Here comes the sun, and kid sun safety

(HealthDay)—Summer sun brings childhood fun, but experts warn it also brings skin cancer dangers, even for kids.

“Don’t assume children cannot get skin cancer because of their age,” said Dr. Alberto Pappo, director of the solid tumor division at St. Jude Children’s Research Hospital in Memphis, Tenn. “Unlike other cancers, the conventional melanoma that we see mostly in adolescents behaves the same as it does in adults.”

His advice: “Children are not immune from extreme sun damage, and parents should start sun protection early and make it a habit for life.”

So, this and every summer, parents should take steps to shield kids from the sun’s harmful UV rays.

Those steps include:

* Avoid exposure. Infants and children younger than 6 months old should avoid sun exposure entirely, Pappo advised. If these babies are outside or on the beach this summer, they should be covered up with hats and appropriate clothing. It’s also a good idea to avoid being outside when UV rays are at their peak, between 10 a.m. and 2 p.m.

* Use sunscreen. It’s important to apply a broad-spectrum sunscreen to children’s exposed skin. Choose one with at least SPF15 that protects against both UVA and UVB rays. Pappo cautioned that sunscreen needs to be reapplied every couple of hours and after swimming—even if the label says it is “water-resistant.”

However, sunscreen should not be used on infants younger than 6 months old because their exposure to the chemicals in these products would be too high, he noted.

* Keep kids away from tanning beds. Melanoma rates are rising among teenagers, partly due to their use of indoor tanning beds. Use of tanning beds by people younger than 30 boosts their risk for this deadly form of cancer by 75 percent, according to the International Agency for Research on Cancer.

* Get children screened. Early detection of melanoma is key to increasing patients’ odds of survival. Children with suspicious moles or skin lesions should be seen by a doctor as soon as possible, Pappo advised. Removing melanoma in its early stages also increases the chances of avoiding more invasive surgical procedures later on, he added.

More information: There are more sun-safety tips at the Skin Cancer Foundation.

The Beat Goes On | Heart Transplants Still a Marvel of Modern Medicine

On this day in 2001, a petite 44-year-old woman received a successful heart transplant at Ronald Reagan UCLA Medical Center, thanks to an experimental Total Artificial Heart designed for smaller patients.

The UCLA patient was the first person in California to receive the smaller Total Artificial Heart, and the first patient in the world with the device to be bridged to a successful heart transplant — that is, to go from needing a transplant to receiving one.

The 50cc SynCardia temporary Total Artificial Heart is a smaller investigational version of the larger 70cc SynCardia heart, which was approved for use in people awaiting a transplant by the Federal Food and Drug Administration in 2004 and has been used by more than 1,440 patients worldwide.

The 50cc device is designed to be used by smaller patients — including most women, some men and many adolescents — with end-stage biventricular heart failure, where both sides of the heart are failing to pump enough blood to sustain the body. The device provides mechanical support until a donor heart can be found

Nemah Kahala, a wife and mother of five, was transferred to UCLA from Kaiser Permanente Los Angeles Medical Center in March.  She was suffering from restrictive heart muscle disease and in critical condition.  Her heart failure was so advanced that repair surgery and other mechanical assist devices could not help.

Kahala was placed on a life support system called extra corporal membrane oxygenation, but this only works for about 10 days before a person’s organs begin to deteriorate.

With the clock ticking, doctors needed to buy time by replacing Kahala’s failing heart with an artificial heart while she waited for a heart transplant.  Her chest cavity was too small for her to receive the larger 70cc artificial heart.  However, under a one-time emergency use permitted under FDA guidelines, her doctors were able to implant the experimental 50cc device.

“Mrs. Kahala’s condition was deteriorating so rapidly that she would have not survived while waiting for a transplant,” said her surgeon, Dr. Abbas Ardehali, a professor of cardiothoracic surgery and director of the UCLA Heart and Lung Transplant Program. “We were grateful to have this experimental technology available to save her life and help bridge her to a donor heart.”

The artificial heart provides an immediate and safe flow of blood to help vital organs recover faster and make patients better transplant candidates.

After the two-hour surgery to implant the artificial heart, Kahala remained hospitalized in the intensive care unit and eventually began daily physical therapy to help make her stronger for transplant surgery.

Two weeks after the total artificial heart surgery, she was strong enough to be placed on the heart transplant list.  After a week of waiting, a donor heart was found.

“In addition to the high-tech medicine that kept her alive, Mrs. Kahala and her family exemplified how a solid support system that includes loved ones and a compassionate medical team practicing what we at UCLA have termed ‘Relational Medicine’ plays an important role in surviving a medical crisis,” said Dr. Mario Deng, professor of medicine and medical director of the Advanced Heart Failure, Mechanical Support and Heart Transplant program at UCLA.

Kahala was discharged from UCLA on April 18.

Since 2012, the UCLA Heart Transplant Program has implanted eight 70cc SynCardia Total Artificial Hearts. UCLA also participated in the clinical study of a 13.5-pound Freedom portable driver — a backpack-sized device that powers the artificial heart, allowing the patient to leave the hospital — that received FDA approval on June 26, 2014.

The FDA cautions that in the United States, the 50cc SynCardia temporary Total Artificial Heart is an investigational device, limited by United States law to investigational use.  The 50cc TAH is in an FDA-approved clinical study.

First Fully Contained Artificial Heart

On the same day, a patient was implanted with the world’s first self-contained mechanical heart after a 7-hour operation, a hospital in Louisville, Kentucky. The procedure was the first major advance in the development of an artificial replacement heart in nearly two decades.

The device, created by Danvers, Massachusetts-based Abiomed Inc., replaces the lower chambers of a patient’s failing heart with a plastic-and-metal motorized hydraulic pump which weighs 2 pounds (1 kg) and is about the size of a grapefruit.

It was the first artificial heart to be free of wires connecting it to the outside.

“This is the first time this has ever been done,” said Kathy Keadle, a spokeswoman at Jewish Hospital where the procedure was performed by University of Louisville surgeons Laman Gray and

Neither Abiomed nor hospital officials would disclose the name, sex or gender of the patients, all of whom are seriously ill.  The long-awaited surgery had been expected by June 30 but was delayed because the company had not completed patient screening.

Abiomed got U.S. Food and Drug Administration approval in February’s 2001 to test the device on as many as 15 patients, all of whom are too ill to be candidates for a heart transplant.  Unlike existing devices, which serve as a temporary solution to extend a patient’s life until a patient can secure a donor heart, the AbioCor heart is designed to be a fully functioning replacement heart.

The trial involved severely ill patients with less than 30 days to live, said John Thero, vice president and chief financial officer of Abiomed.

“This is not a bridge to transplant. There is a scarcity of donor hearts available,” Thero said in a telephone interview. “We are starting with patients who are at the ends of their lives. They are not candidates for transplant and are near death. Our goal is to provide them with a reasonable quality of life and an extension of life.”

Thero said the current candidates had a life expectancy of two months. “While the device is designed to eventually go much longer, if we were able to double someone’s life expectancy, we would be very pleased,” he said.

The 40,000 patients awaiting heart transplants far outnumber the number of hearts available, and a successful mechanical heart could fill a huge need.

Earlier versions of the artificial heart were bulky and provided limited benefit to patients.  In 1982, Dr. Barney Clark, 61, of Salt Lake City, Utah, received the first permanent artificial heart, known as Jarvik-7. He was bound to his bed by protruding cables, tubes and a noisy box-like air compressor during the 112 days that he survived with the artificial heart.

With the Jarvik-7 and other “bridge devices,” the outside connectors leave patients exposed to infection.  The AbioCor contains a small electric motor attached to an implanted battery and is designed to last for years. Patients could wear a battery pack or plug into an electrical outlet to recharge the heart’s battery.

A Brief History of Heart Transplant

Long before human-to-human transplantation was ever imagined by the public, scientists were conducting pioneering medical and surgical research that would eventually lead to today’s transplantation successes. From the late 1700s until the early 1900s, the field of immunology was slowly evolving through the works of numerous independent scientists. Among the notable breakthroughs were Ehrlich’s discovery of antibodies and antigens, Lansteiner’s blood typing, and Metchnikoff’s theory of host resistance.

Because of advances in suturing techniques at the end of the 19th century, surgeons began to transplant organs in their lab research. At the start of the 20th century, enough experimentation had taken place to know that xenographic (cross species) transplants invariably failed, allogenic transplants (between individuals of same species) usually failed, while autografts (within the same individual, generally skin grafts) were almost always successful. It was also understood that repeat transplants between same donor and recipient experienced accelerated rejection, and that graft success was more likely when the donor and recipient shared a “blood relationship.”

Alexis Carrel was a French surgeon and Nobel laureate whose experiments involved sustaining life in animal organs outside the body. He received the 1912 Nobel Prize in Medicine or Physiology for his technique for suturing blood vessels. In the 1930s, he collaborated with the aviator Charles Lindbergh to invent a mechanical heart that circulated vital fluids through excised organs. Various organs and animal tissues were kept alive for many years in this fashion.

Throughout the 1940s and 50s, small but steady research advances were made. In 1958, Dickinson Richards, MD, chairman of the Columbia University Medical Division, and Andre Cournaud were awarded the same Nobel Prize for their work leading to fuller understanding of the physiology of the human heart using cardiac catheterization.

In that same year, Keith Reemtsma, MD, a member of the faculty of Tulane University who later became chairman of the Department of Surgery at Columbia University Medical Center, showed for the first time that immunosuppressive agents would prolong heart transplant survival in the laboratory setting.

At this time, Norman Shumway, MD, Richard Lower, MD, and their associates at Stanford University Medical Center were embarking on the development of heart-lung machines, solving perfusion issues, and pioneering surgical procedures to correct heart valve defects. Key to their success was experimentation with “topical hypothermia,” the localized hyper-cooling of the heart which allowed the interruption of blood flow and gave the surgeons the proper blood-free environment and adequate time to perform the repairs. Next came “autotransplantation,” where the heart would be excised and resutured in place.

By the mid-1960s, the Shumway group was convinced that immunologic rejection was the only remaining obstacle to successful clinical heart transplantation. In 1967, Michael DeBakey, MD, implanted an artificial left ventricle device of his design in a patient at Baylor College of Medicine in Houston.

In 1967, a human heart from one person was transplanted into the body of another by a South African surgeon named Dr. Christiaan Barnard in Cape Town. In early December, Dr. Barnard’s surgical team removed the heart of a 25-year-old woman who had died following an auto accident and placed it in the chest of Louis Washkansky, a 55-year-old man dying of heart damage. The patient survived for 18 days. Dr. Barnard had learned much of his technique from studying with the Stanford group. This first clinical heart transplantation experience stimulated world-wide notoriety, and many surgeons quickly co-opted the procedure. However, because many patients were dying soon after, the number of heart transplants dropped from 100 in 1968, to just 18 in 1970. It was recognized that the major problem was the body’s natural tendency to reject the new tissues.

Over the next 20 years, important advances in tissue typing and immunosuppressant drugs allowed more transplant operations to take place and increased patients’ survival rates. The most notable development in this area was Jean Borel’s discovery of cyclosporine, an immunosuppressant drug derived from soil fungus, in the mid 1970s.

The cardiac transplant program at Columbia University Medical Center began in 1971 as part of an investigational surgery program initiated by Dr. Keith Reemtsma. At that time, Columbia University Medical Center was one of only a handful of medical centers in the nation actively engaged in cardiac transplant research. Columbia University Medical Center’s first cardiac transplant was performed by Dr. Reemtsma in 1977, when survival rates had begun to improve significantly. That patient survived for 14 months. Two additional transplants were performed that year. Initially Columbia University Medical Center accepted patients deemed too risky for transplantation by Stanford and the Medical College of Virginia, the only other medical centers in the country performing heart transplants.

Thanks to the persistence of pioneers in immunosuppression research, transplant patients have dramatically expanded life expectancies. The first immunosuppressant drugs used in organ transplantation were the corticosteroids. In 1983, Columbia University Medical Center became one of a small group of medical centers to initiate clinical trials of cyclosporine; approved for commercial use in November of that year, it is still the most commonly prescribed immunosuppressant used in organ transplantation. General information on the variety of medications that may be prescribed for you is found in the chapter on Medications in the section Care and Concerns after Your Operation.

In 1984, the world’s first successful pediatric heart transplant was performed at Columbia on a four-year-old boy. He received a second transplant in 1989 and lived until he succumbed to other health issues in 2006.

Also, in 1984, in Loma Linda, California, Leonard Bailey, MD, implanted a baboon heart into a 12-day-old girl who came to be known as “Baby Fae.” The infant survived for twenty days as the most famous recipient of xenographic transplantation. Throughout the decade of the 1980s and into the 90s, physicians continue to refine techniques for balancing dosages of immunosuppressant medications to protect the new heart yet allow the patient sufficient immunologic function to stave off infection. In 1994 a new drug, tacrolimus or FK-506, originally discovered in a fungus sample, was approved for immunosuppression in transplant patients. Newer formulations of cyclosporine now enable efficacy (effectiveness) at lower, less toxic dosages.

While research on transplantation issues continues, other techniques for the management and cure of heart disease are also under development. Some future directions include:

Coronary assist devices and mechanical hearts are being developed or perfected to perform the functions of live tissues. Artificial hearts have been under development since the 1950s. In 1966, Dr. DeBakey first successfully implanted a booster pump as a temporary assist device. Columbia’s cardiac surgeons have been instrumental in the development of a LVAD (left ventricular assist device) to function as a bridge-to-transplantation for those waiting for a new heart to become available. Columbia University Medical Center’s lead role in the REMATCH clinical trial helped to lead to approval for the the LVAD as a permanent, or destination, therapy as well.

In 1969, Dr. Denton Cooley implanted the first completely artificial heart in a human, again on a temporary basis. The first permanent artificial heart, designed by Dr. Robert Jarvik, was implanted in 1982. Numbers of patients have received Jarvik or other artificial hearts since, but surviving recipients have tended to suffer strokes and related problems.

There is a tremendous gap in the number of patients waiting for new hearts and the number of organs that actually become available. In addition to avoiding the immunosuppression and rejection complications of transplantation, success in clinical application of such mechanical devices can help resolve the issue of organ availability and thus, stakes are high to continue research in this arena.

Advances in immunosuppression have most recently involved the development and expanded use of polyclonal and monoclonal antibodies to counteract steroid-resistant rejection. Research continues into the management, reversal and avoidance of accelerated atherosclerosis in the transplanted heart, believed to be caused or aggravated by the required suppression of the body’s normal immunology. From the development of more powerful and specific immunosuppressants to new treatments for accelerated graft atherosclerosis, advances in the science of immunology appear to hold the key to expanding the success of heart transplantation in our treatment of end-stage cardiac disease.

If your ticker needs an update, or you are just feeling a little BLAH, go to HealthLynked.com to find the right physician for you.  We are the world’s first every healthcare ecosystem designed to connect physicians to patients in unique ways for the efficient exchange of information.

Transplant the old ways of finding and sharing with your doctor.  Restore great relational medicine.  Go to Healthlynked.com today and sign up for free!

Sources

UCLAnewsroom.edu

Wired.com

Columbiasurgery.org

Title:  The Beat Goes On | Heart Transplants a Marvel of Modern Medicine

 

#heart,#transplant,#immunosuppression

 

11 Ways Laughter IS the Best Medicine, and It IS Contagious !

Do you remember that last time you had a good, hearty, deep from your very soul laugh? For my family, it was last night while we enjoyed fireworks with friends over the lake in anticipation of the 4th of July celebration. Josh Billings said, “Laughter is the fireworks of the soul”; and great wisdom can be found in Proverb (17:22): “A cheerful heart is good medicine, but a broken spirit saps a person’s strength.”

There are tremendous health benefits found in laughing – it strengthens your immune system, triggers the release of endorphins that lift your mood, helps protect your heart, diminishes pain and protects you by reducing effects of stress.

One of the best feelings in the world is that deep belly laugh – to have one and even to hear it in others. While the ability to laugh is a powerful health resource, mentally, emotionally and physically. it can also bring people together and establish amazing connections. Everything from a slight giggle to a side-splitting guffaw can change the atmosphere of a room from chilly unfamiliarity to warm and family-like. Studies have shown a strong, positive bond is created when we laugh with one another.

So, when was the last time you found yourself laughing out loud? Hopefully, you are one of the fortunate ones that has enjoyed the delights of laughing recently – and the powerful preventive benefits its joy offers. There is so much to love about laughter and many ways it promotes wellness and wellbeing in everyday life, at home, work and at play.

What is laughter?

While the brain mechanisms behind laughing (and smiling) remain a mystery, it is often a spontaneous response to humor or other visual, auditory, or emotional stimuli. And, too, it can occur on command—as either voluntary or contrived.

When we laugh, air is forced through the vocal cords as a result of chest wall contractions, in particular from the diaphragm. It is often followed by a deep inspiration of air. Thus, laughter recruits a number of muscles—respiratory, laryngeal, and facial. And when “exuberant,” it can also involve the arms and legs.

When do humans begin laughing?

Our first laugh typically occurs between 3 to 4 months of age—even before we learn to speak! It is believed that a baby’s laugh serves as a way to communicate, bond, and, too, explore sound and vocalization.
There is already so much to love for laughter that it seems greedy to look for more, but that’s exactly what researchers Dr. Lee Berk and Dr. Stanley Tan at the Loma Linda University in California have done. These two doctors have researched the benefits of laughter and found amazing results.

1. Lowers blood pressure
People who lower their blood pressure, even those who start at normal levels, will reduce their risk of stroke and heart attack. So, grab the Sunday paper, flip to the funny pages, and enjoy your laughter medicine, or pull up the latest memes in social media. Of even better, watch your favorite funny movie, or check out these YouTube posts from LucidChart.

2. Reduces stress hormone levels
By reducing the level of stress hormones, you’re simultaneously cutting the anxiety and stress that impacts your body. Additionally, the reduction of stress hormones may result in higher immune system performance. Just think: Laughing along as a co-worker tells a funny joke can relieve some of the day’s stress and help you reap the health benefits of laughter.

Psychologically, having a good sense of humor—and applying it by laughing—may permit us to have a better perspective on things by seeing situations in a “more realistic and less threatening light.” Physically, laughter can put a damper on the production of stress hormones—cortisol and epinephrine—as well as trigger the release of endorphins. Endorphins are our body’s natural painkillers and can boost our mood. And, too, it has been shown that a good LOL or ROTFL — texting slang for “laugh out loud” or “rolling on the floor laughing” — can relax our muscles for up to 45 minutes after.

3. Works your abs
One of the benefits of laughter is that it can help you tone your abs. When you are laughing, the muscles in your stomach expand and contract, similar to when you intentionally exercise your abs. Meanwhile, the muscles you are not using to laugh are getting an opportunity to relax. Add laughter to your ab routine and make getting a toned tummy more enjoyable.

4. Improves cardiac health
Laughter is a great cardio workout, especially for those who are incapable of doing other physical activity due to injury or illness. It gets your heart pumping and burns a similar number of calories per hour as walking at a slow to moderate pace. So, laugh your heart into health.

The American Heart Association states that laughter can help our hearts. Research shows that by decreasing stress hormones, we can see a decrease in blood pressure as well as artery inflammation and bad cholesterol levels. Elevated blood pressure forces our heart to work harder in order to generate the force needed to pump against the increased resistance. And inflammation and high cholesterol contribute to the development of fatty plaques that decrease blood flow to the heart, or, even, complete blockage that can cause a heart attack.

5. Boosts T-cells
T-cells are specialized immune system cells just waiting in your body for activation. When you laugh, you activate T-cells that immediately begin to help you fight off sickness. Next time you feel a cold coming on, add chuckling to your illness prevention plan.

6. Triggers the release of endorphins
Endorphins are the body’s natural painkillers. By laughing, you can release endorphins, which can help ease chronic pain and make you feel good all over.

7. Produces a general sense of well-being
Laughter can increase your overall sense of well-being. Doctors have found that people who have a positive outlook on life tend to fight diseases better than people who tend to be more negative. Smile, laugh, and live longer!

8. Improves bonding
There has been much written that laughter is not primarily about humor, but, instead, social relationships. When we laugh, we create a positive emotional climate and a sense of connection between two people. In fact, with romantic partners, shared laughter—when you laugh together—is an indicator of relationship well-being, in that it enhances closeness and perceptions of partner supportiveness.

9. Can shed pounds
In a study published in the International Journal of Obesity, researchers found that 15 minutes of genuine laughter burns up to 40 calories, depending on the individual’s body weight and laughter intensity. While this cannot replace aerobic physical activity, 15 minutes of daily LOL, over the course of a year, could result in up to 4 fewer pounds.

10. Enhances our ability to fight off germs
Laughter increases the production of antibodies—proteins that surveillance for foreign invaders—as well as a number of other immune system cells. And, in doing so, we are strengthening our body’s defenses against germs. Additionally, it is a well-known fact that stress weakens our immune system. And because laughing alleviates our body’s stress response, it can help dampen its ill-effects.

11. A natural pain-killer
The iconic Charlie Chaplin stated: “Laughter is the tonic, the relief, the surcease for pain.” Although Mr. Chaplin probably meant this figuratively, laughter can literally relieve pain by stimulating our bodies to produce endorphins — natural painkillers. Laughter may also break the pain-spasm cycle common to some muscle disorders. The best part: You do not need a prescription and there are no known side-effects.

Is it contagious?

Yes. The saying “laugh and the whole world laughs with you” is not just figurative, it is literal. When we hear laughter, it triggers an area in our brain that is involved in moving the muscles in our face, almost like a reflex. This is one of the reasons television sitcoms have laugh tracks—a separate soundtrack that contains the sound of audience laughter. We are more likely to find the joke or situation funny and chuckle, giggle, or guffaw.

How to use laughter to heal and uplift.

Laughter is a physical expression of pleasant emotions among human beings. It is preceded by what one sees, hears or feels. When shared, it serves to connect people and increases intimacy and is a good anti-stress medicine.

LOL or lol, has become a very popular element of internet communications and texting in expressing great amusement in a chat. As well, according to research, the smiling and “tears of joy” laughing emoji faces are tops in digital communications. Their usage is so widespread and so common, that we now actually have data that demonstrates that the use and placement of emojis carries an emotional weight which impacts our perception of the messages that frame these icons (understanding the mental states of others is crucial to communication). And yes, in today’s busy world we may be utilizing =D and LOL’s at every turn, but let’s lean in to the hilarious and enjoy the good, hearty health benefits of laughter.

And remember, know when not to laugh. Laughter at the expense of others or in hurtful situations is inappropriate.

Now, make a commitment to laugh more.

In his book, The Travelers Gift, Andy Andrews challenges the traveler to start each day with laughter within moments of waking. It changes your whole being, even if you only laugh for seven seconds. I have tried it. I have faked it, and even as I start with the fake laugh, I can’t stop after seven seconds.

Practice laughing by beginning with a smile and then enact a laugh. Although it may feel contrived at first, with practice, it will likely become spontaneous. At Laughter University (yes, there is one) they encourage at least 30 seconds. There is so much going on around us that is laughable!

We can also move towards laughter by being with those who laugh and return the favor by making them laugh. And, too, surround ourselves with children and pets. On average, children laugh 300 times a day! And we know that laughter is contagious. Studies have shown people are immensely happier just seeing a picture of a dog!

Even make an effort to find the humor in an unpleasant situation, especially with situations that are beyond our control.

For all this, you will be made glad. Laughter wipes away stress, decreases blood pressure, burns calories, alleviates pain, connects us to others, reinvigorates us with hope, helps ward off germs … (the list goes on) – and feels soooo good. LOL for better health, connection and joy!

Want to find a physician who tickles your funny bone or at least knows where it is?  Find them in the fastest growing HealthCare ecosystem around.

HealthLynked is the first of its kind network designed to connect patients with their physicians for a higher purpose – Improving HealthCare!

Ready to get Lynked?  Got to HealthLynked.com to sign up for free!

Sources:
Gaiam.com
laughteronlineuniveristy,com
Dr. Nina Radcliff, Laugh, giggle, be joyful — for lol; ‘The fireworks of the soul’. Washington Post

The Truth About Coffee

Sure the smell of bacon in the morning is great and all, but nothing beats coffee. Let’s get down to the facts: Is coffee good or bad for you? Get the answer to this and more of your coffee questions.
Quiz: Myths and Facts about Coffee http://wb.md/2iRdrmL

Subscribe to WebMD here: https://www.youtube.com/user/WebMD

Follow WebMD here:
Website: http://webmd.com
Facebook: https://www.facebook.com/WebMD/
Pinterest: https://www.pinterest.com/webmd/
Twitter: https://twitter.com/WebMD
Instagram: https://www.instagram.com/webmd/

Source by [author_name]

WebMD,health,nutrition,coffee,the truth about coffee,is coffee good for you,is coffee bad for you,food,caffeine,coffee addiction,decaf,coffee myths and facts

Relativity, Radiology and 6 Things You May not Know About Einstein

More than any other profession, radiologists and radiologic technologists put theoretical quantum physics to practical use Improving the health and lives of their patients. Although quantum light theory can explain everything from the tiniest subatomic particles to immense galaxy-devouring black holes, radiologists apply this technology at the human level to diagnose and treat disease and thus alleviate human suffering.

More than 100 years ago in 1895, Wilhelm Conrad Roentgen discovered a form of radiation which had strange new properties. These new rays were so unique and mysterious that he named them “X-rays”, for the unknown. Although often described as a fortuitous discovery, chance favors the prepared mind, and Roentgen’s astute observations back then are still accurate today.

X-rays

6 Things You May not Know About Einstein
Digital portrait of Wilhelm Roentgen holding a cathode ray tube. Image by Mark Hom
  • transmit in complete darkness
  • invisible to the human eye
  • originate from a cathode ray tube
  • expose covered photographic plates
  • diminish in intensity following the inverse square law of light emission
  • soft tissues appear trans­parent, but metal and bone appear opaque.
  • transparency of intervening objects depends on their molecular density and thickness
  • not reflected by mirrors nor deflected by glass prisms
  • travel at a constant speed – the speed of light
  • share some properties with visible light, yet also have uniquely different properties

For the very first time, doctors (without using a scalpel) could see beyond the skin surface of their patients and peer deep inside the human body. It was later found that X-rays were a form of electromagnetic radiation with wavelengths shorter and with energies greater than visible light.

Subsequent research into particle theory by Albert Einstein and others led to the physics principles that not only laid the groundwork for state-of-the-art medical imaging but also changed the understanding of our entire universe, from the mechanics of the atom to the largest objects in the universe. In 1901, Roentgen received the very first Nobel Prize awarded in physics, an indication that his discovery of a form of invisible light was the beginning of a remarkable scientific journey.

Albert Einstein

Albert Einstein’s theories of relativity soon followed and would explain the space time continuum and the equivalence of mass and energy. Throughout his brilliant career, Einstein was fascinated and preoccupied with the strange properties of light. Einstein once said, “For the rest of my life I will reflect on what light is.”

His concept of special relativity came to him when he was riding his bicycle towards a lamp post. He realized that the speed of light was the only constant for all observers and that the classic Newtonian measurements of mass, distance, and time were all subject to change at velocities approaching the speed of light. Einstein’s relativity means that the science fiction adventures of galaxy-hopping space travel in Star Trek and Star Wars are mere fantasy. The vast distances of space and the universal speed limit of light make intergalactic travel too impractical. If a hypothetical space craft approaches the speed of light, time slows, length compresses, the mass of the space craft increases, and impossibly high amounts of energy are required. At a certain point, the space craft stops accelerating, despite greater and greater energy input.

A result of Einstein’s special theory of relativity has been called the most famous equation in all of science. Energy (E) equals mass (m) multiplied by the speed of light squared (c2), that is E=mc2. This simple equation, which states that energy and mass are interchangeable quantities, is often misinterpreted as the formula of the atomic bomb. The principle of the atomic bomb is bom­bardment of a uranium atom with a neutron that splits the uranium atom into two smaller atoms and more neutrons that trigger a fission chain reaction. Although tremendous energy is released, it is the energy of internuclear binding forces, and there is no appreciable change in mass.

A much better demonstration of E=mc2 is the physics of positron emission tomography (PET scan­ning), in which an electron and positron (the antiparticle of an electron) annihilate each other and convert their masses into pure light energy, consisting of photons traveling in opposite directions. This light is detected and calculated as a three-dimensional image of the patient. Einstein was another founder of radiology because his theory of the Photoelectric Effect (published in 1905 and awarded the Nobel Prize in 1921) explained how X-rays interact with matter. This theory also showed that light was absorbed and emitted in discreet packets of energy, leading to the Quantum Theory revolution in physics. 6 Things You May not Know About Einstein

Here are a few more interesting things to know about Einstein’s theory of relativity:

  1. Einstein relied on friends and colleagues to help him develop his theory. 
    Though the theory of general relativity is often presented as a work of solo genius, Einstein actually received considerable help from several lesser-known friends and colleagues in working on the math behind it. College friends Marcel Grossmann and Michele Basso (Einstein supposedly relied on Grossmann’s notes after skipping class) were especially important in the process. Einstein and Grossman, a math professor at Swiss Polytechnic, published an early version of the general relativity theory in 1913, while Besso—whom Einstein had credited in the acknowledgments of his 1905 paper on the special theory of relativity—worked extensively with Einstein to develop the general theory over the next two years. The work of the great mathematicians David Hilbert—more on him later—and Emmy Noether also contributed to the equations behind general relativity. By the time the final version was published in 1916, Einstein also benefited from the work of younger physicists like Gunnar Nordström and Adriaan Fokker, both of whom helped him elaborate his theory and shape it from the earlier version.
  2. The early version of the theory contained a major error. 
    The version published by Einstein and Grossmann in 1913, known as the Entwurf (“outline”) paper, contained a major math error in the form of a miscalculation in the amount a beam of light would bend due to gravity. The mistake might have been exposed in 1914, when German astronomer Erwin Finlay Freundlich traveled to Crimea to test Einstein’s theory during the solar eclipse that August. Freundlich’s plans were foiled, however, by the outbreak of World War I in Europe. By the time he introduced the final version of general relativity in November 1915, Einstein had changed the field equations, which determine how matter curves space-time.
  3. Einstein’s now-legendary paper didn’t make him famous—at first. 
    The unveiling of his masterwork at the Prussian Academy of Sciences—and later in the pages of Annelen Der Physik—certainly afforded Einstein a great deal of attention, but it wasn’t until 1919 that he became an international superstar. That year, British physicist Arthur Eddington performed the first experimental test of the general relativity theory during the total solar eclipse that occurred on May 29. In an experiment conceived by Sir Frank Watson Dyson, Astronomer Royal of Britain, Eddington and other astronomers measured the positions of stars during the eclipse and compared them with their “true” positions. They found that the gravity of the sun did change the path of the starlight according to Einstein’s predictions. When Eddington announced his findings in November 1919, Einstein made the front pages of newspapers around the world.
  4. Another scientist (and former friend) accused Einstein of plagiarism. 
    In 1915, the leading German mathematician David Hilbert invited Einstein to give a series of lectures at the University of Gottingen. The two men talked over general relativity (Einstein was still having serious doubts about how to get his theory and equations to work) and Hilbert began developing his own theory, which he completed at least five days BEFORE Einstein made his presentation in November 1915. What began as an exchange of ideas between friends and fellow scientists turned acrimonious, as each man accused the other of plagiarism. Einstein, of course, got the credit, and later historical research found that he deserved it: Analysis of Hilbert’s proofs showed he lacked a crucial ingredient known as covariance in the version of the theory completed that fall. Hilbert actually didn’t publish his article until March 31, 1916, weeks after Einstein’s theory was already public. By that time, historians say, his theory was covariant.
  5. At the time of Einstein’s death in 1955, scientists still had almost no evidence of general relativity in action. 
    Though the solar eclipse test of 1919 showed that the sun’s gravity appeared to bend light in the way Einstein had predicted, it wasn’t until the 1960s that scientists would begin to discover the extreme objects, like black holes and neutron stars, that influenced the shape of space-time according to the principles of general relativity. Until very recently, they were still searching for evidence of gravitational waves, those ripples in the fabric of space-time caused (according to Einstein) by the acceleration of massive objects. In February 2016, the long wait came to an end, as scientists at the Laser Interferometer Gravitational Wave Observatory (LIGO) announcedthey had detected gravitational waves caused by the collision of two massive black holes.
  6. You can thank Einstein for GPS. 
    Though Einstein’s theory mostly functions among things like PET scanners and in the black holes and cosmic collisions of the heavens, on an ultra-small scale (think string theory), it also plays a role in our everyday lives. GPS technology is one outstanding example of this. General relativity shows that the rate at which time flows depends on how close one is to a massive body. This concept is essential to GPS, which takes into account the fact that time is flowing at a different rate for satellites orbiting the Earth than it is for us on the ground. As a result, time on a GPS satellite clock advances faster than a clock on the ground by about 38 microseconds a day. This might not seem like a significant difference, but if left unchecked it would cause navigational errors within minutes. GPS compensates for the time difference, electronically adjusting rates of the satellite clocks and building mathematical functions within the computer to solve for the user’s exact location—all thanks to Einstein and relativity.

Quantum Theory

Following Einstein’s ideas that light was transmitted in packets of energy, Niels Bohr and Werner Heisenberg developed a model of the atom that diverged from classic Newtonian physics. The Rutherford atomic model consisting of electrons orbiting the central nucleus was inadequate because charged particles changing direction in an orbit would lose energy and fall into the nucleus. Bohr’s model had to explain the Photoelectric Effect, chemical reactions, and the inherent stability of atoms.

A carbon atom can undergo countless chemical reactions yet remains a carbon atom. As Bohr further investigated the atom, the simplistic idea of light just being a wave and electrons just being particles was no longer valid. With the Photoelectric Effect, Einstein showed that light could be a photon particle. Louis de Broglie then showed that particles could be waves. Both photons and electrons have particle-wave duality. The electron therefore could exist as a standing wave around the nucleus, absorb and emit quanta of light energy, and yet remain stable.

The paradoxes that resulted from Bohr’s quantum theory shook the foundations of science. Werner Heisenberg found that the method of investiga­tion alters the result of an experiment. He explained this idea mathematically in his Uncertainty Principle, which remains a major tenet of quantum mechanics. The light used to measure particles imparts energy, altering the momentum or location of the particles, thus changing the results by the mere act of obser­vation. An experiment can be designed to measure either momentum or location precisely, but not both (the experimenter must choose).

“The violent reaction on the recent development of modern physics can only be understood when one realizes that here the foundations of physics have started moving; and that this motion has caused the feeling that the ground would be cut from science.” – Werner Heisenberg

This finding was unsettling for physicists who strove for precise measurements, because precision was not possible at the atomic and subatomic levels. Heisenberg showed that every experiment (and radiologic examination) is subject to limitation. Einstein objected to this inherent fuzziness, stating that “God does not play dice with the Universe.”

The Doppler Effect

Christian Doppler was a professor who studied mathematics, physics, and astronomy. He published a paper on spin­ning binary star systems, noting that starlight shifts to the violet spectrum when a star is moving toward an observer on Earth, and that starlight shifts to the red when a star is moving away. The explanation was that the wavelength of the light wave was compressed or elongated depending on the motion of the source relative to the observer.

When the Doppler Effect is applied to sound, it explains the tone of an approaching or departing train whistle; when applied to radar it pre­dicts violent weather; when applied to ultrasound (another radiology modality) it determines the direction and velocity of blood flow; and when applied to distant starlight it explains our expanding (red shifted) universe. Using Doppler ultrasound, a technologist can screen for: the risk of stroke from carotid artery stenosis, renal arterial causes of hypertension, abdominal aortic aneurysms, periph­eral vascular disease, deep vein thrombosis, portal vein thrombosis and varices, and post-catheterization pseudo-aneurysms.

Countless lives have been saved or improved because of a phenomenon originally observed in starlight. Doppler’s idea extends well beyond the sonography suite and even tells us about the origins of our universe. Edwin Hubble demonstrated that all objects observed in deep space have a Doppler red-shifted veloc­ity that is proportional to the object’s distance from the Earth and all other interstellar bodies. This tells us that our universe is expanding and supports the theory that the universe was created by the Big Bang, which occurred about 13.7 billion years ago.

Old Master Painters

Artists such as Rembrandt and Vermeer (17th century) were adept at depicting light to create the illusion of realistic three-dimensional subjects on two dimensional canvases. These artists studied the interaction of light with their models and understood visual percep­tion of subtle shading and light to make their artwork dramatic and convincing.

Rembrandt van Rijn’s famous por­traits and self-portraits displayed skill with light source positioning and intensity, later duplicated by movie director Cecil B DeMille who coined the term “Rembrandt lighting,” a technique that is still used today by portrait photographers. Johannes Vermeer was skilled at depicting subjects in naturally lit interiors with a subtle photorealistic style that is con­sidered uncanny even today.

Some believe Vermeer used special optics and mirrors because his depiction of light was too subtle for the naked eye to detect.  For example, scientific analysis showed that his backgrounds demonstrated the inverse square law, with exponential diffusion of light, which is difficult to capture when using only an artistic eye.

Experienced radiologic technologists use artistic vision when they create radiographs. By positioning and framing their subjects and by adjusting contrast and exposure, each image can be a work of art, not only pleasing to the eye but also containing a wealth of infor­mation.

Light as the Medium for Medical Imaging

Light, as visual information, is portrayed in art. Light also is the medium for medical imaging, whether in the form of a backlit film, cathode ray tube monitor, liquid crystal display screen, or plasma monitor. The eye is our most complex and highly evolved sense organ, capable of detecting subtle changes in light and color, and transferring this information (via the optic nerves and optic tracts) to the visual cortex of our occipital lobes.

However, what distinguishes artists and seasoned radiology professionals from other people is post-pro­cessing (i.e., the thinking that occurs after perceiving visual data). Much of science and medicine is about logic, language, analysis, and categorization (left brain functions). However, visual processing (the artistic eye) is about conceptualization, spatial orientation, and pattern recognition (right brain functions). These right brain skills are harder to teach and measure but are just as important in radiology.

With the rapid increases in digital image resolution and in the number of multi-planar images involved with each case, developing the right brain is crucial to make sense of this visual information overload. Knowingly or unknowingly, seasoned radiologists develop the right side of their brains through the experience of viewing thousands of medical images. This “artistic eye” can be further enhanced in radiolo­gists and radiologic technologists who appreciate the techniques used by great artists. Or better yet, they can train their right brains by creating original art themselves.

Conclusion

Radiologists and radiologic technologists use light technology and artistic vision in their daily work. They sense subtle shades, recognize patterns, and use symmetry and bal­ance to detect abnormalities. When this artistic skill is applied in combination with an appreciation for the underlying physics that created the images, a thorough knowledge of human anatomy, and an understanding of the pathophysiology of disease, they serve their patients by providing timely diagnosis and excellent medical care.

Sources:  This is the synthesis of two articles:

[1]  PRUITT, SARAH.  6 Things You Might Not Know About Einstein’s General Theory of Relativity, MARCH 18, 2016, History.com

[2]  Hom, Mark. Radiology: Combining Quantum Theory, Medicine, and Artistic Vision, http://scitechconnect.elsevier.com/radiology-quantum-theory-medicine, January 25, 2016

More Information

For more about Dr. Hom’s writings, concepts, and artwork, please refer to his recent articles and book:

The Art and Science of Light: An Illustrated Retrospective, Mark Hom, Radiologic Technology, July/Aug 2015 86 (6), 702-708.
The Artistic Eye and the Radiologist, Mark Hom, American Roentgen Ray Society, Senior Radiologists Section Notes, Fall 2014.
The Science of Fitness: Power, Performance, and Endurance, Greg LeMond and Mark Hom, Publisher: Elsevier, December 2014.

This article first appeared on Memeburn.comClick here for the original.

Dr. Mark Hom is a Johns Hopkins University trained biologist, an award-winning medical illustrator, an interventional radiologist, an educator of young doctors, an Elsevier author, and an avid fitness cyclist. Dr. Hom’s work with Greg LeMond in their recent book The Science of Fitness: Power, Performance, and Endurance explains how the human body, various organ systems, and individual cells function in the biologic process of exercise. He is currently a member of the Department of Radiology at Virginia Commonwealth University in Richmond, VA, USA.

 

A Heavy Load: Teens and Homework Stress

Teens on average have more than 3 hours of homework a night. That doesn’t leave a lot of time for after-school fun or even sleep. Now experts are questioning whether the amount of homework is leading to harmful levels of stress in teens.

To learn more about teens and stress, see our extensive special report with Soledad O’Brien: http://wb.md/1SNUDwb

Subscribe to WebMD here: https://www.youtube.com/user/WebMD

Follow WebMD here:
Website: http://webmd.com
Facebook: https://www.facebook.com/WebMD/
Pinterest: https://www.pinterest.com/webmd/
Twitter: https://twitter.com/WebMD
Instagram: https://www.instagram.com/webmd/

Source by [author_name]

WebMD,health,special report,teens,teenagers,stress,teens and stress,school,high school,homework,teen sleep,teen pressure,Soledad O’Brien,parenting

  Disruptive Technology Turns 11; Creator Set to Break Through $1T

It  was the worst kept tech secret of all time; and though everyone knew it was coming,  no one predicted how the iPhone would change the world.  11 years after its launch, Apple is now poised to become the first ever $1T company.

While people published rumors and others guessed at design, buyers began to camp outside stores days in advance to snag a $600 device they’d never seen. Before its release, the hype for an Apple-devised phone was off the scale. It even garnered the nickname the “Jesus phone” — or “jPhone”.  Some felt it would be miraculous, while most believed it could in no way live up to the hype.

It wasn’t the first time in tech history a frenzy was create over a new device. The first whispers came in the summer of 1944: a Hungarian inventor living in Argentina had created something sensational. On the day of its release, New Yorkers “trampled on another” in 1945 to buy the first commercially available ballpoint pens, where they paid the equivalent of $175 in today’s money. That was for a pen, not an Ubersmart mobile device that connects you to the universe.

Despite drawing hordes of fans, the iPhone didn’t immediately charm its way into the mainstream because of its high price tag. Just two months after the iPhone’s initial release, Apple trimmed the handset’s price down to $400. That helped a little, but it wasn’t until 2008 — when Apple unveiled the iPhone 3G with a new $200 price tag and access to the faster 3G network — that the smartphone exploded in popularity. Apple sold over 10 million iPhone 3G units worldwide in just five months.

It wasn’t the faster network or the price tag that really set the iPhone ahead of its competitors. Apple’s core philosophy, then and now, is that software is the key ingredient; and the operating system lying beneath the iPhone’s sleek and sexy touchscreen broke new ground. Unlike other cellphones’ software, the iPhone’s operating system was controlled by Apple rather than a mobile carrier.

Just as the Apple II in 1977 was the first computer made for consumers, the iPhone was the first phone whose software was designed with the user in mind. It was the first phone to make listening to music, checking voicemail and browsing the web as easy as swiping, pinching and tapping a screen — pleasant like a massage.

“An iPod, a phone, an internet mobile communicator,” Jobs said when preparing to introduce the iPhone in 2007. “An iPod, a phone, an internet mobile communicator…. These are not three separate devices!”  Apple put a miniature computer in consumers’ pockets.

But that wasn’t enough for iPhone users. Operating on a closed platform, the iPhone was limited to the few apps that Apple offered — and the handset was restricted to one U.S. carrier — AT&T. The iPhone’s software limitations gave birth to an underground world of hackers seeking to add third-party applications, known as the Jailbreak community. And the AT&T exclusivity created a subset of that hacker community focusing on unlocking the iPhone to work with various carriers — today famously known as the iPhone Dev-Team.

Apple did benefit tremendously from iPhone hackers. The company learned from the Jailbreak community that third-party applications were in high demand and would add even more appeal to the phone. This revelation led to Apple opening its iPhone App Store, which launched concurrently with the second-generation iPhone, iPhone 3G.

Fast forward.  The iPhone turned out to be a game-changer – the proverbial paradigm shift wrapped in a sleek black case housing powerful innovative technology.  It has gone on to Impact the lives of hundreds of millions of people around the world, changing the way we communicate, work, learn and play.

77.3 Million iPhones were sold in the fourth quarter of 2017.  Assuming that each boxed iPhone weighs approximately 500g, give or take, that’s around 39,000 metric tons of iPhones, which is the equivalent of 630  Abrams M1A2 battle tanks.  The Sales volume works out to almost ten iPhones a second, and they sold for an average of $796.  This is how Apple will likely crest $1T this year.

Just like that, Apple flipped cellphone business on its head and transformed mobile software into a viable product. But the most surprising thing about the iPhone is the impact it’s had on six major industries.

The PC Industry –  Apple’s stroke of genius was to put one in your pocket. Until the iPhone shipped, PC sales were around 400 million a year.  As the iPhone and smartphones in general have become critical tools for information, used for productivity, communications and pleasure, the PC has become less important to many people. Until the mobile revolution that came with the iPhone, the only way people could access the Internet was from a PC or laptop.

Today, thanks to the iPhone, iPad and all the Android equivalents inspired by Apple’s ideas, people have many more options to make the connections they need regardless of location. Consequently, the PC industry is now shipping only about 275 to 290 million PCs a year, and this has caused a level of industry consolidation that is now concentrated around Lenovo, HP, Dell, Acer and Apple.

Telecom – Before the iPhone, most of the original telco business models were around voice. Voice over IP became popular by 2000 and had already started pushing the telecom companies to move to digital voice instead of traditional landline voice delivery methods. But with the advent of the iPhone, they were effectively forced out of the traditional voice business altogether.  While there were millions of payphones in place a decade ago, Try and locate a payphone today.

Now, telecom providers are data communications companies whose business models have been completely transformed. All have added things like information and entertainment services, and all have become conduits for multiple types of data services to their customers.

Movie and TV – In order to watch a movie, you once  had to go to a movie theater; and to watch a TV show, you had to sit in front of my television at home and scan three channels….plus PBS.  The iPhone created a mobile platform for video delivery, and since 2007, every major movie and TV studio has been forced to expand their distribution methods to include downloaded and streaming services to mobile devices.

We can thank the millions of iPhones in the field, capable of letting people watch video anytime and anywhere, for prodding these studios to make this so. We can also thank the iPhone for fueling new types of video services like YouTube, Netflix and Hulu — video powerhouses, at least 50% of whose content is viewed on some type of mobile device.

Software distribution.  With the launch of the App Store, Apple shook up the mobile industry again by reinventing software distribution. Apple designed the App Store’s model with a do-it-yourself mentality: All software developers had to do was code an interesting app, submit it to the App Store for approval and market the app however they wished.

The App Store’s method is proving far more effective than the old-fashioned computer shareware model, where developers would offer a free trial of their apps and then cross their fingers that consumers would eventually pay. The shareware model especially didn’t help independent coders, whose apps got trampled on by large software companies with fatter marketing budgets.

Video Gaming.  Before 2007, most games were either delivered by way of game consoles, a PC or a dedicated handheld device like the Nintendo DS or Sony PlayStation Portable. The iPhone expanded the market for mobile games as well as created an entirely new category of touch-based gameplay, persuading even holdouts like Nintendo to come aboard with games based on its iconic franchises.

And though the mobile dominant free-to-play model fractionalizes revenue, the potential for brand exposure is unprecedented: Niantic’s augmented reality-angled Pokémon Go alone has been downloaded over 750 million times. Contrast with Nintendo’s entire Mario franchise’s lifetime sales of just over 500 million.

HealthCare. Today, one can use an iPhone to monitor various health metrics as well as access detailed health information, connecting with health professionals and even receiving health advice virtually anytime and anywhere across a number of different applications.  And we’ve only begun to see how smartphones can impact the health industry – an impact that will doubtless expand as this industry embraces the smartphone for outpatient care.

And HealthLynked will be a huge part of this.  We are not unlike the iPhone.  Where multiple apps do one thing, we are combining all that makes mobile health great into one easy to use, secure platform.  It’s sort of a Swiss Army knife, meets iPhone meets medicine, wrapped in the sleek, easy to use interface of a social platform.  You can find it in the Apple Store.

Ready to start taking control of your health in ways never thought possible?  Get Lynked!  Go to HealtheLynked.com to sign up For Free!



Sources:  Blending the two fantastic articles below.

JUNE 29, 2007: IPHONE, YOU PHONE, WE ALL WANNA IPHONE, by  Brian X. Chen.  Brian wrote a book about the always-connected mobile future called Always On (published June 7, 2011 by Da Capo). Check out Brian’s Google Profile.

 

How Apple’s iPhone Changed These 5 Major Industries, By TIM BAJARIN June 26, 2017.  Tim is recognized as one of the leading industry consultants, analysts and futurists, covering the field of personal computers and consumer technology. Mr. Bajarin is the President of Creative Strategies, Inc and has been with the company since 1981 where he has served as a consultant providing analysis to most of the leading hardware and software vendors in the industry.

 

Photo: Young Steve Jobs
Credit: Ben Lovejoy in Tim Cook Tweets, 9to5Mac

 

Title:  Disruptive Technology Turns 11; Creator Set to Break Through $1T

 

#apple,#iPhone,#healthcareIT,#healthcarereform,#healthcareITreform

 

 

Antibody helps detect protein implicated in Alzheimer’s, other diseases

May lead to novel ways to diagnose, monitor brain injury

by Tamara Bhandari•April 19, 2017

Researchers use mouse brains (above) to study ways to measure the brain protein tau, which plays a role in neurodegenerative diseases such as Alzheimer’s. A team led by scientists at Washington University School of Medicine in St. Louis has found a way to measure tau levels in the blood. The study, in mice and a small group of people, could be the first step toward a noninvasive test for tau

Damaging tangles of the protein tau dot the brains of people with Alzheimer’s and many other neurodegenerative diseases, including chronic traumatic encephalopathy, which plagues professional boxers and football players. Such tau-based diseases can lead to memory loss, confusion and, in some, aggressive behavior. But there is no easy way to determine whether people’s symptoms are linked to tau tangles in their brains.

Now, however, a team led by scientists at Washington University School of Medicine in St. Louis has found a way to measure tau levels in the blood. The method accurately reflects levels of tau in the brain that are of interest to scientists because they correlate with neurological damage. The study, in mice and a small group of people, could be the first step toward a noninvasive test for tau.

While further evaluation in people is necessary, such a test potentially could be used to quickly screen for tau-based diseases, monitor disease progression and measure the effectiveness of treatments designed to target tau.

The research is published April 19 in Science Translational Medicine.

“We showed that you can measure tau in the blood, and it provides insight into the status of tau in the fluid surrounding cells in the brain,” said senior author David Holtzman, MD, the Andrew B. and Gretchen P. Jones Professor and head of the Department of Neurology at Washington University School of Medicine in St. Louis.

Tau is a normal brain protein involved in maintaining the structure of neurons. But when tau forms tangles, it damages and kills nearby neurons.

“People with tau diseases have a wide range of symptoms because basically, wherever tau is aggregating, those parts of the brain are degenerating,” Holtzman said. “So if it’s in a memory area, you get memory problems. If it’s in a motor area, you get problems with movement.”

A blood-based screening test, likely years away, would be a relatively easy way to identify people whose symptoms may be due to problems with tau, without subjecting them to potentially invasive, expensive or complicated tests.

“We have no test that accurately reflects the status of tau in the brain that is quick and easy for patients,” Holtzman said. “There are brain scans to measure tau tangles, but they are not approved for use with patients yet. Tau levels can be measured in the cerebrospinal fluid that surrounds the brain and spinal cord, but in order to get to that fluid, you have to do a spinal tap, which is invasive.”

In the brain, most tau proteins are inside cells, some are in tangles, and the remainder float in the fluid between cells. Such fluid constantly is being washed out of the brain into the blood, and tau comes with it. However, the protein is cleared from the blood almost as soon as it gets there, so the levels, while detectable, typically remain very low.

Holtzman, postdoctoral researcher Kiran Yanamandra, PhD, and MD/PhD student Tirth Patel, along with colleagues from C2N Diagnostics, AbbVie, the University of California, San Francisco, and Texas Health Presbyterian Hospital, reasoned that if they could keep tau in the blood longer, the protein would accumulate to measurable levels. Allowing the protein to accumulate before measuring its levels would magnify – but not distort – differences between individuals, in the same way that enlarging a picture of a grain of sand alongside a grain of rice does not change the relative size of the two, but does make it easier to measure the difference between them.

The researchers injected a known amount of tau protein directly into the veins of mice and monitored how quickly the protein disappeared from the blood. The researchers showed that half the protein normally disappears in less than nine minutes. When they added an antibody that binds to tau, the half-life of tau was extended to 24 hours. The antibody was developed in the laboratories of Holtzman and Marc Diamond, MD, of the University of Texas Southwestern Medical Center, and is currently licensed to C2N Diagnostics, which is collaborating with the pharmaceutical company AbbVie in developing the technology.

To determine whether the antibody could amplify tau levels in an animal’s blood high enough to be measured easily, they injected the antibody into mice. Within two days, tau levels in the mice’s blood went up into the easily detectable range. The antibody acted like a magnifying glass, amplifying tau levels so that differences between individuals could be seen more easily.

Tau levels in people’s blood also rose dramatically in the presence of the antibody. The researchers administered the antibody to four people with a tau disease known as progressive supranuclear palsy. Their blood levels of tau rose 50- to 100-fold within 48 hours.

“It’s like a stress test,” Holtzman said. “We appear to be bringing out the ability to see what’s coming from the brain because the antibody amplifies differences by prolonging the time the protein stays in the blood.”

Measuring tau levels in the blood is only useful if it reflects tau levels in the brain, where the protein does its damage, the researchers said.

Both high and low levels of tau in the fluid that surrounds the brain could be a danger sign. Alzheimer’s and chronic traumatic encephalopathy both are associated with high levels of soluble tau, whereas progressive supranuclear palsy and other genetic tau diseases are thought to be associated with low levels.

To see whether elevated brain tau is reflected in the blood, the researchers treated mice with a chemical that injures neurons. The chemical causes tau to be released from the dying neurons, thereby raising tau levels in the fluid surrounding the cells. The scientists saw a corresponding increase of tau in the blood in the presence of the anti-tau antibody.

To lower tau levels, the researchers turned to genetically modified mice that, as they age, have less and less tau floating in their cerebrospinal fluid. Such mice at 9 months old had significantly lower tau levels in their blood than 3-month-old mice with the same genetic modification, again demonstrating the antibody’s ability to reflect levels of tau in the brain.

“It will be helpful in future studies to see if the measurement of tau in the blood following antibody treatment in humans reflects the state of tau in the brain,” Holtzman said.

325Click to share on Facebook (Opens in new window)325Click to share on Twitter (Opens in new window)1Click to share on Pinterest (Opens in new window)1Click to share on LinkedIn (Opens in new window)
Yanamandra K, Patel TK, Jiang H, Schindler S, Ulrich JD, Boxer AL, Miller BL, Kerwin DR, Gallardo G, Stewart F, Finn MB, Cairns NJ, Verghese PB, Fogelman I, West T, Braunstein J, Robinson G, Keyser J, Roh J, Knapik SS, Hu Y, Holtzman DM. “Anti-tau antibody markedly increases plasma tau in mouse and man: Correlation with soluble brain tau.” Science Translational Medicine. April 19, 2017.

This work was supported by the National Institutes of Health (NIH), grant number NIH R01AG048678, C2N Diagnostics, the Tau Consortium and the JPB Foundation.

Holtzman and other authors on this paper developed the antibody used in this study and are inventors on a submitted patent “Antibodies to Tau” that is licensed by Washington University to C2N Diagnostics LLC. This patent subsequently was licensed to AbbVie. Yanamandra was a postdoctoral researcher at Washington University during the course of these studies and now is an employee at AbbVie.

Washington University School of Medicine‘s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

MEDIA CONTACT
Diane Duke Williams, Associate Director for Media Relations

314-286-0111
williamsdia@wustl.edu
WRITER
Tamara Bhandari, Senior Medical Sciences Writer

Tamara Bhandari covers pathology, immunology, medical microbiology, cell biology, neurology, and radiology. She holds a bachelor’s degree in molecular biophysics and biochemistry and in sociology from Yale University, a master’s in public health/infectious diseases from the University of California, Berkeley, and a PhD in infectious disease immunology from the University of California, San Diego.

P314-286-0122
tbhandari@wustl.edu


Republished with permission.  See original and other great articles here.

Link between 2 key Alzheimer’s proteins explained | Targeting tau production may lead to treatment


by Tamara Bhandari•March 21, 2018

Alzheimer’s disease is characterized by clumps of two proteins – amyloid beta and tau – in the brain, but the link between the two has never been entirely clear. Now, researchers at Washington University School of Medicine in St. Louis have shown that people with more amyloid in the brain produce more tau, which could lead to new treatments for the disease based on targeting the production of tau.

It’s a paradox of Alzheimer’s disease: Plaques of the sticky protein amyloid beta are the most characteristic sign in the brain of the deadly neurodegenerative disease. However, many older people have such plaques in their brains but do not have dementia.

The memory loss and confusion of Alzheimer’s instead is associated with tangles of a different brain protein – known as tau – that show up years after the plaques first form. The link between amyloid and tau has never been entirely clear. But now, researchers at Washington University School of Medicine in St. Louis have shown that people with more amyloid in their brains also produce more tau.

The findings, available March 21 in the journal Neuron, could lead to new treatments for Alzheimer’s, based on targeting the production of tau.

“We think this discovery is going to lead to more specific therapies targeting the disease process,” said senior author Randall Bateman, MD, the Charles F. and Joanne Knight Distinguished Professor of Neurology.

Years ago, researchers noted that people with Alzheimer’s disease have high levels of tau in the cerebrospinal fluid, which surrounds their brain and spinal cord. Tau – in the tangled form or not – is normally kept inside cells, so the presence of the protein in extracellular fluid was surprising. As Alzheimer’s disease causes widespread death of brain cells, researchers presumed the excess tau on the outside of cells was a byproduct of dying neurons releasing their proteins as they broke apart and perished. But it was also possible that neurons make and release more tau during the disease.

In order to find the source of the surplus tau, Bateman and colleagues decided to measure how tau was produced and cleared from human brain cells.

Along with co-senior author Celeste Karch, PhD, an assistant professor of psychiatry, and co-first authors Chihiro Sato, PhD, an instructor in neurology, and Nicolas Barthélemy, PhD, a postdoctoral researcher, the researchers applied a technique known as Stable Isotope Labeling Kinetics (SILK). The technique tracks how fast proteins are synthesized, released and cleared, and can measure production and clearance in models of neurons in the lab and also directly in people in the human central nervous system.

Using SILK, the researchers found that tau proteins consistently appeared after a three-day delay in human neurons in a laboratory dish. The timing suggests that tau release is an active process, unrelated to dying neurons.

Further, by studying 24 people, some of whom exhibited amyloid plaques and mild Alzheimer’s symptoms, they found a direct correlation between the amount of amyloid in a person’s brain and the amount of tau produced in the brain.

“Whether a person has symptoms of Alzheimer’s disease or not, if there are amyloid plaques, there is increased production of this soluble tau,” Bateman said.

The findings are a step toward understanding how the two key proteins in Alzheimer’s disease – amyloid and tau – interact with each other.

“We knew that people who had plaques typically had elevated levels of soluble tau,” Bateman said. “What we didn’t know was why. This explains the why: The presence of amyloid increases the production of tau.”

Tau is strongly linked to brain damage, so overproduction of the protein could be a critical step in the development of Alzheimer’s, and reducing tau’s production may help treat the disease, the researchers said.

“These findings point to an important new therapeutic avenue,” Karch said. “Blocking tau production could be considered as a target for treatment for the disease.”

Sato C, Barthélemy NR, Mawuenyega KG, Patterson BW, Gordon BA, Jockel-Balsarotti J, Sullivan M, Crisp MJ, Kasten T, Kirmess KM, Kanaan NM, Yarasheski KE, Baker-Nigh A, Benzinger TLS, Miller TM, Karch CM and Bateman RJ. Tau Kinetics in Neurons and the Human Central Nervous System. Neuron. March 21, 2018.

This work was supported by the National Institutes of Health (NIH), grant number R01NS095773, R01NS078398, K01 AG046374, K01 AG053474, P30DK056341, P01AG003991, UL1TR000448, P30NS098577, P50AG005681, and P01AG026276; Brightfocus Foundation, grant number A2014384S; the National Institute of Neurological Disorders and Stroke, grant numbers P01NS080675 and P30NS098577; Tau SILK Consortium (AbbVie, Biogen, and Eli Lily); Metlife Foundation; ALS Association; DIAN-TU; Hope Center for Neurological Disorders; The Foundation for Barnes-Jewish Hospital; Kanae Foundation for the Promotion of Science; McDonnell Science Grant for Neuroscience; the Tau Consortium; the Knight Alzheimer’s Disease Research Center; Coins for Alzheimer’s Research Trust; Alzheimer’s Association; and resources provided by Washington University Biomedical Mass Spectrometry Research Facility (NIH P41GM103422), Diabetes Research Center (NIH P30DK020579), and the Nutrition Obesity Research Center (NIH P30DK056341).

Washington University School of Medicine‘s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

MEDIA CONTACT
Judy Martin Finch, Director of Media Relations

314-286-0105
martinju@wustl.edu
WRITER
Tamara Bhandari, Senior Medical Sciences Writer

Tamara Bhandari covers pathology, immunology, medical microbiology, cell biology, neurology, and radiology. She holds a bachelor’s degree in molecular biophysics and biochemistry and in sociology from Yale University, a master’s in public health/infectious diseases from the University of California, Berkeley, and a PhD in infectious disease immunology from the University of California, San Diego.

314-286-0122
tbhandari@wustl.edu


In honor of ALzheimers and Brain Awareness Month, this has been reproduced with permission.