When he was 20 years old, Rom Houben was involved in a car accident that left him completely paralyzed. The accident didn't place him in a coma, however, and he tried desperately to communicate with those around him, but to no avail. Dr. House may have recognized "locked-in" syndrome in a few minutes, but Houben's doctors spent 23 years believing their patient was a vegetable, leaving Houben to experience nothing outside the hospital soap operas playing out in his room (apparently, his nurses were frequent gossips).

How did this happen? Houben's doctors determined that he was in a coma using the Glasgow Coma Scale, a widely used system that evaluates eye movement and motor responses. The trouble is that while Houben's body was functioning like a coma patient, his cerebral cortex was still chugging along. It took a brain scan to reveal that Houben was still fully conscious, and he is currently able to communicate thanks to a keyboard that responds to the barest tremors he can coax from his right hand.

While one would hope Houben was the unlucky winner of a terrifying medical lottery, situations like his may not be rare. Neurologist Steven Laureys, who performed the revealing brain scan on Houben, says that in 40 percent of supposedly vegetative patients he examined, brain scans revealed some level of consciousness. Both Houben and Laureys are advocating that doctors lean less on the Glasgow Scale and look more toward brain scans.

Brain scan finds man was not in a coma—23 years later [CNET]

To boost sales of a product called OP-1 Implant with a bone-setting filler called Calstrux. The mixture was not approved by the FDA, and in fact OP-1 was only supposed to be used on a rare bone disease, not on people who simply needed to have their bones knit together fast. Surgeons were urged by Stryker to shape the OP-1/Calstrux paste into a "tootsie roll" or "vienna sausage" shape and implant it. Unfortunately, the substance often broke down and drifted through patients' bodies. Bids of sprouting bone that looked like "oatmeal" or "white sesame seeds" would appear far from the site of injury where the substance had been implanted.

According to NPR:

When those wayward bits bit landed in places they shouldn't have, bone sprouted and, in some patients, had to be surgically removed. According to the papers, then-president of the company, Mark Philip, touted the combination at sales meetings as "perfect" even while knowing it wasn't FDA approved and that the company was receiving complaints about nasty side effects.

The indictment say the president and sales team continued to promote the illegal mixture for two more years, until Feb. 2008, without informing surgeons of the side effects to keep sales rolling.

Stryker and some of its partners have been indicted on several counts of wire fraud and conspiracy.

via NPR (thanks, Kle!)

Researchers believe that the estrogen levels in breast tissue are an early indicator of breast cancer risk. So they've devised a special chip, smaller than a credit card, to extract the estrogen from breast tissue so doctors can study it. Electricity coaxes liquid to move across the chip, based on the science of "digital microfluidics." As the liquid travels, it dissolves the dried tissue sample, then moves along to another reservoir containing a second liquid, and then on to a third reservoir where it circulates and removes contaminants and other biological components. What's left is a purer sample of estrogen, which can indicate your level of cancer risk.

Here's a handy diagram:

[via EurekAlert]

The woman suffered from damaged corneas, and she seemed to have no options if she wanted to regain her sight. Luckily, one of her doctors had heard of a surgery developed in the 1960s in Italy, and in widespread use in Japan. The patient's tooth becomes the scaffold for an artificial cornea.

According to the Miami Herald:

A tooth is used, [lead surgeon Victor] Perez said, because it provides a stable, living platform of tooth, bone and cartilage that can remain alive, get nutrition from the eye and grow into a single piece with the cornea . . . The multistage procedure began in March when Dr. Yoh Sawatari, a dental surgeon at the University of Miami Medical School, extracted the tooth — coincidentally, it was Thornton's eyetooth, also called the canine tooth — shaved it flat horizontally, drilled a hole in it and inserted an acrylic lens. He implanted the tooth/lens prosthesis under the skin inside her cheek, intending to leave it there for three months so the combination could heal together. Unfortunately, she developed a sinus infection, so he had to remove it and re-implant it under a pouch of skin in her upper chest.

Meanwhile, an eye surgeon removed scar tissue lining her damaged cornea.

A month later, surgeons removed a patch of skin from the inside of her cheek and laid it over her cornea to replace the moist tissue lost to the disease.

Two months after that, Perez extracted the tooth-lens combination from her chest, cut a flap out of the skin over the center of her cornea, cut a hole down into the eye and inserted the tooth-lens. He sewed the flap shut to hold in the tooth-lens and cut a tiny hole so the lens can protrude a couple of millimeters out of the eye.

via Miami-Herald

Apparently when this woman had seizures, she felt that her voice had become deeper and her arms were hairy. Once, when a female friend of hers with her as a seizure came on, she thought her friend was turning into a man too. The woman had no history of mental illness, nor did she have symptoms of gender identity disorder.

After imaging her brain, the researchers discovered that she had some damage to her amygdala, and weird electrical activity in her right temporal lobe during seizures. Had they discovered some gender identity center of the brain, which when damaged results in the feeling of changing sex? Absolutely not. In fact, there is no such center in the brain.

Instead, the researchers believe that this unusual case is simply one flavor of a more general experience of self-alienation that comes during epileptic attacks.

Reports ScienceNow:

More likely, [New York University neurologist Orrin Devinsky] says, the amygdala is one node in a network of brain regions essential for self-identity. When neural activity in this network goes haywire, a range of bizarre experiences can result, Devinsky says. The Russian novelist Fyodor Dostoyevsky wrote of feeling the presence of God in the moments preceding a seizure. More common, Devinsky says, are feelings of déjà vu or its opposite, jamais vu, the sense that a familiar environment has become unfamiliar. "In epilepsy, you can experience these intense and extreme emotions and in some cases misidentification of yourself and where you are in relation in the world," he says.

via Science Now

The Swiss scientists used a technology developed to kill uterine fibroids without surgery that an Israeli company modified for use in the brain, according to the MIT Technology Review. That company, Insightec, combined the high-intensity focused ultrasound technology used on the fribroids with CT scans and MRIs to allow doctors to focus on the part of the brain they wish to excise and see the results in real time. Eyal Zadicario, head of InSightec's neurology program, said:

You take a CT scan of the patient's head and tailor the acoustic beam to focus through the skull.

Technology Review elaborates:

The device also has a built-in cooling system to prevent the skull from overheating.

The ultrasound beams are focused on a specific point in the brain—the exact location depends on the condition being treated—that absorbs the energy and converts it to heat. This raises the temperature to about 130 degrees Fahrenheit and kills the cells in a region approximately 10 cubic millimeters in volume.

In effect, the high-intensity focused ultrasound cauterizes a specific, internal section of the brain, destroying the tissue completely.

The nine patients in the Swiss study suffered from chronic pain that couldn't be treated with medications; the ultrasound surgery successfully destroyed a small area of their thalamus, bringing relief from the pain without other, significant side effects. They hope to start testing the machine on Parkinson's patients, in an effort to bring them relief from some of the the physical side effects of that disease.

Brain Surgery Using Sound Waves [MIT Technology Review via Live Science]

An opinion piece by medical researchers Olle Lindvall and Insoo Hyun published today in Science suggests stem-cell tourism is only likely to grow bigger as the general public learns more about the promise of stem-cell therapies. Unfortunately,there are very few vetted stem-cell treatments. And in many countries like the United States such treatments are often banned by law.

That's why clinics in countries with few regulations, like Russia and China, attract stem-cell tourists in droves. Often, these clinics promise cures that are based on nothing but wishful thinking. Such was the case with the boy who had a neuro-degenerative disease and received stem-cell injections in Russia. His parents were fooled by false advertising into believing that stem cells could cure him. The clinicians merely injected his brain with fetal stem cells and sent him home to Israel. There he began to develop brain tumors and tumors in his spine. His doctor speculated that possibly the problem was that the Russian clinic had treated the cells with something to make them grow in culture, and that caused them to grow irregularly when injected into the boy.

Though this is a sad story, Lindvall and Hyun urge scientists not to dismiss stem cell tourism out of hand. Today it might not be the right treatment, but they say in the near future it may represent the forefront of medical innovation. Specifically, it provides a way for terminally ill patients to participate in innovative therapies that have not yet gone through any clinical trials. The difficult thing is figuring out which therapies are legitimate, and which are like those suffered by the boy with brain tumors.

Lindvall and Hyun say that a legit stem-cell therapy has to be peer reviewed, based in sound scientific reasoning, and must have been tested in animals without adverse side effects. Of course, in countries where there is very little medical regulation it is unclear what peer review might mean. Also, as computer simulations of biological processes get better, it's possible that no animal trials would be necessary.

It seems that Lindvall and Hyun are taking a "we know it when we see it" approach to this problem. In other words, they know a promising it stem-cell therapy when they see it; everything else is balderdash. Unless, of course, it turns out to be a brilliant new innovation. Perhaps their boldest statement is that stem-cell tourism has its place in medical science. It could be seen as an unofficial first clinical trial.

What's certain is that we're likely to see more and more cases of stem-cell quackery. Every medical technology, no matter how sophisticated, has its basement practitioners. The weird part is that sometimes basement laboratories are the best place for science to progress.

via Science

Also, it's interesting to note that late last year the International Society for Stem Cell research published a set of guidelines for people considering stem cell tourism.

According to Nature blog The Great Beyond:

The council says Americans living in 2006 were exposed to over seven times more radiation from such scans than those living in 1980, mainly due to computed tomography and nuclear medicine. The council's executive vice president Kenneth Kase says the increase was "not a big surprise to anybody" and doctors are emphasising that such tests are vital in modern medicine (ABC News) . . . The American College of Radiology is warning about overly-high numbers of radiation-based medical tests. The college puts this down to ‘self-referral', where non-radiologists buy imaging equipment and then refer their patients to have tests on these machines (press release).

"There is a fundamental problem when the person ordering the study has a direct financial interest in maximizing the use of a particular piece of equipment," says James Thrall, chair of the College's Board of Chancellors (Reuters). "… Unfortunately, one of the things we have seen in the imaging world is that many physicians look at imaging as the solution to their financial problems."

The health implications of this incredible increase in radiation exposure remain unclear, but what's certain is that some doctors are over-prescribing scans and medical imaging.

Cleveland Plain Dealer has a few simple steps you can take to minimize radiation exposure at the doctor's office, and The Great Beyond has the full story.

According to an urgent press release sent out by the Urbana-Champaign Sanitary District, human placentas are not something you should just flush down the toilet:

For the third time in just over a month, a healthy human placenta has been found by workers at the Urbana-Champaign Sanitary District. Urbana Police contacted the Champaign-Urbana Public Health District (CUPHD), and the Champaign County Coroner's Office for assistance with this unusual situation. According to the Illinois Environmental Protection Agency Rules and Regulations, human placentas are considered potentially infectious medical waste, and should not be disposed of in the municipal sewage system.

"I can say with absolute certainty that the Champaign-Urbana Public Health District has never received a call of this nature," said Julie A. Pryde, Public Health Administrator at CUPHD. "CUPHD has been asked by local authorities to assist with disseminating information to the community to ensure that this situation does not occur again."

Persons assisting with home births, human or animal, should not dispose of placentas through the municipal sewage system-through flushing down the toilet or depositing them in a storm sewer. Placentas should be treated as any other solid, potentially infectious medical waste, and disposed of properly. Hospitals, clinics, and the Champaign-Urbana Public Health District have contracts with licensed medical waste disposal companies.

OK, which mad doctor has been doing experiments with transgenic babies in the sewers again? Seriously, if you're going to be hatching superhuman babies in your underground lair, don't flush the evidence down the toilet, genius.

Press Release at the Urbana-Champaign Public Health District [PDF], via Xenophilia

Technology Review has a terrific, detailed story about the laser tool and how it works. While lasers are crucial to the process, equally important is a light-activated dye. According to Technology Review:

The team took advantage of the fact that a number of dyes are activated in the presence of light. In the case of Rose Bengal—a stain used in just about every ophthalmologist's office to detect corneal lesions—the researchers believe that light helps transfer electrons between the dye molecule and collagen, the major structural component of tissue. This produces highly reactive free radicals that cause the molecular chains of collagen to chemically bond to each other, or "cross-link." Paint two sides of a wound with Rose Benga­l, illuminate it with intense light, and the sides will knit themselves back together. "We call this nano suturing," [Massachusetts General doctor Irene] Kochevar says, "because what you're doing is linking together the little collagen fibers. It's way beyond anything that a thread of any kind can do."

Essentially, the dye becomes a kind of micro-thread. So you're still stitching wounds together the traditional way, except on a much smaller scale. Researchers have been testing the technique at Massachusetts General Hospital with great success - they say the laser technique makes wounds heal faster and more cleanly.

Read more about this intriguing new technique and the science behind it at Technology Review.

According to the Washington Post:

Not everyone in Afghanistan's hinterlands had heard of the drug, leading to some awkward encounters when Americans delicately attempted to explain its effects, taking care not to offend their hosts' religious sensitivities.

Such was the case with the 60-year-old chieftain who received the four pills from a U.S. operative. According to the retired operative who was there, the man was a clan leader in southern Afghanistan who had been wary of Americans — neither supportive nor actively opposed. The man had extensive knowledge of the region and his village controlled key passages through the area. U.S. forces needed his cooperation and worked hard to win it, the retired operative said.

After a long conversation through an interpreter, the retired operator began to probe for ways to win the man's loyalty. A discussion of the man's family and many wives provided inspiration. Once it was established that the man was in good health, the pills were offered and accepted.

Four days later, when the Americans returned, the gift had worked its magic, the operative recalled.

"He came up to us beaming," the official said. "He said, 'You are a great man.' "

"And after that we could do whatever we wanted in his area."

[via Washington Post]

New research confirms that molecules found in pot called cannabanoids are powerful antibiotics. According to Environmental Graffiti:

Scientists studying cannabis related antibiotics were now able to pinpoint the basic backbone structure that is common to all cannabanoids, to be the active component in killing off bacteria. Now that the bio-active section of the cannabanoid molecules has been identified, researchers and drug makers are busy developing and testing antibiotic drugs as well as considering potential uses for cannabanoids in various soaps and cleaning products. At present they are focusing their efforts on the derivatives of the non-psychoactive cannabanoids. This is presumably because the US FDA, and other governing bodies world-wide, might have a hard time with people getting high in order to cure a bacterial infection.

But aren't people with really bad infections the ones who are most in need of a good high? I mean, think about it. When you're sick, you're usually so out of it that all you can do is sit on the couch and watch all the episodes of True Blood stored on your DVR. Wouldn't a nice buzz make that experience better in every possible way?

How Cannabis Could Save Your Life [via Environmental Graffiti]

The group, led by geneticist Francis Collins, used transgenic mice designed to develop symptoms of heart disease like human children with progeria do. They treated the mice with a cancer drug called tipifarnib, part of the FTI family of drugs which are being used experimentally to treat several forms of cancer. It worked incredibly well. Below, you can see a diseased blood vessel at left, and on the right a healthy one treated by the drug.

According to Collins:

This approach worked much better than we thought it would. Not only did this drug prevent these mice from developing cardiovascular disease, it reversed the damage in mice that already had disease.

Now the question is whether it will work in humans. Study co-author Elizabeth Nabel said:

If these drugs are found to have similar effects in children, this could mark a major breakthrough for treating this devastating disease. In addition, these findings shed light on the potential role of FTI drugs to treat other forms of coronary artery disease.

In addition, the more the researchers learn about reversing the effects of premature aging, the more tools they'll have to reverse the effects of normal aging in the general population. Not only could these FTI drugs prevent kids with progeria from dying young — they could potentially prevent them from dying for centuries. Top image via Carlen Altman.

Anti-cancer drug prevents, reverses cardiovascular damage in mouse model of premature aging disorder [NIH News]

Though they've only tested this hunger-killing technique in pigs, the researchers hope it can become a non-invasive alternative to bariatric surgery, where a portion of the colon or stomach is removed to suppress appetite. Said Johns Hopkins bioengineer Aravind Arepally, who worked on the study:

Obesity is the biggest biomedical problem in the country, and a minimally invasive alternative would make an enormous difference in choices and outcomes for obese people. Appetite is complicated because it involves both the mind and body. Ghrelin fluctuates throughout the day, responding to all kinds of emotional and physiological scenarios. But even if the brain says "produce more ghrelin," [this technique] physically prevents the stomach from making the hunger hormone.

Using chemicals to dissolve the blood vessels that feed your upper stomach sounds a bit extreme, but it could save the lives of people whose obesity has led to health problems. And it's a lot less extreme than removing parts of your colon.

Researchers Suppress Hunger Hormone [via Radiology]

It turns out that Ebola exploits a vulnerability in something called the "PI3 kinase pathway," a biochemical mechanism that is responsible for cell longevity and movement, as well for causing the cell to pull things from outside into the cell via a little bubble called an "endosome." Ebola tricks the cell into wrapping it in the endosome bubble and pulling it inside — sort of like a trojan horse. Once inside the cell, the virus breaks out of the endosome and starts replicating.

What the researchers discovered was that if they used a drug that shut down the PI3 kinase pathway, the Ebola remained trapped inside that endosome. Essentially, they used a drug to patch the cell's vulnerable system and keep the virus out.

University of Texas Medical Branch at Galveston immunology professor Robert Davey, an author on the paper, said in a statement:

The nice part about identifying entry mechanisms is you can prevent the virus from infecting the cell. You can stop the whole show before it even gets started. Up to that point, it's really a bus ride for these viruses, and PI3 kinase is the bus driver. Whether you're talking about Ebola or Ebola virus-like particles, they've all got the virus envelope proteins that trigger the PI3 kinase pathway, which is the first step of getting the virus onto that bus.

He also noted that there are other viruses that exploit the PI3 kinase vulnerability, though Ebola is the first that has been observed in the act of doing it. That means the team's breakthrough might affect how other viruses are treated too. And how cells are manipulated, since once you start mucking around with PI3 kinase pathways, you are playing with cellular movement and longevity. Maybe Ebola will actually prove to be the key to unlocking the secret of longevity at a cellular level.

PI3 Kinase-Akt Pathway Controls Cellular Entry of Ebola Virus [PLoS Pathogens via Eurekalert]

Performing a face transplant is a difficult procedure that involves many disciplines. Underlying facial structures can be very complex, so doctors must configure sinuses, reattach blood vessels and nerves, and try to make the result aesthetically pleasing. There are rejection and other immune system issues, similar to other transplant surgeries. On top of all that, there are psychological factors to consider. The patient is literally wearing another person's face. Even when that face replaces one severely disfigured by an injury or a tumor, it can be difficult to adjust.

The two successful transplants took place in 2006 and early 2007, according to British medical journal The Lancet. Doctors waited to judge the success of the surgeries so they would know if the transplants were rejected or if other problems developed. The patients, one a victim of a bear attack and the other a patient with severe facial tumors, report tremendous improvements in their quality of life. You can see a before and after photo of the man who was mauled by a bear above. An entire section of his face was replaced, including bone.

So how far away are we from Nicolas Cage and John Travolta swapping identities the way they did in Face/Off? Probably 100 years. But as this medical technology improves, a whole slew of freaky sci-fi scenarios become possible. Witness relocation? The ultimate secret agent? A black market auction for the face of a dead movie star? Or, like me, we'll all just have that old Payolas song stuck in our heads. Images by: The Lancet via BBC.

Face transplant 'double success'. [BBC News]

Of course, we could take this in the exact opposite direction. How about a gene mod for blue skin? Maybe someone out there wants to osseointegrate an extra set of arms onto his torso. Right now, we're focused on replacing or repairing damaged parts, but how long before we start on the upgrades? This year we dealt with the question of whether an amputee athlete with prosthetic running legs had an unfair advantage over runners with just human legs. Are you feeling post-human yet? Image by: StudioCanal.

Surgery Will Put Dog With Amputated Leg Back On All Fours Again. [Science Daily]

Actually, even the people reporting on this study are pretty skeptical. Says PhysOrg:

The study didn't investigate why the increase in one age group was so much higher than the other. It found the percentage of older children diagnosed with ADHD has been rising by 4 percent each year. Some experts say the increase may reflect that doctors are increasingly considering the possibility of ADHD in older kids who have concentration problems - a trend that coincides with the marketing of ADHD medications to teens and adults.

The finding may also reflect the misuse of Ritalin and other ADHD medications in that age group as study aides and recreational stimulants, some experts speculated. "There are people out there being treated for ADHD that probably don't meet the diagnostic criteria," said Scott Kollins, director of Duke University Medical Center's ADHD Program.

So the increased diagnoses may actually just reflect the increasing hunger for Ritalin among people who want a boost. Or it might be a legitimate transformation in human consciousness. You be the judge.

ADHD Increasing Among Older Children [PhysOrg]