Extreme cancer surgery involves temporarily removing digestive organs

Wow, the case of an extreme cancer surgery is currently being reported on the news. The operation removed (only temporarily) several organs and then the organs had to be sutured back in place. The removal was needed to get access to the cancer in the posterior wall of the patient's abdominal cavity. The article stated that the operation was like taking the engine out of a car in order to repair the car while it is still running.

It took seven surgeons more than 15 hours, in which they removed her stomach, pancreas, spleen, liver and large and small intestines, while keeping Zepp (the patient) alive. Once they cut out the tumor, which was wrapped around a major artery, they painstakingly put all the organs back in her body. - ABC NEWS Online

The removal of the tumor was complicated by its location in the abdomen. Reportedly, the small tumor was wrapped around the aorta and the base of the celiac trunk and superior mesenteric artery. Some portions of her blood vessels had to be replaced with artificial vascular grafts made of Gore-Tex (BIO 26 students saw these in lab).

The surgery took advantage of techniques used in organ transplant operations... including cooling and preserving of the patient's digestive organs after removal from the body. The patient was diagnosed with leiomyosarcoma, a somewhat rare form of cancer of the intestines. It reportedly arises from cells in or around the muscularis mucosa. Check out eMedicine for more information on this form of caner (link to eMedicine).



~~BIO26~~

Love them or hate them... Peeps are here

March brings us two great things... endless hours of college basketball and the endless sugary pleasure of the Peep. I am not sure the relevance of Peeps to physiology or anatomy since they don't have much nutritional value,... we certainly can't measure their forced vital capacity or dissect them to study their fluffy marshmallow interior. Well, perhaps we can use them during a glucose tolerance test to increase blood glucose levels.

One research group has used the Peep as the subject of intense scientific investigation. These scientists studied the health risks of cigarette and alcohol use in Peeps. They concluded:

"The synergistic effect of smoking and alcohol in Peeps produces a rapidly exothermic oxidation reaction, leading to a chemical and morphological divergence from the wild-type Peep phenotypes. Assistant lab members described these divergent Peeps as "less sweet," "crunchier," and "gross" when compared to the Peeps which used either alcohol or tobacco, but not both. For these reasons, it is our strong recommendation to JustBorn Corporation that they supervise young Peeps and educate them of the risks associated with smoking and alcohol."

For further reading on the scientific research on Peeps follow the link courtesy of Emory University scientists and researchers. Peep Research




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My Pink Spongy Lungs...

The lungs are certainly one of the coolest organs to look at in lab class due to their light, fluffy feeling and their ability to expand to large volumes and quickly recoil... amazing! The above image shows a normal lung before and after inflation. Part of the ability of the lungs to expand and recoil is due to the extracellular matrix of the lung tissue which contains collagen and lots of elastin protein fibers. This gives the lungs their ability to recoil after inhalation so that air is exhaled properly. The videos below show this in action...





Smoking is a health hazard for many reasons such as heart disease and cancer, but smoking also can damage the physical structure of the lung. Cigarette smoking leads to neutrophil activation and retention in the lung tissues. Cigarette smoking induces macrophages to release neutrophil chemotactic factors and elastases, thus unleashing tissue destruction. A number of neutrophil-derived and macrophage-derived enzymes known as proteinases and elastases (ie, proteolytic enzymes) can destroy various components of the extracellular matrix of the lung (e.g., elastin fibers) and cause emphysema (see eMedicine). The tissue integrity of the tiniest airways (like the alveoli and respiratory bronchioles) is destroyed over time and normal elasticity is lost. There is also destruction of the aveolar capillaries which impairs gas exchange in the lung. All of this reduces the ability of the lungs to function and this is especially noticeable when patients with emphysema are asked to expire after maximal inhalation. It takes them longer to expire air out of their lungs since exhalation requires the inherent elasticity of the lung tissues, which they have lost with emphysema.



~~BIO26~~

Will Ferrell is Good For Your Arteries.

Well, assuming you find Will to be funny then watching his movies just might improve the functional responses of your arteries. You might have heard "laughter is the best medicine" or maybe even that laughing is good for your heart. But is there any truth to this? The journal Heart (formerly the British Heart Journal) published a scientific letter titled "Impact of cinematic viewing on endothelial function" in 2006 that just might have the answer (link to abstract). Heart 2006;92:261–262

These authors studied the blood flow responses in the arteries of the arm in subjects before and after they watched movies. They compared the vascular responses of individuals that watched movies evoking mental stress (e.g., Saving Private Ryan) versus individuals watching movies evoking laughter (e.g., There's Something About Mary).

They found movies that made you laugh improved endothelial-dependent blood vessel dilation (see the figure below)... this is a fancy way of saying that the arteries and arterioles dilated more in response to a stimulus and thus improved blood flow. The laughter group had improved arterial vasoldilation compared to baseline while the mental stress group actually had impaired vasodilation compared to baseline. They tested this using reactive hyperemia which A&P students remember from lab. Reactive hyperemia is a transient increase in blood flow to an organ or tissues after a period of ischemia or arterial occlusion. Basically, the authors occluded blood flow to the arm for five minutes (ouch) and then released the occlusion. They used ultrasound imaging to capture the diameter changes in the brachial artery during the experiments to assess the functional responses during hyperemia. In class, we merely looked at the redness in the skin to assess the extent of hyperemia (see our class images). In the movie experiments, during hyperemia, brachial arteries dilated to a greater extent in the arms of laughter viewers. By the way, the reason it is called "endothelial-dependent" is because the endothelial cells are important in generating the signals that contribute to the blood flow changes. The mechanisms explaining the findings of this study are unknown but the authors did speculate that nitric oxide (NO) signaling could be involved. You might remember that NO produced by cells, like endothelial cells, can cause smooth muscle relaxation and thus improve blood flow.

Conclusion: go see funny movies and not stressful or scary ones! Superbad, not super scary... after all, it is good for the function of your arteries.

Heart 2006;92:261–262

~~BIO26~~

Eat your heart out...

You don't often get to see an anatomically correct-extra-credit-chocolate-human heart cake... but alas you will today. I am not easily impressed but this cake looked great and the myocardium has never tasted better! Actually, I think I see the left circumflex artery too. Enjoy. [Link to Full Size Cake Heart]




Courtesy of Jaclyn.








~~BIO26~~

♥ ♥ What's in a Kiss? Science of Kissing ♥ ♥

With Valentine's Day upon us, it is not surprising to see web articles about kissing... how to kiss, how not to kiss, best movie kisses, best lips (btw, who is the owner of the famous lips in the pic over there--->). What about the science of kissing? Why do we kiss? Is there a biological basis of kissing? A recent article at Scientific American has all the answers... well, a few answers and it is all free and available if you follow this link. You should check it out but here are some tidbits that I found particularly interesting:

• Kissing may have evolved from primate mothers’ practice of chewing food for their young and then feeding them mouth-to-mouth.
  
• Osculation is the fancy, scientific term for kissing... as in "I don't osculate on the first date."
  
• Up to 10% of the human population does not kiss, that is over 650 million people... I assume that is a cultural thing?
  
• Some scientists theorize that kissing is crucial to the evolutionary process of mate selection. Bad kisser = bad genes? Sort of a litmus test for mates.
  
• The process of kissing utilizes five of the 12 cranial nerves to transmit signals to and from those lips... can you name them? See the end of this blog post. I am trying to remember them all.
  

An interesting issue that caught my attention is the idea of the kiss as an important factor in mate selection (i.e., the litmus test). Does a kiss provide more information about compatibility then we consciously realize? Everybody says how important the first kiss is, right? Perhaps a couple's "kissing compatibility" signals some sort of primal or fundamental fit between potential mates.... or... maybe it is just kissing. Who knows.

One thing not discussed in the article is the origin of lips... there must be some anthropologist studying this stuff... lip morphology? Was a certain type of lip selected for during evolution through mate selection? We might assume nowadays that bright, full lips were probably attractive to mates but is that really true of our ancestors? Is there any biological significance or advantage of full versus thin lips other than mate selection? Have lips changed dramatically since our more ancient, primitive ancestors? Maybe ask your physical anthropology professor. PS- Everything you wanted to know about Lip Anatomy and more courtesy of two different articles at eMedicine. [Link1] and [Link2]

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Answer for 5 Cranial nerves used in kissing: Trigeminal V (sensory touch for tongue and lips); Facial VII (muscles to move lips); Hypoglossal XII (muscle to move tongue); Facial VII and Glossopharyngeal IX (taste sensation from the tongue); hmmm they say 5 of the 12 so perhaps they include Olfactory I (smelling while you kiss).




~~BIO26~~

Panthers, Pucks, Skates, Carotid Arteries... Huh?

Florida Panthers forward Richard Zednik survived a potentially deadly gash to the neck that partially severed his right common carotid artery (Associated Press link). During the hockey action his teammate fell directly in front of him and the teammate's skate came up to neck level slicing directly into Zednik's right neck. In video of the incident, blood can be seen spraying the ice below Zednik as he falls grasping his neck. He quickly got up and skated to the bench, holding his neck. He was rapidly helped from the ice and later underwent emergency surgery to repair his right carotid artery which doctors indicated was hanging on by only a small thread of tissue. His right external and internal jugular veins were not damaged. As of writing, he was in stable condition in the hospital. He seems very lucky! Doctors say he lost approximately 5 units of blood... that is a bit more than 2 liters. Imagine a 2-liter bottle's worth of bood spilling out of your body. During the surgical repair, the right carotid was clamped for several minutes which would seemingly reduce blood flow to the brain. His doctors said he did not seem to have any brain injury or brain damage due to the interrupted carotid blood supply. Of course A&P students know the left common carotid and vertebral arteries also carry blood to the brain.

There is video of the incident on YouTube if you want to see it for yourself (YouTube link).

A great video for physiology / anatomy students is the medical press conference with the Buffalo Sabres team physician and the emergency surgeons that helped save Zednik... linked here (Buffalo General Hospital). Watch this as it has a terrific discussion of the anatomy of Zednik's injury. Interestingly, the team physician mentions that this injury was not like a previous NHL injury to the neck of goalie Clint Malarchuk which severed his jugular vein. The jugular is a low pressure vein carrying blood away from the head while the carotid is a high pressure artery carrying blood to the head. Large artery injuries are always very dangerous due to the threat of rapid blood loss which could severely reduce blood pressure, causing loss of consciousness and eventually death. As the angiogram below shows, the carotid arteries are large and are located close to the aortic arch and the heart itself... thus a severed carotid artery is serious business and Zednik is lucky to be alive.




~~BIO26~~