Stem Cell Clinic

ASK THE DOCTORS: STEM CELL TREATMENT FOR TYPE 1 … – MDJOnline.com

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ASK THE DOCTORS: STEM CELL TREATMENT FOR TYPE 1 ... - MDJOnline.com

Judge credits family, community, fitness and prayer with his rebound … – The Winchester Star

WOODSTOCK Kevin and Kathy Black are grateful for many things this Thanksgiving. Like many families throughout the Valley, theyll gather for fellowship and a meal that might taste a little sweeter after the challenges of the last few years.

Nearly one year ago, Kevin a judge in the 26th Circuit Court who presides in Shenandoah, Warren, Frederick, Clarke, Page, and Rockingham counties and the City of Winchester received a stem cell transplant for treatment of leukemia.

The Woodstock couple, married for 42 years, said they are thankful for family and community support and advances in medicine, adding that they believe Kevins physical fitness and positive attitude were vital in seeing them through the ordeal.

After an unusual fainting spell in the summer of 2020, Kevin, who is notoriously physician-averse, went to get checked out.

Im a guy who never wants to go to the doctor, never wants to have anything done to me. At that time, nobody would see you, Kevin recalled, referencing the practice of telehealth that was common at that stage of the COVID pandemic.

An initial bone marrow biopsy confirmed that Kevin had Chronic Lymphocytic Leukemia (CLL), a type of cancer of the blood and bone marrow that typically progresses more slowly than other types of leukemia.

Kathy, who has served as the Shenandoah County Commissioner of the Revenue for 24 years, recalled doctors telling them, But dont worry, thats the best leukemia to have.

Kathy took a deep dive into understanding what was happening with her husband.

I didnt want to know any of that, said Kevin, aJuvenile and Domestic Relations Court judge for four years before his current appointment and a Woodstock lawyer for 31 years before that.

She started asking questions about a different type of blood cancer.

In August, Kathy was talking about multiple myeloma and the doc had me have a PET scan and she pretty much said, Nope, youre good. You just have CLL. But then she had me go do another bone marrow biopsy in April and then the phone call was the one you dont ever want to hear, Kevin said, adding that he was referred to a multiple myeloma specialist. Of course, I knew that was bad.

Along with CLL, Kevin was diagnosed with multiple myeloma, a cancer that forms in a type of white blood cell called a plasma cell. In multiple myeloma, cancerous plasma cells build up in bone marrow.

From the first bone marrow biopsy to the second, it had exploded. It was moving really fast. Its just lucky that we caught it so early. Its probably an act of God that he got sick originally, Kathy said.

Added Kevin, Oh yeah. I'd never have gone to the doctor. I dont know what would have convinced me. Its really weird when you think how much Ive avoided doctors and healthcare and all that its just fortuitous that the events played the way they did. A lot of people find out they have multiple myeloma theyll be walking along and a leg will break. They say your bones turn into like Swiss cheese.

An avid fitness enthusiast, Kevin lifts weights a couple of times a week and runs about 30 miles each week. He said that he had been feeling great despite his diagnosis.

The day I took my first chemo pill, the night before I had just run up the mountain. When I go by myself I go really hard, he said, adding that he told Kathy that he felt like a million bucks." I said, I cannot believe I have cancer and I cannot believe that Im going to start taking this poison and God knows whats going to happen to me.' It was weird because I felt that good.

After seeking opinions from several oncologists and cancer specialists, Kevin reluctantly came to terms with the fact that hed had to go through a stem cell transplant.

They kill your bone marrow with chemo. I didnt like the sound of that. Before they do all that, they harvest your stem cells, Kevin said. Understand, the idea of somebody sticking me with a needle for my whole life was the most repulsive thing. Ive been stuck by hundreds of needles in the last two years, but anything that sounded like that was just something that I didnt want to do.

Kevin stayed as active as possible before the procedure, continuing his runs up a steep mountainside until his stem cells were harvested in late September 2022. After a couple of mishaps a dog bite and a battle with respiratory syncytial virus (RSV) the transplant finally happened Dec. 1, Kathy said.

A former ultrarunner, Kevin said the transplant was difficult on many levels from the procedure itself which left him humbled at the weakness in his body to the forced 100-day isolation required to protect his rebuilding immune system but grateful for advances in medicine.

Think about what theyve done. Its kind of amazing to think that 20 years ago they didn't have that. The doc told me in Winchester, except for the chemo theyve discovered in the last 20 years, which is way better than what they had, and the stem cell thing, I probably wouldnt be here now, Kevin said.

In the challenges of the process, the couple said they were well supported by their community.

Im grateful for all the support, mostly from Kathy, but also from everybody around me. That would be the number one thing I learned from all of this you really need to have someone there who is capable of processing and advocating for you, Kevin said, adding that the couples three sons and their wives were especially supportive.

Kevin added, My colleagues, they filled in the gaps for what I couldnt do and just all the people who prayed. You realize you need that support. I dont know if you take it for granted, but you just dont realize the support you have around you until you get in that situation.

The Blacks, who connected with another local couple who were going through the stem cell transplant process, said they are happy to talk with others about their experiences.

It was nice to have this other couple that we could talk to and I could talk to his wife about her job as the caregiver. It helped us so we would hope that if either of us could help someone, wed be happy to, Kathy said, adding that her staff stepped up to cover for her and keep things running smoothly at the county office and friends were there to lend an ear or a shoulder or provide a meal.

Set to retire from her post at the end of the year, Kathy added, Im thankful that Kevin is such a strong person because I don't know how to live without him. Our kids were very helpful. Even right now. Our second son is coming home from Asheville for the week. He was supposed to come yesterday, but hed had the flu and they wanted to make sure that his wife didnt have it before they came. The thoughtfulness and caring that everyone has shown were blessed to live in a community like this where people are more than willing to help you.

Kevin said that he was especially grateful for his longtime friend, Roy Marshall, who emphasized the importance of staying positive.

We had some talks and thats where I got his wisdom about how so many people were so gloomy [during cancer treatment]. I made my mind up that I didnt want to be that person, Kevin said, adding that Roy helped introduce him to ultrarunning, a sport he enjoyed for several years in his 40s.

Noting that hed always been interested in staying healthy, Kevin said that he met Roy when he returned to the area after law school.

My whole lifestyle all along lent itself to somebody who could weather all this stuff, he said. Theres no cure. Someday, most likely, thisll come back and Ill have battle two. Hopefully, going out and running and staying in shape will help me go through the next battle. The sermon I would preach to people is you need to get yourself in as good a shape as you can because when round two comes, you want to have something to fight it with.

That being said, Kevin added, Im not doing what Im doing to get ready for round two. Thats a collateral benefit. Im just trying to live my life.

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Judge credits family, community, fitness and prayer with his rebound ... - The Winchester Star

Crew Studies Biology and Works in Dragon as Station Turns 25 – NASA Blogs

The space station is pictured from the SpaceX Crew Dragon Endeavour during its departure and flyaround on Nov. 8, 2021.

Space biology and Dragon work were the top duties at the beginning of the week for the Expedition 70 crew. The International Space Station also turned 25 years old today with its first module having orbited Earth since 1998.

Eye scans were on the biomedical research schedule for four astronauts on Monday afternoon. Commander Andreas Mogensen kicked off the exams activating the Ultrasound 2 device then setting up communications gear allowing doctors on the ground to remotely monitor the activities. Mogensen from ESA (European Space Agency) then took turns with flight engineers Loral OHara, Jasmin Moghbeli, and Satoshi Furukawa in the Columbus laboratory module participating in the regularly scheduled eye exams.

Mogensen partnered with Moghbeli from NASA at the end of the day and practiced SpaceX Dragon Endurance undocking and landing procedures on the crew spacecrafts computers. Mogensen earlier unpacked medical supply kits from Endurance and stowed them inside the orbital outpost. OHara from NASA and Furukawa from JAXA (Japan Aerospace Exploration Agency) worked inside Endurance as well configuring orbital plumbing gear in the vehicle that has been docked to the station since Aug. 27.

OHara later worked on a space botany study to promote STEM (Science, Technology, Engineering, and Math) education among tribal members. Five varieties of seeds provided by the Choctaw Nation of Oklahoma are exposed to microgravity for several months then returned to Earth and planted next to the same seeds left on Earth for comparison. Furukawa turned off a microscope in the Kibo laboratory module and removed samples for a study that was observing how cells sense gravity or the lack gravity. He then stayed in Kibo setting up research hardware and connecting an incubator for an upcoming experiment to observe stem cell growth that may support regenerative medicine technology.

In the Roscosmos segment of the space station, veteran cosmonaut Oleg Kononenko spent the day inside the Nauka science module checking its airlock, ventilation, and docking systems. Flight Engineer Nikolai Chub attached sensors to himself monitoring his cardiac activity then cleaned air ducts inside the Nauka and Poisk modules. Flight Engineer Konstantin Borisov wore a sensor-packed cap that recorded his responses while practicing futuristic planetary and robotic piloting techniques on a computer.

On Nov. 20, the International Space Station passes 25 years since the first module launched into orbit. The Zarya module lifted off in November 1998 from the Baikonur Cosmodrome in Kazakhstan and would shortly be joined by the Unity module less than a month later. Through this global endeavor, 273 people from 21 countries now have visited the unique microgravity laboratory that has hosted more than 3,000 research and educational investigations from people in 108 countries and areas.

Learn more about station activities by following thespace station blog,@space_stationand@ISS_Researchon X, as well as theISS FacebookandISS Instagramaccounts.

Get weekly video highlights at:https://roundupreads.jsc.nasa.gov/videoupdate/

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Crew Studies Biology and Works in Dragon as Station Turns 25 - NASA Blogs

Wall thickness analysis method for judging the degree of lower … – Nature.com

Patients

The institutional review board of our hospital approved this study (Number 20150129). All patients provided written informed consent. From April 2014 to October 2019, patients with complete follow-up data who underwent internal fixation surgery for lower extremity fractures at our hospital were recruited. The follow-up data included X-ray and CT data 9months after surgery. Two senior orthopedic doctors and an imaging physician judged the degree of fracture healing in the patients according to the patients X-ray, CT and clinical data. According to the above criteria, the status was judged as bone healing, poor bone healing and bone nonunion. If the diagnosis was inconsistent among the three doctors, the same result provided by two of the doctors was taken, and if the results of the three doctors were not the same, the case was excluded. A total of 79 patients were included in the study. A total of 112 CT scans were performed, 49 of the scans were judged to show bone healing (group A), 37 were judged to show poor bone healing (group B), and 26 were judged to show nonunion (group C). There were 21 females in group A, with an average age of 46.712.4years and a follow-up time of 18.73.4months. There were 12 cases of femoral fracture, 37 cases of tibial fracture, 15 cases of intramedullary nail fixation, and 34 cases of plate screw fixation in group A. There were 15 females in group B, with an average age of 51.214.5years and an average follow-up time of 14.73.8months. There were 9 cases of femoral fracture, 28 cases of tibial fracture, 24 cases of plate fixation, and 13 cases of intramedullary nail fixation in group B. There were 15 females in group C, with an average age of 49.213.5years and an average follow-up time of 15.74.4months. There were 8 cases of femoral fracture, 18 cases of tibial fracture, 17 cases of plate fixation, and 9 cases of intramedullary nail fixation in group C (Table1). The fractures of the samples were diaphyseal and metaphyseal, not intra-articular fractures.

Hardware: GE 64-row spiral CT machine (Light Speed spiral CT, GE, USA). Dell high-performance computer (CPU: E3-1225 V2 3.20GHz, memory: 16GB, graphics card: NVIDIA Quadro K4200, operating system: Windows 10, 64-bit).

Software: Mimics Research 20.0, 3-matic Research 12.0 (Materialise, Belgium), provided by Sandi Tribe (Shanghai) Technology Co., Ltd.

The lower limbs of the patients were placed in parallel with the toes up, and a full-length scan was performed. The CT scan interval was 0.625mm, and the matrix size was 512512 pixels. The scan voltage was 140kV, the exposure was 100 mAs, and the screw pitch was 0.625mm (GE 64-slice spiral CT machine with automatic tube current control system with the same scan parameters on both sides). The obtained general DICOM 3.0 standard format data were stored.

Mimics 20.0 software was used to directly read the CT images in DICOM 3.0 format. Three-dimensional geometric models were established under the same threshold conditions for the affected side with internal fixation, the affected side without internal fixation and the unaffected side, and the average CT data of the models were recorded.

The three sets of data from the models of the healthy side, the affected side with internal fixation, and the affected side without internal fixation were imported into 3-matic Research 12.0. An adaptive triangle mesh was applied, and the side length was set to 1mm to optimize the details of the model. The detailed characteristics of the model were retained, and the maximum wall thickness threshold was set to 10,000mm during wall thickness analysis.

To interpret the weak areas of the cortical bone in terms of the wall thickness and the transformation in terms of the relationship between the density and stiffness of the material, the median wall thickness of the unaffected limb and the affected limb with and without internal fixation was measured. The analysis was performed as follows: in the Analyze tab, the Create Wall Thickness Analysis button was clicked, and then Cortical As Entity was selected. The threshold was set to 10,000.0mm. A histogram with the wall thickness distribution was displayed, and a series of colors was visualized on the Cortical 3D object, with green representing thinner structures and red corresponding to thicker areas.

We performed three-dimensional reconstruction of the CT data of the healthy and affected segments under the same conditions, resulting in wall thickness graphs corresponding to the basic phase and the target phase, respectively. Three-dimensional reconstruction of the CT data of the affected limb with simulated removal of the internal fixation was performed, yielding a wall thickness graph corresponding to the simulated phase (Fig.1).

Three phases of wall thickness analysis: the basic phase (A), the target phase (B), and the simulated phase (C).

The ratio of the median wall thickness and the average CT value in the simulated phase to the corresponding values in the basic phase was calculated to obtain the ratios R2 and R4: R2=median wall thickness of the simulated phase/median wall thickness of the basic phase; R4=average CT value of the simulated phase/average CT value of the basic phase. The product of the average CT value and the median wall thickness was defined as the healing index (HI), and R5=simulated phase HI/basic phase HI.

The fracture healing state was evaluated through imaging and clinical examinations at 9months after surgery. The bone healing of patients was observed for half a year after removal of the internal fixation to monitor for refracture. In the case that nonunion continued to be observed, bone grafting and internal fixation were performed again. Patients with poor bone healing were further observed. If there were no signs of healing, bone grafting was performed.

The criteria for bone healing were as follows: X-ray images showed blurring of the fracture line and a continuous callus passing through the fracture line11; additionally, upon the release of external fixation, the patient does not have any tenderness at the fracture site, can walk with weight, and has no longitudinal pain in the fractured limb on percussion12.

The criteria for bone nonunion were as follows: Nonunion was defined by pain and abnormal activity at the fracture site, persistent light-transmitting bands on X-ray examination, and no progress in the formation of the callus at 12weeks after treatment13.

Poor bone healing was defined as a healing state between that of bone healing and bone nonunion.

Measurement data are expressed as the meanstandard deviation or median, and Pearson or Spearman correlation analysis was performed. One-way ANOVA was conducted to analyze differences between multiple groups. Receiver operating characteristic (ROC) curve analysis was performed for the diagnostic analysis, and the critical point of diagnosis was analyzed by the maximum Youden index method. P<0.05 was set as statistically significant, and all data analyses were performed by SPSS (version 20.0; IBM Corp., Armonk, NY, USA).

Informed consent was obtained from all the patients and the study was approved by Biomedical Ethics Committee of Anhui Medical University (reference number 20150129). The study has been performed in accordance with the ethical standards of the Declaration of Helsinki in 1964.

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Wall thickness analysis method for judging the degree of lower ... - Nature.com

A national strategy for CAR-T therapies urgently needed – Irish Medical Times

In a decade, CAR-T cell treatment might be the first step for many cancer patients

Around this time last year, the staff at Irish Medical Times were getting ready to host the Irish Healthcare Awards, and, in particular, preparing to give an award to Prof Larry Bacon (representing a wider team of doctors and healthcare staff at St Jamess Hospital) for conducting the first Irish cell treatment for lymphoma, the first time that a Chimeric Antigen Receptor T-Cell (CAR-T) had been used in Ireland.

Previous to this, any patient who could benefit from this personalised therapy had to travel to the UK to receive the treatment. The job of preparing a patient for this treatment is a complex one involving collecting the patients own T cells, which were then prepared for transport to the UK in the hospitals on-site stem cell laboratory.

When these cells were sent overseas and re-engineered to target cancer cells, they were then sent back to St Jamess stem cell lab for qualification, before they were re-infused into the patient. The patient would receive three days of lymphodepleting chemotherapy before infusion. It was a serious operation, and a cause for celebration that we could do this kind of complex work here.

This CAR-T therapy which uses modified cells from a persons own body to fight cancer, is potentially life-saving for some patients diagnosed with certain types of blood cancers lymphoma, leukaemia and myeloma.

Emerging research also suggests that such therapies could have the potential to treat other types of cancers in the future including some solid tumours, and that could change the paradigm in cancer treatment in Ireland. It would be a huge shift in how we treat cancer, and the potential for improved treatment and cure rates is obvious.

This whole area of advanced therapy medicinal products (ATMPs) is a hugely exciting and promising area in the world of medicine. These medicines based on tissue, genes or cells have the potential to provide ground-breaking opportunities for treating disease and injury.

Its exciting, but we cant say exactly how this might change things. Using your own T cells to fight cancer might surpass current methods by a good margin. Or not. Certainly, were not going to stop with the current technology its simply going to get better.

In a decade, CAR-T cell treatment might be the first step for many cancer patients. We dont know. Or, at least, this was what we presumed that CAR-T therapy was here, was working, and was here to stay.

However, a new report on the progress of CAR-T therapy in Irelandhas pointed out that in Ireland, it is likely that it will be too expensive to provide these therapies at a significant scale under the current commercial routes through which they are available.

The current health and manufacturing systems are also likely not adequately equipped, resourced or structured currently to develop or deliver CAR-T or other cancer immunotherapies alongside existing health services at the larger scale that could potentially benefit patients in the future here.

This poses a fundamental and existential problem for the Irish health service and the HSE. Science is pointless without application; there is no point in being able to do CAR-T cell therapy and not being able to do CAR-T cell therapy (because you dont have the money). If we dont have the money to implement a system so that it saves lives, what, after all, was the point of all the research?

The report, which was developed by a team of researchers in Maynooth University in collaboration with Breakthrough Cancer Research, calls on the Government and the National Cancer Control Programme (NCCP) to urgently consider and develop a national strategy for Ireland around the provision of cellular therapies, including CAR-T therapies.

It is vital that such a strategy would consider how to achieve more sustainable mechanisms to develop, and deliver, new and available treatments to patients, at a cost that is more affordable to the national public health system.

The report outlines ten policy recommendations which seek to recognise and address patients current needs and sets out key components that need to be considered under such a national strategy.

I wont bore you with a list of the recommendations, except to point out that politically, the easiest thing to do here is to do what we always do ignore this problem while it is still a relatively small one that affects very few people.

But since the technology is always moving, and we would reasonably expect a lot more people to become suitable candidates for CAR-T therapy, it makes sense now to plan to be able to afford the treatment for everybody.

Obviously, ATMPs offer huge hope for the future treatment of cancers, and the fear would be that in anticipation of that cost, the Irish government stalls and delays in its bureaucratic manner kicking the can of medicine down the road until some later time when we can afford it.

That would be a huge mistake, a fatal error. A negation of our will to control our destiny. We can and we should invest in this technology and reduce cancer deaths just cause. Just because we can and because it is a just cause. We can save people and we can show others how to do it. We should welcome this challenge, invest in it, and demonstrate the point of economic success. And we should lead, where possible certainly in the area of investment.

We need to move in the direction of the light. There are problems to be solved relating to cost, but these problems will come anyway. Investing now will save money later, because, lets face it, were not going to let people die if we have their actual cure.

We would and have shown we are capable of letting people die if we dont get to them on time. And often the bureaucratic behemoth seems to move very slowly. Almost deliberately slowly.

We need to move quickly and enthusiastically on this. Its an opportunity to do great good for science and medicine in this country. And save lives. As Mathew Perry would have said: Could there be more noble goals?

The question for us now is whether we want to embrace the future of medical innovation and technology, or whether we want to remain the country with the health service that has the best excuses in the world for failure.

The time has come to be know for something else, something that is a powerful force in medicine strategic forward planning to improve services of the future. Services not even imagined yet.

We could do that by embracing and pushing ATMPs because their role in medicine is only going to grow.

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A national strategy for CAR-T therapies urgently needed - Irish Medical Times