Testing the new technology
After losing his forearm in a car crash, 26-year-old Pierpaolo Petruzziello agreed to participate in a one-month medical experiment to test out a robotic hand that can be controlled by a patient’s thoughts. Now, doctors say that the test run was successful, and may open the door for major developments to come.

More progress to come
Unlike most other prosthetics, this robot hand wasn’t implanted directly into Petruzziello, but was connected with a series of electrodes that were attached to the nerve endings on his severed arm.
The Associated Press reports that, at a press conference, the medical team played video footage of the patient controlling the hand’s actions with his mind as the device sat next to him. During the experiment, he learned to wiggle his fingers, make a fist, and grab objects. Said Petruzziello, “It felt almost the same as a real hand… you can’t imagine what they did to me.” Neurologist Paolo Maria Rossini jokingly added, “Some of the gestures cannot be disclosed because they were quite vulgar.” (Awesome.)

See the video here

This experience is very helpful for patients who have suffered only partial loss of a hand or arm
Other similar thought-controlled prosthetic experiments have been successful in the past, but all of those only worked when a limb was completely severed. Scientists hope that this development may offer solutions for patients who have suffered only partial loss of a hand or arm. Although the project lasted only a month, it was still the longest that electrodes had remained connected to a patient’s nervous system.

Further challenges ahead
Doctors acknowledge that the next challenge is to develop a more durable device that can function for years on end. It’s clear, though, that the significance of this particular success shouldn’t be downplayed. There may still be barriers to overcome, but if prosthetic science progresses as rapidly as it has, it should only be a matter of time before someone smashes through them — with a robotic fist or otherwise.

The treatment
An invisible knife that uses high-intensity sound waves to penetrate the body and destroy tumours is set to revolutionise cancer treatment, it is claimed.
In five to 10 years ultrasound could replace conventional surgery and radiotherapy for patients with many different types of cancer, scientists said.

About the technique
The technique is undergoing early trials for liver and kidney cancer in the UK while a French team using a different system has already achieved disease-free results treating men with prostate cancer.
In China, where the technology has been pioneered, anecdotal evidence from studies of thousands of patients is said to be “astounding”.
Ultrasound surgery focuses bursts of high energy sound waves on the tumour, heating it to a temperature of 60 degrees Celsius. The tumour cells are destroyed while surrounding tissue is left unharmed.
Professor Gail ter Haar, who is leading trials of an experimental system at the Royal Marsden Hospital in Sutton, Surrey, England, said the technique could treat tumours up to the size of a small orange.

Testing ultrasounds
At this stage the trials are confined to testing the safety of the technique, but Prof ter Haar said they had already yielded “really exciting results”.
She told the American Association for the Advancement of Science’s annual meeting in Seattle yesterday: “I think there will be cancers for which it will revolutionise treatment, but we’re a long way from knowing which they will be, and exactly how it should be employed”.

What is treatment?
Patients with liver and kidney cancer are taking part in the Royal Marsden studies.
Treatment consists of two-second long bursts of ultrasound delivered to the surface of the body by a machine mounted on a gantry.
A number of bursts are needed to clear an organ of cancer.

Testing accross the world
At a different centre in Oxford, England, Prof ter Haar has been using a commercial device developed in China to treat a similar group of patients.
She has worked with Chinese physicians who have already treated about 3,000 cancer patients with ultrasound.
Although the Chinese trials were not as scientifically rigorous as those in the UK, the anecdotal evidence was impressive.
“The results in China are really quite astounding,” said Prof ter Haar.
“There are patients who are disease free with tumours for which there are no other treatments, particularly in the pancreas.”
She said that theoretically, ultrasound should be suitable for a wide range of solid tumours.
“If you can image a tumour with diagnostic ultrasound you should be able to treat it,” she told the meeting.

Not all cancers can be targeted with ultrasound
However, since the sound beam could not travel through bone or air, certain cancers would be difficult to treat.
Brain tumours and lung cancers deep behind the rib cage fell into this category.

Thinking about the tough cancer areas
Scientists in the UK and United States were working on the problem of getting ultrasound into the brain.
“Its very appealing for the brain because it’s a trackless form of damage,” said Prof ter Haar.
“You only get damage at the focus so you don’t damage the rest of the brain through which you’ve got to travel. If we could solve that problem it would be very exciting.”

Different applications and challenges of ultrasound
Dr Jean-Yves Chapelon from the French research institute Inserm in Lyon described a different ultrasound system now at an advanced stage of development which he had used to treat 242 men with prostate cancer.
The results were due to be published in the next few months.
Dr Chapelon said the treatment was as effective as conventional surgery or radiotherapy, and safer.
In this case the ultrasound beam was delivered through the rectum. After five years of followup, 80 per cent of low-risk patients were found to be disease-free and effectively cured.
For medium-risk patients the success rate was 60 per cent and for patients with high-risk aggressive cancers, 50 per cent. The men had an average age of 71.
Traditional treatments for older men with prostate cancer carry a high risk of impotence and urinary incontinence, but 40 per cent of the patients recovered their potency and only eight per cent were unable to control their urine flow.

Impressive results
Not one patient had died of cancer although the first was treated as long as 11 years ago.
“We believe that this therapy challenges other therapies,” said Dr Chapelon.
However, he said that at present it was still difficult to convince specialists that ultrasound therapy could be as good as conventional treatment.
Prof ter Haar said there was still much work to do before ultrasound became universally available as a cancer treatment.
She expected the process of patient trials, publication of data, and introduction into hospitals to take between five and 10 years.

Other applications for ultrasound
Another possible application of ultrasound might be on the battlefield, according to Dr Shahram Vaezy, from the University of Washington in Seattle.
His team was working on miniaturising ultrasound equipment that could be used to treat wounded soldiers, or accident victims.
A big advantage of ultrasound was that it had the ability to stop bleeding by sealing broken blood vessels, he said.
Dr Vaezy told the meeting: “The application we are pursuing is treating internal bleeding, to develop a non-invasive method of treating patients at the scene of an accident, for example”.

“We are going to put this in the clinicians’ hands,” GE chief executive Jeffrey Immelt said after pulling a Vscan from a suit jacket pocket during an on-stage talk at a Web 2.0 Summit in San Francisco.

“This really could be the stethoscope of the 21st Century.”

Vscan has the potential to improve the ability of doctors to diagnose patients by allowing them to quickly view images of internal organs, according to General Electric.

The devices are geared for doctors who would be able to easily carry them about and use them for non-invasive views of what is going on in the bodies of patients.

Vscan flips open to show a video screen and has a sensor attached to a wand. GE did not disclose the proposed price for the device, which will be tested with the help of US doctors.

The news

Why is this important?
Doctors today have lots of treatments to prevent a heart attack. But once it strikes, there’s no way to restore the heart muscle it kills. Gradually the weakened heart quits pumping properly, leading to deadly heart failure .
Hence the focus on embryonic stem cells, master cells that can give rise to any tissue in the body. Until now, scientists haven’t known how to turn master cells into producing pure cardiac muscle .

Previous attempts were a failure
Up to now, researchers have tried injecting heart attack survivors with mixes of different kinds of stem cells, next-generation types like those found in bone marrow. The idea was that perhaps once those cells were inside a damaged heart, ones capable of growing cardiac muscle would receive a “get to work” signal and take root. But that was not successful.
The new research , published in Friday’s edition of the journal Science, is a more targeted approach.

How did they do it
The team genetically engineered mice so that certain cells in the embryos’ developing hearts would light either fluorescent red or green. As they watched the embryos grow, an overlapping of colors signaled developing heart muscle. When the team plucked out those cells, they were pure ventricle generators, which is not enough.
Next the team cultivated the stem cells and a thin strip of mouse heart muscle grew on the top of the cell. What happened next is that the muscle started to beat by itself. The best thing about this is “This looks like the kind of work a normal heart tissue strip would do,” said Dr Chien “We went from embryonic stem cells to an organ.”

Is it portable to humans?
Yes because what the team has done is to use a mice stem cell that is present in both human and mouse embryos.

What’s next
This was not a fully developed piece of heart muscle but only a thin strip.
To be usable, it would have to be thicker, more three-dimensional, for more beating strength. It also needs a nourishing blood supply. So a next big challenge is pinpoint which one of those master heart stem cells can grow into blood vessels.

Opportunities
The experiment offers a possible new opportunity for cell therapy.
The team will now develop two approaches. Either they can try and develop cells outside of a body to a full heart and them implement that in a human body or they can try to inject the cells onto the heart once a muscle has developed and see if that helps.

What was the news ?
The news was that the latest HIV large scale trial of a vaccine showed that the vaccinated group had a reduced rate of 31% of infection versus the control group. The trial took place in Thailand.

What vaccine was this ?
The trial used two vaccines (ALVACR HIV and AIDSVAXR B/E) that were matched to the strain of HIV that is predominant in Thailand (Clade E). The study had hypothesized that the vaccine would reduce HIV acquisition by 50 percent. The study results were statistically significant, although they did not reach the level that had been specified as the rate of infection was reduced by 31%.

How large was the trial?
This is a big study with 16,000 adults enrolled since 2003. Budget was solid too as the US government put up 105 million dollars for the study.
The study recruited adults in the community in two provinces of Thailand with high HIV prevalence (Chon Buri and Rayong), but did not specifically target individuals at high risk of HIV infection. Volunteers for the study were adults aged 18-30. It was a randomized trial, matched for sex, behavior, age.
Out of the 16,000 adults, half got the vaccine and half got the placebo. The study started in 2003 the Volunteers were tested for AIDS for 3 years. The results were only ready just 3 weeks ago (beginning of September 09)

What should we make of the success ?
First it should be understood that the result was a surprise. After all the two strands of vaccine used were both proved to be inefficient.
The effect is modest but it’s a stepping stone. It open up doors to identify what the exact mechanisms of this protection is. Scientists now will have to identify what has protected these people in order to try to amplify that effect in future test.

Is it ethical to conduct HIV tests on people that will practice unprotected sex ? Isn’t it better to teach them to have protected sex?
Actually, in vaccine trials huge as these, all participants and everyone who gets the vaccine are intensively counseled on how to avoid being infected. It makes the vaccine trial more difficult but training is a very important part of the aid program. The training is conducted by special counselors completely dissociated from the scientists.

Why is it so hard to make a vaccine against HIV?
The virus has been discovered in 1981. It has been in the history of science the most challenging virus to tackle because of its specificity:
a) The immune response of the body is far less than for any other virus, it has been branded ‘inadequate’. Only about 2% of infected people have developed natural immunity read here

b) The ability of HIV to establish latency, allowing it to “hide” in host cells and elude immune surveillance

c) The extraordinary diversity and mutability of the virus; the capacity of the virus to avoid a protective immune response by masking more conserved components of the virus; and the ability of HIV to destroy or cause the dysfunction of critical immune system cells.

Hope
There are several other vaccine candidates in the research pipeline and today’s encouraging results will provide renewed enthusiasm for human clinical trials, as well as additional HIV vaccine discovery.

Excellent reading
Preventing HIV – the seach of an HIV vaccine