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National
- Cocaine Addiction Rooted in ScienceTopic
- Tumor Cells May Help Stroke Patients
- Impotence Help in a Pill
- Researchers Find Clues to Religious Euphoria
- Harnessing Light Kills Cancer Cells
- Doctors Advocate Drug Treatment Over Punishment
- Some Couples Make Adoption Their First Choice
- AIDS Research Takes on New Focus
NATIONAL
The Scientist
The Philadelphia Inquirer
NBC Nightly News
WHYY-TV12
Cocaine Addiction Rooted in Science
Years after a person has smoked his last pipe of crack, the mere sight of an old haunt, a spent match, or even a drug scene on TV can set off a profound desire to return to cocaine. At one time, doctors prescribed willpower, thinking weak character alone led to repeat drug use. Thanks to the work of Anna Rose Childress, PhD, clinical associate professor of psychology in psychiatry, scientists now know the factors at play are as much physiological as psychological.
In the past decade, as researchers hunted for clues to drug addiction, Childress discovered that anticipation of a high drove addicts to use cocaine, not the fear of withdrawal, as is the case with many other drugs. To prove her case, she showed addicts films of drug use and with the help of PET scans watched the pleasure centers in their brains light up.
“We’re stuck with a wonderful brain that’s wired to pursue things that are pleasurable because those are the things that allow us to survive as a species,” Childress told The Philadelphia Inquirer. “And that system encourages you to repeat what activates you. We’re prisoners to it.”
Researchers hope that the pairing of scientists and addicts eventually will produce anti-craving medication to end relapses.
Drug educators hope the pairing of scientists and students will help decrease drug use today.
The National Institute on Drug Abuse has launched a new program, “Mind Over Matter,” to bring discoveries such as Childress’ into middle-school classrooms. The theory: If you show students the effects of drugs on their brains, instead of just preaching the harms, they’ll pay attention.
“If you even so much as hint at giving an anti-drug
talk, you lose them,” said Cathrine Sasek, science
education coordinator at the institute. “You can,
however, talk about the brain — they pay attention to
the neurobiology of drug abuse.”
Reports began December 1.
Reuters
Boston Globe
The Tampa Tribune
ScienceDaily
Discovery
Channel Online
Tumor Cells May Help
Stroke Patients
Researchers know that implanting fetal tissue in stroke and Parkinson’s patients can help them recover motor function and memory abilities. But the politically charged atmosphere surrounding abortion and the inability of fetal tissue to withstand freezing has made its use more and more impractical. Researchers at Penn and the University of South Florida believe they have found the answer.
Virginia M.-Y. Lee, PhD, and John Q. Trojanowski, MD, PhD, both professors of pathology and laboratory medicine, took cells from a 19-year-old man with a rare lung cancer. They treated these immature cells with retinoic acid to strip them of cancer qualities and to turn them into neurons. Paul R. Sanberg, PhD, professor and director of neurosurgical research at Florida, then implanted the cells into rats that had suffered strokes. Within a month, the rats showed improved memory and motor skills.
“With fetal tissue every tissue donor is somewhat different,” Sanberg said. “They could be infected, there could be a variety of things. With these cells, every patient gets the same cells.”
One of the biggest advantages, the researchers say, is freezing seems to have no effect on the cells.
The researchers envision a day when the tumor cells can be cloned in mass quantities, kept frozen at hospitals, and then thawed in the operating room.
“The clinical potential is that a readily available supply of cryopreserved human neuronal cells, made under controlled conditions and stored frozen, could be used as replacement therapy to reverse the deficits of strokes,” Lee said.
The researchers hope to use the cells on humans within a
year.
Reports began February 26.
Fortune
The Wall Street Journal
The New York Times
Up to 30 million American men suffer from impotence, and yet only an estimated 3 million have sought help from their doctors. The reason? The treatment, until today, involved an injection or implant — unpleasant thoughts for most men. The drug company Pfizer Inc. understood. In April, the government approved Pfizer’s Viagra, the first pill to treat impotence.
“The dropout rate for these [old] therapies is 40 percent to 60 percent,” said Gregory Broderick, MD, director of Penn’s Center for Male Sexual Dysfunction. “Since Viagra is a pill, more men will be willing to seek treatment.”
The development, Broderick told The New York Times, could mean urologists will see fewer patients. “I suspect that much more of the treatment will be with the general practitioner. Patients may even be able to phone in and get prescriptions. Doctors may say: ‘Here, take these two Viagras and call me in the morning.’”
Some fear Viagra will find its way into the hands of men who really don’t need it medically but who want to improve their performance.
“How do we draw the line between what is a medical
condition and what is simply not as good as performance as
we would prefer?” Arthur Caplan, PhD, director of the
Center for Bioethics, asked in The Wall Street Journal.
Reports began March 19.
The Philadelphia
Inquirer
San Jose Mercury News
San Diego Union-Tribune
Times Leader (Wilkes-Barre, Pa.)
Centre Daily Times (State College, Pa.)
Researchers Find Clues to Religious Euphoria
Can science explain the mystical aspects of religion? Eugene d’Aquili, MD, clinical associate professor of psychiatry, and Andrew Newberg, MD, a fellow in nuclear medicine, believe brain scans have provided clues. Their two-year study of brains of people engaged in Buddhist meditation indicates that sensations of calm, unity, and transcendence correspond to increased activity in the brain’s frontal lobes and decreased activity in the parietal lobes.
“We can’t say we can see God with these imaging studies,” Newberg said. “What we can say is: When somebody has religious experiences, this is what it’s doing to them.”
The two men are particularly intrigued by two neurological subsystems: the ergotropic, or fight-or-flight system, which raises the heart rate and blood pressure under stress, and the trophotropic, or calm system. D’Aquili and Newberg hypothesize that religious practices can so stimulate one of these systems that the related brain circuit starts to “reverberate” while shutting down the opposite system.
If activity is very high in one circuit, the spillover can activate the opposite system, creating a tremendous release of energy that may feel like bliss. In very rare cases, both systems can operate at maximum power, possibly inducing brain activities perceived by the mind as the religious state of “absolute unity of being.”
Although they have found clues, the two men insist that reducing mystical experience to merely a neurochemical flux would be foolish.
“What’s really real? It’s a big
issue,” Newberg said.
Reports began February 19
The Times and
Post-Intelligencer (Seattle)
Plain Dealer (Cleveland)
Orange County Register (Santa Ana, Calif.)
Morning Call (Allentown, Pa.)
Times (Reading, Pa.)
Eagle (Reading, Pa.)
Harnessing Light Kills Cancer Cells
Scientists once scoffed at the idea of using light to fight cancer, but potent new drugs that make diseased cells vulnerable to light beams has turned many into believers. The government recently approved light therapy to fight advanced esophogeal cancer and early lung cancer, and researchers see promise in other areas as well. Stephen Hahn, MD, assistant professor of radiation oncology, is testing the treatment on three cancers: ovarian, advanced lung, and mesothelioma.
“It sounded kind of goofy ... that shining visual light on something would kill a cancer cell,” he told The Associated Press.
The key is injecting photosensitizers that concentrate in
diseased cells but quickly clear out of normal cells.
Hitting the diseased area with a laser’s non-burning
red light makes the photosensitizer produce a toxic oxygen
molecule that kills targeted cells.
Reports began March 4.
Morning Call
(Allentown, Pa.)
Easton Times
Doctors Advocate Drug Treatment Over Punishment
In an unusually strong critique of government drug policy, the nation’s medical establishment called the country’s emphasis on punishment rather than treatment fundamentally flawed and a costly mistake. The group, the Physician Leadership on National Drug Policy, argued addiction can be treated as effectively as diabetes or asthma.
“This doesn’t mean the criminal justice system has no role here, but it shouldn’t be left to deal with addiction on its own,” said June Osborn, chair of the group.
The doctors’ sentiments run counter to public opinion. A study in March showed that Americans want more jail time and less treatment for drug users. The doctors countered by saying media accounts have misled Americans.
To bolster their arguments, the doctors cited evidence that drug addiction is in part genetically determined.
“It would be very hard for someone who doesn’t have the genetic trait for alcoholism to become addicted to alcohol,” said Thomas McLellan, PhD, professor of psychology in psychiatry. “Yes, there is a choice involved, but so is there in insulin-dependent diabetes. You wouldn’t be insulin dependent if you watched your diet and reduced salt intake.”
The doctors also argued that treating drug addiction is as effective as treating asthma or diabetes. About 50 percent of diabetics fail to go through with their treatments, and about 40 percent of drug addicts fail.
“Would you consider a 50 to 60 percent success rate
in diabetes treatment a success? Most of the world does. The
same can be said of drug treatment,” McLellan said.
Reports started March 18.
Los Angeles Times
Fort Worth Star-Telegram
Some Couples Make
Adoption Their First Choice
Even in the face of recent high-tech advances in fertility, some couples are picking adoption over conception as their first choice. Some believe there are too many children in the world without families to create more; others are inspired by religious reasons; and still others, those also adopted, see it as a way to build families.
“The drive to have biological children with one’s partner is very, very strong,” Arthur Caplan, PhD, director of Penn’s Center for Bioethics, told the Los Angeles Times. “Most people see children as a way to have something that is both a reflection of themselves and as a way to share in a project with another. ... But a few people seem capable, from ego or altruism, of transcending the biological pressure.”
People who track adoptions usually don’t ask couples
if they tried to conceive, so reliable figures on those who
adopt by first choice are unavailable. An estimated 1
million American children are adopted.
Reports started Feb. 14.
The Philadelphia Inquirer
AIDS Research Takes on New Focus
Since Robert W. Doms, MD, PhD, assistant professor of pathology and laboratory medicine, made a crucial discovery two years ago, the focus of AIDS research has changed. Scientists now have hope of discovering a way to block the deadly virus from getting inside cells. If a breakthrough occurs, the treatment probably would be much cheaper than current therapies, making it affordable for the Third World. The approach also could be used to treat other disorders involving the immune system, including lupus and rheumatoid arthritis.
“It’s the most competitive area in AIDS research today,” Doms told The Philadelphia Inquirer.
The research focuses on chemokine receptors on the surface of white blood cells that HIV targets. These receptors are used as docking stations by chemokines, proteins key in the immune system. HIV takes over the receptors, using them as gateways into cells.
Scientists identified one HIV gateway, dubbed CD4, but research showed the virus needed two gateways to commandeer a cell. Acting on a hunch based on other studies, Doms’ team found the missing link — the CCR5 receptor.
As far as scientists now know, HIV needs CCR5 in the early stages of the disease and another gateway, CXCR4, in the later stages to invade a cell. CD4 plays an important role in a person’s ability to fight infection, so blocking that receptor is infeasible. But blocking CCR5 would cause no ill effects.
The research is still in the early stage and faces many obstacles. Scientists fear that if they block CCR5, HIV would merely mutate into a more virulent strain that uses CXCR4.
“It is a new and exciting area with broad
implications,” Doms said.
The report appeared February 23.
LOCAL
Aston Press (Glen
Mills, Pa.)
Garnet Valley Press (Glen Mills, Pa.)
Drexel Hill Press (Newtown Square, Pa.)
Thornbury Press (Glen Mills, Pa.)
County Press (Newtown Square, Pa.)
Safety Glasses Prevent Sports Injuries
Each year, 500,000 people suffer from sports-related eye injuries, and most are preventable. Nicholas J. Volpe, MD, of the Scheie Eye Institute, advocates the use of face and eye protection in any sport involving a ball or puck, stick or racquet, or body contact. Higher-risk sports include basketball, baseball, racquetball, and hockey.
“You should never play any sport with a high-moving ball unless your eyes are protected with certified safety glasses,” Volpe said. “Eyeglass lenses, ordinary plastic lenses, open-sided eye guards, and contact lenses do not give adequate protection.”
And don’t forget the children. School-age children
account for 160,000 sports-related injuries each year.
Reports began January 28.
Philadelphia Weekly
Alternative Medicine Goes Mainstream
Acupuncture has been used in China for at least 3,000 years to treat illness and pain. And while American physicians have traditionally been skeptical of the treatment, that view is changing.
An article in Philadelphia Weekly discussed the ways that acupuncture and other alternative forms of medicine are making their way into academic medical centers. Penn, the article said, is “probably the granddaddy in this area” because it has offered acupuncture in the Department of Rehabilitation Medicine since 1973. Yong Kim, MD, clinical associate in rehabilitation medicine, told the Weekly that he remembers a time when acupuncture was commonly called “quakupuncture” by conventional Western physicians. These days, Kim said, Penn’s clinic is “officially called an acupuncture clinic.”
In 1990, when a landmark study was conducted, Americans made about 425 million visits to providers of alternative medicine. They paid $13.7 billion for the treatments, even though insurance companies reimbursed them for only $3.4 billion.
In November, a federal panel reviewed acupuncture and concluded that, for some ailments, it is an effective treatment. The panel’s decision was partially based on evidence that acupuncture appears to alleviate the nausea of pregnancy and chemotherapy and the pain of dental surgery. It may also work against drug addiction, headaches, and menstrual cramps. However, the panel concluded that there was not overwhelming evidence that acupuncture helped with lower back pain and asthma.
Kim and colleague Patrick LaRiccia, MD, clinical
associate in rehabilitation medicine, are part of a task
force that will plan an integrative medicine program at
Penn. “Patients are demanding it,” LaRiccia said.
The task force is examining ways to coordinate treatments in
the areas of herbalism, meditation, massage therapy, and
acupuncture—treatments that have existed for some time
in various departments.
The report appeared February 18.
Perspectives
"“It is a very important event and one of those things that needs to be quite carefully examined.”— William N. Kelley, MD, dean of the School of Medicine and CEO of Penn’s Health System “Relief and Warnings Greet Planned Sale of Six Hospitals” The Philadelphia Inquirer, 3/14
“The toughest question facing the health-care system today is not managing how we die; it’s managing disability and dementia. That’s what most people fear.”—Arthur Caplan, PhD, director of Penn’s Center for Bioethics “Life’s Last Chapter: How Well Will We Care?” The Philadelphia Inquirer, 3/1
“Where do we draw the line between reasonable compensation and coercion or bribing women?”— Christos Coutifaris, MD, PhD, associate professor,Division of Human Reproduction “Life for Sale: Market for a Woman’s Eggs Is Heating Up” The Philadelphia Inquirer, 3/8
“Many people will be watching New York because this is the first of its kind to try to set some rules for governing this very brave and sometimes very bizarre world of reproductive technology.” — Arthur Caplan, PhD, director of Penn’s Center for Bioethics “Bill Would Govern Use of Dead Men’s Sperm” [Subject: proposed New York law] The New York Times, 3/7
“We have confirmed that limbic structures indeed activate in response to signals which trigger cocaine craving in humans; this does not happen in response to viewing nature videos or in control subjects who have no cocaine history.”—Anna Rose Childress, PhD, clinical associate professor of psychology in psychiatry “Antidrug Program Stresses Science” The Scientist, 2/2
Snips & Clips
ROUGH SPOTS . . . Makeup and face creams can hold hidden dangers. “There’s a long list of chemicals found in products such as face creams that can prompt redness, itchiness, or flaking in certain users,” Christen Mowad, MD, an assistant professor and director of contact dermatology, told Weight Watchers magazine. A visit to a dermatologist for a patch test can uncover allergies. Appeared in the March issue.
MIND GAMES . . . Good sex is in the mind, at least for women. Research by Thomas Cash, PhD, a psychology professor at Old Dominion University, shows that women who like the way they look have orgasms more often than women who focus on their less-than-ideal physiques. But in today’s culture of super-thin models, developing a good self-image is difficult. “We look at the images we’re presented, and we compare ourselves to them to see how we stack up. Unfortunately, if we’re choosing common mass media images as they are currently portrayed, the majority of us falls short,” David B. Sarwer, PhD, a psychologist with the Center for Human Appearance, told Weight Watchers magazine. Appeared in the March issue.
PREGNANT MEN . . . Sue Stabene, RN, a parenting class instructor, wants men to get a little taste of pregnancy to understand the trials their wives face. During her classes, she urges the men to strap on 35 pounds of faux breasts and third-trimester belly. Stabene also urges the moms to wait until their contractions are coming two to five minutes apart before heading for the hospital. “You’ll be more comfortable in your own house than the emergency room — bake a casserole and freeze it for your return after the baby is born, clean the bathroom, or just walk around,” she told Main Line Life. Printed January 22.
CONCUSSION MYSTERIES . . . Despite all the advances in medicine, researches still know relatively little about concussions. The American Society of Orthopedic Sports Medicine recently flew 15 of the nation’s top concussion experts to a two-day conference in Chicago. After outlining their work, they came to a conclusion: Their knowledge was still rudimentary. Doctors do agree that concussions are not mere bruises. Instead, they involve damage at the cellular level, Paul Marcotte, MD, assistant professor of neurosurgery, told The Philadelphia Inquirer. Printed March 18.
DIFFICULT DECISIONS . . . Relatives watching loved ones die too often consider feeding tubes from an emotional perspective. But in medical terms, tube feeding is merely a treatment that might not benefit the patient. Guilt about starving the patient or causing unnecessary pain drives many decisions, even though feeding tubes cause a host of complications. And once a tube has been inserted, any decision to remove it usually creates emotional trauma for relatives because they mistakenly believe the lack of food, and not the underlying disease, will kill their loved one. Arthur Caplan, PhD, director of Penn’s Center for Bioethics, recommends doctors prepare families for the possibility of removing the tube. “If you start an intervention, you should outline with people the circumstances under which you would stop it, and that should be revisited with people every six months or a year,” he told The Philadelphia Inquirer. Printed March 18.
GUNS KILL . . . C. William Schwab, MD, chief of the Division of Traumatology and Surgical Critical Care, and Donald Kauder, MD, associate professor of surgery, helped state Rep. Dwight Evans make a point about gun control. Evans, a likely mayoral candidate next year, called a news conference to urge the Legislature to limit people to buying one gun a month. “Medicine has been made powerless by the ever-increasing access to handguns, the type of handguns, the number of bullets used, and the amount of tissue destroyed,”
Schwab said. The report appeared in The Philadelphia Inquirer March 31.
ALCOHOL ABUSE . . . Basketball star Charles Barkley’s recent decision to cut back on alcohol has highlighted abuse. Charles O’Brien, MD, PhD, professor of psychiatry, told WTXF-TV that drinkers start feeling the effects with just the first glass. “They’re likely to say things kind of inappropriate, they might insult people, might make off-color jokes. Our brains are pretty good at observing other people. But our brains are not good at observing ourselves.” Aired February 26.
VIOLENCE AND SEX . . . The level of sex-related violence in the United States is reaching epidemic proportions. One in eight women is raped, 50 percent are sexually harassed on the job, and 38 percent have been molested by the time they are 18, according to Mary Anne Layden, PhD, a psychologist and director of education at the Center for Cognitive Therapy. “It’s a problem that has been ignored and denied,” Layden told The Reporter (Lansdale, Pa.). “Society is confused by what is healthy sex and what is unhealthy.” Appeared January 26.
FORTY WINKS . . . Sleeping on the job may have been a cardinal sin a generation ago, but today it is beginning to be accepted, especially for people in high-stress jobs, because breaking up the day with a nap can increase efficiency. But David Dinges, PhD, associate professor of psychology and director of the Unit for Experimental Psychiatry, cautioned in Parade Magazine that nappers need to be aware of “sleep inertia,” grogginess and slight disorientation that might last up to 15 minutes. Nappers should plan to take a few minutes to regain their full mental acuity after waking. Appeared March 22.
HMO TREND? . . . Aetna U.S. Healthcare Inc. is considering a new system that would allow patients to skip an initial visit with their primary care physician and go directly to specialists in five areas: cardiology, ophthalmology, allergy, otolaryngology, and dermatology. The company has asked health systems to submit applications to provide the services, and Penn’s system reponded. “This could have big implications for the Philadelphia marketplace,” David Shulkin, MD, the Health System’s chief medical officer and chief quality officer, told the Philadelphia Business Journal. “Essentially what it means is specialists will have to look at how it is they are delivering care.” Appeared February 20.
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May, 1998 Rebecca Harmon, Director of Media Relations
Media Review is published monthly by the University of Pennsylvania Medical Center's Office of Public Affairs to keep the faculty and administration aware of recent Penn-specific media highlights. To make comments, write to Editor, Media Review, 220 Blockley Hall, 3400Spruce Street, Philadelphia, PA 19104 |
