E Pluribus Unum
From many, one.
My cloning experiment began Monday when Dr. Terrence L. Stull of the Children’s Medical Research Institute explained the procedure.
Although Stull and everyone in his lab were too polite to say so, I gather explaining such basic experimental techniques is similar to teaching a child multiplication tables or how to conjugate simple verbs in another language — something exceedingly mundane for an expert. But Stull said he still finds this stuff remarkable.
My little exposure to it in college gave me the same feeling, although I don’t think I have the personality to be a successful scientist.
Paul Whitby, a Ph.D.-holding bacteria researcher from England who works in Stull’s lab, explained how he would swab the inside of my cheek and then isolate and clone a gene active in oxygen transportation. This gene is one the lab has studied in the past, so they are familiar with how to isolate and clone it.
You use specific enzymes to isolate a section of DNA you’re looking for, whose sequence you hopefully already know. You combine it with a plasmid (a circular piece of bacterial DNA into which other DNA can be spliced), which takes up the new DNA. The bacteria then can be grown in such a way that you can tell which ones have taken up plasmids with the new DNA. To be sure you have what you want, you sequence the DNA.
Should we successfully get my gene spliced and taken up, we could then grow bajillions of clones of the bacteria.
I have two more visits to make before the process is complete. I’ll go into a little more detail and explain practical applications when I write my story.
From many cells to one, back to many. E Pluribus Unum. Sort of.
For health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.
Jeff Raymond, Medical Writer
Double the fun
When Dr. Terrence L. Stull, scientific director of the Children’s Medical Research Institute, asked me if I’d like to stop by his lab to be cloned, I thought he was kidding.
“Silly scientist,” I thought to myself, chalking his suggestion up to the gentle ribbing reporters often receive, “clone the newspaper guy and you’ll have twice as many inane questions.”
Ha, ha.
Turns out Stull wasn’t kidding.
He suggested taking a cheek swab and cloning the cell in his lab. He proposed I explain how the process works. The quirkiness of the suggestion aside, I was taken with the idea of teaching people about cloning.
For all the stories people read about cloning, few have a clue how scientists reproduce a strand of DNA, much less a monkey or sheep.
I did some related work while a biology student at the University of Tulsa but never really felt like I had a good handle on it. Nevertheless, DNA sequencing, genetics and related science fascinated and humbled me.
So, Monday morning I’m having a cheek cell cloned. Technically, an epithelial cell, which is a good place to start because it is easily accessible and fairly simple.
I hope to show how routine the process has become yet how far scientists, even those as capable as Stull and his CMRI colleagues, are from being able to clone a fully functioning Oklahoman reporter.
What is the most impressive to me is that technology has leveled the playing field in molecular biology. Researchers don’t have to have tens of millions of dollars or an endowed chair at Harvard to make a mark. We are all made of cells, and cells reveal their secrets to those who ask the right questions and look in the right places for answers.
I don’t know if any of my little experiment Monday will ever make it into the newspaper, or exactly what I’m going to do with it. If only there were two of me, then I could figure things out.
Jeff Raymond, Medical Writer
Burning off those Thanksgiving calories
Reflecting on how long I will have to run today to burn off the vanilla ice cream, blueberries and pecans I ate last night (to say nothing of the latte yesterday and other transgressions), I decided to look at some calorie calculators to figure out the damage from tomorrow’s gluttony. The results were discouraging, to say the least.
This is what the Thanksgiving calorie calculator on about.com told me:
-One ounce of potato or tortilla chips
-One teaspoon of chip dip
-One tablespoon ranch dressing
-Six ounces of white and dark turkey
-Half a cup of stuffing
-Half a cup of cranberry sauce
-Half a cup of mashed potatoes
-Half a cup of gravy
-Half a cup of green bean casserole
-Half a cup of candied sweet potatoes
-A dinner roll, A pat of butter
-A slice of pumpkin pie
-Half a cup of whipped cream
=2,095 calories
=20.95 miles walking
Using a running calculator at coolrunning.com, I would have to run three miles a day for the better part of a week to burn off that one meal.
This isn’t necessarily that accurate or reliable, but it is a useful reminder of what I must do (and not do) to keep in shape.
Jeff Raymond, Medical Writer
Diabetes is seldom alone
A recent study from the University of Michigan Health System and the Veterans Administration Ann Arbor Healthcare System found 92 percent of older diabetes sufferers have at least one major chronic condition in addition to diabetes, and nearly half have three or more diseases besides diabetes.
“The sheer number, and the severity, of these other conditions appears to decrease patients’ ability to manage their diabetes,” according to a press release, which suggested doctors learn to better treat “the whole person” rather than that person’s individual ailments.
The study was published online before appearing in next month’s issue of the Journal of General Internal Medicine. Researchers used data from a nationally representative sample of 1,901 adults with diabetes who were 55 years old or older in 2002.
The researchers looked at the influence a range of medical conditions had on participants’ ability to manage their diabetes and whether the conditions were linked to diabetes.
“Patients are dealing with these issues day to day, and they’re affecting the way people prioritize and manage their own self-care,” author Dr. Eve Kerr said in the release. “Meanwhile, we physicians talk to patients about their diabetes, but not about how their heart failure or their hypertension is affecting how they manage their diabetes. These results show that we need to be treating the whole patient, but we don’t yet have systems designed to do that.”
The more diseases a person had along with diabetes, the study found, the more they prioritized the other conditions ahead of diabetes. Participants also often didn’t associate the other conditions with diabetes, such as understanding how the metabolic disorder puts them at higher risk of heart disease and stroke. Lack of awareness of the association often means diabetes sufferers don’t put enough emphasis on controlling blood pressure and cholesterol, for example.
Jeff Raymond, Medical Writer
More women choosing double mastectomy
Researchers have found a 150 percent increase between 1998 and 2003 in American women who choose to have both breasts removed when cancer has been found in one breast.
I reported not long ago on Oklahoma’s rank in the number of women who choose to have a prophylactic mastectomy or choose to have a mastectomy rather than lumpectomy despite general agreement among doctors and researchers that survival chances are equal for both procedures.
To read the story, click here.
The recent study, published in the Oct. 22 edition of the Journal of Clinical Oncology, was the first to examine the trend on a national level. The study’s authors caution that aggressively removing both breasts may not be necessary since most patients will never develop cancer in the second breast, and the risk of cancer spreading to other parts of the body is a greater threat that development of cancer in the second breast.
“Although breast cancer is now often diagnosed at earlier stages, we’re seeing more women having contralateral prophylactic mastectomy, even though there are very little data showing that this irreversible procedure improves overall survival,” study author Dr. Todd M. Tuttle said in a press release. Tuttle is chief of surgical oncology and associate professor of surgery at the University of Minnesota. “We need to determine why this is occurring and use this information to help counsel women about the potential for less invasive options.”
Among 152,755 women diagnosed with state I, II or III breast cancer during the period studied, 59,460 underwent single mastectomy; 4,969 other women who were candidates for single mastectomy chose to have the other breast removed as well.
Tuttle suggested reasons women choose to remove the second breast is an increase in public awareness of the role of genetics in breast cancer and more frequent testing for certain gene mutations, which increase the risk of cancer in the second breast. He also attributed the increase to less invasive mastectomy techniques and improved breast reconstruction.
This subject particularly interests me because I can’t imagine how difficult the decision must be for women who are vulnerable and reeling from being told they have cancer.
Jeff Raymond, Medical Writer
Disability risk higher in states with rich-poor gap
Canadian researchers have found Americans who live in states with high rates of income inequality are much more likely to have a disability that limits their ability to complete daily tasks such as dressing, bathing and getting around at home.
“We have always known personal income and education can affect one’s health outcomes,” study author and University of Toronto assistant professor Esme Fuller-Thomson said in a press release. “What we didn’t know until now was the substantial strength of the relationship between state-level income inequality and disability. This research shows that individuals have a higher likelihood of physical disability when they live in states where wealth is distributed very unevenly.”
Researchers looked at information collected from 645,000 Americans through the 2003 American Community Survey. Their study findings are published in the British journal Public Health.
Other findings include:
- In states with a greater income gap, the wealthy were also at a health disadvantage and more likely to have “high-level” disabilities.
- Living in a state with unequal wealth distribution is nearly as much of a risk factor as gender in predicting certain disabilities. Americans living in states with high income inequality were 11 per cent more likely to have a disability than those living in states where wealth is more widely distributed.
- New York, Arizona and the District of Columbia were the three regions with the highest levels of income inequality.
Wanna talk about this? E-mail me at jraymond@oklahoman.com.
Jeff Raymond, Medical Writer
Stroke risk
The risk of a major stroke within a week of a minor stroke (or transient ischemic attack) is substantial, according to a report to appear in the December issue of the British journal The Lancet Neurology.
The lowest risk of having a subsequent stroke was among patients treated as emergency cases in specialist stroke units.
Studies have reported conflicting risk of having a major stroke after a minor stroke, with results ranging from no increased risk to 12.8 percent greater risk.
Researchers from the University of Oxford in the United Kingdom combined results from 18 groups of 10126 patients overall, and showed that the risk of a major stroke after a minor stroke is a “substantial” 5.2 percent at 7 days. This means one in 20 patients who have a minor stroke will have a major one within a week.
“Although the individual results of the studies are inconsistent, this study shows that this can be almost fully explained by differences in study method, setting, and treatment. Further, they found that the lowest risks of stroke were seen in studies of emergency treatment in specialist stroke units (0-9%) and the highest in population-based studies without urgent treatment (11%),” according to a press release on the study.
The authors emphasized that “urgent treatment in specialist units” may reduce the risk of subsequent strokes.
Jeff Raymond, Medical Writer
Last Integris drive-through flu clinic
Integris Pacer Fitness Center is offering its last drive-through flu clinic of the season.
Just drive up, roll down the window, roll up your sleeve and get vaccinated.
The clinic will be from 9 a.m. to 1 p.m. Saturday in the Integris Baptist Medical Center East Parking Lot.
The cost per flu shot is $22. A pneumonia shot is $30. Medicare will not be accepted.
Jeff Raymond, Medical Writer
Baby Boomers mistaken
One in four Baby Boomers incorrectly thinks they have coverage for long-term care expenses, according to survey results from American’s Health Insurance Plans.
The survey found that many Baby Boomers have misconceptions about who pays for long-term care services.
If you are still unclear on all this, Medicare does not pay for long-term care. Medicaid does, but only for those who are poor or who have spent down their assets.
“This should be a wake-up call to Baby Boomers. They aren’t factoring expenses for long-term care into their retirement planning and are missing an opportunity to protect themselves,” Karen Ignagni, president and CEO of the insurance group, said in press release.
Spoken like a true insurance industry representative, but she nonetheless makes a good point.
The survey also found:
-Even among Baby Boomers nearing or at age 60, only one in four feels “very familiar” with long-term care insurance.
-Thirty-percent of Baby Boomers think they have coverage for long-term care expenses. Most likely do not.
-Fifty-four percent of Baby Boomers think Medicare will pay for long-term care.
Now, I realize these surveys are often commissioned by insurance companies that have a vested interest in selling policies. I also know firsthand that long-term care insurance is laughably expensive for a person my age — my only point of comparison. Maybe it will be a better value when I near retirement.
Just for the record: I’m not interested in buying insurance. Call me in 30 years or so.
To learn more, visit www.ltcchampions.org or www.ahip.org.
Jeff Raymond, Medical Writer
Diabetes south of the border
During my recent vacation to Guanajuato, Mexico, I learned Oklahoma and Mexico have something unexpected in common: Diabetes now is Mexico’s leading cause of death, ravaging the nation just as it ravages Oklahoma.
Although diabetes is not the leading cause of death in the Sooner State (heart disease is), its toll is huge, especially among minority groups. I didn’t expect a more traditional, less affluent culture would have such a problem.
I thought the disease, at least the type 2 variety, was more of an affliction of rich countries where exercise is insufficient; inexpensive, nutritionally empty food is plentiful; desk jobs are the norm and stress is everywhere.
Sure, Mexican food isn’t always the healthiest cuisine, with its many fried delicacies, fattening sauces and lots and lots of carbohydrates, but people walk more, and fast food is less a part of people’s diets than here. And certainly not all Mexican food is unhealthy.
Granted, Hispanics on the U.S.-Mexico border (and in general) are more likely to have diabetes than whites, but I always figured that was more an issue of poor nutritional knowledge and the difficulty of eating well and working out when raising a family on little money than anything else.
So, I found several stories I read in Mexican newspapers while on vacation interesting. This is from a recent edition of the Mexican newspaper Milenio, handily translated using Google:
Mexico City – The Ministry of Health warned that the lack of prevention and education on diabetes are the leading causes of its growth, (so) it is necessary to work on measures to prevent it, especially in public schools.
The director of the Metabolic Syndrome Clinic at the National Institute of Respiratory Diseases, Guadeloupe Fabian, warned that although the federal agency carries out activities important to control diabetes, it is essential that the Ministry of Education, universities and the pharmaceutical industry get involved.
Otherwise, diabetes … could become a pandemic.
Fabian emphasized that physical inactivity and poor diet are two predominant factors for the development of diabetes, which also affects children, and that 50 percent are related to problems of hypertension.
Sound familiar? Here’s more, from the Nov. 4 edition of El Universal:
Mexico City – Today it is natural to see a young man no more than 20 years old rely on injected insulin or suffer attacks of high blood pressure, conditions that two decades ago were exclusive to adults. The sedentary lifestyle, excess intake of junk food and a lack of natural nutrients are the main factors incidents youth to acquire these pathologies.
In view of Aurora Serralde Zuñiga, medical specialist in clinical nutrition at the National Institute of Medical Sciences and Nutrition Salvador Zubirán (INNSZ), the facilities of modern life based on technological devices promote less physical activity in young people. “On many occasions spend hours, for work or school, sitting in front of a computer or moving car and no longer walk,” he said.
In Mexico there are on average 6.5 million diabetics 20 years old or older.
“The genetic predisposition that the Mexican has the disease, coupled with bad eating habits and physical inactivity, results in juvenile diabetes,” said Jesus Montes Carrizales, a specialist in sports medicine of Tecnologico de Monterrey.
If the family pillar in the development of the young, not teaching good eating habits such as consumption of vegetables, fiber and water, and no physical activity … promotes the consumption of pizza, hamburgers and fries while watching television The young think that it is normal and healthy.
To prevent diabetes, high blood pressure, cholesterol and heart problems at an early age, both specialists invite young people to be physically active constant change the fries and soda for fruit and water, and leave the car for a walk.
And this from the newspaper’s Nov. 3 edition:
Mexico City – Mexico occupies ninth place worldwide in the number of patients with type II diabetes, totaling 6.6 million people with the disease, warned internal medicine specialist Paul Frenk.
If that trend continues in the coming years this figure could more than double, said the expert from the Latin American Society of Internal Medicine (Solami) and the American Diabetes Association.
Frenk warned that more and more young people, including children, are suffering the disease, which has become the common enemy to overcome throughout the world, and “in 2020 Mexico is expected to reach nearly 15 million diabetics.”
Frenk noted that the most regrettable matters is that increasing numbers of children and young people who develop the disease, which only some 15 years ago was designated for the elderly.
“We have the habits of our neighbors to the north, now the games are children via computer and fun is television and movies, and no longer exercise. Is a major problem and that we have to begin to change in the home and school,” he mentioned.
Diabetes is a serious public health problem, which will have an impact on catastrophic costs for both public health services, and for those who suffer and have no insurance or are covered by a social security program.
This due to diseases that develop as a result of diabetes, such as chronic renal failure, blindness and heart disease.
In Mexico diabetic retinopathy is the number one cause of blindness and is the first reason for myocardial infarction (heart attack), and that diabetes causes severe damage to the kidneys.
Any thoughts on diabetes in Mexico or Oklahoma? E-mail me at jraymond@oklahoman.com.
Jeff Raymond, Medical Writer
