients enrolled in the trial, TMS will be administered to these brain areas once per second for 16 minutes daily over a three-week period. One-third of the subjects in the trial will start out receiving a placebo form of TMS. After three weeks, these subjects will also be offered a trial of real TMS. The study will use a magnetic resonance imaging brain scan to precisely position TMS over desired brain regions.

To learn about the study/contact info, go here
Flashback: TMS Studied for Difficult-to-Treat Cases of Depression
Our transcranial magnetic stimulation archive

OTC

brain age sm Mind Games for Baby Boomers, SeniorsThe Associated Press is reporting that a new Nintendo based game is designed for older consumers, by engaging them in “a daily regimen of number games, word puzzles and reading exercises designed. It also lets players test their intelligence levels through IQ-type quizzes. It saves the results so progress can be tracked or compared with others.” Apparently, the game is extremely popular in Japan, where even some hospitals have started to introduce Nintendo DS units in waiting rooms and patient floors. Now the game is showing up in North America.
From the official website of Nintendo:

After decades of exercising players’ thumbs, Nintendo is now moving to their minds. Brain Age: Train Your Brain in Minutes a Day for Nintendo DS will help players flex their mental muscles. Brain Age represents the first in a series of U.S. brain-training titles that already have taken Japan by storm…
Three separate titles in the brain-training series are currently a huge craze in Japan. Each of them has achieved sales of more than 1 million units, with the most recent title hitting that milestone in less than a month. The craze has been fueled largely by older players, many of whom had never played a video game system before.
Brain Age (known as Brain Training in Japan) was inspired by the work of Professor Ryuta Kawashima, a prominent Japanese neuroscientist. His studies evaluated the effect of performing reading and mathematic exercises to help stimulate the brain.
“Young or old, everyone looks for ways to get a mental edge,” says Reggie Fils-Aime, Nintendo of America’s executive vice president of sales & marketing. “Our brain-training series, led by Brain Age, builds on the popularity of word and number puzzles and acts as a treadmill for the mind.”
Brain Age presents players with a series of fun mental brain-training challenges that incorporate word memorization, counting and reading. It even includes sudoku number puzzles, which have become extremely popular features in newspapers around the country. The distinctive touch screen of Nintendo DS lets users write their responses, just as though they were using a PDA. Players even turn the Nintendo DS sideways to make it feel more familiar, like a book. The more often users challenge themselves, the better they become at the tasks and the lower their estimated DS “brain age.”

More
The original Japanese version pages
(hat tip: Membrana.ru)

OTC

pro img01 WOW PENWOW-PEN, aka real pen type optical mouse, promises to eliminate carpal tunnel syndrome and repeated stress injuries that are often experienced courtesy of regular mouse abuse.
From product’s page, in broken English:

Whenever we use the desktop mouse, we always feel big fatigue and pain on neck, shoulder and arm due to teisted arm and ankle muscles, carpal tunnel syndrome, and RSI(Repeated Stress Injuries)especially using it for a long time.
When user uses Wow-Pen, he grips it with fingers, not with the whole hand and arm. That’s why the user doesn’t have his aem and ankle teisted and folded to last his working even for a long time.
pen02 sm WOW PENWow-pen user always carry and use it anytime & anywhere due to the compact size and light weight.
- Very easy to carry it with notebook.
- To be useful on various narrow spaces.
- Convenlently portable anyplace due to the compact size and light weight
Wow-pen makes you enjoy real hand-written, noting and painting on various softwares.
- It can make notes directly on web page.
- The hand-written, graphic and picture can be transmitteed via e-mail directly.
- AVI(Audio Vidio Interleaving) recording & saving.

Hopefully the device works better than their English.
Here’s what we want to know. Would you recommend it to us: abusers of the horizontal mouse and sufferers of repeated stress injuries? Please let us know!
Product page
(hat tip: Gizmodo)

If you are in the potentially lucrative market of patient bed design/manufacture, you better listen to the FDA, which issued new guidance to reduce patient entrapment:
13476w7 FDA Issues Tips for Safer Beds

Key body parts at risk of entrapment are:
- Head
- Neck
- Chest
Potential zones of entrapment in a hospital bed system are:
Zone 1 : Within the rail
Zone 2 : Under the rail, between the rail supports or next to a single rail support
Zone 3 : Between the rail and the mattress
Zone 4 : Between the rail, at the ends of the rail
Zone 5 : Between split bed rails
Zone 6 : Between the end of the rail and the side edge of the head or foot board
Zone 7 : Between the head or foot board and the mattress end

Medgadget.com would like to thank all of its US readers for contributing their tax dollars towards the brilliant FDA release titled “Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment.”
(hat tip: KidneyNotes)

mammo sm Computer Aided Detection (CAD) Mammography by iCADSiemens Medical Solutions has announced that it will offer Computer-Aided Detection (CAD) mammography system as an option for use with its MAMMOMAT® NovationDR full-field digital mammography system. The TotalLook system, manufactured by Nashua, NH based company iCAD, Inc., assists radiologists in comparing breast images year-to-year to detect even subtlest changes that may be indicative of breast cancer.
Company describes some of the options, available on its POWERLook™ machine:
mammo1 sm Computer Aided Detection (CAD) Mammography by iCAD

Magnify
More than just a regional zoom. Magnify any area on the view by moving the area of interest box over the section, a high resolution view of the section will appear in the box to the right at your choice of 2X, 4X or 8X centered anywhere on the mammogram. Then power the section box around the view to see anywhere you want to take a closer look. Information about the area of interest is shown in text below the magnified view such as size of area and number of calcifications.
Window / Level
Window and level each image to see more detail at various levels of gray. The two monitors to the right show the area of interest at the normal window and level and at a darker one on the right. Window and Level can be achieved by three different methods: dynamically, via custom presets or automatically. To dynamically change W/L, move the mouse while holding the right mouse button down and roll up and down for window and left and right to change level. Four custom levels can be set for each of the buttons at the bottom left on the screen. Touch a button and the window and level automatically updates to the new value. Or Autorange with the Dmin/Dmax button. POWERLook automatically ranges the view between the brightest and darkest area shown. No need to glide through W/L changes.

mammo combo sm Computer Aided Detection (CAD) Mammography by iCAD

Rules / Grids
Simply click once on the full-size view to see ruler tic marks or click twice to see grid marks. Actual metric sizes are shown in reference to the view and the magnified area of interest. And best of all the rules automatically track with the magnification so that you can track actual size even when under a tight magnification.
Flip
Flip allows you to flip the one view that was upside down right side up without having to redo the case.
Invert
Invert the grayscale and see the information from another perspective, it may be just the view that you need to pick up a subtle detail

More from the company…

mdcalc MDCalc, The Clinical Calculator
Launched by a medical student (who blogs over at Grahamazon.com), this new medical calculator has tons of useful features. From the blog-press release:

I got tired of wading through Google searches to find a calculator for all those medical calculations that you often have to use, but don’t use often enough to remember: the A-a O2 Gradient, the Calcium Correction in Hypoalbuminemia, the FENa, the MDRD. And countless others. (Easy ones, too, including the BMI and a patient age calculator.) I’m going for the Guinness Book of World Records, Most Medical Equations on One Website.
I’ve also included a number of scores and risk calculations, including the Framingham Cardiak Risk, the PORT Score/Community-Acquired Pneumonia Severity Scale, Ranson’s Criteria for Pancreatitis and the Strep Pharyngitis Probability Score. Not to mention the TIMI Scores.
You can even download the equations to your PDA.

This one is going to our blogroll!
MDCalc

lincoln The Presidents and Their Infirmities
Ah, the American President — the most powerful person in the world. Love ‘em or hate ‘em, we can’t get enough of our presidents. And when they show themselves to be like us — flawed and beset and occasionally quite ill — well, that just makes them more irresistable.
So we got a kick out of Health In Plain English’s Presidential Disease site.
We’ve already blogged about Eisenhower’s heart attack, but there’s a lot to be said about a quick, easy-access compendium of all presidents. Why ones got shot? Depressed? Who was an alcoholic? It’s all there, on one page.
And, just as diseases tell us a lot about a person and their era (epiglottitis killed Washington!), we think the HIPE Presidential site says a lot about them.
For instance, their take on Jimmy Carter suggests they might be Republicans.
carter The Presidents and Their Infirmities
That’s all for this week, thanks for stopping by and remember to visit on Monday for more medgadgets!