Top 10 Medical Breakthroughs of the Last 10 Years   

Top 10 Medical Breakthroughs of the Last 10 Years

Research and technological advances in the last decade pushed the envelope cutting-edge medicine.

Stem cells have the remarkable potential to develop into many different cell types in the body. In theory, they serve as on-the-fly repair systems for the body, dividing without limit to replenish other cells as long as the person or animal is alive.

In November 1998, a team of scientists from the University of Wisconsin reported the first successful derivation and prolonged culture of human embryonic stem cells - cells that are parent cells of all tissues in the body. Although the clinical applications of stern-cell research are years or even decades away, the achievement has profound implications on transplant medicine, drug discovery, and basic developmental biology. Stem-cell research opens the possibility of growing everything from scratch-from heart muscle to bone marrow and brain tissue.

Many diseases, such as Parkinson's and type 1 diabetes mellitus, occur because of the death or dysfunction of just one of a few cell types. Replacing those cells would provide lifelong treatment.

Hormone replacement therapy (HRT) has long been a widely accepted treatment for the effects of menopause on older women. In 2000, the Women's Health Initiative study changed all this.
The WHI, a group studying the effects of HRT among 16,000 women between ages 50 and 79, found that the risks of the therapy far outweighed its benefits and recommended that women stop taking estrogen-progestin combinations.

Results of the study showed that per 10,000 women on HRT, the risk of:
 • Breast cancer increased by 8
 • Colorectal cancer decreased by 6
 • Heart attacks increased by 7
 • Hip fractures decreased by 5
 • Blood clots increased by 18
 • Stroke increased by 8

In 2000, researchers found that interferon beta medications, if given early on, reduce the progression of multiple sclerosis. Interferon beta medications resemble the body's natural antibody, interferon, produced during a response by the immune system to disease. It is not completely clear how interferon beta medications work in people with MS, but it is known that they affect the immune system and help fight viral infections. They also work by preventing inflammation and demyelination (destruction of the sheath that surrounds nerves) in the central nervous system. Interferon beta medications also limit the activity of gamma interferon, which is a protein produced by the immune system that worsens MS.

In December 2000, scientists from the University of Toronto in Canada developed a potent vaccine that appears to prevent and treat the disabling memory loss and dementia associated with Alzheimer's disease. The disease develops when tox1c biochemical compounds known as amyloid beta peptides accumulate in the brain, forming what are known as amyloid plaque deposits.

These plaques injure nerve cells, and this is thought to lead to the symptoms of Alzheimer's.

The Toronto team bred mice with amyloid plaques and mental impairment similar to that seen in Alzheimer's patients. The team "immunized" the mice with a vaccine made from the amyloid beta peptides. They found that their vaccine helped block the production of plaques, clean up brain tissue, and preventive symptoms of Alzheimer's. The vaccine works by stimulating the immune system to attack amyloid plaques.

Preliminary tests on humans conducted in July 2001 showed promising results.

Begun in October 1990 and completed in April 2003, the Human Genome Project (HGP) has been hailed as one of the greatest medical breakthroughs in human history. The International research effort to sequence and map all of the estimated 20,000 to 25,000 genes of Homo sapiens gave us, for the first time, the ability to read nature's complete genetic blueprint for building a human being. Though the HGP has been completed, analysis of the project's data will continue for many years.

Technology and resources generated by the HGP and other genomics research are starting to have profound impacts on biomedical research and are expected to revolutionize biological research and clinical medicine. Diagnostic tests will be more rapid and specific, making possible earlier treatment of many illnesses. Other potential benefits and applications of the HGP include rational design, gene therapy, and pharmacogenomics ("customized drugs").

In early 2004, researchers from the University of Pennsylvania and Tufts University found that the experimental drug torcetrapib doubled levels of high density lipoprotein, the good cholesterol,
in people with abnormally low HDL levels and at the same time reduced LDL (low-density lipoprotein) levels.

Until now, doctors have focused largely on lowering bad cholesterol by giving patients statins, which reduce the risk of heart attacks by one-third. Many experts hope to lower the incidence of heart attack further by boosting HDL as well.

The latest generation of anticancer drugs-just like "smart bombs"-hone in on abnormalities particular to
tumor cells. These drugs, which include imatinib and gefitinib, are more selective than traditional cancer drugs, which attack all dividing cells. However, gefitinib, a last-resort lung cancer drug, only works in about 10 percent to 20 percent of patients.

In 2004, researchers from Harvard identified a genetic mutation in lung cancer cells that seems to predict whether gefitinib will be effective. If the results hold up, tumor cells could be tested and only people likely to respond to gefitinib would be given the drug.

In June 2004, a team of neuroscientists successfully implanted a chip into the brain of a quadriplegic man that allowed him to check e-mail, play computer games, and control a television by simply using his thoughts.

The chip, called BrainGate Neural Interface System, was developed by Cyberkinetics, a neuro-technology company, following research under taken at Brown University in Rhode Island. BrainGate offers the possibility of previous unimaginable levels of independence to the severely disabled.
The four-millimeter square chip, which is placed on the surface of the motor cortex area of the brain, contains
100 electrodes each thinner than a hair strand that detect neural electrical activity. The sensor is then connected to a computer via a small wire attached to a pedestal mounted on the skull.

Up to five more patients are to be recruited to the pilot clinical study for further research into the safety and potential utility of the device.

Although hundreds of thousands are in need, only a very small number of people worldwide Are able to receive donor hearts every year. In September 2004, the U.S. Food and Drug Administration (FDA) received its first-ever application for marketing approval of a completely self-contained artificial heart.

Manufactured by Massachusetts-based ABIOMED and a product of over 20 years of design, research and testing, the AbioCor Implantable Replacement Heart is designed to sustain the body's circulatory system and to extend the lives of patients who would otherwise die of heart failure. Its unique design allows it to be totally implanted with in the body Unl1ke the artificial hearts of the past patients are not tethered to a large, air-pumping console nor do they have wires or tubes piercing their skin.

The AbioCor is driven by a high-precision electrohydraulic system that pumps seamlessly to drive consistent and stable circulation, similar to a patient's natural heart. This device also contains a microprocessor chip and internal diagnostics that continuously monitor patient vitals.
The complete system is powered by a small external battery that transmits power across the skin without wires, eliminating risk of infection and allowing for a better quality of life. Additionally, with the use of the internal battery, which lasts over 60 minutes, patients can enjoy swimming or bathing.

In September 2004, after many years of study, the drug bevacizumab was approved by the FDA to treat colon cancer. The drug may also be effective against other cancers. What is unique about bevacizumab is the way it fights cancer: by shutting down blood supply.

For decades, doctors have known that cancer needs to form a network of new blood vessels to grow and spread in a process called angiogenesis. The protein that fuels this process is called VEGF (vascular endothelial growth factor); bevacizumab works by blocking this protein Starved of oxygen and crucial nutrients, malignant tumors shrivel, thereby slowing the spread of the cancer. The drug, the first of its kind to win FDA approval, also helps increase the effectiveness of standard chemotherapy.

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