May 19, 2012

Airway Bypass for Emphysema Patients

Human lung
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Blood vessels aren’t the only things that can be bypassed. The ability to restore blood flow after an artery has been blocked by plaque has saved many people, but people with conditions such as emphysema have not had such benefits in the past. A new surgical technique has been under trial which would bypass the airway to help balance the airflow in and out of the lungs of emphysema patients.

Progressive and irreversible, this lung disease is a chronic condition that causes the lungs to lose elasticity and the airways inside to collapse. Air cannot leave the lungs during exhalation, a condition known as hyperinflation. This leaves the person always short of breath and sometimes dependent on oxygen, and they are left with few options for treatment of their condition. Typical daily activities like walking and eating are made difficult because the person is always working so hard just to breathe right.

A new procedure is in development and being used on people, and it is even minimally invasive. Using the mouth to get to the lungs, surgeons can use a flexible scope to place a stent that enables trapped air to leave the lung, and that creates a new pathway for air to pass through. It is first necessary to use a probe, to make sure the site the physician is working on isn’t near any blood vessels, and within a couple of hours, up to six stents could be placed within the airway.

While it was still in clinical trial stages, the procedure showed potential in improving the quality of life of patients, as of results reported in October of 2007. Pulmonary function was improved and the ability to breath made much easier up to six months after the procedure was done. This makes the airway bypass a viable option for treatment for people with severe lung problems, experts say, and can even help those waiting for a lung transplant.

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Medical Frontiers: Separating Conjoined Twins

FortunioLiceti-TwinDissection
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Rare medical conditions can occur suddenly and be difficult to treat. They range to such severity that they are often life threatening. One condition that has challenged the frontiers of medicine is the birth of conjoined twins. This situation has been documented historically as far back as the year 1100, and there is the occasional news story about a set of such twins being born, usually somewhere overseas.

When two babies are born conjoined, their chances of survival are very low, if in fact they are born alive, as more than half are stillborn. The twins develop from the same fertilized egg, in contrast to twins normally developing out of two eggs inside the female. Typically, if one egg divides after fertilization, identical twins can be the result. In rare cases, the egg starts to split but does not fully separate and conjoined fetuses develop.

There are a few different kinds of conjoined twins. They can be connected at the upper torso, in which case it is likely they will share a heart. These are known as thoracopagus twins and it is usually impossible to save both by separation. Twins connected at the breastbone to waist, or omphalopagus twins, are another type, in which they can share a liver or gastrointestinal organs. Craniophagus twins, or babies connected at the head, are the rarest of conjoined twins, and can even share parts of their brains. However, a couple of these were successfully separated in recent years and covered in high-profile news stories.

Separating the twins is a delicate, risky, and time-consuming procedure. It can take more than a day of operating to accomplish the task, with multiple surgical teams on the case. The chances for recovery depend on the type of connection and the organs that are shared. No known cases of twins conjoined at the heart have resulted in survival. Still, survival rates for many separation surgeries has gone up, when in the past there was no hope, so separating conjoined twins is one of those medical frontiers that provides new possibilities with advances in medicine.

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Battling Alzheimer's Disease at the Molecular Level

The red and yellow colors indicate that Pittsb...
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Alzheimer’s Disease affects millions of older Americans. This degenerative brain condition often develops slowly in otherwise relatively healthy people and progresses to the point where they can no longer care for themselves. Family members are left to watch as affected loved ones lose their memories and require full-time care. There have been no treatments to stop the disease, but recent advances in scientific understanding may lead to future treatments.

The brain of an Alzheimer’s patient has lots of plaque, which is characteristic of the full-blown onset of the illness. A substance known as beta-amyloid leads to the formation of this plaque, and is what is believed to trigger the nerve cell damage and death that causes the symptoms of the disease.

Scientists in Germany have proven that a protein, called ADAM10, can inhibit the formation of beta-amyloid by cutting the protein from which it is formed, on a molecular level. Experts have dubbed the formation protein as amyloid precursor protein. There are a couple of enzymes that interact with this protein to create beta-amyloid, and blocking those can inhibit its creation. An enzyme, called alpha secretase, which can even cut the precursor protein without forming the Alzheimer’s causing substance, has even been found.

By analyzing brain cells in mice and in human cell cultures, scientists have found that this ADAM10 gene prevented beta-amyloids from forming, and in fact was the only one that could do so. A less active version of this gene could possibly leave people more susceptible to the degenerative brain disease, and stimulating ADAM10 may be a potential means for therapy in Alzheimer’s patients. Even more, antibodies discovered by the same scientists might allow the measurement of the protein in spinal fluid.

This research, therefore, could lead to methods for early diagnosis as well as treatment. For a devastating disease for which there has been no way to assess risk in getting or even treating after its onset, this potential is welcome news. Various experiments using the proteins and antibodies are underway and any future medical breakthroughs that result in the future would be welcome by many people.

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