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November 2007

November 30, 2007

Olympus to Buy Gyrus Group

TOKYO, Nov. 26, 2007 -- Olympus Corp. of Japan announced that it will acquire Gyrus Group PLC, a UK-based manufacturer of devices that enable less invasive surgeries, for $1.9 billion in cash.

Gyrus Group is based in Reading, England, and has approximately 1434 employees. Its main business segments include products for ENT (ear, nose and throat) surgeries, laparoscopic surgery, urology and gynecology.

Olympus, a manufacturer of cameras and other optical products, said the acquisition will allow it to expand its Medical Systems business by strengthening its minimally invasive product offerings. There is growing market demand for such systems, Olympus said, which can reduce pain and discomfort from surgery and could help limit medical costs. Olympus Medical Systems Corp.'s main product lines include gastrointestinal endoscopes, ultrasound endoscopes, therapeutic devices, and surgical endoscopes. 

"The operations of Gyrus' and Olympus' medical systems are highly complementary. I am confident that this planned partnership will generate significant synergies and opportunities for both firms. The combination of technological capabilities will further enhance product systems, which I expect will enable surgeons and their staffs to ultimately perform safer and more effective surgical procedures with better patient outcomes," said Tsuyoshi Kikukawa, president of Olympus.

Olympus said it expects to expand its worldwide marketing network, particularly in urological and gynecological systems, in which Gyrus has an established US market presence. Olympus said Gyrus' capabilities will allow it to accelerate development and commercialization of energy-based technology equipment.

The transaction, which is expected to close in the first half of 2008, is subject to customary closing conditions, including the approval of Gyrus shareholders.

For more information, visit: www.olympus.com

MRI Is More Sensitive At Detecting Early Signs Of Breast Cancer Than Mammography

If used with appropriate diagnostic criteria, MRI is much more sensitive than mammography for detecting breast cancers before they have developed to an invasive stage, and particularly good at identifying those lesions which are more likely to progress to dangerous forms of cancer, according to a study published in The Lancet. This finding is in stark contrast to previous studies comparing the two techniques that concluded MRI can not detect early cancers as effectively as mammography.

Debates over which screening modality is best for detecting ductal carcinoma in situ (DCIS)---an early type of breast cancer in which cancerous cells are present but are confined to the milk ducts within the breasts---have in the past focused on identification of microcalcifications, small areas where cells have died and subsequently turned into calcium deposits, which are used as a hallmark of cancerous growth. Mammography can visualise these features in a breast scan whereas MRI cannot.

However, scientists have recently found that MRI can detect another feature of DCIS---the growth of new blood vessels around the cancerous cells---by virtue of the fact that the contrast agent (an injected chemical used to enhance differences between different areas or tissues under inspection) will be seen outside its usual domain of the intravascular space in places where the vessel wall is corrupted by new vessel growth.

What is more, MRI seems to be able to distinguish between subsets of DCIS which are high-grade and low-grade---classifications that refer to the likelihood of these lesions progressing to invasive breast cancer, in which the cancerous cells break out of the ducts and invade surrounding breast tissue. In high-grade DCIS, the density of small new blood vessels is high, showing up as a higher level of enhancement on MRI images, more so than in low grade DCIS, making the former easier to spot.

Using this new observation of MRI's DCIS identification potential, Christiane Kuhl and colleagues from the University of Bonn's radiology department, which is associated with an academic national breast centre, compared the technique with mammography and assessed the two screening modalities' effectiveness at diagnosing DCIS, which is treated surgically to remove the risk that it will develop into invasive cancer. "We investigated the sensitivity of each method of detection and compared the biological profiles of mammography-diagnosed DCIS versus DCIS detected by MRI alone," explain the authors.

The researchers identified their study sample from the 7319 women who were referred to their breast centre over a 5 year period and received MRI in addition to mammography for diagnostic assessment and screening. The final study cohort consisted of the 167 patients who had undergone both mammography and MRI before biopsy and who had received the final surgical pathology diagnosis of pure DCIS.

Reviewing the method through which the final diagnosis had been made, the researchers found that 93 (56%) cases of DCIS were diagnosed by mammography and 153 (92%) by MRI. Of the 89 cases of high-grade DCIS, 43 (48%) were missed by mammography, but diagnosed by MRI alone and all 43 of the cases missed by mammography were detected by MRI. Overall, MRI detected significantly more cases of any grade of DCIS than did mammography and produced a lower proportion of false negatives: mammography was falsely negative in 74 (44%) cases, whereas MRI was falsely negative in 14 (8%) cases.

"Our study suggests that the sensitivity of film screen or digital mammography for diagnosing DCIS is limited," write the authors. "Mammography tends to identify breast cancers with comparatively benign biological profiles and although more low-grade DCIS will be diagnosed if MRI is used in addition to mammography, and thus more women could be overdiagnosed with a possibly prognostically irrelevant disease, one should note that 60% of the cases of DCIS diagnosed by MRI alone were high grade." There is, therefore, the researchers conclude, reason to assume that MRI helps anticipate the diagnosis of lesions that, if left undetected, would progress to invasive breast cancer.

However, the researchers caution that since breast MRI is currently used only rarely in clinical practice, their results are not really applicable to a general screening setting because few radiologists can offer a level of expertise for MRI that comes close to that required for diagnostic mammography. Nevertheless, they firmly conclude that current recommendations regarding the use of MRI for screening for DCIS are not appropriate.

In an accompanying editorial, Carla Boetes and Ritse Mann from Radboud University Nijmegen Medical Centre, note that the observation that "MRI detects many DCIS lesions that go unnoticed on mammography implies that some invasive carcinomas can be prevented by timely intervention on the basis of MRI findings. As such, MRI has the potential to increase survival when used to detect breast cancer."

MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Kuhl CK, Schrading S, Bieling HB, Wardelmann E, Leutner CC, Koenig R, Kuhn W, Schild HH. Lancet 2007; 370: 485-92

http://www.esoncology.org

November 29, 2007

Little Facebook is all grown up

Facebook Beckons to Businesses, Who Beckon to Users
By Clint Boulton

Nearly four years after launching, Facebook moved into its second stage of life on Nov. 6 with Facebook Ads, an online ad platform that lets businesses reach users in the company's social network of 52 million users.

That new stage is powerful because now Facebook users can not only share information about Web sites and businesses with their friends but invite friends to weigh in on shopping and other activities on the Web. Yes, Facebook has become a sort of online mall, where users can shop with the input of their friends.

The service that enables this is Beacon. Beacon is an API (application programming interface) in Facebook Pages, which allow businesses to have a presence on its social network. Some 44 Web brands or retailers are using Beacons to display the activities of their fans on their pages and on those user's Facebook feeds.

Web sites participating in Beacon can allow users to sell an item, buy an item or view video. When users who are logged into Facebook visit a site in the Ads network, they receive a prompt asking whether to they want to share those activities with their friends on Facebook. Friends may view those actions through the Facebook News Feed or Mini-Feed stories.

Online auctioneer eBay, for example, plans next year to use Beacon to let sellers include their eBay listings in their Facebook News Feeds. This will allow them to share information about the items they are selling with their network of friends.

Facebook is able to tread further down the e-commerce rabbit hole because its developer platform was expanded to Facebook pages, allowing businesses and organizations on Facebook to add applications onto their pages and enable users to interact with them.

On Nov. 7, Blockbuster launched MovieClique, an application that allows Facebook users to create lists of movies they want to see, or movies they've already seen, along with ratings and reviews, to share with their friends.

Peer review is always nice but MovieClique also lets subscribers of Blockbuster's online rental service rent movies directly from Blockbuster without leaving the Facebook site.

Think about that value proposition: Facebook lets users review and rate movies and share this information with friends, who may rent videos from the same place. Advertising and reputation are driving e-commerce.

November 28, 2007

“The Knowledge Hub for Pathology”—the USCAP's “Pathology Commons”—wide open—fully stocked and free to all who wish to visit the Website!

The Knowledge Hub for Pathology may be viewed at www.uscap.org .  Excerpted editorial by Dr. David Hardwick, Professor of Pathology, University of British Columbia below.  Full editorial available in November's

In this [month's] issue of Human Pathology, Drs Fortna and Wertheim review “The Knowledge Hub for Pathology”, a compendium of the most current academic considerations of the United States and Canadian Academy of Pathology (USCAP) members and contributors worldwide. Presenters at the USCAP annual meetings have created a vast cornucopia of studies, clinical presentations, and courses that focus on the most current matters of interest to pathologists. To ensure the integrity of “this compilation of poster abstracts, presentations, case reports, and short courses,” they are reviewed, validated, and authenticated by knowledgeable reviewers before being presented first at an Annual Meeting, then later posted on the USCAP website.

The Knowledge Hub for Pathology has tapped the resources of leading academic pathologist practitioners, as sophisticated analysts of the diagnostic aspects of anatomic/surgical pathology, whose cutting edge studies provide knowledgeable advice to clinicians and. As Fortna and Wertheim note, the short courses “are by experts in their given fields and are undoubtedly the most useful components of the Hub.” This is accomplished through integration of the very latest techniques including proteomic and genomic microarray studies as well as appropriate personal microscopic assessments.

Fortna and Wertheim also state “the Knowledge Hub's main strengths include its global accessibility and breadth of information.” The importance of information from all sources emphasized in previous Human Pathology editorials and underscores the need to expand information and data management to enhance diagnostic acumen.

The Knowledge Hub for Pathology also provides additional insights into the progression from Data → Information → Knowledge with extensive testing, retesting, and, finally, attributed trust and wisdom. Of course, given another major pathology mission—research, the length of time before existing knowledge is reviewed and iterated, to emerge as more current knowledge, is typically very short nowadays. Thus the title “The Knowledge Hub” was chosen to reflect the primacy of knowledge in diagnostic medicine and to underscore the need for pathologists to use all the tools at their disposal to integrate information from disparate sources into their knowledgeable advice for clinicians.

Given the current attention on Wiki sites, blogs, etc, it is de rigueur to be part of an open source Web site, phenomena still early in their development. Readers must understand that although the logic of self-governing systems and freedom pervades The Knowledge Hub, unlike many blogs, submitted material is carefully reviewed for authenticity and posted for a limited time, 3 years for scientific abstracts and 6 years for short courses, to remove them from the Web site by their ‘best before’ date. The Knowledge Hub does not “compete” with journals, as scientific abstracts are a bridge between study and official journal publication. Fortna and Wertheim understand and correctly emphasize that The Knowledge Hub “should not be considered a substitute for standard pathology texts” in that short courses are removed from the Web site in compliance with the USCAP Web site Posting Protocol as they are expected to become textbook material in the fullness of time. The Knowledge Hub by design focuses on the most current emerging topics of interest to pathologists! Organization and searchability of The Knowledge Hub, as noted by Fortna and Wertheim, “makes navigation through it somewhat difficult.” This is a fair criticism and they further conclude “many of these problems will be corrected in future refinements of the site.” They also note that “the Hub is in its infancy,” highlighting the fact that the USCAP is truly a pioneer in this realm, with the Hub being continually reconfigured to provide the most current easily searchable knowledge free to pathologists worldwide.

Lasers Used in Cytometry

A white light source based on an ultrafast high-power fiber laser integrated with photonic crystal fiber was used in the first application of optical supercontinuum lasers in flow cytometry.

Researchers at the National Cancer Institute (NCI) of the US National Institutes of Health conducted the experiments and reported the results in a recent issue of the journal Nature.

Ultrafast fiber laser maker Fianium, based in Southampton, England, is the manufacturer of the SC450 laser used in the experiment.

"Even the most modern cytometers typically provide for not more than four laser wavelengths," said William Telford, a research scientist at NCI. "This is largely due to limited selection of wavelengths available with existing laser technology. Supercontinuum white light lasers provide wavelengths that are difficult to produce using traditional technologies, allowing virtually any fluorophore to be analyzed by flow cytometry."

Anatoly Grudinin, general manager of Fianium, based in Southampton, England, said, "The SC450 laser used for flow-cytometery experiments at NCI generated 4 W of power distributed across the 450 to 2500 nm range, offering sufficient spectral power density to compete with single-wavelength lasers" and that the company's latest models of supercontinuum lasers offer powers up to 8 W, covering a spectral range of 390 to 2600 nm. The lasers are being used in micromachining, instrumentation, machine vision, defense and security (THz imaging) and biomedical research, among other applications.

www.fianium.com

November 27, 2007

Virtual Computer Models: Creating a Precise Digital You

Auckland scientists are trying to be the first in the world to develop computer models of individual humans that could achieve hundreds of things from saving lives to allowing people to "try on" clothes online.

Some of the aims of the "physiome project" at the US $6 million Auckland Bioengineering Institute at the University of Auckland:

  • Carrying out virtual operations to predict results of surgery on children with cerebral palsy. Surgeons would lengthen or shorten muscles on computer models to simulate the child's gait to test the likely success of surgery.
  • Testing drug toxicity using computers.
  • Motivating people to reduce obesity by showing simulations of how they'd look given lifestyle choices such as eating fast food.

The long-term aim is to incorporate cells, tissues and organs in computer models to help with medical diagnosis, surgical planning, design of body implants and ultimately drug discovery, said the institute's director and head of the physiome project Peter Hunter, who is also director of computational physiology at Oxford University.

"If you can get this notion of being able to make these models customizable to an individual, and then to have quite a lot of information specifically to that individual, that will make them very important long- term for disease tracking or disease diagnosis."

Scientists are five to 10 years away from testing drugs on computer models of the heart -- which could reduce some of the need for animal and human drugs testing, and cut the cost and time involved in developing drugs, he said. Getting approval from the U.S. Food and Drug Administration for a new drug now costs about $1 billion and can take 12 years.

Hunter says this could also prevent disasters such as Merck's discovery in 2004 that people taking its arthritis drug Vioxx had a higher rate of heart attacks and strokes than those on a placebo.

Virtualmodelhealth

Exposing diseases in 3-D

Scientists at Northwestern University's Feinberg School of Medicine are mapping parts of the lethal bacteria in three dimensions, exposing a new and intimate chemical portrait of the biological killer down to its very atoms. This view of the disease will offer scientists who design drugs a fresh opening into the bacteria's vulnerabilities, and thus enable them to create drugs to disable it or vaccines to prevent it.      

Anthrax is just the beginning. The Feinberg School is directing an ambitious national project that will map a rogues' gallery of 375 proteins from deadly infectious diseases over the next five years. It is being funded by a $31 million contract from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. The payoff could be a wave of new medicines to wipe out some of the worst scourges to ever infect the human race.   

"The concept is fairly simple," said Wayne Anderson, who is leading the national project at the Feinberg School's new Center for Structural Genomics of Infectious Diseases. "If you have a lock and a key and you don't know what either one looks like, how will you design them to fit together?" The lock is Anderson's metaphor for the disease; the key is the drug or vaccine that will slip inside its atomic structure and destroy it. 

To figure out where to throw the chemical equivalent of a monkey wrench into the anthrax cell -- and others --Anderson will be mapping key proteins the bacteria uses to do its work. 

"We'll see what the proteins look like and see what they need to grow so scientists can use this information to design drugs to knock them out," explained Anderson, a professor of molecular pharmacology and biological chemistry. “We might look at a protein that copies a virus' or bacteria's genome so it can infect people.  If we can find a chemical to stop it from working, it prevents the virus from reproducing and spreading infection.”

The proteins in his lab, by the way, are not capable of triggering an infectious disease. "You need the actual virus or bacteria for that," Anderson said.

Eventually Anderson's gallery will be filled with the not-so-pretty genetic portraits of proteins from the plague, cholera, rabies, West Nile virus, viral encephalitis and Ebola, just to name a few. He'll also be looking at newly emerging diseases and drug resistant infections. His team -- which includes researchers at seven other institutions -- will churn out the three dimensional atomic structures of at least 75 disease proteins a year and quickly post their discoveries on a special website for scientists who can immediately use the information to work on new drugs.

This mega-assault on these diseases at such dizzying speed, scientifically speaking, represents a tectonic shift in how researchers are attacking infectious diseases.

Up until now, molecular pharmacologists -- the people who design new medicines -- had to work at a much slower pace because they had access to only one protein image from a disease at a time. 

New state-of-the art technology has accelerated the process.  "Now we are going through the genome and finding 100 proteins from a bacteria," explained Anderson. "We're looking at all of these and providing the information so scientists can look at more than one at a time."

To obtain these unusual proteins for their "photo op," Anderson first has to grow them into crystals. A few steps from his office is the “nursery,” where hundreds of thousands of viral and bacterial protein crystals grow in what resemble miniature ice-cube trays. The trays are stacked in giant incubators to keep the proteins at their favorite temperature.

Because Anderson is never sure what environment will produce a crystal -- some proteins prefer more acidity or salt than others, he tries hundreds of different recipes for each one.

Viewing these proteins down to the arrangement of their atoms requires an intense x-ray beam. One of the few sites in the country with this technology is the enormous Synchrotron at Argonne National Laboratory. From the air, the Synchrotron looks like an indoor track. And, in a way, it is.  The only runners, however, are electrons circling the Synchrotron, which is actually a 40-sided polygon one kilometer around. As the electrons race around the polygon, they shoot off intense x-ray beams.

Working with equipment inside a special lead-walled station to protect them from radiation, scientists place a protein crystal -- just 1/10 of a millimeter -- into the Synchrotron x-ray beam. As the x-rays scatter off the crystal, the diffraction pattern reveals the location of the protein's electrons and atoms, a process called x-ray crystallography.

The university will launch a website, www.csgid.org, for scientists who specialize in different bacteria or viruses, so they can scan the project's list of infectious diseases and suggest which proteins Anderson and his colleagues should examine. “We hope we'll get suggestions from people in the scientific community," said Anderson, who also is co-director of Northwestern's Synchrotron Research Center. "Their knowledge can be a big help to us because each bacteria makes thousands of proteins."  The website also will be continuously updated to show scientists newly mapped proteins.   

"We hope our effort will lay the groundwork for new drugs to treat or prevent some of the worst infectious diseases to plague our country and the world," Anderson said.

November 26, 2007

News from RSNA Meeting

Some news from RSNA meeting in Chicago this week

GE Healthcare, the imaging unit of General Electric Co., will be tantalizing the radiologists and their cohorts with promises of HDCT, echoing the high-definition sales pitches of the consumer television industry.

The term is really a metaphor to describe what GE believes is a major improvement in the clarity of computer-generated images made by X-rays to provide cross-section images of a patient's anatomy.

In this case, said Gene Saragnese, GE's vice president of molecular imaging and computed tomography, researchers have found a way to boost image clarity while reducing the dose of X-ray radiation a patient experiences.

The key to this magic lies in a new material the company has developed that serves as a detector of the X-rays after they pass through a patient's organs.

GE describes its gemstone detector as a "4,600-karat megagarnet," but it is a synthetic creation rather than a decorative gem.

"It's the first new detector material in 20 years," said Saragnese. "We anticipate it will mean a 50 percent radiation dose reduction for patients."

The new scanner is a work in progress that has yet to be approved by the Food and Drug Administration, Saragnese said, but the company hopes it will whet the appetites of the docs and technicians kicking the tires at McCormick Place.

Meanwhile at the show, Toshiba Medical Division will roll out a new CT scanner that already is in some hospitals, has FDA approval and will get a full commercial launch next year.

Toshiba's new machine looks at about three times as much tissue as machines now available, meaning that in one pass it can take in a person's entire brain or heart.

The goal is to help emergency room doctors quickly diagnose patients who appear to be having a stroke or heart attack, said Doug Ryan, senior director of Toshiba's CT business unit for North America.

The company's engineers have been working nearly a decade on the new machine, he said.

Among their problems was developing computer programs fast enough to cope with all the information gathered by taking such a large look in a single pass.

Getting an accurate diagnosis quickly is especially important for stroke patients. While most strokes are caused by clots blocking the flow of blood to the brain, some are caused by broken vessels and bleeding in the brain. Clot-busting drugs and blood thinners might help patients with clots, but they are quite harmful to those who suffer from brain hemorrhaging.

To be effective, stroke therapies should be applied within three hours of onset, said Ryan, and he estimates that Toshiba's new machine can provide brain images to physicians within 15 minutes.

Equipment is expected to cost $2.5 million.

In Appalachia, the doctor comes on wheels

Mobile clinics are main source of health care for thousands

When Diane Dotson is sick, she waits for the wagon.

If she's lucky, it'll only be a few days. But it could be a several weeks before St. Mary's Health Wagon, a free mobile clinic that makes rounds in central Appalachia, arrives in this remote community in southwest Virginia to help the sick.

The clinic squeezes in next to a car wash, parked in Sister Pauline Champagne's front yard, where she chats with patients sitting on lawn chairs in the makeshift outdoor "waiting room." As Sister Champagne calls off each name from her clipboard, patients step into the cramped quarters of a modified RV.

Inside, there are two tiny patient rooms and a bench behind the driver's seat for the next person in line.

Mobile clinics are the main source of health care for thousands living in the mountains, where doctors and health insurance are lacking. Some mobile clinics show up weekly or monthly, others only once a year.

On this particular September morning, Dotson drove 15 miles from her home in Phelps, Ky. to get her blood pressure and heart checked. Dotson, the wife of a disabled coal miner, suffers from high blood pressure and depression.

The couple is buried under a $13,000 debt stemming from an outpatient surgery Dotson had in 1998. Getting health care beyond the mobile clinic is no longer an option.

"I don't know if I'll even live to pay it off," Dotson said. "I don't know what I'd do without the clinic."
Dotson's story is not uncommon in central
Appalachia, a region burdened by health care disparities.

Overall, the region has high rates of deaths from cancer, heart disease, diabetes and stroke. Economically, the region lags behind the rest of the nation with high levels of unemployment, low incomes and deficits in education. The region also struggles with the prevalence of illnesses from obesity, smoking and a lack of physical activity.

The rugged, picturesque mountains that keep so many tied to the region only compound the health care problem, keeping doctors scarce and making mobile clinics an alternative to traditional medicine.

"We're their health source," said Ron Brewer, who coordinates the Remote Area Medical Volunteer Corps mobile clinic program for rural Tennessee. "They depend on us as their visit to the doctor."

The services offered by the mobile clinics, typically funded through grants and donations, vary from clinic to clinic.

Some only offer dental or eye care. Others, including St. Mary's Health Wagon, offer virtually the same care offered by a family physician. Most partner with a local physician who reviews serious cases and negotiates referrals with physicians willing to work on such cases.

"We like those days when we can have a sinus infection or an earache," said Netza Mullins, a health coordinator with the Kentucky River Foothills Development Council, which runs a mobile clinic that travels between eastern Kentucky's Powell and Estill counties.

"But because of the lack of health care and lack of health insurance, these folks are very chronic," she said. "Train wrecks is exactly what we call them."

"There's a lot of folks at or below the poverty line," said Stan Brock, head of the RAM Volunteer Corps. "If you look at the profile of people waiting in line, they are clearly in need of help."

November 24, 2007

IBM’s World Community Grid Could Speed Up Cancer Research

Canadian researchers expect to accelerate the war on cancer by tapping into a global network of hundreds of thousands of people who volunteer their idle computer time to tackle some of the world’s most complex problems.

The research team, led by Dr. Igor Jurisica at the Ontario Cancer Institute (OCI), and scientists at Princess Margaret Hospital and University Health Network, are the first from Canada to use the World Community Grid, a network of PCs and laptops with the power equivalent to one of the globe’s top five fastest supercomputers.

The team will use World Community Grid to analyze the results of experiments on proteins using data collected by scientists at the Hauptman-Woodward Medical Research Institute in Buffalo, New York. This analysis would take conventional computer systems 162 years to complete. However, using World Community Grid, Dr. Jurisica anticipates the analysis could be finished in one to two years, and will provide researchers with a better way to study how proteins function, insight that could lead to the development of more effective cancer-fighting drugs.

“We know that most cancers are caused by defective proteins in our bodies, but we need to better understand the specific function of those proteins and how they interact in the body,” said Dr. Jurisica. “We also have to find proteins that will enable us to diagnose cancer earlier, before symptoms appear, to have the best chance of treating the disease -- or potentially stopping it completely.”

The research team now has more than 86 million images of 9,400 unique proteins that could be linked to cancer, captured in the course of more than 14.5 million experiments by colleagues at Hauptman-Woodward.

This comprises the most comprehensive database on the chemistry of a large number of proteins, a resource that will help researchers around the world unlock the mystery of how many cancers, such as breast, prostate or childhood leukaemia, grow.

Approximately 150,000 Canadians will be diagnosed with cancer and more than 70,000 will die of the disease in 2007 alone.

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