Archives: 4/2009

atomheart Atomic Bombs Yield Cardiology DataA collaboration between Lawrence Livermore National Laboratory, Karolinska Institute, Université Claude Bernard Lyon, Lund University and Lund University Hospital, analyzed heart biopsies for Carbon-14 content of people born before, during and after the period of above ground testing of nuclear weapons. By using temporal analysis of historical content of 14C in relation to what was in the DNA of cardiac tissue, the researchers discovered that people regenerate heart cells naturally, but the rate slows down over time. Between ages 25 and 75, the average annual regeneration rate goes from one to just under half of one percent.
From Lawrence Livermore NL:

Carbon 14 atmospheric concentration levels remained relatively stable until the Cold War, when above-ground nuclear bomb tests caused a sharp increase, or peak, which decreased slowly after the end of above-ground testing in 1963. This spike in carbon 14 in the atmosphere serves as a chronometer of the past 55 years.
Because DNA is stable after a cell has gone through its last cell division, the concentration of carbon 14 in DNA serves as a date mark for when a cell was born and can be used to date cells in humans.
The team determined the ages of heart cells by determining the time at which the sample’s carbon 14 concentration corresponded to the atmospheric concentration. Buchholz [Lawrence Livermore National Laboratory scientist] found that people born around or after the nuclear bomb tests corresponded to atmospheric concentrations several years after the subjects’ birth, indicating substantial postnatal DNA syntheses.
“By analyzing individuals born at different times before 1955, it is possible to establish the age up to which DNA synthesis occurs, or whether it continues beyond that age,” Buchholz said.
In the study, carbon 14 concentrations were elevated in subjects compared to those people born up to 22 years before the beginning of nuclear bomb tests.
“DNA of myocardial cells is synthesized many years after birth, indicating that cells in the human heart do, in fact, renew into adulthood,” Buchholz said. “At the age of 50, 55 percent of the heart’s cells remain from the time around birth and 45 percent have been generated later.”
Cardiac muscles have a striated appearance and their contraction in the heart propels blood from the atria and ventricles to the blood vessels of the circulatory system.
The limited recovery in humans after a heart injury, such as a heart attack, demonstrates failing regeneration of heart cells. But the team concluded that the renewal of heart cells, as indicated by the mixing of carbon 14 in the DNA, suggest that the development of pharmacological strategies to stimulate this process may be a rational alternative or complement to cell transplantation strategies for heart cell replacement.

Abstract in Science
Read more: Healing heart attack victims, one cell at a time …

heartstartmrx Philips HeartStart MRx ALS Defib Gets  Fresh Updates
Philips has just announced additional new enhancements to the company’s popular HeartStart MRx cardiac monitor/defibrillator. The company says it has improved the signal analysis processing software in the unit, as as well as patient management tools, and that will allow for quick handover of patients from EMR to physicians and nurses in the ER.
3fasdfacd3 Philips HeartStart MRx ALS Defib Gets  Fresh UpdatesFrom the press release:

The MRx now features the next-generation Q-CPR Measurement and Feedback tool as well as support system- or institution-wide quality improvements using robust retrospective data review capabilities. This update features the innovative new Q-CPR meter – already the winner of a Red Dot International Design award—which displays visual feedback directly where the caregiver is focused—on the patient’s chest.
Q-CPR remains the only tool currently available that allows professionals to get feedback on ventilations as well as compressions. The first generation Q-CPR is supported by more published data than any other CPR quality-improvement tool, including studies in the Archives of Internal Medicine and Journal of the American Medical Association.
The enhanced HeartStart MRx also features multiple data management solutions designed to streamline the flow of patient information. Specifically, Philips’ Periodic Clinical Data Transmission collects ECG and vital patient information in the field and periodically sends this data to the receiving hospital, enabling physicians to analyze and track patients ahead of their arrival. Only the MRx has a built-in Ethernet port that allows for IP-based transfer of code event summaries at LAN speed. New file-forwarding software called Data Messenger has also been added to automate the transfer of clinical care event summaries for reliable review by medical directors.
The HeartStart MRx is the only monitor/defibrillator to offer Philips’ new DXL ECG Algorithm, which enables analysis of 12-lead electrocardiogram (ECG) data. Unlike other 12-lead algorithms, the DXL Algorithm identifies the STEMI-CA (Culprit Artery) and provides Critical Values. Philips STEMI-CA pinpoints the probable congested artery, while Critical Values highlight any of four distinct life-threatening conditions requiring immediate clinical attention. In addition, enhanced gender-specific criteria provide valuable information for diagnosing cardiac emergencies in women. These tools provide user-friendly data designed to speed triage, quickly mobilize resources and more efficiently prepare for treatment in the Cath lab.
Two additional tools available on the HeartStart MRx are the Philips Acute Cardiac Ischemia Time Insensitive Predictive Instrument (ACI-TIPI) and Thrombolytic Predictive Instrument (TPI) algorithms, which enable medics to alert and prepare the hospital ahead of the arrival of a suspected STEMI patient and/or bypass the closest hospital for a cardiac specialty center. ACI-TIPI provides a percentage score indicating the probability that the patient is experiencing acute cardiac ischemia. TPI provides mortality predictions in considering the use of thrombolytics to treat STEMI patients when percutaneous coronary intervention (PCI) is not readily available.

Press release: NEW ENHANCEMENTS TO THE PHILIPS HEARTSTART MRx SUPPORT FAST TRIAGE OF STEMI PATIENTS …
Product brochure: Philips HeartStart MRx ALS Monitor
Product page: HeartStart MRx ALS Monitor for EMS…
Flashbacks: HeartStart MRx Monitor/Defibrillator Transmits Wireless Data

We have followed the Defense Department’s investment in developing advanced prosthesis spurred by noted medical technology developer Dean Kamen. Over the weekend, CBS 60 Minutes, took us on a behind the scenes tour of Dean Kamen’s company, DEKA, and the most recent advancements in prosthesis development.

Ling [Dr. Geoffrey Ling, an Army colonel and neurologist who's leading the Revolutionizing Prosthetics program] told Pelley [60 Minutes correspondent] it’s a very large scale project. “It is very much like a Manhattan Project at that scope. It is over $100 million investment now. It involves well over 300 scientists, that is engineers, neuroscientists, psychologists.


The technology development is fascinating and ever improving, but clearly there is a ways to go to make this prosthetic cost effective and more functional for widespread implementation.
60 Minutes: The Pentagon Bionic Arm…
NOTE: Please join us in welcoming a new addition to Medgadget editorial board. Martin Neumann is a a post-doc in Nuclear, Plasma and Radiological Engineering at University of Illinois. In addition to holding a PhD in Nuclear Engineering, he is also a medical student, now finishing his second year. In between exams, upcoming USMLE, post-doc work, ets, he will be blogging to educate all of us. This is his first post.

  • AdvaMed Statement on FDA Call for Data on Certain Medical Devices… [AdvaMed]
  • Disease in a warming climate: Fears of a global rise in infectious conditions may be unfounded…. [Nature]
  • MRI pressure on EU grows… [The Engineer]
  • What the Recession Means for Hospitals, Nurses… [WSJ]
  • Open source gets hearing but no action at HIMSS… [Dana Blankenhorn]
  • Are hospitals passing off their low-profit patients?… [Chicago Tribune]
  • Reality Check on Foodborne Illness Rate… [WSJ]
  • AstraZeneca Accused of Suppressing Negative Seroquel Study… [WSJ]
  • Failure to Shock Prompts Zoll to Recall AEDs… [MedPage Today]
  • Medtronic Completes Acquisition of CoreValve Inc…. [Medtronic]
  • Medsphere transformation appears complete… [Dana Blankenhorn]
  • CVS joins Google Health Rx network: millions can access medication records online… [Google]
  • Doc in the box now out of the box… [HealthBlog @ MSFT]
  • Cardiology treatment co CorAssist raises $5.25m … [Globes]
  • Researcher Faked Data in Sleep Apnea Study… [WSJ]
  • Exercise Is Safe, Improves Quality of Life in Patients With Chronic Heart Failure… [NIH]
  • Scientists Report Important Step in Biomarker Testing for Alzheimer’s Disease… [NIH]
  • Biologically active coatings significantly improve implants… [Nanowerk]
  • In December we reported on a goofy device for people with restless leg syndrome that makes a game out of all that shaking. Ever since, many of our readers have been twitching ever since to get their hands on the device. Now Engadget has revealed that the Yurex is going on sale at the end of April, and the manufacturer released this video introducing the device:


    Product page: Yurex
    Flashback: Restless Legs 2.0

    Bonnie Bassler, a Princeton biologist, gave a fascinating TED lecture about her group’s research into how bacteria communicate. By studying how animals interact with bacteria and experimenting with the behavior of colonies, the researchers uncovered very unexpected group behavior in these primitive creatures.


    Link: Bonnie Bassler: Discovering bacteria’s amazing communication system …

    13249 winfree crystals Scientists Create a programmable DNA origami seedA team of Caltech scientists managed to create specialized DNA “seeds” that can activate a mixture of DNA to combine into a preprogrammed pattern. This ability to create self assembling DNA structures, known as algorithmic crystals, that can be coded for in advance, may lead to all sorts of scientific and clinical uses.

    In the work, the researchers designed several different versions of a DNA origami rectangle, 95 by 75 nanometers, which served as the seeds for the growth of different types of ribbon-like crystals of DNA. The seeds were combined in a test tube with other bits of DNA, called “tiles,” heated, and then cooled slowly.
    “As it cools, the first origami seed and the individual tiles form, as their component DNA molecules begin sticking to each other and folding into shape–but the tiles and origami don’t stick to each other yet,” Winfree explains.
    “Then, at a lower temperature, the tiles start to stick to each other and to the origami. The critical concept here is that the DNA tiles will only form crystals if the process gets started by a seed, upon which they can grow,” he says.
    In this way, the DNA ribbons self-assemble themselves, but only into forms such as ribbons with particular widths and ribbons with stripe patterns prescribed by the original seed.
    The work, Winfree says, “exhibits a degree of control over information-directed molecular self-assembly that is unprecedented in accuracy and complexity, which makes me feel that we are finally beginning to understand how to program information into molecules and have that information direct algorithmic processes.”

    Press release: Caltech Scientists Control Complex Nucleation Processes using DNA Origami Seeds …
    Abstract in PNAS: An information-bearing seed for nucleating algorithmic self-assembly

    768979iii Introducing EchoJournal
    Medgadget is proud to announce the launch of our companion site, an echocardiography video sharing community called EchoJournal. It is a video site, designed to present transthoracic and transesophageal loops for discussion and storage. EchoJournal combines many of the features familiar to users of other video sharing sites, including easy uploading, comments and discussions, and the ability to create communities for your academic department, professional group, or school. The site will be curated by David E. Winchester, MD, a Cardiology Fellow at the University of Florida, who has already uploaded tons of interesting cases, and is ready for many more.
    Here’s a list of selected additional features:

  • There are channels of the site focused towards whatever your interest or level of education might be, from students to practicing physicians, and sections for unique or unknown cases.
  • Follow your friends and the videos they upload.
  • Share your videos or keep them private and invite only.
  • Automatic looping makes discussion with others easy.
  • Download videos or link directly to the video for you website or for your next presentation.
  • Create your own profile
  • Rate other videos and discuss unknown cases
  • We offer a number of languages for upload and discussions
  • The site is absolutely free to use.
  • We hope you’ll enjoy EchoJournal. If you are a clinician interested in echocardiography, join us and get started uploading your videos and discussing cases.
    Here’s a sample video, taken from the site (calcified mitral valve, turbulent flow, aliasing):

    MIT Technology Review is profiling a muscle functional analysis device developed in a collaboration between scientists at Harvard Medical School and MIT. Using advanced electrical impedance myography techniques, the probe can sense the state of muscle tissue through the skin.
    Here’s Seward Rutkove, a Harvard neuroscientist, demonstrating and explaining the device:


    More from MIT Technology Review