Medicine & Health

Patients in intensive care units are kept alive with breathing machines, dialysis, tube feeding and other extraordinary measures until their bodies can begin to recover from critical illness or traumatic injury.Sepsis, sometimes called blood poisoning, is the leading cause of death among critically ill patients in the United States. For many years, scientists believed it was the result of an uncontrolled inflammatory response, but several studies that involved anti-inflammatory drugs were not successful at improving survival. Now, a research team led by Richard S. Hotchkiss, M.D., professor of anesthesiology and of medicine and associate professor of surgery and of molecular biology and pharmacology, and Irene E. Karl, Ph.D., research professor of medicine at Washington University School of Medicine in St. Louis have found that how immune cells die in sepsis might be a key to whether patients survive. When immune cells die through a process known as programmed cell death, or apoptosis, a patient’s chance of survival appears to be much lower than if cells die through a different mechanism called necrosis.

At the time of the first MRI scans, the turquoise color shows areas of the hippocampus in patients with mild Alzheimer’s disease that are shaped differently than in healthy older people. Two years later, even more changes have occurred, represented by the purple color.Even when people have no symptoms, their brains already may be dotted with the plaques and tangles that characterize Alzheimer’s disease. As treatments to halt the progress of Alzheimer’s disease appear on the horizon, scientists are looking for new ways to identify Alzheimer’s-associated changes in the brain before cognitive decline begins. By examining brain images, researchers, led by John G. Csernansky, M.D., the Gregory B. Couch Professor of Psychiatry, and Lei Wang, Ph.D., research associate in psychiatry, both at Washington University’s Silvio Conte Center for Neuroscience Research, found that the volume and shape of certain brain structures change in different patterns during Alzheimer’s disease than in healthy aging. They believe that someday using these imaging techniques may allow for earlier diagnosis of Alzheimer’s disease, preferably before the most devastating symptoms appear.

Photo courtesy of Vanderbilt UniversityThe “CEO” in your brain appears to be concerned more about the consequences of your actions than how hard they are to produce. That is the implication of a detailed study of the neuronal activity in a critical area of the brain, called the anterior cingulate cortex (ACC), published in the Oct. 3 issue of the journal Science. The finding is important because the ACC plays a key role in disorders such as schizophrenia and obsessive-compulsive disorder in humans, suggests Joshua Brown, study co-author and WUSTL research associate in psychology.

October Medical Science & Health Tip Sheet

New lens replacement material may aid cataract patientsA gel-like material eventually could replace diseased and aging lenses in the eyes of patients with cataracts. The material also might eventually mean the end of bifocals and contact lenses for millions of people who suffer from presbyopia — literally “old vision” — a condition that makes it difficult for people over 40 to read without magnification. Researchers from the Veterans Affairs (VSA) Hospital and Washington University School of Medicine reported on the gel in New York at the 226th national meeting of the American Chemical Society, the world’s largest scientific society. The technology could represent a totally different approach to the treatment of cataracts and presbyopia.

The United States Department of Health and Human Services announced today that Washington University School of Medicine in St. Louis will anchor a multi-institutional Midwest Regional Center for Excellence in Biodefense and Emerging Infectious Diseases Research (MRCE). The center will be funded by a five-year, $35 million grant from the National Institute of Allergy and Infectious Diseases (NIAID).

David GutmannJust as films or plays feature both stars and a supporting cast, in the brain the cells called neurons have “starring roles.” But a team of epilepsy researchers led by David H. Gutmann, M.D., Ph.D., the Donald O. Schnuck Family Professor of Neurology at Washington University School of Medicine, has found that a type of supporting cell in the brain is responsible for some epileptic seizures. Studying mice that develop a genetic disorder called tuberous sclerosis complex (TSC), which affects about 50,000 Americans and causes debilitating epileptic seizures in half of them, Gutmann’s team found that cells called astrocytes played a critical role in the development of seizures. The researchers found that mice that lack a particular gene developed seizures, and they say that gene, combined with the knowledge that the “supporting” astrocyte cells are responsible for the seizures, provides new targets for treating epilepsy.

A new technique in development will produce quick and efficient radiation dosing.Researchers at Washington University in St. Louis have developed a technique that makes radiation oncologists significantly faster at calculating radiation dosages for patients undergoing cancer treatment. The technique also provides a more carefully controlled dosage of radiation to cancerous cells that is less likely to damage nearby healthy tissues. The research team — led by Victor Wickerhauser, Ph.D., professor of mathematics in Arts & Sciences and Joseph O. Deasy, Ph.D., assistant professor of radiation oncology at the School of Medicine — has turned to a mathematical tool called wavelet analysis to calculate radiation dose distributions. The tool has helped speed up the dose calculations by a factor of two or more compared to the standard dose calculation technique.

Richard CholeInfection of the tonsils, or tonsillitis, is one of the most common infectious diseases of childhood. More than 400,000 tonsillectomies are performed annually in the U.S., making it one of the most common surgical procedures involving children. Prior to surgery, pediatricians prescribe antibiotics, and children get better, but infections can return in a pattern that repeats itself until the doctor — or the frustrated parents — finally decide that the tonsils must come out. Now researchers, led by Richard A. Chole, M.D., Ph.D., Lindburg Professor and head of the Department of Otolaryngology at Washington University School of Medicine in St. Louis, have discovered that bacteria often form biofilms in the wet and warm folds of the tonsils, and that these may serve as reservoirs of repeated infection. Recent evidence has linked biofilms to a variety of persistent infections.

MatavaChildren who participate in sports or are physically active in hot weather can be at risk for heat-related illnesses. Each year in the United States, there are a number of tragic stories about young athletes who lose their lives after playing or practicing in the heat. The problems can occur when athletes of any age work hard in extreme heat and humidity, but the risks can be even greater in children because children tend to sweat less than adults, making it harder for their bodies to cool off. Matthew Matava, M.D., assistant professor of orthopaedic surgery at Washington University School of Medicine in St. Louis and head team physician for the St. Louis Rams, says parents and coaches need to make sure kids take things slowly and gradually get used to playing and practicing in the heat and humidity. They also need to make it easy for children to get a drink during practice, with more frequent drink breaks as the temperature and humidity levels rise.