Monday, August 30, 2010

My new interest - IPs (for corneal regeneration?)

A better way to grow stem cells
New synthetic surfaces overcome challenges posed by existing methods for cultivating stem cells.

Anne Trafton, MIT News Office

Human pluripotent stem cells, which can become any other kind of body cell, hold great potential to treat a wide range of ailments, including Parkinson’s disease, multiple sclerosis and spinal cord injuries. However, scientists who work with such cells have had trouble growing large enough quantities to perform experiments — in particular, to be used in human studies.

Furthermore, most materials now used to grow human stem cells include cells or proteins that come from mice embryos, which help stimulate stem-cell growth but would likely cause an immune reaction if injected into a human patient.

To overcome those issues, MIT chemical engineers, materials scientists and biologists have devised a synthetic surface that includes no foreign animal material and allows stem cells to stay alive and continue reproducing themselves for at least three months. It’s also the first synthetic material that allows single cells to form colonies of identical cells, which is necessary to identify cells with desired traits and has been difficult to achieve with existing materials.

The research team, led by Professors Robert Langer, Rudolf Jaenisch and Daniel G. Anderson, describes the new material in the Aug. 22 issue of Nature Materials. First authors of the paper are postdoctoral associates Ying Mei and Krishanu Saha.

Refining surfaces

Human stem cells can come from two sources — embryonic cells or body cells that have been reprogrammed to an immature state. That state, known as pluripotency, allows the cells to develop into any kind of specialized body cells.

It also allows the possibility of treating nearly any kind of disease that involves injuries to cells. Scientists could grow new neurons for patients with spinal cord injuries, for example, or new insulin-producing cells for people with type 1 diabetes.

To engineer such treatments, scientists would need to be able to grow stem cells in the lab for an extended period of time, manipulate their genes, and grow colonies of identical cells after they have been genetically modified. Current growth surfaces, consisting of a plastic dish coated with a layer of gelatin and then a layer of mouse cells or proteins, are notoriously inefficient, says Saha, who works in Jaenisch’s lab at the Whitehead Institute for Biomedical Research.

“For therapeutics, you need millions and millions of cells,” says Saha. “If we can make it easier for the cells to divide and grow, that will really help to get the number of cells you need to do all of the disease studies that people are excited about.”

Previous studies had suggested that several chemical and physical properties of surfaces — including roughness, stiffness and affinity for water — might play a role in stem-cell growth. The researchers created about 500 polymers (long chains of repeating molecules) that varied in those traits, grew stem cells on them and analyzed each polymer’s performance. After correlating surface characteristics with performance, they found that there was an optimal range of surface hydrophobicity (water-repelling behavior), but varying roughness and stiffness did not have much effect on cell growth.

They also adjusted the composition of the materials, including proteins embedded in the polymer. They found that the best polymers contained a high percentage of acrylates, a common ingredient in plastics, and were coated with a protein called vitronectin, which encourages cells to attach to surfaces.

Using their best-performing material, the researchers got stem cells (both embryonic and induced pluripotent) to continue growing and dividing for up to three months. They were also able to generate large quantities of cells — in the millions.

Creating new synthetic materials for stem-cell growth is a longstanding problem that many researchers have tried to solve, says Sheng Ding, an associate professor of chemistry at the Scripps Research Institute. “In the past, it was more of a trial-and-error process,” he says. “The beauty of this work is that they can design these in a very systematic way. This is really a platform that can be applied not just to human embryonic stem cells, but also other cells.”

The MIT researchers hope to refine their knowledge to help them build materials suited to other types of cells, says Anderson, from the MIT Department of Chemical Engineering, the Harvard-MIT Division of Health Sciences and Technology, and the David H. Koch Institute for Integrative Cancer Research. “We want to better understand the interactions between the cell, the surface and the proteins, and define more clearly what it takes to get the cells to grow,” he says.

Other MIT authors of the paper are Said Bogatyrev, Z. Ilke Kalcioglu, Maisam Mitalipova, Neena Pyzocha, Fredrick Rojas and Krystyn Van Vliet. Jing Yang, Andrew Hook, Martyn Davies and Morgan Alexander of the University of Nottingham (United Kingdom) and Seung-Woo Cho of Yonsei University (Korea) are also authors of the paper.

A Biosynthetic Alternative to Human Donor Tissue for Inducing Corneal Regeneration: 24-Month Follow-Up of a Phase 1 Clinical Study

Sci Transl Med 25 August 2010:
Vol. 2, Issue 46, p. 46ra61
DOI: 10.1126/scitranslmed.3001022
Research Article
A Biosynthetic Alternative to Human Donor Tissue for Inducing Corneal Regeneration: 24-Month Follow-Up of a Phase 1 Clinical Study
Per Fagerholm1,*, Neil S. Lagali1,*, Kimberley Merrett2, W. Bruce Jackson2, Rejean Munger2, Yuwen Liu3, James W. Polarek4, Monica Söderqvist5 and May Griffith1,2,†

+ Author Affiliations

1Departments of Clinical and Experimental Medicine, and Ophthalmology, Faculty of Health Sciences, Linköping University, Cell Biology Building, Level 10, SE-581 83 Linköping, Sweden.
2University of Ottawa Eye Institute, Ottawa, Ontario, Canada K1H 8L6.
3CooperVision Inc., 5870 Stoneridge Drive, Suite 1, Pleasanton, CA 94588, USA.
4FibroGen Inc., 409 Illinois Street, San Francisco, CA 94158, USA.
5Synsam Opticians, Box 362, Trädgårdstorget 2, 581 03 Linköping, Sweden.

1Departments of Clinical and Experimental Medicine, and Ophthalmology, Faculty of Health Sciences, Linköping University, Cell Biology Building, Level 10, SE-581 83 Linköping, Sweden.
2University of Ottawa Eye Institute, Ottawa, Ontario, Canada K1H 8L6.
3CooperVision Inc., 5870 Stoneridge Drive, Suite 1, Pleasanton, CA 94588, USA.
4FibroGen Inc., 409 Illinois Street, San Francisco, CA 94158, USA.
5Synsam Opticians, Box 362, Trädgårdstorget 2, 581 03 Linköping, Sweden.
†To whom correspondence should be addressed. E-mail: may.griffith@liu.se
AbstractCorneas from human donors are used to replace damaged tissue and treat corneal blindness, but there is a severe worldwide shortage of donor corneas. We conducted a phase 1 clinical study in which biosynthetic mimics of corneal extracellular matrix were implanted to replace the pathologic anterior cornea of 10 patients who had significant vision loss, with the aim of facilitating endogenous tissue regeneration without the use of human donor tissue. The biosynthetic implants remained stably integrated and avascular for 24 months after surgery, without the need for long-term use of the steroid immunosuppression that is required for traditional allotransplantation. Corneal reepithelialization occurred in all patients, although a delay in epithelial closure as a result of the overlying retaining sutures led to early, localized implant thinning and fibrosis in some patients. The tear film was restored, and stromal cells were recruited into the implant in all patients. Nerve regeneration was also observed and touch sensitivity was restored, both to an equal or to a greater degree than is seen with human donor tissue. Vision at 24 months improved from preoperative values in six patients. With further optimization, biosynthetic corneal implants could offer a safe and effective alternative to the implantation of human tissue to help address the current donor cornea shortage.

Sunday, July 11, 2010

FDA approves nation’s first implantable eye telescope to treat blindness

July 9, 2010
From: "Telemedicine and e-Health"


U.S. Food and Drug Administration officials have approved a first-of-its-kind technology - a tiny telescope implanted inside the eye - to counter incurable age-related macular degeneration (AMD), the nation's leading cause of blindness in older adults. According to Allen W. Hill, chief executive officer of Saratoga, CA-based VisionCare Ophthalmic Technologies Inc., the Implantable Miniature Telescope's magnification capability reduces the impact of the blind spot caused by end-stage AMD. Smaller than a pea, the telescope is implanted in one eye in an outpatient surgical procedure. In the implanted eye, the device renders enlarged central vision images over a wide area of the retina to improve central vision, while the non-operated eye provides peripheral vision for mobility and orientation. Ninety percent of patients in a 219-person study had their vision improved with the device; VisionCare will conduct a post-approval study to monitor patient outcomes under commercial conditions, Hill said. 


Despite recession, medical imaging market to post 14 percent gain by 2012
The medical imaging market is expected to recover from the adverse effects of the economic downturn and the significant decline in reimbursement, and generate more than $6.5 billion worldwide by 2012, according to a report by market research firm Frost & Sullivan. According to Frost & Sullivan Research Associate Simone Carron, the revenue upturn - a 14 percent increase from the $5.7 billion posted in 2009 - will be driven by "advancements in technology and new clinical applications for imaging modalities," including hybrid systems with innovative developments such as radiation reduction and better temporal resolution. Market segments covered in the report include computed radiography and digital radiography (CR and DR), magnetic resonance imaging (MRI), computed tomography (CT), 3 dimensional (3D) and computer aided design (CAD), ultrasound, C-arms, imaging informatics, contrast media and auto injectors, mammography, molecular imaging and nuclear medicine.    


New ECG sensor can detect heart and brain activity without touching skin
Researchers at the University of California at San Diego have developed a medical sensor that can read electrocardiogram (ECG) and other data through clothing, without ever touching the skin. According to UCSD graduate student Mike Chi, who created the device with UCSD bioengineer Gert Cauwenberghs, traditional ECG electrodes detect the time it takes for waves of changing polarity caused by heart-muscle contractions to travel to different sensors, which reveals the electrical activity of different parts of the heart. The sensors are messy, allergy-inducing, uncomfortable and motion-sensitive, and can't be used outside the clinic or for long periods of time. But the UCSD sensor, slightly larger than a quarter, can detect faint changes in capacitance and amplify them, while canceling out ambient electrical noise. Multiple sensors embedded in material and wired together create a portable monitor that patients can wear over clothing during their daily routine. This could mean increased monitoring time and better compliance from patients, Chi said. Incorporating the sensors into a headband could also make it possible to monitor electrical activity in the brain. Chi is creating a startup company, Cognionics, to develop the sensors further, and has already begun talks with medical-device companies.   

Broadband projects awarded $795 million in latest round of federal grants
The Obama administration has announced $795 million in grants and loans for 66 new broadband projects across the country, including $62.5 million to a group of national research and education networking organizations to link libraries, schools, and other organizations and offer the capacity for high-bandwidth applications like telemedicine and distance learning. The funding, matched by $200 million in outside investments, is part of the $7.2 billion included in the 2009 federal economic stimulus package to expand broadband access nationwide. President Obama said tens of millions of Americans and more than 685,000 businesses, 900 healthcare facilities and 2,400 schools in all 50 states stand to benefit from the awards. About one-third of the funding has been awarded. A complete list of the newest recipients is available at www.whitehouse.gov.


CDC awards $2 million to Public Health Laboratories for e-data exchange
The Centers for Disease Control and Prevention has awarded $2 million to the Association of Public Health Laboratories (APHL) to help advance the use of electronic information exchange among APHL members. According to APHL President Patrick Luedtke, MD, the award is funded as a cooperative agreement through the Health Information Technology for Economic and Clinical Health Act. The agreement will support technical assistance to state health departments, public health laboratories and hospitals to help them link disparate laboratory reporting systems. The grant period extends for 24 months beginning July 1, 2010. The grant "brings us one step closer to the real goal of electronic exchange of lab data: healthier people," Luedtke said.


Berwick appointed new head of Medicare and Medicaid Services
Bypassing the Senate's ongoing debate - and confirmation delay - President Obama this week has installed Dr. Donald Berwick as administrator of the Centers for Medicare and Medicaid Services (CMS). According to White House Communications Director Dan Pfeiffer, Obama appointed Berwick, the chief executive officer of the Institute for Healthcare Improvement in Boston, while Congress was in recess because "there's no time to waste with Washington game-playing." Obama had nominated Berwick for the position in April, but his confirmation was delayed for political reasons. Because the appointment was made while the Senate is not in session, Berwick's term as CMS administrator will last only until the end of the next session of Congress, in late 2011. Berwick is also Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School, and Professor of Health Policy and Management at the Harvard School of Public Health.   


Neuros Medical receives $1.5 million from DoD to treat amputee 'stump' pain
Willoughby, OH-based neurostimulation medical device maker Neuros Medical Inc. has received a $1.5 million grant from the U.S. Department of Defense to develop a drug-free treatment for chronic residual limb pain or "stump" pain, experienced by nearly 1 million amputees. According to Neuros Medical President Jon J. Snyder, the company's Nerve Block technology - consisting of a pacemaker-sized generator and electrode - uses high frequency alternating current stimulation to block chronic pain signals in the peripheral nervous system. Military casualties and amputations experienced by those serving in Iraq and Afghanistan have increased the need to develop effective treatments for patients suffering from chronic residual limb pain, he said.   Full Story

Domestic medical travel could derail telemedicine's market growth
Telemedicine may have an unexpected barrier in its efforts to become a medical care method of choice. According to a report in USA Today, more employers and insurers are offering financial incentives to encourage workers to consider traveling to specialists for the care they need. The use of "domestic medical travel" - in which workers are sent to facilities with high-quality care and lower prices - can help employers reduce their costs 20 percent to 40 percent - more than enough to cover the travel expenses. Employers with domestic travel programs say they save money in part by negotiating a single rate, which includes fees for surgeons, anesthesiologists and all medical care up until the patient is discharged, according to the report. Although it is promising, the concept could backfire if employers and insurers focus solely on cost, rather than quality, USA Today notes.     Full Story

Doctors, insurers using software to simplify medical jargon for patients
Federal and state officials are encouraging public health professionals, doctors and insurers to simplify the language they use to communicate with the public in patient handouts, medical forms and health Web sites. According to a report in The Wall Street Journal, nearly 9 out of 10 adults have difficulty following routine medical advice, often because it's incomprehensible to average people. A new federal program called the Health Literacy Action Plan is promoting simplified language nationwide. And some health insurers, doctors' practices and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases and suggests plain-English replacements. Use of such products can help insured persons "better appreciate the importance of preventive services and recommended checkups," according to Jo Poorman, senior director of print and digital media for Chicago-based Health Care Service Corp., a Blue Cross and Blue Shield provider. Full Story

Health IT products expected to push sales of handheld devices through 2015
Handheld device sales for healthcare use are expected to increase over the next five years as physicians and hospitals purchase new information technology systems, according to a report by New York City-based Kalorama Information. Already at $8.2 billion globally in 2009, handheld sales are expected to increase by seven percent through 2015, according to "Handhelds in Healthcare: The World Market for PDAs, Tablet PCs, Handheld Monitors & Scanners." Stimulus incentives are a big factor, as are a growing and aging population, a shortage of qualified medical professionals, cost restraints, and medical error reduction measures, according to the report. The propensity of doctors and nurses to use the devices is also driving sales, Kalorama Information Publisher Bruce Carlson said.  

PharmaTrust to expand use of pharmaceutical ATMs in Canada
Oakville, Ontario-based PharmaTrust and the Ontario Telemedicine Network (OTN) are expanding use of its ATM-like pharmaceutical drug dispensers in hospitals throughout the Canadian province. According to Steve Gesner, chief information officer at PharmaTrust, the deal with OTN will allow the company to quickly deploy its MedCentres - often described as a "pharmacist in a box" - at a number of the province's 1,000 hospitals. The application links a trained pharmacist to the patient through a two-way audio-video line. A scanner allows the pharmacist to read a prescription, which is then filled using drugs stored in the machine. The units have been tested at three locations in Ontario for several months, and the company recently signed a deal to provide MedCentre machines in Great Britain. Gesner said discussions are continuing with roughly 30 health facilities, and up to one-third are showing "strong interest" in adopting the new technology. Full Story

University of Rochester pediatric telehealth program to receive NOVA award
The University of Rochester Medical Center (URMC)'s pediatric telemedicine program, Health-e-Access Telemedicine, will receive an American Hospital Association NOVA Award at AHA's annual forum in San Diego on July 24. According to AHA President and Chief Executive Officer Rich Umbdenstock, the award honors hospital community collaborations that improve community health. Launched in 2001, Health-e-Access Telemedicine uses Web-based telemedicine to connect youngsters in child care centers, schools, or community centers to a pediatrician or nurse practitioner who is part of the child's primary care medical home. The program encompasses 23 community-based sites, as well as mobile units and teledentistry. URMC is one of five programs to receive a NOVA award at the upcoming forum. The others are the Community-Based Alternatives to the Emergency Room in Fort Myers, FL, Healthy Futures in Traverse City, MI, Healthy San Francisco in San Francisco, and the Pediatric Asthma Program in Chicago.


Monte Gibbs, former chief technology officer for MyLife.com, has been named CTO of Private Access... Greg Hales, program coordinator for telehealth at North Country HealthCare, announced they have registered with the FDA for a formal study to evaluate digital stethoscopes in telemedicine applications... Daniel J. Webster Jr. has joined The Computer Merchant (TCM) as senior vice president, Healthcare Practice... Patrick K. Moore, JD, has joined c3o Telemedicine Solutions as executive vice president for business development... Mark Parkinson, Governor of Kansas, established a not-for-profit organization to help the state's development of a health information exchange... Dominic Mack, MD, of Morehouse School of Medicine, announced they received $19.5 million in federal stimulus funding and will be using it to help rural Georgian doctors and hospitals to set up and implement electronic medical record systems... Please send us your news on Movers and Shakers in the field.


• Seventh Annual Healthcare Unbound Conference & Exhibition July 19-20, 2010 - San Diego, CA Networks, platforms and applications for technology-enabled participatory medicine. Special focus on remote monitoring, home telehealth, mhealth and ehealth for chronic care management and wellness promotion. Featuring an aging services educational track. Supporting organizations include: AAHSA, CAST and DMAA: The Care Continuum Alliance. www.tcbi.org
  

Sunday, April 25, 2010

Blue Eyed Malaysian Boy

You'd probably be familiar with the character Billy (Blue Boy), played by Mark Slade, the naughty pampered cowboy son of the main character "Big" John Cannon (played by Leif Erikson). But here in Malaysia you don't usually get to see a blue eyed boy. So it is really something strange to see a local boy with blue eyes that it gets the attention of a local newspaper.

Sunday, April 18, 2010

Age-related macular degeneration (AMD)

Sunday April 18, 2010

These old eyes

By Dr KEWALJIT SINGH

Young eyes, old eyes ... A study showed a 2% risk of AMD during middle age, but this risk increased to nearly 30% in those over age 75. – AFP

Dr Kewaljit Singh is a consultant ophthalmologist.

He will be speaking at a public health talk entitled ‘Don’t let ageing, diabetes and sunlight damage your eyes’ on April 24, in Bukit Kiara Resort. To reserve a seat, please contact 03-55693660. This article is courtesy of Cambert. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

Sunday, April 4, 2010

Laser Eyebag Removal anyone?

Marissa Esthetic, a surgical cosmetic clinic has so many things to offer for anyone willing to go under the knife.

Well, not surgery exactly, but among others it claims to have fiber optics or laser treatment. This fiber optics surgery is for eye-bags removal.

Other services being offered include skin treatment, hormone replacement therapy,
COLON CLEANSING
CHEMICAL PEELING
EDTA (CHELATION)
Enzyme Therapy
FILLERS
GLUTATHIONE
LASERLIPOLISIS
MICRODERMABRASION
SERDEV SUTURE
SKIN CARE
SURGILIPS
SKIN TIGHTENING
SILKY SKIN HAIR REMOVAL

How effective or safe these treatments are, I am not sure. Read the blog posting of the

Laser Eye Bag Removal

The treatment costs RM1,200 and it is a special offer from the clinic.

I hope some experts on this would comment further.

Below is an article in yesterday's Mingguan Malaysia by a Dr Rushmini Maris Ismail (not sure if she's an ophthalmologist or a plastic surgeon) promoting her services on laser/fiber optic treatment for people with bad looking eye-bags.

The article also carries an ad to the Marissa Esthetics website and Poliklinik Penawar Semenyih.

Friday, April 2, 2010

Trials for 'bionic' eye implants

By Jonathan Fildes (Science and technology reporter, BBC News, San Francisco)

A bionic eye implant that could help restore the sight of millions of blind people could be available to patients within two years.

US researchers have been given the go-ahead to implant the prototype device in 50 to 75 patients.

The Argus II system uses a spectacle-mounted camera to feed visual information to electrodes in the eye.

Patients who tested less-advanced versions of the retinal implant were able to see light, shapes and movement.

"What we are trying to do is take real-time images from a camera and convert them into tiny electrical pulses that would jump-start the otherwise blind eye and allow patients to see," said Professor Mark Humayun, from the University of Southern California.















Bionic eye technology

1: Camera on glasses views image

2: Signals are sent to hand-held device

3: Processed information is sent back to glasses and wirelessly transmitted to receiver under surface of eye

4: Receiver sends information to electrodes in retinal implant

5: Electrodes stimulate retina to send information to brain

Retinal implants are able to partially restore the vision of people with particular forms of blindness caused by diseases such as macular degeneration or retinitis pigmentosa.

About 1.5 million people worldwide have retinitis pigmentosa, and one in 10 people over the age of 55 have age-related macular degeneration.

Both diseases cause the retinal cells which process light at the back of the eye to gradually die.

The new devices work by implanting an array of tiny electrodes into the back of the retina.

A camera is used to capture pictures, and a processing unit, about the size of a small handheld computer and worn on a belt, converts the visual information into electrical signals.

These are then sent back to the glasses and wirelessly on to a receiver just under the surface of the front of the eye, which in turn feeds them to the electrodes at the rear.

The whole process happens in real time.

Growing dots

First-generation, low-resolution devices have already been fitted to six patients.

"The longest device has been in for five years," said Professor Humayun.

"It's amazing, even with 16 pixels, or electrodes, how much our first six subjects have been able to do."

Terry Byland, 58, from California was fitted with an implant in 2004 after going blind with retinitis pigmentosa in 1993.

"At the beginning, it was like seeing assembled dots - now it's much more than that," he said.

"When I am walking along the street I can avoid low-hanging branches - I can see the edges of the branches."

Mr Byland is also able to make out other shapes.

"I can't recognise faces, but I can see them like a dark shadow," he said.

Brain change

The new implant has a higher resolution than the earlier devices, with 60 electrodes.

It is also a lot smaller, about one square millimetre, which reduces the amount of surgery that needs to be done to implant the device.

The technology has now been given the go-ahead by the US Food and Drug Administration to be used in an exploratory patient trial.

This will take place at five centres across America over two years, with 50-75 patients aged over 50.

If successful, the device could be commercialised soon after, costing around $30,000 (£15,000). Other devices could then be developed with higher resolution or a wider field of view, said Professor Humayun.

Future work includes studying the effects the implants have on the brain.

"We are actually studying what happens to the visual cortex over time," said Professor Humayun.

The research was presented at the American Association for the Advancement of Science (AAAS) annual meeting in San Francisco, US.