20091112-1

GoogleNews.com, November 12, 2009  —  Transplant surgeons at the University of Maryland Medical Center (UMMC) have successfully completed a four-way kidney exchange involving eight patients from four states. The youngest recipient is a 10-year-old Catonsville, Md., boy, and the oldest a 74-year-old man from Virginia Beach, Va.

All four of the living donors had a kidney removed through an incision through their navel, which speeds recovery and leaves virtually no scar. University of Maryland School of Medicine surgeons have performed more of these single-incision laparoscopic surgeries than any hospital in the country, but this is the first time that the technique has been used in a multiple kidney exchange.

All of the donors and recipients are recovering well following the surgeries, which took place on Nov. 2 and Nov. 3, 2009.

Stephen T. Bartlett, MD, surgeon-in-chief at UMMC and professor and chairman of surgery at the University of Maryland School of Medicine, who performed two of the transplants, says, “This large living donor kidney exchange requires extensive planning and coordination, but it provides great benefits to people with kidney failure who do not have a compatible living donor.”

“We’ve been a national leader in kidney transplantation and laparoscopic donor kidney removal for many years, and our singular focus has always been on providing the highest quality care and the best outcomes for patients. This is yet another significant advance that will benefit patients from Maryland and throughout the country,” he continued.

Kidney exchanges, or swaps as they are sometimes called, allow living donors and their intended recipients to proceed with surgery, even if their blood and tissue types don’t match.

They are paired with other donors and recipients who are incompatible with each other but are a match with others in the group. The patients are from Maryland, Virginia, Massachusetts and Florida. Two of the donors are female, and the other two donors and all of the recipients are male. There is one married couple, but the wife was not a match for her husband.

“Four people who otherwise would not have had matching donors now have lifesaving kidneys – from people they’ve never met. And this transplant chain was set in motion by a man who simply wanted to donate a kidney to someone in need,” says Matthew Cooper, MD, director of kidney transplantation at UMMC and associate professor of surgery at the School of Medicine, who oversaw the series of surgeries.

Only a handful of hospitals in the country have performed large kidney transplant exchanges such as this one. The procedures, which took place over two days in four operating suites at the medical center, required extensive coordination and planning not only in the operating rooms, but also in the waiting rooms.

Because the right to privacy for the donors and recipients is protected throughout the process, transplant coordinator Debbie Iacovino arranged separate waiting areas in different parts of the hospital for their families to ensure anonymity.

The kidney exchange started with a 59-year-old man from a suburb of Boston, Mass., who offered to donate a kidney to someone in need. His kidney was given to a Maryland man who was not a match with his intended donor, a woman who is also from Maryland. The woman was matched with a 10-year-boy from Catonsville whose kidneys were failing because of a congenital abnormality.

A friend of the boy’s family, a 50-year-old lawyer from Catonsville, gave his kidney to a 64-year-old Florida man, whose wife was a donor for 74-year-old man from Virginia Beach, Va. The Virginia man’s son-in-law will be a “bridge” donor, who will give his kidney to a yet-undetermined recipient at a later date, which will allow the chain of transplants to continue.

Edward Behn, of Westborough, Mass., who started off the chain of transplants, says it didn’t matter to him who received his kidney. “Do your good turn,” he added, referring to the slogan, “Do a good turn daily,” used by the Boy Scouts of America, a group with whom he has been actively involved for many years.

About one third of patients who have a relative or friend willing to donate are not able to receive the kidney because of blood type or tissue-type incompatibility. Kidney exchanges increase the pool of donors and allow incompatible pairs to be matched with other pairs in the same situation.

Benjamin Philosophe, MD, PhD, director of the Division of Transplantation at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine, notes that patients who receive kidneys transplanted from living donors fare better than those who receive kidneys from deceased donors.

“There is a significant difference in outcomes with living-donor kidney transplants. There is also a severe shortage of kidneys from deceased donors, with people waiting three to five years to get a kidney. So, living donor transplants are often the best option for patients. With these types of kidney exchanges, we can dramatically increase the availability of donor kidneys and help many more people who need a transplant,” Philosophe says.

More than 82,000 people waiting for kidneys are on the official list maintained by the United Network for Organ Sharing (UNOS). Last year, 16,517 received transplants – 5,967 from living donors.

E. Albert Reece, MD, PhD, MBA, vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, says, “Our physicians are always working to develop better and more innovative ways to help patients, and this four-way kidney exchange is another example of that diligence and excellent work. I congratulate Dr. Bartlett and the entire transplant team for this wonderful achievement.”

Jeffrey A. Rivest, president and chief executive officer of the University of Maryland Medical Center, notes, “The University of Maryland Medical Center has performed the largest number of minimally invasive kidney removals of any hospital in the world, starting in March 1996 and passing the 1,000 patient mark in 2005. These delicate, complicated surgeries demonstrate the tremendous expertise of our medical staff, nurses and technicians.”

“Providing anesthesia for patients undergoing transplantation is challenging because of the nature of the surgery and the medical condition of the patients. We work closely with our surgical colleagues to ensure the safest care and highest quality outcomes,” says Peter Rock, MD, chief of Anesthesiology at UMMC and professor and chairman of Anesthesiology at the School of Medicine.

He adds, “We are excited to have played a key role in these kidney transplants in order to improve the lives of the kidney recipients.”

In April 2009, University of Maryland surgeons began to remove donor kidneys through an opening in the navel, becoming the first hospital in Maryland and only the third hospital in the United States to use this approach. Since then, about 30 of these single-incision surgeries have been performed at the University of Maryland Medical Center.

In the procedure, surgeons insert a camera and two instruments into the specially designed port in order to separate the kidney from its attachments in the abdomen. The kidney is removed through the same opening, which is covered with a tiny bandage. Donors are discharged within a day or two.

The New York Times, November 11, 2009, by Nicholas Wade  —  The best possible kind of regenerative medicine would surely be to entice the body to use nature’s own methods to regrow a damaged limb or organ. The genes that made the structure in the first place are still present in every cell of the body but somehow repressed. Could they not be reactivated to make the patient as good as new?

Many animals do regenerate parts of their bodies. Deer regrow their antlers, and some lizards their tails. The zebra fish can also regrow its tail, and researchers at the Salk Institute have now taken a first step toward understanding how.

The minnowlike zebra fish, a common sight in tropical aquariums, is a standard laboratory animal, and although mice are probably more common in labs, they do not regrow their tails. The Salk team assumed that animals would regenerate a limb by using the same set of genes as were deployed during embryonic development, so they looked at a class of master genes that controlled an egg’s development into an embryo.

These genes are governed by a special kind of dual-purpose switch, which represses the genes but prepares them for activity. Thus, the master genes spring into action the instant the switch is flipped.

These dual-purpose switches were at first thought to be confined to the egg and embryonic stem cells, where they were discovered three years ago. But the switches are now being noticed in adult cells as well.

The Salk Institute scientists – Scott Stewart, Zhi-Yang Tsun and Juan Carlos Izpisúa Belmonte – have now found that dual-purpose switches control many of the 100 or so genes that are activated in the regenerating cells of a zebra fish’s tail. They report their findings in the current Proceedings of the National Academy of Sciences.

The switches consist of chemical modifications to the chromatin, the material that wraps and controls access to the DNA of every cell. Genes are most directly controlled through nearby regions of DNA that are themselves turned on by certain regulatory proteins. But a second layer of control is built into the chromatin, which has to unpack itself if the regulatory proteins are to have access to the underlying DNA.

Zebra fish tails can be cut off with a razor blade (the fish are anesthetized first). Within 12 hours, genes that are usually silenced throughout the fish’s adult life are turned on.

The Salk biologists have found that a key event in this activity is the appearance of an enzyme known as a methylase. The methylase homes in on the chromatin and removes chemical attachments from one half of the dual-purpose switches, and the genes are turned on.

The team has shown they can prevent the cut tails from regenerating by giving the fish a drug that inhibits the methylase. Dr. Belmonte said in an interview that he hoped to develop techniques for the opposite process, that of initiating regeneration by turning on the methylase gene.

Do people have the same dual-purpose switches built into their genetic circuitry?

“It would be wonderful,” Dr. Stewart said, “if we have retained the whole apparatus for regeneration but for the trigger.”

One reason for hope is that the genes for embryonic development are very similar in all vertebrates. But in people, a wound prompts the formation of only scar tissue.

An approach to regeneration, followed in stem cell research, is to take an embryonic stem cell and try to nudge it down the right paths of development toward a particular kind of adult tissue. Nature, though, seems to do the opposite, starting with adult cells. In the zebra fish, the adult cells at the site of the wound turn into a blastema, a set of cells that have reverted to a stemlike state, and each type of cell then grows and divides to reform the muscles, nerves or skin of the missing tissue. The rationale of nature’s approach is presumably that the adult cells know things, like their proper position and population size in the body, which embryonic cells do not.

“Both approaches are valid,” Dr. Stewart said. “Human stem cells are much more in vogue and easier to obtain funding for. But we’ve said, ‘Let’s see how nature does it.’ “

GoogleNews.com, ScienceDaily.com, November 11, 2009   –  A gene associated with longevity in roundworms and humans has been shown to affect the function of stem cells that generate new neurons in the adult brain, according to researchers at the Stanford University School of Medicine. The study in mice suggests that the gene may play an important role in maintaining cognitive function during aging.

 

“It’s intriguing to think that genes that regulate life span in invertebrates may have evolved to control stem cell pools in mammals,” said Anne Brunet, PhD, assistant professor of genetics. She is the senior author of the research, which will be published Nov. 6 in Cell Stem Cell.

 

Unlike your skin or your intestine, your adult brain doesn’t make a lot of new cells. But those it does are critical to learning, memory and spatial awareness. To meet these demands, your brain maintains two small caches of neural stem cells, which can both self-renew and give rise to neurons and other cells known as oligodendrocytes and astrocytes. Properly balancing these functions allows you to generate new nerve cells as needed while also maintaining a robust neural stem cell pool.

 

As mice and other organisms age, the pool of neural stem cells in the brain shrinks and fewer new neurons are generated. These natural changes correlate with the gradual loss of cognitive ability and sensory functions that occur as we approach the end of our lives. However, the life span of some laboratory animals can be artificially extended by mutating genes involved in metabolism, and some humans outlive their life expectancy (about 70 years for someone born in 1960) by decades. Brunet and her colleagues wanted to know why.

 

The researchers studied a family of transcription factors called FoxO known to be involved in proliferation, differentiation and programmed cell death. FoxO genes are required for the extreme longevity seen in some strains of laboratory roundworms, and a single mutation in the FoxO3 gene has recently been associated with long life in Japanese, German, American and Italian populations.

 

“We wanted to know if FoxO3 could be involved in regulating the pool of neural stem cells,” said Brunet. To do so, the researchers examined laboratory mice in which the FoxO3 gene was knocked out. While mice can live without FoxO3, such mice usually die from cancer between 12 and 18 months after birth. The normal life span of a laboratory mouse is about 30 months.

 

Brunet and her colleagues used mice of three different ages, both with and without the gene: 1-day-old (newborns), 3-month-old (young adult) and 1-year-old (middle age). They found that, overall, adult and middle-aged mice without FoxO3 had fewer neural stem cells than did age-matched mice with this regulatory protein. There were no significant differences between the newborn mice with and without FoxO3, suggesting that FoxO3 loss only affects adults.

 

The researchers also discovered that the few stem cells found in the adult mice without FoxO3 more rapidly churned out neural cell precursors — those cells destined to become new neurons — than did the mice with normal FoxO3 levels. In fact, the brains of the mice that lacked FoxO3 were heavier than the control group, perhaps because they were burning through their pool of neural stem cells by making too many new nerve cells.

 

When the researchers looked at the neural stem cell in a laboratory dish, they found that those from young and middle-aged adult mice lacking FoxO3 — but not those from newborn mice — seemed to be compromised in their ability to self-renew and to generate the three types of nerve cells. Further investigation bolstered their findings when they discovered that the FoxO3 protein regulates the expression of genes involved in quiescence and differentiation in cells.

 

The researchers concluded that FoxO3 may be needed for the stem cells to re-enter a waiting state called quiescence that normally occurs after dividing. Cells that are unable to enter quiescence are less able to self-renew and may lose their ability to become any of the three nerve cell types.

 

Together, the research results suggest that FoxO3 is important to regulate the pool of neural stem cells in the adult brain.

 

Although the researchers studied mice of varying ages, from birth to about one year, Brunet stressed that their current study does not address changes that might occur in FoxO3 levels or activity over time — a technically difficult endeavor they are now pursuing.

 

“We suspect that indeed there will be some changes,” said Brunet. “But they will be relatively subtle. We know that the level of FoxO3 doesn’t vary drastically, but it’s possible the protein becomes less active over a mouse’s life span. Or perhaps it simply becomes overwhelmed by the accumulated molecular changes of aging.”

 

Brunet and her colleagues, along with collaborators at the University of Arkansas, are working on creating a mouse in which FoxO3 levels are artificially elevated. If their theory about the function of the protein in the brain is correct, it’s possible that the neural stem cell pools of these mice will be protected from the ravages of time.

 

“We’re very interested in understanding how everything unravels during the aging process,” said Brunet.

 

In addition to Brunet, other Stanford researchers involved in the work include postdoctoral scholars Valérie Renault, PhD, Dervis Salih, PhD, and Ashley Webb, PhD; graduate students Victoria Rafalski, Alex Morgan and Saul Villeda; undergraduates Jamie Brett and Camille Guillerey; research assistant Pramod Thekkat; assistant professor of radiation oncology Nicholas Denko, MD, PhD; associate professor of neurosurgery Theo Palmer, PhD; and assistant professor of medicine and of pediatrics Atul Butte, MD, PhD.

 

The research was funded by the National Institutes of Health, the California Institute for Regenerative Medicine, the Brain Tumor Society, the Esther A. & Joseph Klingenstein Fund Inc., the American Federation for Aging Research, the National Science Foundation, the Lucile Packard Foundation for Children’s Health and the National Library of Medicine.


Adapted from materials provided by Stanford University Medical Center.

GoogleNews.com, November 11, 2009

TORONTO–(Business Wire)–

Ontario, Canada is supporting a world-class stem cell research project to help

revolutionize treatments for major health conditions like cancer, heart disease

and traumatic injuries, and create high-value jobs in Toronto.

 

The province is supporting the Ontario Initiative in Personalized Stem Cell

Medicine, a project led by Dr. Janet Rossant of the University of Toronto and

SickKids hospital. Dr. Rossant’s team of 30 world-renowned stem cell researchers

will use advanced technologies to develop cutting-edge health-care products. The

provincial investment of $10 million in the project will also support the

training and employment of 400 highly qualified research staff over the next

five years in Ontario.

 

Funding world-class research is part of the Ontario Innovation Agenda – the

Ontario government’s plan to build an innovation economy that turns new

knowledge into new jobs, better health care, a cleaner environment and endless

possibilities for Ontario families.

 

“In the 21st century, economic stimulus must create jobs today and tomorrow – it

must be both shovels in the ground, and support for innovative people and

innovative thinking. This funding is part of a larger investment in research

infrastructure that will support 1,300 construction jobs and more than 3,300

scientists across our province – including 400 highly-skilled research jobs

right here in the GTA. We are demonstrating, once again, that our government

understands the value of science to our economy today and for creating the jobs

of the future,” said John Milloy, Minister of Research and Innovation.

 

“The global market for stem cell therapies is estimated to reach $20 billion by

next year. This field of research is exploding and the Ontario government

understands the need to keep Ontario research and biotechnology at the forefront

– to advance new discoveries, create new therapies and keep many of the world’s

best researchers right here in Ontario,” said Dr. Janet Rossant, Director for

the Ontario Initiative in Personalized Stem Cell Medicine.

 

QUICK FACTS

 

* Ontario scientists Dr. James Till and Dr. Ernest McCulloch were the first to

discover stem cells in the 1960s. Ontario continues to be a global leader in

stem cell research today.

* Recently, Ontario’s Dr. Andras Nagy developed a safer way to make

embryonic-like stem cells from a patient’s own skin cells without the use of

methods that could make the cells cancerous – a discovery that named him to

Scientific American’s first ever Top 10 Honour Roll.

* The Ontario Research Fund – Global Leadership Round in Genomics & Life

Sciences (GL2) promotes research excellence in Ontario by supporting

internationally significant research in genomics and gene-related areas,

including stem cell research.

Build these five heart-healthy foods into your daily diet for great taste – and better health.

By Kathleen M. Zelman, MPH, RD, LD
WebMD Feature

Reviewed by Brunilda Nazario, MD

Nothing matters more than taking good care of your heart. Getting regular exercise, not smoking, and controlling stress are just a few things health experts recommend, along with eating a variety of nutritious, heart-healthy foods that make up a healthy diet.

Where to start? Add these five “super-foods” to boost nutritional goodness while eating your way to a healthier heart.

1) Blueberries

Blueberries top the list as one of the most powerful disease-fighting foods. That’s because they contain anthocyanins, the antioxidant responsible for their dark blue color. These delicious jewels are packed with fiber, vitamin C, and are available all year long. Boost heart health by adding them into your diet regularly. Here’s how:

1. Top your whole-grain cereal with fresh or frozen blueberries to add delicious flavor, a dose of fiber, and heart-healthy antioxidants.
2. Power up pancakes, waffles, or muffins with fresh, frozen, or dried blueberries for a nutritious breakfast.
3. Eat them plain or mix with other fruit for a low-calorie, high-fiber tasty fruit salad, dessert, or snack.

Recipe idea: Make an irresistible trifle by layering lady fingers, light whipped topping or low-fat pudding, and blueberries. Or puree a batch of berries for a breakfast or dessert sauce.

2) Salmon

This cold-water fish is a great source of protein and is also packed with heart-healthy omega-3 fatty acids. The American Heart Association advises eating salmon and other omega-3 rich foods twice a week for benefits that go beyond heart health. Americans love salmon because it is so versatile, easy to cook, and tastes great.

1. Salmon is easy to prepare on the grill, in the oven or microwave, or on the stovetop. Save leftovers to toss into pasta dishes, make into salmon cakes, add to salads, or mix into dips or spreads.
2. Smoked salmon comes in two varieties. The raw type is commonly used in appetizers and on bagels with cream cheese and capers. The dry smoked type has more of a cooked appearance. You can enjoy it the same way as the raw style, and add it to cooked dishes such as pasta.
3. Salmon cooks in a matter of minutes and its delicate texture quickly absorbs and showcases the flavor of added ingredients. For example, toss chunks of salmon into a chowder of corn and potatoes, or wrap salmon with herbs and chopped onion and tomatoes in parchment or aluminum foil and grill or bake 12 minutes for a satisfying meal.

Recipe idea: Marinate salmon in a lime, onion, garlic, and soy mixture for 15 minutes before grilling for a delicious fish taco or grilled fish sandwich.

3) Soy Protein

This inexpensive, high-quality protein contains fiber, vitamins, and minerals — all the ingredients for a heart-healthy meal. Also, a diet rich in soy protein can lower triglycerides, which help prevent cardiovascular disease and keep your heart strong and healthy. In those with high cholesterol levels, the benefits of soy foods are due to their high levels of polyunsaturated fats, fiber, vitamins, and minerals.

  1. Pack a soy protein bar or a bag of soy nuts for a quick snack during the day.

2. Edamame (the Japanese name for green soybeans) are snacks even kids will love! Find these nutritious nuggets in the freezer section at your supermarket. Boil them, then serve warm in the pod. Pop them out of the pod to eat plain or with a low-fat dip.
3. Tofu, made of soy beans, takes on the flavor of spices and foods you cook with it. Saute cubed tofu with green and red peppers, sliced garlic, and a dash or two of curry powder. Or add tofu to soups for a healthy dose of fat-free protein.

Recipe idea: Soy milk is not just for the lactose-intolerant. Make a nutritious beverage with chocolate soy milk, a banana, and some ice for a delicious smoothie.

4)  Oatmeal

Grandma called it roughage and we need plenty of it each day. Oatmeal is one way to get it. Oats are nourishing whole grains and a great source of vitamins, minerals, and cholesterol-lowering fiber. The FDA allows manufacturers of oats to make health claims about the grain on their products, suggesting that a diet high in oats can reduce the risk for heart disease. Research shows oats lower cholesterol levels, keep you regular, and may help prevent certain cancers.

1. A warm bowl of oatmeal fills the belly for hours with its high fiber content. Top it off with fruit (such as blueberries or strawberries) for added fiber, vitamins, and minerals.
2. Add oats whenever you bake. Substitute up to one-third of the flour with oats in pancakes, muffins, quick breads, cookies, and coffee cakes for an added dose of fiber.
3. Use oats in place of bread crumbs in dishes such as meatloaf, meatballs, or breading on poultry.

Recipe idea: Make your own crunchy granola by baking three cups of oats at 350 degrees for 25 to 30 minutes. Stir occasionally, then cool and mix in a variety of chopped dried fruit, nuts, and seeds.

5) Spinach

Popeye knew firsthand the value of eating spinach. Hands down, spinach is the powerhouse of the vegetable kingdom. Its rich, dark color comes from the multiple phytochemicals, vitamins, and minerals (especially folate and iron) that also fight disease, protect against heart disease, and preserve your eyesight.

1. Keep frozen, chopped spinach in your freezer for an easy, quick addition to pizza, pasta, soups, and stews. Just defrost and squeeze the liquid from a box of chopped spinach before you toss into cooked dishes.
2. Mix fresh spinach with salad greens or alone, then top with peeled and segmented Mandarin oranges or sliced strawberries, nuts, and crumbled cheese for a satisfying and delicious salad.
3. Steam spinach, mix with garlic, a little olive oil, and a squeeze of lemon for a low-fat potato topper.

Recipe idea: Mix spinach with pine nuts and raisins, then stuff into winter squash and bake for a colorful, delicious main or side dish.