New stem cell studies at the University of Maryland Dental School demonstrate that surgeons could one day routinely use strong, mold-able, and inject-able pastes to regenerate needed bone tissue to repair broken bones, fractures, genetic defects, even combat bone wounds.
The Dental School’s Huakun Xu, PhD, MS; Michael Weir, PhD, MS; and Ryan Zhao, MD, PhD, presented their findings today at the World Stem Cell Summit at the Baltimore Convention Center before hundreds of stem cell experts from 25 countries.
The Dental School presentation showed that human stem cells seeded in a tissue engineering scaffolding exhibited “excellent attachment and osteogenic differentiation,” which is the process of laying down new bone material.
The researchers said the new findings buoy hopes that an inject-able paste of stem cells will be available one day to fill any shape of cavity from bone defects, breaks or wounds by regenerating needed bone tissue.
In test tube studies, stem cells from bone marrow, when placed into an inject-able scaffold of calcium phosphate and chitosan, started growing and forming minerals needed for new bone tissue.
Xu, an associate professor, is the principal investigator of a $230,000 grant from the Maryland Stem Cell Research Fund for “Stem Cell Delivery via Inject-able, Nano-apatite Scaffolds for Bone Engineering,” and a $1.84 million grant from the National Institute of Dental and Craniofacial Research.
The Dental School researchers have so far tested four scaffolding materials for gripping and holding the stem cells. “Which of the materials will be used in a commercial product really depends on where you want to place the material, whether in the jaw bone, the cranium or other bones,” said Weir, a research assistant professor.
Weir said, “Ultimately we want this to be an inject-able paste so we can put it into voids that are not square, rectangular or circular, that they are irregular shapes that need to be filled. The paste will include the cells.”
Xu added that such a product could also be used in periodontal bone repair, mandibular and maxillary ridge augmentation, reconstruction of frontal sinus and craniofacial skeletal defects, and other stress-bearing orthopedic applications. After a tumor removal or traffic accident, there may be a need to repair the damage or void left. It will beneficial, he said, to have a paste that can be shaped easily to achieve a high degree of aesthetics. After shaping, the paste hardens to form a solid scaffold full of pores and channels and still containing stem cells throughout, still living and growing to form new bone. Eventually the scaffold material degrades and is replaced entirely by new bone tissue grown from the stem cells.
The researchers found that a significant number of the cells were alive after a few weeks in the scaffolding material. They then discovered that the cells were differentiating into osteoblasts, essentially turning into bone cells. (From Greek words for bone, an osteoblast cell is responsible for bone formation.)
After staining the scaffold, the researchers found the osteoblasts forming “a lot” of the mineral, which then forms the bone after only 21 days, said Weir. In a subsequent experiment, the cells survived even better when mixed in a gel of the scaffolding material.
The researchers have recorded similar success with umbilical cord-derived stem cells, which “appear to be more potent in terms of growth and transforming into osteoblasts on the scaffold than the cells from bone marrow,” said Xu. It is likely that the umbilical cord cells are more vital because they are younger than stem cells obtained from the adult bone marrow and in theory will act more quickly to repair wounds or bone defects.
Xu explained: “When a 16-year-old breaks a bone, it usually takes a few weeks to heal. In a 60-year-old, it likely takes a few months. Umbilical cord stem cells are only 9 months old and hence are fast in healing.” Xu said human umbilical cord stem cells have the promise to be a superior alternative to bone marrow-derived stem cells, the latter requiring an invasive procedure to harvest. For combat medics, the umbilical cord derived stem cells could potentially be on the shelf and used in the field without causing immunuorejection, said Xu.
Xu said that after a literature search, he believes his laboratory is the first to investigate the seeding of umbilical cord-derived stem cells in injectable and load-bearing scaffolding for bone tissue engineering.
“We are excited about the promise of encapsulating umbilical cord stem cells in an injectable scaffold for stem cell delivery and bone regeneration.” Xu said. “Our research is still in an early stage. We will perform more systematic investigations and animal studies. If indeed human umbilical cord stem cells delivered using injectable scaffolds are more effective in bone regeneration than the commonly studied bone marrow stem cells, it will broadly impact the field of stem cell-based regenerative medicine.”
Peter Emerson asked:
Biotechnology and religion often do not mix. Consider some of the major biotechnological advances that have happened within the past decade. With each news report outlining the benefits of the new technology, it also touches on the opposition, often by religious groups.
Biotechnology and religion is a matter of ethics. Where do you draw the line between science and religion? Do religious groups have a right to try and intervene? Controversial sciences such as cloning and stem cell research will inevitably raise the question of ethics. Is it right for humans to try to spark life? Some say it is playing God. Others see it as important. It is hard to say whether or not biotechnology and religion really can mix.
Do you want to understand the subject of biotechnology and religion better? The best thing to do is research. Go to your library and look up the different resources on biotechnology and also on science and how it and religion have functioned over the years. It seems that each generation has a controversial science that causes the religious to question it. The generation after that looks at the new science as normal and doesn?t think of it. Will this happen to the current field of biotechnology? Will cloning become so common that most people won’t think it is strange or remarkable?
It seems that biotechnology and religion don’t necessarily need to compete with each other. Perhaps the issue of one versus the other has to do more with a lack of knowledge than ethics. I think that both sides will coexist better if they understood each other a little more and were more tolerant of their own differences. So when a new scientific advancement in the field of biotechnology comes out, instead of panicking and becoming outraged, perhaps opponents can practice a little understanding.
Kanquona Bhattacharjee asked: Medical science is doing wonders by means of its inventions and its proper application. It has enabled mankind to show his mastery over the god. The medical professionals are curing a number of people of their diseases and giving them a new lease of life everyday. A man can change his god-gifted features wishfully with the help of science. Even gender change is no longer a matter of surprise and awe. So man is seen defying their god in a way. But still he is unable to conquer the place occupied by the almighty God; he cannot impart life to all persons who are destined die. There are many such avenues left that are to be ventured by man. So, day–by-day man is trying to reach the ultimate knowledge.
Of late, a striking invention of medical science has made man to see a ray of hope. Patients of incurable diseases have to undergo very painful process to continue their life. The patients of Thalassemia have to live on blood transfusion throughout their life. But the invention of the procedure to cure blood disorder has shown its patients a gleaming horizon.
The doctors claims that the
cord blood or can be better explained as the blood collected from the umbilical cord of a woman, soon after her second delivery , can save her first thalassemic born child. This blood is collected after the umbilical cord has been severed from the new-born. The
cord blood is a rich source of stem cell. These cells are found at different stages of foetal development. Stem cells are also present in several adult tissues. It has the potentials to cure almost 75 serious ailments, from blood disorder to heart and eye ailment to Type 1 diabetes. Diseases such as lupus, multiple sclerosis, Crohn’s disease, rheumatoid
arthritis, to name a few, can be cured using
cord blood. Stem cells form part of our blood and immune system and they help to grow other cells in our body’s system. Thus it is expected to be a cure for cancer also.
The most striking feature that has made the invention more useful is the capacity of storing the
cord blood. There are banking facilities where the parents can store the blood. If the first child of a couple is suffering from a blood disorder or any other disease that stem cell can cure, and the mother is expecting her second child, she could store her
cord blood. This blood has the quality to cure her first thalassemic child. Number of couples is storing their
cord blood for any future need. The parents who decide to store the
cord blood have to undergo a proper HLA (human leukocyte antigen) match. It is a procedure through which the immune system recognizes ‘self’ and rejects ‘non-self’ cell, then the stem cell is transplanted into the patient’s body.
There are mainly three kinds of stem cell transplantation namely adult stem cells, embryonic stem cells and
cord blood cells. Here one caveat is that the stem cells taken from adult bone marrow or peripheral blood stem cells are prone to rejection while
cord blood stem cells are more adaptable and acceptable. However in India, the adult stem cells are mainly collected from bone marrow. For bone marrow, a perfect 6 out of 6 HLA match is required to prevent tissue rejection. But in case of
cord blood stem cells for some diseases even 2 out of 6 match will suffice, but the chance is rare as the
cord blood is collected immediately after birth.
In India the banking facility is available in the cities like Mumbai, Gurgaon, Chennai, and soon Kolkata will have one. Before delivery the parents can deposit Rs. 35000/- to Rs. 40000/- ($800 to $1000) initially and have to pay 10% of the deposit annually. So people can any corner of the world can store the
cord blood stem cells of their children into these banks quite easily. With rapid advancement in stem cell research, the day is not too far when we will bid adieu to all generic diseases.
With a simple, new technique, orthopaedic surgeons can now regenerate damaged cartilage in injured joints with stems cells harvested from their patients’ own blood.
AS she took the last steps to the top of Batu Caves, Joanna Hart was exhilarated. It was not something expected she could ever achieve at this point of her life, not when only two years ago, at age 34, she was offered an option usually given to people twice her age: a knee replacement for her left knee.
“Every time I go for X-rays, the radiologist look at the result and go, “‘Gosh, what happened to your knee? Your knee looked like a 70-year-old’s!’ It was very bad,” she described.
The medical history of her left knee was as extensive as it was active. Recurrent dislocations when she was 16 to 19 years old had resulted in a bad knee. “I was doing the high jump, long jump, relay, netball and hockey then. And so when I was 19 my kneecap dislocated – it wouldn’t stay in, it kept coming out,” she explained.
Her doctors recommended surgery to set her kneecap in the correct position to avoid it from dislocating further. However, it ended up giving her a different set of problems. The kneecap was set too high and it was rubbing against her bones.
“Over the years, all the cartilage got worn away,” she said. And as a result of that, bone spurs (osteophytes) started growing where her cartilage had worn off.
“As a midwife, I was very active. And I kept fracturing off those osteophytes and they got stuck in my joint,” she said. “And by then I wouldn’t be able to straighten or bend my leg because it’ll be locked. So, I had to go for surgery – they’ll pull the bit out, sew it up, and off I go again. This kept happening over a period of about 10 years.”
But being physically active in her line of work had kept her knee mobile. It was only when she stopped working that the spurs began building up in her joints again.
“Again, I couldn’t straighten my leg. So, I went to see a surgeon, who looked at the results of my arthroscopy (a minimally invasive surgical procedure to examine or treat a joint), and told me that I needed a total knee replacement,” she said.
As Hart was not keen on the idea, she hesitated – until she found another option that she could accept.
Stem cell repair
What Hart stumbled upon was a minimally invasive procedure, which was in its final stages of research in goats.
Using stem cells from goats, the doctors were able to stimulate cartilage regeneration in the goats’ knees.
“My quality of life was getting lesser by the day because at that point, after all the surgeries, I had to give up athletics, netball and hockey. And then I had to give up jogging and running,” Hart said.
However, what mattered most to her were not the activities she had to give up, but the life she was looking forward to with her children.
“I have two young children and I want to be able to go horse riding and skiing with them. A knee replacement is only going to stop the pain, but it would not make the restrictions any better.”
So, after the completion of animal studies (now accepted for publication in the Arthroscopy: The Journal of Arthroscopic and Related Surgery), Hart proceeded with the surgery. “Now I’m able to jog a little – more like shuffling, really – but I’m moving around a lot more, and I’m going for a skiing holiday this Christmas!” she said with a big grin.
“It’s really simple,” said orthopaedic surgeon Dr Saw Khay Yong, who led the research. “Once the diagnosis of cartilage injury is made, we then start with surgery where the patient has arthroscopy with subchondral drillings into the damaged cartilage areas.
“The stem cells are then harvested one week after surgery. It is a weekly injection into the knee joint starting at one week after surgery, for five consecutive weeks.”
Getting creative with old tools
“Peripheral blood stem cells (PBSCs) have been used by haematologists to treat leukemia patients for the last 20 years and subchondral drilling (the drilling of bone under cartilage layers) is also an established procedure in orthopaedics,” he said.
It all came together when Dr Saw and his colleagues, spurred by the desire to find another alternative to conventional methods of treating damaged cartilage, decided to give stem cells a try.
“If you look at cartilage injuries, currently there are a lot of possible solutions, but the results are inconsistent,” he said.
As some of the current options to treat damaged cartilage (autologous chondrocyte implantations, cartilage transfers and cartilage transplants) may be quite expensive and they often require multiple surgeries, they have never been attractive to him, Dr Saw said.
“So, we started to look into ways we can use stem cells to regenerate our cartilage with the University Veterinary Hospital at Universiti Putra Malaysia,” he added.
Their study in goats started in 2005, where Dr Saw’s team harvested stem cells from goat bone marrow and injected them into the goats’ knees after creating defects (by drilling holes in the cartilage and bone in their joints). When the study was completed in 2007, they proceeded to perform the procedure in humans.
What the procedure does is to accelerate the natural healing process that happens in articular (or hyaline) cartilages in the knee.
“Usually, when you have a partial thickness injury (when the cartilage wear has not exposed the underlying bone), there is no evidence of repair. But when you have a full thickness injury that penetrates into the bone, you can access the bone marrow stem cells within it, which will then initiate repair,” he explained.
By creating full thickness injuries by drilling holes in the bones where cartilage has worn out, you can create an environment where the cartilage can start to heal. And, to aid the process, doctors provide the building blocks: stem cells and hyaluronic acid (a chemical present in cartilage).
But how do the stem cells know where to go? Dr Saw explains: “When you drill the bone, it forms a blood clot. And when that happens, injured cells send out homing signals that attract stem cells from the bone marrow. After that, physiotherapy will provide the environment for the cells to grow into cartilage cells.
“And in this procedure, we provide the stem cells through injections,” he adds.
For the young and active
Although two-year results of the procedure in his patients are encouraging, Dr Saw is not recommending it for everyone.
As it takes a lot of physiotherapy and time – about two years – to achieve best results, he reckons that this might not be the best alternative for the elderly.
Former Miss Malaysia and model Betty Anne Brohier, 43, would attest to the challenges one has to face during recovery. A torn (and later removed) left meniscus (cartilage in the knee joint) when she was in her teens had stopped her from participating in sports but her job as a model has kept her on her feet (and heels) most of the time.
“It used to be quite painful but I thought it was fine. But throughout the years the pain became worse and it affected both knees,” she said.
Her left knee was on the verge of ”collapsing” when she finally agreed to undergo the procedure. “After the surgery, I stayed in the hospital for one week. Following that, for about six months, I used to go for physiotherapy three to four hours every day,” she said.
The road to recovery was long as she needed to learn how to walk and use her leg again. It took her six weeks after surgery to be able to move her leg. Another five months was spent moving around in crutches.
“No pain, no gain, I guess,” she pointed out.
Shashank Nayak asked:
The article deals with the benefits the human race can reap if embryonic stem cell research is made legal in America. When I hear that President Bush’s ideology prevents him from sanctioning embryonic stem cell research, I just wonder in which century do we live in! Embryonic stem cells are cells that are, as the name suggests are the ones derived from embroyos.
These embryos are not the ones that are fertilized in a woman’s body, but are the ones that are fertilized invitro-in an in vitro fertilization clinic-and then donated for research purposes with informed consent of the donors. As long as the embryonic stem cells in culture are grown under certain conditions, they can remain undifferentiated (unspecialized). But if cells are allowed to clump together to form embryoid bodies, they begin to differentiate spontaneously.
They can form muscle cells, nerve cells, and many other cell types. Specifically their possibility of differentiating into nerve cells is worth serious consideration. Some of us as healthy people, with a functional spinal cord may think( as President Bush certainly does) that embryonic stem cell research ultimately leads to the destruction of the human embryo involved, and is thus equal to murder of a human being.
This is the same as saying that a molecule of H2O is same as a litre of water in all respects( including the prospect of water’s ability to quench thirst). An embryo is not sentient. It does not feel like we humans do. Just think of the possibilities. People who have broken their spinal cords in accidents could walk and function normally again. Christopher Reeves would have been waking. But it is too late for him now. I sincerely hope that Bush or the president after him approves the Bill which would sanction embryonic stem cell research.
John M Campbell asked: The carotid arteries are 2 blood vessels, one either side of the neck, that each transport blood to the brain from the heart. These arteries can become partly or totally blocked resulting in the decrease of blood flow to the brain. This condition in turn is caused by atherosclerosis, also known as hardening of the arteries. Atherosclerosis is the outcome of a build up of cholesterol and calcium on the inner lining of the arteries. These deposits are referred to as plaques, which might eventually become so thick that they totally prevent the blood flow through the arteries. Those with untreated blocked carotid arteries are statistically likely to have a stroke.
Carotid artery occlusive disease is a permanent but treatable condition.
Treatment is designed to stop further blockage and stroke. If there is some blockage devoid of symptoms,
treatment will probably be limited to regular checkups, with ultrasound being used to monitor the condition along with medication that will cause the blood to thin to prevent the blood cells from clotting. Even if the arteries are severely narrowed, there is no guarantee of symptoms. If the blockage is severe, surgery might be recommended to reduce the possibility of stroke.
The most usual method of surgery, carotid endarterectomy, seeks to remove the plaque from the artery. For some patients, a balloon angioplasty (the inflating of a balloon to press the plaque to the artery wall), with the placement of a stent, may be recommended. If a carotid artery is 100% blocked, then it is unlikely anything would done to clear it because the risk of stroke is too high during or post operation.
Efforts are then concentrated on keeping the opposite carotid as open as possible. A person can live a good life with only one open carotid artery. The body is smart enough to reroute blood via a complex network to the side of the brain that would normally get blood via the blocked carotid. A dietitian (check with her MD) could help you devise an eating plan that is healthy & affordable.work).
If the brain is deprived of oxygen, it stops working — with potentially catastrophic effects. If the resulting impairment is permanent, we call the event a stroke. If it is temporary, it’s called a transient ischemic attack (TIA).
Every human has 4 carotid arteries through which blood moves from heart to brain. TIAs and strokes normally begin with an increase of cholesterol plaque in the carotid arteries — the large blood vessels on either side of the neck which supply blood to the head and brain.
Eric Schultz asked: The Democratic Party is looking to regain the White House after eight years. Whether they succeed or not will depend on their stated positions on major issued affecting the lives of all Americans. If a majority of the electorates views match the Democratic candidate’s own opinions, the chances of occupying the White House are bright. So what is the Democratic Party’s stand on major issues. Here they are.
1. Economic Issues:
Democrats favor a higher minimum wage and more regular increases in order to assist the working poor. Democrats have opposed tax cuts and incentives to oil companies, favoring a policy of developing domestic renewable energy. Democrats believe that they always provide a balanced budget. They are in favor of higher taxes on the rich and businesses and better control on government spending to keep budget deficit under control. Democrats favor affordable and quality health care and more government intervention in this area. Democrats will strengthen environmental protection laws and impose stringent sanctions on polluters. Democrats aim to provide low-cost publicly funded college education with low tuition fees and increase availability of grants and scholarships. Democratic Party is in support of a progressive tax structure and has vowed to adjust the Alternate Minimum Tax (AMT) to give permanent AMT relief for those tax payers who were never meant to pay it.
2. Social Issues:
Democratic Party supports equal opportunity for all Americans and favors affirmative action as a way to redress past discrimination. Democratic believes that discrimination against persons because of their sexual orientation is wrong, support adoption rights for same-sex couples and opposes the military’s “Don’t ask, Don’t tell” policy. Democratic Party supports easy access to women for birth control and public funding of contraception for poor women. Democratic Party strongly supports all stem cell research.
3. Foreign Policy Issues:
Democrats believe in use of military force against those responsible for attacks against the United States and a majority voted for invasion of Afghanistan, while being divided (29 for and 21 against) on attacking Iraq. Democrats usually oppose the doctrine of unilateralism and believe that the United States should act in the international arena through strong alliances and international support.
4. Legal Issues:
Democrats oppose the use of torture as an instrument of interrogation of military prisoners. Democratic Party supports the right to individual privacy and supports legal restrictions on monitoring by law enforcement agencies. Democrats believe in preventive methods of crime control and emphasize improved community policing. Democratic Party favors gun control measures and introduced Gun Control Act of 1968, the Brady Bill of 1993 and Crime Control Act of 1994.
Now you know the Democrats position on various issues of national importance affecting the common citizen’s life. Did that help you make-up your mind? Hope so.
Mike Selvon asked:
The stem cell research debate has spanned numerous decades, with presidents like George HW Bush, Ronald Reagan and George W. Bush rejecting funding science that tampered with human embryos, and presidents like Bill Clinton and Barack Obama appropriating money toward an end that justifies the means. If a primitive bundle of cells can be used to save thousands or millions of lives and alleviate suffering, then is it worth it? Or does embryonic stem cell research cross the line between man and God?
When does human life begin? This is the quintessential theological question behind embryonic stem cell research. Devout Catholics and Protestants will tell you, “Human life begins at conception, at the very moment when sperm and egg come together. Development from there on out should be left up to God and God only.” They argue the problem is that embryos are killed in the process of harvesting stem cells, therefore aborting the developing embryo.
In a speech on August 9, 2001, former President George W. Bush explained, “While we must devote enormous energy to conquering disease, it is equally important that we pay attention to the moral concerns raised by the new frontier of human embryo stem cell research. Even the most noble ends do not justify any means.” Pope Benedict XVI went so far as to say human stem cell research was “not only devoid of the light of God but also devoid of humanity.”
The Iranian position on embryonic stem cell research is that it’s a necessary and common pathway to medical discovery. According to the Koran, human life begins at Day 120, when the embryo is blessed with a soul, so the fetal stem cells being derived when the embryo is less than two weeks’ old is of little moral concern to them. In a letter to a scientist, Ayatollah Khamenei commended the pursuit of “lofty objectives,” predicting “huge humanitarian wealth.” He did, however, caution against producing identical parts of human beings, which would be considered cloning, which is rejected in Iranian culture.
Lawyers may argue either for or against stem cell research. They can argue that stem cells cannot develop into humans outside of the uterus or that these spare embryos are routinely destroyed by flushing them down the drain, incineration or leaving them out to perish; so why not use these extra embryos to save lives?
Yet they may also argue that these embryos can be adopted, rather than destroyed, or that embryonic stem cell research is senseless murder. This complex argument may become null and void if adult stem cells can be effectively harvested and reverted back to their primal state, although it may take years before the process is fully perfected.
William Phoenix asked: In my assigned surfing of the internet I come across a variety of topics and sites. Recently, I came across something regarding stem cell research and MS. Humor me just once and read about this important issue. (I am already 48 and we still aren’t cloning headless bodies to replace organs that wear out so naturally I am concerned. I want to be writing for you people when I am 100! I mean, it is 2009 and we don’t have all the things we should have. We don’t have flying cars. We don’t have Star Trek-level medical science. We don’t even have medical science on par with “Space:1999″. But I digress…)
Everyone is aware of the controversy. Even musicians such as Dream Theater are aware of the stem cell debate: “This embryonic clay wrapped in fierce debate; Would be thrown away or otherwise discarded, Some of us believe it may hold the key to
treatment of disease and secrets highly guarded”. For now let us focus on one aspect of stem cell research: the cure for MS.
Recently, scientists discovered that they can prevent and even reverse the crippling condition of MS (multiple sclerosis). Specific findings at the Northwestern University Feinberg School of Medicine in Chicago, Illinois show that “17 out of 21″ people with (the most common) relapsing-remitting MS tested had their health improve as a result of aggressive stem cell
treatment.
Past studies demonstrated that stem cell
treatment could stabilize the condition but it had not yet shown that the same treatment was capable of reversing the condition. The leader of this study, Richard K Burnt, observed that this treatment is undoubtedly “a feasible procedure”. It is called autologous non-myeloablative haemopoietic stem cell transplantation. Not only does the treatment appear to stave off neurological progression but it also seems to reverse neurological disability.
The procedure causes the suppression of the immune system and revitalizes it with new cells. Medical experts think the new cells reset the immune system of the patient.
A three-year follow up was done and it revealed that 81% of MS sufferers saw an improvement of one point or more on a disability scale. No patient scored lower than before the operation. A spokesperson for the MS Society, Dr. Douglas Brown, said that research is increasingly demonstrating that these cells are showing “more… potential in the treatment of MS” and that now science needs to continue to show how effective they can be.
A serious issue worth serious consideration. I know when my time comes, I just plain won’t want to go yet. If this type of research can help then I say we support it. As always, I am waiting to hear what you all have to say.
My name is Phoenix and…that’s the bottom line.
Mike Selvon asked: Imagine a world where a new liver or kidney can be grown from your own stemcells in a Petri dish and then transplanted into your body. A knee injury, a burn or a damaged heart can be fixed with a patch that regroups with surrounding tissues and repairs itself.
Alzheimer’s and Parkinson’s would become a thing of the past, as fresh stem cells work diligently to make new connections in the brain. Imagine a world where stem cells can be implanted into spinal cords or eyes to restore full functioning in the disabled. This world is not so distant, given recent advances. There are a number of places where you can research stem cell treatments.
One place to do some research on stem cells is the California Institute for Regenerative Medicine (CIRM). Despite former President Bush’s ban on federal stem cell research funding, the rogue Californians approved a 2004 ballot initiative (Proposition 71) that set aside state funds for just that purpose.
As a result, $3 billion was appropriated to California research facilities, making the state an epicenter of stem cell news. On their site, you might like to read their comprehensive annual report, which reads much more like a magazine than a lofty scientific publication. You can read about awards, its therapy treatments, studies and stem cell research facilities at Cirm web site.
Another great place to research stem cells is Medical News Today (at Medicalnewstoday). Here you’ll read the latest
articles on stem cell news adapted from press releases, reports, newspaper
articles and medical journals. You can sign up for daily or weekly newsletters to keep you abreast of all trials, treatments and research being conducted. You can watch a Youtube video titled “Everything You Wanted To Know About Stem Cells.” You can learn all about “What Are Stem Cells,” in addition to looking up current news on this comprehensive site.
With the new allocation of federal stem cell research funding, a number of facilities across the country will be receiving money to research stem cell therapies. For instance, the University of Buffalo will receive $4.9 million for human stem cell research. The University of California at Irvine will receive $27.2 million to build a new stem cell research facility and the University of San Diego will get $2.8 million to improve their current facilities. It may take another 10 years to produce a widely recommended cure, but research has been promising.
Colum Fitzroy asked: If you or a loved one are one of the millions of children and adults in the United States suffering from congestive heart failure, there is reason now to be hopeful. An effective
treatment may be on the horizon, thanks to stem cell research being done by a company in Florida.
Heart failure doesn’t mean your heart stops working. It means your heart is not working as well as it should. It’s not pumping enough blood, perhaps because your heart doesn’t fill up with enough blood, or it doesn’t pump blood forcefully enough to the rest of your body. The main causes of heart failure are diabetes, high blood pressure, and coronary artery disease.
Coronary artery disease is also one of the leading causes of heart attacks, which happen when plaque blocks the flow of blood (and oxygen) to an area of the heart. This causes damage and even the death of heart tissue. In adults, it takes time to develop heart failure, sometimes many years, as the pumping action of the heart gradually weakens. Sometimes only the right side of the heart can be affected. But most of the time both sides are affected. If the right side of your heart has the condition, then your lungs won’t get enough blood. That means your lungs won’t pass along enough oxygen to your blood. You may then notice a build-up of fluid in your feet, ankles, legs, liver, abdomen, and sometimes in the veins in the neck.
If the left side of your heart is affected, then the rest of your body will not get enough oxygen from the blood. In both kinds of heart failure, you can be short of breath and tired all of the time. Sometimes, heart failure can lead to a heart attack, also known as myocardial infarction. According to the National Institutes of Health (NIH), as many as five million people in the United States suffer from heart failure, and 300,000 of these die every year.
Although there are different kinds of
treatment for heart failure, no one has come up with a cure. But progress is being made. One company is exploring the use of stem cells in heart failure patients to reverse the damage (scarring) in tissue after a heart attack. The U.S. Food and Drug Administration has given the go-ahead to Sunrise, Fla.-based Bioheart, Inc. (BHRT) to begin a Phase I clinical trial for the company’s proprietary stem cell mixture to treat congestive heart failure.
Because this is a so-called Phase I trial, it will involve only a small number of patients, in this case 15. The goal of any Phase I trial is to test both the safety and effectiveness of a new drug or
treatment. Bioheart’s trial will be conducted at different locations and will assess the safety and cardiovascular effects of implanting its stem cell mixture in congestive heart failure patients who have experienced a heart attack.
The mixture consists of stem cells from a patient’s own thigh muscle that have been modified to over-express a certain protein. The stem cells are injected directly into the scar tissue in the heart using a needle-tipped catheter inserted into the groin. The company hopes to prove that its stem cell mixture can grow new heart muscle within the scar tissue that will in turn be able help the repair process.
Bioheart also hopes the procedure will improve the patient’s heart function, exercise capacity, and quality of life. When it tested the stem cell mixture in earlier preclinical studies, heart function in the tested animal improved 54 percent compared to 27 percent for an earlier version of the mixture. Meanwhile, heart function in animals treated with a placebo declined by 10 percent.
According to Bioheart, the preclinical studies also showed that its stem cell product candidate enhanced blood vessel formation in damaged hearts. The company says its clinical trial will begin sometime this year. So results won’t be available for awhile. But heart failure patients have at least a ray of hope that stem cell research will someday provide a viable treatment for their debilitating condition.
Al K asked: Ms. L wrote me:
Hello Dr. Kavokin,
I was reading some of your literature and found it to be quite informative. I have a question that perhaps you may be able to answer: If a woman’s ovarian cyst ruptures, (especially multiple cysts from PCOS) can these ruptured cysts become an infection?
Hi, MS. L
Short answer: anything can become infected. Though I do no think ruptured ovarian cyst becomes infected very often, did not hear about that. I will look more literature and probably place the answer on my website.
Sincerely,
Alex
OK. I looked the literature.
I didn’t do very extensive literature search. Should admit.
Anyway, some available books mention that ovarian cyst may become infected. However the infection is not described as the main complication in ovarian cyst rupture.
Also, I don’t remember that anybody told me otherwise. Maybe there is some specialized article that says: the condition happens in one point three percent of cases with Standard Deviation of half percent. I don’t know exact percentage. Need to look more. PubMed service did not give many abstracts on PCOS + infection.
Anyway.
So how would it look alike?
A young woman comes to ER. She is premenopausal. She complains on mild (or maybe severe) pain in her belly. ER Doctor takes history. The woman also mentions changes in her menstrual interval. Let’s say regular is 28 days. Last one was delayed.
Physician puts gloves, puts jelly on gloves. Then he puts his two fingers into the female vagina.
The other hand is on belly. Then he starts to palpate.
It is named pelvic exam. Modest name. Though in Russia it is named vaginal exam, which it is.
Is it a common type of exam? Depends. They usually send you to CT (computer tomography) scan if there is severe abdominal pain. Charge 1000. Boom.
Done.
Exclude the price. Exclude delay in reading (somebody should look and interpret what is going on). Exclude radiation. CT scan gives better picture than just poking your belly.
CT scan helps to diagnose abdominal pain of uncertain origin. You can really image what is going on. Though, there are cases when physical exam gives more clues. Physical exam must be performed always. Pelvic exam is somewhat a special one.
I remember how I performed a pelvic exam in medical school. It is actually difficult even just to insert two fingers into vagina first time.
Female Gynecologist asks me: “So, what do you feel?”
Patient goes the same, encourages me:
“What do you feel, what do you feel, do you feel it?”
I guess she felt a sort of museum artifact.
Heck, I did not feel anything.
Well. Actually I felt something – aside from uterus – something round. I would say 5 cm in diameter (would it be less I probably would not feel it at all) and semi-solid on touch. Also I saw that the patient grimaces. It is tender when I push hard.
It’s it. How to say that it was tuboovarian abscess (that it was) for sure, I don’t know.
You really need experience to perform this type of exam. Experienced gynecologist can tell almost precisely what is going on.
Let’s discuss that woman in ER. She will have tenderness on one side. Physician should be able to feel a mobile cystic mass.
(Cyst or rather cystis is Latin for bubble. Palpate is Latin for touch. It means you touch something and feel what it is).
What if the pain is severe? It often means that the cyst ruptured.
My impression is that modern ER orders CT scan right away. If you are not very sure what is going on, you will go from less expensive methods to more expensive and end up with CT anyway. Ruptured cyst causes significant pain. Here CT is indicated.
Alternatively they may order Ultrasound Exam. Transvaginal ultrasound uses the probe inserted into vagina. Ultrasound is cheaper than CT. Ultrasound visualizes cysts clearly. Though, ultrasound gives less information for excluding other pathology. Ultrasound is also safe from the radiation point of view.
In PCOS ultrasound shows increased number of small cysts in both ovaries. Usually more than five confirms the diagnosis.
Culdocentesis may give some useful information too. The name came from cul-de-sac. It’s French I guess. Cul-de-sac is one of the pouches in the pelvis. Centesis means: stick a needle and draw. These days it is considered an outdated method. But if you do not have other machines, it is very useful.
If the content is blood, the ruptured cyst was probably Corpus luteum cyst. If the content is purulent the ruptured thing was probably a tubo-ovarian abscess or other pelvic inflammatory disease (PID).
Other abnormal masses can rupture as well. Teratoma gives oily fluid, endometrioma gives “chocolate” old blood.
What is a follicle?
Female body is created for reproduction and childbearing. Oocyte is the start for a new human being in the ovaries. Several layers of specialized membranes surround an oocyte.
The membranes protect the oocyte, help in feeding and nurturing of this small cell.
One of layers has a beautiful name Zona pellucida. Pellucida means shiny in Latin.
When the oocyte matures, a small bubble (follicle) filled with special fluid is formed around.
In mid-cycle the follicle bursts and the oocyte goes first into peritoneal cavity, next into ovarian tubes (fallopian tubes). The tubes lead into uterus. Tubes, by the way, have special small hair-like things inside – fimbria. They beat in one direction. They propel the oocyte into uterus.
I remember I read somewhere that there are 11000 follicles. When a girl is born, there is no more multiplication of oocytes. After the birth the follicles sit dormant. When the female goes into her reproductive age, the follicles start to grow and mature (one by one).
Only 400 of them mature.
Yeah, it should be like this. Calculate. Average cycle is 28 days. So there are around 12 cycles a year. Women start to menstruate at 13-15 years old. The menopause is around 45-55 years. Total is 30-40 years
Multiply everything together. It should be around 400.
By the way, an interesting thought.
All those discussion about abortion and Stem Cell research.
Somewhere in nineteen century the baby was considered the baby when it was born. The church even struggled to admit anything like existence of cells etc. Rare baby actually survived beyond first year.
Heck, the hypothesis that human been consists of small cells was actually admitted widely not so long ago. Maybe hundred years ago. Then, all that research happened. People learned how the fetus is created and how it grows. Now the public idea is that fertilized oocyte is already the baby.
Have you seen any oocyte under microscope? Even a human hair near an oocyte looks like a skyscraper near a real human.
Now, if the public perception had shifted this way in several decades, shouldn’t we punish all women for that they recklessly loose 400 potential babies during lifetime. Isn’t it a crime?
Then, maybe we should punish every man for losing millions of sperms – also potential babies.
Where did this idea come from that fertilized oocyte is the baby and non-fertilized oocyte is not?
Shouldn’t we move the boundary a little bit earlier?
Need to think about that.
Anyway.
Ovarian follicle (follicle means small bubble in Latin) usually mature, rupture and release the oocyte that was in this follicle. Sometime the rupture delays. Then ovulation delayes. (Ovulation is rupture and release of the oocyte. Oocyte is the cell that eventually becomes the fetus after sperm gives the genetic material).
Normal cycle is divided into follicular phase (when the follicle grows) and luteal phase.
Luteum means yellow in Latin.
When the follicle ruptures (by the way rupture means burst or tearing), the oocyte goes out.
The cavity that left behind (remember it was small bubble) is filled with blood and special cells, producing hormones. These special cells grow in quantity and fill that cavity. These cells produce hormones that help the fertilized oocyte to attach and to grow in the uterus. Because they grow in quantity, they create a yellowish body in the ovary. It is literally yellowish. The name is Corpus Luteum (corpus=body, luteum = yellow).
This is normal cycle.
As we said, the follicle sometime doesn’t rupture (there is a bunch of reasons). A physician should sort out several different conditions. This is an abnormal cycle.
If follicle does not rupture it becomes the follicular cyst. Cyst also means bubble in Latin. There are actually plenty of different kinds of bubbles in medical Latin. Big ones and small ones. Normal and abnormal.
OK, the cyst did not rupture. Then what happens?
Well. If cyst doesn’t rupture, it usually resolves. That fluid inside the cyst is reabsorbed and the cyst collapses.
However, if the cyst ruptures, it causes acute pain. The pain comes from irritation of peritoneum (lining of peritoneal cavity) with blood and cyst content.
Why it is not painful when a regular follicle ruptures and releases the oocyte? Probably, a regular follicle is too small. In addition it doesn’t cause much bleeding.
In contrast the cyst is a really big bubble (sometime 5-10 cm in diameter). If it ruptures, it instantaneously release bunch of special fluid. Plus, there is significant bleeding because there are a lot of blood vessels around to feed.
Significant is of course relative.
For example, take 5-10-20 ml of blood from a patient vein in a hospital daily. He complains about the pain from the needle mostly.
But if you get the same 10 ml of blood into peritoneum… Wow.
You will cry. There are plenty of nerve endings. Peritoneum is too touchy-feely. Tender.
Besides, the cyst has high concentration of prostaglandins. Prostaglandins, in their turn, are mediators of inflammation. They should cause significant pain directly and indirectly.
From the other hand bleeding could be really significant. Then it becomes really dangerous.
A physician also should not miss an ectopic pregnancy. Doctor will order a pregnancy test for that. If an ectopic pregnancy starts to bleed, this is really really worrisome. It seems like your blood did not left your body. However the blood is in the abdominal cavity. It left the blood vessels. It is internal bleeding. You die quickly.
Polycystic ovarian syndrome is a little bit different animal actually. Here is some genetic predisposition.
Classically: an overweight young female presents with oligomenorrhea or amenorrhea, anovulation, acne, hirsutism, and or infertility.
What is what? Poly = many. Many, many, many men.
So PCOS means bunch of those bubbles in the ovaries. The follicles did not rupture on time, as they should. Oligo means a little. Meno is derived from menses. Rrhea means flow in Latin
So olygomenorrhea = flowing a little bit (less than it should).
A- is a prefix that means “No”. So, amenorrhea = no flow at all.
Hirsutism. I don’t remember where it came from, but means hairy or hairiness. Actually excessive hairiness.
Causes of PCOD or PCOS (disease or syndrome) are obesity, genetic predisposition and some other causes of Luteinizing hormone (LH) excess.
There is a self-amplifying cycle:
LH stimulates theca lutein cells. Theca means sort of capsule. Doesn’t really matter, just an anatomical term.
Those cells are special. They produce androstendione and testosterone. Androstendione and testosterone are actually male hormones. You know, bodybuilders use these hormones to get muscle bulk. You probably heard about those hormones. Sport doping uses testosterone.
So, athletes build their muscles and trash their liver.
Rumors say that a famous Hollywood actor used the hormones. Later he got liver transplant.
Though he always denied the use.
Anyway, female body converts androstendione into estrone (a weak estrogen). Fat cells do this. Estrone is a female hormone already.
Basically any body produces androgens (andros = man) and estrogens (female hormones). Just the proportion of those hormones makes us male or female.
The cycle happens in normal person as well.
The estrone stimulates pituitary secretion of LH.
Pituitary is a small gland in you brain. Pea Size.
It’s small, but it sooooo powerful.
Pituitary has another name – hypophysis. Hypo means down, phys means growth, so this gland is growing from below the rest of the brain. Pituitary gets bunch of connections from hypothalamus.
Hypothalamus means “below thalamus”.
These two areas of brain regulate almost all the hormone production in organism.
Higher levels in brain hierarchy regulate them.
Hypophysis gets a command. Then it produces some intermediate messengers and hormones.
The hormones go into blood and control whole body.
Hormones are like orders, like messages to the rest of the body.
Brain may give quick orders: Signals go through the nerves. It is like a phone order or cablegram.
Brain also regulates organism through the hormones. This is like a mail order.
Sort of if the brain sends letters by regular mail. The hypophysis is the Post Office in this case.
PCOS kicks in when a woman is obese. There are more fat cells to convert
androstendione to estrone. Estrone has such effect that it stimulates pituitary secretion of LH.
LH in its turn goes back to those theca lutein cells we discussed and turns them on again, to produce more androstendione, which is again converted into estrone.
Self-amplifying cycle
In addition, that increased level of testosterone causes the hirsutism (she becomes hairy like a male) and acne in female.
In a normal person this cycle is probably designed to support the development of fetus.
Estrogen helps placenta to grow. Placenta supports fetal growth.
However, in a person with PCOD the cycle is going out of normal control. In this case LH causes growth of the cysts in the ovaries.
Why?
Because the corpus luteum cyst is partially made by overgrowth of those theca lutein cells. LH stimulates theca lutein cells.
Also, women with PCOS have intolerance to glucose (sugar) and resistance to insulin.
It means there is a lot of insulin (hormone that helps to utilize glucose mainly).
However excessive insulin does not work. Either receptors to insulin do not work or something else, but the glucose is not utilized. Hence, energy inside the cells drops. Hence, a big pile of other problems mounts. As if it is Diabetes Mellitus. Diabetes is a different topic of discussion. For us, it is worthwhile to mention that people with diabetes are very much prone to any infection.
PCOS causes acanthosis nigricans also. Acantocytes are special skin cells.
Nigricans means black in Latin. That thing looks like thickened pigmented skin. When you touch it, it feels like velvet. Usually it happens in axilla, neck, below breast, in inner thigh and vulva. So, mostly all those places where skin folds.
The treatment for PCOS includes different medications: oral contraceptives, progesterone,
glucocorticoids, ketoconazole, spironolactone, cyproterone, flutamide, cimetidine, finasteride, ovarian wedge resection, laparascopic electoracutery, mechanical hair removal, etc.
All methods break the cycle of overproduction. The medications are either hormones themself or hormone-like substances that occupy receptor site and prevent regular hormone to work.
The medications act on different levels. Normal hormones have very complicated regulation. There are loops and feedbacks in the pathways.
To suppress a hormone production or action, you give similar hormone or another hormone or non-hormone at all, that goes to the feedback loop and breaks it and so on. It’s really long separate discussion.
Basically, you either decrease hormone production or shift ratio toward female hormones.
Another way, the best probably, is weight loss. No fat cells – no conversion of andrgoens etc… You can make conclusions yourself.
It’s the first line of treatment.
For a simple follicular ovarian cyst (not PCOS) doctor rules out ectopic pregnancy. Then he may send patient home and repeat pelvic exam in 6-8 weeks. Especially, if the cyst was small, less than five cm in diameter.
For larger cysts, doctor would order pelvic ultrasound.
Most follicular cyst will resolve on their own in six to eight weeks. Though, a physician may give oral contraceptives. Again, this suppresses stimulation of cyst by hormones from the hypophysis. The hormones are named gonadotropins.
If the cyst is still there after 6-8 weeks, a suspicion arises that the cyst maybe malignant. Then doctor orders other studies. CT scan. Physician may perform surgical procedures also. He looks what is this cyst really.
Corpus luteum cyst is usually not treated. However, oral contraceptives may be used.
Rupture of any kind of those cysts leads to another story. Acute pain, bleeding into peritoneum.
Sometime bleeding is very severe and is true emergency. You need also to distinguish other process in the abdomen. For example, appendicitis looks similar. You can treat mild case of non-complicated cyst rupture with just observation. Appendicitis almost always requires surgery.
There are many other problems arise. Surgeon scratches his head: what’s going on? Is this this or is this that? Here is the CT scan gives big advantage.
Now, going back to the question of Ms. L.
If the cyst was infected, I don’t’ see a reason why a ruptured cyst wouldn’t become infected.
Cyst content is very nutrient-rich. Remember? All those cells and their products are dedicated to feeding the oocyte (future baby). Should be very tasty for any bacteria.
Rupture may cause significant bleeding as well. This blood is also different from the blood in your vessels.
This blood is sitting in the pelvis, not moving, quickly clotting. Clotting prevents entry of white blood cells. “No flow” prevents entry of antibodies. Absence of flow prevents entry of other protective chemicals (complement etc).
So, it is very nutrient-rich media for bacteria growth.
They can go wild. Why not?
If a female had another pelvic infection before, that infection can flare up. In a normal person peritoneal cavity should be sterile. However, any gynecological or gastrointestinal infection may supply bacteria. Now, mix these bacteria with the content of the leaking cyst. It just destined to become infected.
Actually Ms. L later answered her own question in another e-mail. She had cysts multiple times and they became infected several times.
So, to answer the question:
Will the ruptured cyst become infected? Not necessarily. Rather not. Can it become infected?
Yes.
Simon Paisley asked: Stem cells are currently used for treating some diseases, and offer hope of a future cure for many of today’s incurable diseases. Parents are now able to have blood or cells from the umbilical cord of their newborn child stored for the child’s future disease treatments. This article gives an overview of the process of stem cell storage.
Stem cell storage is becoming a more and more popular choice among parents of newborn children, and is relatively common in the USA. It is now becoming increasingly common in the UK. These cells have been used for bone marrow transplants since 1988. They may, in the future, offer a cure for many diseases for which there is presently no cure. Conditions and injuries such as heart disease, brain damage, deafness, blindness and diabetes. Even hair loss and missing teeth could be treatable in the future.
The idea behind storage of your child’s stem cells is that they will have a supply of compatible cell types to be used in the
treatment of any disease, injury or condition that they might suffer from in the future. Obviously, this also depends on advances being made in medical procedures using these cells. If a cure for this condition has not been discovered by the time the child has developed it, then they are of no use for
treatment purposes. The current range of conditions treatable with stem cells is relatively small, however, significant time and money is being put into this area of research and future cures seem to be highly likely.
The storage process begins at the birth of the child, using an umbilical
cord blood collection kit supplied by the
cord blood storage company. A healthcare professional (a phlebotomist, doctor, nurse etc.) collects blood from the umbilical cord using the collection kit. The process is painless for both mother and baby, and is completely harmless to both. The blood is then transported to the laboratory for processing by the technicians. In some laboratories the whole blood is frozen, but other laboratories extract the stem cells before freezing. The sample is frozen using liquid nitrogen at around minus 190 degrees Celsius, and can be stored in the storage tank at this temperature indefinitely. Some storage tanks use liquid phase nitrogen and some use vapour phase nitrogen. Vapour phase nitrogen appears to be increasingly popular as there has been some evidence of liquid phase nitrogen transferring infectious diseases from one sample to others.
