The Complications of Obesity And Their Devastating Effects

What is becoming increasingly common in western countries such as the UK is the onset of obesity. Some would say that it has dominated health related news for the last few years. Following this, increasing numbers are likely to result in increasing concerns. What many people associate with obesity is the increasing risk of developing heart related diseases and the early development of diabetes. However what many people fail to realise is that obesity is becoming increasingly related to many different cancers. Although all these diseases could be considered equally devastating, the spread of cancer and it's effects is the cause of many funded research projects throughout the world. It is indeed of the worlds emergencies.

According to an article published in the Lancet medical journal, obesity has the potential to put people 'at greater risk of developing 10 of the most common cancers'. The study has arrived at this link through investigating the health of 5 million people which is an incredible number for a study. Additionally these people were monitored over an extended period of 7 years, which is very comprehensive in my opinion. It follows that I have increased confidence in the findings due to the sheer scale of the study - however it is always important to understand the study holistically before drawing conclusions.

It is fair to say that obesity can increase the risk of developing cancer in general with age. However what was unique about this study was that the size of a risk is dependent on the type of tumour. For example, the study found that cancer of the uterus carried the biggest risk when an individual becomes obese. Conversely leukaemia carried the lowest relative risk. Obviously men will not suffer from cancer of the uterus, so the biggest risk that is posed to obese men is gallbladder cancer, according to the study.  Scientists from the London School of Tropical Medicine found that 'each 13-16 kg of extra weight an average adult gained was linked firmly and linearly to a greater risk of six cancers'.

Furthermore, a high Body Mass Index (BMI) has been linked to higher risk of the incidence of cancer of the liver, colon and ovaries just to name a few. However what was very peculiar is that the researchers found that an increased BMI seemed to be linked with a decreased risk in prostate cancer. Of course, this only displays a correlation which doesn't always necessarily indicate a causal link, nevertheless this statistic is intriguing. Despite the links to risks with BMI, one may assume these links are sufficiently linear. But according to Dr Krishnan Bhaskaran who led the research team, "There was a lot of variation in the effect of BMI on different cancers". An example he described was that the risk of cancer of the uterus increased 'substantially' with increased BMI however this link proved more 'modest' when looking at other tumour types.

So it is evident that scientists will need to investigate the causal mechanism behind the differences in increased risk. Dr Bhaskaran suggests that "BMI must affect cancer risk through a number of different processes, depending on cancer type". Although quite vague, this statement enforces that cancer is an area of research that will need to be fully understood in the coming years in order to cause medical advances in the scientific world.



Credit to Smitha Mundasad, BBC News Health Reporter for the original article. Read more on the subject here.

Could the Ebola Virus Reach The UK?

This year one of the biggest stories in heath news and in fact world news is the outbreak of the Ebola virus. Notably, this outbreak has seen the biggest surge in infections and fatalities in human history. The Ebola virus is known to cause the most unpleasant of symptoms, from vomiting and fatigue to bleeds from the eyes and nose ('internal and external bleeding'). As of 27th July 2014, the virus has claimed the lives of 660 people in areas with weak healthcare systems such as Sierra Leone and Liberia. The high mortality rate of around 90% shows how potent the virus really is. Even healthcare staff clothed in complete overalls have been known to be infected. Currently there is no cure for the disease - the only appropriate action for healthcare services is to isolate the infected and transfer them into intensive care.

The UK foreign secretary Philip Hammond has described to the BBC that this outbreak is a "threat" to the UK. Very urban areas in sub-sahrhan African countries have been the most affected, so perhaps the virus could strike an impact in the UK or other Western countries with built-up areas.

The virus is able to be transmitted through bodily fluids and faecal matter, it means the virus can be contained more easily than airborne diseases in areas where people are in close proximity of each other. One of the most discussed environments for the virus to be transmitted in passenger planes. Commercial flights will only carry a few toilet facilities for passengers to use. It follows that there is a risk many people could become infected through use of one toilet facility.

Recently, it was reported that one man from Liberia who showed signs of the Ebola virus was permitted to board a plane to Nigeria. Nigeria hadn't reported any cases of the virus up until the man arrived in Nigeria and died shortly after in a isolation ward due to infection. It is even confirmed he vomited whilst on the plane, and despite having 'high fever', he boarded the flight.

So how is this outbreak being 'controlled'? As mentioned, the infected will need have an accurate diagnosis followed by isolation in hospital. This is primarily to reduce the chances of the virus claiming another host. Appropriate sanitation will also need to be ensured to minimise the exposure of bodily fluids or faecal matter to the environment.

In my view, an outbreak in the UK will be able to be controlled more effectively than in less equipped areas in Africa. Also higher standards of sanitation and healthcare would mean reduced risks of transmission between individuals.


Credit to Adam Withnall and Tomas Jivanda who write for The Independent. Links to articles in The Independent:

Published 26th July 

Published 27th July

Published 30th July

The Ongoing Pursuit For Stem Cell Medicine

In recent times, attention has been drawn to a particular area of biological science involving the use of stem cells. In biology, these are a type of undifferentiated cells which are capable of being multipotent or even pluripotent (embryonic stem cells only). This truly remarkable characteristic has intrigued and ultimately inspired scientists to develop techniques that can be applied to the medical field.

However we must appreciate that there are two types of stem cell. Adult and embryonic. Embryonic stem cells are derived from a 'small hollow ball of cells' called a blastocyst. This is one of the immediate results of fertilisation. What scientists are interested in is the inner cell mass - these cells are undifferentiated but more importantly they are pluripotent. This means that they have the capacity to develop into any type of cell in the body. Conversely, adult stem cells are considered multipotent, meaning they have the capability to develop into one type of cell however the variety is limited. In the human body, the most common extraction point for adult stem cells is bone marrow (although many other tissues and organs are known to produce stem cells, including the brain, heart and skin). Interestingly, foetuses have also been found to have stem cells.

Some adult stem cells such as fibroblasts can actually be reprogrammed genetically for them to 'behave like embryonic stem cells'. These are known as induced pluripotent stem cells.

Another fascinating property of stem cells is that during asymmetric division, two daughter cells are produced with contrasting characteristics. One cell is the result of self-renewal, whilst the other the result of differentiation. This explains how our body is able to heal and repair itself - any type of cell can be made available to any site where it is needed. This ability for these cells to replicate themselves and differentiate is a marvel of genetics. So how is this controlled? An engaging article in a Biological Sciences Review magazine gave me an insight.

Differentiation of stem cells is dependent on 'changing the expression of the self-renewal and pluripotency control genes'. Scientists have carefully monitored which genes switch on or off during differentiation for a variety of cell types. The result is, we can identity which genes control differentiation for a vast array of cell types. An example given is that for the production of cartilage cells (chondroctyes), adult stem cells need to 'express high levels of the gene SOX-9. This gene encourages the expression of a different gene called COL2A1 as a consequence. As genes code for polypeptides, it follows that COL2A1 codes for the production of the type-2 collagen protein. Cartilage largely comprises of this protein.


When adult stem cells are used in medicine, scientists tend to use induced pluripotent stem cells (see above) as their diversity for differentiation is a significant advantage. However for medical applications in the body, sometimes we require the aid of biomaterials to supplement the use of implanted stem cells.  The example used in this article is treatment of back pain due to a slipped disc. The pain is caused by an indentation into the spinal cord by a disc, causing a compression. Intevertebral disc cells are produced by stem cells in a lab, which can them be cultured and left to proliferate. One approach to treating the condition is to 'seed' the cells into a synthetic hydrogel. This compound exists as a gel at body temperature, it is also thermosensitive. This gel can then be 'injected into the damaged disc, where it would form a gel and act like a shock absorber, similar to a natural disc'.

The potential of stem cells in medical application is exciting and promising with continuous ongoing research. Diseases such as Alzheimer's and muscular dystrophy could one day be in combat with emerging stem cell treatments to improve the lives of those who endure the pain of these conditions.


Credit to Dr Stephen Richardson, lecturer in cell tissue engineering at the University of Manchester who wrote for the Biological Sciences Review (Volume 26, Number 4)

New Assisted Dying Bill in Review

One of the latest news stores this week is the review of the assisted dying bill, which if passed will give permission for doctors to administer doses of powerful drugs to end the lives of those whose quality of life is seriously compromised. Essentially euthanasia, this will allow people who are seriously terminally ill to consider whether they would want to sustain their lives any longer. For me, this is a topic in which people should approach with caution as it is real lives, real people, real stories that we are dealing with.

On a basic level (although I respect this isn't a simple topic at all) we are evaluating the quality of a persons life against the longevity or quantity of their life. Indeed it leaves the nation divided in opinion. Speaking to The Independent, oncologist Professor Karol Sikora  believes that the implementation of this power for doctors will result in "death squads" of doctors.

What is important to note is that assisted dying will be of significant relevance to the terminally ill who have been told the have 'less than six months to live'. If this bill is passed, it will mean doctors will have a further big responsibility, more vitally important choices to make.

Doctors in my opinion may only make up a fraction of this matter. In medicine, the patient is the paramount figure of every case - ultimately it is their choice whether to end their own lives or not. I believe they should have the choice, providing they are sane and in "the right frame of mind". No doubt, their families will have a part to play in every patient's decision.

However British Prime Minister David Cameron is concerned that if passed, the bill may cause people to be "pushed into things that they don't actually want for themselves."

Some may argue that assisted dying will help to suppress the needless suffering of the terminally ill - this could have an effect on families as well will lessened responsibility and emotional suffering perhaps.

What do people think? Well according to a 'poll for ITV this week, 70% of Britons are behind the assisted dying bill, with 10% disagreeing'.

In my view, I believe that the bill should be passed. The attention must be brought to the patients themselves. It is they who endure terrible suffering, it is they who should be given a choice.

Credit to Natasha Culzac, reporter for The Independent for the original article. Click here for more on the story.

Meeting the Target - The NHS and A&E

With the population as large as ever in the UK, subsequently in the last few years there has been a noticeable and increasing strain on NHS services across the board. However I believe, along with many others, that the Accident and Emergency Department can be considered to be under the biggest of pressures today. A programme on the BBC I watched recently showed exactly the effects of this population pressure on staff and patients alike. The Panorama documentary was a rather short 30 minutes, nevertheless a real eye-opener to the general public to appreciate the scale of the problem.

I encourage you to see it and I have embedded the video below:


What I found quite shocking is that many of the staff are under constant pressure from the many patients who arrive to the hospital every hour. However it isn't just the local pressure - government-set deadlines and targets ensure the conveyer belts of NHS services are rolling quickly. One doctor in the film says "it's a more stressful place to work than it once was"when referring to the A&E Department of today.

Judging from the documentary, the staff seem stressed, however I deeply respect their professionalism as when dealing with the wide variety of patients, they control their emotions. This is vital when dealing with the public and representing an organisation as important as the NHS. One example from the clip I especially remember is when a heavy alcoholic was admitted to A&E. His rowdy, agitated and rather unpredictable manner meant the nurses in particular were dealing with a tough patient. Refraining from raising their voice too much, they managed to control the patient. In fact if he had turned very aggressive, the staff may have been at risk from harm. The number of alcoholics and drug abusers admitted to A&E is alarming, and they are transported to hospital 'around the clock'. For this hospital alone there are '3 to 4 overdoses a day'.

The pace at which staff need to work is tremendously quickly, whilst being efficient. It shows how training is vitally important to sustain such roles in the health service.

In the video, I was rather interested to see that one GP said that she once wanted to work for the A&E department of the NHS as it suited here own interests. However she ended up settling for a job less manic as a GP, as she no longer wanted to be part of a "sinking ship". She is clearly an experienced health professional, and I respect here view which is why I appreciate the scale of the problem we face in A&E.

One of the major problems in fact is the limited number of hospital ward beds available to patients after they leave the A&E department. Some patients are left to wait hours. The large number of patients poses a dilemma. The NHS need to strike a balance between treating as many people as possible and giving each patient the thorough and correct care they need to make a good recovery.

Solutions to the problem are already being implemented. However many people simply aren't aware of alternative healthcare services that have been made available by the NHS. Walk-in centres and dialling 111 are just a named couple that one could use in out-of-hours for GP's instead of visiting A&E. More awareness is needed to inform the public that personal health advice is available very readily on a local level and is easily accessible.

New Blood Test For The Detection of Alzheimer's

One of the big health stories that have emerged this week is the formulation of a new blood test which will have the potential 'to detect which people with failing memories will go on to develop Alzheimer's disease'. When I quote 'failing memories', what I am referring to is mild cognitive impairment. Statistically, 60% of those who have this form of memory loss go on to develop Alzheimer's. For the general public, it is imperative to note that this a diagnostic solution, not a cure. Nevertheless, getting a correct diagnosis with vast amounts of research can lead on to the synthesis of new drugs which can be used to treat the disease. Increases in research funding would allow scientists to draw closer to a solution - but this is difficult as scientific research isn't advancing at a rate we might think. There are inevitably restrictions due to funding and legal issues.

Only 'after a decades work', has this new blood test been derived which shows the unbelievable timescale of innovation. The test involves looking at 10 sets of proteins that are suspended in the blood. Kings College London in conjunction with Proteome Sciences have published the study. The claim is that this test 'can predict the onset of Alzheimer's in the next 12 months in people with memory problems with an accuracy of 87%'. The cost of such a test can be estimated at around £100 to £300.

Instantly in my brain I question the "87%" accuracy as I'm concerned that for a test as significant as this, a very high high accuracy is desired in order to diagnose the right people. Alzhiemer's and other forms of dementia are one of the most common diseases in our society - according to David Cameron, it "stands alongside cancer as one of the greatest enemies of humanity". I fear he is right. With an ageing population and with the development of the latest treatments to prolong life expectancy, epidemiological evidence says the incidence of these diseases are rising.

With this new test, the key turning point is that people will be identified as having the potential to go on to develop Alzheimer's. Not simply diagnosing those who have Alzheimer's. This is crucial. Read enough into the disease and you'll probably realise that Alzheimer's is very complex. This is why we need to diagnose people at the earliest opportunity. Professor Simon Lovestone from Kings College London puts it perfectly: "Alzheimer's begins to affect the brain many years before patients are diagnosed with the disease. Many of our drug trials fail because by the time patients are given the drugs, the brain has already been too severely affected".


The scientists in the investigation wrote for the journal Alzheimer's and Dementia, and investigated in a variety of proteins that have been linked to Alzheimer's before. Blood samples were taken from 1148 individuals. A large sample some may think, but the size of the problem we are confronting means the next stage for this test is for it to be trialled on around 5000-10000 people. 


A larger sample size means more reliability which will make this study more valid and thus promising. Also getting more accurate results with the test will reduce the risk of misdiagnosis which is outstandingly important. 

Personally I believe this to be positive and promising news, but we need to be sure that this will work. I hope that in the end this could develop into effective treatment for one of the most devastating diseases that exist in our society today. 

Credit to Sarah Boseley, health editor for The Guardian on the original article. More on the story can be followed here.

Organ Transplant Increase Globally

With organ transplantation becoming increasingly in demand, it seems as though steadily the healthcare services of the world are steadily reaching that demand. According to the BBC, 4655 organ transplants were carried out between 2013 and 2014. In fact this is a 10% increase on the interval of the previous year which is interesting to note. But what is more important is that over many years, the numbers have only increased.

This is very encouraging with this rate of progress however many patients are still left over extended periods of time without an organ transplant available.

However how many of us are actually organ donors? The short answer is 20 million registered. The major problem today is the inability for families to give consent of their deceased loved ones to be organ donors after death. The families decision can therefore override the decision made by the loved ones to become organ donors. This could explain the fact that 3 people a day die because organs aren't simply available for transplant, according to NHS Blood and Transplant Data.

I must agree that the decision of the family must be taken into consideration, however it must be the duty of the donor to inform their family of their decision. Ensuring the whole family has made an informed decision is imperative so that their is less risk of organs becoming unavailable 'at the last minute'.

Nevertheless, living donors are equally as important, if not more so. 'Just over 1000' transplants were possible with living donors.

The bottom line question that is asked in this article is "If we would accept an organ for ourselves or would want someone we love to be saved by a transplant shouldn't we be willing to donate one too?".


In fact while we are on the subject, I would like to elaborate on the idea of organ transplantation and consent. In February, I received my quarterly copy of the Biological Sciences Review. I remember there being an interesting column on how consent for organ donation has changed over the past decade or so, with specific insight into the work of the Human Tissue Authority (HTA).

The HTA was set up in 2005, following events where sometimes hospitals 'retained human organs and tissues without consent'. Therefore the subsequent purpose of the HTA was 'to ensure that valid consent is in place for the removal, storage an use of human tissue and organs'. Living matter that was catered for by the HTA ranges from the very small to the large, cells to organ systems.

In 2012, the HTA decided to take on responsibility not just to ensure consent, but ensure that if organs were retained, they would be preserved for their quality. Also making sure the organs were safe for transplantation.

Another important duty of the HTA is to regulates the actions of 'all organisations that remove, store and use tissues and organs for research, medical truing, post-mortem examination, education and training, and display in public'.

In addition to handing organs and tissues from dead donors, the HTA also has responsibility for the viability of all organs and bone marrow tissue from living donors.

I really like the idea of having a HTA as it reassures the public of the safety and viability of organs when organ transplantation is needed. It acts like a 'watchdog' by inspecting organisations that store, remove and use human tissue. By licensing these organisations, hospitals, and the public will know of the quality of the organs that will be used for transplantation.

Another positive aspect I feel that will emerge from this is increased confidence in organ donation. The HTA 'hopes more people will donate their tissues for scientific and medical research…for transplants…fore medical education and training.'

What astonishes me the most is that according to this article, in the year 2011-2012, 'the HTA approved 1214 living organ donations…the vast majority (96%) were kidneys'. It seems that kidney transplantation, living kidney transplantation is very much in demand. Only the remainder were donated liver lobes.

But who receives the donation? In fact 9 out of 10 donations were for the family members. Converesly there were 39 "altruistic" donations, were the donor wishes there organ to be directed to the patient in the hospital with the most clinical need.

In truth, I have endless appreciation for the donors that give up part of their own body, to help others, sometimes others that they even don't know. No knowledge of family history, personality, causes of the health issue…nothing. It is the ultimate selfless act.


Credit to Alan Clamp, current Chief Executive of the HTA, who wrote for the Biological Sciences Review (Volume 26, Number 3)

Additional credit to Nick Triggle of the BBC whose article can be found here

Rise of Antibiotic Resistance Means 'We are all to blame'

One of the biggest stories in the media brewing at this present time is the consequences of further antibiotic resistance to our current and best antibiotics. Perhaps UK Prime Minister David Cameron is a tad too late to say that this could mean an eventual turn to the "Dark Ages" with our current progress with developing new antibiotic drugs.

Mr Cameron has stated that 'governments and drug companies [need to] work together to "accelerate" the discovery of a new generation of antibiotics'. However, common knowledge of the drug trial system explains that these new drugs won't be available for prescription tomorrow - in fact some particularly gruelling clinical trials can take up to 15 years according to Cancer Research UK. With the alarming rate of increasing antibiotic resistance, perhaps the development of new solutions may not be able to keep pace with the continuing evolution of bacteria. These bacteria acquire 'antibiotic resistance genes' with new, random mutations to their genetic sequences.

Max Pemberton writes for The Daily Telegraph that discovering new antibiotics would be 'nothing more than a sticking plaster, concealing an underlying wound that we all need to accept exists'. Personally I fear he may be probably right, with increased application of antibiotics, there is an inevitable increase in the probability of antibacterial resistance due to mutation.

Although at present we 'render [antibiotics] useless', it seems that it is our only solution to the evolutionary suberbugs. In evolutionary terms, microorganisms such as bacteria can be considered the most successful organisms ever to have inhabited this earth. Their numbers growing incomprehensibly larger.

It is a frightening prospect to know that our seemingly useless drugs are being made to look an insignificant problem to microbes. It is absolutely imperative that scientific researchers all over the world work together to investigate new approaches to tackling this ever-pressing, escalating problem.

But what escalates antibiotic resistance? Pemberton makes a good point that partly it is due to human activity and more particular - our greed. Mass factory farming for example allows diseases to spread 'like wildfire' - this would require mass doses of antibiotic in turn. There has been evidence to suggest farmers treat even healthy livestock with antibiotics, this will fuel further the rise of antibiotic resistance. Measures like banning factory farming and limiting the use of antibiotics on animals could contribute to a long-term solution. But it would be no easy task I guarentee. I am sure many people would appreciate a rise in price of meat if it means combating the problem we face.


This pressing issue has brought about recent changes in the primary care system of the UK for example. Doctors (GP's) have been told to 'make patients wait five days for antibiotics', according to Christopher Hope, Senior Political Correspondent of The Daily Telegraph. This suggestion has been made in an attempt to 'wean people off a reliance on the drugs'. This step is one in a series of others aiming to reduce the need to give people antibiotics inappropriately.

GP's are often pressurised into prescribing antibiotics, some patients insisting that is what will treat their problem. Sore throats are an example: the measures would cut the need to prescribe antibiotics for sore throats 'from 90% to 40%'.

However prescribing the antibiotics in the first place isn't the only issue - how do we monitor the patients taking the drugs after prescription? As a general rule, it is essential for patients to complete a course of antibiotics. Secondary responses of diseases such as with Tuberculosis are possible.

Andrew Miller MP, chairman of the committee for MP's, said it had heard of 'GP's prescribing antibiotics simply as "dummy" placebos', in the attempt to satisfy patients.

In fact according to the article, since 2000 'only five new classes of antibiotic had been discovered and most were ineffective'. Ineffective against Gram-negative bacteria that is. These are bacteria that do not stain using the Gram staining method.

I am keen to see how the UK government will deal with this issue in the near future...

Credit to Max Pemberton and Christopher Hope (Senior Political Correspondent) for their articles in The Daily Telegraph (UK) published on Monday 7th July 2014.

Should NHS End-of-life Social Care be Free?

With an increasingly ageing population, there is more need than ever for social care in communities to support older patients. Currently the NHS is spending around £69 million on this social care for cancer patents alone.

Personally I think it would be very appropriate to provide free care to those nearing the end of their lives. The trouble is at the moment is that around half of these patients die in hospital - the costs of maintenance to the NHS total to large sums.

In a MacMillan Cancer Support survey, 8 out of 10 people would prefer to die in their own home. However from statistical data we can see that many people have it "against their wishes".

Caring for these patients in their community would substantially reduce costs to the NHS from around £685 million to around £340 million a year. In my view it would be morally wrong to have a patients will not fulfilled, however it is disheartening to see that not everyone can be accommodated.

A Department of Health representative has said that "We want to make sure that people nearing the end of their lives can choose where to spend their last days and have more of a say on how they are cared for". 


Credit to Nick Triggle (BBC News Health Correspondent) for the original article which can be found here. 

The Incredible Human Hand!

I remember watching a couple of months ago, a documentary about the anatomy of the human hand. However I revisited the documentary not too long ago and I thought it would be great to post on here how extraordinary it was.

I must put it simply… it was truly fascinating! Never before on a television broadcast had a dissection been shown to the general public audience. It amazes me how the producers managed to obtain permission to do so. It just shows their passion for showing the world how remarkable the human body really is.

The programme was broadcasted by the BBC, this episode called Dissected: The Incredible Human Hand, presented by George McGavin.

The documentary can be seen here:



At the start of the programme, it was definitely a new experience for me when an arm was brought onto the dissection table. An unnamed person has donated this part of their body to medical science, and I appreciate that enormously as this programme did open my eyes a little more and enrich my learning experience.

Mr Donald Sammut, one of the worlds leading hand surgeons performed this dissection.



An incision was first made at the top of the forearm, and a skin "flap" was created in order to remove the integumentary layer and adipose (fat) tissue. Once this was done, the main muscles of the forearm could be seen. In association with these muscles, tendons are seen to be attached to each end of the muscle - and as I know from my biology classes, tendons transmit the forces of muscles onto bones.

At one point, Mr Sammut used his surgical instrument to tug on the tendon, which in turn caused the 5th digit (little finger) to be pulled upwards - almost if it were about to grip onto an object. I found this absolutely fascinating; a dead, motionless hand becoming animated once more.

How complex and intricate the very details of the internal structure are made me appreciate how we are able to carry out an infinitely diverse array of tasks with our hands.

Obviously you could see each tendon for each digit which also shows the very mechanical nature of our hands.

A tough protective layer was then removed which is located directly below the skin. This allows us to see the vital major structures and fine details such as the major artery and the major nerves.

The many muscles around our thumbs is quite extraordinary as it allows us to carry out a great multitude of tasks using various grips. Many ligaments hold in place a saddle joint made up of the thumb meta-carpel and the trapezium to minimise injury. This joint is in fact according to Mr Sammut one of the most likely to wear over time. What was most impressive to me in this section of the documentary was how the tendons are arranged in the hand. Moving towards the distal part of the hand from the wrist, the tendons are each encased in a sheath which offers protection. Quentin, the dissection assistant notes that this sheath, when removed allows the tendons to be seen in their 'pristine' condition. The deep tendon runs all the way to the most distal joint, and the superficial one splits part-way to attach to the one-but-most-distal joint. This to me is a marvel of biomechanics.

According to Quentin, the nerves are "probably the most difficult part in the hand to dissect, but it also makes them the most exciting". It's truly amazing how every part of the hand, every tissue in fact is supplied with a nervous network. At the fingertips alone, 20,000 nerves terminate at each finger to allow for as much sensory information to be obtained from the environment.

Overall, what was most surprising is that if we were to lose one finger by choice, the index finger would be the one we could 'most do without'. In the words of Mr Donald Sammut:

"Although it is included in everything [you] do, you can exclude it from everything you do."

I highly recommend anyone to watch this documentary, even if it is just for appreciation!

Feel free to leave a comment below, I'd be interested to hear what you thought about that dissection!

The Potential of Recombinant Proteins to Treat Disease

An article in the Biological Sciences Review (Volume 23, Number 4) grabbed my attention today, although it was published in April 2014. Nonetheless I feel it is very relevant. It was about how recombinant proteins can be used to treat certain chronic diseases, rheumatoid arthritis and multiple sclerosis are just a named couple.

I don't feel I should need to go into all the theory about protein synthesis, but in case you weren't sure, below is a very useful visual intuition:



Recombinant proteins are synthesised by manipulating the cell and almost 'tricking' the cell to making the desired proteins we require. Usually this is achieved by introducing some (foreign) DNA into the cell which codes for the functional protein, then the normal 'protein expression' is able to follow using ribosomes. One example of this would be insulin protein being synthesised by bacteria by using it's plasmid as a vector. One thing to note is that if mammalian cells and bacterial cells were to be used, the protein product many not necessarily be identical as the protein folding procedure may slightly differ for eukaryotic and prokaryotic cells.

Examples of recombinant proteins include insulin as mentioned and therapeutic antibodies.

What I find very exciting is that these antibodies are able to target specific cells - you may have heard of monoclonal antibodies under the same context. This could mean the targeting of cancer cells, as cancer cells have a unique antigen on their plasmalemma. Therefore therapeutic antibodies can be engineered to target these cells. The formation of an antigen-antibody complex can result in a number of consequences: inhibition of growth, immobilisation (pathogenic cells) and detoxification.


One interesting idea from the article explains how using therapeutic antibodies may help to lessen the pain for individuals with chronic diseases such as arthritis, by inhibiting the activity of certain ion channels in nerve cells.

Ion channels are transmembrane (intergal) proteins that allow passage of ions from one cell to another - pain signals are achieved in this way. Some rare individuals have equally the rare inability to feel pain. This condition was explained by scientists who saw that there was a rare mutation in the gene SCN9A (this gene codes for the synthesis of these ion channels). Therefore using this fascinating occurrence there is the potential of using specific therapeutic antibodies to target these particular ion channels. The result of this will inevitably be a reduction in the number of functioning ion channels.

I appreciate that this technique may not cure the disease for good, but this would be a major breakthrough in pain management for chronic diseases. These conditions have dramatic effects on an individuals quality of life, so lessening the pain can improve their mental health.


It would be a major achievement to get this treatment underway. However like with any drug rigorous testing over many stages must be carried out first.

I look forward to seeing the progress of this idea in the future…

Credit to Katharine Cain, postdoctoral scientist at UCB pharmaceutical company, for the original article.

New 'Non-invasive' Technique for Identifying Oesophageal Cancer

Scientists from the University of Southampton being part of a larger international effort, have recently trialed a new technique which would allow oesophageal cancer to be diagnosed sooner for those who are likely to develop it.

A condition known as Barrett's oesophagus (or complications with 'heartburn') is a problem where people have frequent acid reflux. This is where stomach acid enters the oesophageal tube via the cardiac sphincter when lumen is not closed sufficiently. This condition if serious can ultimately be the cause of subsequent oesophageal cancer.

The main discovery was the identification of two genes that can mutate which could lead onto oesophageal cancer.

However to identify these genes in the first place, DNA inevitably needed to be sequenced. Scientists used modern techniques to sequence the DNA of patients with Barrett's oesophagus and of those with oesophagul cancer. The findings were published in the journal Nature Genetics. This way of identification is coupled with a relatively new method of obtaining the mutated cells from the oesophageal lining. A "sponge-on-a-string" test is used to obtain the cell samples says Rebecca Fitzgerald, professor at the University of Cambridge (MRC Cancer Unit).

A non-invasive technique such as this is a major advantage in my view. It could mean a lower probability of the potential subsequent complications of surgery for example. I am sure for many patients, a non-invasive technique is very desirable.

Oesophageal cancer is one of the hardest cancers to diagnose early and has a low survival rate according to the American Cancer Society. If this technique is widely successful then this will ultimately lead to treatment being available to those who are enduring the early stages of this cancer.

I encourage further reading on the article which can be found here. (Credit to Catharine Paddock PhD for original article)