Tag Archives: Tissue (biology)

Chemotherapy

Definition:
Chemotherapy is a medical treatment that is needed in order to stop cancer cells from growing and its tracks. Chemotherapy is extremely effective in treating cancer. It is even more effective when it is used with other treatments like radiotherapy. It is also sometimes needed to relief the symptoms, and it is design to give a longer life by causing the disease to go into remission-the stage in which there are no active symptoms.  Chemotherapy works differently than surgery or radiotherapy – two other treatments designed to fight against the cancer as well. Chemotherapy drugs travel throughout the whole body. This is important because it allows the durgs to reach part of the body where the cancer cells may have spread out. In combination with surgery means that fewer surgical procedures need to be done. Follow-up surgery can often be avoided if chemotherapy is used.

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On the other hand, radiation therapy, or radiotherapy, is the use of high energy rays to treat such disease. Is it very important to know that radiation causes damage to cancer cells, so they stop growing. With each treatment, more of the cells die and the tumor shrinks. The dead cells break down and are carried away by the blood, eventually passing out of the body. Normal cells that are also exposed to the radiation process start to repair themselves afterwards, and the process lasts just a few hours. You might be concerned that radiation hurts, but is actually quite painless. Also, in case you are wondering, the radiation gets into your body and then passes out -it does not cause you to become radioactive.

To understand how chemotherapy works, it is helpful to know some basics about the cells of the body. Everything in your body is made up of cells. A group of cells is called tissue and tissues make up all the organs, the major structures of your body. Tissue stays healthy because cells grow and reproduce, new cells replace the ones that are damaged because of injury. This means that a combination of drugs may be used to attack cancer cells so that each drug can attack the cells in a different phase.

Cancer is a disease in which abnormal cells in the body grow and multiply at a very high rate. There are more than 100 specific types of cancer cells. Cancer also may involve the spread of abnormal cells around the body. Normal cells in our body grow, divide, and die in a way that maintains health and does not damage the body. A majority for the cancer cases are due to age issues because of the fact that in adulthood your cells divide only to replace worn-out or dying cells, or in other cases, to repair injuries. Cells make up all living tissue and stronger throughout your childhood. But cancer cells continue to grow and divide, even though they are no serving in any of the vital functions, and can spread to other parts in the body. These cells clump together and form tumors (lumps) that may destroy normal tissue. If cells break off from a tumor, they can travel  throughout the blood stream or the lymphatic system. When they settle in and grow; eventually, forming other tumors. When a tumor spreads out to a new place, it is called metastasis. Even when cancer spreads, it’s called by the name of the body where it originally started and developed. Leukemia, a type of cancer growing, does not usually form a tumor, it is an exception to the rule. The cancer cells get into the blood and the organs that make blood bone narrow, then they circulate through other tissues, where they eventually develop and grow.

Chemotherapy damages cancer cells, but it also can damage normal cells. Damage to these cells is what causes the side effects of chemotherapy treatment. For instance normal cells that divide quickly, such as blood cells and the cells of hair follicles, are more likely to be damaged by chemotherapy medications. In other words, in healthy cells the damage does not last, and many only happen on the days you are actually taking the drugs. Chemotherapy is usually given is several cycles. Depending on the drug and combination, it may last to a few hours, days, or weeks.

How Chemotherapy Is Given
Just as other medicines can be taken in various forms, there are several ways to get chemotherapy. In most cases, it’s given intravenously into a vein, also referred to as an IV. An IV is a tiny tube inserted into a vein through the skin, usually in the arm. The IV is attached to a bag that holds the medicine. The chemo medicine flows from the bag into the vein, which puts the medicine into the bloodstream. Once the medicine is in the blood, it can travel through the body and attack cancer cells.

Sometimes, a permanent IV called a catheter is placed under the skin into a larger blood vessel of the upper chest. That way, a child can get chemotherapy and other medicines through the catheter without having to always use a vein in the arm. The catheter remains under the skin until all the cancer treatment is completed. It can also be used to obtain blood samples and for other treatments, such as blood transfusions, without repeated needle sticks.

Chemo also can be:

•taken as a pill, capsule, or liquid that is swallowed
•given by injection into a muscle or the skin
•injected into spinal fluid through a needle inserted into a fluid-filled space in the lower spine (below the spinal cord)

Chemotherapy is sometimes used along with other cancer treatments, such as radiation therapy, surgery, or biological therapy (the use of substances to boost the body’s immune system while fighting cancer).

Lots of kids and teens receive combination therapy, which is the use of two or more cancer-fighting drugs. In many cases, combination therapy lessens the chance that a child’s cancer will become resistant to one type of drug — and improves the chances that the cancer will be cured.

When and Where Chemotherapy Is Given
Depending on the method used to administer chemotherapy, it may be given at a hospital, cancer treatment center, doctor’s office, or at home. Many kids receive chemotherapy on an outpatient basis at a clinic or hospital. Others may need to be hospitalized to monitor or treat side effects.

Kids may receive chemotherapy every day, every week, or every month. Doctors sometimes use the term “cycles” to describe a child’s chemotherapy because the treatment periods are interspersed with periods of rest so the child can recover and regain strength.

Dosage :
Dosage of chemotherapy can be difficult: If the dose is too low, it will be ineffective against the tumor, whereas, at excessive doses, the toxicity (side effects, neutropenia) will be intolerable to the patient. This has led to the formation of detailed “dosing schemes” in most hospitals, which give guidance on the correct dose and adjustment in case of toxicity. In immunotherapy, they are in principle used in smaller dosages than in the treatment of malignant diseases.

In most cases, the dose is adjusted for the patient’s body surface area, a measure that correlates with blood volume. The BSA is usually calculated with a mathematical formula or a nomogram, using a patient’s weight and height, rather than by direct measurement.

Side Effects:
Although chemo often effectively damages or eliminates cancer cells, it also can damage normal, healthy cells. And this can lead to some uncomfortable side effects.

The good news is that most side effects are temporary — as the body’s normal cells recover, the side effects gradually go away.

Cancer treatment is multifaceted — that is, patients receive a lot of care (i.e., fluid and nutrition support, transfusion support, physical therapy, and medicines) to help them tolerate the treatments and treat or prevent side effects such as nausea and vomiting.

It’s difficult to pinpoint which side effects a  patient might experience, how long they’ll last, and when they’ll end.

The common side effects are:
1.Fatigue
2.Discomfort and Pain
3.Skin Damage or Changes
4.Hair Loss and Scalp Sensitivity
5.Mouth, Gum, and Throat Sores
6.Gastrointestinal Problems

Other side effects are:
•Anemia
•Blood Clotting
•Increased Risk of Infection

Chemo may cause a reduction in white blood cells, which are part of the immune system and help the body to fight infection. Therefore,  the patient  is more vulnerable to developing infections during and after chemo.

•Long-Term Side Effects
Chemotherapy can cause long-term side effects (sometimes called late effects), depending on the type and dose of chemotherapy and whether it was combined with radiation. These effects may involve any organ, including the heart, lungs, brain, kidneys, liver, thyroid gland, and reproductive organs. Some types of chemotherapy drugs may also increase the risk of cancer later in life. Receiving chemo during childhood also may place some kids at risk for delayed growth and cognitive development, depending on the child’s age, the type of drug used, the dosage, and whether chemotherapy was used in addition to radiation therapy.

Newer anticancer drugs act directly against abnormal proteins in cancer cells; this is termed targeted therapy and is technically not chemotherapy.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://englendd.wordpress.com/2011/06/05/chemotherapy/
http://kidshealth.org/parent/system/ill/chemotherapy.html#
http://en.wikipedia.org/wiki/Chemotherapy

http://medicineworld.org/cancer/lead/11-2008/concurrent-chemotherapy-in-lung-cancer.html

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Dupuytren’s contracture

Definition:
Dupuytren’s contracture is a painless thickening and contracture of tissue beneath the skin on the palm of the hand and fingers.
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It is  a disease of the palmar fascia (thin but tough layer of fibrous tissue between the skin of the palm and the underlying flexor tendons of the fingers) resulting in progressive thickening and contracture of fibrous bands on the palmar surface of the hand and fingers.  Fasciitis implies inflammation of the fascia, and contracture implies thickening and tightening of the diseased fascia.  Basically, the tissue on the palm side of the hand thickens (can become as thick as 0.5cm) and essentially “shrinks” and produces a tightness in the area of the hand which the diseased tissue overlies.  It occurs most often in the fourth and fifth digits (ring and small fingers).  It is a very common problem and often arises in the hands of middle aged persons;  however, it can be seen as early as the twenties.  This entity does run in families in some cases.  It is seven times more common in men than women.  It has been associated with diabetes and can be seen in alcoholics with cirrhosis of the liver.  It has also been associated with epilepsy but may be a result of the use of anticonvulsant drugs rather than the presence of epilepsy itself.  The underlying cause is unknown.

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Dupuytren contracture varies in its rate of progression from minor skin puckering for many years to rapid contracture (fixed flexed position) of fingers.

People of northern European descent are more often affected and it can run in families. Men are affected more often than women and the condition is most likely to occur over the age of 40.

Causes:
The cause is unknown, but minor injury and your genes may make you more likely to develop this condition. It can run in families. It’s not caused by a person’s type of job or work environment, manual work or vibrating tools.

One or both hands may be affected. The ring finger is affected most often, followed by the little, middle, and index fingers.

A small, painless nodule develops in the connective tissue on the palm side of the hand and eventually develops into a cord-like band. In severe cases, it’s difficult or even impossible to extend the fingers.

The condition becomes more common after the age of 40. Men are affected more often than women. Risk factors are alcoholism, epilepsy, pulmonary tuberculosis, diabetes, and liver disease.

Symptoms:
Dupuytren contracture initially may cause only a minor painless lump in the palm of the hand near the base of the finger(s). Dupuytren contracture most commonly affects the ring (fourth) finger, but it can affect any and all fingers.Pain and the position of the fingers may make it difficult to perform everyday activities with the hand.The appearance of the deformity can cause distress.Dupuytren contracture can also affect one or both hands.

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Dupuytren contracture is seldom associated with much, if any, pain unless the affected fingers are inadvertently forcefully hyperextended.

The ring finger is affected most often, although any finger can be involved. In 50 per cent of cases both hands are affected. It can affect the toes and soles of the feet, but this is rare.

Diagnosis:
Dupuytren’s contracture is diagnosed by the doctor during the physical examination of the affected hand.

A physical examination of the palm by touch (palpation) confirms the presence of thickened scar tissue (fibrosis) and contracture. Restriction of motion is common.

Previous burns or hand injury can lead to scar formation in the palm of the hand which can mimic true Dupuytren contracture.

Treatment:
Often, treatment isn’t needed if the symptoms are mild. Exercises, warm water baths, or splints may be helpful.

If normal hand function is affected, surgery is usually recommended to release the contracture and improve the hand’s function.

There are three main surgical options:
•Open fasciotomy – opening the skin and cutting the thickened tissue
•Needle fasciotomy – pushing a needle through the skin to cut the thickened tissue
•Open fasciectomy – cutting open the skin and removing the thickened tissue

Prognosis: The disorder progresses at an unpredictable rate. Surgical treatment can usually restore normal movement to the fingers. The disease can recur following surgery in some cases.

Prevention:
Since the precise cause of Dupuytren’s contracture is unknown, it’s difficult to prevent.
Awareness of risk factors may allow early detection and treatment.
Avoiding excessive intake of alcohol may help to reduce the risk of it developing in susceptible individuals.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/dupuytrens1.shtml
http://www.med.und.edu/users/jwhiting/dupdef.html
http://www.nlm.nih.gov/medlineplus/ency/article/001233.htm
http://www.medicinenet.com/dupuytren_contracture/article.htm

http://www.prlog.org/10501551-who-first-described-dupuytrens-contracture.html

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Foe Turns Friend

A-beta, a protein implicated in Alzheimer’s, may be the brain’s shield against germs.
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For years, a prevailing theory has been that one of the chief villains in Alzheimer’s disease has no real function other than as a waste product that the brain never properly disposed of.

The material, a protein called beta amyloid, or A-beta, piles up into tough plaques that destroy signals between nerves. When that happens, people lose their memory, their personality changes and they stop recognising friends and family.

But now researchers at Harvard suggest that the protein has a real and unexpected function — it may be part of the brain’s normal defences against invading bacteria and other microbes.

Other Alzheimer’s researchers say the findings, reported in the current issue of the journal PLoS One, are intriguing.

The new hypothesis got its start late one Friday evening in the summer of 2007 in a laboratory at Harvard Medical School. The lead researcher, Rudolph Tanzi, a neurology professor who is also director of the genetics and aging unit at Massachusetts General Hospital, said he had been looking at a list of genes that seemed to be associated with Alzheimer’s disease.

To his surprise, many looked just like genes associated with the so-called innate immune system, a set of proteins the body uses to fight infections. The system is particularly important in the brain, because antibodies cannot get through the blood-brain barrier, the membrane that protects the brain. When the brain is infected, it relies on the innate immune system to protect it.

That evening, Tanzi wandered into the office of a junior faculty member, Robert Moir, and mentioned what he had seen. As Tanzi recalled, Moir turned to him and said, “Yeah, well, look at this.”

He handed Tanzi a spreadsheet. It was a comparison of A-beta and a well-known protein of the innate immune system, LL-37. The likenesses were uncanny. Among other things, the two proteins had similar structures. And like A-beta, LL-37 tends to clump into hard little balls.

In rodents, the protein that corresponds to LL-37 protects against brain infections. People who make low levels of LL-37 are at increased risk of serious infections and have higher levels of atherosclerotic plaques, arterial growths that impede blood flow.

The scientists could hardly wait to see if A-beta, like LL-37, killed microbes. They mixed A-beta with microbes that LL-37 is known to kill — listeria, staphylococcus, pseudomonas. It killed eight out of 12. “We did the assays exactly as they have been done for years,” Tanzi said. “And A-beta was as potent or, in some cases, more potent than LL-37.”

Then the investigators exposed the yeast Candida albicans, a major cause of meningitis, to tissue from the hippocampal regions of brains from people who had died of Alzheimer’s and from people of the same age who did not have dementia when they died.

Brain samples from Alzheimer’s patients were 24 per cent more active in killing the bacteria. But if the samples were first treated with an antibody that blocked A-beta, they were no better than brain tissue from non-demented people in killing the yeast.

The innate immune system is also set in motion by traumatic brain injuries and strokes and by atherosclerosis that causes reduced blood flow to the brain, Tanzi noted.

And the system is spurred by inflammation. It’s known that patients with Alzheimer’s have inflamed brains, but it hasn’t been clear whether A-beta accumulation was a cause or an effect of the inflammation. Perhaps, Tanzi said, A-beta levels rise as a result of the innate immune system’s response to inflammation; it may be a way the brain responds to a perceived infection. But does that mean Alzheimer’s disease is caused by an overly exuberant brain response to an infection?

That’s one possible reason, along with responses to injuries and inflammation and the effects of genes that cause A-beta levels to be higher than normal, Tanzi said. However, some researchers say that all the pieces of the A-beta innate immune systems hypothesis are not in place.

Dr Norman Relkin, director of the memory disorders programme at New York-Presbyterian / Weill Cornell hospital, said that although the idea was “unquestionably fascinating”, the evidence for it was “a bit tenuous”.

As for the link with infections, Dr Steven DeKosky, an Alzheimer’s researcher at the Virginia School of Medicine, noted that scientists have long looked for evidence linking infections to Alzheimer’s and have come up mostly empty handed.

But if Tanzi is correct about A-beta being part of the innate immune system, that would raise questions about the search for treatments to eliminate the protein from the brain.

“It means you don’t want to hit A-beta with a sledgehammer,” Tanzi said.

But other scientists not connected with the discovery said they were impressed by the new findings. “It changes our thinking about Alzheimer’s disease,” said Dr Eliezer Masliah, who heads the experimental neuropathology laboratory at the University of California, San Diego.

Source : New York Times News Service

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Umbilical Hernia

Definition :
An umbilical hernia is an outward bulging (protrusion) of the abdominal lining or part of the abdominal organ(s) through the area around the belly button

 

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An umbilical hernia is a protrusion of the peritoneum and fluid, omentum, or a portion of abdominal organ(s) through the umbilical ring. The umbilical ring is the fibrous and muscle tissue around the navel (belly-button). Small hernias usually close spontaneously without treatment by age 1 or 2. Umbilical hernias are usually painless and are common in infants.

UMBILICAL Hernias, and nearby hernias called “Paraumbilical Hernias” develop in and around the area of the umbilicus (belly button or navel). A Congenital (present since birth) weakness in the naval area exists. This was the area at which the vessels of the fetal and infant umbilical cord exited through the muscle of the abdominal wall. After birth, although the umbilical cord disappears (leaving just the dimpled belly-button scar), the weakness underneath may persist. Hernias can occur in this area of weakness at any time from birth through late adulthood. The signs and symptoms include pain at or near the navel area as well as the development of an associated bulge or navel deformity. This bulge pushes out upon the skin beneath or around the navel, distorting the normal contour and architecture in or around the navel (creating an ‘OUTIE’ instead of a normal ‘INNIE‘).
Although often appearing at or just after birth, these hernias can also occur at any time during later life. In INFANTS, these hernias may gradually close by age 3 or 4 and surgery can often be delayed until then, unless the hernias are causing problems or enlarging. This decision should be made after examination by a Pediatrician or skilled Surgeon. In ADULTS however, umbilical hernias cannot “heal”, and do gradually increase in size and often become problematic. Incarceration or Strangulation may occur….CLICK & SEE

Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. An Acquired umbilical hernia directly results from increased intra-abdominal pressure and are most commonly seen in obese individuals.

Causes:

Children:
Umbilical hernias are fairly common. Such a hernia is obvious at birth, as it pushes the belly button outward. This is more obvious when the infant cries, becauses increased pressure results in more noticable bulging.

In infants, the defect is not usually treated surgically. In most cases, by age 3 the umbilical hernia shrinks and closes without treatment.

Umbilical hernia repair may be necessary for children for the following reasons:

*The herniated tissue is stuck in the protruding position, or if blood supply is affected
*The defect has not closed by age 3 or 4
*The defect is very large or unacceptable to parents for cosmetic reasons
*An umbilical hernia in an infant occurs when the muscle through which blood vessels pass to feed the developing fetus doesn’t close completely.

Adults:
Umbilical or para-umbilical hernias are relatively common in adults. They are more common in overweight people and in women, especially after pregnancy. Most surgeons recommend they be surgically repaired, as they tend to get bigger ov

Without surgery, there is a risk that some abdominal contents, typically a bit of fat or intestine, will get stuck (incarcerated) in the hernia defect and become impossible to push back in, which is typically painful. If the blood supply is compromised (strangulation), urgent surgery is needed.

Incarcerated abdominal tissue may cause nausea, vomiting, and abdominal distension.

Any patient with a hernia that cannot be reduced, or pushed back in, while lying down and relaxed should seek urgent medical attention.

Symptoms
A hernia can vary in width from less than 1 centimeter to more than 5 centimeters.

There is a soft swelling over the belly button that often bulges when the baby sits up, cries, or strains. The bulge may be flat when the infant lies on the back and is quiet.

Risks Factors:
Risks for any anesthesia include the following:
*Strangulation of bowel tissue is rare but serious, and needs immediate surgery.
*Reactions to medications
*Breathing problems, pneumonia
*Heart problems

Risks for any surgery include the following:
*Bleeding
*Infection
*Risks specific to umbilical hernia surgery include injury to bowel, which is rare.

Diagnosis:
The doctor can find the hernia during a physical exam.

Treatment
Usually, no treatment is needed unless the hernia continues past age 3 or 4. In very rare cases, bowel or other tissue can bulge out and lose its blood supply (become strangulated). This is an emergency needing surgery.

Most umbilical hernia repairs are done on an outpatient basis, but some may require a short hospital stay if the hernia is very large. After surgery, the patient’s vital signs are monitored and he or she will remain in the recovery area until stable. Medication is supplied for pain as necessary. Patients, or parents if the patient is a child, are taught to care for the incision at home. Full activity can be resumed in 2-4 weeks.

Prognosis:

Most umbilical hernias get better without treatment by the time the child is 3 – 4 years old. Those that do not close may need surgery. Umbilical hernias are usually painless.

Expect successful repair of the hernia. The long-term prognosis is excellent. Very rarely the hernia will recur. Recurrence is more common if a larger hernia (more than 3 cm) is repaired without a mesh.

Recovery
Most umbilical hernia repairs are done on an outpatient basis, but some may require a short hospital stay if the hernia is very large.

After surgery, the health care team will monitor the patient’s vital signs. The patient will stay in the recovery area until stable. Pain medication is prescribed as needed.

Patients, or parents if the patient is a child, are taught to care for the surgical cut at home. Full activity can be resumed in 2-4 weeks.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://hernia.tripod.com/types.html
http://www.nlm.nih.gov/medlineplus/ency/article/000987.htm
http://www.nlm.nih.gov/medlineplus/ency/article/002935.htm
http://en.wikipedia.org/wiki/Umbilical_hernia

Steps on Enlarged Heart ‘Uncovered’

Researchers in the US claim to have got new insight into the mechanisms that underlie an enlarged heart — a finding that could lead to development of new treatment for managing this common cardiac ailment.

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An enlarged heart can lead to heart failure (Image: CNRI, Science Photo Library)

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According to them, high blood pressure, heart valve disease and heart attacks can lead to a abnormal thickening of the heart muscle, called myocardial hypertrophy, which plays a role in the pathological increase in the heart size.

At the molecular level, signals driving myocardial hypertrophy, like elevated levels of catecholamine hormones, activate the Myocyte Enhancer Factor (MEF) proteins. This alters gene expression in heart muscle cells and induces an adverse developmental paradigm known as “fetal gene response”.

“Previous research has shown that the signalling pathways leading to MEF2 are altered during pathological cardiac hypertrophy. Although we know that enzymes called histone deacetylases (HDACs) control MEF2 activity, it was not clear that HDACs and MEF2 were integrated into a larger signalling unit,” lead author John D Scott said.

To further identify the molecular mechanisms associated with cardiac hypertrophy, Scott and colleagues at the University of Washington studied cardiac A-Kinase Anchoring Proteins (AKAPs), which are known to play a critical role in organising signalling complexes in response to catecholamine hormones and transmitted signals within cells.

The researchers found that AKAP-Lbc functions as a scaffolding protein that selectively directs catecholamine signals to the transcriptional machinery to potentiate the hypertrophic response, the ‘Cell Press‘ journal reported.

“Our study supports a model where AKAP-Lbc facilitates activation of protein kinase D, which in turn phosphorylates the histone deacetylase HDAC5 to promote its export from the nucleus. The reduction in nuclear HDAC5 favoured MEF2 transcription and onset of cardiac hypertrophy,” Scott said.

Sources: The Times Of India

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