The Salina Journal from Salina, Kansas on May 4, 2001 · Page 5
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The Salina Journal from Salina, Kansas · Page 5

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Friday, May 4, 2001
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-THE SAUNA JOURNAL HEALTH FRIDAY, MAY 4, 2001 AB I T BONE MARROW CELLS Stem cells yield surprises Latest research shows bone marrow cells may start growth of organs By DANIEL Q. HANEY The Associated Press BOSTON — Some surprisingly versatile bone marrow cells can transform themselves into building blocks of lungs, intestines, skin and probably most other parts of the body, raising the possibility of a rich and accessible source of spare parts, new animal research suggests. The findings are the latest in the fast-moving field of stem cell research, which almost weekly produces fresh insights into the elusive cells the body uses to build and repair itself. The blood, the brain and many other parts of the body have their own specialized stem cells that can make replacement cells when existing ones are damaged or die off. However, the emerging research shows some of these stem cells are amazingly adaptable, able to generate an assortment of seemingly unrelated types of cells. The latest of these' is a marrow stem cell investigators say is the closest adult cell yet to the primordial stem cells found in embryos. Drs. Diane Krause of Yale and Neil Theise of New York University discovered that just one bone marrow stem cell, impiant- • STROKE TREATMENT ed in a mouse, eventually gives rise to new cells all through the creature's body The researchers said they expect the same will prove true for humans. "This opens entirely new avenues of research and changes what we understood about stem cells," krause said. The research is published in today's issue of the journal CeU. Bone marrow stem cells were the first known adult stem cells. Until recently, experts believed they produced only new blood cells. Two years of experiments However, experiments over the past two years have shown marrow stem cells can make cells that are incorporated into the liver, heart, bones and muscle, among other things. Still, no one knew if a single kind of marrow stem cell could make all of these things, or whether the marrow hid stem cells that specialized in each body part. The new research suggests that indeed one basic stem cell is able to make all of these things. To prove this, the researchers, working with Dr. Saul Sharkis of Johns Hopkins University, purified stem cells from the marrow of male mice. Then they took single copies of these cells and transplanted one apiece into 30 female mice whose marrow had been destroyed by radiation. Eleven months later, the researchers scanned the five sur- Until now... the only known stem cells multitalented enough to produce such an army of tissue are those found in early embryos. Those cells give rise to the entire human body. viving females for tissue that grew from that one cell. It was easy to find, because each of the male-derived cells contained a Y chromosome — something females lack. As expected, the females had male-derived blood. But doctors were astonished to find females also had male-derived cells throughout their lungs, all along their gastrointestinal tracts and in their skin, Krause said. If the marrow stem cells truly work as the latest research suggests, they could have many uses for making and repairing organs. Krause said giving people extra doses of the stem cells grown from their body's own supply might hasten the repair of damaged organs. Or it may be possible to trigger stem cells already in the marrow to do this. Until now, the researchers said, the only known stem cells multitalented enough to produce such an array of tissue are those found in. early embryos. Those cells give rise to the entire human body "There is a resting stem cell in the bone marrow that has all the potential of an embryonic stem cell," Theise said. However, Dr. Evan Snyder, who studies brain stem cells at Boston's Children's Hospital, said this point is yet to be proven beyond doubt. "Whether these are really the adult version of embryonic cells we don't know," he said. The issue is especially sensitive because experimentation with embryonic stem cells is so controversial. They are derived from leftover embryos destined to be discarded after test-tube fertilization, and abortion opponents say it is wrong to use them for research. Snyder and others cautioned that the latest discovery should not be used to argue against continuing research with the embryonic stem cells. "Everything that comes out raises new questions and questions previous answers," Snyder said. "To cut off any avenue of investigation would be unfortunate and shortsighted and premature." Blacks may get short end of the stick i Study finds whites imore likely to get key ; stroke treatment ; By The Associated Press I DALLAS — Whites are five I times more likely than blacks I to receive emergency clot-bust- I ing treatment for stroke, re; searchers found. ; Only 1.1 percent of blacks re; ceived the drug TEA in a study ! of the, nation's top hospitals, ; compared with 5.3 percent of ; whites. Researchers said a large I racial; disparity,persisted even 1 after they took into account i age, gender, type of insurance ; and severity of the stroke. ir SENIOR CARE One of the study's authors. Dr. S. Claiborne Johnston, said more research is required to learn why treatment differs by race. "We have to consider the possibility that racism is contributing," said Johnston, assistant professor of neurology at the University of California at San Francisco. In general, researchers found low overall use of TEA — the only Food and Drug Administration-approved clot-buster for strokes caused by blood clots. Among aU patients who arrived at the hospital within two hours of the onset of symptoms, fewer than a quarter received the drug. The study was published in the May issue of the American Heart Association journal Stroke. A stroke is a lack of blood flow that kills brain tissue. Strokes are occasionally caused by a burst blood vessel. But most are ischemic strokes, which happen when arteries feeding the brain are blocked by a clot. TEA has revolutionized is­ chemic stroke care. But the drug must be given within three hours of the first symptoms. It raises the risk of bleeding in the brain — an effect that makes some doctors reluctant to use it. In the new study, researchers reviewed records at 42 U.S. academic medical centers of 1,195 ischemic stroke patients treated in 1999. Even among the 189 patients considered good candidates for TEA — those who arrived at the hospital within three hours and had no other conditions that made treatment unsafe — whites were three times more likely than blacks to get the drug. No blacks were documented as having refused the drug, while three whites were. Johnston said if race is a factor, it is a subtle one. He said other studies have shown that blacks are more likely to decline risky medical treatments. "I think doctors internalize that. Because of that, they may not be offering the drug to African-Americans as frequently, thinking that they may not accept the risk," Johnston said. T ELDERLY CARE Experts search for hip solution Broken hips for older Americans often start of more trouble By The Associated Press WASHINGTON — For thousands of elderly Americans every year, a broken hip is not just a painful inconvenience but the start of a downward spiral toward death. Medical experts now are searching for ways to improve the survival rate. This scenario happens more than 340,000 times a year in America: an elderly person falls, breaks a hip, and life is changed forever. One in four such patients die within a year About four percent don't survive the first hospital treatment, usually dying of pneumonia. For those who make it to rehabilitation, about half never recover the ability to walk alone. About 40 percent must move into a long-term care facility. It is, says Dr Allen Morris, a St. Louis orthopedic surgeon, a grim picture for the nation's elderly and a shameful record for the U.S. health-care system. Nearly epidemic "This is a near-epidemic type of situation," said Morris. "The problem is a matter of money and a problem with the system." Right now, the direct and indirect costs of hip fractures in the United Sates is about $12.6 billion a year With the graying of America, the number of fractures is expected to reach more than 650,000 by the year 2050, and the cost will more than double. Morris, representing the American Academy of Orthopedic Surgeons, is co-chairman of a conference of 40 national health organizations meeting this week in Washington to draw up apian to revolutionize the way elderly hip fracture patients are treated in the United States. Among the issues being studied by the group: • Federal Medicare funding now severely limits the days a hip fracture patient can spend in the hospital. Often a patient must leave before he or she is ready Often, no effort is made for a smooth transition of care — from the hospital to a rehabilitation center or a nursing home. Filling the cracks "These patients often fall through the cracks and don't get the care they need," Morris said. This is one reason so many die in the first year, he said. • Many patients are denied access to federally funded rehabilitation facilities because they fail to meet the minimum physical standards. Morris said to be admitted to such centers, patients must be strong enough to perform three hours of rehab exercises a day "For many frail hip-fracture patients, three hours is simply more than they can do, so that rehab care is de­ nied'them," he said. • Frevention measures are not being addressed sufficiently. Health-care givers need to do more to prevent and control osteoporosis. Stronger bones would mean fewer broken hips. • Morris said the elderly should be more closely screened for the tendency to fall. Such screening is frequently ignored, he said. Once a patient is evaluated, then there are ways to limit the risk of falls. • Find ways to improve the quality of life for the patients and their families. • Address the psychological changes from the effects of a hip fracture. "The sudden loss of freedom is devastating to a person psychologically," Morris said. "The incidence of depression is extraordinarily high among these people because of the sudden changes in environment and the loss of independence." ljustices give seniors more health-care power i Seniors with Medicare I benefits through ;HMOs win right to sue ; By The Associated Press 1 SAN FRANCISCO — About ll.5 million California seniors who receive Medicare benefits through HMOs won the right Thursday to sue their health maintenance organizations for damages. The 5-2 ruling by the state 'Supreme Court came in the lease of a man who was denied a llung transplant. His HMO allegedly forbid the transplant •because it cost too much. > Before he died in 1999, [George McCall sued Facificare ;of California and others. The [year before his death, a court Iruled that disabled people and Ithose 65 and older enrolled in a ;Medicare HMO could pursue ;only federal administrative claims, to get services they alleged were withheld. On Thursday the high court said seniors and disabled people who sustain injuries because of a lack of care can sue in California courts. Damages in such cases can be in the millions. Legal experts said the 1998 decision was the nation's only such ruling. "This decision from the Supreme Court is a very significant patients' rights case for those on Medicare," said Jeffrey Ehrlich, an attorney representing several seniors now free to pursue damage claims. Lawyer Jeff Grass, defending the Southern California physicians in the case, predicted more lawsuits against doctors and HMOs. "I don't think that this is good," Grass said. "The people I've represented have all been patient-oriented. 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