Archives: 11/2008

Medgadget Exclusive

2008 Medical Sci-Fi Contest: Please Meet the Stories!

by Gene Ostrovsky on Nov 28, 2008 • 5:49 pm

56754epo 2008 Medical Sci Fi Contest: Please Meet the Stories!We are excited to announce the results of this year’s medical sci-fi contest, and to present to all our readers the top three stories, as decided by our distinguished panel of reviewers.
First, we would like to thank Epocrates, a company that generously donated to the winner the latest version of Epocrates Essentials Deluxe, a premium mobile suite of drugs, diseases and diagnostics that also features a medical dictionary, coding reference, clinical calculators and more, as well as the latest Palm® Tungsten™ E2 handheld. Medgadget is also awarding to the winner a boxed set of The Complete Wreck (A Series of Unfortunate Events, Books 1-13) by Lemony Snicket.
34563dem2 2008 Medical Sci Fi Contest: Please Meet the Stories!We would like to extend our appreciation to the judges, all of whom are our friends, who joined Medgadget’s team in grading the entries: Dr. Allen Roberts from GruntDoc, Dr. Val Jones from the newly opened Getting Better, and Amy Tenderich from Diabetes Mine.
And now to the winner. By a majority decision, the winner of the 2008 Medgadget’s Sci-Fi Award is…Mr. Charles Pappas for his story titled Different Day, Same Chip. Mr. Pappas tells Medgadget that he is a Senior Writer for Exhibitor and Corporate Event magazines, was also Yahoo Internet Life’s investigative reporter, and has written for Advertising Age, Smoke, POV, and Nerve. His first book, It’s a Bitter Little World, an ode to film noir, was published in 2005 by Writer’s Digest Books.
Please also meet the runners up: Kevin Bond for 30 Minutes of Clinical Ethics and Daniel Gow for the story titled APA 4000. We would like to extend our heartfelt appreciation to all the talented writers who submitted their prose: it was a competitive contest, and we look forward to reading your entries next year.
And now to the part everyone has been waiting for: the stories themselves. We hope you’ll enjoy reading them as much as we did…
UPDATE: For your convenience, you can print all three stories and have them on the go.

56765gif 2008 Medical Sci Fi Contest: Please Meet the Stories!

Different Day, Same Chip
by Charles Pappas

Calories In Today: 2,875
Calories Out Today: 1,180
I knew I shouldn’t have had that Krispy Kreme. I thought I nuked
enough calories on the treadmill this morning but nooooo, that glazed
vixen donut had to rear its raspberry- filled little head and give me
that come-gobble look.
Your health insurance premium for the next quarter is $397.55.
OMG, I hate when they Twitter that annoying message to my iPhone. I
want to take a Ginzu knife and carve the RFID chip out of my wrist —
but that would violate the end user agreement, which, BTW, Craig
Venter himself couldn’t have decoded.
Signing up for the chip implant will save you 20 percent on your
premium, the HMOs say. You’ll be able to take control of your health,
the HMOs promise. Well, yeah, if by "take control" you mean they
monitor you 24/7. Calories in, calories out, glucose, cholesterol,
heart rate, blood pressure, and blood alcohol level, a constant
calculus of your well being. You’re free to have the chip surgically
removed, of course. You’re also free to inform your auto insurance
company that you’re going to drive without a seat belt, deactivate the
airbag, and hold a can of Pabst Blue Ribbon in both hands while you
steer with your feet. It’s an automatic cancellation, the blue screen
of insurance death.
***
I took the stairs to the office and skipped lunch. How much do I
burn per hour when I don’t eat? I forget.
Calories In Today: 2,875
Calories Out Today: 1,527
Your health insurance premium for the next quarter is now $383.57.
I only use the calories in and out, and health insurance premium
factoids. I only update them every time the calories change and it
shakes its Magic 8-Ball and recalibrates what I’m going to hemorrhage
out of my checking account. I downloaded a widget that ribboned the
info across the bottom of my Firefox browser like those news crawls on
MSNBC but the stress of just looking at it raised my cortisone stress
hormone level higher than a Dubai skyscraper, which raised my
insurance premium, which raised my cortisone…Sisyphus, table for
one.
When Medtronic came out with the chip, no one believed that it
would sell. "Cash in These Chips," The Wall Street Journal snarked.
Who would want their insurance company getting stalker-y inside their
bloodstream? Then Aetna-Cigna started making you an offer you couldn’t
refuse: you don’t have to be chipped, it’s a free country,
Constitution, Bill of Rights, blah, blah, blah, but we don’t have to
gamble on your Marlboro-smoking, Budweiser-drinking, Guacamole Bacon
Burger-scarfing butt either. No chip? No problem — for them. Your
premiums doubled and your minimum deductible exploded like an ejector
seat to $1,000, $2,000, sometimes $2,500. No exceptions. It was as
legal as it was lucrative. Every HMO followed suit like they were
running a red light. You had no choice, really.

(more…)

Radiology / Surgery

Stereo Navigator: The First Commercially Available Breast PET-Guided Biopsy System

by Gene Ostrovsky on Nov 26, 2008 • 1:39 pm

43345wii1 Stereo Navigator: The First Commercially Available Breast PET Guided Biopsy System
Naviscan, Inc., a San Diego, CA firm, is reporting that the US FDA has granted the company marketing approval for the world’s first Positron Emission Mammography (PEM)-guided biopsy system. A company rep tells Medgadget that Stereo Navigator™, as the technology is called, is comprised of software that resides on the company’s system and some hardware to help position the breast.
More about the device:

Stereo Navigator™, the PEM-guided biopsy accessory, is indicated for the localization of lesions in female breasts, as identified on a PET image. This guidance system will now enable physicians to guide compatible interventional devices towards abnormalities visible on PET.
"The strength of our high-resolution PET scanner has always been the ability to resolve suspicious lesions down to 2 mm,” said Paul Mirabella, Chairman & CEO. “Now we can also offer biopsy guidance, providing physicians with the all important pathological confirmation to determine the optimal course of treatment.”
This Stereo Navigator biopsy feature represents the cutting edge of targeted molecular imaging in the breast. The accessory uses a stereotactic frame fixed between the scanner’s paddles to guide the insertion of a compatible interventional device into the breast. Accurate targeting is possible due to the high-resolution 3-D tomographic images acquired. Localization of the abnormality is verified using a PET-visible line source that is inserted into the needle track allowing the user to confirm trajectory and position. The accessory is compatible with the following breast biopsy systems: Mammotome® from Ethicon Endo-Surgery, Inc., ATEC® from Hologic, Inc., and EnCor® from SenoRx Corporation.

Product page: PEM-Guided Biopsy with Stereo Navigator…
Press release…

Cardiac Surgery

Subcutaneous Implantable Cardiac Defibrillators

by Gene Ostrovsky on Nov 26, 2008 • 12:02 pm

defib x220 Subcutaneous Implantable Cardiac DefibrillatorsImplantable defibrillators have always suffered from risks associated with attaching leads to the heart and the often necessary surgeries to replace them. Now Cameron Health, a San Clemente, California company, is trialing a new implantable defibrillator that sits just below the skin and has no leads going to the heart, and so functions more like an external unit.
MIT Tech Review reports:

Cameron’s device, dubbed the subcutaneous-ICD, or S-ICD, uses leads placed just beneath the skin above the rib cage. Whereas a normal ICD would generate less than 30 joules per shock, the S-ICD generates 80 joules. Nonetheless, it’s only marginally bigger than a traditional ICD, largely thanks to improvements in battery and capacitor technologies. The device itself sits beneath the skin below the armpit, instead of in the chest.
The new device has another advantage, says Grace [Andrew Grace, a cardiologist at the Papworth Hospital, in Cambridge, England, who helped develop the device]: it provides a much better view of what’s going on inside the heart. Electrical noise inside the heart can confuse ICDs with embedded leads. Currently, Smith says, one in three ICD patients suffers unnecessary shocks because the ICD misinterprets the state of the heart. That should be much less of a problem with the new device, he says.
Cameron believes that despite the additional demand for power, it can get a battery life of about five years out of its device, which is similar to that for existing ICDs.

More from MIT Tech Review…

Anesthesiology

TRIGO, The Compact Electronic Anesthesia Machine

by Gene Ostrovsky on Nov 26, 2008 • 11:21 am

46534rew1 TRIGO, The Compact Electronic Anesthesia Machine
Technology is moving forward, and the Germans are just outdoing themselves. The hitherto unheard of concept of wall-mounted anesthesia machines is now a reality, thanks to EKU Elektronik GmbH, from Leiningen, Germany. And if you want this blower to move from location to location, just mount it on a little cart, and take it to your favorite colonoscopy suite.
More about the TRIGO machine:
46534rew2 TRIGO, The Compact Electronic Anesthesia Machine

With the performance of a bigger mobile anaesthesia machine the TRIGO finds its place as wall mount device in the induction. Besides the electronic gas mixer and the Multimode-Anaesthesia-Ventilator including different ventilation parameters also various optional monitoring functions can be integrated (O2, CO2, anaesthetic agents, N2O). These are displayed numerically or graphically and adjusted either by touch or by a conventional wheel. As a modern wall mount device with the installation depth of a bookshelf (“shelf unit”) the TRIGO offers more freedom of movement in the induction room.
Functions:
- 6,4″ colour touch-screen TFT-LCD with central rotary button
- dialogue handling at the screen
- self-test and control of the single components in the standby mode
- automatic leakage test
- electronic control of the adjusted gas dosage
- electronic supervision of the pressure gas supply with display and alarm function for lower deviation in pressure
- compensation of variations in pressure supply
- detection of the system compliance
- dynamic compliance compensation
- wide adjustment range from 200 ml to 11 litres
- precise resolution and display of the scale in 20 ml steps
- automatic switchover of the scale at higher flow values
- automatic fresh gas dosing for low flow operation
- low-pressure-technology from 2 bar pressure
- display of the measured values as curves and numeric values
- configurable basic adjustments, specific for each ventilation mode
- default parameters can be defined
- integrated monitor for volume, pressure, O2, anaesthetic agents, N2O, CO2
- electronic PEEP
- for neonatal, paediatric and adult application
- error state and service information logging
- best optic and acoustic visualising of the alarms
- single vaporizer holding for different vaporizers (Halothane, Enflurane, Isoflurane, Sevoflurane, Desflurane)
- compact circle system, CO2-absorber canister is exchangeable during operation without any leakage
- RS232 interface for connection to electronic anaesthesia documentation and clinical IT-network
Security system:
- electronic O2-deficiency detection
- electronic N2O-blockage
- O2-emergency dosage (min. 4 L/min O2 flow in case of total failure)
- emergency dosage for gas supply failure: failure AIR: 100% O2, failure N2O: 100% O2, failure O2: 100% AIR
- automatic check for correct covering of the single gas supply channels every time the device is switched on
- operation is guaranteed for at least 30 minutes at power supply failure by an internal rechargeable battery
Ventilation parameters:
- CMV (volume controlled ventilation)
- PCV (pressure controlled ventilation)
- MAN./SPONT. (manual, spontaneous), spontaneous ventilation with apnea control
- SIMV (synchronous intermittend mandatory ventilation)
- MMV (mandatory minute ventilation)
- ASB (pressure support ventilation)

Press release…
Product page: TRIGO…

Ob/Gyn / Urology

Vaginal Cones by GlysBy: Add Color (and Pelvic Strength) to Your Life

by Gene Ostrovsky on Nov 26, 2008 • 10:56 am

54645ert Vaginal Cones by GlysBy: Add Color (and Pelvic Strength) to Your LifeAt the recently concluded Medica 2008 conference, Italian firm GlysBy was showcasing to the world its pastel-colored collection of vaginal cones, devices that the company says can aid to prevent incontinence by strengthening pelvic floor muscles.
Here’s what GlysBy says you will get if you exercise “just 10 minutes a day”:

This set of Pelvic-Floor Training Aids comprises four tampon-shaped cones that differ in colour and weight:
Colour Weight: yellow 20g, blue 34g, green 50g, purple 68g
How do the Pelvic-Floor Training Aids work?
Exercising with Pelvic-Floor Training Aids helps us become aware of our pelvic floor and helps train the muscles of the pelvic floor. The cones work as follows:
If a cone is inserted into the vagina, it tends to slip out again. It is then prevented from slipping out by repeated muscular reflexes (“bio-feedback phenomenon”) and, throughout the course of exercising, by increasingly conscious muscular contractions. Drawing together and tensing the muscles of the pelvic floor trains and strengthens these muscles, similar to body building with weights. Exercising may thus at first give rise to sensations of pain in the pelvic area (muscular soreness). At the same time, however, awareness of the pelvic floor will be improved.
How to use the Pelvic-Floor Training Aids
The woman starts by testing the strength of her pelvic floor. This can be done by inserting the yellow (lightest) cone deep into the vagina (see illustration, comparable with inserting a tampon).
Should she be able to keep this cone in place for approx. 1 minute in a standing position, she may try the next heavier cone (green first, then blue and purple last). The cone that she can only just hold shows you how strong your pelvic floor is and she should start exercising with this cone.
The woman should exercise at least twice a day in a standing position or when walking. At the beginning she may only be able to hold the cone for a very brief period. The exercising time should be increased gradually until the cone with which you are exercising can be held for approx. 10 minutes per exercising session for several days in succession. Once this stage has been achieved, she may exercise with the next heavier cone.
It may be helpful to use lubricating gel when exercising with Pelvic-Floor Training Aids particularly in the event of vaginal dryness.
How does exercising success become apparent?
Upon regular exercise, the muscles of the pelvic floor will usually become considerably stronger after a mere few weeks. According to numerous clinical studies, atony of the bladder can thus be improved.

To learn more about the device, that bears the European CE Mark of approval, check out the product page: Vaginal Cones by GlysBy…
Press release…

in the news...

Testosterone…”The Perfect Weapon of Mass Destruction”

by Stephen Sheehan on Nov 26, 2008 • 6:07 am

SexandWar Testosterone...The Perfect Weapon of Mass DestructionTestosterone is getting a bit of a bad rap in the news lately. Our recent post about testosterone’s effects on stock market traders may help to explain trading behavior, while another article at Wired magazine discusses how testosterone may be “The Perfect Weapon of Mass Destruction”.
The article is written by Alexis Madriga and is based on an interview with the authors of Sex and War. In their book, UC Berkeley obstetrician, Malcolm Potts and science writer Thomas Hayden, explore how technology and testosterone influence the warring behavior observed in primates.
From Wired:

…But the most fascinating parts of the book look at how modern technology has interacted with our Stone Age brains’ risk calculators to produce the brutality and aggression of the world today.
In this Wired.com interview with Hayden and Potts, they talk about the evolutionary adaptation that allows us to kill our enemies, how chimps and bonobos inform our knowledge of human nature, and why the most destructive weapon might be a hormone, not a bomb.
Wired.com: Why did you write this book? Why sex and war as topics?
Sex and War co-author Thomas Hayden: Let me tell you the why from two different perspectives. For me personally, the why goes back to the beginning of the Iraq war in 2003. I was a correspondent at a national news magazine (U.S. News & World Report) at the time and the war was the big story. As a science reporter, I was trying to understand the big story of the day through the lens of science.
I was struck by how big a factor the desire for revenge for 9/11 seemed to be. I was struck by the momentum, the emotional momentum, in the rush to war. It seemed once we’d been talking about war for a while, it almost became inevitable, despite lots of logical arguments against going to war. I wanted to understand why that was.

Read the rest of the article at Wired.com…

Genetics

SMRT: New High Speed DNA Sequencing Technology Promises Cheaper Genetic Testing

by Gene Ostrovsky on Nov 26, 2008 • 12:35 am

pacific bioscience diagram SMRT: New High Speed DNA Sequencing Technology Promises Cheaper Genetic Testing
Pacific Biosciences, a four year old company out of Menlo Park, California that managed to raise $120 million in venture capital last year (a large sum of money, had we not been conditioned to counting in trillions in the last few weeks), has just released details about its new DNA sequencing technology. Called single-molecule real-time sequencing (SMRT®), the technology promises genetic testing at under $200 per person, according to Bloomberg.
The company explains how SMRT® allows “for the first time, the observation of natural DNA synthesis by a DNA polymerase as it occurs,” and how the sequencing is done:

Our approach is based on eavesdropping on a single DNA polymerase molecule working in a continuous, processive manner. Distinguished by its long reads, short run times, and high quality sequence data with less effort and cost, SMRT DNA sequencing promises to be a transformative technology that will enable a new paradigm in genomic analysis.
PacBio’s SMRT technology is built upon two key innovations that overcome major challenges facing the field of DNA sequencing:

  • The SMRT chip, which enables observation of individual fluorophores against a dense background of labeled nucleotides by maintaining a high signal-to-noise ratio, and
  • Phospholinked nucleotides, which produce a completely natural DNA strand through fast, accurate, and processive DNA synthesis

    • DNA sequencing is performed on SMRT chips, each containing thousands of zero-mode waveguides (ZMWs). Utilizing the latest geometries available in semiconductor manufacturing, a ZMW is a hole, tens of nanometers in diameter, fabricated in a 100 nm metal film deposited on a silicon dioxide substrate. Each ZMW becomes a nanophotonic visualization chamber providing a detection volume of just 20 zeptoliters (10-21 liters). At this volume, the technology detects the activity of a single molecule among a background of thousands of labeled nucleotides.
    The ZMW provides a window for watching DNA polymerase as it performs sequencing by synthesis. Within each chamber, a single DNA polymerase molecule is attached to the bottom surface such that it permanently resides within the detection volume. Phospholinked nucleotides, each type labeled with a different colored fluorophore, are then introduced into the reaction solution at high concentrations which promote enzyme speed, accuracy, and processivity. Due to the small size of the ZMW, even at these high biologically relevent concentrations, nucleotides occupy the detection volume only a small fraction of the time. In addition, visits to the detection volume are fast, lasting only a few microseconds due to the very small distance that diffusion has to carry the nucleotides. The result is a very low background.
    When DNA polymerase incorporates complementary nucleotides, the enzyme holds each nucleotide within the detection volume for tens of milliseconds—orders of magnitude longer than the amount of time it takes a nucleotide to diffuse in and out of the detection volume. During this time, the engaged fluorophore emits fluorescent light whose color corresponds to the base identity. Then, as part of the natural incorporation cycle, the polymerase cleaves the bond that previously held the fluorophore in place and the dye diffuses out of the detection volume. Following incorporation, the signal immediately returns to baseline and the process repeats.
    Unhampered and uninterrupted, the DNA polymerase continues incorporating bases at a speed of tens per second. In this way, the SMRT approach produces a completely natural long chain of DNA in minutes. Simultaneous and continuous excitation and detection occurs across all of the thousands of ZMWs in the SMRT chip in real time. Researchers at Pacific Biosciences have demonstrated this approach has the capability to produce reads thousands of nucleotides in length.

    Watch a nicely produced video outlining SMRT® technology…
    More from Bloomberg…
    Technology backgrounder (.pdf)…

    Radiology

    Overcoming Scattering in Light Penetrating Imaging Systems

    by Gene Ostrovsky on Nov 26, 2008 • 12:24 am

    fig5 x220 Overcoming Scattering in Light Penetrating Imaging SystemsResearchers from the Institute for Biological and Medical Imaging at the Helmholtz Center in Munich and Northeastern University in Boston have come up with an interesting solution to the old problem of reduced resolution of infrared light when it scatters while traveling through tissue. Using a femtosecond laser and a camera with a shutter faster than the time it takes for many of the photons to scatter, the scientists were able to image photons that arrived earlier than others (i.e. traveled in a more or less straight line), and did the least scattering. This technology will undoubtedly improve the quality of images researchers get using fluorescent protein tagging, as well as other light refracting imaging modalities. The question we have for our physicist audience is whether this concept can be applied to X-ray tomography to improve the resolution of CT scanners.
    Read at MIT Technology Review…
    Image: Laser light that passes directly through animal tissue (A) is less diffuse than light that the tissue scatters (B). Images made using unscattered light (C) show the localization (red) of a tumor in a mouse more clearly than those made with scattered light (D). They also show the tumor’s extent in the other side of the lung. Credit: National Academy of Sciences

    in the news...

    Individually Manufactured Replacement Bones in Clinical Trial

    by Gene Ostrovsky on Nov 26, 2008 • 12:03 am

    redone jaw Individually Manufactured Replacement Bones in Clinical TrialUsing CT data, doctors in Japan are implanting individually crafted replacements for skull bones. In a new clinical study of 70 adults over the next two years, the researchers will evaluate whether the new 3-D printed material can be clinically beneficial.
    From AFP:

    It can match the complicated structures of the jaw, cheek and other parts of the skull down to one millimetre (0.039 of an inch), a level significant enough to make a difference in human faces, researchers told AFP.
    “It can also be replaced by your own bone, which wasn’t possible before” with conventional sintered ceramic bones, said Tsuyoshi Takato, an orthopedic surgeon and professor at the University of Tokyo’s Graduate School of Medicine.
    The implants are currently limited to use in the skull because, unlike limbs, they do not have to carry the body weight.
    The custom-made bones are created from the calcium phosphate powder and a solidifying liquid which is more than 80 percent distilled water, using computer-assisted design.
    In the same way that an ink-jet printer propels droplets onto a piece of paper, a device squirts the liquid on a 0.1-millimetre-thick layer of the powder to form a desired shape.

    More from AFP…

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