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Gene Therapy: The Future of Vision Treatment

Leber congenital amaurosis is an inherited retinal disease that can cause blindness. This rare eye disorder can cause severe vision loss among infants, affecting two to three infants per 100,000 births. Fortunately, new medical treatment for this condition has recently been developed. In todays post, your glaucoma doctor from EyeSite of The Villages discusses how gene therapy can help treat inherited retinal problems.

Understanding Leber Congenital Amaurosis

The retina is a specialized tissue at the back of the eye that detects light and color. Leber congenital amaurosis attacks this part of the eye, causing severe visual impairment. Its considered an inherited degenerative disease, wherein both of the parents of the affected child carry a defective gene, including the RPE65 gene. Scientists have identified 14 genes with mutations that can cause this eye condition.

Patients diagnosed with Leber congenital amaurosis have reduced vision at birth. During infancy, parents may notice a lack of visual responsiveness and unusual eye movement. Typical eye exams conducted by a cataract doctor, however, may reveal normal retinas during eye exams. Electroretinography tests, however, may detect little if any activity in the retina.

Introduction to Gene Therapy

In 2009, Israeli researchers found a herd of Awassi sheep that suffered from day blindness. They began gene therapy trials for the sheep. The treatment included injecting a virus that carries a normal copy of the missing gene. The treated sheep regained their day vision, while the untreated remained visually impaired.

How Gene Therapy Can Help

After successful clinical trials, gene therapy has been approved by the Food and Drug Administration to treat Leber congenital amaurosis. This therapy doesnt restore normal eyesight; instead, it allows patients to see shapes and light. It involves injecting a healthy version of the affected gene in the retina, which helps detect light and convert it into visual signals for the brain to interpret.

Turn to the EyeSite of The Villages glaucoma doctor to help diagnose different eye conditions. We offer comprehensive eye exams to gauge your vision health. Call us today at (352) 504-4560 to schedule an appointment. We serve residents of Lady Lake and Fruitland Park, FL.

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Gene Therapy: The Future of Vision Treatment

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Genetics and Male Infertility –

The development of in vitro fertilitzation (IVF) has allowed many couples to have the families they might otherwise have been unable to create independently. At the same time, this technology has allowed researchers to study the genetic make-up of the earliest stages of embryos. These advances are providing insights into the link between genetics and infertility and how defects (mutations) in specific genes may result in male or female infertility. It is possible that many cases of unexplained infertility will one day be found to have a clear genetic basis.

What has been learned in the last two decades of assisted reproduction is that some cases of severe male factor infertility are clearly related to gene deletions, mutations or chromosomal abnormalities.

Some men with very severe male factor infertility will be found, upon testing their blood chromosomes (known as a "karyotype") to have an extra X chromosome. That is, instead of having a 46 XY karyotype, they have a 47 XXY karyotype. This condition is known as "Klinefelter Syndrome" and can result in failure to achieve puberty or even when puberty is achieved, these men often have male infertility. Some men with Klinefelter Syndrome can father pregnancies through the use of in vitro fertilitzation (IVF) with Intra-Cytoplasmic Sperm injection (ICSI). So far, we are not seeing an increased risk of Klinefelter Syndrome or other chromosome abnormalities in the offspring achieved in these cases.

Also discovered in recent years is that some men with very severe low sperm counts will be found to have deletions in a certain part of their Y chromosome, known as the DAZ gene. Their karyotype is normal (46 XY) but close inspection of the Y chromosome shows there are sections of the chromosome that are missing. A portion of these men will have no recoverable sperm in the ejaculate or on testicular surgery and donor sperm is the only option. With other deletions in the DAZ gene, there is a small amount of sperm present and conception with IVF-ICSI is possible. In these cases, the male offspring which will always inherit their father's Y chromosome, will also have this deletion, and will themselves be infertile.

A single gene mutation in the gene for Cystic Fibrosis (CF) is associated with absence of the part of the tube (the "vas deferens") that leads from the testicle to the urethra in the penis. These men are usually carriers for the CF gene mutation and do not themselves have the disease of Cystic Fibrosis. Sperm can be recovered from the testicles in these men to be used for IVF with ICSI but it is imperative that their wife (or egg provider) be fully tested for CF mutations as well, otherwise there is significant risk of having a child with Cystic Fibrosis.

For men with sperm counts routinely in the less than 5 million total motile sperm range, testing for genetic conditions is warranted so that these men or couples can be made aware of the genetic issues and how these issues might affect their offspring.

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Genetics and Male Infertility -

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Biology and sexual orientation – Wikipedia

The relationship between biology and sexual orientation is a subject of research. While scientists do not know the exact cause of sexual orientation, they theorize that a combination of genetic, hormonal, and social factors determine it.[1][2][3] Hypotheses for the impact of the post-natal social environment on sexual orientation, however, are weak, especially for males.[4]

Biological theories for explaining the causes of sexual orientation are favored by scientists[1] and involve a complex interplay of genetic factors, the early uterine environment and brain structure.[5] These factors, which may be related to the development of a heterosexual, homosexual, bisexual, or asexual orientation, include genes, prenatal hormones, and brain structure.

A number of twin studies have attempted to compare the relative importance of genetics and environment in the determination of sexual orientation. In a 1991 study, Bailey and Pillard conducted a study of male twins recruited from "homophile publications", and found that 52% of monozygotic (MZ) brothers (of whom 59 were questioned) and 22% of the dizygotic (DZ) twins were concordant for homosexuality.[6] 'MZ' indicates identical twins with the same sets of genes and 'DZ' indicates fraternal twins where genes are mixed to an extent similar to that of non-twin siblings. In a study of 61 pairs of twins, researchers found among their mostly male subjects a concordance rate for homosexuality of 66% among monozygotic twins and a 30% one among dizygotic twins.[7] In 2000 Bailey, Dunne and Martin studied a larger sample of 4,901 Australian twins but reported less than half the level of concordance.[8] They found 20% concordance in the male identical or MZ twins and 24% concordance for the female identical or MZ twins. Self reported zygosity, sexual attraction, fantasy and behaviours were assessed by questionnaire and zygosity was serologically checked when in doubt. Other researchers support biological causes for both men and women's sexual orientation.[9]

Bearman and Brckner (2002) criticized early studies concentrating on small, select samples[10] and non-representative selection of their subjects.[11] They studied 289 pairs of identical twins (monozygotic, or from one fertilized egg) and 495 pairs of fraternal twins (dizygotic, or from two fertilized eggs) and found concordance rates for same-sex attraction of only 7.7% for male identical twins and 5.3% for females, a pattern which they say "does not suggest genetic influence independent of social context".[10]

A 2010 study of all adult twins in Sweden (more than 7,600 twins)[12] found that same-sex behavior was explained by both heritable factors and individual-specific environmental sources (such as prenatal environment, experience with illness and trauma, as well as peer groups, and sexual experiences), while influences of shared-environment variables such as familial environment and social attitudes had a weaker, but significant effect. Women showed a statistically non-significant trend to weaker influence of hereditary effects, while men showed no effect of shared environmental effects. The use of all adult twins in Sweden was designed to address the criticism of volunteer studies, in which a potential bias towards participation by gay twins may influence the results;

Biometric modeling revealed that, in men, genetic effects explained .34.39 of the variance [of sexual orientation], the shared environment .00, and the individual-specific environment .61.66 of the variance. Corresponding estimates among women were .18.19 for genetic factors, .16.17 for shared environmental, and .64.66 for unique environmental factors. Although wide confidence intervals suggest cautious interpretation, the results are consistent with moderate, primarily genetic, familial effects, and moderate to large effects of the nonshared environment (social and biological) on same-sex sexual behavior.[12]

Twin studies have received a number of criticisms including self-selection bias where homosexuals with gay siblings are more likely to volunteer for studies. Nonetheless, it is possible to conclude that, given the difference in sexuality in so many sets of identical twins, sexual orientation cannot be attributed solely to genetic factors.[13]

Another issue is the finding that even monozygotic twins can be different and there is a mechanism which might account for monozygotic twins being discordant for homosexuality. Gringas and Chen (2001) describe a number of mechanisms which can lead to differences between monozygotic twins, the most relevant here being chorionicity and amniocity.[14] Dichorionic twins potentially have different hormonal environments because they receive maternal blood from separate placenta, and this could result in different levels of brain masculinisation. Monoamniotic twins share a hormonal environment, but can suffer from the 'twin to twin transfusion syndrome' in which one twin is "relatively stuffed with blood and the other exsanguinated".[15]

Chromosome linkage studies of sexual orientation have indicated the presence of multiple contributing genetic factors throughout the genome. In 1993 Dean Hamer and colleagues published findings from a linkage analysis of a sample of 76 gay brothers and their families.[16] Hamer et al. found that the gay men had more gay male uncles and cousins on the maternal side of the family than on the paternal side. Gay brothers who showed this maternal pedigree were then tested for X chromosome linkage, using twenty-two markers on the X chromosome to test for similar alleles. In another finding, thirty-three of the forty sibling pairs tested were found to have similar alleles in the distal region of Xq28, which was significantly higher than the expected rates of 50% for fraternal brothers. This was popularly dubbed the "gay gene" in the media, causing significant controversy. Sanders et al. in 1998 reported on their similar study, in which they found that 13% of uncles of gay brothers on the maternal side were homosexual, compared with 6% on the paternal side.[17]

A later analysis by Hu et al. replicated and refined the earlier findings. This study revealed that 67% of gay brothers in a new saturated sample shared a marker on the X chromosome at Xq28.[18] Two other studies (Bailey et al., 1999; McKnight and Malcolm, 2000) failed to find a preponderance of gay relatives in the maternal line of homosexual men.[17] One study by Rice et al. in 1999 failed to replicate the Xq28 linkage results.[19] Meta-analysis of all available linkage data indicates a significant link to Xq28, but also indicates that additional genes must be present to account for the full heritability of sexual orientation.[20]

Mustanski et al. (2005) performed a full-genome scan (instead of just an X chromosome scan) on individuals and families previously reported on in Hamer et al. (1993) and Hu et al. (1995), as well as additional new subjects. In the full sample they did not find linkage to Xq28.[21]

Results from the first large, comprehensive multi-center genetic linkage study of male sexual orientation were reported by an independent group of researchers at the American Society of Human Genetics in 2012.[22] The study population included 409 independent pairs of gay brothers, who were analyzed with over 300,000 single-nucleotide polymorphism markers. The data strongly replicated Hamer's Xq28 findings as determined by both two-point and multipoint (MERLIN) LOD score mapping. Significant linkage was also detected in the pericentromeric region of chromosome 8, overlapping with one of the regions detected in the Hamer lab's previous genomewide study. The authors concluded that "our findings, taken in context with previous work, suggest that genetic variation in each of these regions contributes to development of the important psychological trait of male sexual orientation". Female sexual orientation does not seem to be linked to Xq28,[18][23] though it does appear moderately heritable.[24]

In addition to sex chromosomal contribution, a potential autosomal genetic contribution to the development of homosexual orientation has also been suggested. In a study population composed of more than 7000 participants, Ellis et al. (2008) found a statistically significant difference in the frequency of blood type A between homosexuals and heterosexuals. They also found that "unusually high" proportions of homosexual males and homosexual females were Rh negative in comparison to heterosexuals. As both blood type and Rh factor are genetically inherited traits controlled by alleles located on chromosome 9 and chromosome 1 respectively, the study indicates a potential link between genes on autosomes and homosexuality.[25][26]

The biology of sexual orientation has been studied in detail in several animal model systems. In the common fruit fly Drosophila melanogaster, the complete pathway of sexual differentiation of the brain and the behaviors it controls is well established in both males and females, providing a concise model of biologically controlled courtship.[27] In mammals, a group of geneticists at the Korea Advanced Institute of Science and Technology bred a female mice specifically lacking a particular gene related to sexual behavior. Without the gene, the mice exhibited masculine sexual behavior and attraction toward urine of other female mice. Those mice who retained the gene fucose mutarotase (FucM) were attracted to male mice.[28]

In interviews to the press, researchers have pointed that the evidence of genetic influences should not be equated with genetic determinism. According to Dean Hamer and Michael Bailey, genetic aspects are only one of the multiple causes of homosexuality.[29][30]

In 2017, Nature published an article with a genome wide association study on male sexual orientation. The research consisted of 1,077 homosexual men and 1,231 heterosexual men. A gene named SLITRK6 on chromosome 13 was identified.[31] The research supports another study which had been done by Simon LeVay. LeVay's research suggested that the hypothalamus of gay men is different from straight men.[32] The SLITRK6 is active in the mid-brain where the hypothalamus is. The researchers found another gene, named "thyroid stimulating hormone receptor" (TSHR) on chromosome 14 which dna sequence is different also for gay men.[31] TSHR stimulates thyroid and grave disease interrupted the function of TSHR. The previous research also indicated that grave disease had been seen more in gay men than in straight men.[33] Research indicated that gay people have lower body weight than straight people. It had been presumed that the overactive TSHR hormone lowered body weight in gay people.[34][35]

In 2018, Ganna et al. performed another genome wide association study on sexual orientation of men and women with data from 26,890 people who had at least one same-sex partner and 450,939 controls. The data in the study was meta-analyzed and obtained from the UK Biobank study and 23andMe. The researchers identified four variants more common in people who reported at least one same-sex experience on chromosomes 7, 11, 12, and 15. The variants on chromosomes 11 and 15 were specific to men, with the variant on chromosome 11 located in an olfactory gene and the variant on chromosome 15 having previously been linked to male-pattern baldness. The four variants were also correlated with mood and mental health disorders; major depressive disorder and schizophrenia in men and women, and bipolar disorder in women. However, none of the four variants could reliably predict sexual orientation.[36]

A study suggests linkage between a mother's genetic make-up and homosexuality of her sons. Women have two X chromosomes, one of which is "switched off". The inactivation of the X chromosome occurs randomly throughout the embryo, resulting in cells that are mosaic with respect to which chromosome is active. In some cases though, it appears that this switching off can occur in a non-random fashion. Bocklandt et al. (2006) reported that, in mothers of homosexual men, the number of women with extreme skewing of X chromosome inactivation is significantly higher than in mothers without gay sons. 13% of mothers with one gay son, and 23% of mothers with two gay sons, showed extreme skewing, compared to 4% of mothers without gay sons.[37]

Blanchard and Klassen (1997) reported that each additional older brother increases the odds of a man being gay by 33%.[38][39] This is now "one of the most reliable epidemiological variables ever identified in the study of sexual orientation".[40] To explain this finding, it has been proposed that male fetuses provoke a maternal immune reaction that becomes stronger with each successive male fetus.This maternal immunization hypothesis (MIH) begins when cells from a male fetus enter the mother's circulation during pregnancy or while giving birth.[41]Male fetuses produce H-Y antigens which are "almost certainly involved in the sexual differentiation of vertebrates".These Y-linked proteins would not be recognized in the mother's immune system because she is female, causing her to develop antibodies which would travel through the placental barrier into the fetal compartment. From here, the anti-male bodies would then cross the blood/brain barrier (BBB) of the developing fetal brain, altering sex-dimorphic brain structures relative to sexual orientation, increasing the likelihood that the exposed son will be more attracted to men than women.[41]It is this antigen which maternal H-Y antibodies are proposed to both react to and 'remember'. Successive male fetuses are then attacked by H-Y antibodies which somehow decrease the ability of H-Y antigens to perform their usual function in brain masculinisation.[38]

However, the maternal immune hypothesis has been criticized because the prevalence of the type of immune attack proposed is rare compared with the prevalence of homosexuality.[42]

The "fraternal birth order effect" however, cannot account for between 71-85% of male homosexual preference.[43] Additionally, it does not explain instances where a firstborn child displays male homosexual preference (MHP).[44]

In 2017, researchers discovered a biological mechanism of gay people who tend to have older brothers. They think Neuroligin 4 Y-linked protein is responsible for a later son being gay. They found that women had significantly higher anti-NLGN4Y levels than men. The result also indicates that number of pregnancies, mothers of gay sons, particularly those with older brothers, had significantly higher anti-NLGN4Y levels than did the control samples of women, including mothers of heterosexual sons.[45]

In 2004, Italian researchers conducted a study of about 4,600 people who were the relatives of 98 homosexual and 100 heterosexual men. Female relatives of the homosexual men tended to have more offspring than those of the heterosexual men. Female relatives of the homosexual men on their mother's side tended to have more offspring than those on the father's side. The researchers concluded that there was genetic material being passed down on the X chromosome which both promotes fertility in the mother and homosexuality in her male offspring. The connections discovered would explain about 20% of the cases studied, indicating that this is a highly significant but not the sole genetic factor determining sexual orientation.[46][47]

Research conducted in Sweden[48] has suggested that gay and straight men respond differently to two odors that are believed to be involved in sexual arousal. The research showed that when both heterosexual women and gay men are exposed to a testosterone derivative found in men's sweat, a region in the hypothalamus is activated. Heterosexual men, on the other hand, have a similar response to an estrogen-like compound found in women's urine.[49] The conclusion is that sexual attraction, whether same-sex or opposite-sex oriented, operates similarly on a biological level. Researchers have suggested that this possibility could be further explored by studying young subjects to see if similar responses in the hypothalamus are found and then correlating these data with adult sexual orientation.[citation needed]

A number of sections of the brain have been reported to be sexually dimorphic; that is, they vary between men and women. There have also been reports of variations in brain structure corresponding to sexual orientation. In 1990, Dick Swaab and Michel A. Hofman reported a difference in the size of the suprachiasmatic nucleus between homosexual and heterosexual men.[50] In 1992, Allen and Gorski reported a difference related to sexual orientation in the size of the anterior commissure,[51] but this research was refuted by numerous studies, one of which found that the entirety of the variation was caused by a single outlier.[52][53][54]

Research on the physiologic differences between male and female brains are based on the idea that people have male or a female brain, and this mirrors the behavioral differences between the two sexes. Some researchers state that solid scientific support for this is lacking. Although consistent differences have been identified, including the size of the brain and of specific brain regions, male and female brains are very similar.[55][56]

Simon LeVay, too, conducted some of these early researches. He studied four groups of neurons in the hypothalamus called INAH1, INAH2, INAH3 and INAH4. This was a relevant area of the brain to study, because of evidence that it played a role in the regulation of sexual behaviour in animals, and because INAH2 and INAH3 had previously been reported to differ in size between men and women.[57]

He obtained brains from 41 deceased hospital patients. The subjects were classified into three groups. The first group comprised 19 gay men who had died of AIDS-related illnesses. The second group comprised 16 men whose sexual orientation was unknown, but whom the researchers presumed to be heterosexual. Six of these men had died of AIDS-related illnesses. The third group was of six women whom the researchers presumed to be heterosexual. One of the women had died of an AIDS-related illness.[57]

The HIV-positive people in the presumably heterosexual patient groups were all identified from medical records as either intravenous drug abusers or recipients of blood transfusions. Two of the men who identified as heterosexual specifically denied ever engaging in a homosexual sex act. The records of the remaining heterosexual subjects contained no information about their sexual orientation; they were assumed to have been primarily or exclusively heterosexual "on the basis of the numerical preponderance of heterosexual men in the population".[57]

LeVay found no evidence for a difference between the groups in the size of INAH1, INAH2 or INAH4. However, the INAH3 group appeared to be twice as big in the heterosexual male group as in the gay male group; the difference was highly significant, and remained significant when only the six AIDS patients were included in the heterosexual group. The size of INAH3 in the homosexual men's brains was comparable to the size of INAH3 in the heterosexual women's brains.

However, other studies have shown that the sexually dimorphic nucleus of the preoptic area, which include the INAH3, are of similar size in homosexual males who died of AIDS to heterosexual males, and therefore larger than female. This clearly contradicts the hypothesis that homosexual males have a female hypothalamus. Furthermore, the SCN of homosexual males is extremely large (both the volume and the number of neurons are twice as many as in heterosexual males). These areas of the hypothalamus have not yet been explored in homosexual females nor bisexual males nor females. Although the functional implications of such findings still haven't been examined in detail, they cast serious doubt over the widely accepted Drner hypothesis that homosexual males have a "female hypothalamus" and that the key mechanism of differentiating the "male brain from originally female brain" is the epigenetic influence of testosterone during prenatal development.[58][59]

William Byne and colleagues attempted to identify the size differences reported in INAH 14 by replicating the experiment using brain sample from other subjects: 14 HIV-positive homosexual males, 34 presumed heterosexual males (10 HIV-positive), and 34 presumed heterosexual females (9 HIV-positive). The researchers found a significant difference in INAH3 size between heterosexual men and heterosexual women. The INAH3 size of the homosexual men was apparently smaller than that of the heterosexual men, and larger than that of the heterosexual women, though neither difference quite reached statistical significance.[60]

Byne and colleagues also weighed and counted numbers of neurons in INAH3 tests not carried out by LeVay. The results for INAH3 weight were similar to those for INAH3 size; that is, the INAH3 weight for the heterosexual male brains was significantly larger than for the heterosexual female brains, while the results for the gay male group were between those of the other two groups but not quite significantly different from either. The neuron count also found a male-female difference in INAH3, but found no trend related to sexual orientation.[60]

A 2010 study, Garcia-Falgueras and Swaab asserted that "the fetal brain develops during the intrauterine period in the male direction through a direct action of testosterone on the developing nerve cells, or in the female direction through the absence of this hormone surge. In this way, our gender identity (the conviction of belonging to the male or female gender) and sexual orientation are programmed or organized into our brain structures when we are still in the womb. There is no indication that social environment after birth has an effect on gender identity or sexual orientation."[61]

The domestic ram is used as an experimental model to study early programming of the neural mechanisms which underlie homosexuality, developing from the observation that approximately 8% of domestic rams are sexually attracted to other rams (male-oriented) when compared to the majority of rams which are female-oriented. In many species, a prominent feature of sexual differentiation is the presence of a sexually dimorphic nucleus (SDN) in the preoptic hypothalamus, which is larger in males than in females.

Roselli et al. discovered an ovine SDN (oSDN) in the preoptic hypothalamus that is smaller in male-oriented rams than in female-oriented rams, but similar in size to the oSDN of females. Neurons of the oSDN show aromatase expression which is also smaller in male-oriented rams versus female-oriented rams, suggesting that sexual orientation is neurologically hard-wired and may be influenced by hormones. However, results failed to associate the role of neural aromatase in the sexual differentiation of brain and behavior in the sheep, due to the lack of defeminization of adult sexual partner preference or oSDN volume as a result of aromatase activity in the brain of the fetuses during the critical period. Having said this, it is more likely that oSDN morphology and homosexuality may be programmed through an androgen receptor that does not involve aromatisation. Most of the data suggests that homosexual rams, like female-oriented rams, are masculinized and defeminized with respect to mounting, receptivity, and gonadotrophin secretion, but are not defeminized for sexual partner preferences, also suggesting that such behaviors may be programmed differently. Although the exact function of the oSDN is not fully known, its volume, length, and cell number seem to correlate with sexual orientation, and a dimorphism in its volume and of cells could bias the processing cues involved in partner selection. More research is needed in order to understand the requirements and timing of the development of the oSDN and how prenatal programming effects the expression of mate choice in adulthood.[62]

The early fixation hypothesis includes research into prenatal development and the environmental factors that control masculinization of the brain. Some studies have seen pre-natal hormone exposures as the primary factor involved in determining sexual orientation.[63][64][65] This hypothesis is supported by both the observed differences in brain structure and cognitive processing between homosexual and heterosexual men. One explanation for these differences is the idea that differential exposure to hormone levels in the womb during fetal development may change the masculinization of the brain in homosexual men. The concentrations of these chemicals is thought to be influenced by fetal and maternal immune systems, maternal consumption of certain drugs, maternal stress, and direct injection. This hypothesis is connected to the well-measured effect of fraternal birth order on sexual orientation.

Daryl Bem, a social psychologist at Cornell University, has theorized that the influence of biological factors on sexual orientation may be mediated by experiences in childhood. A child's temperament predisposes the child to prefer certain activities over others. Because of their temperament, which is influenced by biological variables such as genetic factors, some children will be attracted to activities that are commonly enjoyed by other children of the same gender. Others will prefer activities that are typical of another gender. This will make a gender-conforming child feel different from opposite-gender children, while gender-nonconforming children will feel different from children of their own gender. According to Bem, this feeling of difference will evoke psychological arousal when the child is near members of the gender which it considers as being 'different'. Bem theorizes that this psychological arousal will later be transformed into sexual arousal: children will become sexually attracted to the gender which they see as different ("exotic"). This proposal is known as the "exotic becomes erotic" theory.[66]

Bem sought support from published literature but did not present new data testing his theory.[67] Research cited by him as evidence of the "exotic becomes erotic" theory includes the study Sexual Preference by Bell et al. (1981)[67] and studies showing the frequent finding that a majority of gay men and lesbians report being gender-nonconforming during their childhood years. A meta-analysis of 48 studies showed childhood gender nonconformity to be the strongest predictor of a homosexual orientation for both men and women.[68] In six "prospective" studiesthat is, longitudinal studies that began with gender-nonconforming boys at about age 7 and followed them up into adolescence and adulthood 63% of the gender nonconforming boys had a homosexual or bisexual orientation as adults.[69]

Sexual practices that significantly reduce the frequency of heterosexual intercourse also significantly decrease the chances of successful reproduction, and for this reason, they would appear to be maladaptive in an evolutionary context following a simple Darwinian model (competition amongst individuals) of natural selectionon the assumption that homosexuality would reduce this frequency. Several theories have been advanced to explain this contradiction, and new experimental evidence has demonstrated their feasibility.[70]

Some scholars[70] have suggested that homosexuality is indirectly adaptive, by conferring a reproductive advantage in a non-obvious way on heterosexual siblings or their children. By way of analogy, the allele (a particular version of a gene) which causes sickle-cell anemia when two copies are present, also confers resistance to malaria with a lesser form of anemia when one copy is present (this is called heterozygous advantage).[71]

Scholars have also pointed out that Darwin himself described kin selection in The Origin of Species, so under a Darwinian model of evolution, not only individuals, but family groups (bloodlines) can compete for selection.

Brendan Zietsch of the Queensland Institute of Medical Research proposes the alternative theory that men exhibiting female traits become more attractive to females and are thus more likely to mate, provided the genes involved do not drive them to complete rejection of heterosexuality.[72]

In a 2008 study, its authors stated that "There is considerable evidence that human sexual orientation is genetically influenced, so it is not known how homosexuality, which tends to lower reproductive success, is maintained in the population at a relatively high frequency." They hypothesized that "while genes predisposing to homosexuality reduce homosexuals' reproductive success, they may confer some advantage in heterosexuals who carry them". Their results suggested that "genes predisposing to homosexuality may confer a mating advantage in heterosexuals, which could help explain the evolution and maintenance of homosexuality in the population".[73]

However, in the same study, the authors noted that "nongenetic alternative explanations cannot be ruled out" as a reason for the heterosexual in the homosexual-heterosexual twin pair having more partners, specifically citing "social pressure on the other twin to act in a more heterosexual way" (and thus seek out a greater number of sexual partners) as an example of one alternative explanation. Also, the authors of the study acknowledge that a large number of sexual partners may not lead to greater reproductive success, specifically noting there is an "absence of evidence relating the number of sexual partners and actual reproductive success, either in the present or in our evolutionary past".

The heterosexual advantage hypothesis was given strong support by the 2004 Italian study demonstrating increased fecundity in the female matrilineal relatives of gay men.[46][47] As originally pointed out by Hamer,[74] even a modest increase in reproductive capacity in females carrying a "gay gene" could easily account for its maintenance at high levels in the population.[47]

The "gay uncle hypothesis" posits that people who themselves do not have children may nonetheless increase the prevalence of their family's genes in future generations by providing resources (e.g., food, supervision, defense, shelter) to the offspring of their closest relatives.

This hypothesis is an extension of the theory of kin selection, which was originally developed to explain apparent altruistic acts which seemed to be maladaptive. The initial concept was suggested by J. B. S. Haldane in 1932 and later elaborated by many others including John Maynard Smith, W. D. Hamilton and Mary Jane West-Eberhard.[75] This concept was also used to explain the patterns of certain social insects where most of the members are non-reproductive.

Vasey and VanderLaan (2010) tested the theory on the Pacific island of Samoa, where they studied women, straight men, and the fa'afafine, men who prefer other men as sexual partners and are accepted within the culture as a distinct third gender category. Vasey and VanderLaan found that the fa'afafine said they were significantly more willing to help kin, yet much less interested in helping children who aren't family, providing the first evidence to support the kin selection hypothesis.[76][77]

The hypothesis is consistent with other studies on homosexuality, which show that it is more prevalent amongst both siblings and twins.[76][77][78][bettersourceneeded] Since both twins and non-twin siblings share genes and therefore have a higher factor of genetic redundancy, there is less genetic familial risk if the strategy is expressed. It is speculated that environmental and hormonal stress factors (linked to resource feedbacks) may act as triggers.

Since the hypothesis solves the problem of why homosexuality has not been selected out over thousands of years, despite it being antithetical to reproduction, many scientists consider it the best explanatory model for non-heterosexual behaviour such as homosexuality and bisexuality. The natural bell curve variation that occurs in biology and sociology everywhere, explains the variable spectrum of expression.

Vasal and VanderLaan (2011) provides evidence that if an adaptively designed avuncular male androphilic phenotype exists and its development is contingent on a particular social environment, then a collectivistic cultural context is insufficient, in and of itself, for the expression of such a phenotype.[79]

Some studies have found correlations between physiology of people and their sexuality; these studies provide evidence which suggests that:

Whether genetic or other physiological determinants form the basis of sexual orientation is a highly politicized issue. The Advocate, a U.S. gay and lesbian newsmagazine, reported in 1996 that 61% of its readers believed that "it would mostly help gay and lesbian rights if homosexuality were found to be biologically determined".[106] A cross-national study in the United States, the Philippines, and Sweden found that those who believed that "homosexuals are born that way" held significantly more positive attitudes toward homosexuality than those who believed that "homosexuals choose to be that way" or "learn to be that way".[107][108]

Equal protection analysis in U.S. law determines when government requirements create a suspect classification" of groups and therefore eligible for heightened scrutiny based on several factors, one of which is immutability.

Evidence that sexual orientation is biologically determined (and therefore perhaps immutable in the legal sense) would strengthen the legal case for heightened scrutiny of laws discriminating on that basis.[109][110][111]

The perceived causes of sexual orientation have a significant bearing on the status of sexual minorities in the eyes of social conservatives. The Family Research Council, a conservative Christian think tank in Washington, D.C., argues in the book Getting It Straight that finding people are born gay "would advance the idea that sexual orientation is an innate characteristic, like race; that homosexuals, like African-Americans, should be legally protected against 'discrimination;' and that disapproval of homosexuality should be as socially stigmatized as racism. However, it is not true." On the other hand, some social conservatives such as Reverend Robert Schenck have argued that people can accept any scientific evidence while still morally opposing homosexuality.[112] National Organization for Marriage board member and fiction writer Orson Scott Card has supported biological research on homosexuality, writing that "our scientific efforts in regard to homosexuality should be to identify genetic and uterine causes... so that the incidence of this dysfunction can be minimized.... [However, this should not be seen] as an attack on homosexuals, a desire to 'commit genocide' against the homosexual community.... There is no 'cure' for homosexuality because it is not a disease. There are, however, different ways of living with homosexual desires."[113]

Some advocates for the rights of sexual minorities resist linking that cause with the concept that sexuality is biologically determined or fixed at birth. They argue that sexual orientation can shift over the course of a person's life.[114] At the same time, others resist any attempts to pathologise or medicalise 'deviant' sexuality, and choose to fight for acceptance in a moral or social realm.[112] Chandler Burr has stated that "[s]ome, recalling earlier psychiatric "treatments" for homosexuality, discern in the biological quest the seeds of genocide. They conjure up the specter of the surgical or chemical "rewiring" of gay people, or of abortions of fetal homosexuals who have been hunted down in the womb."[115] LeVay has said in response to letters from gays and lesbians making such criticisms that the research "has contributed to the status of gay people in society".[112]

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Biology and sexual orientation - Wikipedia

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Japan Approves iPS Cell Therapy Trial for Spinal Cord …

The Japanese governments health ministry has given the go-ahead for a trial of human induced pluripotent stem cells to treat spinal cord injury, Reutersreports today (February 18).Researchers at Keio University plan to recruit four adults who have sustained recent nerve damage in sports or traffic accidents.

Its been 20 years since I started researching cell treatment. Finally we can start a clinical trial, Hideyuki Okano of Keio University School of Medicine told a press conference earlier today, The Japan Timesreports. We want to do our best to establish safety and provide the treatment to patients.

The teams intervention involves removing differentiated cells from patients and reprogramming them via human induced pluripotent stem cells (iPSCs) into neural cells. Clinicians will then inject about 2 million of these cells into each patients site of injury. The approach has been successfully tested in a monkey, which recovered the ability to walk after paralysis, according to the Times.

Its not the first time Japan has approved the use of iPSCs in clinical trials. Last year, researchers at Kyoto University launched a trial using the cells to treat Parkinsons disease. And in 2014, a team at the RIKEN Center for Developmental Biology led the first transplant of retina cells grown from iPSCs to treat a patients eye disease.

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Japan Approves iPS Cell Therapy Trial for Spinal Cord ...

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Stem Cell Therapy for Anti-Aging and Sexual Performance …

Stem Cell Therapy has been around for quite some time, but due to high cost it was primarily used for recovery in athletes and the financial elite. However, with the progression of science and knowledge, stem cell therapy has become much more widely used and financially attainable.

Tampa Rejuvenation is the first in Tampa Bay to utilize the benefits of stem cell therapy for the purpose of anti-aging and sexual performance. We realize as our patients age, their bodies no longer have the regenerative properties to attain the desired results from using their growth factors alone as with our PRP, or Plasma Rich Platelet, therapy. Although many patients will still yield improvement with the PRP alone, the magnitude of cytokines and growth factors in your blood as you age will deplete with age. By implementing stem cell therapy, the number of growth factors are exponential allowing our bodies to regenerate on a magnitude that is otherwise unattainable with some results lasting for 3-5 years.

Stem Cell Therapy can be used to restore vitality to the skin, encourage the growth of hair, and even restore sexual performance and pleasure.

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Stem Cell Therapy for Anti-Aging and Sexual Performance ...

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Endocrine Diseases in Pregnancy | GLOWM


Pregnancy is a unique clinical scenario in which several endocrine disorders may be more frequent and/or have specific considerations for diagnosis and treatment. In this review, anterior pituitary insufficiency, adrenal, parathyroid, and thyroid disorders of pregnancy are discussed.

Anterior pituitary insufficiency is an uncommon disease. The etiology includes destruction of the anterior pituitary gland by tumors, infarction (postpartum necrosis or Sheehan's syndrome), idiopathic disease (Simmonds' disease), surgery, and radiotherapy to the pituitary gland. There have also been reports of pituitary necrosis in patients with elevated intracerebral pressure.1 Disease of the hypothalamus affecting the secretion of releasing hormones may produce a similar clinical picture; some cases of Sheehan's syndrome and idiopathic hypopituitarism are due to hypothalamic diseases.2 Finally, congenital hypopituitarism is a rare diagnosis among newborn infants.3

Sheehans syndrome

The most common cause of panhypopituitarism in women of childbearing age is postpartum necrosis, or Sheehan's syndrome.4 The pathogenesis is not clear, although Sheehan in his original description did associate it with severe postpartum hemorrhage.5 Although the classic clinical etiology of Sheehan's syndrome in about 90% of patients is severe bleeding of the anterior pituitary during delivery or immediately postpartum, no catastrophic event can be detected in more than 10% of patients.

Lack of lactation after delivery, amenorrhea, loss of pubic and axillary hair or failure of pubic hair to grow back, anorexia and nausea, lethargy and weakness, and weight loss are typical presenting signs and symptoms. On physical examination, the findings depend on the severity and duration of the disease. Commonly, the skin has a waxy character with fine wrinkles about the eyes and mouth. There is some periorbital edema, and a decrease in pigmentation is often seen. Axillary and pubic hair becomes increasingly sparse. Atrophy of the breast tissue may be present. Even in those patients losing weight, cachexia is not a feature of the disease. Hypotension may be present, and normocytic anemia is common. However, this full constellation of symptoms does not occur in every patient, and it is not unusual for the full-blown picture to take 1020 years to develop. Occasionally, the diagnosis is made when the patient develops acute adrenal insufficiency secondary to a stressful situation (e.g. infection, trauma, surgery).

It was recognized by Sheehan that not all patients with pituitary apoplexy develop panhypopituitarism, and partial pituitary insufficiency is not uncommon. In one retrospective case series of 44 patients in France, only 88% had hypopituitarism, with adrenocorticotropic hormone (ACTH) deficiency most common (70%).6 A few patients with partial hypopituitarism may present with the classic syndrome of acute panhypopituitarism with deficiency of all pituitary hormones. However, after treatment with corticosteroids alone, there is a spontaneous normalization in the menstrual cycle, with a return of thyroid test results to normal limits.

Successful pregnancies following a diagnosis of Sheehan's syndrome have been reported.7, 8, 9 In a few patients, the diagnosis of partial hypopituitarism may occur upon the presentation of a pregnancy. Although several patients conceive after treatment with gonadotropin, others conceive spontaneously, an indication of partial pituitary failure. Placental function is not altered in patients with pituitary insufficiency.

Pituitary adenoma

During normal pregnancy, the pituitary enlarges by approximately one-third of its size.10 Pituitary insufficiency in women of childbearing age may result in the setting of a pituitary tumor, usually in association with increased production of prolactin. The most common symptom is secondary amenorrhea with galactorrhea, although cases of primary amenorrhea have been reported. When there is local expansion of the tumor, patients may have neurologic symptoms, such as headache or bilateral temporal hemianopia. In such cases, other pituitary hormones may become affected with growth hormone, ACTH, and thyrotropin-stimulating hormone (TSH) deficiencies.

The diagnosis is confirmed by the use of appropriate tests to investigate each of the pituitary hormones. Baseline or random determination of serum pituitary hormone concentrations is of no value in the diagnosis of the disease; dynamic tests to evaluate pituitary reserve must be used. The most practical tests are presented in Table 1. However, their use in pregnancy is limited because of the blunted response of many of these tests.

Table 1. Tests of anterior pituitary hormone reserve



Normal Response

Response in Pregnancy


L-Dopa, 500 mg, GH levels at 0, 1, 2 hour

by 10 ng/dl


Insulin hypoglycemia 0.1 U regular IV/kg, then draw GH at 0, 20, 60, 90 min

by 10 ng/dl



Insulin hypoglycemia (see above), then draw cortisol at 0, 20, 60, 90 min

by 10 g/dl


Metyrapone 750 mg every 4 hour 6

Urinary 17-KGS



Free thyroxine index


Serum TSH



Can no longer be tested, given the inavailability of TRH


Assess by regularity/presence of menses

When anterior pituitary insufficiency develops in pregnancy, the clinical manifestations may be local signs, such as headaches and visual disturbances, which are the consequence of an acute enlargement of, or bleeding into, the pituitary gland.11 The initial manifestations also could be related to endocrine deficiency, mainly hypoglycemia, nausea, vomiting, and hypotension secondary to ACTH deficiency.

Isolated ACTH deficiency is rare and has been infrequently described.12, 13 Acute enlargement of the pituitary gland is characterized by severe, deep, midline headaches (lasting for 23 days) and visual field disturbances. Severe hypoglycemia with convulsions and coma, unresponsive to large doses of glucose, but rapidly reversible after the administration of hydrocortisone, can be seen.

Partial or total hypopituitarism developing in patients with diabetes mellitus has been reported.14 In a review of 31 cases (19 women), the episode was associated with pregnancy in 11 (during the postpartum period in seven and during the antepartum period in four, with three maternal deaths).15 The mean age of the patients in this case series was 27 years, and the mean duration of their diabetes mellitus was 6 years, which makes vascular complication an unlikely cause of pituitary insufficiency. Furthermore, no specific vascular changes were found in the examined pituitary glands. Characteristically, the patients developed severe headaches that lasted for a few days with or without visual field disturbances, and a decrease in insulin requirement was observed. There was a high proportion of women with fetal loss. Although the mechanism supporting the increased risk of hypopituitarism among individuals with diabetes mellitus remains unclear, an association between pituitary antibodies and type 1 diabetes mellitus has been described.16

Lymphocytic hypophysitis

Lymphocytic hypophysitis can be another cause of pituitary dysfunction,17 and in pregnant women, usually presents close to delivery or in the immediate postpartum period.18 Sheehan described lymphocytic infiltration of the pituitary gland in some women with postpartum pituitary insufficiency,19 and it is possible that many of the cases mentioned above were due to lymphocytic hypophysitis.

The clinical presentation may be characterized by headaches and visual disturbances related to pressure from the expanding lesion mimicking a pituitary tumor;20, 21 spontaneous regression of the lesion was seen in several cases.22 diabetes insipidus and galactorrhea. Report of a case and review of the literature) The differential diagnosis between pituitary tumor and hypophysitis can be made only by histologic examination.18 Conversely, the patient may present with signs and symptoms of hypopituitarism, such as protracted hypoglycemia responding to glucocorticoid therapy and hypotension. It can also present in the postpartum period as pituitary insufficiency, similar to Sheehan's syndrome without the history of profound bleeding.22, 23, 24, 25

Involvement of other endocrine glands has been recognized, consistent with the concept of an autoimmune disease,26 in addition to antibodies against pituitary cells.27 It is possible that these cases are typical of the autoimmune polyendocrine deficiency syndrome that may be exacerbated during pregnancy or in the immediate postpartum period.


Patients with partial or total hypopituitarism who become pregnant spontaneously or after treatment with gonadotropins may carry a normal pregnancy with no increase in the dose of corticosteroid replacement therapy. The usual amount of hydrocortisone in patients with pituitary insufficiency is 2030 mg/day (two-thirds of the total amount in the morning and one-third in the evening). In some instances, the amount of hydrocortisone can be decreased by one-third of the total dose because the effect of hydrocortisone is potentiated during pregnancy by estrogen.28 However, this potentiation does not occur when synthetic corticosteroids (i.e. prednisone, dexamethasone) are used. The equivalent amounts of prednisone and dexamethasone, respectively, are 5.07.5 mg daily and 0.50.75 mg daily. Because these patients have ACTH deficiency, aldosterone secretion is normal and there is no need for mineralocorticoid replacement therapy. If thyroid deficiency is present, the amount of levothyroxine needed for replacement is usually 0.10.2 g daily.

Successful pregnancy in cases of isolated growth hormone deficiency has been reported.29, 30 In these patients, lactation was unimpaired and placental function studies and intrauterine growth were normal.

The most common pituitary tumor diagnosed in women of childbearing age is a prolactinoma.31 It can be accompanied by amenorrhea, oligohypomenorrhea, and anovulation, and with or without galactorrhea. Hyperprolactinemia decreases gonadotropin-releasing hormone (GnRH) secretion, accounting for the infertility observed in these patients. Pituitary tumors are divided, according to size, into microadenomas (less than 10 mm in diameter) and macroadenomas (greater than 10 mm in diameter); the latter are further classified according to suprasellar extension and invasion of adjacent structures. Serum prolactin concentrations correlate fairly well with the size of the tumor. Hyperprolactinemia in the absence of a pituitary adenoma (idiopathic hyperprolactinemia) is a common finding.


Serum prolactin levels in women with prepregnancy hyperprolactinemia, with a few exceptions, remained unchanged during pregnancy. It was shown that prolactin levels did not change significantly in most women with baseline prolactin levels of over 60 pg/dL.32 However, in those patients with prolactin levels of less than 60 pg/dL, the mean level doubled at the end of pregnancy and returned to pretreatment levels at the end of lactation. Therefore, serum prolactin determination during pregnancy is not a predictor of tumor growth and is of no value in monitoring tumor growth.

The incidence of complications during pregnancy in patients with pituitary tumors varies according to tumor size. Due to the stimulatory effect of estrogen on lactotrophs, the size of the tumor increases in 2.7% of microprolactinomas and 22.9% of macroprolactinomas during pregnancy.31 In one study of 56 pregnant women with microprolactinomas, one developed headaches and five showed mild tumor growth.33 In studies of pregnant women with macroprolactinomas, the proportion of women developing neurologic symptoms and visual disturbances is significantly decreased upon treatment.31

Complications can occur at any stage of pregnancy. In patients with microadenomas, visual field examinations are indicated only if there are signs and symptoms of tumor enlargement, in which case an MRI is also indicated. If there is any objective evidence of tumor enlargement, bromocriptine is resumed and continued throughout pregnancy at up to 20 mg/day. If after a few days there is no improvement, dexamethasone 4 mg every 6 hours can be added. Surgery is indicated in those complicated cases not responding to the above therapies, but the recurrence rate is high among those with invasive prolactinomas even after surgery.34

Breastfeeding is not contraindicated in mothers with a diagnosis of prolactinoma. There is no difference in the remission rates of women with prolactinomas managed with dopamine-receptor agonists who breastfeed following delivery versus those who do not.35 It is advisable in patients with microadenomas to measure prolactin levels a few months after delivery and to reinstate bromocriptine therapy in the presence of persistent hyperprolactinemia. A pituitary MRI should be repeated in cases of macroprolactinoma soon after delivery because of the potential for tumor size increase.


Once the diagnosis of prolactinoma is made, several types of therapy are available. The choice of therapy depends on tumor size, radiologic classification, local symptoms, and the patient's age and desire for pregnancy or current pregnancy.36

Medical therapy with dopamine-receptor agonists has been very effective in producing ovulation among hyperprolactinemic women37 and restores ovulation in approximately 90% of cases.31 Bromocriptine has historically been the preferred option, and no significant adverse effects have been observed in over 6000 pregnancies managed with bromocriptine.38 Most patients respond to doses of 2.55 mg/day, although occasionally a dose of 7.5 mg/day or more is needed. Bromocriptine is effective not only in normalizing prolactin levels but also in reducing the size of the tumor.31 It is advisable to use mechanical contraception during the first few months of bromocriptine therapy until the rhythm of the menstrual period is established. In those patients who have side effects such as nausea and vomiting, the oral bromocriptine tablet can be administered vaginally.39

Cabergoline is another dopamine-receptor agonist which can be considered.40 Although only 800 pregnancies have been reported with its use, there similarly does not appear to be any increased risks of preterm delivery or congenital malformations associated with this medication.38 In one 10-year observational study of 143 women, carbergoline therapy during pregnancy resulted in the ability of nearly 98% of the women to breastfeed following delivery.41 Once conception takes place, the dopamine-receptor agonist should be discontinued and the patient followed closely. For women in whom the macroprolactinoma is likely to increase, or in whom pressure symptoms occur, therapy during pregnancy should be continued.42

Radiation therapy as the initial and only therapy is seldom indicated, as medical therapy is usually very effective. The duration required for radiation therapy to normalize serum prolactin levels is lengthy and may produce hypopituitarism as a last sequela. Radiation therapy is indicated in those with prolactinomas refractory to conventional therapy.43

Surgical treatment, mainly transsphenoidal adenectomy, has been effective in restoring ovulation in patients with small tumors.32 The cure rate (i.e. sustained normalization of serum prolactin concentrations) is about approximately 70% at both 5 and 10 years of follow up; the associated proportion of successful pregnancy was similar.44 The best results are obtained in patients with microadenomas with low initial serum prolactin levels and lack of abnormal postoperative residual tissue.45

A recommended treatment approach in patients who wish to conceive is summarized in Table 2. It is suggested that treatment with bromocriptine be continued for at least 12 months before conception because it seems to reduce the risk of tumor enlargement during pregnancy.46

Table 2. Management of women with pre-conception hyperprolactinemia

Visual field monthly

*Therapy for 1 year before conception

Acromegaly is a chronic disease caused by hypersecretion of growth hormone by the adenohypophysis of the pituitary gland. It is almost always associated with a benign pituitary tumor and is characterized by slow and progressive enlargement of the acral parts. Facial changes are typical, but they usually develop so gradually that neither the family nor the patient recognizes the changes. As in other endocrine disorders, comparison of the patient's photographs taken over many years may be the only clue to the progression of the disease. Symptoms may be due to local expansion of the tumor (i.e. headaches and visual field disturbances), or they may be due to the somatic effects of chronic excess growth hormone, such as hyperhidrosis, weight gain, arthralgias, and acroparesthesia (carpal tunnel syndrome). Most women with acromegaly have been reported to suffer from oligohypomenorrhea or amenorrhea. In addition to the bony deformities, organomegaly (particularly enlargement of the heart, thyroid, and liver) is not uncommon on physical examination. The skin appears coarse and leathery. Galactorrhea with hyperprolactinemia is a common finding.


The diagnosis is confirmed by an elevation in plasma insulin-like growth factor 1 (IGF-1) levels and a lack of suppression of growth hormone following the administration of a glucose load.47 However, IGF-1 levels may not be reliable during pregnancy, as they can be physiologically increased48 or decreased during pregnancy.49

Thus, suspected cases of acromegaly among pregnant women should be confirmed with a growth hormone suppression test, which requires determination of plasma growth hormone levels before and 1 and 2 hours after the administration of a solution of 100 g glucose orally. A normal response is characterized by growth hormone levels lower than 1 g/L after glucose administration. Patients with acromegaly typically have elevated baseline IGF-1 levels and respond to the glucose load with no growth hormone suppression of growth hormone concentration or even occasionally with a paradoxical increase.

In patients with acromegaly, there are increased risks of several associated cormorbidities, including hypertension, diabetes mellitus, cardiovascular disease, osteoarthritis, and sleep apnea, which should be evaluated for upon the confirmed diagnosis of acromegaly.47


Treatment is mandatory in patients with the disease because the long-term prognosis is poor; untreated individuals have an almost 3-fold increased mortality rate.48 Conventional pituitary irradiation, transsphenoidal hypophysectomy,50 and drug therapy with octreotide (or other somatostatin receptor analogues) or the growth receptor antagonist, pegvisomant51 are used most often and can improve disease survival.52

Acromegaly during pregnancy

There are limited data of successful pregnancies in women with acromegaly. In 1954, Abelove and colleagues reported two normal pregnancies in an acromegalic woman and reviewed 33 reported cases from the world literature.53 Since that time, several other cases have been published, including a recent report of ten pregnancies among eight acromegalic women in Brazil, in which plasma IGF-1 levels were not significantly changed during gestation.54 In most instances, the infants have been reported as being normal. However, in a case described by Fisch et al.,55 the infant was born with acromegalic features. In this infant, growth was above average during the neonatal period, but a normal growth pattern subsequently returned, although no serum laboratory measurements were obtained. The lack of acromegalic features in most cases is in accordance with the report by King and colleagues demonstrating no placental transfer of growth hormone from mother to fetus.56

Historically, bromocriptine has been used as a successful treatment to induce pregnancy in patients with acromegaly.57, 58 In each of these cases, pregnancy occurred in spite of persistent elevated serum growth hormone levels.

The current guidelines for management of acromegalic women during pregnancy have been summarized in the 2014 Endocrine Society guidelines for acromegaly.47 In general, discontinuation of long-acting medical therapy (somatostatin receptor analogues or pegvisomant) is recommended approximately 2 months prior to attempting to conceive; therapy can be replaced with short-acting octreotide instead during the pre-conception period. During gestation, medical therapy should only be administered only for tumor and headache control, and plasma growth hormone and IGF-1 levels should not be monitored.

Diabetes insipidus is an uncommon disease characterized by polyuria and polydipsia due to a deficiency of antidiuretic hormone (central or neurogenic diabetes insipidus) or the peripheral resistance to the antidiuretic hormone at the renal tubules (nephrogenic diabetes insipidus). Central diabetes insipidus may be a result of a lesion at the level of the hypothalamus or pituitary gland. It may arise following hypophysectomy, invasion of the neurohypophysis by tumors, malignant metastasis (i.e. breast cancer), trauma, granulomas, or infection. In 50% of cases, however, it is considered idiopathic, with some causes probably on an autoimmune basis. Nephrogenic diabetes insipidus is a hereditary disorder affecting males; therefore, symptomatic women carriers are extremely rare. Several cases of transient nephrogenic diabetes insipidus during pregnancy and/or postpartum have been reported. A third type of diabetes insipidus, called psychogenic, which is rarely reported in pregnancy,59 is differentiated from the other two in most cases by the results of the water deprivation test.


Endocrine Diseases in Pregnancy | GLOWM

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male pattern baldness and genetics? | Yahoo Answers

Please don't bother my friend!

I reckon that you are quiet young, so the thought of going bald scares you.

I had that too when I was in my early 20s, because baldness is a common thing too in my family.

I'm almost 40 now and YES I'm almost bald too LOL! But in reality going bald is a very slow process. Nobody (some rare cases excepted) is completely bald in their early 20s.

You see this is what I'm trying to say: -When you are 20 you don't wanna look like a bald old man (and that's not gonna happen I promise)

BUT: -When you are 40+ you don't wanna look like a 20 year old! (Although the media wants to make us believe that "young" is the way to be)

So when you reach the age of 40 you won't bother about a little or more baldness because all of of your male generation members have the same "problem" (which isn't a problem)

Since in prehistory man was hairy like an ape and now we are allmost hairless I think the ability of loosing hair is a step ahead in evolution! And I feel that being a little or more bald is very masculine!

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male pattern baldness and genetics? | Yahoo Answers

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List of Endocrine Disorders | Thyroid & Endocrine System …

Photo:via Imgur

Diabetes mellitus, commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications. Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, stroke, chronic kidney failure, foot ulcers, and damage to the eyes. Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced. There are three main types of ...more on Wikipedia

Symptoms: Polyphagia, Acanthosis nigricans, Hyperglycemia, Weight gain, Fatigue, + more

Treatments: Smoking cessation, Insulin lispro, Anti-diabetic medication, Physical examination, Chromium(III) picolinate, + more

Risk Factors: Tobacco smoking, Personal History of Gestational Diabetes, Indigenous peoples of the Americas, Asian American, Hispanic, + more

Parent Disease: Endocrine diseases, Nutrition disorder

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List of Endocrine Disorders | Thyroid & Endocrine System ...

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Stem cell numbers in a damaged knee – Dr. Marc Darrow is a …

Are there enough stem cells in your knees to heal the damage of osteoarthritis? If yes, why arent those stem cells fixing your knees now? Is it a lack of numbers?

Marc Darrow MD, JD. Thank you for reading my article. You can ask me your questions about bone marrow derived stem cells using the contact form below.

In 2011, doctors at the University of Aberdeen published research in the journal Arthritis and rheumatism that provided the first evidence that resident stem cells in the knee joint synovium underwent proliferation (multiplied) and chondrogenic differentiation (made themselves into cartilage cells) following injury.(1)This paper, presenting the idea that stem cells in an injured knee increased in numbers in preparation of healing has been cited by more than 40 medical studies.

If the stem cells in your knee synovial lining are abundant and have the ability to rebuild cartilage after injury, why isnt your knee fixing itself?

One of those 40 studies was performed by researchers at theUniversity of Calgary in 2012. Among their questions, if the stem cells in the knee synovial lining are abundant and have the ability to rebuild cartilage after injury, why isnt the knee fixing itself? Here is what they published:

Since osteoarthritis leads to a progressive loss of cartilage and synovial progenitors (rebuilding) cells have the potential to contribute to articular cartilage repair, the inability of osteoarthritis synovial fluid Mesenchymal progenitor cells (stem cell growth factors) to spontaneously differentiate into chondrocytes suggests that cell-to-cell aggregation and/or communication may be impaired in osteoarthritis and somehow dampen the normal mechanism of chondrocyte replenishment from the synovium or synovial fluid. Should the cells of the synovium or synovial fluid be a reservoir of stem cells for normal articular cartilage maintenance and repair, these endogenous sources of chondro-biased cells would be a fundamental and new strategy for treating osteoarthritis and cartilage injury if this loss of aggregation & differentiation phenotype can be overcome.(2)

This research was supported in a study from December 2017 In Nature reviews. The paper suggested that recognizing that joint-resident stem cells are comparatively abundant in the joint and occupy multiple niches (from the center of the joint to the out edges) will enable the optimization of single-stage therapeutic interventions for osteoarthritis.(3) The idea is to get these native stem cells to repair.

Now we know that there are many stem cells in the knee, when there is an injury there are more stem cells. If we can figure out how to get these stem cells turned on to the healing mode, the knee could heal itself of early stage osteoarthritis. So the problem is not the number of stem cells, BUT, communication.

This failure to communicate was also seen in other research. In 2016, another heavily cited paper, this time fromTehran University for Medical Sciences, noted that despite their larger numbers,the native stem cells act chaotically and are unable to regroup themselves into a healing mechanism and repair the bone, cartilage and other tissue. Introducing bone marrow stem cells into this environmentgets the native stem cells in line and redirects them to perform healing functions. The joint environmentis changed from chaotic to healing because of communication.(4) It should be pointed out that 62 medical studies cited the research in this papers findings).

A recentpaper from a research team inAustralia confirms how this change of joint environment works. It starts with cell signalling a new communication network is built.

University of Iowa research published in theJournal of orthopaedic research

Serious meniscus injuries seldom heal and increase the risk for knee osteoarthritis; thus, there is a need to develop new reparative therapies. In that regard, stimulating tissue regeneration by autologous (from you, not donated) stem/progenitor cells has emerged as a promising new strategy.

(The research team) showed previously that migratory chondrogenic progenitor cells (mobile cartilage growth factors) were recruited to injured cartilage, where they showed a capability in situ (on the spot) tissue repair. Here, we tested the hypothesis that the meniscus contains a similar population of regenerative cells.

Explant studies revealed that migrating cells were mainly confined to the red zone (where the blood is and its growth factors) in normal menisci: However, these cells were capable of repopulating defects made in the white zone (the desert area where no blood flows. Migrating cell numbers increased dramatically in damaged meniscus. Relative to non-migrating meniscus cells, migrating cells were more clonogenic, overexpressed progenitor cell markers, and included a larger side population. (They were ready to heal) Gene expression profiling showed that the migrating population was more similar tochondrogenic progenitor cells (mobile cartilage growth factors) than other meniscus cells. Finally, migrating cells equaledchondrogenic progenitor cells in chondrogenic potential, indicating a capacity for repair of the cartilaginous white zone of the meniscus. These findings demonstrate that, much as in articular cartilage, injuries to the meniscus mobilize an intrinsic progenitor cell population with strong reparative potential.(6)

The intrinsic progenitor cell population with strong repair potential are in your knee waiting to be mobilized.

So what are we to make of this research?There are a lot of stem cells in a knee waiting to repair. The problem is they are confused and not getting the correct instructions. Stem cell therapy can fix the communication problem and begin the repair process anew.

A leading provider of bone marrow derived stem cell therapy, Platelet Rich Plasma and Prolotherapy11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025

PHONE: (800) 300-9300

1 Kurth TB, Dellaccio F, Crouch V, Augello A, Sharpe PT, De Bari C. Functional mesenchymal stem cell niches in adult mouse knee joint synovium in vivo. Arthritis Rheum. 2011 May;63(5):1289-300. doi: 10.1002/art.30234.

2 Krawetz RJ, Wu YE, Martin L, Rattner JB, Matyas JR, Hart DA. Synovial Fluid Progenitors Expressing CD90+ from Normal but Not Osteoarthritic Joints Undergo Chondrogenic Differentiation without Micro-Mass Culture. Kerkis I, ed.PLoS ONE. 2012;7(8):e43616. doi:10.1371/journal.pone.0043616.

3 McGonagle D, Baboolal TG, Jones E. Native joint-resident mesenchymal stem cells for cartilage repair in osteoarthritis. Nature Reviews Rheumatology. 2017 Dec;13(12):719.

4Davatchi F, et al. Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow-up of three patients. Int J Rheum Dis. 2016 Mar;19(3):219-25.

5. Freitag J, Bates D, Boyd R, Shah K, Barnard A, Huguenin L, Tenen A.Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy a review.BMC Musculoskelet Disord. 2016 May 26;17(1):230. doi: 10.1186/s12891-016-1085-9. Review.

6 Seol D, Zhou C, et al. Characteristics of meniscus progenitor cells migrated from injured meniscus. J Orthop Res. 2016 Nov 3. doi: 10.1002/jor.23472.

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Stem cell numbers in a damaged knee - Dr. Marc Darrow is a ...

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Steps of PBSC or bone marrow donation – Be The Match

Step 1: Get ready to donate

Once you join the Be The Match Registry, you will be included in patient searches every day. If you match a patient, you will be contacted to confirm that you are willing to donate. If you agree to move forward, you will be asked to update your health information and participate in additional testing to see if you are the best match for the patient. If you are the best match, you will:

There are two methods of donation: PBSC and bone marrow. The patients doctor will choose which one is best for the patient.

The time it takes for a donor to recover varies. It depends on the person and type of donation. Most donors are able to return to work, school and other activities within 1 to 7 days after donation. Be The Match considers donor safety a top priority and will follow up with you regularly until you are able to resume normal activity.

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Steps of PBSC or bone marrow donation - Be The Match

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Journal of Stem Cell Research and Therapy- Open Access …

PUBMED NLM ID: 101586297 | Index Copernicus Value: 84.95 The Journal of Stem Cell Research & Therapy is an open access journal that showcases seminal research in the field of stem cell therapy. As stem-cells are flag-bearers of translational research, the field has an interdisciplinary feel by including oncology, clinical research, medicine and healthcare under the aegis of stem-cell therapy. It also includes scientific research related to the auxiliary areas of Biology by prioritizing scholarly communication milieu and transfers expert knowledge synthesized from the ever burgeoning stem-cell literature. In order to create such impactful content, the Journal of Stem Cell Research & Therapy brings together an expert Editorial Board, which comprises of noted scholars in the field of Cell Biology. Every single article is subjected to rigorous peer review by illustrious scientists. In addition to Research Articles, the Journal also publishes high quality Commentaries, Reviews, and Perspectives aimed at synthesizing the latest developments in the field, and putting forward new theories in order to provoke debates amongst the scholars in the field. The journal thus maintains the highest standards in terms of quality and comprehensive in its approach.The journal aims to provide the authors with an efficient and courteous editorial platform. The authors can be assured of an expeditious publishing process. In this regard, the journal also provides advance online posting of the accepted articles. The Journal of Stem Cell Research & Therapy ensures barrier-free, open access distribution of its content online and thus, helps in improving the citations for authors and attaining a good impact factor.

Scholarly Journal of Stem Cell Research & Therapy is using online manuscript submission, review and tracking systems of Editorial Manager for quality and quick review processing. Review processing is performed by the editorial board members of Journal of Stem Cell Research and Therapy or outside experts; at least two independent reviewers approval followed by editor approval is required for acceptance of any citable manuscript.

It is an undifferentiated cell which is capable of transforming into more cells of same type or multiple other types. They are found in multicellular organisms. They can differentiate into cells of blood, skin, heart, muscles, brain etc. In adult human being, they replenish the dead cells of various organs. Stem cells are being used for treatment of various diseases like diabetes, arthritis, few cancers, bone marrow failure etc.

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They can develop into any cell type or organ in the body. A single totipotent stem cell can give rise to an entire organism. Fertilized egg or a zygote is the best example. Zygote divides and produces more totipotent cells. After 4 days the cells lose totipotency and become pluripotent.

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They can differentiate into any cell type in the human body. Embryonic stem cells are mostly pluripotent stem cells. They have the ability to differentiate into any of three germ layers: endoderm, mesoderm, or ectoderm.

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These are multipotent stem cells normally found in the bone marrow and are derived from mesenchyme. They differentiate into adipocytes, chondrocytes, osteoblasts, myocytes and tendon. MSCs can also be extracted from blood, fallopian tube, fetal liver and lungs.

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They are the multipotent stem cells derived from mesoderm and located in red bone marrow. They are responsible for production of red blood cells, white blood cells and platelets. HSCs give rise to myeloid lineage (which forms erythrocytes, eosinophils, basophils, neutrophils, macrophages, mast cells and platelets) and lymphoid lineage (which forms T-lymphocytes, plasma cells and NK cells).

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They can differentiate into more than one cell type, but only into a limited number of cell types. Hematopoietic stem cells are considered multipotent as they can differentite into red blood cells, platelets, white blood cells but they cannot differentiate into hepatocytes or brain cells.

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Cells with stem cell like abilities have been observed breast cancer, colon cancer, leukemia, melanoma, prostate cancer which can form new cells and lead to tumorigenesis. They cause relapse and metastasis by giving rise to new tumors. Scientists are developing methods to destroy CSCs in place of traditional methods which focus on bulk of cancer cells.

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They are derived from Hematopoietic stem cells. They differentiate into Erythrocyte progenitor cell (forms erythrocytes), Thrombocyte progenitor cell (forms platelets) and Granulocyte-Monocyte progenitor cell (forms monocytes, macrophages, neutrophils, basophils, eosinophils, dendritic cells).

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They are the self-renewing, multipotent stem cells in the nervous system that differentiate into neurons, astrocytes and oligodendrocytes. They repair the nervous system after damage or an injury. They have potential clinical use the management of Parkinsons disease, Huntingtons disease and multiple sclerosis.

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They are derived from embryo in the blastocyst stage. They are pluripotent stem cells. They give rise to all derivatives of the three primary germ layers: endoderm (stomach, colon, liver, pancreas, intestines etc.), mesoderm (muscle, bone, cartilage, connective tissue, lymphatic system, circulatory system, genitourinary system etc.) and ectoderm (brain, spinal cord, epidermis etc.).

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Embryonic stem cells are derived from the fetus are used in treatment of various diseases. As ESCs are pluripotent, they can differentiate into any cell type. Researchers are able to grow ESCs into complex cells types like pancreatic -cells and cardiocytes. Fetal cell therapy is generating lot of controversy from religious groups and ethics committees.

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Research is being done to use stem cells for the treatment of diabetes mellitus. Human embryonic stem cells may be grown in vivo and stimulated to produce pancreatic -cells and later transplanted to the patient. Its success depends on response of the patients immune system and ability of the transplanted cells to proliferate, differentiate and integrate with the target tissue.

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The procedure to replace damaged cells (in cancers, aplastic anemia etc.) with healthy stem cells of the same person or in another compatible person to restore the normal production of cells. It can either be autologous or allogeneic. Bone marrow HSCs are generally used for the transplantation.

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They are the totipotent, undifferentiated cells present in the meristems (shoot and root apices) of a plant. They never undergo aging process and can grow into any cell in the plant throughout its lifetime. They have numerous applications in production of cosmetics, perfumes, pigments, insecticides and antimicrobials.

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Several types of dental stem cells have been isolated from mature and immature teeth, exfoliated deciduous teeth and apical papilla, MSCS from tooth germs and from human periodontal ligament. They are found to be multipotent and can give rise to osteogenic, adipogenic, myogenic and neurogenic cell lineages.

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Adipose tissue is a huge source of mesenchymal stem cells which differentiate into various cell types. They can be easily extracted in large numbers by a simple lipo-aspiration. They have good application potential in regenerative medicine. ASCs are found to have the ability to differentiate into bone cells, cartilage cells, nerve cells, adipocytes etc.

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Preservation of stem cells is critical for both research and clinical application of stem-cell based therapies. Properly preserved stem cells can be later used in the field of regenerative medicine for treating congenital disorders, heart defects etc. Currently there is no universal method for preserving stem cells and the existing methods are expensive.

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MSCs can be applied in osteoarthritis treatment through implantation and microfracture as well as intra-articular injections. Single injection studies have showed improvement from pain which decreased overtime. Multiple, regular MSC injections into joints may be necessary.

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OMICS International through its Open Access Initiative is committed to make genuine and reliable contributions to the scientific community. OMICS International hosts over 700 leading-edge peer reviewed Open Access Journals and organizes over 1000 International Conferences annually all over the world. OMICS International journals have over 10 million readers and the fame and success of the same can be attributed to the strong editorial board which contains over 50000 eminent personalities that ensure a rapid, quality and quick review process. OMICS International signed an agreement with more than 1000 International Societies to make healthcare information Open Access. OMICS International Conferences make the perfect platform for global networking as it brings together renowned speakers and scientists across the globe to a most exciting and memorable scientific event filled with much enlightening interactive sessions, world class exhibitions and poster presentations.

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Women’s History in Science Is Hidden in the Footnotes …

Read: Hidden Figures and the appeal of math in an age of inequality

One name sprang readily to mind: Jennifer Smith. Huerta-Snchez remembered reading a classic, decades-old paper in which Smith was thanked in the acknowledgments for ably programming and executing all the computations. That seemed odd. Today, programming is recognized as crucial work, and if a scientist did all the programming for a study, she would expect to be listed as an author. It was weird to me that Smith was not an author on that paper, Huerta-Snchez says. [Rori and I] wanted to see if there were more women like her.

The duo recruited five undergraduate students, who looked at every issue of a single journalTheoretical Population Biologypublished between 1970 and 1990. They pored through hard copies of almost 900 papers, pulled out every name in the acknowledgments, worked out whether they did any programming, and deduced their genders where possible. Rochelle Reyes, one of the students, says that she was extremely motivated to do this work, having grown up on stories of under-recognized pioneers like Rosalind Franklin, who was pivotal in deciphering the structure of DNA, and Henrietta Lacks, whose cells revolutionized medical research. I was fortunate to grow up in a diverse environment with a passion for science as well as social justice, Reyes says.

She and her colleagues found that in the 1970s, women accounted for 59 percent of acknowledged programmers, but just 7 percent of actual authors. That decade was a pivotal time for the field of population genetics, when the foundations of much modern research were laid. Based on authorship at the time, it seems that this research was conducted by a relatively small number of independent individual scientists, nearly all of whom were men, the team writes. But that wasnt the case.

Its hard to know what sort of contributions people in the past have made behind the scenes, says Jessica Abbott, a geneticist at Lund University. But this study shows that its possible to get the right kind of data if you think creatively.

Margaret Wu, for example, was thanked in a 1975 paper for help with the numerical work, and in particular for computing table I. She helped to create a statistical tool that scientists like Huerta-Snchez still regularly use to estimate how much genetic diversity there should be in a population of a given size. That tool is called the Watterson estimator, after the 1975 papers one and only authorG. A. Watterson. The paper has since been cited 3,400 times.

Skeptics might argue that the programmers listed in these old papers were just doing menial work that wasnt actually worthy of authorship. Rohlfs says thats unlikely, especially in the cases of Wu, Jennifer Smith, and Barbara McCann, who were repeatedly name-checked in many papers. They were doing work that was good enough that they were being called back again and again, she says. The team even talked with William Hill, Smiths former supervisor at the University of Edinburgh, who described her work as both technical and creative. (He didnt, unfortunately, know where Smith ended up, and the team never managed to track her down.)

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Women's History in Science Is Hidden in the Footnotes ...

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Where Do Stem Cells Come From? | Basics Of Stem Cell …

Where do stem cells come from? Learn the basics of master cells to better understand their therapeutic potential.

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Where do stem cells come from? You have probably heard of thewonders of stem cell therapy. Not only do stem cells make research for future scientific breakthroughs possible, but they also provide the basis for many medical treatments today. So, where exactly are they from, and how are they different from regular cells? The answer depends on the types of stem cells in question.

There are two main types of stem cells adult and embryonic:

Beyond the two broader categories, there are sub-categories. Each has its own characteristics. For researchers, the different types of stem cells serve specific purposes.

Many tissues throughout the adult human body contain stem cells. Scientists previously believed adult stem cells to be inferior to human embryonic stem cells for therapeutic purposes. Theydid not believe adult stem cells to be as versatile as embryonic stem cells (ESCs), because they are not capable of becoming all 200 cell types within the human body.

While this theoryhas notbeen entirely disproved, encouraging evidence suggests that adult stem cells can develop into a variety of new types of cells. They can also affect repair through other mechanisms.

In August 2017, the number of stem cell publications registered in PubMed, a government database, surpassed 300,000. Stem cells are also being explored in over 4,600 cell therapy clinical trials worldwide. Some of the earliest forms of adult stem cell use include bone marrow and umbilical cord blood transplantation.

It should be noted that while the term adult stem cell is used for this type of cell, it is not descriptive of age, because adult stem cells can come from children. The term simply helps to differentiate stem cells derived from living humans as opposed to embryonic stem cells.

Embryonic stem cells are controversial because they are made from embryos that are created but not used by fertility clinics.

Because adult stem cells are somewhat limited in the cell types they can become, scientists developed a way to genetically reprogram cells into what is called an inducedpluripotent stem cell or iPS cell. In creating inducedpluripotent stem cells, researchers hope to blend the usefulness of adult stem cells with the promise of embryonic stem cells.

Both embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) are known as pluripotent stem cells.

Pluripotent stem cells are a type of cell that has the capacity to divide indefinitely and create any cell found within the three germ layers of an organism: ectoderm (cells forming the skin and nervous system), endoderm (cells forming pancreas, liver, endocrine gland, and gastrointestinal and respiratory tracts), and mesoderm (cells forming connective tissues, and other related tissues, muscles, bones, most of the circulatory system, and cartilage).

Embryonic stem cells can grow into a much wider range of cell types, but they also carry the risk of immune system rejection in patients. In contrast, adult stem cells are more plentiful, easier to harvest, and less controversial.

Embryonic stem cells come from embryos harvested shortly after fertilization (within 4-5 days). These cells are made when the blastocysts inner cell mass is transferred into a culture medium, allowing them to develop.

At 5-6 days post-fertilization, the cells within the embryo start to specialize. At this time, they no longer are able to become all of the cell types within the human body. They are no longer pluripotent.

Because they are pluripotent, embryonic stem cells can be used to generate healthy cells for disease patients. For example, they can be grown into heart cells known as cardiomyocytes. These cells may have the potential to be injected into an ailing patients heart.

Harvesting stem cells from embryos is controversial, so there are guidelines created by the National Institutes of Health (NIH) that allow the public to understand what practices are not allowed.

Scientists can harvest perinatal stem cells from a variety of tissues, but the most common sources include:

The umbilical cord attaches a mother to her fetus. It is removed after birth and is a valuable source of stem cells. The blood it contains is rich in hematopoietic stem cells (HSC). It also contains smaller quantities of another cell type known as mesenchymal stem cells (MSCs).

The placenta is a large organ that acts as a connector between the mother and the fetus. Both placental blood and tissue are also rich in stem cells.

Finally, there is amniotic fluid surrounding a baby while it is in utero. It can be harvested if a pregnant woman needs a specialized kind of test known as amniocentesis. Both amniotic fluid and tissue contain stem cells, too.

Adult stem cells are usually harvested in one of three ways:

The blood draw, known as peripheral blood stem cell donation, extracts the stem cells directly from a donors bloodstream. The bone marrow stem cells come from deep within a bone often a flat bone such as the hip. Tissue fat is extracted from a fatty area, such as the waist.

Embryonic donations are harvested from fertilized human eggs that are less than five days old. The embryos are not grown within a mothers or surrogates womb, but instead, are multiplied in a laboratory. The embryos selected for harvesting stem cell are created within invitro fertilization clinics but are not selected for implantation.

Amniotic stem cells can be harvested at the same time that doctors use a needle to withdraw amniotic fluid during a pregnant womans amniocentesis. The same fluid, after being tested to ensure the babys health, can also be used to extract stem cells.

As mentioned, there is another source for stem cells the umbilical cord. Blood cells from the umbilical cord can be harvested after a babys birth. Cells can also be extracted from the postpartumhuman placenta, which is typically discarded as medical waste following childbirth.

The umbilical cord and the placenta are non-invasive sources of perinatal stem cells.

People who donate stem cells through the peripheral blood stem cell donor procedure report it to be a relativelypainless procedure. Similar to giving blood, the procedure takes about four hours. At a clinic or hospital, an able medical practitioner draws the blood from the donors vein in one of his arms using a needle injection. The technician sends the drawn blood into a machine, which extracts the stem cells. The blood is then returned to the donors body via a needle injected into the other arm. Some patients experience cramping or dizziness, but overall, its considered a painless procedure.

If a blood stem cell donor has a problem with his or her veins, a catheter may be injected in the neck or chest. The donor receives local anesthesia when a catheter-involved donation occurs.

During a bone marrow stem cell donor procedure, the donor is put under heavy sedation in an operating room. The hip is often the site chosen to harvest the bone marrow. More of the desired red marrow is found in flat bones, such as those in the pelvic region. The procedure takes up to two hours, with several extractions made while the patient is sedated. Although the procedure is painless due to sedation, recovery can take a couple of weeks.

Bone marrow stem cell donation takes a toll on the donorbecause it involves the extraction of up to 10 percent of the donors marrow. During the recovery period, the donors body gradually replenishes the marrow. Until that happens, the donor may feel fatigued and sore.

Some clinics offer regenerative and cosmetic therapies using the patients own stem cells derived from the fat tissue located on the sides of the waistline. Considered a simple procedure, clinics do this for therapeutic reasons or as a donation for research.

Stem cells differ from the trillions of other cells in your body. In fact, stem cells make up only a small fraction of the total cells in your body. Some people have a higher percentage of stem cells than others. But, stem cells are special because they are the mothers from which specialized cells grew and developed within us. When these cells divide, they become daughters. Some daughter cells simply self-replicate, while others form new kinds of cells altogether. This is the main way stem cells differ from other body cells they are the only ones capable of generating new cells.

The ways in which stem cells can directly treat patients grow each year. Regenerative medicine now relies heavily on stem cell applications. This type of treatment replaces diseased cells with new, healthy ones generated through donor stem cells. The donor can be another person or the patient themselves.

Sometimes, stem cells also exert therapeutic effects by traveling through the bloodstream to sites that need repair or by impacting their micro-environment through signaling mechanisms.

Some types of adult stem cells, like mesenchymal stem cells (MSCs), are well-known for exerting anti-inflammatory and anti-scarring effects. MSCs can also positively impact the immune system.

Conditions and diseases which stem cell regeneration therapy may help include Alzheimers disease, Parkinsons disease, and multiple sclerosis (MS). Heart disease, certain types of cancer, and stroke victims may also benefit in the future. Stem cell transplant promises advances in treatment for diabetes, spinal cord injury, severe burns, and osteoarthritis.

Researchers also utilize stem cells to test new drugs. In this case, an unhealthy tissue replicates into a larger sample. This method enables researchers to test various therapies on a diseased sample, rather than on an ailing patient.

Stem cell research also allows scientists to study how both healthy and diseased tissue grows and mutates under various conditions. They do this by harvesting stem cells from the heart, bones, and other body areas and studying them under intensive laboratory conditions. In this way, they get a better understanding of the human body, whether healthy or sick.

With the following stem cell transplant benefits, its not surprising people would like to try the therapy as another treatment option.

Physicians harvest stem cell from either the patient or a donor. For an autologous transplant, there is no risk of transferring any disease from another person. For an allogeneic transplant, the donor is meticulously screened before the therapy to make sure they are compatible with the patient and have healthy sources of stem cells.

One common and serious problem of transplants is the risk of rejecting the transplanted organs, tissues, stem cells, and others. With autologous stem cell therapy, the risk is avoided primarily because it comes from the same person.

Because stem cell transplants are typically done through infusion or injection, the complex and complicated surgical procedure is avoided. Theres no risk of accidental cuts and scarring post-surgery.

Recovery time from surgeries and other types of treatments is usually time-consuming. With stem cell therapy, it could only take about 3 months or less to get the patient back to their normal state.

As the number of stem cell treatments dramatically grew over the years, its survival rate also increased. A study published in the Journal of Clinical Oncology showed there was a significant increase in survival rate over 12 years among participants of the study. The study analyzed results from over 38,000 stem cell transplants on patients with blood cancers and other health conditions.

One hundred days following transplant, the researchers observed an improvement in the survival rate of patients with myeloid leukemia. The significant improvements we saw across all patient and disease populations should offer patients hope and, among physicians, reinforce the role of blood stem cell transplants as a curative option for life-threatening blood cancers and other diseases.

With the information above, people now have a better understanding of the answer to the question Where do stem cells come from? Stem cells are a broad topic to comprehend, and its better to go back to its basics to learn its mechanisms. This way, a person can have a piece of detailed knowledge about these master cells from a scientific perspective.

If you found this blog valuable, subscribe to BioInformants stem cell industry updates.

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Where Do Stem Cells Come From? | Basics Of Stem Cell Therapy

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Where Do Stem Cells Come From? | Basics Of Stem Cell ...

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An injectable bone marrowlike scaffold enhances T cell …

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Kuznetsov, S. A. et al. The interplay of osteogenesis and hematopoiesis: expression of a constitutively active PTH/PTHrP receptor in osteogenic cells perturbs the establishment of hematopoiesis in bone and of skeletal stem cells in the bone marrow. J. Cell Biol. 167, 11131122 (2004).

Song, J. et al. An in vivo model to study and manipulate the hematopoietic stem cell niche. Blood 115, 25922600 (2010).

Wils, E.-J. et al. Flt3 ligand expands lymphoid progenitors prior to recovery of thymopoiesis and accelerates T cell reconstitution after bone marrow transplantation. J. Immunol. 178, 35513557 (2007).

Maillard, I. et al. Notch-dependent T-lineage commitment occurs at extrathymic sites following bone marrow transplantation. Blood 107, 35113519 (2006).

Garber, K. Driving T-cell immunotherapy to solid tumors. Nat. Biotechnol. 36, 215219 (2018).

Jangalwe, S., Shultz, L. D., Mathew, A. & Brehm, M. A. Improved B cell development in humanized NOD-scid IL2R null mice transgenically expressing human stem cell factor, granulocyte-macrophage colony-stimulating factor and interleukin-3. Immun. Inflamm. Dis. 4, 427440 (2016).

Ripamonti, U. Bone induction by recombinant human osteogenic protein-1 (hOP-1, BMP-7) in the primate Papio ursinus with expression of mRNA of gene products of the TGF- superfamily. J. Cell. Mol. Med. 9, 911928 (2005).

Heliotis, M., Lavery, K., Ripamonti, U., Tsiridis, E. & Di Silvio, L. Transformation of a prefabricated hydroxyapatite/osteogenic protein-1 implant into a vascularised pedicled bone flap in the human chest. Int. J. Oral Maxillofac. Surg. 35, 265269 (2006).

Warnke, P. et al. Growth and transplantation of a custom vascularised bone graft in a man. Lancet 364, 766770 (2004). Dendritic cell activating scaffold in melanoma.

Carragee, E. J., Hurwitz, E. L. & Weiner, B. K. A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned. Spine J. 11, 471491 (2011).

Biffi, R. et al. Use of totally implantable central venous access ports for high-dose chemotherapy and peripheral blood stem cell transplantation: results of a monocentre series of 376 patients. Ann. Oncol. 15, 296300 (2004).

Li, M. O. & Rudensky, A. Y. T cell receptor signalling in the control of regulatory T cell differentiation and function. Nat. Rev. Immunol. 16, 220 (2016).

Hoffmann, P., Ermann, J., Edinger, M., Fathman, C. G. & Strober, S. Donor-type CD4+CD25+regulatory T cells suppress lethal acute graft-versus-host disease after allogeneic bone marrow transplantation. J.Exp. Med. 196, 389399 (2002).

Wan, Y. Y. & Flavell, R. A. YinYang functions of transforming growth factor- and T regulatory cells in immune regulation. Immunol. Rev. 220, 199213 (2007).

Bencherif, S. A. et al. Injectable cryogel-based whole-cell cancer vaccines. Nat. Commun. 6, 7556 (2015).

Palchaudhuri, R. et al. Non-genotoxic conditioning for hematopoietic stem cell transplantation using a hematopoietic-cell-specific internalizing immunotoxin. Nat. Biotechnol. 34, 738 (2016).

Bencherif, S. A. et al. Injectable preformed scaffolds with shape-memory properties. Proc. Natl Acad. Sci. USA 109, 1959019595 (2012).

Macdonald, M. L. et al. Tissue integration of growth factoreluting layer-by-layer polyelectrolyte multilayer coated implants. Biomaterials 32, 14461453 (2011).

Sprinzak, D. et al. Cis-interactions between Notch and Delta generate mutually exclusive signalling states. Nature 465, 86 (2010).

Nandagopal, N. et al. Dynamic ligand discrimination in the Notch signaling pathway. Cell 172, 869880 (2018).

Zakrzewski, J. L. et al. Adoptive transfer of T-cell precursors enhances T-cell reconstitution after allogeneic hematopoietic stem cell transplantation. Nat. Med. 12, 1039 (2006).

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Genetic Testing at Dana-Farber Cancer Institute – Dana …

Genetic Testing Q&AQ: What are genes?

A: Genes are individual units of inheritance made of DNA. We all have two copies of each gene; we inherit one copy from each of our parents and pass one copy on to each child. The exact DNA sequence of a gene is a code with instructions to make a functioning protein (like a recipe). Changes to the DNA code can cause the gene not to work and stop its protein from being made.

A: Genetic testing is a process that looks for alterations in a person's genes. Alterations in certain genes may lead to an increased risk of cancer. Therefore, genetic testing results may be helpful in tailoring cancer screening recommendations.

Genetic testing involves sending a blood sample to a specialized lab for analysis. Results are returned to the ordering physician and genetic counselor, who then discloses them to the patient and arranges appropriate follow-up care.

A: Genetic counselors are trained licensed professionals who have earned a Master's degree in genetic counseling from an accredited program. Cancer genetic counselors specifically counsel patients about inherited cancer syndromes, the chance they might carry a gene in a form that confers increased risk of specific inherited cancer syndromes, the mechanics of genetic testing, the patient's chance of having an inherited susceptibility to cancer, and the implications of being found to carry or not carry a genetic risk for cancer.

The role of a genetic counselor is to assist individuals and families in understanding genetic disorders. Genetic counselors:

Genetic counselors often help to interpret confusing or uncertain test results, and also educate patients and providers on new testing options. For this reason, genetic counselors may maintain contact with patients over time.

A: During the visit, your genetic counselor will take a detailed family history in order to evaluate the likelihood that you could have an inherited predisposition to cancer. Features of a family history that suggest a hereditary susceptibility include:

The genetic counselor may then discuss the option of testing and will explain the relevant gene(s) and associated syndrome in terms of cancer risks and medical management issues. Common concerns of genetic testing, including issues of insurance discrimination and confidentiality, will be discussed. Possible results of genetic testing, as well as the cost and logistics of testing, insurance coverage, or options if insurance does not cover, will also be reviewed. Your genetic counselor will help to guide you in making the best decisions regarding genetic testing for yourself, as a decision to undergo genetic testing or not is truly a personal decision.

A: Information regarding personal and family cancer history including the specific cancer(s), age(s) at diagnosis or information about pre-cancerous conditions such as colon polyps and copies of personal or family genetic test results are requested for your visit. Other medical records such as pathology reports, surgical reports, or summary notes) are often useful. Also helpful are prior pathology reports.

A: We recommend general guidelines for a healthy lifestyle as endorsed by the American Cancer Society and the National Cancer Institute, as these may also help reduce your risk for developing cancer.

In the videos below, Dana-Farber cancer genetics specialists provide answers to a variety of questions about specific genetic tests, interpreting test results, and genetic risk for cancer.

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Genetic Testing at Dana-Farber Cancer Institute - Dana ...

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Stem Cell Therapy For Knees | What You Need To Know …

The main conditions treated by stem cell injections include knee osteoarthritis, cartilage degeneration, and various acute conditions, such as a torn ACL, MCL, or meniscus. Stem cell therapy may speed healing times in the latter, while it can actually rebuild tissue in degenerative conditions such as the former.

Thats a major breakthrough. Since cartilage does not regenerate, humans only have as much as they are born with. Once years of physical activity have worn it away from joints, there is no replacing it. Or at least, there wasnt before stem cell therapy.

Now, this cutting-edge technology enables physicians to introduce stem cells to the body. Thesemaster cells are capable of turning into formerly finite cell types to help the body rebuild and restore itself.

Although it may sound like an intensive procedure, stem cell therapy is relatively straightforward and usually minimally invasive. These days, physicians have many rich sources of adult stem cells, which they can harvest right from the patients own body. This obviates the need for embryonic stem cells, and thereby the need for moral arguments of yore.

Mesenchymal stem cells (MSCs) are one of the main types used by physicians in treating knee joint problems. These cells live in bone marrow, butincreasing evidence shows they also exist in a range of other types of tissue.This means they can be found in places like fat and muscle. With a local anesthetic to control discomfort, doctors can draw a sample of tissue from the chosen site of the body. The patient usually doesnt feel pain even after the procedure. In some cases, the physician may choose to put the patient under mild anesthesia.

They then isolate the mesenchymal stem cells. Once they have great enough numbers, physicians use them to prepare stem cell injections. They insert a needle into the tissue of the knee and deliver the stem cells back into the area. This is where they will get to work rebuilding the damaged tissue. Although the mechanisms arent entirely clear, once inserted into a particular environment, mesenchymal stem cells exert positive therapeutics effectsinto the local tissue environment.

Mechanisms of action of mesenchymal stem cells appear to include reducing inflammation, reducing scarring (fibrosis), and positively impacting immune system function.

Thats not quite enough to ensure a successful procedure, however. Thats why stem cell clinics may also introduce growth factors to the area. These are hormones that tell the body to deliver blood, oxygen,and nutrients to the area, helping the stem cells thrive and the body repair itself.

Physicians extract these growth factors from blood in the form of platelet-rich plasma (PRP). They take a blood sample, put it in a centrifuge and isolate the plasma, a clear liquid free of red blood cells, but rich in hormones needed for tissue repair.

So, what can a patient reasonably expect when it comes to stem cell therapy, in terms of time and cost outlay?

The answers to both of these questions differ depending on the clinic doing the procedure and the patients level of knee degradation. Some clinics recommend a course of injections over time. Meanwhile, others prepare the injection and deliver it back to the patient in only a matter of hours. Either way, the treatment is minimally invasive, with fast healing times and a speedy return to normal (and even high-intensity) activity.

Some quotes for stem cell knee treatment are as low as $5,000. Others cost up to $20,000 or more. Again, this depends on how many treatments a patient needs, as well as how many joints theyre treating at the same time. Because its easier to batch prepare stem cells, a patient treating more than one knee (or another joint) can address multiple sites for far less. The procedure would only cost an addition of about $2,000 or so per joint.

No treatment proves effective every time. However, insofar as patients reporting good results for stem cell injections, the overall evidence does lean in a beneficial direction.Studies at the Mayo Clinic, for instance, indicate that while further research is needed, it is a good option for arthritis in the knee. Anecdotal reports are positive as well. Patients report it as an effective alternative to much more invasive solutions, such as arthroscopic or knee replacement surgery.

Other studies point to the need for caution. Stem cell therapy and regenerative medicine, in general, are only now exiting their infancies. There arent enough high-quality sources from which to draw at this point, so hard and fast conclusions remain elusive. Of the studies that do exist, some contain unacceptably high levels of bias.

Of course, any new treatment will face these kinds of challenges in the beginning. For those who need an answer to knee pain, and havent yet found one that works, its likely worth the risk that it wont prove as effective as they hoped. But what about other risks?

The good news about this form of stem cell therapy is that the patient uses their own cells. That means they completely skip over the dangers that accompany donor cells. The main one of which is graft-versus-host disease (in which the donor cells initiate an immune response against the patients body). Because the cells have all the same antibodies, neither the body nor the reintroduced cells will reject one another.

Also, the relatively low-stakes outpatient nature of the procedure (versus, say, a bone marrow transplant) means that the chances of something going wrong are much reduced.

However, there do exist some risks wherever needles come into play. It is possible to get an infection at the site of the blood draw as well as at the injection site, but these risks are quite low. Other risks include discoloration at theinjection site or soreness. While some people fear the possible growth of stem cells at the site of injection into a tumor, it is unlikely for this to happen, because physicians utilize adult stem cells for these procedures that have a low proliferative capacity.

These adult stem cells tend to be much safe than pluripotent stem cell types. Examples of pluripotent stem cells are embryonic stem cells (derived from embryos) and a type of lab-made stem cell known as induced pluripotent stem cell (iPS cell).

For those who think stem cell therapy could prove beneficial, its time to set up a consultation with your doctor. Multiple factors will influence whether or not its a good idea. These include age, health, andseverity of the condition and other available treatments. However, overall, this form of regenerative medicine is reasonably affordable, very low-risk, and typically effective.

Are you seeking a stem cell treatment for your knees or other joints?To support you,we have partnered withOkyanosa state-of-the-art facility providing patients with advanced stem cell treatments.

The group offers treatments for arange of chronic conditions, includingosteoarthritis and degenerative joint disease, which are leading causes of knee pain.

If you are seeking a stem cell treatment for knee pain or other chronic condition,contact Okyanos for a Free Medical Consultation.

What questions do you still have about stem cell therapy for knees? Ask them below and we will get you answers.

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Stem Cell Therapy For Knees | What You Need To Know ...

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Osiris Cryonics

Cryonics is an effort to save lives by using temperatures so cold that a person beyond help by today's medicine might be preserved for decades or centuries until a future medical technology can restore that person to full health. Cryonics is a second chance at life. It is the reasoned belief in the advancement of future medicinal technologies being able to cure things we cant today.

Many biological specimens, including whole insects, many types of human tissue including brain tissue, and human embryos have been cryogenically preserved, stored at liquid nitrogen temperature where all decay ceases, and revived. This leads scientists to believe that the same can be done with whole human bodies, and that any minimal harm can be reversed with future advancements in medicine.

Neurosurgeons often cool patients bodies so they can operate on aneurysms without damaging or rupturing the nearby blood vessels. Human embryos that are frozen in fertility clinics, defrosted, and implanted in a mothers uterus grow into perfectly normal human beings. This method isnt new or groundbreaking- successful cryopreservation of human embryos was first reported in 1983 by Trounson and Mohr with multicellular embryos that had been slow-cooled using dimethyl sulphoxide (DMSO).

And just in Feb. of 2016, there was a cryonics breakthrough when for the first time, scientists vitrified a rabbits brain and, after warming it back up, showed that it was in near perfect condition. This was the first time a cryopreservation was provably able to protect everything associated with learning and memory.

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Osiris Cryonics

Recommendation and review posted by Bethany Smith

Generate Fresh Mitochondria with PQQ – Life Extension

In 1983, Life Extension introduced a relatively little-known compound called coenzyme Q10. Our review of the literature back then had unearthed data confirming its power to boost the health and energy output of the mitochondria.

Today, scientists recognize mitochondrial dysfunction as a key biomarker of aging.1-6 To take one instance, researchers have recorded evidence of 50% more mitochondrial damage in the brain cells of humans over 70 compared to middle-aged individuals.7 Mitochondrial dysfunction and death are now definitively linked to the development of virtually all killer diseases of aging, from Alzheimers and type 2 diabetes to heart failure.8-11

The good news is that mitochondrial dysfunction can be reversed.12 The scientific literature is now filled with studies documenting the therapeutic power of CoQ10 to thwart degenerative disease by boosting mitochondrial health and bioenergetic (energy-producing) capacity.13-16

The latest advance in the area of mitochondrial bioenergetics is the coenzyme pyrroloquinoline quinone or PQQ.

PQQs critical role across a range of biological functions has only gradually emerged. Like CoQ10, it is a micronutrient whose antioxidant capacity provides extraordinary defense against mitochondrial decay.

But the most exciting revelation on PQQ emerged early in 2010, when researchers found it not only protected mitochondria from oxidative damageit stimulated growth of fresh mitochondria!17

In this article, you will learn of this novel coenzymes ability to combat mitochondrial dysfunction. You will find out how it protects the brain, heart, and muscles against degenerative disease. You will also discover its potential to reverse cellular aging by activating genes that induce mitochondrial biogenesisthe spontaneous formation of new mitochondria in aging cells!

PQQ is ubiquitous in the natural world. Its presence in interstellar stardust has led some experts to hypothesize a pivotal role for PQQ in the evolution of life on Earth.18 It has been found in all plant species tested to date. Neither humans nor the bacteria that colonize the human digestive tract have demonstrated the ability to synthesize it.19 This has led researchers to classify PQQ as an essential micronutrient.20

PQQs potential to stimulate mitochondrial biogenesis was foreshadowed by repeated early findings indicating its central role in growth and development across multiple forms of life.

It has been shown to be a potent growth factor in plants, bacteria, and higher organisms.21,22 Pre-clinical studies reveal that when deprived of dietary PQQ, animals exhibit stunted growth, compromised immunity, impaired reproductive capability, and most importantly, fewer mitochondria in their tissue. Rates of conception, the number of offspring, and survival rates in juvenile animals are also significantly reduced in the absence of PQQ.23-25 Introducing PQQ back into the diet reverses these effects, restoring systemic function while simultaneously increasing mitochondrial number and energetic efficiency.

As the primary engines of almost all bioenergy production, the mitochondria rank among the physiological structures most vulnerable to destruction from oxidative damage. PQQs formidable free radicalscavenging capacity furnishes the mitochondria with superior antioxidant protection.

At the core of this capacity is an extraordinary molecular stability.30 As a bioactive coenzyme, PQQ actively participates in the energy transfer within the mitochondria that supplies the body with most of its bioenergy (like CoQ10).

Unlike other antioxidant compounds, PQQs exceptional stability allows it to carry out thousands of these electron transfers without undergoing molecular breakdown. It has been proven especially effective in neutralizing the ubiquitous superoxide and hydroxyl radicals.31 According to the most recent research, PQQ is 30 to 5,000 times more efficient in sustaining redox cycling (mitochondrial energy production) . . . than other common [antioxidant compounds], e.g. ascorbic acid.21 A consistent finding in the scientific literature is that nutrients like PQQ provide more wide-ranging benefits than conventional antioxidants the general public relies on.

PQQs dual capacity as a cell signaling modulator and a superior antioxidant renders it optimally effective in combating degenerative disease and age-related declines in the bodys most energetic organs: the heart and brain.

The revelation of its ability to favorably affect system-wide cell development, metabolism, and mitochondrial biogenesis affords an explanation for a wealth of data on its neuroprotective and cardioprotective benefits.

PQQ has been shown to optimize health and function of the entire central nervous system. It reverses cognitive impairment caused by chronic oxidative stress in pre-clinical models, improving performance on memory tests.32 It has also been shown to safeguard the Parkinsons disease gene, DJ-1, from self-oxidationan early step in the onset of disease.33

Reactive nitrogen species (RNS), like reactive oxygen species, impose severe stresses on damaged neurons.34 They arise spontaneously following stroke and spinal cord injuries and have been shown to account for a substantial proportion of subsequent long-term neurological damage. PQQ suppresses RNS in experimentally induced strokes.35 It also provides additional protection by blocking gene expression of inducible nitric oxide synthase (iNOS), a major source of RNS, following spinal cord injury.36

PQQ powerfully protects brain cells against oxidative damage following ischemia-reperfusion injurythe inflammation and oxidative damage that result from the sudden return of blood and nutrients to tissues deprived of them by stroke.37 Given immediately before induction of stroke in animal models, PQQ significantly reduces the size of the damaged brain area.38

PQQ also interacts in a beneficial manner with our brains neurotransmitter systems. In particular, PQQ protects neurons by modifying the important NMDA receptor site.39,40 NMDA is a powerful mediator of excitotoxicity, a response to long-term overstimulation of neurons that is associated with many neurodegenerative diseases and seizures.41-43 PQQ also protects against neurotoxicity induced by other toxins, including mercury.44,45

A mounting body of evidence points to PQQ as a potent intervention in Alzheimers disease and Parkinsons disease. Both are triggered by accumulation of abnormal proteins that initiate a cascade of oxidative events resulting in brain cell death. PQQ prevents development of a protein (alpha-synuclein) associated with Parkinsons disease.46 It also protects nerve cells from the oxidizing ravages of the amyloid-beta protein linked with Alzheimers disease.47 A 2010 study revealed that PQQ could prevent formation of amyloid beta molecular structures.48

PQQ has also been shown to protect memory and cognition in both aging animals and humans.49,50 It stimulates production and release of nerve growth factor in cells that support neurons in the brain.51 This may partially explain why PQQ supplementation of aging rats resulted in marked improvement of their memory function.49

In humans, supplementation with 20 mg per day of PQQ resulted in improvements on tests of higher cognitive function in a group of middle-aged and elderly people.50 These effects were significantly amplified when the subjects also took 300 mg per day of CoQ10.

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Generate Fresh Mitochondria with PQQ - Life Extension

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Federal Shelf Life Extension Program Fact Sheet | State …

Fact Sheet Overview

The federal Shelf Life Extension Program (SLEP) extends the expiration dates on qualifying drugs and other materiel in federal stockpiles. SLEP is administered by the U.S. Department of Defense (DoD) in cooperation with the U.S. Food and Drug Administration (FDA).1 The program is an acknowledgement that the actual shelf life of drugs and other medical products may be longer than their stated expiration date, depending on their storage conditions. The purpose of SLEP is to defer replacement costs of stockpiled drugs by extending their useful life.

The program was established in 1986 through an interagency agreement between the DoD and the FDA in response to a Congressional directive to address U.S. Air Force drug stockpiles.2 This initial SLEP program was intended to extend the useful shelf life of medicines with limited commercial use (e.g., chemical agent antidotes) or which the government held in such large quantities that the manufacturer would not accept them for credit when the drugs expired.3 Since then, other federal agencies have entered into a memorandum of agreement with the DoD to participate in SLEP, including other branches of the military, the Strategic National Stockpile (SNS), the Department of Veterans Affairs (VA), the U.S. Postal Service, and the Bureau of Federal Prisions.2

SLEP is currently available only for federally-maintained stockpiles, although there have been ongoing deliberations between the federal government and the states about extending SLEP to state-maintained stockpiles or creating a separate SLEP-like program for state stockpiles. (See State Stockpiles discussion below.)

Note: As of March 2012, Congress is in the process of reauthorizing the Pandemic and All-Hazards Preparedness Act (PAHPA), which may impact a number of laws and programs described below. Please see ASTHO EUA Current Issues Winter 2012 for more information about reauthorization and its potential impact on EUAs and related issues. (Download a printable PDF.)

SLEP is a fee-for-service program. Participating agencies are required to pay for the FDAs periodic, comprehensive testing and analysis of the drugs and other medical materiel in the SLEP process. Items eligible for SLEP are tested by the FDA. Products that pass testing are granted extended expiration dates but must undergo ongoing testing to monitor their continued shelf life.4 Products that fail testing at any time are destroyed.4 Products that do not receive additional extensions of their expiration dates or are not tested for SLEP are destroyed at their final expiration dates.4 Maintaining controlled storage conditions appropriate for the product(s) is an important factor in the SLEP process.

The program is operated by the DoD Defense Medical Materiel Program Office (DMMPO) (formerly the Defense Medical Standardization Board [DMSB]) and regularly interacts with the FDA and agencies participating in SLEP.2,5 The DMMPO/DoD role in SLEP is to conduct programmatic and administrative functions, including but not limited to: (1) identifying products eligible for testing to FDA; (2) updating the SLEP expiration database; (3) conducting a cost-benefit analysis of extending a drugs expiration date; (4) ordering labels for relabeled drugs; and (5) billing participant agencies.2

The FDA is responsible for testing and evaluating drugs for SLEP. Specifically, the FDA: (1) determines the appropriate tests and methods for the candidate drugs; (2) conducts tests on samples of the candidate drugs; (3) analyzes test results and determines whether and for how long extension is possible; and (4) performs other research to address SLEP issues.2

Not every item stockpiled is a candidate for SLEP. Because of the costs involved in testing, the program is primarily designed for large stockpiles of drugs and medical materiel that are housed in environmentally controlled facilities.2 FDA-approved prescription drugs are most frequently designated for SLEP testing by program participants. Biological products such as vaccines, serums, and nutritional products or items with a history of poor SLEP performance are not eligible for testing.2,4 Items where testing would be time or cost prohibitive are not accepted.4 The focus on testing has been on products that are militarily significant, have limited commercial use, are purchased in large quantities (e.g., antivirals), or are used only if there is an event requiring their administration.2

The procedure to determine whether a drug or other medical materiel is eligible for extension under SLEP involves testing by the FDA. If an extension is granted, the approval document identifies the length of the extension and relabeling requirements. Products under SLEP are regularly retested and must be destroyed if at any time they fail testing.2

An Emergency Use Authorization (EUA) is a type of permission under FD&C Act 564 that allows for the use of an unapproved medical product or an unapproved use of an approved medical product (drugs, biologics [e.g., vaccines], and devices [e.g., diagnostics]) during certain types of emergencies. Products extended under SLEP through the exercise of FDA enforcement discretion receive a new expiration date that is different than the one originally contained on the products labeling and is considered a deviation from the items prior approved use. Similarly, some SNS products may have been stored in conditions that exceeded labeled temperature ranges. Currently, an EUA is required to ensure that SLEP-extended drugs are not in violation of the FD&C Act. (See also ASTHO Current Issues and UpdatesSummer 2011Evolving Policy Issues.) During the H1N1 influenza pandemic in 2009, Tamiflu (in capsules and suspension form) that was held in the SNS, much of which had been tested and extended under SLEP, was distributed to states and localities.2 The FDA issued an EUA that allowed the use of these products beyond the labeled expiration date without requiring that they be relabeled.

States have developed and maintained their own stockpiles of medicines and supplies in addition to those provided by the federal government through the SNS. In preparation for a pandemic, the federal government offered states a 25 percent subsidy to purchase additional antivirals through the SNS program. However, stockpiles held by states, whether purchased with state or federal funds, are not eligible for SLEP.10 In 2006, the National Strategy for Pandemic Influenza: Implementation Plan directed the HHS, the DoD, the VA, and the states to explore expanding SLEP to state stockpiles.11 Similarly, in a report about antiviral strategies for a pandemic, the Institute of Medicine recommended that the SLEP program be extended to other public and private stockpiles.10 That report also suggested using the information gained through SLEP to facilitate the use of properly stored recently expired drugs held outside SLEP.10 These recommendations acknowledged the high cost of replacing expired stockpiles and the potential scarcity of the drugs during a severe pandemic as important reasons for seeking to extend the drugs expiration dates.10

An FDA-led interagency workgroup that included the DoD, the CDC, and the VA determined that including state antiviral stockpiles in SLEP is not currently feasible.2 Reasons cited for the decision included programmatic, resource, quality, and legal considerations:

In addition to evaluating the feasibility of including states in SLEP, the HHS has been analyzing the feasibility of creating a separate SLEP-like program for extending state stockpiles. The Biomedical Advanced Research and Development Authority (BARDA) within the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) has been evaluating the infrastructure necessary to support a new program for states and analyzing the comparative cost effectiveness of shelf-life testing to repurchasing for state inventories.12 Cost factors to be considered include laboratory testing, storage site inspection, state personnel, relabeling for extended products, destruction for products not extended, and transportation for products being tested or destroyed.12 The HHS, BARDA, and the states conducted a detailed analysis with state-specific data in 2011, but no results have been released as of March 2012.12

SLEP currently impacts states primarily through SNS deployments containing medicines that have received, or subsequently receive, shelf-life extensions. Shelf-life-extended products that have an expired label date or that have been relabeled may cause concern among healthcare providers and the public about the safety and efficacy of the extended items. Liability fears can arise among healthcare providers and others dispensing the shelf-life-extended items. Furthermore, complications can arise in determining what products are eligible for SLEP when SNS assets have been mixed with non-SNS assets in state, local, or regional stockpiles.

While extending expiration dates potentially saves money for states by reducing the frequency of replacing expired stockpiled medicines, if state stockpiles are eventually included in the federal SLEP or a similar program for states, states will also have to consider the logistical, personnel, and financial implications of participating in such an initiative.

Note: This document was compiled from JuneDecember 2011 and reflects the laws and programs current then. It reflects only portions of the laws relevant to public health emergencies and is not intended to be exhaustive of all relevant legal authority. This resource is for informational purposes only and is not intended as a substitute for professional legal or other advice. The document was funded by CDC Award No. 1U38HM000454 to the Association of State and Territorial Health Officials; Subcontractor PI Elliott, Logan Circle Policy Group LLC.

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Federal Shelf Life Extension Program Fact Sheet | State ...

Recommendation and review posted by Bethany Smith

Grateful Casey Female Cannabis Seeds by Connoisseur Genetics

Here we have reversed the True Cannabliss cut of Head Seeds Casey Jones, now widely available on the Amsterdam coffee shop scene and we used it to pollinate itself. Casey Jones is a true elite strain in seed form and we are extremely grateful to Head Seeds for bringing it to the world. The spectrums of flavour we hope to represent with these S1s are a meaty/earthy funk with sweet fruity diesel undertones. We give all credit to grateful Head Seeds as all we did was remake his already outstanding work into fem seed Expect monster yields.

All our descriptions and images have come direct from the breeders who operate in a legal climate much different to that within the United Kingdom. Take note, you should NEVER try cultivating any cannabis plants within ANY jurisdiction where such cultivation is illegal. Our seeds are sold purely for souvenirs and should be treated as a curio or novelty item and should never be germinated. PLEASE DO NOT BREAK THE LAW!

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Grateful Casey Female Cannabis Seeds by Connoisseur Genetics

Recommendation and review posted by Bethany Smith

The Cost Of Stem Cell Therapy And Why It’s So Expensive …

How much is stem cell therapy? As stated by CBC Canada,the cost of stem cell therapy is $5,000 to $8,000per stem cell treatment for patients. According to a Twitter poll by BioInformant, the cost can be even higher. Our May 2018 poll found that stem cell treatments can cost as much as $25,000 or more. This article explores the key factors that impact the cost of stem cell therapy, including the type of stem cells used within the protocol, the number of treatments required, and the site of theclinic. It also provides pricing quotes from stem cell clinics within the U.S. and worldwide.

In this article:

Stem cell therapy is the use of living cells as therapeutics to treat disease or injury. Read on to learn about the cost requirements of these procedures.

CBC Canadas pricing involves Cell Surgical Network (CSN) following its protocol to remove fat tissue and process it before re-injecting [adipose-derived stem cells] either directly or intravenously into the same patient. Unfortunately, the U.S. FDA and Department of Justice (DOJ) sent this network of stem cell treatment providers a permanent injunction notice in May 2018. Therefore, patients should not seek treatments from the group at this time.Although Cell Surgical Network (CSN) is based in California, it has a network of approximately 100 U.S. treatment centers. They also have three Canadian clinics located in Vancouver, Sudbury,andKamloops.

The controversy such as the one above stirs up questions about the safety of stem cell procedures. Anyone considering stem cell therapy from any tissue or source will benefit from understanding the possible consequences of stem cell therapy and the factors driving costs.

For the patient, a stem cell transplant involves multiple steps, including:

There are also real costs for the doctors who provide stem cell treatments. They have overhead costs, including:

There is also time and expertise required toperform the procedure and offer post-operative care. In some cases, the physician must pay licensing fees to access stem cell sourcing, processing, or delivery technologies.

Stem cell treatment has gained more and more traction over the last decade. It has been helped along by considerable advances in research. In 2017, the number of scientific publications about stem cells surpassed 300,000. The number of stem cell clinical trials has also surpassed4,600 worldwide.

However, stem cell therapy is still expensive. Among the cheapest and easiest options is to harvest adipose-derived stem cells (ADSCs) those that exist in adult fat layers and re-deliver them to the patient. Unlike harvesting from bone marrow or teeth, providers can feasibly remove fat, separate stem cells, then re-inject them into a patient the same day. This approach is typically less expensive than those that require more invasive procedures for harvesting. Because of its practicality in terms of cost, it has become a common approach to stem cell treatment.

Relatively easy harvesting stilldoesnt translate to inexpensive cost, although some are certainly more affordable than others. For orthopedic conditions, the costof stem cell therapy is typically lower, averaging between $5,000 and $8,000. Examples of these types of medical conditions include:

Note that these prices are typically out-of-pocket costs paid by the patientbecause most insurance companies will not cover them. They are considered experimental and unapproved by the FDA. This means patients needing stem cell treatment will need to use their own savings.

Although fat is a frequently utilized source for stem cells, it is also possible for physicians to utilize stem cells from bone marrow. Regenexx provides this service in the U.S. and Cayman Islands. With theRegenexxstem cell injection procedure, a small bone marrow sample is extracted through a needle, and blood is drawn from a vein in the arm. These samples are processed in a laboratory, and the cells it contains are injected into an area of the body that needs repair. On June 19, 2018, ACAP Health, a leading provider in innovative, clinical-based solutions partnered with Regenexx to reduce high-cost musculoskeletal surgeries.ACAP Health is a national leader in employer healthcare expense reduction. It is one of the first healthcare groups to partner with a stem cell treatment group to support insurance coverage to patients.

A recent Twitter poll conducted by BioInformant reported that, on average, patients can expect to spend $25,000 or more on stem cell therapies. According to the poll,

Most likely, those paying lower stem cell treatment costs under $5,000 were pursuing treatment for orthopedic or musculoskeletal conditions. In contrast, those paying higher treatment costs were likely getting treated for systemic or more complex conditions, such as diabetes, multiple sclerosis (MS), neurodegenerative diseases (such as Alzheimers disease or dementia), psoriatic arthritis, as well as the treatment for autism.

In the U.S., treatment protocols vary depending on the clinic and the treating physician. A one-time treatment that utilizes blood drawn from a patient can cost as little as $1,500. However, protocols that utilize a bone marrow or adipose (fat) tissue extraction can run as much as $15,000 $30,000. This is because bone marrow extraction is an invasive procedure that requires a penetrating bone and adipose tissue extraction requires a medical professional trained in liposuction.

For treatments that require a systemic or whole-body approach, the cost tends to be in the higher range, often averaging from $20,000 to $30,000. Examples of the diseases or conditions requiring this type of stem cell treatment include:

These higher costs reflect the complexity of treating these patients and the fact that multiple treatments are often required.

Founded by Dr. Neil Riordan, a globally recognized stem cell expert, theStem Cell Institutein Panama is one of the worlds most trusted adult stem cell therapy centers. Over the past 12 years, the center has performed more than10,000 procedures, making it a widely recognized destination for stem cell treatments.

Working in collaboration with universities and physicians worldwide, its stem cell treatment protocols utilize combinations of allogeneic human umbilical cord blood stem cells and autologous bone marrow stem cells to treat a wide variety of conditions.

A reader of BioInformant was recently treated for psoriatic arthritis at the Stem Cell Institute in Panama in early 2018. The price of his stem cell treatment was $22,000. With travel and lodging included, the total expenses were approximately $30,000.

Because of its proximity to the U.S., Mexico is increasingly becoming a destination for medical tourism.Before choosing a stem cell treatment provider in Mexico, ensure the clinic is fully authorized by COFEPRIS, the Mexican equivalent to the FDA.

One patient who recently shared stem cell treatment quotes with BioInformant found that the treatment for glycogen storage disease, a metabolic disorder that often onsets in infancy and continues into adulthood, would cost $23,900 throughGIOSTAR Mexico.

In contrast, the patient was quoted$33,000 throughCelltex, a U.S.-based company that treats patients in Cancun, Mexico.Celltex follows FDA regulations concerning the export of cells to Mexico and is compliant with the standards and procedures of COFEPRIS. Celltex also has an alliance with a certified hospital in Mexico, which is approved to receive cells and administer them to patients by a licensed physician.

In contrast, the patient was quoted $10,000 from Stem Cell Therapy of Las Vegas and Med Spa, an American clinic. This price difference may reflect regulatory restrictions that prevent U.S. providers from expanding cells. It may also reflect the therapeutic approach used by the clinic, as well as the quality of their expertise.

In Mexico, where certain types of stem cell expansion are allowed that are restricted within the U.S., treatment protocols vary depending on the clinic and the treating physician. A one-time treatment that utilizes peripheral blood from a patient can cost as little as $1,000. In contrast, protocols that utilize more invasive sources of stem cells can run as much as $15,000 $35,000. Examples of invasive procedures includebone marrow and adipose tissue extraction. In some cases, hospitalization may be required, which raises costs. The location of a stem cell facility can factor heavily into thecost of the procedure.

Not every cost associated with treatment gets billed to the patient at the time of the procedure. Hidden costs such as reactions to the treatment, graft-versus-host disease, or disability derived from the treatment can all result in more money to the patient, to insurance, or to the government.

For example, in the case of someone with cancer, it frequently isnt viable to harvest the patients own stem cells because they may contain cancerous cells that can reintroduce tumors to the body. Instead, the patient would receive stem cells by transplant. Treatments that involve cells from another person are called allogeneic treatments. The danger here is that the body may see those cells as invaders and attack them via the immune system, a condition known as graft-versus-host disease (GvHD). The body (host) and the introduced stem cells (graft) then battle rather than coexist.

Transplanted cells often face the risk of being rejected by their host; this article discusses the effect of plasma exchange on acute graft vs. host disease

Katie Bunde (@kbuns76) May 29, 2018

In addition to making the stem cell treatments less effective or ineffective, GvHD can be deadly. Roughly30 to 60 percent ofhematopoieticstem cell and bone marrow transplantationpatients sufferfrom it, and of those, 50 percent eventually die. The hospital costs associated with it are substantial.

Another hidden cost is the potential to disrupt a system that formerly functioned adequately. The best current example of this isthe case of Doris Tyler, who received bilateral stem cell injections in her eyes from Drs.RobertHalpernand JamieWalraven of Stem Cell Center of Georgia. According to her, while her vision was failing, it was still good enough to perform various tasks, and now it is not. That means the cost increases for her, as well as potential insurance or disability claims (though again, insurance is unlikely to cover the specific consequences of this action).

Because of tight regulations surrounding stem cell procedures performed in the United States, many stem cell treatment providers provide both on-shore (U.S.-based) and offshore (international) treatment options.Depending on where a treatment is received, patients may have to pay travel, lodging,and miscellaneous expenditures.

For example, Regenexx offers treatments at a wide range of U.S. facilities using non-expanded stem cells. However, it also offers a laboratory-expanded treatment option at a site in the Cayman Islands, which can administer higher cell doses to patients by expanding the cells in culture within a laboratory.

Similarly, Okyanos (pronounced Oh key AH nos) offers treatments to patients at its Florida location and provides more involved stem cell procedures at its offshore site inGrand Bahama. It was founded in 2011 and is a stem cell therapy provider specializing in treatments for congestive heart failure (CHF) and other chronic conditions. It is fully licensed under the Bahamas Stem Cell Therapy and Research Act and adheres to U.S. surgical center standards.

Similarly, Celltex is headquartered in Houston, Texas, but offers stem cell treatments in Cancun, Mexico. Celltex specializes in storing a patients mesenchymal stem cells (MSCs) for therapeutic use.

While no hard evidence yet points to stem cell clinics raising their rates as a result of lawsuits, that is a typical response in industries whose products or services the public perceives as a high risk.

An additional danger to stem cell treatment providers,points out Nature, is the reduction of bottom-line profits through former patients winning suits. If clinics have to pay out the money they earned and then some to individuals suing for damages, they may soon become faced with an unviable business model. That is a definite concern for those hoping to leverage these treatments now and in the future.

As with any other area of medicine, patient evaluations of stem cell providers and treatments run the gamut from extremely satisfied to desolately unhappy. Those like Doris Tyler who have lost their eyesight exist at the negative end of the spectrum. However, many others praise stem cell treatments for their power to heal diseases, boost immunity, fight cancer, and more.

For example, BioInformants Founder and President, Cade Hildreth, had a favorable experience with stem cell therapy. Cade had bone marrow-derived stem cells collected and then had them re-injected into the knee to treat a devastating orthopedic injury. Cade was able to reverse pain, swelling, and scarring to reclaim an elite athletic ability.

As of now, this much is clear. There exists enough interest in America and across the world that stem cell providers are continuing to offer a wide range of treatments. Stem cell treatments also offer the potential to reverse diseases that traditionally had to be chronically managed by drugs. Like most medical practices, stem cell treatments will require further testing to reveal merits and faults. Until then, the public will likely continue to pursue services when medical needs arise.

Although the cost of stem cell therapy is pricey, some patients choose to undergo the treatment because it is more economical than enduring the costs associated with chronic diseases.

Although most stem cell therapy providers do not provide FDA-approved procedures, the Food and Drug Administration (FDA) continues to encouragepatients to pursue approved therapies, even if there is a higher associated treatment cost.

Providers rarely post their prices for stem cell treatments in print or digital media because they want patients to understand the benefits of therapy before making a price decision. Additionally, the price of stem cell treatments varies by condition, the number of treatments required, and the complexity of the procedure, factors that can make it difficult for medical providers to provide cost estimates without a diagnostic visit for the patient. However, in many cases, it is not in the patients best interest to make treatment decisions based on the cost of stem cell therapy. The best way to know whether to pursue stem cell therapy is to explore patient outcomes by condition and compare the healing process to other surgical and non-surgical treatment options.

The cost of stem cell therapy is indeed expensive, especially because the procedures are rarely covered by health insurance. However, with the right knowledge and a clear understanding of the treatment process, the risk of undergoing stem cell therapy can be worth it, especially if it removes the requirement for a lifetime of prescription medication. Although stem cell therapy has associated risks, it has improved thousands of lives and will continue to play in a key role in the future of modern medicine.

Download this infographic for your reference:

Are you seeking a stem cell treatment? If so, we have partnered with GIOSTAR to help you acccess medical guidance and advice.

In alignment with what we believe at BioInformant, GIOSTARs goal is to offer cutting-edge, extensively researched stem cell therapy options designed to rejuvenate and improve a patients quality of life.

Click here to Schedule a Consultation or ask GIOSTAR a question.

If you found this blog valuable, subscribe to BioInformants stem cell industry updates.

As the first and only market research firm to specialize in the stem cell industry, BioInformant research is cited by The Wall Street Journal, Xconomy, AABB, and Vogue Magazine. Bringing you breaking news on an ongoing basis, we encourage you to join more than half a million loyal readers, including physicians, scientists, executives, and investors.

Do you think the cost of stem cell therapy is too much? Share your thoughts in the comments section below.

Up Next: Japan to Supply Human Embryonic Stem Cells (hESC) for Clinical Research

Cost Of Stem Cell Therapy And Why Its So Expensive

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The Cost Of Stem Cell Therapy And Why It's So Expensive ...

Recommendation and review posted by Bethany Smith

Endometriosis – Diagnosis and treatment – Mayo Clinic


To diagnose endometriosis and other conditions that can cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.

Tests to check for physical clues of endometriosis include:

Laparoscopy. In some cases, your doctor may refer you to a surgeon for a procedure (laparoscopy) that allows the surgeon to view inside your abdomen. While you're under general anesthesia, your surgeon makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for signs of endometrial tissue outside the uterus.

A laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options. Your surgeon may take a tissue sample (biopsy) for further testing. Often, with proper surgical planning, your surgeon can fully treat endometriosis during the laparoscopy so that you only need one surgery.

Treatment for endometriosis usually involves medication or surgery. The approach you and your doctor choose will depend on how severe your signs and symptoms are and whether you hope to become pregnant.

Doctors typically recommend trying conservative treatment approaches first, opting for surgery if initial treatment fails.

Your doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), to help ease painful menstrual cramps.

If you find that taking the maximum dose of these medications doesn't provide full relief, you may need to try another approach to manage your signs and symptoms.

Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue.

Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment.

Therapies used to treat endometriosis include:

If you have endometriosis and are trying to become pregnant, surgery to remove the endometriosis implants while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery however, endometriosis and pain may return.

Your doctor may do this procedure laparoscopically or, less commonly, through traditional abdominal surgery in more-extensive cases. Even in severe cases of endometriosis, most women can be treated with laparoscopic surgery.

In laparoscopic surgery, your surgeon inserts a slender viewing instrument (laparoscope) through a small incision near your navel and inserts instruments to remove endometrial tissue through another small incision. After surgery, your doctor may recommend taking hormone medication to help improve your pain.

Women with endometriosis can have trouble conceiving. If you're having difficulty getting pregnant, your doctor may recommend fertility treatment supervised by a fertility specialist. Fertility treatment ranges from stimulating your ovaries to make more eggs to in vitro fertilization. Which treatment is right for you depends on your personal situation.

Surgery to remove the uterus (hysterectomy) and ovaries (oophorectomy) was once considered the most effective treatment for endometriosis. But endometriosis experts are moving away from this approach, instead focusing on the careful and thorough removal of all endometriosis tissue.

Having your ovaries removed results in menopause. The lack of hormones produced by the ovaries may improve endometriosis pain for some women, but for others, endometriosis that remains after surgery continues to cause symptoms. Early menopause also carries a risk of heart and blood vessel (cardiovascular) diseases, certain metabolic conditions and early death.

Even when the ovaries are left in place, a hysterectomy may still have a long-term effect on your health, especially if you have the surgery before age 35.

Finding a doctor with whom you feel comfortable is crucial in managing and treating endometriosis. You may want to get a second opinion before starting any treatment to be sure you know all of your options and the possible outcomes.

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

If your pain persists or if finding a treatment that works takes some time, you can try measures at home to relieve your discomfort.

Some women report relief from endometriosis pain after acupuncture treatment. However, research is sparse on this or any other alternative treatment for endometriosis. If you're interested in pursuing this therapy in the hope that it could help you, ask your doctor to recommend a reputable acupuncturist. Check with your insurance company to see if the expense will be covered.

If you're dealing with endometriosis or its complications, you may want to consider joining a support group for women with endometriosis or fertility problems. Sometimes it helps simply to talk to other women who can relate to your feelings and experiences. If you can't find a support group in your community, look for one on the internet.

Your first appointment will likely be with either your primary care physician or a gynecologist. If you're seeking treatment for infertility, you may be referred to a doctor who specializes in reproductive hormones and optimizing fertility (reproductive endocrinologist).

Because appointments can be brief, and it can be difficult to remember everything you want to discuss, it's a good idea to prepare in advance of your appointment.

For endometriosis, some basic questions to ask your doctor include:

Make sure that you understand everything your doctor tells you. Don't hesitate to ask your doctor to repeat information or to ask follow-up questions for clarification.

Some potential questions your doctor might ask include:

Excerpt from:
Endometriosis - Diagnosis and treatment - Mayo Clinic

Recommendation and review posted by Bethany Smith

Somatic cell nuclear transfer – Wikipedia

In genetics and developmental biology, somatic cell nuclear transfer (SCNT) is a laboratory strategy for creating a viable embryo from a body cell and an egg cell. The technique consists of taking an enucleated oocyte (egg cell) and implanting a donor nucleus from a somatic (body) cell. It is used in both therapeutic and reproductive cloning. Dolly the Sheep became famous for being the first successful case of the reproductive cloning of a mammal.[1] In January 2018, a team of scientists in Shanghai announced the successful cloning of two female crab-eating macaques (named Zhong Zhong and Hua Hua) from fetal nuclei.[2] "Therapeutic cloning" refers to the potential use of SCNT in regenerative medicine; this approach has been championed as an answer to the many issues concerning embryonic stem cells (ESC) and the destruction of viable embryos for medical use, though questions remain on how homologous the two cell types truly are.

Somatic cell nuclear transfer is a technique for cloning in which the nucleus of a somatic cell is transferred to the cytoplasm of an enucleated egg. When this is done, the cytoplasmic factors affect the nucleus to become a zygote. The blastocyst stage is developed by the egg which helps to create embryonic stem cells from the inner cell mass of the blastocyst.[3] The first animal that was developed by this technique was Dolly, the sheep, in 1996.[4]

The process of somatic cell nuclear transplant involves two different cells. The first being a female gamete, known as the ovum (egg/oocyte). In human SCNT (Somatic Cell Nuclear Transfer) experiments, these eggs are obtained through consenting donors, utilizing ovarian stimulation. The second being a somatic cell, referring to the cells of the human body. Skin cells, fat cells, and liver cells are only a few examples. The nucleus of the donor egg cell is removed and discarded, leaving it 'deprogrammed.' What is left is a somatic cell and an denucleated egg cell. These are then fused by inserting the somatic cell into the 'empty' ovum.[5] After being inserted into the egg, the somatic cell nucleus is reprogrammed by its host egg cell. The ovum, now containing the somatic cell's nucleus, is stimulated with a shock and will begin to divide. The egg is now viable and capable of producing an adult organism containing all the necessary genetic information from just one parent. Development will ensue normally and after many mitotic divisions, this single cell forms a blastocyst (an early stage embryo with about 100 cells) with an identical genome to the original organism (i.e. a clone).[6] Stem cells can then be obtained by the destruction of this clone embryo for use in therapeutic cloning or in the case of reproductive cloning the clone embryo is implanted into a host mother for further development and brought to term.

Somatic cell nuclear transplantation has become a focus of study in stem cell research. The aim of carrying out this procedure is to obtain pluripotent cells from a cloned embryo. These cells genetically matched the donor organism from which they came. This gives them the ability to create patient specific pluripotent cells, which could then be used in therapies or disease research.[7]

Embryonic stem cells are undifferentiated cells of an embryo. These cells are deemed to have a pluripotent potential because they have the ability to give rise to all of the tissues found in an adult organism. This ability allows stem cells to create any cell type, which could then be transplanted to replace damaged or destroyed cells. Controversy surrounds human ESC work due to the destruction of viable human embryos. Leading scientists to seek an alternative method of obtaining stem cells, SCNT is one such method.

A potential use of stem cells genetically matched to a patient would be to create cell lines that have genes linked to a patient's particular disease. By doing so, an in vitro model could be created, would be useful for studying that particular disease, potentially discovering its pathophysiology, and discovering therapies.[8] For example, if a person with Parkinson's disease donated his or her somatic cells, the stem cells resulting from SCNT would have genes that contribute to Parkinson's disease. The disease specific stem cell lines could then be studied in order to better understand the condition.[9]

Another application of SCNT stem cell research is using the patient specific stem cell lines to generate tissues or even organs for transplant into the specific patient.[10] The resulting cells would be genetically identical to the somatic cell donor, thus avoiding any complications from immune system rejection.[9][11]

Only a handful of the labs in the world are currently using SCNT techniques in human stem cell research. In the United States, scientists at the Harvard Stem Cell Institute, the University of California San Francisco, the Oregon Health & Science University,[12] Stemagen (La Jolla, CA) and possibly Advanced Cell Technology are currently researching a technique to use somatic cell nuclear transfer to produce embryonic stem cells.[13] In the United Kingdom, the Human Fertilisation and Embryology Authority has granted permission to research groups at the Roslin Institute and the Newcastle Centre for Life.[14] SCNT may also be occurring in China.[15]

In 2005, a South Korean research team led by Professor Hwang Woo-suk, published claims to have derived stem cell lines via SCNT,[16] but supported those claims with fabricated data.[17] Recent evidence has proved that he in fact created a stem cell line from a parthenote.[18][19]

Though there has been numerous successes with cloning animals, questions remain concerning the mechanisms of reprogramming in the ovum. Despite many attempts, success in creating human nuclear transfer embryonic stem cells has been limited. There lies a problem in the human cell's ability to form a blastocyst; the cells fail to progress past the eight cell stage of development. This is thought to be a result from the somatic cell nucleus being unable to turn on embryonic genes crucial for proper development. These earlier experiments used procedures developed in non-primate animals with little success.

A research group from the Oregon Health & Science University demonstrated SCNT procedures developed for primates successfully using skin cells. The key to their success was utilizing oocytes in metaphase II (MII) of the cell cycle. Egg cells in MII contain special factors in the cytoplasm that have a special ability in reprogramming implanted somatic cell nuclei into cells with pluripotent states. When the ovum's nucleus is removed, the cell loses its genetic information. This has been blamed for why enucleated eggs are hampered in their reprogramming ability. It is theorized the critical embryonic genes are physically linked to oocyte chromosomes, enucleation negatively affects these factors. Another possibility is removing the egg nucleus or inserting the somatic nucleus causes damage to the cytoplast, affecting reprogramming ability.

Taking this into account the research group applied their new technique in an attempt to produce human SCNT stem cells. In May 2013, the Oregon group reported the successful derivation of human embryonic stem cell lines derived through SCNT, using fetal and infant donor cells. Using MII oocytes from volunteers and their improved SCNT procedure, human clone embryos were successfully produced. These embryos were of poor quality, lacking a substantial inner cell mass and poorly constructed trophectoderm. The imperfect embryos prevented the acquisition of human ESC. The addition of caffeine during the removal of the ovum's nucleus and injection of the somatic nucleus improved blastocyst formation and ESC isolation. The ESC obtain were found to be capable of producing teratomas, expressed pluripotent transcription factors, and expressed a normal 46XX karyotype, indicating these SCNT were in fact ESC-like.[12] This was the first instance of successfully using SCNT to reprogram human somatic cells. This study used fetal and infantile somatic cells to produce their ESC.

In April 2014, an international research team expanded on this break through. There remained the question of whether the same success could be accomplished using adult somatic cells. Epigenetic and age related changes were thought to possibly hinder an adult somatic cells ability to be reprogrammed. Implementing the procedure pioneered by the Oregon research group they indeed were able to grow stem cells generated by SCNT using adult cells from two donors aged 35 and 75, indicating that age does not impede a cell's ability to be reprogrammed.[20][21]

Late April 2014, the New York Stem Cell Foundation was successful in creating SCNT stem cells derived from adult somatic cells. One of these lines of stem cells was derived from the donor cells of a type 1 diabetic. The group was then able to successfully culture these stem cells and induce differentiation. When injected into mice, cells of all three of the germ layers successfully formed. The most significant of these cells, were those who expressed insulin and were capable of secreting the hormone.[22] These insulin producing cells could be used for replacement therapy in diabetics, demonstrating real SCNT stem cell therapeutic potential.

The impetus for SCNT-based stem cell research has been decreased by the development and improvement of alternative methods of generating stem cells. Methods to reprogram normal body cells into pluripotent stem cells were developed in humans in 2007. The following year, this method achieved a key goal of SCNT-based stem cell research: the derivation of pluripotent stem cell lines that have all genes linked to various diseases.[23] Some scientists working on SCNT-based stem cell research have recently moved to the new methods of induced pluripotent stem cells. Though recent studies have put in question how similar iPS cells are to embryonic stem cells. Epigenetic memory in iPS affects the cell lineage it can differentiate into. For instance, an iPS cell derived from a blood cell will be more efficient at differentiating into blood cells, while it will be less efficient at creating a neuron.[24] This raises the question of how well iPS cells can mimic the gold standard ESC in experiments, as stem cells are defined as having the ability to differentiate into any cell type. SCNT stem cells do not pose such a problem and continue to remain relevant in stem cell studies.

This technique is currently the basis for cloning animals (such as the famous Dolly the sheep),[25] and has been theoretically proposed as a possible way to clone humans. Using SCNT in reproductive cloning has proven difficult with limited success. High fetal and neonatal death make the process very inefficient. Resulting cloned offspring are also plagued with development and imprinting disorders in non-human species. For these reasons, along with moral and ethical objections, reproductive cloning in humans is proscribed in more than 30 countries.[26] Most researchers believe that in the foreseeable future it will not be possible to use the current cloning technique to produce a human clone that will develop to term. It remains a possibility, though critical adjustments will be required to overcome current limitations during early embryonic development in human SCNT.[27][28]

There is also the potential for treating diseases associated with mutations in mitochondrial DNA. Recent studies show SCNT of the nucleus of a body cell afflicted with one of these diseases into a healthy oocyte prevents the inheritance of the mitochondrial disease. This treatment does not involve cloning but would produce a child with three genetic parents. A father providing a sperm cell, one mother providing the egg nucleus, and another mother providing the enucleated egg cell.[10]

In 2018, the first successful cloning of primates using somatic cell nuclear transfer, the same method as Dolly the sheep, with the birth of two live female clones (crab-eating macaques named Zhong Zhong and Hua Hua) was reported.[2][29][30][31][32]

Interspecies nuclear transfer (iSCNT) is a means of somatic cell nuclear transfer used to facilitate the rescue of endangered species, or even to restore species after their extinction. The technique is similar to SCNT cloning which typically is between domestic animals and rodents, or where there is a ready supply of oocytes and surrogate animals. However, the cloning of highly endangered or extinct species requires the use of an alternative method of cloning. Interspecies nuclear transfer utilizes a host and a donor of two different organisms that are closely related species and within the same genus. In 2000, Robert Lanza was able to produce a cloned fetus of a gaur, Bos gaurus, combining it successfully with a domestic cow, Bos taurus.[33]

Interspecies nuclear transfer provides evidence of the universality of the triggering mechanism of the cell nucleus reprogramming. For example, Gupta et al.,[34] explored the possibility of producing transgenic cloned embryos by interspecies somatic cell nuclear transfer (iSCNT) of cattle, mice, and chicken donor cells into enucleated pig oocytes. Moreover, NCSU23 medium, which was designed for in vitro culture of pig embryos, was able to support the in vitro development of cattle, mice, and chicken iSCNT embryos up to the blastocyst stage. Furthermore, ovine oocyte cytoplast may be used for remodeling and reprogramming of human somatic cells back to the embryonic stage.[35]

SCNT can be inefficient. Stresses placed on both the egg cell and the introduced nucleus in early research were enormous, resulting in a low percentage of successfully reprogrammed cells. For example, in 1996 Dolly the sheep was born after 277 eggs were used for SCNT, which created 29 viable embryos. Only three of these embryos survived until birth, and only one survived to adulthood.[25] As the procedure was not automated, but had to be performed manually under a microscope, SCNT was very resource intensive. The biochemistry involved in reprogramming the differentiated somatic cell nucleus and activating the recipient egg was also far from understood. However, by 2014, researchers were reporting success rates of 70-80% with cloning pigs[36] and in 2016 a Korean company, Sooam Biotech, was reported to be producing 500 cloned embryos a day.[37]

In SCNT, not all of the donor cell's genetic information is transferred, as the donor cell's mitochondria that contain their own mitochondrial DNA are left behind. The resulting hybrid cells retain those mitochondrial structures which originally belonged to the egg. As a consequence, clones such as Dolly that are born from SCNT are not perfect copies of the donor of the nucleus. This fact may also hamper the potential benefits of SCNT-derived tissues and organs for therapy, as there may be an immunoresponse to the non-self mtDNA after transplant.

Proposals to use nucleus transfer techniques in human stem cell research raise a set of concerns beyond the moral status of any created embryo. These have led to some individuals and organizations who are not opposed to human embryonic stem cell research to be concerned about, or opposed to, SCNT research.[38][39][40]

One concern is that blastula creation in SCNT-based human stem cell research will lead to the reproductive cloning of humans. Both processes use the same first step: the creation of a nuclear transferred embryo, most likely via SCNT. Those who hold this concern often advocate for strong regulation of SCNT to preclude implantation of any derived products for the intention of human reproduction,[41] or its prohibition.[38]

A second important concern is the appropriate source of the eggs that are needed. SCNT requires human egg cells, which can only be obtained from women. The most common source of these eggs today are eggs that are produced and in excess of the clinical need during IVF treatment. This is a minimally invasive procedure, but it does carry some health risks, such as ovarian hyperstimulation syndrome.

One vision for successful stem cell therapies is to create custom stem cell lines for patients. Each custom stem cell line would consist of a collection of identical stem cells each carrying the patient's own DNA, thus reducing or eliminating any problems with rejection when the stem cells were transplanted for treatment. For example, to treat a man with Parkinson's disease, a cell nucleus from one of his cells would be transplanted by SCNT into an egg cell from an egg donor, creating a unique lineage of stem cells almost identical to the patient's own cells. (There would be differences. For example, the mitochondrial DNA would be the same as that of the egg donor. In comparison, his own cells would carry the mitochondrial DNA of his mother.)

Potentially millions of patients could benefit from stem cell therapy, and each patient would require a large number of donated eggs in order to successfully create a single custom therapeutic stem cell line. Such large numbers of donated eggs would exceed the number of eggs currently left over and available from couples trying to have children through assisted reproductive technology. Therefore, healthy young women would need to be induced to sell eggs to be used in the creation of custom stem cell lines that could then be purchased by the medical industry and sold to patients. It is so far unclear where all these eggs would come from.

Stem cell experts consider it unlikely that such large numbers of human egg donations would occur in a developed country because of the unknown long-term public health effects of treating large numbers of healthy young women with heavy doses of hormones in order to induce hyperovulation (ovulating several eggs at once). Although such treatments have been performed for several decades now, the long-term effects have not been studied or declared safe to use on a large scale on otherwise healthy women. Longer-term treatments with much lower doses of hormones are known to increase the rate of cancer decades later. Whether hormone treatments to induce hyperovulation could have similar effects is unknown. There are also ethical questions surrounding paying for eggs. In general, marketing body parts is considered unethical and is banned in most countries. Human eggs have been a notable exception to this rule for some time.

To address the problem of creating a human egg market, some stem cell researchers are investigating the possibility of creating artificial eggs. If successful, human egg donations would not be needed to create custom stem cell lines. However, this technology may be a long way off.

SCNT involving human cells is currently legal for research purposes in the United Kingdom, having been incorporated into the Human Fertilisation and Embryology Act 1990.[42][5] Permission must be obtained from the Human Fertilisation and Embryology Authority in order to perform or attempt SCNT.

In the United States, the practice remains legal, as it has not been addressed by federal law.[43] However, in 2002, a moratorium on United States federal funding for SCNT prohibits funding the practice for the purposes of research. Thus, though legal, SCNT cannot be federally funded.[44] American scholars have recently argued that because the product of SCNT is a clone embryo, rather than a human embryo, these policies are morally wrong and should be revised.[45]

In 2003, the United Nations adopted a proposal submitted by Costa Rica, calling on member states to "prohibit all forms of human cloning in as much as they are incompatible with human dignity and the protection of human life."[46] This phrase may include SCNT, depending on interpretation.

The Council of Europe's Convention on Human Rights and Biomedicine and its Additional Protocol to the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine, on the Prohibition of Cloning Human Being appear to ban SCNT of human beings. Of the Council's 45 member states, the Convention has been signed by 31 and ratified by 18. The Additional Protocol has been signed by 29 member nations and ratified by 14.[47]

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Somatic cell nuclear transfer - Wikipedia

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Parkinson’s Glossary: The Michael J. Fox Foundation …

Acetylcholinesterase inhibitors

A class of drugs used to treat mild to moderate dementia in Parkinson's disease. These drugs increase brain levels of a neurotransmitter called acetylcholine, which helps neurons communicate with each other and is involved in memory, learning and thinking.

See also: dementia

Adult stem cells


A clumping of proteins inside cell bodies in the brain, which may be toxic. Aggregation of the protein alpha-synuclein is found in Lewy bodies, a pathological hallmark of Parkinson's disease.

See also: alpha-synuclein, Lewy bodies


A chemical that binds to a receptor on a cell and triggers a response by that cell.

See also: dopamine agonist


Inability to move ("freezing") or difficulty in initiating or maintaining a body motion. From the Greek a, without, and kinesia, movement.

See also: freezing


A protein normally found in neurons, and present in high concentrations in Lewy bodies. A genetic mutation in this protein is the basis for a rare inherited form of Parkinson's disease. For more information see alpha-synuclein as a priority area.

See also: aggregate

Animal models

Normal animals modified mechanically, genetically or chemically, used to demonstrate all or part of the characteristics of a disease. With models, researchers can study the mechanisms of a disease and test therapies. Also known as preclinical models.


A class of drugs often effective in reducing the tremor of Parkinson's disease. They work by blocking the action of acetylcholine, a neurotransmitter in the brain. However, because acetylcholine is involved in memory, learning and thinking, anticholinergic drugs can bring about cognitive side effects including confusion or dementia.

See also: dementia


A chemical compound or substance that inhibits oxidation - damage to cells' membranes, proteins or genetic material by free radicals (the same chemical reaction that causes iron to rust). Some studies have linked oxidative damage to Parkinson's disease.

Antiparkinsonian medication

A medicine used to treat Parkinson's disease. For more information see what patients on our Patient Council have to share on the topic of medication.


A movement disorder marked by loss of balance and decreased muscle coordination during voluntary movements.


A movement disorder sometimes confused with Parkinson's disease that manifests in low, repetitive, involuntary, writhing movements of the arms, legs, hands, and neck that are often especially severe in the fingers and hands.

Autonomic dysfunction

Any problem with the functioning of the autonomic nervous system, which controls unconscious body functions that affect the bladder, bowels, sweating, sexual function and blood pressure.

Basal ganglia

A region deep within the brain consisting of large clusters of neurons responsible for voluntary movements such as walking and movement coordination. Many of the symptoms of Parkinson's disease are brought on by loss of or damage to dopamine neurons in this region, which encompasses the striatum, the subthalamic nucleus, and the substantia nigra.

See also: dopamine, neuron, striatum, subthalamic nucleus, substantia nigra

Bilateral surgery

Surgery performed on both sides of the brain.


Specific, measurable physical traits used to determine or indicate the effects or progress of a disease or condition. For example, high blood pressure is a biomarker of potential cardiovascular disease. No validated biomarker of Parkinson's disease currently exists.

Blood-brain barrier

A thin layer of tightly packed cells separating the central nervous system from the body's blood stream. This layer is crucial to protecting the brain from foreign substances, but also blocks some potentially therapeutic treatments from entering the brain via orally administered drugs.


One of the cardinal clinical features of Parkinson's disease, the slowing down and loss of spontaneous and voluntary movement. From the Greek brady, slow, and kinesia, movement.

Cell replacement therapy

A strategy aiming to replace cells damaged or lost by disease or injury with healthy new cells. Cell replacement in Parkinson's aims to replace with new cells the dopamine-producing cells in the brain that are progressively lost through Parkinsons's disease. For more information see the MJFF Viewpoint on Cell Replacement Therapy for more information.

Central nervous system

Central nervous system (CNS) is a term referring to the brain and spinal cord.

See also: CNS


A general term for movement disorders that can be confused with Parkinson's disease, which are characterized by involuntary, random, jerking movements of muscles in the body, face, or extremities.

Clinical trials

Organized medical studies that test the effectiveness of various treatments, such as drugs or surgery, in human beings.


Abbreviation for "Central Nervous System," a term referring to the brain and spinal cord.

See also: Central nervous system

Coenzyme Q10

The most common form of Coenzyme Q, a vitamin-like antioxidant. Results of the first placebo-controlled, multicenter clinical trial of the compound, published in October 2002, suggested that it might slow disease progression in patients with early-stage Parkinson's disease. The results have yet to be confirmed in a larger study.

Cognitive dysfunction

The loss of intellectual functions (such as thinking, remembering, and reasoning) of sufficient severity to interfere with daily functioning. The term cognitive dysfunction includes dementia and executive dysfunction, and may also encompass changes in personality, mood, and behavior. Cognitive dysfunction in Parkinson's disease typically does not respond to dopamine replacement therapy and ranges from mild impairment to dementia.

See also: dementia, executive dysfunction, mild cognitive impairment


Irresistible impulses to act, regardless of the rationality of the motivation, or acts performed in response to such impulses. Some compulsive behaviors, such as compulsive gambling, hypersexuality, binge eating and shopping, have been associated with dopamine agonists used to treat Parkinson's disease, though this association has not been conclusively established.

COMT inhibitor

A drug that blocks an enzyme (catchol-O-methyltransferase) that breaks down dopamine. COMT inhibitors include entacapone and tolcapone. Tolcapone has been known to cause serious liver problems and has been withdrawn from the Canadian and European markets.

See also: enzyme, dopamine


A naturally occurring amino acid that helps to supply energy to muscle cells. A preliminary clinical trial in 200 Parkinson's patients, published in February 2006, suggested that creatine may slow the progression of PD and may therefore merit additional study. A much larger study is underway to further evaluate the potential neuroprotective effects of creatine.

CT scan

CT (Computed Tomography) scan is a technique that uses a series of X-rays to create image "slices" of the body from different orientations to create a two-dimensional cross sectional images of the body. Sometimes called CAT scan, for Cmputed Axial Tomography.

See also: imaging


Deep brain stimulation

Deep Brain Stimulation (DBS) is a surgical procedure that uses a surgically implanted, battery-operated medical device called a neurostimulator - similar to a heart pacemaker and approximately the size of a stopwatch - to deliver electrical stimulation to targeted areas in the brain that control movement, blocking the abnormal nerve signals that cause tremor and PD symptoms. At present, the procedure is used primarily for patients whose symptoms cannot be satisfactorily controlled with medications. For more information see what patients on our Patient Council have to share on the topic of DBS and late stage treatments.

See also: pallidotomy, surgical therapies, thalamotomy


A decline in memory and/or intellectual functioning severe enough to interfere with social or occupational functioning. Some Parkinson's patients experience dementia, generally at later stages of disease progression. This symptom does not typically respond to dopamine replacement therapy.

See also: cognitive dysfunction, executive dysfunction


A mental state, and non-dopamine-responsive symptom of Parkinson's disease, characterized by feelings of despondency and a lack of ability to initiate activity. For more information see what patients on our Patient Council have to share on the topic of emotion.

See also: cognitive dysfunction

Developmental biology

The study of the process by which organisms grow and develop. Developmental biology studies in Parkinson's disease hold potential to identify therapeutic targets and new cell replacement strategies.


Identification or naming of a disease by its signs and symptoms.



A gene of unknown function implicated in rare inherited cases of Parkinson's disease.


A neurotransmitter chemical produced in the brain that helps control movement, balance, and walking. Lack of dopamine is the primary cause of Parkinson's motor symptoms.

Dopamine agonist

A class of drugs commonly prescribed in Parkinson's disease that bind to dopamine receptors and mimic dopamine's actions in the brain. Dopamine agonists stimulate dopamine receptors and produce dopamine-like effects.




Involuntary, uncontrollable, and often excessive movements that are a common side effect of levodopa treatment for Parkinson's disease. These movements can be lurching, dance-like or jerky, and are distinct from the rhythmic tremor commonly associated with Parkinson's disease. For more information see what patients on our Patient Council have to share on the topic of dyskinesia and dystonia.


Difficulty swallowing. A common problem in Parkinson's that increases the risk of inhaling food or liquids into the airways, which in its later stages can lead to a condition known as "aspiration pneumonia."

See also: dopamine-non-responsive


A movement disorder that may be confused with Parkinson's disease. Dystonia is characterized by abnormal and awkward posture or sustained movements of a hand, foot, or other part of the body; may be accompanied by rigidity and twisting. For more information see what patients on our Patient Council have to share on the topic of dyskinesia and dystonia.

Embryonic stem cells

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Parkinson's Glossary: The Michael J. Fox Foundation ...

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Cellular Therapies Section Subsections – AABB

Groups called subsections allow members of the CT Section to focus on specific topic areas. Subsections work to identify challenges and develop materials to meet the needs of the field. Section participation is open to all AABB individual members who may enroll in any subsection(s) they choose.

CT Spanish LanguageCord BloodCT Asia Pacific GroupCT ManagementCT Product Collection and Clinical PracticesCT Product Manufacturing and TestingCT Quality OperationsCT Regulatory AffairsNovel Therapies and CT Product Development

This group is for Spanish-speaking members or those members located in Spanish-speaking regions. Members will be able to join live discussions and participate with fellow SLS members in regular subsection meetings held at 'convenient' times for the zones encompassed in the Latin America region. The SLS will address CT issues related to cord blood; donor qualification; manufacturing; storage and transport challenges; quality operations; regulatory issues; and development. The group will also address specific regional issues for developing programs. All interested individual AABB members who speak Spanish and would like to share their CT interests, insights and expertise in may join. (Meets 3rd Wednesdays at 10:00am ETmonthly)

La Subseccin en Espaol (SLS) ofrece a todos sus miembros la oportunidad de conocer e interconectarse con otros profesionales hispanohablantes. Los miembros pueden formar parte de discusiones estimulantes con otros colegas de la subseccin durante las reuniones regulares. Los convenientes horarios de estas reuniones han sido establecidos para acomodar a miembros localizados en Latinoamrica. El SLS abarcar temas de Terapia Celular (CT) relacionados con cordn umbilical; requisitos para donacin de productos celulares; retos en la manufactura, almacenamiento y transporte de productos de terapia celular; operaciones de calidad y temas especficos para el desarrollo de otros programas regionales. Todos los miembros hispanohablantes de AABB que deseen compartir sus intereses, visiones y experiencias pueden ser parte de esta subseccin. (Se rene el tercer mircoles de cada mes a las 10:00 am ET)

This group works on topics such as donor issues for public banking (recruitment, consent, screening/testing), manufacturing, storage and transport challenges, licensure, international issues, and private and family banking issues. (Meets 1st Thursdays at 1:00pm ET monthly)

For members located in the Asia-Pacific region, a designated group called the Asia Pacific Group or APG is available. Members will be able to join live discussions and directly participate with fellow APG members in regular subsection meetings held at 'convenient' times for the zones encompassed in this region. Countries in the region include Australia, China, Guam, Hong Kong, India, Indonesia, Japan, Malaysia, New Zealand, Philippines, Qatar, Singapore, South Korea, Sri Lanka, Taiwan, Thailand and Vietnam.

CT issues related to cord blood, donor qualification, manufacturing, storage and transport challenges, as well as quality operations, regulatory, development and specific regional issues will be addressed. The APG meeting time is tailored to those in the Asia-Pacific; however, all interested individual AABB members who would like to share their CT interests, insights and expertise may join. (Meets 2nd Wednesdays, monthly at 0400 UTC coordinated universal time)

This group works on topics such as reimbursement issues (Centers for Medicare/Medicaid (CMS), Food and Drug Administration (FDA)), funding sources for cell therapy development and clinical trials - federal and other public sources, venture capital, charitable donations (disease advocacy groups), as well as the administrative business (e.g. budgets, human resources , workload recording, cost accounting, job descriptions, staffing models, personnel management/project management, strategic planning, Lean/process engineering tools, expense reduction initiatives and cost containment) of cell therapy production. (Meets 2nd Tuesdays at 12:00pm ET bimonthly)

This group focuses primarily on clinical topics associated with the collection, transport, utilization and outcomes of cellular therapy products obtained from peripheral blood by apheresis, bone marrow, cord blood and other sources by the use of new technologies. Clinical topics include donor and recipient screening, eligibility, mobilization and collection, informed consent, product administration and infusion-related adverse events. (Meets 2nd Mondays at 1:00pm ET monthly)

This group works on technical topics and operational aspects related to the manufacturing and testing of CT products such as cryopreservation, cell separation and selection, automation, product characterization, assay development, validation and implementation. (Meets 3rd Thursdays at 11:00am ET monthly)

This group works on topics such as Quality Program design, risk assessment and risk management, vendor and supply qualification, facility, environmental and operational controls. (Meets 3rd Thursdays at 2:00pm ET monthly)

This group works on US and international topics involving regulations, guidance and policies from a variety of sources. Examples include FDA, Health Canada, European Medicine Evaluation Agency (EMEA), Office for Human Research Protections (OHRP), NIH, Regulatory Affairs Certification (RAC), and Health Resources and Services Agency (HRSA). (Meets3rd Tuesdays at 11:00am ET monthly)

This group works on topics such as 'new' research and preclinical studies, new devices for manipulating cells as well as later-stage cellular product development, validation, and technology transfer for clinical production. Examples include developments in the areas of induced pluripotent cells (iPS cells), tissue-derived cells, genetic engineering, structural materials, and biomaterials to name a few. (Meets 2nd Thursdays at 12:00pm ET monthly)

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Cellular Therapies Section Subsections - AABB

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