October 2005 Archive

Monday, October 31, 2005

Doctors, Cadavers, and America's First Riot

Note: The Good Old Days is our regular Friday column. It is presented today as a special for Halloween.

On this Halloween, we present a story that starts as a tale of the macabre, and evolves into star-studded massacre.

It's the tale of the first riot in the young United States, a riot not about taxes or whiskey but cadavers, and the inappropriate procurement of them. We turn to the writings of Dr. John Wilson:

The Doctors Mob, one of the most violent outbreaks of civil unrest in early American history, was a furious response to the common practice of obtaining cadavers for anatomical dissection by robbing graves. This hazardous and loathesome business, made necessary by the gross inadequacy of legal provisions for obtaining cadavers for medical instruction, was carried out by a disparate group, generally referred to as "resurrectionists." Medical students and teachers of anatomy were frequently involved in grave robbing, and there was a more or less disreputable assortment of entrepreneurs who sold cadavers to medical schools or private teachers of anatomy.

Resurrectionists preferred to rob the graves of the poor, the unknown, and enslaved Blacks as least likely to be noticed and cause public outcry; but no graves were exempt unless there was some protection such as an iron coffin, a vault, or a watchman standing guard with a shotgun from dusk to dawn for two weeks, after which the corpse was so decomposed as to be of little use for dissection.

Grave robbing at its best was a complicated and dangerous undertaking that required careful planning to avoid detection, and considerable skill to complete the task with dispatch. Two strong men, two large canvas tarpaulins, digging tools, and a dark lantern to light the scene but invisible from a distance, were the essentials. Dirt was removed from only the head end of the coffin and placed on one of the tarpaulins. After silently breaking through the lid of the coffin, weakened by a row of holes bored across it, the corpse was hauled up by a hook inserted under the chin or, alternatively, by a rope attached to a ring on the back of a harness strapped under the arms. The body was then stripped of all clothing and wrapped in the other tarpaulin. The clothes were thrown back into the coffin, the excavated dirt returned to the grave, and its surface restored exactly to its prior appearance to disarm suspicion of tampering.

In the hands of experts, the over-all job required about an hour. The deceased, wrapped in the tarpaulin, was placed in a wagon, whose inconspicuous drive past the graveyard was carefully timed to coincide with the completion of the disinterment, and thence the cadaver was delivered to the medical school through a clandestine entrance. Bodies were usually procured during the cool season from November to February when anatomy courses were given, and were dissected immediately because embalming was not in use, putrefaction progressed rapidly, and discovery was always to be feared.

How did this particular uprising occur? Legend suggests its genesis was a series of unfortunate events starting on April 13, 1788, at the old New York Hospital in lower Manhattan:

Monday, October 31, 2005

Predicting Fracture with Lasers

Filed under: Orthopedic Surgery

There's a new, more complete way to image bone strength. Instead of just relying on X-rays of the mineral phase of bone, lasers can quantify the organic phase. This press release from researchers at the Imperial College of London explains further:

Although X-rays can be used to measure bone strength, they can only be used to measure bone mineral density, which only accounts for part of the strength. The new Raman spectroscopic technique allows scientists to measure the collagen, which also affects bone strength by eliminating the spectral components of overlying tissues.

The scientists plan to develop this work into a test for women during adolescence to predict the likelihood of osteoporosis developing in later life. By taking steps earlier on, such as increasing exercise to build up bone mass, this could prevent the need for more interventions such as Risedronate (Actonel) later.

More from Dr. Edward Draper...

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First Contact with a Universal Translator

Filed under: ENT , Neurology

Do you remember how everyone on Star Trek could immediately communicate with new aliens? Casual viewers just dismissed it as lazy writing, but the hardcore fans knew otherwise -- everyone on the show had a tiny "universal translator" implant that decoded foreign languages in realtime.

That always seemed fanciful to us, but now researchers at Carnegie Mellon are making it happen. The Pittsburgh Post-Gazette has more:

Mr. Jou, a graduate student in language technologies at Carnegie Mellon University, was simply mouthing words in his native Mandarin Chinese. But 11 electrodes attached to his face and neck detected his muscle movements, enabling a computer program to figure out what he was trying to say and then translate his Mandarin into English.

The result boomed out of a loudspeaker a few seconds later:

"Let me introduce our new prototype," a synthesized voice announced. "You can speak in Mandarin and it translates into English or Spanish."

It's not clear to us why he was photographed drinking bottled water. Maybe his device is advanced enough to translate "Perrier" from the French.

More from Szu-Chen Jou's page at Carnegie Mellon...

Hat tip: WMMNA

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The Athena Radar-Responsive Tag

Filed under: Military Medicine

The Athena Radar-Responsive Tag is not strictly speaking a medical device, but rather a military safety gadget to prevent friendly fire casualties. Developed by the Sandia National Laboratories, along with General Atomics Aeronautical Systems, Inc. and Sierra Monolithics Inc., the system has just been tested during Exercise "Urgent Quest" in the United Kingdom.

During the demonstration, Athena tags were placed on military vehicles participating in the exercises. The device, tracked via aircraft radar, can be used to identify both U.S. and coalition forces during combat to avoid fratricide. During war, fratricide is the act of killing one's own soldiers.
Aircraft on bombing runs used their on-board radar systems to ensure there were no friendly troops in their sights. If an Athena-tagged vehicle was present, a unique identifier appeared on the pilot's screen alerting him to a friendly force in his target area, thereby avoiding a potential friendly fire incident.

In preparation for Exercise Urgent Quest, the Athena tag has been demonstrated with several U.S. and European aircraft. In addition to combat identification, the tag can be used for blue force tracking, a similar but not identical mission.

Sandia Project administrator Darick Lewis says the exercises were intended to evaluate the effectiveness of various technologies in preventing friendly fire.

"Ideally, worthy candidate technologies can be transitioned into final development programs and produced for warfighter use," he says. "Athena is effective because it utilizes a fighter aircraft's existing radar for detection. It is simple, rugged, small and inexpensive to integrate."

The Sandia press release...

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A Modified Femtosecond Laser for Medical Applications

Filed under: Nanomedicine

The Fraunhofer Institute for Biomedical Engineering IBMT has developed a modified femtosecond laser system that has already been clinically tested for the diagnosis of melanomas, and is expected to be employed in the future for a wide variety of diagnostic and treatment modalities:

One in two short- or long-sighted adults could be treated by a laser operation, and femtosecond lasers are being increasingly used. This type of laser can be focused through the tissue directly onto the working area, saving time and improving the healing process. There is a disadvantage, however: residual radiation permeates the eye right through to the retina, and may cause impaired vision. Karsten König and his team at the Fraunhofer Institute for Biomedical Engineering IBMT are working on eliminating these side effects. "We are attempting to remove tissue constituents gently and very precisely using extremely low pulse energies of just a few nanojoules," explains König. This is made possible by a heavily modified femtosecond laser system with a very high pulse sequence, which can focus its beam with great accuracy using precision optics from Zeiss.
The laser paves the way for entry into nanolaser medicine, a new branch dealing with the diagnosis and therapy of individual cells. Depending on the laser power and optics used, the system can be a "femtoscope" providing insights into living tissue which are a thousand times more precise than the best computer tomographs. It is also a precision tool. The team of research scientists succeeded in performing the world's smallest incision into living tissue - with a width of just 70 nanometers. This opens up new possibilities: gene transfer by light, in which foreign genetic material is inserted into living cells using ultra-short laser pulses, without destroying the cells. "In this way we can introduce pharmaceutical agents or genes into individual cells," emphasises König. He has been awarded the new Technology Prize for his human-centered technology.

The first application - diagnosis and therapy of melanomas - was realized in cooperation with dermatologists at Jena University Hospital. The "femtoscope" renders the cell layers of the skin visible. Diseased cells are diagnosed by comparing samples. In future, doctors could use the same device for treatment: The diseased cell would be radiated with increased laser power and destroyed. After approval of the process, it would no longer be necessary to perform biopsies and time-consuming histological tests.

The Fraunhofer Institute for Biomedical Engineering IBMT homepage...

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TempTouch® for Diabetics

Filed under: Medicine

TempTouch®

The San Antonio Express-News is reporting that a local company, Xilas Medical, Inc will be honored at the 2005 Stars of Innovation Gala, an event hosted by the San Antonio Technology Accelerator Initiative. The company makes a number of medgadgets to diagnose and prevent diabetic neuropathy and its complications. TempTouch® by Xilas has caught our attention.

According to Express-News, TempTouch® is a "wandlike thermometer for diabetics who have nerve damage to check for "hot spots" or inflammation on the bottoms of their feet."

From the company's website:

TempTouch® provides the patient with an "early warning" of inflammation and potential ulceration. Our product is designed as a non-invasive, predictive, self-management tool to be used at home by the patient on a daily basis. The methodology used in previous clinical trials was to compare temperatures of one foot to the other in like positions. TempTouch® has been proven highly effective in NIH-sponsored clinical trials in detecting inflammation which occurs before an ulcer actually breaks the surface of the skin. Once the inflammation has been detected, patients are able to off-load and/or reduce activity levels to avoid more serious problems such as ulceration. A prescription form is required for the instrument...

A simple instrument to prevent serious problems. Cleared by the FDA since March.

More here...

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More on Wikipedia

Filed under: Net News

Dr. RW Donnell points out a Wikipedia article about evidence based medicine. A nice intro for the common folk.

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New Dyslexia Gene Identified

Filed under: Genetics

Researchers from Yale have achieved a breakthrough in the genetics of reading disorders. On chromosome 6, they've identified a gene called DCDC2 and linked it to dyslexia:

Dr. Gruen and co-authors used a statistical approach to study and compare specific DNA markers in 153 dyslexic families. "We now have strong statistical evidence that a large number of dyslexic cases - perhaps as many as 20 percent - are due to the DCDC2 gene," said Gruen. "The genetic alteration on this chromosome is a large deletion of a regulatory region. The gene itself is expressed in reading centers of the brain where it modulates migration of neurons. This very architecture of the brain circuitry is necessary for normal reading."

To facilitate reading, brain circuits need to communicate with each other. In reading disabilities, these circuits are disrupted. In people with dyslexia, compensatory brain circuits are inefficient and they have a hard time learning to read.

The research effort was thwarted for years, until it was discovered that scientists were accidentally studying gene CDCD2.

More from Dr. Gruen's laboratory...

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Friday, October 28, 2005

Hospitals Offer Incentives to Doctors for Chosing Cheaper Implants

Filed under: Society

HCA Inc. is the first of what might be many hospital chains offering doctors a portion of the savings by chosing a less expensive option when it comes to implants (mostly orthopedic implants at this point). Termed "gain sharing," the idea has device manufacturers pitted against hospitals and US regulators trying to cut Medicare costs. Reuters reports:

"We want to be careful it doesn't result in just putting in cheap implants and going to the lowest common denominator," Stryker Corp. Chief Executive Stephen MacMillan said this week at the Cleveland Clinic's Medical Innovation Summit.
Gain-sharing can involve various types of cost-cutting. Under one version, hospitals provide doctors with financial incentives to switch to an approved vendor to give the hospital more leverage in contract negotiations with the device maker.

Analysts say the deals could lead to pricing pressure for device makers, who have enjoyed price gains of about 3 percent to 5 percent a year for several years.

But the U.S. Department of Health and Human Services inspector general has approved seven plans it said were carefully crafted to protect patients, and it is considering another proposal by HCA Inc.

But the U.S. Department of Health and Human Services inspector general has approved seven plans it said were carefully crafted to protect patients, and it is considering another proposal by HCA Inc.

HCA has entered into gain-sharing contracts with three orthopedic device makers -- Stryker, Zimmer Holdings Inc. and Johnson & Johnson's DePuy unit, HCA spokesman Jeff Prescott said.

"We had a panel of orthopedic physicians describe to us the best devices, and we then approached those manufacturers, thus ensuring that those on contract were recognized as producing high-quality devices," Prescott said.

Several protections were included, such as requiring a review of patient outcomes, Prescott said.

Doctors traditionally hate having their choices regulated by administrative types, so offering incentives to go with a cheaper option certainly beats forcing the cheapest option on them. However, if hospitals can offer doctors "gain sharing" for going with a cheaper implant, can device companies offer "gain sharing" for going with a more expensive one?

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Chewing Gum Speeds Recovery After Laparoscopic Surgery

Filed under: Surgery

You either love or hate chewing gum, but who can now argue against it being useful? A recently conducted study shows that patients who use chewing gum have shorter hospital stays after laparoscopic colon surgery than those who don't.

HealthDay writes:

"We know that patients who undergo laparoscopic surgery have a faster recovery and less pain than with traditional techniques. We wanted to see if we could do even better. People today want to get home as soon as possible, back to their lives and families," Dr. James McCormick, a laparoscopic surgeon at The Western Pennsylvania Hospital in Pittsburgh and a lead investigator in this study, explained in a prepared statement.
"Something as simple as chewing gum can help make that a reality," he said.

In the study, 102 patients undergoing elective colon resection surgery were divided into two groups. Those in the control group received the standard fare after abdominal surgery -- sips of clear liquid. The patients in the study group were also given gum to chew at mealtimes.

Patients who chewed gum went home, on average, one day sooner than those who didn't receive gum, the researchers found.

The study authors said chewing gum after surgery can prevent or reduce postoperative ileus, a condition where the digestive system remains inactive for a period of time following surgery. Ileus is a major cause of postoperative problems and prolonged hospital stays, and costs up to $1 billion a year in the United States, the researchers said.

"There are a few scientific theories which attempt to explain why this approach works. Most prevalent is the concept of 'sham feeding,' " McCormick said.

"It is normal to sit down at meal time and chew and swallow for 15 minutes," he explained. "Gum chewing stimulates that activity nicely. The sooner the body thinks it is normal, the sooner it will act normally. And the sooner you get to go home."

The study was presented this week at the annual meeting of the American College of Surgeons, in San Francisco.

Read the abstract...

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Folding@home Medgadget Team

Filed under: Medgadget Exclusive

Thanks to the wise idea of our friends at Engadget, who just organized a Folding@home team to pool together idle computer resources, in order to help the folks at Stanford with protein folding simulations, we decided to do the same and form our own team. On that note, those of you interested in donating your unused computer time, for the advancement of biomedical science, are invited to join our team of medgadgeteers. The necessary software and information about the project can be found on the Folding@home main page. Spiffy screen saver is included in the package.

More at Medgadget.com's team page (team #47094)...

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Victory® Pacemakers

Filed under: Cardiac Surgery , Cardiology

St. Jude Medical, Inc. is describing its Victory® pacemakers, a family of devices with a new European CE Mark approval, now cleared for sale in EU countries:

The pacemakers offer an important combination of features, including optimized settings to save time at implant, VIP(TM) (Ventricular Intrinsic Preference) technology to minimize ventricular pacing, the FastPath(TM) summary screen to speed follow-up exams, and advanced technologies to extend the life of the device in patients.
"The Victory pacemaker comes with optimized settings right out of the box, which greatly reduces device set-up time at implant," said Wolfgang Ehrlich, M.D., who performed the first implant at the Kerckhoff Klinik in Bad Nauheim, Germany.

A cardiac surgery team directed by Wolf-Peter Kloevekorn, M.D. and the cardiology department, under the direction of Christian Hamm, M.D., assisted in the first implant procedure.

"The ability of the Victory pacemaker to measure thresholds and intrinsic events and display those results with EGMs (intracardiac electrograms) for quick verification means that 80% of standard follow-up testing is complete when the patient walks in the door," said Johannes Sperzel, M.D., who performed the first patient follow-up.

Victory(R) pacemakers also introduce VIP(TM) technology, an enhancement developed from years of clinical experience with the AutoIntrinsic Conduction Search (AICS) feature. VIP(TM) technology is designed to promote more natural heart function and minimizes ventricular pacing. This is an important clinical consideration, since studies such as St. Jude Medical's DAVID (Dual-Chamber And VVI Implantable Defibrillator) trial have shown that excessive ventricular pacing may contribute to heart failure in some patients. VIP(TM) technology is designed to allow the patient's own heartbeat to be "in control" the majority of the time.

Any necessary in-clinic testing can be completed more rapidly than before with the FastPath(TM) summary screen, which provides pre-set test values and increases flexibility with multiple follow-up options. This allows clinicians to spend more time with the patient and less time programming the device.

Engineered to anticipate a wide variety of the diagnostic and therapy needs of patients, Victory(R) pacemakers (models 5810 and 5816) also offer a suite of algorithms designed to make it easier for physicians to manage patients with atrial fibrillation (AF). AF is the world's most common cardiac arrhythmia that results in a very fast, uncontrolled heart rhythm caused when the upper chambers of the heart (atria) quiver instead of beating.

Other innovative technology in the Victory(R) pacemakers includes ventricular AutoCapture(TM) pacing, Advanced Hysteresis and Auto Rest Rate, which may improve the longevity of the pacemaker as well as reduce the number of replacement surgeries patients must undergo.

The press release is here...

St. Jude Medical website...

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Revealed: How to Knit a DNA Model

Filed under: not funny

A knitted version of the left-handed double helix DNA with full DIY instructions can be found over at Kimberly Chapman's Knitting Gallery. Those of you reading today's print edition of Medgadget, that you purchased at your local kiosk, can now participate in the Folding@Home project without the need of a modern computer.

Update: Medgadget reader Comet informs us about this nice Knitted Digestive System.

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Gold Nanorods Brighten Future for Medical Imaging

Filed under: Nanomedicine , Nuclear Medicine , Radiology

Researchers at Purdue University are developing nano dye for to-be-defined medical imaging technique of the future, and results are already quite impressive:

Researchers at Purdue University have taken a step toward developing a new type of ultra-sensitive medical imaging technique that works by shining a laser through the skin to detect tiny gold nanorods injected into the bloodstream.
In tests with mice, the nanorods yielded images nearly 60 times brighter than conventional fluorescent dyes, including rhodamine, commonly used for a wide range of biological imaging to study the inner workings of cells and molecules.

Findings are detailed in a research paper that appeared online last week in Proceedings of the National Academy of Sciences.

Gold nanorods represent a possible way to overcome barriers in developing advanced medical imaging techniques that use light to analyze blood vessels and underlying tissues.

"One obstacle is that light in the visible spectrum does not pass through tissue very well," said Alexander Wei, an associate professor of chemistry who worked with Cheng and other Purdue researchers, including Philip S. Low, a professor of chemistry.

Imaging methods might be developed using laser pulses in longer wavelengths of light, beyond the visible range in a region of the spectrum called near infrared.

"There is a window of light in the near infrared, wavelengths from about 800 to 1,300 nanometers, which could be harnessed for new imaging technologies," Wei said.

Tiny gold rods with a certain "aspect ratio" of length to width shine brightly when illuminated by light in this spectral region. The gold nanorods are ideal for a type of imaging called "two-photon fluorescence," which provides higher contrast and brighter images than conventional fluorescent imaging methods.

Photons are the individual particles that make up light. In two-photon fluorescence, two photons hit the nanorod at the same time.

Because of the two-photon effect, the method might enable scientists to develop advanced "non-linear optical techniques" that provide better contrast than conventional technologies. Cheng is applying the two-photon fluorescence and other non-linear optical effects to develop imaging methods that provide improved contrast over conventional technologies.

The researchers injected the nanorods into mice and then took images of the tiny structures as the nanorods flowed through blood vessels in the animals' ears. Individual nanorods proved to be 58 times brighter than the two-photon fluorescence from a single rhodamine molecule. Within a half hour after being injected, the nanorods could no longer be observed in the animals' blood, presumably because the rods had been filtered out of the blood by the kidneys.

"To be able to detect cells at an early stage of disease such as cancer, it is important to have a reliable technique that has sensitivity at the single-particle level," Wei said. "The gold nanorods demonstrate that Cheng's nonlinear imaging methods are capable of this level of detection."

The press release...

Flashback: 'Gadonanotubes': A Nanotech Contrast for MRI

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Color Perception Is Not in the Eye of the Beholder: It's in the Brain

Filed under: in the news...

An interesting set of experiments by scientists from the University of Rochester:

First-ever images of living human retinas have yielded a surprise about how we perceive our world. Researchers at the University of Rochester have found that the number of color-sensitive cones in the human retina differs dramatically among people--by up to 40 times--yet people appear to perceive colors the same way. The findings, on the cover of this week's journal Neuroscience, strongly suggest that our perception of color is controlled much more by our brains than by our eyes.
Williams [David Williams, Allyn Professor of Medical Optics and director of the Center for Visual Science -ed.] and his research team, led by postdoctoral student Heidi Hofer, now an assistant professor at the University of Houston, used a laser-based system developed by Williams that maps out the topography of the inner eye in exquisite detail. The technology, known as adaptive optics, was originally used by astronomers in telescopes to compensate for the blurring of starlight caused by the atmosphere.

Williams turned the technique from the heavens back toward the eye to compensate for common aberrations. The technique allows researchers to study the living retina in ways that were never before possible. The pigment that allows each cone in the human eye to react to different colors is very fragile and normal microscope light bleaches it away. This means that looking at the retina from a cadaver yields almost no information on the arrangement of their cones, and there is certainly no ability to test for color perception. Likewise, the amino acids that make up two of the three different-colored cones are so similar that there are no stains that can bind to some and not others, a process often used by researchers to differentiate cell types under a microscope.

Each subject was asked to tune the color of a disk of light to produce a pure yellow light that was neither reddish yellow nor greenish yellow. Everyone selected nearly the same wavelength of yellow, showing an obvious consensus over what color they perceived yellow to be. Once Williams looked into their eyes, however, he was surprised to see that the number of long- and middle-wavelength cones--the cones that detect red, green, and yellow--were sometimes profusely scattered throughout the retina, and sometimes barely evident. The discrepancy was more than a 40:1 ratio, yet all the volunteers were apparently seeing the same color yellow.

"Those early experiments showed that everyone we tested has the same color experience despite this really profound difference in the front-end of their visual system," says Hofer. "That points to some kind of normalization or auto-calibration mechanism--some kind of circuit in the brain that balances the colors for you no matter what the hardware is."

More...

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Urine Test To Detect Bladder Cancer

Filed under: Diagnostics , Oncology , Pathology , Urology

The earlier you diagnose it, the more effective the treatment will be. This is the valid rule for all types of cancer, and bladder cancer is definitely not an exception. Of course this is by far not an easy task.

In the latest edition of The Journal of the American Medical Association, a group of Italian researchers reports on a new urine test to detect bladder cancer.

Reuters writes:

The test for the enzyme telomerase in urine was found to be accurate 90 percent of the time in men, after the cancer diagnoses were confirmed with standard invasive examinations of the bladder and urinary tract. The test also detected the disease in early stages.
Despite the demonstrated accuracy of the test in a small study of 218 male patients, the researchers said further study is needed for what is a promising diagnostic tool.

"It is not recommended for use in routine screening programs because of the low incidence of bladder cancer, and should be aimed at high-risk sub-groups. Specifically, smokers have about a three-fold increased risk of developing bladder cancer compared to nonsmokers," study author Maria Aurora Sanchini wrote.

Read the abstract of this study...

NOTE: The Good Old Days is on vacation. Nice weekend to all of you! See you back on Monday.

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Thursday, October 27, 2005

Pillow for Snorers

Filed under: Medicine , OTC

Mia over at Popgadget describes this specialized pillow from (where else?) Japan:

This new pillow by Francebed Medical Service Co. should settle the issue by recording the snores, as well as helping to find out which pillow position makes the snoring stop, or at least ease in volume. The recording device is attached to a sensor in the pillow, which has three layers of stuffing, so that the snoring sleeper can find out if differing the pillow height affects the snoring. The same monitoring could be achieved with any sound activated recording device and a mountain of different-sized pillows but I really don't think I ever want to hear what I sound like sleeping. I like having the option of denial.

Here is free clinical advice for all of you obstructive sleepers out there. To save yourself a trip to Japan, put up a tee shirt that has a breast pocket, so the pocket is on the back. Insert tennis ball into the pocket, and go to sleep. Since most people obstruct while sleeping on their back, you will not: you will be forced to sleep on the side. Save your heart from pulmonary hypertension: snoring often is way too serious a symptom to ignore.

Link at Popgadget...

(hat tip: Gizmodo)

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Tiny Robots for Remote Surgery

Filed under: Space Medicine , Surgery , Telemedicine

Mini-robots created at UNMC Mini-robots created by researchers at the University of Nebraska Medical Center might one day perform surgery in space by doctors located on the ground:

Each camera-carrying robot -- the width of a lipstick case -- would illuminate the patient's abdomen, beam back video images and carry different tools to help surgeons stop internal bleeding by clamping, clotting or cauterizing wounds.
Sound far-fetched? Not for physicians and engineers at the University of Nebraska Medical Center and University of Nebraska-Lincoln, who already are turning the sci-fi idea into reality with a handful of miniature prototypes.

"We want to be the Microsoft leader in this technology and be the state that changes the way surgery is done," said Shane Farritor, Ph.D., associate professor in the Department of Mechanical Engineering in UNL's College of Engineering and Technology.

"This work has the potential to completely change the minimally invasive surgery landscape," said Dmitry Oleynikov, M.D., director of education and training for the minimally invasive and computer-assisted surgery initiative. "This is just the start of things to come regarding robotic devices at work inside the body during surgery."

It's a stark contrast to existing laparoscopic techniques, which allow surgeons to perform operations through small incisions. The benefits of laparoscopy are limited to less complex procedures, however, because of losses in imaging and dexterity compared to conventional surgery.

"These remotely controlled in vivo robots provide the surgeon with an enhanced field of view from arbitrary angles, as well as provide dexterous manipulators not constrained by small incisions in the abdominal wall," Dr. Oleynikov said.

In fact, the view is better than the naked eye, he said, because the in-color pictures from the roaming robots are magnified 10x.

On the battlefield, these tiny soldiers can be inserted into wounds and allow remote surgeons to determine how critical the injury is and what immediate steps can be taken to ensure survival.

The UNMC and UNL team also plans to soon test a final prototype of a mobile biopsy robot designed to take samples of tissue. In addition, the design team is making modified robots that can be inserted into the stomach cavity through the esophagus.

The 3-inch long, aluminum-cased robots contain gears, motors, lenses, camera chips and electrical boards. "Three inches seems to be our limit at the moment because of the electrical components we use," said designer Mark Rentschler, a Ph.D. candidate in biomedical engineering at UNL. "If we were to make 1,000 robots we would be able to afford customized electrical components that would reduce the size of the robot by half."

The design team said initially the mini-robots will be single-use devices, although they eventually may be able to be sterilized for multiple use.

The group intends to create a local, spin-off company and then seek FDA approval of the devices, which would be applicable for any laparoscopic or minimally invasive surgery - from gall bladder to hernia repair.

"We're the first in the world to come up with this technology," Dr. Oleynikov said. "Everybody knows this is a Nebraska effort."

The press release...

Additional at the Washington Post...

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Anesthesiology Group: No Widespread Use of Brain Devices Needed

Filed under: Anesthesiology , Critical Care

BIS: The Blackbox The American Society of Anesthesiologists (ASA) has once again decided not to recommend widespread use of "brain function monitoring devices" as necessary tools to prevent intraoperative awareness under general anesthesia. The Task Force of the ASA has just published a practice advisory to help anesthesiologists deal with this serious complication of general anesthesia. The news is indeed a blow to manufacturers of these devices, despite their positive spin press releases.

Here is the explanation from the ASA:

Brain function monitoring devices, made by a handful of companies, use processed electroencephalographic data to assign a numeric value to a patient's depth of sedation. One application for which they are marketed is to help minimize the risk of intraoperative awareness.
The report recognizes the devices as a possible tool for monitoring selected patients, but concludes that the decision to use this emerging technology should be made on a case-by-case basis by the individual practitioner.

"There is still much to be discovered about how these devices work, and in which situations they are best applied," Dr. Guidry said. "We are interested in following their continued evolution and to conducting further research in this area. Meanwhile, brain function monitors are an option to be used when the anesthesiologist deems it appropriate, just as he or she makes choices about specific drugs, dosages, warming devices, and other types of monitors depending on the individual patient."

From an historical perspective, ASA's approach to these monitors is consistent with its approach to other types of equipment used by anesthesiologists. For example, capnographs and pulse oximeters are widely used today to monitor surgical patients' breathing and blood oxygen levels. Yet language encouraging their use in ASA standards and guidelines did not happen overnight; it was strengthened gradually as the devices' usefulness, reported by anesthesiologists and researchers, became more evident.

One also has to recognize the fundamental difference between capnographs, pulse oximeters, and brain function monitoring devices, such as the pictured BIS monitor of Aspect Medical Systems. While capnographs and pulse oximeters calculate physically measurable values (partial pressure of CO2; percentage of hemoglobin saturation), BIS Monitor and others cook up a single number through proprietary secret algorithms. The secrecy of how the monitor translates information from the electroencephalogram (EEG) into a single number will make it even more difficult to popularize such devices. After all, physicians are scientists, and naturally have reservations about the data from a black box. As for us, we'll take BIS anytime someone passes gas at us.

More at the WaPo...

The BIS technology...

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Monday, October 31, 2005

Doctors, Cadavers, and America's First Riot

Monday, October 31, 2005

Predicting Fracture with Lasers

First Contact with a Universal Translator

The Athena Radar-Responsive Tag

A Modified Femtosecond Laser for Medical Applications

TempTouch® for Diabetics

More on Wikipedia

New Dyslexia Gene Identified

Friday, October 28, 2005

Hospitals Offer Incentives to Doctors for Chosing Cheaper Implants

Chewing Gum Speeds Recovery After Laparoscopic Surgery

Folding@home Medgadget Team

Victory® Pacemakers

Revealed: How to Knit a DNA Model

Gold Nanorods Brighten Future for Medical Imaging

Color Perception Is Not in the Eye of the Beholder: It's in the Brain

Urine Test To Detect Bladder Cancer

Thursday, October 27, 2005

Pillow for Snorers

Tiny Robots for Remote Surgery

Anesthesiology Group: No Widespread Use of Brain Devices Needed