Organ Treatment The Italian Way
Technique could work for all transplantable organs
RADIATION TECHNIQUE
ROME
Italian doctors claim they had made a breakthrough in cancer treatment by removing a patient's liver, rushing it off to a nearby nuclear reactor to be treated with radiation, and then putting it back into the patient.
"The patient is doing very well. There are no more metastases and the liver has recuperated to normal," said Tazio Pinelli, professor at Italy's National Nuclear Physics Institute.
"The operation allows the complete treatment of the sick organ and we can expect it to work for all transplantable organs: kidneys, pancreas, lungs," said Pinelli, who worked with the team of doctors who conducted the experiment at the San Matteo hospital in Pavia, northern Italy.
The December 2001 operation on a 48-year-old Italian man with advanced liver cancer was the result of 15 years of research by surgeon Aris Zonta at the San Matteo hospital and INFN scientists. Tests had shown the man's liver to be riddled with cancerous cells. Before the operation it was injected with the amino acid borophenylalanine, which is absorbed six times better by cancerous cells than normal cells. Once removed, the liver was rushed to a nearby scientific nuclear reactor and bombarded with radiation for 11 minutes, and was back inside the patient within 35 minutes.
The radiation, which was absorbed to a greater extent by the borophenylalanine, destroyed the cancerous tissue. "After 10 days all the metastases were eradicated and the holes in the liver were gradually filled with normal tissue," said Pinelli.
HOPE FOR DIALYSIS PATIENTS
SYDNEY
Australian scientists hope to begin human trials next year of a procedure for growing blood vessels in a patient's own abdomen, a breakthrough that could offer new hope to people in need of kidney dialysis.
Julie Campbell of the University of Queensland's School of Biomedical Science said tests on rats, mice, rabbits, and dogs had shown arteries could be grown in 25 centimeter (10 inch) lengths using the procedure. Campbell said the same process could be carried out in humans as early as next year. "So far we have done this in rats, rabbits, and dogs and we hope to get into humans by the middle of next year," she said.
The new procedure involves growing tissue around an artificial tube placed inside a patient's abdominal cavity and then using the tissue to replace diseased or damaged blood vessels.
"In other words, the patient grows their own replacement blood vessel, so there is no chance of rejection," Campbell said.
The tubes of living tissue, with the artificial tube removed, could be used to treat a number of arterial problems and would be of particular help to patients needing kidney dialysis.
Current dialysis procedures involve taking a synthetic tube or a blood vessel from a patient's leg and inserting it into their arm to serve as access, or fistula, for the tube that connects the circulatory system to the blood filtering machine.
"Because this fistula is damaged three times a week or more for many years, it can become very damaged," Campbell said. "And if you have to sacrifice your own veins which get taken out, so then you have lost them forever. [But] if we can have a substance that uses the patient's own tissue, then it can be grown over and over again, because we can grow this in three weeks."
PREDICTING BREAST CANCER
WASHINGTON
Dutch scientists have identified a gene group whose analysis enhanced the ability to predict development of breast cancer in women already afflicted with localized tumors, according to a 10-year study published in the New England Journal of Medicine. This could allow development and marketing of a test to tell women with localized tumors whether they were likely to develop full-blown breast cancer, and to adjust their treatment accordingly.
The 295 women, all under the age of 53, began the study having "primary breast carcinomas," 151 with lymph node-negative tumors and 144 with lymph node-positive tumors. Using a new genetic profiling technique known as microarray analysis, the 295 women were divided into two groups, 180 having an unfavorable prognosis for breast cancer and 115 having a favorable prognosis.
Ten years later, the probability for the absence of metastasis, or generalized cancer, was 50.6 percent in the unfavorable prognosis group and 85.2 percent in the favorable group, according to the study by researchers at the Netherlands Cancer Institute in Amsterdam.
They concluded that "the gene-expression profile we studied is a more powerful predictor of the outcome of disease in young patients with breast cancer than standard systems based on clinical and histologic criteria."
ESTROGEN IN CARCINOGEN LIST
WASHINGTON
Estrogens used in hormone replacement therapy and oral contraceptives have been added to the US government's list of substances known to cause cancer.
The latest edition of the biennial Report on Carcinogens from the National Institute of Environmental Health adds 17 substances to the list of those known or reasonably anticipated to pose a risk of cancer, bringing the total to 228. The report is published every two years after lengthy study and scientific reviews.
"The public is well served by this dispassionate report that helps all of us ensure that the American public is made aware of potential cancer hazards," Health and Human Services Secretary Tommy Thompson said.
The latest report is the first to list as a group the hormones known as steroidal estrogens used in hormone replacement therapy and oral contraceptives. Studies have shown a link between hormone replacement therapy and the use of oral contraceptives and the risk of uterine and breast cancer in women.
Also newly listed as known causes of cancer are broad spectrum ultraviolet radiation, whether generated by the sun or by artificial sources, wood dust, nickel compounds, and beryllium and its compounds commonly used in industry.
GENE TROUBLE
WASHINGTON
The US Food and Drug Administration has put a temporary hold on certain gene therapy trials after a second child in a French program developed "a leukemia-like condition."
"In a precautionary measure, the FDA placed on clinical hold all active gene therapy trials using retroviral vectors to insert genes into blood stem cells," the agency said. The FDA said it took the action after learning about the second child in the program, broadening action taken after the first case came to light last summer.
"Both this child and another who had developed a similar condition last August has been successfully treated by gene therapy for X-linked severe combined immunodeficiency disease, also known as bubble baby syndrome," it said. The term "bubble baby" stems from the need to totally isolate babies with the syndrome, who are susceptible to the slightest infection due to lack of a normal immune system, in a plastic bubble-like chamber.
"Infants with [the syndrome] have a gene defect that leads to a complete lack of white blood cells that can fight infection," said the FDA. "Without treatment, they die from complications of infectious diseases during the first year of life. The only treatment for this condition is a bone marrow transplant."
Early results in the French study on 11 affected children, in which a normal gene was inserted into blood stem cells of the patient, found nine of the 11 "had promising results and could leave the hospital and lead relatively normal lives."
LIKE A ROLLING BALL
WASHINGTON
American researchers have discovered how the human embryo attaches itself to the wall of the uterus about a week after fertilization. A study published in Science provides a better understanding of the molecular process by which the embryo manages to stop its voyage around the uterine walls and attach itself to begin its nine-month development into a human being. The findings, according to the researchers, should aid in treating infertility and miscarriages that occur early in pregnancy.
Failure of the embryo to attach itself to the uterus is believed to be the cause of three-quarters of miscarriages, according to researchers at the University of California at San Francisco. About six days after fertilization, they found, the molecules on the surface of the embryo, at that stage called the blastocyst, interact with molecules in the uterine wall to create a sticky substance.
"It's like a tennis ball rolling across a surface covered in syrup," said lead author Susan Fisher. "The embryo's journey along the uterine wall is arrested by the sticky interaction."
The study found that at the moment of attachment, the cells on the surface of the blastocyst excrete a protein called L-selectin while the uterine wall becomes rich in carbohydrates, an interaction enabling the wandering embryo to come to a stop. Once at a stop, the embryo is able to attach itself to the uterine wall, where it begins to be nourished by the mother's blood via the placenta.
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