Medicine & Health

Faddis and colleagues use a catheter with a magnet at its tip combined with a magnetic guidance system machine to help guide the magnetic catheter as it moves inside the heart.Thanks to advances in cardiology and in magnetic technology, it’s now possible to use magnetic fields to guide tools used to treat certain heart rhythm problems. Cardiologists can treat heart rhythm abnormalities without surgery by using catheters to deliver treatment. Catheters are long, narrow tubes that are run from the groin to the heart via blood vessels using X-ray images for guidance. A team at Washington University School of Medicine in St. Louis has found that the Magnetic Navigation System (MNS) developed by Stereotaxis Inc. allows them to guide catheters within the heart more accurately. Instead of a standard design, MNS catheters contain a magnetic tip. In the same way the needle on a compass aligns itself with the direction of the Earth’s magnetic field, the catheter’s magnetic tip aligns itself with a magnetic field surrounding the patient and allows physicians to more easily guide the catheter in order to locate and treat problem areas in the heart.

Dr. James Lowe in the operating room.Beauty may be in the eye of the beholder, but plastic and reconstructive surgeons at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis are trying to learn the basics of aesthetic beauty in various ethnic groups. When plastic surgeons operate, they don’t want to make African-Americans, Hispanics, Asians, Native Americans and other groups look the same. Rather, they hope to preserve ethnicity while at the same time restoring or enhancing beauty. The Washington University team is one of only a handful worldwide that is scientifically studying ways to preserve ethnicity in plastic surgery procedures, and as more people from different ethnic backgrounds seek plastic surgery, defining aesthetic attractiveness in various ethnic groups is becoming more important.

A protein known as Pgp has pumped an imaging agent that glows away from a tumor on the lower right of this mouse.Oncologists dread the appearance of MDR1 P-glycoprotein (Pgp), a protein found on the surface of drug-resistant cancers that pumps away chemotherapy treatments. Now researchers have discovered Pgp also rids cells of a bioluminescent agent used in imaging research. According to David Piwnica-Worms, M.D., Ph.D., professor of molecular biology and pharmacology and of radiology and director of Washington University’s Molecular Imaging Center, the finding means scientists now have a direct, real-time method for assessing treatments designed to block drug resistance in animal models of cancer because if Pgp is present, the imaging agent is expelled from cells, it’s also likely that those cells will be resistant to chemotherapy. On the other hand, the discovery also means basic researchers, who make frequent use of the luminescent imaging agent (derived from a sea pansy or soft coral), have to make sure that what they are seeing isn’t being affected by interactions with Pgp.

In some people smoking rewires the brain, producing a powerful addiction that may never be entirely cured, experts say. An estimated 35 million smokers try to kick the habit each year, but only about 7 percent succeed in remaining smoke-free for more than a year. Most relapse within a few days of quitting and require multiple attempts before they can give up cigarettes. “The people who could quit, quit. Now we’re left with a group of really committed smokers,” explains WUSTL geneticist Laura Bierut in a recent St. Louis Post-Dispatch news article.

Little is understood about how depression makes people feel sad, but neuroscientists do know that the brain chemical serotonin is involved. School of Medicine researchers studied 46 people with active depression and compared positron emission tomography (PET) scans of their brains to scans from 29 people who were not depressed. The team was measuring levels of a particular type of serotonin receptor called the 5-HT2A receptor.

Human nuclear cataract (as seen through a slit lamp)Ophthalmology researchers at Washington University School of Medicine in St. Louis have identified a key risk factor for the development of cataracts. For the first time, they have demonstrated an association between loss of gel in the eye’s vitreous body — the gel that lies between the back of the lens and the retina — and the formation of nuclear cataracts, the most common type of age-related cataracts.

WUSTL professors David N. Harris and John C. Morris were among experts commenting in a recent St. Louis Post-Dispatch story on public health implications of the discovery of mad cow disease at a Washington state dairy farm. Harris, who conducts research on prion brain proteins associated with the disease, said that no one yet knows what the protein’s regular function is. Morris, a neurology specialist, said that Great Britain’s experience with the disease suggests that most people who were exposed to tainted meat did not get sick. “It’s undeniable that there is this link (with BSE), and it’s such a scary illness that it overshadows the fact that the individual risk is quite small,” Morris said.

Photo courtesy of National Eye Institute, National Institutes of HealthVisual perception changes as eyes age.Graphic design can be a matter of life and death. Literally. According to the Journal of the American Medical Association, more than 40 percent of Americans aged 65 and over use five or more different medications each week, making unintended drug interactions a major contributor to an estimated annual 180,000 fatal or life-threatening adverse drug reactions. Yet drug labeling is a kind of typographical Wild West, says Ken Botnick, professor of visual communications in the School of Art at Washington University in St. Louis. “Drug companies are required to divulge certain types of information but there are no requirements in terms of how accessible that information is made,” Botnick explains. “Typically, decisions about the way information is organized — the hierarchy of presentation, the size and clarity of type — are simply afterthoughts.” Medical information design is just one of the issues to be explored as part of “Visual Design for an Aging Population,” a national symposium Botnick is organizing in March 2004.

Photo by David Kilper/WUSTL PhotoWendy F. Auslander, Ph.D. (left), works with St. Louis-area peer counselors in the “Eat Well, Live Well” program she pioneered with colleagues at the School of Medicine.As the cases of type 2 diabetes in African-American women increase at an epidemic rate, researchers are examining risk factors involved with this disease in order to create programs that will hopefully slow this growing problem. According to a recent study at the George Warren Brown (GWB) School of Social Work at Washington University in St. Louis, African-American women at risk for type 2 diabetes experience long periods of depression due, in part, to a lack of economic and social resources. “At the beginning of our study, 40 percent of our sample of African-American women at risk for type 2 diabetes reported clinically significant depression,” says Wendy Auslander, Ph.D., professor at GWB and co-author of the study. “Unlike their nondepressed peers, these women reported fewer economic assets and greater economic distress. Issues such as unemployment, low self-esteem and a low appraisal of their economic situation contributed to their depression.”

Chest x-ray of a lung affected by pneumoniaMany medical advances involve complicated new technologies or procedures. But Linda Mundy, M.D., associate professor of medicine and an infectious diseases specialist at Washington University School of Medicine in St. Louis, recently reported good results with a new pneumonia treatment that can be summed up in a single sentence: Get patients up out of bed earlier and more often, and they check out of the hospital an average of one day sooner. Mundy says the high volume of U.S. pneumonia hospitalizations could make the new treatment a potent cost-saver, but added that a second study of the approach, known as early mobilization, is needed to confirm the beneficial effects.