Gall stone dissolving agents.

During the decade in which the medical dissolution of gall stones has become feasible several drugs have been introduced but only the two listed in the British National Formulary have been intensively evaluated and shown to be effective--chenodeoxycholic acid and the closely allied ursodeoxycholic acid. The dissolution of gall stones was last reviewed in the "BMF" in 1976, at which stage experience with chenodeoxycholic acid was limited. Since then the indications and potential for this bile acid in treating gall stones have become better understood, and data on the newly introduced ursodeoxycholic acid are being evaluated. Cholesterol, but not pigment, gall stones are amenable to oral dissolution treatment. This review will cover firstly, chenodeoxycholic acid, secondly, ursodeoxycholic acid, then a comparison of the two drugs, an assessment of the place of medical dissolution in the management of gall stones, and, finally, the dissolution of stones in the common bile duct.     

Proteomics: general strategies and application to nutritionally relevant proteins

Proteomics as a subset of applied genomics technologies will be a key area of biology during the first decade or two of the new Millennium, and that it will have major impact, both directly and indirectly, on nutritional science. The aim of this review is to summarize information about general strategies of proteome and its application to important food proteins (plant, animal, and microbial). Methods are also described for protein separation, identification and determination. This article covers papers published within the last decade.     

Analyzing gene regulation in ascidian embryos: new tools for new perspectives

Ascidians are marine protochordates at the evolutionary boundary between invertebrates and vertebrates. Ascidian larvae provide a simple system for unraveling gene regulation networks underlying the formation of the basic chordate body plan. After being used for over a century as a model for embryological studies, ascidians have become, in the past decade, an increasingly popular organism for studying gene regulation. Part of the renewed appeal of this system is the use of electroporation to introduce transgenic DNAs into developing embryos. This method is considerably more efficient than conventional microinjection assays and permits the simultaneous transformation of hundreds of embryos. Electroporation has allowed the identification and characterization of cis-regulatory DNAs that mediate gene expression in a variety of tissues, including the notochord, tail muscles, CNS, and endoderm. Electroporation has also provided a simple method for misexpressing patterning genes and producing dominant mutant phenotypes. Recent studies have used electroporation to create "knock-out" phenotypes by overexpressing dominant negative forms of particular proteins. Here we review the past and present uses of electroporation in ascidian development, and speculate on potential future uses.     

A decade after the first full human genome sequencing: when will we understand our own genome?

The contrast between the pomp of celebrating the first full human genome sequencing in 2000 and the cautious tone of recollections a decade thereafter could hardly be greater. The promises with regard to medical cures and biotechnology applications have been realized not even nearly to the expectations. Understanding the human genomes means knowing the genes' and proteins' functions and their interconnectedness via biomolecular mechanisms. This articles estimates how long will it take to achieve this goal if we extrapolate from the previous decade (indeed, a century!) and the possible disruptive trends in science, technology and society that may accelerate the pace of progress dramatically.     

When "personhood" begins in the embryo: avoiding a syllabus of errors

The following essay was delivered at the conference "Ontogeny and Human Life" at the Ponifical Athenaeum "Regina Apostolorum," November, 2007. Sponsored by the Legion of Christ, the Pontifical Academy for Life, and the John Templeton Foundation, the sessions focused on when the conceptus became a "person." My essay focused on the scientific conclusions that could aid such discussions. Moreover, after listening to the philosophical, legal, and theological discussions that ensued, I responded theologically as well. New concepts in modern embryology have made scientists revise their views concerning the autonomy of embryos and the mechanisms that generate such embryos. There are interactions between the sperm and the female reproductive tract and egg which had never been known until recently. There are also interactions between the developing organism and its environment that had been unsuspected a decade ago. Gut bacteria induce the development of the mammalian digestive system and immune system by changing the gene expression patterns in the mammalian intestine. Conversely, chemicals in our technological society can adversely affect the embryo, rendering it sterile or prone to tumors later in life. While there is no consensus among scientists as to when human life begins, both Church and science can become allies in persuading governments to regulate or ban the production and use of these fetotoxic chemicals. These new views of embryonic development change many of the stories told about human embryos and fetuses, and they have implications concerning the use of science as evidence for theological positions.     

Autophagy: from phenomenology to molecular understanding in less than a decade

In 2000, it was suggested to me that "Autophagy will be the wave of the future; it will become the new apoptosis." Few people would have agreed at the time, but this statement turned out to be prophetic, and this process of 'self-eating' rapidly exploded as a research field, as scientists discovered connections to cancer, neurodegeneration and even lifespan extension. Amazingly, the molecular breakthroughs in autophagy have taken place during only the past decade.     

Observations on a Medical Teacher Training Program

An increasing interest in educational science as applied to medical education is apparent in the past decade. Recently, a six-week teacher training program was held at the Center for the Study of Medical Education at the University of Illinois. Fifteen medical faculty members, including five Canadians, participated. During this period there was an opportunity to engage in discussions and independent study of several aspects of medical education, using the personnel from the Center''s four major divisions as resource people. Training in educational science is important for all teachers, and a centre to provide this type of instruction should be available in Canada.     

Role of polysaccharides in Pseudomonas aeruginosa biofilm development

During the past decade, there has been a renewed interest in using Pseudomonas aeruginosa as a model system for biofilm development and pathogenesis. Since the biofilm matrix represents a crucial interface between the bacterium and the host or its environment, considerable effort has been expended to acquire a more complete understanding of the matrix composition. Here, we focus on recent developments regarding the roles of alginate, Psl, and Pel polysaccharides in the biofilm matrix.     

The rise and fall (… and rise?) of acetone/butanol fermentations

For a decade or so early this century the Weizmann process for the production of acetone and butanol was of immense economic importance. Its demise was brought about by the growth of the petrochemical industry. However, recent developments in biotechnology and economic changes have stimulated a renewed interest in this form of fermentation which may again become commercially important.     

Scientific Citizenship and good governance: implications for biotechnology

In the wake of public distrust regarding biotechnology, it has been suggested that the debate should be moved "upstream", whereby the public help to set research priorities. Although many scientists see this as an illogical reaction to a loss of faith in science, we argue that the boundaries between science and its technological applications have become blurred and this produces conflicts of interests that have led to this crisis of trust. Furthermore, this distrust is also a crisis in governance that calls for a new open and democratic approach to scientific research. We propose that the concept of Scientific Citizenship, based on good governance, will help to restore public trust and bridge the gap between science and the society that it serves. Integral to this is the suggestion that the governance of science forms part of the training for scientists.     

Commercializing medical technology

As medicine moves into the 21st century, life saving therapies will move from inception into medical products faster if there is a better synergy between science and business. Medicine appears to have 50-year innovative cycles of education and scientific discoveries. In the 1880’s, the chemical industry in Germany was faced with the dilemma of modernization to exploit the new scientific discoveries. The solution was the spawning of novel technical colleges for training in these new chemical industries. The impact of those new employees and their groundbreaking compounds had a profound influence on medicine and medical education in Germany between 1880 and 1930. Germany dominated international science during this period and was a training center for scientists worldwide. This model of synergy between education and business was envied and admired in Europe, Asia and America. British science soon after evolved to dominate the field of science during the prewar and post World War (1930’s–1970’s) because the German scientists fled Hitler’s government. These expatriated scientists had a profound influence on the teaching and training of British scientists, which lead to advances in medicine such as antibiotics. After the Second World War, the US government wisely funded the development of the medical infrastructure that we see today. British and German scientists in medicine moved to America because of this bountiful funding for their research. These expatriated scientists helped drive these medical advances into commercialized products by the 1980’s. America has been the center of medical education and advances of biotechnology but will it continue? International scientists trained in America have started to return to Europe and Asia. These American-trained scientists and their governments are very aware of the commercial potential of biotechnology. Those governments are now more prepared to play an active role this new science. Germany, Ireland, Britain, Singapore, Taiwan and Israel are such examples of this government support for biotechnology in the 21st century. Will the US continue to maintain its domination of biotechnology in this century? Will the US education system adjust to the new dynamic of synergistic relationships between the education system, industry and government? This article will try to address these questions but also will help the reader understand who will emerge by 2015 as the leader in science and education.     

Making women visible in the embryo experimentation debate

Rowland contends that threats to the welfare of women have received too little attention in discussions about embryo experimentation. The first group of egg donors for this purpose would be women in in vitro fertilization programs, women who are vulnerable to emotional coercion by doctors interested in superovulation for the purpose of gaining spare embryos. Furthermore, the masculine emphasis on control and dominance that characterizes science will inevitably lead ?researchers to transplant experimental embryos to check on the results of their manipulations. Other elements of the social context that raise the potential for abuse of women's bodies are the increasing commercialization of reproductive technologies and the increasing control by the male-dominated medical profession over the process of procreation. Finally, there is danger that it will become routine policy to screen all embryos for abnormalities and to "improve" them if abnormalities are found.     

Recruiting medical groups for research: relationships, reputation, requirements, rewards, reciprocity, resolution, and respect

Background

In order to conduct good implementation science research, it will be necessary to recruit and obtain good cooperation and comprehensive information from complete medical practice organizations. The goal of this paper is to report an effective example of such a recruitment effort for a study of the organizational aspects of depression care quality.

Methods

There were 41 medical groups in the Minnesota region that were eligible for participation in the study because they had sufficient numbers of patients with depression. We documented the steps required to both recruit their participation in this study and obtain their completion of two questionnaire surveys and two telephone interviews.

Results

All 41 medical groups agreed to participate and consented to our use of confidential data about their care quality. In addition, all 82 medical directors and quality improvement coordinators completed the necessary questionnaires and interviews. The key factors explaining this success can be summarized as the seven R's: Relationships, Reputation, Requirements, Rewards, Reciprocity, Resolution, and Respect.

Conclusion

While all studies will not have all of these factors in such good alignment, attention to them may be important to other efforts to add to our knowledge of implementation science.     

Scanning the horizon for high value-add manufacturing science: Accelerating manufacturing readiness for the next generation of disruptive,high-value curative cell therapeutics

Background

Since the regenerative medicine sector entered the second phase of its development (RegenMed 2.0) more than a decade ago, there is increasing recognition that current technology innovation trajectories will drive the next translational phase toward the production of disruptive, high-value curative cell and gene-based regenerative medicines.

构建融合医学人文教育的新型医学遗传学教学模式

医学遗传学是广泛涉及基础与临床学科的综合性课程,对于医学生是至关重要的必修课程。现代医学已由传统的生物-医学模式向生物-心理-社会医学模式转化,医学诊疗模式从最初的以"疾病为中心"到"以病人为中心"的方式转变,医生不仅精通医术,更要理解患者的心理,与其进行良好的沟通,因此现代医学成为了一门具有自然科学、人文社会科学双重属性的综合性科学体系。长期以来,我国医学院校的教学仍然是生物医学知识和技能占据主导地位,人文课程不受重视。因此,必须加强医学人文知识的学习和技能培训,只有这样才能在未来的医疗工作中掌握良好的医患沟通技巧,建立和谐的医患关系,对处理好日渐增多的医疗纠纷、维护医患双方的共同利益具有重要意义。     

莲根在个体发育中表现出的适应

本文研究了莲根和根第在个体发育中的发生与发育及其适应。苗端发育先于根端;节生根首先从胚芽第一节发生。很少的种子在种子萌发时有胚根原基的微弱发育,但从未见胚根突出种皮。须根系仅由节生根组成而根端终生不发育成直根系,该须根系应称为原生须根系。其特点是在一个生长季节之内死亡,是一种新的发育类型,特命为年内全更新型。     

Quantifying your body: A how-to guide from a systems biology perspective

During the coming decade we will see an accelerated digital transformation of healthcare. Leading this change within the institutional medical community are both the move to digital medical records and the use of digital biomedical measurement devices. In addition to this institutional evolution, there is a non-institutional, bottom-up, unorganized, highly idiosyncratic movement by early adopters to "quantify" their own bodies. In this article, I share my decade-long personal experience of tracking many blood and stool biomarkers, which provide insight into the health or disease of major subsystems of my body. These results are interpreted in the context of the genetics of my human DNA and that of the microbes in my gut. Even though I am a computer scientist and not a medical professional, by using commercially available tests and a systems biology integrative approach, I have become an early example of Leroy Hood's vision of the emergence of predictive, preventive, personalized, and participatory (P4) medicine. It is an individual's story illustrating how each of us can contribute to realizing this paradigm shift.     

Where medical science and human behaviour meet.

Although we may be wrong about the details, we should try to imagine what the future holds for hospital consultants. The days of the independent consultant in the same post for 30 years are over, and there will be a change from "the" consultant to a few tiers of senior staff. Patients will increasingly demand to see specialists, so more specialists will be needed. As patients and their advocates become better informed the traditional rationing of clinical care to patients in Britain, such as restricting access to specialists, cannot continue. There is a current trend for evidence based health care, but the idea that each element of medical practice can be dictated by systematic evidence based research will prove to be naïve--such research informs practice rather than dictates it. Science will continue to act as the guide to medical practice but specialists will not be turned into a set of logical operators running programs designed by health planners.