A doctor who loves night shifts

Emergency medicine physician, world-class educator and blogger extraordinaire Dr. Mike Cadogan was recently interviewed by Elsevier Australia:

Interviewer:

What are the best and worst parts of night shifts? Do you have any tips for surviving nights?

Mike Cadogan:

I love night shifts. The dark corridors, the cool air, the rising moon, the autonomy of decision-making, the authority, the midnight snacks and the sense of joyous achievement walking home with the sun rising and against the tide of tired, depressed faces gripping their morning coffees and bemoaning the need to be at work on such a glorious sunny day…

Think positive, be strong and enjoy autonomy. Remember that everybody else is on night shift with you, and most of them don’t want to be there either…but there is no need to be grumpy, rude, or pompous. Make friends with the night owls and collaborate, you will find your workload will dramatically decrease… Make enemies with the permanent night staff at your peril!

References

Interview with Mike Cadogan, author of the acclaimed On Call: Principles and Protocols by Student Ambassador Emma Sharp.
Image source: A halo around the Moon. Wikipedia, GNU Free Documentation License.

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Ads for Target in-store clinic

Target pushes hard the ads for its in-store clinics - 4 of them in the Sunday edition of The Chicago Tribune:

Walmart is also entering the field of NP-staffed clinics in a major way, followed by CVS Pharmacy:

Walmart has been adding health clinics to its stores during the last 3 years as part of its drive for "one-stop shopping." There were 100 in-store clinics in 21 states in 2010.

In fact, Minute Clinic is the largest retail clinic chain in the country, with 600 clinics in CVS stores in 24 states. Almost half of Minute Clinic's clientele don't have a primary-care doctor of their own.

Comments from Twitter:

@napernurse: Pharm son works for #Walgreens. Costs them $5 to be seen by NP for whatever 🙂 Can just walk-in & now WAG on "Blue Button" campaign.

Related:
"The Clinic" at Walmart - Operated by "Family Medicine Specialists"

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Insulin is one of the top 10 high risk medications worldwide for prescription errors

Insulin has been identified as one of the top 10 high risk medicines worldwide. Errors are common - the first national audit in England and Wales showed prescribing errors in 19.5% of cases.

Not only are mistakes common, they often lead to harm - 3% of medication errors are related to insulin, but these errors were also twice as likely to cause harm as errors for other prescribed drugs.

Errors relating to insulin arise because insulin has a narrow therapeutic range and requires precise dose adjustments with careful administration and monitoring.

Over 20 different types of insulin are in use, in various strengths and forms, and with a range of delivery devices, including insulin syringes (from vials), insulin pens (prefilled or reusable), or infusion pumps.

References:

Safer administration of insulin: summary of a safety report from the National Patient Safety Agency. BMJ 2010; 341:c5269 doi: 10.1136/bmj.c5269 (Published 13 October 2010).

Image source: Wikipedia, public domain.

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Oral symptoms of systemic diseases – what to suspect?

Examination of the oral cavity (mouth) may reveal findings pointing to an underlying systemic condition, and allow for early diagnosis and treatment.
Oral examination should include evaluation for:
- mucosal changes
- periodontal inflammation and bleeding
- condition of the teeth
Examples of lesions:
- Oral findings of anemia may include mucosal pallor, atrophic glossitis, and candidiasis.
- Oral ulceration may be found in patients with lupus erythematosus (SLE), pemphigus vulgaris, or Crohn disease. Oral manifestations of lupus erythematosus may include honeycomb plaques (silvery white, scarred plaques); raised keratotic plaques (verrucous lupus erythematosus); erythema, purpura, petechiae, and cheilitis.
Oral findings in patients with Crohn disease may include diffuse mucosal swelling, cobblestone mucosa, and localized mucogingivitis.
- Diffuse melanin pigmentation may be an early manifestation of Addison disease.
- Periodontal inflammation or bleeding should prompt investigation of conditions such as diabetes mellitus, human immunodeficiency virus (HIV) infection, thrombocytopenia, and leukemia.
- In patients with gastroesophageal reflux disease (GERD), bulimia, or anorexia, exposure of tooth enamel to acidic gastric contents may cause irreversible dental erosion. Severe erosion may require dental restoration. 
- In patients with pemphigus vulgaris, thrombocytopenia, or Crohn disease, oral changes may be the first sign of disease.
References:
Oral manifestations of systemic disease. Chi AC, Neville BW, Krayer JW, Gonsalves WC. Am Fam Physician. 2010 Dec 1;82(11):1381-8.
Image source: Head and neck. Wikipedia, public domain.

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Elsa Peretti Bone Collection

Sleek. Classy. Modern. Three words I wish described my apartment (and my life) but sometimes I am lacking. Perhaps with a gorgeous piece from Elsa Peretti’s collection at Tiffany, I can fill those voids. I mean, the description of the cuff on the website reads-

The sublime symmetry and sensuous contours have an ergonomic quality that makes them one with the body.

Who doesn’t want that? The bangle ($575) and the black crystal candlestick ($250) come in a variety of materials and prices. I think that candlestick, with it’s flat femur-like base, is just jaw droppingly gorgeous. Any time I can subtly sneak a little anatomy into my housewares, I’ll do it.

 

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Damien Hirst at Chatsworth House

As part of the Beyond Limits sculpture exhibit at Chatsworth House in England, Damien Hirst has created two beautiful anatomical sculptures.

Damien Hirst Beyond Limits

Together they are Myth and Legend. Legend is exposed horse with wings open wide. Myth is the unicorn, two of whom’s legs have the skin pulled back.

Hirst sites his fascination with the relationship between science and religion and how the two interact. Hirst said, “to cut open mythical creatures and expose them as no different to mortal horses is somehow still magical. It’s kind of like exploding a myth to make it real.

Beyond Limits opens September 16 and runs through October 30th. 20 artists are featured.

As a fan of horses and any horse-like mythical creature, I am completely in love with these sculptures. I like the idea of using religions or religious ideas that are considered to be known as false. It forces the viewer to reflect on current religious ideals and question the validity of them. What makes a unicorn any less real than anything in Islam, Christianity, and so on?

Damien Hirst Myth Chatsworth House

[sources: Chatsworth + MyModernMet]

 

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Broken Sundowns

Amy Hastlehurst Im just a skeleton

Amy Hastlehurst Veins

Photographer Amy Hastlehurst caught my attention. Just being 16, her photography and portraits are an absolute treasure to see. She mentions on her flickr account that she thinks “too many people look at themselves and don’t see what lies underneath their skin” and would like to continue this series of anatomy styled images.

I got in touch with the artist, a lovely girl at that, and this is what she said:

These photographs were inspired by my total detachment, I was sitting in class one day and looking down at my hands. I had wondered what was underneath my skin. I began to trace my blue veins up my arm, and when I got home redrew over it darker and took a series of photographs. I suppose this is where the idea came from, I wanted to bring the reality of our being to the surface, that we are not only skin yet a complex network of bones and flesh and organs. It also arose from my interest in the human body.
Watch out for this girl, I think she could be huge.

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Fritz Kahn: Making Sense of the Human Body, Lecture, NYC, September 21


Wow. News of this awesome sounding lecture just in; Hope to see you there!

Fritz Kahn: Making Sense of the Human Body
Date: Wednesday, September 21
Registration will begin at 7:00pm.
Presentation will begin at 7:30pm.
Price: $12

We are pleased to have Thilo von Debschitz from Germany in our next SenseMaker Dialogs to speak on Fritz Kahn. Born in 1888, Fritz Kahn was a doctor and a world-famous popular science writer who illustrated the form and function of the human body with spectacular, modern industrial analogies. Kahn's magnum opus, the five-volume series Das Leben des Menschen (The Life of Man), was published in 1922 to international accolade; his intricate and elegant depictions of the human body as a functioning machine influenced artists and scientists for decades to come. Fritz Lang's film Metropolis was greatly inspired by Fritz Kahn's aesthetic.

However, Fritz Kahn's sucess was abruptly ended when the Nazis rose to power. Because of the oppressive censorship during the Third Reich, most of the works by Fritz Kahn, a Jewish intellectual, were banned, publicly burned and destroyed. In pursuit of Kahn's nearly lost legacy, Thilo and his sister Uta tracked down rare gems in second-hand books stores, combed international archives, and followed biographical leads from far-flung sources. The result is the first monograph about Fritz Kahn published worldwide, Fritz Kahn–Man Machine, which Thilo will speak about on September 21.

Thilo von Debschitz, a German designer and art director, worked at well-known international advertising and design agencies before founding his own creative agency Q in 1997. Q has won numerous national and international awards and honors, such as the European Design Award in 2011, in communication design, interactive design, and print design.

In addition to his agency business, Thilo von Debschitz enjoys editorial projects. His recent, most passionate book project was initiated by mere chance and published in collaboration with his sister, Uta: Fritz Kahn–Man Machine, the first monograph about Dr. Fritz Kahn (1888-1968). Fritz Kahn–Man Machine offers readers an overview of the life and work of Fritz Kahn, a pioneer of information design, whose genius lay in his ability to bring clarity to the mysteries of nature through analogies, metaphors, and humor. At the SenseMaker Dialogs, Thilo von Debschitz will not only present an introduction to Fritz Kahn, but also discuss cognitive visual concepts by other creative thinkers, some of whom have been influenced by Fritz Kahn’s work.

For more, and to purchase tickets, click here. For more on the book Fritz Kahn–Man Machine--and to purchase a copy--click here. Also: added bonus: I have heard a rumor that there will some original Fritz Kahn artifacts on hand at the lecture... another reason to make it out of the house that evening.

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Artist’s Talk: The Creation of The Cosmorama of the Great Dreamland Fire at The Coney Island Museum, Sept. 22


As many of you already know, I am currently fulfilling the role of artist in residence at The Coney Island Museum. As such, last April I launched an exhibition there in collaboration with artist Aaron Beebe that will be on view until April of this year. Entitled "The Great Coney Island Spectacularium," the exhibition aims to explore, celebrate, and evoke through installation, artifacts, and newly commissioned works turn of the 20th Century Coney Island with its bizarre, spectacular and, amazingly, forgotten immersive amusements.

Although this seems nearly unbelievable, on an average day in Coney Island around 1900, one might be able to experience one or more of the following: A midget village modeled on 16th century Nuremberg and featuring its own parliament, hotel, stables with midget ponies, vaudeville house, and midget fire department rushing off to put out imaginary fires; A recreation of the destruction of Pompeii by volcano, San Francisco by earthquake, Galveston by flood, and/or Titanic by iceburg; Freakishly small premature infants battling for their lives in infant incubators; A recreation village of the head-hunting Bontac Tribe of the Philippines with real tribespeople on display; An immersive spectacular which staged tenement fires every half hour and featured a cast of 2,000; A Boer War reenactment featuring real Boer War veterans; A trip to the moon, under the sea, or to heaven and hell by way of being buried alive in a glass coffin; and, as they say, much, much more. How could this have all been forgotten, we ask in this exhibition, and our memory of Coney Island sanitized to a place of mere hotdogs, roller coasters, petty crime and freaks? What does it say about who we are now, and what have we lost in this historical omission?

The centerpiece of our exhibition is The Cosmorama of the Great Dreamland Fire, which is an immersive 360 degree spectacle based on the great panoramas and cosmoramas that populated Coney Island in the 19th century. It tells the story with image, sound, and light of the most spectacular disaster in Coney Island history: the complete and dramatic destruction of Dreamland, one of the three great parks that made up turn of the century Coney Island, by fire 100 years ago in 1911. Dreamland was never rebuilt, but had it been, Beebe and I are certain it would have given pride of place to a disaster spectacle that allowed visitors to experience the great fire that had destroyed it. The Cosmorama of the Great Dreamland Fire is our attempt to create the attraction that should have been, and to allow contemporary audiences to experience a 19th century-style immersive spectacle of the sort celebrated in the exhibition.

Next Thursday September 22, the crew behind the construction and conception of The Cosmorama--myself included--will be at The Coney Island Museum giving a presentation about the making of the piece, followed by guided tours of the exhibition. We will also be on hand to answer any questions you might have.

I think this will be a really great event. And for those of you who have yet to make it out to see the exhibition, a great excuse to finally make the trek and have a beer in the Cosmorama!

Full details follow. Very much hope very much to see you there!

Date: Thursday, September 22
Time: 7:30pm - 8:30pm
Admission: $5, Free for Coney Island USA Members.
Loction: The Coney Island Museum, 1208 Surf Avenue, Brooklyn

The Cosmorama of the Great Dreamland Fire is the first Cyclorama in Coney Island since Luna Park met its own fiery demise in the 1940's. The art of creating a full-scale immersive Victorian entertainment was lost to Coney Island's denizens until this year. Find out how the Coney Island Museum resurrected the theatrical skills and the know-how necessary to create a 360-degree painted panorama with sound and lights for the 21st century.

Aaron Beebe, director of the Coney Island Museum; Joanna Ebenstein, Artist in residence for 2011; and their collaborators will be on hand to discuss the ins-and-outs and the technology behind the Cosmorama, with detailed technical descriptions from the lighting designers, the scenic artists, and the producers of this new and exciting spectacle.

Beebe and Ebenstein will be joined by the artisans and craftspeople from the Metropolitan Opera and other institutions who helped make this work possible. Guided tours of the Cosmorama will be held.

More on The Great Coney Island Spectacularium can be found here. More on The Cosmorama can be found here.

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Call for Papers: Sensualising Deformity: Communication and Construction of Monstrous Embodiment, Edinburgh, June 15-16


I just got word of a call for papers for an excellent sounding upcoming conference. Details below:

The University of Edinburgh
Sensualising Deformity: Communication and Construction of Monstrous Embodiment
June 15-16, 2012

Confirmed Plenary Speakers:

Prof. Jeffrey Jerome Cohen
George Washington University

Dr. Peter Hutchings
Northumbria University

From freak exhibitions and fairs, medical examinations and discoveries to various portrayals in arts and literature, images of deformity (or monstrosity, used separately or interchangeably depending on context) have captivated us for centuries. The result is a significant body of critical and artistic works where these bodies are dissected, politicized, exhibited, objectified or even beatified. Nonetheless, there remains a gap, an unexplored, unspoken or neglected aspect of this complex field of study which needs further consideration. This two-day interdisciplinary conference aims to bring the senses and the sensuous back to the monstrous or deformed body from the early modern period through to the mid-twentieth century, and seeks to explore its implications in diverse academic fields.

We hope to bring together scholars and students from a wide range of disciplines to engage in a constructive dialogue, network, and exchange ideas and experiences, connecting a community of researchers who share a fascination with deformity, monstrosity, and freakery.

Possible topics may include (but are not limited to):

  • Spectacle/fetishisation of monstrosity and deformity; monstrous sexuality/eroticisation
  • The monster as a catalyst of progression/ historical perspectives
  • Monstrous symbolism, prodigality, or beatification
  • The racialised body; exoticising difference
  • Monstrosity in medical literature; disability narratives
  • Monstrous becoming; the ‘sensed’ body
  • Deformed aesthetics; monstrosity in the visual arts
  • (De) gendering the deformed body; humanisation vs objectification

We welcome proposals for 20-minute presentations from established scholars, postdoctoral researchers and postgraduate students from various teratological backgrounds, e.g. in literature, history, media and art studies, philosophy, religious studies, history of science,medical humanities, and critical and cultural theory. Proposals should be no more than 300 words, in .doc format, and should include a brief 50-word biography.

Please submit your abstracts no later than 31 January 2012 to sdefconference@ed.ac.uk

Dr. Karin Sellberg (The University of Edinburgh)
Ally Crockford (The University of Edinburgh)
Maja Milatovic (The University of Edinburgh)

For more info, visit the conference blog by clicking here.

Image: From the conference blog, where they cite the images as courtesy of the BMJ Publishing Group, BMJ 1889, June 8; 1(1484): 1288–1289.

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The Midnight Archive Episode 1: Modern Day Mummies, Online and Available for Viewing!

The Midnight Archives: Tales From the Observatory is a new web-based documentary series "centered around the esoteric and always exotic personalities that spring from Observatory," the Brooklyn-based event/gallery space I run with a handful of other collaborators. The series is created and directed by film-maker Ronni Thomas, who has plans to upload approximately one new episode per week to the new Midnight Archive website.

Episode one, entitled Modern Day Mummies--which documents the work of Sorceress Cagliastro, our esteemed Observatory mummification instructor--has just been uploaded and is now available for viewing! You can check out the video above, but make sure to keep visiting The Midnight Archive website (which can be found here) or sign up for their mailer in order to catch exciting, soon-to-be-uploaded episodes featuring such Observatory luminaries as anthropomorphic taxidermy teacher Sue Jeiven, automaton keeper Jere Ryder, and occult walking tour mastermind Mitch Horowitz. You can get a sense of some of the other pieces and personalities you have to look forward to by viewing the teaser on Boing Boing by clicking here.

And, just a quick FYI: We have a few last openings for Sorceress Cagliastro's next mummification class, which will take place October 9th; if you are interested in enrolling, please email me at morbidanatomy [at] gmail.com; more on the class can be found here.

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Embodied Fantasies: Multi-disciplnary Conference, SVA, October 28-30 2011


I have just been alerted to a pretty fantastic sounding conference that will be taking place at School of Visual Arts in New York City this October. Details follow; hope to see you there!

Embodied Fantasies:
International Conference
October 28-30 2011
SVA, Fine Arts Building
335 West 16th Street, New York, NY 10011

Embodied Fantasies, a concept central to art history, theory and practice is concurrently a topic debated in the fields of the neuro-and-cognitive sciences, philosophy and phenomenology. This theme will be addressed in a transdisciplinary conference hosting scholars and artists from the fields of architecture, art history, visual art, history of science and psychology among others. Discussions will focus on concepts of embodiment as they relate to sexuality, aesthetics, epistemology, perception and fantasy itself. Approaches to the role of fantasies will be viewed beyond traditional conceptions to include complex thinking processes, subjectivity, and the inter-subjective. Prominent attention will be paid to fantasies and images as a form of knowledge production.

Panel I: Oxymoronic Places and Spaces
Alex Arteaga: What Is a Fantasy in a Non-given World?
Sabine Flach: Negotiations and Metamorphosis: Visualizing Carsten Höllers' SOMA
Suzanne Anker: Neo-Neuro: Untangling Utopia
Boris Goesl: Star Arts or Celestial Embodiments
Dan Hutto: Moderator

Panel II: Ghost Hearts

Mark Dery: (title pending)
Alva Noe: Making Pictures, Making Worlds Available
Sabine Flach: Moderator

Panel III: Thwarted Expectations
Gerhard Scharbert: Fantasias: Experimental Induced Psychosis and Modern Aesthetics in 19th Century France
Arthur Miller: Creative Processes Within Fantasies: The Strange Friendship of Wolfgang Pauli and Carl Jung Frank Gillette: Experimental Epistemology: Patterns That Connect Dan Hutto: Embodied Imaginings
Alex Arteaga: Moderator

Plenary Speakers
Gabriele Brandstetter: Fantasies of the Catastrophe: Embodiment and Kinaesthetic Awareness in the Performance-installation of Naoko Tanaka's "Die Scheinwerferin" (2011)
Sabine Flach and Suzanne Anker: Moderators

Panel IV: Pose and Expose
Alexander Schwan: Body Calligraphies: Dance as an Embodied Fantasy of Writing
Nicola Hille: Embodied Fantasies: Spencer Tunick's Body Sculptures
Shelley Rice: The Grass is Always Greener: Self-Portraiture in the Age of Facebook
Suzanne Anker: Moderator

Panel V: Between the Flesh and the Shell
McKenzie Wark: A Minimum of Serious Seduction: The Situationist International as Embodied Fantasies
Zoran Terzi?: From Phantasia to Phantasma – Embodied Notions and the Anticipation of Politics Through the Arts
Frank Gillette: Moderator

Panel VI: Shadowing Fire
Margareta Hesse: Carousels of Perception
Romana Filzmoser: Chimerizing the Body: Art theoretical Concepts of Fantasy in Italian and English 17 Century Obscene Literature
Laura Taler: SPIEGELEI: Affect as Lever
Mathius Kessler: (title pending)
Arthur Miller: Moderator

General Public: $150
Graduate and Undergraduate Students: $75
Order tickets via Eventbrite by clicking here.

Conference Organizers
Suzanne Anker
Chair, BFA Fine Arts Department
School of Visual Arts, NYC

PD Dr. Sabine Flach
Visiting Scholar
BFA Fine Arts Department
School of Visual Arts, NYC

You can see the full schedule and get more details by clicking here. You can purchase tickets by clicking here.

Image: Suzanne Anker, Embodied Fantasies, 2011. Inkjet print.

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A kinetic model for quantitative evaluation of the effect of H2 and osmolarity on hydrogen production by Caldicellulosiruptor saccharolyticus

Background:
Caldicellulosiruptor saccharolyticus has attracted increased interest as an industrial hydrogen producer. The aim of the present study was to develop a kinetic growth model for this extreme thermophile. The model is based on Monod kinetics supplemented with the inhibitory effects of hydrogen and osmotic pressure, and the liquid-to-gas mass transfer of H2.
Results:
Mathematical expressions were developed to enable the simulation of microbial growth, substrate consumption and product formation. The model parameters were determined by fitting to experimental data. The derived model corresponded well with experimental data from batch fermentations in which the stripping rates and substrate concentrations were varied. The model was used to simulate the inhibition of growth by hydrogen and solute concentrations, giving a critical dissolved hydrogen concentration 2.2 mmol/L and an osmolarity of 0.27-0.29 osm/L of 2.2 mmol/L. The inhibition by hydrogen, being a function of the dissolved hydrogen concentration, was demonstrated to be mainly dependent on the hydrogen productivity and mass-transfer rate. The latter can be improved by increasing the stripping rate, thereby allowing higher hydrogen productivity. The experimentally determined degree of oversaturation of dissolved hydrogen was 12 to 34 times the equilibrium concentration, and was comparable to the values given by the model.
Conclusions:
The derived model is the first mechanistically based model for fermentative hydrogen production, and provides useful information to improve our understanding of the growth behavior of C. saccharolyticus. The model can be used to determine optimal operating conditions for hydrogen production regarding the substrate concentration and the stripping rate.Source:
http://www.biotechnologyforbiofuels.com/rss/

High level secretion of cellobiohydrolases by Saccharomyces cerevisiae

Background:
The main technological impediment to widespread utilization of lignocellulose for production of fuels and chemicals is the lack of low-cost technologies to overcome its recalcitrance. Organisms that hydrolyze lignocellulose and produce a valuable product such as ethanol at a high rate and titer could significantly reduce the costs of biomass conversion technologies, and will allow separate conversion steps to be combined in a consolidated bioprocess (CBP). Development of Saccharomyces cerevisiae for CBP requires the high level secretion of cellulases, particularly cellobiohydrolases.
Results:
We expressed various cellobiohydrolases to identify enzymes that were efficiently secreted by S. cerevisiae. For enhanced cellulose hydrolysis, we engineered bi-modular derivatives of a well secreted enzyme that naturally lacks the carbohydrate-binding module, and constructed strains expressing combinations of cbh1 and cbh2 genes. Though there was significant variability in the enzyme levels produced, up to ~0.3 g/liter CBH1 and ~1 g/liter CBH2 could be produced in high cell density fermentations. Furthermore, we could show activation of the unfolded protein response as a result of cellobiohydrolase production. Finally, we report fermentation of microcrystalline Avicel cellulose to ethanol by CBH-producing S. cerevisiae strains with the addition of beta-glucosidase.
Conclusions:
Gene or protein specific features and compatibility with the host are important for efficient cellobiohydrolase secretion in yeast. The present work demonstrated that production of both CBH1 and CBH2 could be improved to levels where the barrier of CBH sufficiency in the hydrolysis of cellulose was overcome.Source:
http://www.biotechnologyforbiofuels.com/rss/

Fear of Dying During Heart Attack May Make Matters Worse

(HealthDay News) -- People who become very afraid of dying in the moments during and days after a heart attack also seem to have more inflammation, an indicator that they may, in the long run, do worse than patients who are less fearful, a small British study suggests.

The finding, published online June 1 in the European Heart Journal, "reminds us of the connection between the mind and the body," said Dr. Suzanne Steinbaum, a preventive cardiologist with Lenox Hill Hospital in New York City.

"This trial shows us that when patients are so fearful, there's an increase in inflammation and decrease in heartbeat variability, which could lead to poor outcomes. So we must address not only the body issues but the mind issues as well," she said.

Added Dr. Robert Gramling, associate professor of family medicine at the University of Rochester Medical Center in New York: "This and the vast literature related to emotions and mind/body interactions are confirmatory that understanding people's emotional response does interplay with the biologic mechanisms. Read more...

Cardiofy Heart Care Supplement

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Improvements in human sperm quality by long-term in vitro co-culture with isolated porcine Sertoli cells

BACKGROUND

Spermatogenesis is a complex process where spermatogonial germ cells become spermatozoa with the indispensable support of Sertoli cells (SCs), which provide ‘ad hoc’ structural and nutritional support. Unfortunately, for most sperm dysfunctions, no therapies are yet available except assisted reproductive technologies (ART) that are based on the use of different culture media to preserve sperm in vitro. However, sperm culture is only possible for short periods of time, since long-term culture would invariably and irreversibly damage the cells with negative impact on their fertilization potential.

METHODS

Fresh sperm cells (5 ml of 20 x 106/ml) were co-cultured with SCs layers, derived from prepubertal pig testes or incubated in cell free SC medium or BWW (Biggers, Whitten and Whittingham) medium for 2, 4 or 7 days. Sperm viability, motility, mitochondrial status, DNA fragmentation, chromatin integrity, intracellular calcium and acrosome status were assessed after every co-culture or incubation time, but capacitation and induction of acrosome reaction (AR) with progesterone was only evaluated after 7 days.

RESULTS

SCs layers derived from prepubertal pig testes (co-culture of sperm and SC feeder, CCSCF) were able to preserve normal sperm viability, motility and normal mitochondrial function, after 7 days of culture; CCSCF did not induce AR or hyperactivation of spermatozoa, keeping the sperm in a quiescent state for 7 days of culture. Nevertheless, the sperm were readily able to initiate AR after stimulation with progesterone.

CONCLUSIONS

CCSCF maintained good sperm viability and motility for 7 days. This approach could improve retention of sperm viability and motility during ART procedures and maintain sperm viability, during transfer between two distant Centres, avoiding the need for cryopreservation.

Source:
http://humrep.oxfordjournals.org/rss/current.xml

Bilateral histological evaluation of exocrine testicular function in men with obstructive azoospermia: condition of spermatogenesis and andrological implications?

BACKGROUND

The aim of this study was to investigate whether there is a need for diagnostic biopsies in men with obstructive azoospermia (OA).

METHODS

Sixty-three adult men with OA due to vasectomy, bilateral inflammation or bilateral aplasia of the vas deferens were included in the study. We determined testicular volume, sexual hormone levels and testicular histologies of right and left testes (236 biopsies from 118 testes) during diagnostic and therapeutic infertility surgery (microsurgical vasal reconstruction or testicular/epididymal sperm extraction). Spermatogenesis was histologically classified according to the Holstein score from 0 (Sertoli cell-only, complete absence of germ cells) to 10 (100% of tubules with elongated spermatids).

RESULTS

All patients (mean age 34 ± 5 years) had low glucosidase levels (5.4 ± 4.2 mU/ejaculate), normal serum FSH levels (4.6 ± 2.5 mU/ml) and normal testicular volumes (right 21 ± 8 ml; left 19 ± 6 ml). Median histological score for right and left testis was 9. There were eight patients with score differences ≥ 3 between right and left testis (14% of men), showing that even in men with OA, there may be differences in spermatogenic activity between both sides. In all of these patients, normal spermatogenesis was found in the larger testis. Testicular histology (spermatogenesis score) was positively correlated with testicular volume and negatively correlated with FSH levels.

CONCLUSIONS

Patients with OA may not need to be biopsied for diagnostic purposes. Our data support the use of unilateral therapeutic biopsy in men with OA and that the larger testicle should be operated on when there is a significant difference in size.

Source:
http://humrep.oxfordjournals.org/rss/current.xml

Mast cell tryptase stimulates production of decorin by human testicular peritubular cells: possible role of decorin in male infertility by interfering with growth factor signaling

BACKGROUND

Myofibroblastic, peritubular cells in the walls of seminiferous tubules produce low levels of the extracellular matrix (ECM) protein decorin (DCN), which has the ability to interfere with growth factor (GF) signaling. In men with impaired spermatogenesis, fibrotic remodeling of these walls and accumulation of tryptase-positive mast cells (MCs) occur.

METHODS

Human testicular biopsies with normal and focally impaired spermatogenesis (mixed atrophy) were subjected to immunohistochemistry and laser micro-dissection followed by RT–PCR. Primary human testicular peritubular cells (HTPCs), which originate from normal and fibrotically altered testes (HTPC-Fs), were studied by qRT–PCR, western blotting, enzyme-linked immunosorbent assay measurements and Ca2+ imaging. Phosphorylation and viability/proliferation assays were performed.

RESULTS

Immunohistochemistry revealed DCN deposits in the walls of tubules with impaired spermatogenesis. Mirroring the situation in vivo, HTPC-Fs secreted more DCN than HTPCs (P< 0.05). In contrast to HTPCs, HTPC-Fs also responded to the main MC product, tryptase, and to a tryptase receptor (PAR-2) agonist by further increased production of DCN (P< 0.05). Several GF receptors (GFRs) are expressed by HTPCs and HTPC-Fs. DCN acutely increased intracellular Ca2+-levels and phosphorylated epidermal GF (EGFR) within minutes. Platelet-derived GF (PDGF) and EGF induced strong mitogenic responses in HTPC/-Fs, actions that were blocked by DCN, suggesting that DCN in the ECM interferes with GF/GFRs signaling of peritubular cells of the human testis.

CONCLUSIONS

The data indicate that the increase in testicular DCN found in male infertility is a consequence of actions of MC-derived tryptase. We propose that the increases in DCN may consequently imbalance the paracrine signaling pathways in human testis.

Source:
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