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History, In the News, Science

Museum sheds some light on early electric medical devices

Museum sheds some light on early electric medical devices

electric fishThis Wired.com story on the 20th century medical devices housed at the Bakken Museum had me at “electric torpedo fish.”

As the story explains, we’ve experimented with the possible medical applications of electricity since 1st century AD when Roman physician Scribonius Largus applied electric torpedo fish to his patients as a therapy for headaches, gout, or hemorrhoids.

We’ve refined our use of electricity for medicine a bit over the years. The Bakken Museum in Minneapolis showcases some of our progress in this field.

From the piece:

The museum’s collection, which also includes some 11,000 books and scientific manuscripts dating back to the 13th century, focuses on the use of electromagnetism in medicine.

Assistant curator Adrian Fischer (below) compiled this selection of some of the Bakken’s more rare and unusual devices, such as the Garceau Nerve Stimulator (above) that was made sometime between 1940 and 1970. Fischer says the documentation accompanying this device suggests it was used to stimulate the cerebral cortex during brain surgery, for example, to help surgeons pinpoint the source of a patient’s epileptic seizures.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: The history of biotech in seven bite-sized chunksA low-cost way to keep premature babies warm and well and Stanford engineers create wireless, self-propelled medical device that swims through blood stream
Photo by BioDivLibrary

Genetics, History, Research, Science, Stanford News

Caribbean genetic diversity explored by Stanford/ University of Miami researchers

Caribbean genetic diversity explored by Stanford/ University of Miami researchers

Virgin IslandsUpcoming holidays likely mean time spent eating and talking with rarely seen relatives – something that could be considered a boon or a trial. One thing I enjoy, however, is the opportunity to learn more about my family history and ancestry through discussions with older family members.

Now, research conducted by Stanford geneticists Carlos Bustamante, PhD, and Andres Moreno-Estrada, MD, PhD, has shown that we carry a surprising amount of similar information in our genes. The strands of DNA include information not just about who our parents, grandparents and great grandparents were, but also about how they mingled with other population groups throughout history. And they did so by studying one of the biggest melting pots of recent past: the Caribbean. The research, conducted in collaboration with  Eden Martin, PhD, from the University of Miami, was published today in PLoS Genetics.

As described in our release:

The researchers compared patterns of genetic variation found in populations in and around the Caribbean, which has had a particularly tumultuous past since Christopher Columbus stumbled into the Bahamas in 1492. Not only did they identify an influx of European genes into the native population that occurred within a generation of Columbus’ arrival, but they also discovered two geographically distinct pulses of African immigration that correspond to the beginning and height of the transatlantic slave trade.

The study demonstrates how deciphering genetic echoes from the distant past can illuminate human history. But it also helps explain why some populations, like Latinos, who may be classified by medical researchers as a single group, display marked differences among populations in susceptibility to diseases or responses to therapeutic drugs.

If you’re into history, the findings are fascinating. For example, the research shows that the Caribbean islands were first populated about 2,500 years ago by people from inland South America, and it indicates that the European component of the Caribbean gene pool was likely contributed by relatively few individuals who settled in the islands (subsequent waves of European immigrants came primarily to the mainland of the Americas). But geneticists and clinicians are also paying close attention to studies such as these. As Moreno-Estrada told me:

All this affects what we call a genetic-mapping strategy to identify disease variants specific to population subgroups. For example, those individuals with more European influence may be at increased risk for certain diseases because that genetic contribution was made by only a few individuals. Or, perhaps Caribbeans with more African ancestry may share an increased risk of diseases with others from West Africa. We’re not yet at the point where we are able to say which populations are most likely to have specific diseases, but now we can begin to figure out the important components.

Previously: On the hunt for ancient DNA, Stanford researchers improve the odds, Stanford study investigates our most recent common ancestors and Recent shared ancestry between Southern Europe and North Africa identified by Stanford researchers
Photo by Navin75

Health Disparities, History, Medicine and Society, Public Health, Rural Health, Stanford News

Broken promises: The state of health care on Native American reservations

Broken promises: The state of health care on Native American reservations

RosebudI traveled to Haiti a month after the 2010 earthquake to report on what was happening there for Stanford Medicine magazine. So when I went to the Rosebud Indian Reservation in South Dakota this year with a group of Stanford students, I was incredulous to learn that the average life expectancy in this community was one year lower than Haiti’s – 46 versus 47 - and a full 33 years shorter than the average American.

Statistically speaking, the poor health of Native Americans living the Great Plains of the United States rivals many developing countries. I had no idea. Diabetes, alcoholism, and depression rates are frighteningly high. Suicide rates are 10 times the national average.

My goal in writing my in-depth story, which appears in the current issue of Stanford Medicine and was just recommended as a Longreads pick, was to try to understand how this could possibly be true, and to lend some perspective as to what could be done to change it. What I found was a toxic mix of causative factors: isolation, poverty, poor nutrition, poor education - each of which has its roots in history. What became strikingly clear during my visit to the federally funded Rosebud Indian Health Service Hospital on the reservation was that the United States government has never kept its promises, made in multiple treaties, to provide health care to Native Americans in exchange for land.

From my piece:

One afternoon during a visit to the hospital, I walk from the ER to a separate wing to find the CEO, [Sophie Two Hawk, MD, who also happens to be the first Native American to graduate from the University of South Dakota's medical school]. Her door’s ajar, and she waves me in. She’s dressed in the military-style uniform of the U.S. Public Health Service Commissioned Corps, her long, gray hair pulled back in a braid that drops down her back. She’s doing paperwork — denying a pile of requests from her physicians for additional care for their patients. The requests are appropriate, she says, but the hospital just doesn’t have the money to pay for the care. “If someone shows up with a torn ACL, we can’t afford to fix it,” she says. “He will walk with a limp.” Two Hawk, like many others, links the poor health statistics of Native Americans not only to the lack of adequate (federal) funding but to the community’s tragic history. The hopelessness, the despair — it’s rooted in history.

The story delves into some of that history, including the forced relocation of Native American children to faraway boarding schools, another particularly ugly chapter in history that I knew nothing about. This forced relocation led to “cultural distortion, physical, emotional and sexual abuse, and the ripple effect of loss of parenting skills and communal grief,” a government study states. Hope on the second poorest county in the country – neighboring Pine Ridge Indian Reservation comes in first place – is a struggle to find. But it’s there, particularly in the strong bonds of the community itself:

Leaving Two Hawk, I head to the office next door where another Native American hospital employee, psychologist Rebecca Foster, PhD, works. When I knock on her office door, she’s taking a break to cradle her week-old grandson. Foster and her husband, Dan, also Native and a psychologist at the hospital, have 14 children — seven of those adopted from relatives on the reservation who were unable to care for them. All seven of those children are special needs, like the baby’s father, who was born with fetal alcohol syndrome… ” I see a lot of kids who are depressed, who talk about suicide,” she says, then pauses to look into the eyes of her grand baby. “And yet, kids are still resilient. They still have a desire to have a good life, to be happy, to accomplish things. No matter where you come from, you can never completely destroy that. There are very few kids here who don’t have a dream. What I tell young people is that there is a difference between having to stay here because you are trapped and choosing to be here because you have something to give. One’s a prison, the other is a home.”

Previously: Finding hope on the Rosebud Indian Reservation, Getting back to the basics: A student’s experience working with the Indian Health Service, Lessons from a reservation: Clinic provides insight on women’s health issues, Lessons from a reservation: South Dakota trip sheds light on a life in rural medicine and Lessons from a  reservation: Visit to emergency department shows patient care challenges
Illustration by Jeffrey Decoster

Bioengineering, Genetics, History, Immunology, Stanford News

Leonard Herzenberg, FACS developer and Stanford professor, dies

HerzenbergIt’s a huge responsibility (and a privilege) to write about someone’s life after they have died; I inevitably come away wishing I had known the subject personally. That’s how I felt when writing about Leonard Herzenberg, PhD, who died last week. He was a scientific giant and a passionate advocate for those less fortunate than himself, and he and his wife of 60 years, Leonore Herzenberg, collaborated scientifically at Stanford for five decades.

From the obituary:

“Len was a valuable and treasured member of our Stanford Medicine community for more than 50 years,” said Lloyd Minor, MD, dean of the medical school. “He was a kind, thoughtful and just person eager to share scientific discoveries and opportunities with his friends and colleagues, and to improve access to education and career-advancement opportunities to women and disadvantaged youth. FACS technology made possible the birth of modern immunology, stem cell research and proteomics, and significantly advanced the clinical care of people with diseases such as cancer and HIV infection. Len’s scientific accomplishments are prodigious. But it is his commitment to helping others that will be his enduring legacy.”

Over and over again I heard words like “warm,” “welcoming” and “remarkable” while writing this article. And, although I had worked with Len Herzenberg in the past (most notably in 2006 when he was awarded the Kyoto Prize), I didn’t realize the extent of his sense of fairness and responsibility to others. From the article:

Herzenberg was well known for his pursuit of social justice, his desire to help those less fortunate then himself and his warm and welcoming demeanor. He donated the money accompanying his Kyoto Prize to nonprofit organizations working to improve health, human rights and education.

And:

[The Herzenbergs] encouraged minority teenagers to pursue a college education by establishing a program to bring high school students from East Palo Alto to Stanford to learn about medicine, biology and the multiple benefits of higher education. In addition, from the 1960s onward, Leonard Herzenberg conducted a behind-the-scenes campaign to expand career advancement opportunities for women in immunology and in science in general.

Please feel free to leave your thoughts and remembrances about Len Herzenberg, or messages to his family, on our online guestbook. The family requests that, in lieu of flowers, donations in Len’s memory be made to the Len and Lee Herzenberg endowed fund at the Stanford School of Medicine. Gifts may be sent to Stanford Medical Center Development, 3172 Porter Drive, Suite 210, Palo Alto, CA. 94304, or made online. Plans for a memorial service will be announced at a later date.

Photo by Steve Gladfelter

Evolution, Genetics, History, Research, Science, Stanford News

On the hunt for ancient DNA, Stanford researchers improve the odds

On the hunt for ancient DNA, Stanford researchers improve the odds

110427-N-YY9999-002On the surface, it’s perfect Halloween fodder: Ancient Peruvian mummies, Bronze and Iron Age human teeth from Bulgaria and a thousands-of-years old hair sample from Denmark. In fact, one attendee of Stanford geneticist Carlos Bustamante’s talk this morning at the annual conference of the American Society of Human Genetics in Boston quipped that his introduction sounded like “the start of a joke.”

But really old human DNA (we’re talking thousands of years) holds amazing secrets about our distant past. What did we look like? Where did our ancestors come from? What diseases may we have had? Unfortunately, it’s much more difficult than it seems to unlock these mysteries.

Stanford postdoctoral scholar Meredith Carpenter, PhD, explained the problem in an e-mail to me yesterday:

From Neandertals to mammoths to Otzi the Iceman, discoveries in ancient DNA sequencing have been making headlines.  But what you might not realize is that most of the ancient genomes sequenced to date have come from exceptionally well-preserved specimens – Otzi, for example, was literally frozen in ice for 5000 years.

Ancient DNA specimens from temperate environments, in contrast, are much trickier to sequence because they contain high levels of environmental contamination, primarily derived from bacteria and other microbes inhabiting the ancient bone. This contamination often makes it too expensive to sequence the tiny amounts of endogenous DNA (which degrades over the years due to exposure to the elements) remaining in a sample.

Now, Carpenter and Bustamante, PhD, and their colleagues have hit upon a way to enrich, or increase the proportion of ancient human DNA in an environmental sample from about 1.2 percent to nearly 60 percent–rendering it vastly easier to sequence and analyze. They do so by exposing the sample to a genome-wide panel of human-specific RNA molecules to which the degraded DNA in the sample can bind. The effect is somewhat like stirring a pile of iron-rich dirt with a powerful magnet to isolate the metal from the soil.

This isn’t Bustamante’s first foray into the secrets of ancient DNA. Last year he published very interesting results showing that the ancestors of the famous Iceman likely came not from mainland Italy, as previously thought, but instead from the islands of Corsica or Sardinia. This new technique should enable researchers to learn even more about our ancestors, including those oh-so-intriguing mummies.

According to Carpenter:

We hope that this new method will enable ancient DNA researchers to more cheaply sequence a larger number of specimens, providing broader insight into historical populations rather than just a few well-preserved individuals.

The research is published online today in the American Journal of Human Genetics. If you’re interested in following tweets from the conference, which goes through tomorrow, you can do so by following hashtag #ASHG2013.

Previously: Iceman’s origins discovered at Stanford, Stanford study investigates our most-recent common ancestors  and Recent shared ancestry between Southern Europe and North Africa identified by Stanford researchers.
Photo by Official US Navy Imagery

History, Humor, Medicine and Literature, Science, Technology

Half-century climb in computer’s competence colloquially captured by Nobelist Michael Levitt

Half-century climb in computer's competence colloquially captured by Nobelist Michael Levitt

ancient computerOn October 9, the day Stanford macromolecule-modeling maven Michael Levitt, PhD, won his Nobel Prize, I wrote him a note of congratulations.

He wrote back six days later: “Thanks so much. It has been one wild ride! It will be good for the field, though, and I will learn to disappear and still have time for myself.” It’s a wonder he got back to me as soon as he did, crushed as he must feel by the cheering throngs dogging him at every turn since Nobel day. But he has made a point of replying quickly and gracefully to not only well-wishers but deadline-driven reporters.

Although his Nobel was for chemistry, the lab Levitt operates in is stocked with shelves full of ones and zeroes. His expertise lies in the field of computer science, a field of which Alfred Nobel had no inkling when he created the awards in his final will, written in 1895.

As we all know, Nobel made his millions in the explosives field. No explosion he could have imagined in 1895 has been more profound, in recent decades, than the explosion in computing power pithily encapsulated in Moore’s law. In the late 1960s, Levitt began constructing his increasingly detailed simulations of the giant biomolecules that animate our cells and, in a sense, our souls as well, by pumping punchcards into what was then among the world’s most potent computers (dubbed Golem in memory of a powerful, soulless giant of medieval Jewish folklore) at Israel’s Weizmann Institute.

Since those seminal days, the ones-and-zeroes game has picked up speed. Responding to an e-mailed query from science writer Lisa Krieger of the San Jose Mercury News, Levitt put it this way:

The computer that I used in 1968 allowed me 300 [kilobytes] of memory, or about 1/10,000th of the memory on a smart phone. [An extremely complex,  fifty-step computation] took 18 minutes on the Golem computer… for a cost of about five million 1965 U.S. dollars ($35 million today). The same calculation takes 0.18 seconds on an Apple MacMook PRO laptop costing $3,500. This means that the calculation is… 6,000 times faster on a computer costing… 10,000 times less.

If cars had changed in the same way, Levitt drolly noted, “a 1965 Cadillac that cost $6,000 in 1965 dollars ($40,000 today) would actually cost just four dollars. More amazingly, it would have a top speed of 600,000 miles an hour and be able to carry 50,000 people.”

Makes me wonder: Just how long will it be before we can no longer tell our computers from ourselves?

Previously: But is it news? How the Nobel Prize transformed noteworthy into newsworthy, Nobel winner Michael Levitt’s work animates biological processes, No average morning for Nobel winner Michael Levitt and Stanford’s Michael Levitt wins 2013 Nobel Prize in Chemistry
Photo by kalleboo

Genetics, History, Medicine and Society, Research, Stanford News

The dawn of DNA cloning: Reflections on the 40th anniversary

The dawn of DNA cloning: Reflections on the 40th anniversary

DNA for Cohen blogAs you might guess, I write a lot about science for my job. And it’s always great fun to hear about all the newest findings – some of which appear to have the potential to be genuinely groundbreaking in their field. But I rarely stop to contemplate how science, like every other human endeavor, has a very real, very important history that echoes through the papers I write about today.

In today’s Online Early Edition of the Proceedings of the National Academies of Science, Stanford geneticist Stanley N. Cohen, MD, reflects on his role, together with that of Herbert Boyer, PhD, (then at the University of California, San Francisco), in a series of events 40 years ago that led to the first instances of “DNA cloning” and an explosion in the fields of genetics, biotechnology and medicine.

The article is a fascinating read that clearly took a great deal of effort. When I asked Cohen why he felt it was important to accept the invitation to write such an article, here’s what he told me:

DNA cloning has now become such an integral part of the biological sciences that it is sometimes difficult for students and other young scientists to imagine that there was once uncertainty about whether genes could be propagated and cloned in a foreign host.   The invitation from the PNAS provided an opportunity for me to write a first-person account of the science and events that led to successful DNA cloning 40 years ago.  It also provided a format to explain the scientific logic underlying the crucial experiments, describe some of the personal interactions involved, and point out the scientific and political consequences of the findings. I’ve tried to combine my personal perspective with careful documentation of the history – while communicating the sense of scientific excitement that existed at the time.  Not the least of my intents was to remind people – at a time when public support of basic research is decreasing – that the invention of DNA cloning, which has had important practical applications in addition to contributing to knowledge about the workings of genes and cells in health and disease, resulted from the pursuit of fundamental questions about biological phenomena.

I highly encourage scientists (and science writers!) at all stages of their careers to take a look. If you’re interested in learning more about the history of science in the early days of biotechnology, you should check out the Regional Oral History collection at U. C. Berkeley’s Bancroft Library, which includes interviews with Cohen and Boyer as well as Stanford’s Paul Berg, PhD, and Niels Reimers. Reimers founded Stanford’s Office of Technology Licensing, which obtained the patent on the recombinant DNA technology.

Previously: Why basic research is the venture capital of the biomedical world and First U.S. heart transplant among the top 50 breakthroughs in science
Photo by Christian Guthier

History, Infectious Disease, Microbiology, Public Health, Research, Stanford News

Did microbes mess with Typhoid Mary’s macrophages?

Did microbes mess with Typhoid Mary's macrophages?

macrophage with salmonella insideMary Mallon (a.k.a. “Typhoid Mary“) didn’t mean any harm to anybody. An Irish immigrant, she made her living for several years about a century ago by cooking for better-off families in the New York City area. Strangely, the people she cooked for kept on coming down with typhoid fever – but not Mary.

Mallon, alas, turned out to be a chronic asymptomatic carrier of Salmonella typhi, the bacterial strain that causes typhoid fever. Typhoid is a deadly disease that, while no longer a huge problem in the United States, infects tens of millions – and kills hundreds of thousands – of people around the world every year.

“She didn’t know she had it,” says Stanford microbiologist Denise Monack, PhD. “To all outward appearances, she was perfectly healthy.”

Salmonella strains, including one called S. typhimurium, also cause food poisoning in people and pets, taking an annual human toll of 150,000 globally. While S. typhi infects only humans, closely related S. typhimurium can infect lots of mammals.

Between 1 and 6 percent of people infected with S. typhi become chronic, asymptomatic typhoid fever carriers. Nobody has known why this happens, but it’s a serious public-health issue. To address this, Monack has developed an experimental mouse model that mimicks asymptomatic typhoid carriers. In a new study published in Cell Host & Microbe, she and her colleagues put that model to good effect, showing that Salmonella has a sophisticated way of messing with our immune systems. The bacteria set up house inside voracious attack cells called macrophages (from the Greek words for “big eater”). Macrophages, are known for their ability to engulf and digest pathogens and are called to the front lines of an immune assault against invading microbes. Ornery critters that they are, macrophages would seem like the last thing bacteria bent on long-term survival would want to meet.

But, as I wrote in my release about this study, a macrophage has two faces, depending on its biochemical environment:

“Early in the course of an infection,” [Monack] said, “inflammatory substances secreted by other immune cells stir macrophages into an antimicrobial frenzy. If you’re not a good pathogen, you’ll be wiped out after several days of causing symptoms.” But salmonella is one tough bug. And our bodies can’t tolerate lots of inflammation. So, after several days of inflammatory overdrive, the immune system starts switching to the secretion of anti-inflammatory factors. This shifts macrophages into a kinder, gentler mode. Thus defanged, anti-inflammatory macrophages are more suited to peaceful activities, such as wound healing, than to devouring microbes.

And, sure enough, Monack and her colleagues showed that salmonella germs have a way (still mysterious, but stay tuned) of taming macrophages, flipping an intercellular switch inside of these thug-like cells that not only expedites their champ-to-chump shift but induces them to pump out tons of glucose, the bug’s favorite food. What better place to hide than in the belly of the beast?
Previously: TB organism’s secret life revealed in a hail of systems-biology measurements
Photo by AJC1

Cancer, History, In the News, Science

Some resolution for the immortal cells of Henrietta Lacks

Some resolution for the immortal cells of Henrietta Lacks

We’ve written quite a bit here about Henrietta Lacks, the poor black woman who died in 1951 of cervical cancer, and whose cancer cells – taken without her knowledge – led to great advances in biomedical research. (Lacks’ story was told in the award-winning The Immortal Life of Henrietta Lacks.) Lacks’ family, in the words of Smithsonian blogger Rachel Nuwer, have “harbored a deep discontent about their relative’s stolen cells;” “they were never informed that Lacks’ cells were taken; they never received any royalties from the HeLa line; and researchers often ignored Lacks’ great personal legacy.”

Today, there’s big news about Lacks, with Nature reporting that the family reached a deal with the National Institutes of Health regarding access to the so-called HeLa cells. Ewen Callaway explains how the agreement came to be and also addresses the issue of financial compensation:

Some Lacks family members raised the possibility of [it],[NIH director Francis] Collins says. Directly paying the family was not on the table, but he and his advisers tried to think of other ways the family could benefit, such as patenting a genetic test for cancer based on HeLa-cell mutations. They could not think of any. But they could at least reassure the family that others would not make a quick buck from their grandmother’s genome, because the US Supreme Court had this year ruled that unmodified genes could not be patented. [Henrietta’s granddaughter Jeri] Lacks-Whye says that the family does not want to dwell on money — and that her father has often said he “feels compensated by knowing what his mother has been doing for the world.”

Previously: Do you have a ‘HeLa’ story? Share it with Rebecca Skloot, Will Henrietta Lacks now get her due?, Image of the Week: HeLa cells and Immortal cells: Henrietta Lacks lives on and on

Health Costs, Health Policy, History, Stanford News

The history of U.S. health care in about 1,000 words

The history of U.S. health care in about 1,000 words

“All men are created equal” may be the guiding legal principle for citizens of the United States, but not when it comes to health care coverage and outcomes, says Victor Fuchs, PhD, one of the nation’s foremost health economists and the Henry J. Kaiser Jr. Professor, Emeritus, at Stanford.

In a Viewpoint published today in the Journal of the American Medical Association, Fuchs provides a history lesson on how and why the U.S. health care system spends more than double on per-person health expenditures than other advanced nations, and he offers some strategies for controlling future costs.

“This is the best short piece on U.S. health care that I’ve ever seen,” Howard Bauchner, MD, editor-in-chief of JAMA, told me.

Beginning today, the Affordable Care Act expands the number of Americans receiving preventive care, providing new federal funding to state Medicaid programs that choose to cover preventive services. It also requires that states pay primary care physicians no less than 100 percent of Medicare payment rates for primary care services.

While the health-care reforms mandated in the act include some provisions to motivate health-care providers to become more efficient, less fragmented and more accountable, it doesn’t include revenue sources for all its new services. Fuchs says, “More comprehensive reforms are necessary to avoid financial disaster.”

According to Fuchs, there are three fundamental differences in the U.S. system — driven by its history — that make it difficult for the U.S. to adopt a less costly government-financed health care system. There is a distrust of large government that began when America broke away from the strong-armed British Empire. There is a reluctance to redistribute wealth across all citizens, in part because of the country’s cultural diversity. And there are “choke points” in the U.S. political system — such as the cost of election campaigns and the Senate filibuster — that give deep-pocketed special interest groups the upper hand in preventing sweeping reforms.

As a new Congress returns to work with health care reform high on its new year’s resolutions, Fuchs’ editorial provides a starting point, grounded in history, for a new round of negotiations.

Previously: Study: If Americans better understood the Affordable Care Act, they would like it more, Does the Affordable Care Act address our health-cost problem?, Stanford economist Victor Fuchs: Affordable Care Act “just a start” and An expert’s historical view of health care costs

From Dec. 24 to Jan. 7, Scope will be on a limited holiday publishing schedule. During that time, it may also take longer than usual for comments to be approved.

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