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Brings a new meaning to "coldhearted".
January 19, 2008 6:42 AM   Subscribe


 
That's mesmerizing ..thanks for the link !
posted by elpapacito at 6:53 AM on January 19, 2008 [1 favorite]


If true, this could lead to a massive shift in medicine. Great link!
posted by darkstar at 6:56 AM on January 19, 2008 [1 favorite]


At last, we will have conquered death!

No? Well, hop to it, doctors! I only have about 30 years left.
posted by Astro Zombie at 6:58 AM on January 19, 2008


At last, we will have conquered death!

posted by Astro Zombie


Heh...
posted by darkstar at 7:00 AM on January 19, 2008 [5 favorites]


Very interesting, thanks!
posted by languagehat at 7:17 AM on January 19, 2008 [1 favorite]


Thanks!
posted by RenMan at 7:26 AM on January 19, 2008 [1 favorite]


Comment: So this is what Miracle Max would call "mostly dead?"

That is one of the best comments ever.

Also: this is really interesting.
posted by dirtynumbangelboy at 7:28 AM on January 19, 2008 [1 favorite]


This is not only going to change the face of emergency care, it's going to force Hollywood to completely rewrite all those dramatic med-drama scenes.
posted by nax at 7:32 AM on January 19, 2008 [3 favorites]


http://en.wikipedia.org/wiki/Reperfusion_injury

and especially
http://en.wikipedia.org/wiki/Myocardial_infarction#Reperfusion

not to be glib, but this is nothing new. newsweek has gotta be running low on real news to halfass a story like that.
posted by Doorstop at 7:33 AM on January 19, 2008 [2 favorites]


Please don't ever link to Newsweek for a science post.
posted by rxrfrx at 7:40 AM on January 19, 2008 [4 favorites]


in addition:

- the story shouldn't be about reperfusion injury so much as it should be about the ICE SLURRY that this guy came up with. its damn nifty - a biocompatible way of decreasing body temperature without causing shock or toxic effects.

http://www.uchospitals.edu/pdf/uch_003646.pdf

http://www.uphs.upenn.edu/news/News_Releases/apr07/resuscitation-center.html
posted by Doorstop at 7:44 AM on January 19, 2008


Yeah, reperfusion injury is kind of old news.

Did you know that if your carotid artery is 99.9% blocked by plaque, a surgeon can operate on it and open it up, clean out that plaque and restore blood flow; but if it is 100% blocked, the same operation is a net harm? "Reperfusion injury" is the name we give to what happens when you do that, which is a slightly different phenomenon than what this article is talking about.
posted by ikkyu2 at 7:48 AM on January 19, 2008 [1 favorite]


A random thought: in drowning, the hearth is still providing oxygen to the cells by pumping blood but the lungs full of water have stopped providing oxygen to the blood. How long do you have to restart the lungs?
posted by francesca too at 7:49 AM on January 19, 2008


Old news or not- wow.
posted by pointilist at 7:53 AM on January 19, 2008 [2 favorites]


This non-scientist thinks this info is way cool. Thanks.
posted by GrammarMoses at 8:07 AM on January 19, 2008 [1 favorite]


not to be glib, but this is nothing new. newsweek has gotta be running low on real news to halfass a story like that.

Yeah, reperfusion injury is kind of old news.


So? This is "old news" too. Are we only allowed to post up-to-the-second, just-discovered stuff on MeFi? (In which case, of course, we're accused of "newsfilter.") The criterion is "Found something cool on the web and want to share it with everyone else? Great!" This is definitely something cool and it hasn't been on MeFi before, so great, and if you happen to already know it, by all means feel free to contribute something else to the stew, like ikkyu2 did.
posted by languagehat at 8:11 AM on January 19, 2008 [7 favorites]


Good post. A science I wasn't aware of. Thanks
posted by pearlybob at 8:18 AM on January 19, 2008 [1 favorite]


My partner seemed to think this was old news, too, but it still sounds awesome. I guess knowing that reperfusion exists and knowing how to stop it are two different things.
posted by anotherpanacea at 8:20 AM on January 19, 2008


In future I will read the last few years' worth of JAMA before posting.
posted by Pope Guilty at 8:23 AM on January 19, 2008 [15 favorites]


Neat stuff, and a great post. Every time I read about this type of discovery, I get the feeling that we're going to regret beating nature. That this will, as they say, not end well.
posted by M.C. Lo-Carb! at 8:24 AM on January 19, 2008 [1 favorite]


wasn't denying its awesomeness... i was critiquing Newsweek for overlooking the REAL story. solving a dilemma about HOW to treat the heart WITHOUT causing an ischemic event as a result. the ice slurry is the real story!!! newsweek overlooked that... hence why i posted the next two links.
posted by Doorstop at 8:25 AM on January 19, 2008


francesca too: From Wikipedia:
There are rare but documented cases of survivable submersion for extreme lengths of time. In one case a child named Michelle Funk survived drowning after being submerged in cold water for 70 minutes. In another, an 18 year old man survived 38 minutes under water. This is known as cold water drowning.
posted by weapons-grade pandemonium at 8:30 AM on January 19, 2008


I'm bringing oxy back
Them other docs don't know how to act
posted by srboisvert at 8:30 AM on January 19, 2008 [10 favorites]


Based on the article, I can't tell: Are scientists able to tell if the the mitochondria actually direct apoptosis?
Also, I know the mitochondria is the primary controller of apoptosis, but I thought it was also controlled by other extracellular signals.
posted by jmd82 at 8:32 AM on January 19, 2008


I knew that not learning how to perform CPR was actually a good thing.
posted by Dipsomaniac at 8:36 AM on January 19, 2008


Where this could really come in handy is in the treatment of strokes.
posted by delmoi at 8:38 AM on January 19, 2008


1) CPR is STILL good if administered ASAP and continued til Hospitalization.

2) Mitchondria contain the major mechanisms of cell death, but are not the only triggers in the cell. Cool news on that front is the targeting of mitochondria in the search for a "cure" for cancer.

PS - sorry i didn't make the links functional before.
posted by Doorstop at 8:46 AM on January 19, 2008 [2 favorites]


I hadn't seen this before, thanks for the post.
posted by oneirodynia at 9:17 AM on January 19, 2008


Could this help "cure" cancer?

If lack of oxygen followed by resumption of oxygen
can jumpstart the cell's defense against cancerous growth,
Might there be a way to use this technique to get the cells to destroy actual
cancer cells?

I assume it wouldn't be simple
(hey, let's make the tumor hold its breath, then we'll
slap this oxygen mask on it! Shazam! Give that orderly the
Nobel Prize!)

But, is there an obvious reason why this sounds so science- fictiony?

On preview:
Doorstop: that cure for cancer link is awesome!

In addition to restarting the mitochondria, are there other ways to reboot the oxygen in a cell?
posted by mer2113 at 9:28 AM on January 19, 2008


The problem with turning this into a cancer treatment is that this is a normal mechanism. Both cancer cells and normal cells have the same off-switch.
posted by zennie at 9:50 AM on January 19, 2008


Interesting.
Would this suggest that anti-angiogenic drugs would be more effective if administered in a "on-off" cycle?
posted by Hutch at 9:50 AM on January 19, 2008


The article focussed on the way that heart cells respond to oxygen, but the big problem, as I understand it, is the way the brain deals with oxygen starvation. I'm not a doctor (obviously) but I was under the impression that nerve cells extinguished rapidly when their oxygen supply was removed.
posted by lekvar at 10:18 AM on January 19, 2008


Exactly lekvar. that's why they use the heart/lung machine to keep oxygen supply to the brain-- it's all well and good to save the heart but not much use if the brain is dead.

this is why CPR is still necessary.
posted by Maias at 10:38 AM on January 19, 2008


To get oxygen back don't you have to have a lack of it in the first place?
posted by juiceCake at 11:27 AM on January 19, 2008


(RE: mer2113's post: the random hard line breaks make it look like some sort of weird science extemporaneous poetry.)
posted by caution live frogs at 11:31 AM on January 19, 2008 [1 favorite]


Both cancer cells and normal cells have the same off-switch.

With the main problem being that cancer cells turn off that switch, which is why reactivating the mighty mitochondria works is some cases and has potential to do bigger and better things. And I didn't know that drug had no patent so it should be available cheaply. Sweet.

To get oxygen back don't you have to have a lack of it in the first place?

Basically. Transfer of O2/CO2 mainly occurs by diffusion.
posted by jmd82 at 11:52 AM on January 19, 2008


A random thought: in drowning, the hearth is still providing oxygen to the cells by pumping blood but the lungs full of water have stopped providing oxygen to the blood. How long do you have to restart the lungs?

Depends: if you don't mind being a vegetable/organ-donor, you've got a fairly long time if the water is cold -- CPR is still indicated even after 30 or 45 minutes according to some guidelines. However, if you're talking about complete recovery without permanent brain damage, it's a lot less, maybe 5-7 minutes at the outside.
posted by Kadin2048 at 12:44 PM on January 19, 2008


This is a bit off the topic but I had to vent. In Doorstop's link is this:

DCA can cause pain, numbness and gait disturbances in some patients, but this may be a price worth paying if it turns out to be effective against all cancers. The next step is to run clinical trials of DCA in people with cancer. These may have to be funded by charities, universities and governments: pharmaceutical companies are unlikely to pay because they can’t make money on unpatented medicines. The pay-off is that if DCA does work, it will be easy to manufacture and dirt cheap.

GRRARRGH!!! THE HATE, IT HURTS SO GOOD!
posted by JHarris at 1:41 PM on January 19, 2008


JHarris - Welcome to my miserable future profession.

The GOOD side to that the fact that it is so cheap and unable to be patented is that, once clinical trials ARE finished, these drugs will be provided for next to nothing and be available in huge quantities!

Also, if pharmaceuticals knew what was good for their own profit, they would realize that there IS money in preventive medicine, and that there are ways to make a killing off helping the little guy without making him pay through the nose. Unfortunately, I don't believe any of them are going to change their minds any time soon.

Actually, if anyone has any good articles on HOW preventive medicine is profitable for everyone, I would be very interested in them. I honestly don't have much info to back up my claim - just a lecture I had over a year ago...
posted by Doorstop at 1:58 PM on January 19, 2008


There are several different ways to quickly chill a person for this kind of therapy. When my dad went into cardiac arrest last year, it took the EMTs almost half an hour to get his heart started again before they could even bring him to the ambulance. Once he was in the ER, they hooked him up to an Arctic Sun machine. It consists of some pretty amazing cooled-gel pads that fit around the thighs and torso. They kept his body temperature at 33 degrees C for 24 hours, and then gradually warmed him back up over the course of another day. Despite many doctors telling us that people just don't come back after what he went through, he made it and is fully recovered. It's awesome, and even the doctors who knew enough to initiate the hypothermic treatment are astounded. The ER docs, the cardiologists, the neurologists... They're all astounded. So, yeah, it's old-ish news, but still really freaking cool.

There's a video here about using induced hypothermia to treat strokes, too.
posted by vytae at 2:56 PM on January 19, 2008 [3 favorites]


Yeah! Totally! Reperfusion injury = OFN. Have you been under a rock?!

News to me.
posted by danherwig at 3:56 PM on January 19, 2008




ooops... sorry about that broken html tag
posted by Sam.Burdick at 4:24 PM on January 19, 2008


Lynn Margulis' (and others') perbrilliant insight that mitochondria were originally free-living aerobic microorganisms that developed a symbiotic relationship with other, larger, otherwise anaerobic microorganisms to give rise to what we now think of as eukaryotic cells (of which we and other 'higher' life forms are composed) may offer a slightly different perspective on their role in both reperfusion injury and apoptosis.

Mitochondria are now completely dependent on the cells which contain them because many of their genes have migrated to the nucleus of those cells, but originally they must have retained the capacity to live freely, as well. If those cells were to be injured or were to move or be carried into a region where there was too little available oxygen for the mitochondria to live or reproduce or even to be useful to the larger cell, the ability to kill that cell and try their luck elsewhere would have been strongly selected for. From this perspective, killing the cells that contain them in the cases of apoptosis and reperfusion injury could be seen as an aspect of the retention of that primordial ability.

In the case of apoptosis, the mitochondria might kill the cell when it's nearly used up its telomeres (the Hayflick limit) or the cell is injured by a toxin, or when a cell of the immune system somehow signals them to.

In reperfusion injury, the fact that the mitochondria wait until oxygen is restored to kill the cell is particularly interesting, because that would have been the best strategy in the primordial situation. The mitochondria, as obligate aerobes, would only have had a chance of surviving and moving on in a high-oxygen environment.
posted by jamjam at 1:06 AM on January 20, 2008 [2 favorites]


A random thought: in drowning, the hearth is still providing oxygen to the cells by pumping blood but the lungs full of water have stopped providing oxygen to the blood. How long do you have to restart the lungs?

If you're drowning in fresh water it's the hypervolemia that'll getcha. (water in lungs enters blood = bad for brain)
posted by sero_venientibus_ossa at 12:06 PM on January 20, 2008


Hypoxia is being used in cancer treatments in other ways too. Large portions of solid tumours are hypoxic due to the chaotic nature of their blood supply. Unfortunately the hypoxic parts are very resistant to both chemotherapy and radiotherapy and are linked with a more malignant phenotype (e.g. more aggressive and more likely to spread). This is linked at least in part to similar biochemical pathways described here. You only need to leave a very small amount of the tumour behind for it to repopulate and having it regrow from a core of drug resistant cells is, obviously, a bad thing.

So a group I used to work for is developing drugs which are targeted to the hypoxic regions of the tumours (one is entering phase 2, the rest are earlier in the development pathway). These drugs are administered as non-toxic compounds and (according to their proposed mechanism) remain so in oxygenated parts of the body. However they become converted to a cytotoxic chemical in the absence of oxygen (using enzymes found naturally in the body) thus killing only very hypoxic cells. Since the only cells in the body with this very low level of oxygen are found within tumours, the drug becomes targeted and theoretically has very low toxicity elsewhere. Plus the drug happens to be attacking the hardest to kill and most aggressive cancer cells.

Personally I will be interested to see how DCA copes with severely hypoxic cancer cells and how well it would combine with a hypoxia activated drug. I've been out of the cancer field for a couple of years now (hopfully temporarily) but have been following the DCA story with interest.
posted by shelleycat at 2:43 PM on January 20, 2008


Was news to me when I read it in Newsweek a few months ago. All medical professionals I've mentioned it to have scoffed, which shows the state of medicine today...
posted by gjc at 3:48 PM on January 20, 2008


Was news to me when I read it in Newsweek a few months ago. All medical professionals I've mentioned it to have scoffed, which shows the state of medicine today...

My stepdad's a doctor, and he thinks the whole thing is super-nifty and going to revolutionise how this sort of thing is treated. 'Course, he's one of those optimist types. :)
posted by Pope Guilty at 1:55 PM on January 22, 2008


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