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Archive for August, 2012

Spiced Eggplant with Bulgur Salad

Spiced Eggplant with Bulgur Salad

Ingredients

  • 1/2 cup olive oil, divided, plus more for drizzling
  • 2 tablespoons finely chopped preserved lemon peel
  • 2 garlic cloves, smashed
  • 2 teaspoons ground cumin
  • 1 teaspoon ground coriander
  • 1 teaspoon paprika
  • 3/4 teaspoon ground cinnamon
  • 1/2 teaspoon crushed red pepper flakes
  • 1/2 teaspoon kosher salt plus more
  • 2 medium eggplants (9–10 ounces each), halved lengthwise
  • 1 cup quick-cooking bulgur
  • 1/2 cup pitted green olives, quartered lengthwise
  • 1/2 small red onion, very thinly sliced
  • 1/3 cup currants
  • 1/3 cup flat-leaf parsley, chopped
  • 1/3 cup fresh cilantro, chopped, plus more for garnish
  • 1/4 cup pistachios, toasted and lightly crushed
  • 2 tablespoons fresh lemon juice
  • Freshly ground black pepper
  • Ingredient Info

    Preserved lemons have been soaked in salt and lemon juice for several weeks. They are available at specialty foods stores, Middle Eastern markets, and kalustyans.com. Bulgur is available at better supermarkets and at natural foods stores.

Preparation

  • Preheat oven to 350°. Stir 1/4 cup oil, next 7 ingredients, and 1/2 tsp. salt in a small bowl for spice mix. Score flesh of each eggplant half with 1/2″-deep diagonal crisscrossing lines, spacing 1″ apart (do not cut through skin). Drizzle 1 Tbsp. oil over cut side of each half, allowing it to soak in. Season lightly with salt. Brush or spoon spice mix over, dividing evenly. Place eggplants, cut side up, on a rimmed baking sheet. Roast until soft and very tender in center, 50–60 minutes.
  • Meanwhile, place bulgur in a large bowl and cover with 1 1/2 cups boiling water. Let soak for 45 minutes to soften and absorb water. Stir in olives, onion, currants, parsley, 1/3 cup cilantro, pistachios, and lemon juice. Season to taste with salt and pepper. Let stand for at least 30 minutes for flavors to meld. DO AHEAD: Eggplant and bulgur salad can be made 2 hours ahead. Let stand at room temperature.
  • Serve eggplant warm or at room temperature. Place an eggplant half on each plate. Spoon some bulgur salad and a dollop of yogurt alongside. Sprinkle with remaining cilantro and drizzle with oil.

Bonappetit

Vitamin B3 ‘helps kill superbugs’

Drug-resistant MRSA

Antibiotic resistance is increasing

Vitamin B3 could be the new weapon in the fight against superbugs such as MRSA, researchers have suggested.

US experts found B3, also known as nicotinamide, boosts the ability of immune cells to kill Staphylococcus bacteria.

B3 increases the numbers and efficacy of neutrophils, white blood cells that can kill and eat harmful bugs.

The study, in the Journal of Clinical Investigation, could lead to a “major change in treatment”, a UK expert said.

B3 was tested on Staphylococcal infections, such as the potentially fatal MRSA (Methicillin-resistant Staphylococcus aureus).

Such infections are found in hospitals and nursing homes, but are also on the rise in prisons, the military and among athletes.

‘Turn on’

The scientists used extremely high doses of B3 – far higher than that obtained from dietary sources – in their tests, carried out both on animals and on human blood.

Continue reading the main story

“Start Quote

I cannot see why this couldn’t be used straight away in infected patients”

Prof Mark Enright, University of Bath

And the researchers say there is as yet no evidence that dietary B3 or supplements could prevent or treat bacterial infections.

The researchers say B3 appears to be able to “turn on” certain antimicrobial genes, boosting the immune cells’ killing power.

Prof Adrian Gombart, of Oregon State University’s Linus Pauling Institute, who worked on the research, said: “This is potentially very significant, although we still need to do human studies.

“Antibiotics are wonder drugs, but they face increasing problems with resistance by various types of bacteria, especially Staphylococcus aureus.

“This could give us a new way to treat Staph infections that can be deadly, and might be used in combination with current antibiotics.

“It’s a way to tap into the power of the innate immune system and stimulate it to provide a more powerful and natural immune response.”

Prof Mark Enright, of the University of Bath, said: “Neutrophils are really the front line against infections in the blood and the use of nicotinamide seems safe at this dose to use in patients as it is already licensed for use.

“This could cause a major change in treatment for infections alongside conventional antibiotics to help bolster patients immune system.

“I would like to see in patient clinical trials but cannot see why this couldn’t be used straight away in infected patients.”

BBC

Young cannabis smokers run risk of lower IQ, report claims

Prof Terrie Moffitt, researcher: “Those who started using cannabis regularly when they were in secondary school had lost, on average, about eight IQ points”

By Dominic Hughes Health correspondent, BBC News

Young people who smoke cannabis for years run the risk of a significant and irreversible reduction in their IQ, research suggests.

The findings come from a study of around 1,000 people in New Zealand.

An international team found those who started using cannabis below the age of 18 – while their brains were still developing – suffered a drop in IQ.

A UK expert said the research might explain why people who use the drug often seem to under-achieve.

For more than 20 years researchers have followed the lives of a group of people from Dunedin in New Zealand.

They assessed them as children – before any of them had started using cannabis – and then re-interviewed them repeatedly, up to the age of 38.

Having taken into account other factors such as alcohol or tobacco dependency or other drug use, as well the number of years spent in education, they found that those who persistently used cannabis – smoking it at least four times a week year after year through their teens, 20s and, in some cases, their 30s – suffered a decline in their IQ.

The more that people smoked, the greater the loss in IQ.

It is such a special study that I’m fairly confident that cannabis is safe for over-18 brains, but risky for under-18 brains”

Professor Terrie Moffitt Institute of Psychiatry, King’s College London

The effect was most marked in those who started smoking cannabis as adolescents.

For example, researchers found that individuals who started using cannabis in adolescence and then carried on using it for years showed an average eight-point IQ decline.

Stopping or reducing cannabis use failed to fully restore the lost IQ.

The researchers, writing in the US journal Proceedings of the National Academy of Sciences, found that: “Persistent cannabis use over 20 years was associated with neuropsychological decline, and greater decline was evident for more persistent users.”

“Collectively, these findings are consistent with speculation that cannabis use in adolescence, when the brain is undergoing critical development, may have neurotoxic effects.”

One member of the team, Prof Terrie Moffitt of King’s College London’s Institute of Psychiatry, said this study could have a significant impact on our understanding of the dangers posed by cannabis use.

“This work took an amazing scientific effort. We followed almost 1,000 participants, we tested their mental abilities as kids before they ever tried cannabis, and we tested them again 25 years later after some participants became chronic users.

There are a lot of clinical and educational anecdotal reports that cannabis users tend to be less successful in their educational achievement, marriages and occupations”

Professor Robin Murray Instuitute of Psychiatry, King’s College London

“Participants were frank about their substance abuse habits because they trust our confidentiality guarantee, and 96% of the original participants stuck with the study from 1972 to today.

“It is such a special study that I’m fairly confident that cannabis is safe for over-18 brains, but risky for under-18 brains.”

Robin Murray, professor of psychiatric research, also at the King’s College London Institute of Psychiatry but not involved in the study, said this was an impressive piece of research.

“The Dunedin sample is probably the most intensively studied cohort in the world and therefore the data are very good.

“Although one should never be convinced by a single study, I take the findings very seriously.

“There are a lot of clinical and educational anecdotal reports that cannabis users tend to be less successful in their educational achievement, marriages and occupations.

“It is of course part of folk-lore among young people that some heavy users of cannabis – my daughter calls them stoners – seem to gradually lose their abilities and end up achieving much less than one would have anticipated. This study provides one explanation as to why this might be the case.

“I suspect that the findings are true. If and when they are replicated then it will be very important and public education campaigns should be initiated to let people know the risks.”

Prof Val Curran, from the British Association for Psychopharmacology and University College London, said: “What it shows is if you are a really heavy stoner there are going to be consequences, which I think most people would accept.

“This is not occasional or recreation use.”

She also cautioned that there may be another explanation, such as depression, which could result in lower IQ and cannabis use.

Marjorie Wallace, chief executive of the mental health charity SANE, said: “In a significant minority of people who are vulnerable the drug can act as a trigger to illnesses like schizophrenia which may last a lifetime.”

Illicit drug use by young people has been decreasing since the mid 1990s, but the rate of decline in cannabis use throughout most of the last decade has been slow, official statistics show.

BBC

Tuning a piano ‘moulds the mind’

The changes occurred outside of auditory brain areas

Tuning a piano also tunes the brain, say researchers who have seen structural changes within the brains of professional piano tuners.

It appears that listening to two notes played simultaneously to get them pitch perfect causes the brain to adapt.

Brain scans revealed highly specific changes in the hippocampus, which governs memory and navigation. These correlated with the number of years that tuners had been doing this job.

The study is published in Neuroscience.

The Wellcome Trust researchers at University College London and Newcastle University used magnetic resonance imaging to compare the brains of 19 professional piano tuners and 19 other people.

What they saw was highly specific changes in both the grey matter – the nerve cells where information processing takes place – and the white matter – the nerve connections – within the brains of the piano tuners.

Investigator Sundeep Teki said: “We already know that musical training can correlate with structural changes, but our group of professionals offered a rare opportunity to examine the ability of the brain to adapt over time to a very specialised form of listening.”

Other researchers have noted similar hippocampal changes in taxi drivers as they build up detailed information needed to find their way around London’s labyrinth of streets.

Prof Tim Griffiths, who led the latest study, said: “There has been little work on the role of the hippocampus in auditory analysis.

“Our study is consistent with a form of navigation in pitch space as opposed to the more accepted role in spatial navigation.”

BBC

Traffic-light blood test shows hidden alcohol harm

Beer in a glass

Repeated exposure to alcohol can scar the liver

By Michelle Roberts Health editor, BBC News online

 

A traffic-light colour-coded blood test can reveal hidden liver damage caused by drinking above recommended alcohol limits, say experts.

The UK doctors who devised the test say anyone who regularly drinks more than three or four bottles of wine a week, for example, is at significant risk.

Ultimately, GPs could offer the test to patients, especially since many people do not recognise unsafe drinking.

Often damage is only noticed at a late stage as the liver starts to fail.

Although the liver can heal itself to some extent, repeated onslaught will cause irreparable damage.

Amber means we can’t be absolutely sure but there is at least a 50:50 chance that you have scarred liver, and there is a significant possibility that you could die of it within 5 years”

Dr Nick Sheron Liver expert at the University of Southampton

By the time the patient reaches hospital, the liver can be very scarred. And even when they stop drinking entirely, in many cases it is too late and they will die of liver complications over the next 12 months.

The traffic-light test can give an early colour-coded warning – green means damage is unlikely, amber means there is a 50:50 chance it is there, and red means the liver is most probably damaged and potentially irreversibly.

It combines a routine liver test doctors already use with two others that measure the level of scarring, also known as fibrosis.

Tried and tested

To try it out, the University of Southampton researchers tested more than 1,000 patients at their liver clinic.

Dangerous drinking

  • Although it can take as long as 10 to 20 years, drinking just a bit more than you should over time can seriously harm your liver
  • Not feeling any side effects from drinking does not mean that you are not risking chronic ill-health or lasting liver damage from alcohol-related liver disease
  • Are you drinking too much? Take the test

This revealed that the traffic-light test was also good at predicting the prognosis of liver disease. Half of the liver patients had a red traffic light and (of a subset of these who were followed up) about a quarter died over the next five years, whereas none of the patients with a green test died or developed complications.

The findings are published in the British Journal of General Practice.

Dr Sheron’s team have also been investigating how the test can be used in primary care.

Preliminary results in about 400 hazardous drinkers from 10 GP surgeries suggest many patients are willing to be tested and that learning the result can change behaviour.

A third of those given a green result cut down on their alcohol intake, while more than two-thirds of those given a red or amber result subsequently drank less.

Dr Nick Sheron, who devised the test, said: “It is a powerful tool and message for people. We can say, ‘Amber means we can’t be absolutely sure but there is at least a 50:50 chance that you have a scarred liver, and there is a significant possibility that you could die of it within 5 years’.

“We find that for most patients this is a pretty good stimulus to stop drinking or at least to cut down to safe levels.”

He said, generally, people were receptive to being tested.

“People are immensely curious about if their alcohol intake is doing any harm. They want to take the test.”

As well as people who drink more than the recommended amount, people who drink and are overweight or have type-two diabetes should consider getting tested, says Dr Sheron. This is because they are at increased risk of liver damage.

The Department of Health says men should not regularly drink more than three to four units of alcohol a day and women should not regularly drink more than two to three units a day.

“Regularly” means drinking every day or most days of the week. And if you do drink more heavily than this on any day, allow 48 alcohol-free hours afterwards to let your body recover.

The Royal College of Physicians (RCP) advises no more than 21 units per week for men and 14 units per week for women. But also, have two to three alcohol-free days a week to allow the liver time to recover after drinking anything but the smallest amount of alcohol.

There are one and a half units of alcohol in a small glass (125 ml) of ordinary strength wine (12% alcohol by volume) or a standard pub measure (35 ml) of spirits (40% alcohol by volume).

Estimates suggest 10 million or one in five adults in England drink above recommended levels.

Prof Sir Ian Gilmore, chair of the Alcohol Health Alliance, said: “One of the challenges of liver disease, which is rising dramatically in this country, is the silent nature of the condition until it is often too late to reverse the damage.

“However minor changes in standard liver blood tests are so common that it is difficult for GPs to know when to refer for specialist advice.

“This large study from Sheron and colleagues in Southampton may prove really useful for guiding the right patients towards specialist care in a timely way.”

Andrew Langford of the British Liver Trust said: “If we are to make an in-road in reducing liver deaths – the only big killer increasing year on year – we have to make it easier for primary care to better understand the management of liver conditions as well as spotting the signs early.”

BBC

Sterling performance for IHH Healthcare post-listing

KUALA LUMPUR: IHH Healthcare Bhd net profit for the second quarter ended June 30 jumped by a whopping 426% to RM403.5mil on revenue of RM2.7bil that reflected an increase of 231% year-on-year.

For the first half-year, net profit for Asia’s biggest healthcare services provider rose 195% to RM527.4mil from a year ago. Revenue climbed by 137% to RM3.97bil year-on-year.

IHH said the sterling performance was driven by consolidation of Acibadem Holdings from Jan 24, one-time profit from the sale of Mount Elizabeth Novena medical suites and fair valuation gain on Mount Elizabeth Novena’s investment properties held for rental, improved performance of its existing operations as well as greater demand for quality healthcare services in Asia.

Basic earnings per share for the first six months rose to 8.63 sen from 4.97 sen a year ago.

Excluding the sale of medical suites, IHH earnings before interest, tax, depreciation and amortisation (EBITDA) for the first half-year rose 74% year-on-year to RM581.4mil, while profit after tax and minority interests grew 35% to RM250.3mil.

Managing director Dr Lim Cheok Peng said the group’s first financial report post-listing reflected the real and growing demand for quality healthcare that IHH subsidiaries provided.

“We are seeing growth across the board in in-patient admissions, more complex medical cases undertaken by our hospitals and rising student enrolment in our education programmes.

“We remain fully committed to leveraging on our scale and leading market positions to capture further opportunities and expand our presence in our home markets,” he said at a briefing.

According to IHH, while the consolidation of Acibadem and the recognition of profits from the sale of 216 medical suites at Parkway Pantai’s Mount Elizabeth Novena Specialist Centre helped boost the results, improved performance in the group’s existing operations also contributed to the outstanding revenue and EBITDA growth.

The strong growth was driven by higher in-patient admissions at Parkway Pantai’s hospitals in both Malaysia and Singapore, as demand for quality healthcare services in the region continued to grow and there were more local and foreign patients seeking treatment.

In addition, revenue intensities at Parkway Pantai hospitals increased to about RM19,467 and RM4,520 per in-patient admission in Singapore and Malaysia respectively, up from RM18,297 and RM4,131 respectively in the first half of 2011.

The Star

The importance of foot care

Local hospitals provide foot screenings as injuries could lead to infections, amputation

by Woo Sian Boon

 

SINGAPORE – As a supermarket cashier, Madam Kee Keng Ai is accustomed to standing on her feet for several hours staight, wearing covered shoes.

But the 47-year-old, who suffers from diabetes, runs the risk of foot-related infections and ulcerations due to secondary complications such as a loss of sensation or poor blood circulation. Such injuries, if left untreated, increase a diabetic’s chances of having to go through limb amputations, doctors say.

Fortunately, a regular diabetic foot screening at Tan Tock Seng Hospital (TTSH) has helped Madam Kee detect a reduction of sensation and the formation of calluses on her right toe, which was later removed to lower the risk of ulcerations.

In recent years, amputations involving diabetic patients have made up a majority of such cases in local hospitals.

At TTSH, out of the 138 amputations conducted last year, 125 were diabetic cases. In 2010, diabetic limb amputations also made up 90 per cent of the total number of amputees.

At Singapore General Hospital (SGH), about 540 lower limb amputations attributable to diabetes have been performed annually in the past four years.

But Dr Bee Yong Mong, SGH’s Diabetes Centre Director and Consultant at the Department of Endocrinology, felt that “up to half of the cases of amputations are preventable”. While diabetic patients choose to pay attention to their diet to manage their condition, podiatrists and specialists have noted that proper foot care is still not a big part of the routine.

“Despite the educational and awareness programmes, many patients with diabetes have yet to appreciate the importance of foot care as part of the overall management of diabetes,” said Dr Bee.

TTSH Head of Podiatry Department Aurelie Petitjean, meanwhile, felt that patients did not know how diabetes could affect their feet.

“Patients often are unaware of how the complications of diabetes can lead to ulcers, gangrene and ultimately amputation,” she said.

The hospital also faces “a big problem” as patients fail to turn up for appointments with their podiatrist.

“People sometimes do not realise the importance of attending diabetic foot screenings to have their feet assessed. To address this, we are trying to create more awareness by calling patients a week before their appointments … We also give out pamphlets, posters and give talks around the hospital to educate both patients and healthcare professionals,” said Ms Petitjean.

To manage lower limb problems in diabetic patients, TTSH, SGH and Khoo Teck Puat Hospital have dedicated podiatric departments which conduct diabetic foot screenings, provide treatment and educate patients on the importance of proper foot care.

Besides regular self-care, podiatrists also recommend that diabetic patients go for an annual foot screening to detect any early signs of abnormal foot conditions to help prevent infections and, ultimately, amputations.

TodayOnline

Sally Park Lets You Forget Where You Parked Without Losing Your Car

 

BY LORY GIL

Sally Park ~ Park stress-free by Azurcoding iconSally Park ~ Park stress-free ($0.99) by Azurcoding is a convenient parking app that will help you remember when you parked, where you parked, and how long you have before the meter maid slaps you with a $48 parking ticket. If you’ve ever forgotten where you parked, this app will save your tired feet some unnecessary walking.

IMG_2680This app is so easy to use it is ridiculous. All you have to do is open the app and tap the big “Park” button. The app will automatically drop a pin at that location. You can head out to that rock concert with complete confidence that you’ll still be able to find your car in the dark when the concert is over.

The app will tell you how many feet you are from your car. If you need more help, you can tap the map to see the best route to get to your car.

If you want a little more from your parking experience, have no fear. Sally Park also includes a timer to remind you of when your meter is about to run out. You can set it for between one minute and two hours and forty minutes. You will get a reminder when you have five minutes left and an alert when your meter has expired.

Users can also take a picture of where they are parked with this app and write a note to help remind them of where their car is. If you park in a six-floor parking garage, you can snap a quick picture of your car and the surroundings and write a note to remind you that you parked on the third floor near the stairwell. This will make things a lot easier for you when you get back from a business trip and can’t remember where you parked your car in that giant airport parking structure.

This is a very useful and convenient app. The fact that it is so simple to use makes it a great buy for anyone with a car. We’ve all forgotten where we parked at least one time in our lives. Sally Park will make sure that never happens again.

IMG_2684IMG_2682IMG_2681IMG_2680IMG_2679

 

比人類耳朵更小助聽器‧BAHA助失聰者恢復聽力

(檳城訊)長度2.5公分及寬度只有1.5公分的BAHA骨傳導植入式助聽器(Bone Anchored Hearing Aid,BAHA)比人類的耳朵更小,卻是單邊耳聽覺神經性失聰人士,以及單邊和雙邊耳傳導性失聰人士和失聰鼻咽癌患者恢復聽力的大功臣,讓他們有機會聽見生命的新希望。

耳鼻喉頭頸外科醫生李萬來表示,BAHA是於80年代開始在歐洲市場推出,並於90年代引進我國,當時它只適用於單邊和雙邊耳傳導性失聰人士。近5年來,由於其功能技術日益進步,因此現在它也適用於單邊耳聽覺神經性失聰人士。

“失聰又分為聽覺神經性失聰(Sensorineural Hearing Loss)、傳導性失聰(Conductive Hearing Loss)和混合型失聰(Mixed Hearing Loss)3種類型。"他說,聽覺神經性失聰是指內耳的耳蝸先天性比較小而影響聽覺,也指耳蝸正常但有先天性缺陷或因為嚴重傷風和咳嗽而使病毒有機會侵略內耳並導致內耳發炎,以及發生意外損傷內耳和曾動過腦部腫瘤手術而造成的失聰。傳導性失聰則是指外耳沒有耳管,以及中耳沒有耳骨或有耳骨但長有良性的膽脂瘤(Cholesteatoma)而形成聽力障礙。

失聰分3類型

至於混合型失聰結合傳導性和聽覺神經性失聰兩種類型,由內耳、中耳和外耳的問題所引起,失聰原因包括老年失聰(Presbycusis)、噪音創傷(NoiseTrauma)、耳毒性藥物(Ototoxicity)和先天性聽力障礙所致。

“老年失聰是由於人隨著年齡增長而導致聽覺神經老化,耳骨變硬影響聽力,有些人則是因為被震耳欲聾的爆竹聲損傷中耳耳膜而影響聽覺神經,造成耳膜破洞和耳骨脫節,或是一星期五天,每天超過5小時處在有噪音的地方,而造成噪音創傷。"此外,還有長期服用和接觸耳毒性藥物如肺結核(Tuberculosis,簡稱TB)藥物或進行化療者也會因為經常接觸對聽力有影響的藥物而失聰。一些患者則是因為先天性遺傳因素而在40歲以後,其前庭系統內的毛細胞(Hair Cells)比一般人早退化而有聽力障礙。

他表示,單邊和雙邊傳導性失聰人士和單邊耳聽覺神經性失聰人士適用BAHA來接收聲波多於植入人工耳蝸和普通助聽器,因為它是通過正常的耳蝸毛細胞讓這些類型失聰人士接收聲波,其所收聽到的聲音猶如聽力正常的人一樣。

他進一步解釋,無論是單邊或雙邊的傳導性失聰人士主要是由於外耳和中耳的缺損而有聽力障礙,其耳蝸內的毛細胞是正常的,而單邊耳聽覺神經性失聰人士的一邊耳蝸雖然已受損,但另一邊的耳蝸毛細胞還正常。因此這些類型的失聰人士都適用BAHA,反之,耳蝸毛細胞不正常的失聰人士則適用人工耳蝸或普通助聽器,通過電極和擴聲器刺激聽覺神經來讓他們收聽聲音。

他指出,根據香港中文大學教學醫院威爾斯親王醫院(Prince of WalesHospital)於2008年的研究指出,經過電療和化療後而有單邊或雙邊耳傳導性失聰後遺症的鼻咽癌(NasopharyngealCancer,簡稱NPC)的患者,因為耳蝸毛細胞依然正常,因此可以藉由配戴BAHA來接收聲音。

避免頭影效應

“以前失聰的鼻咽癌患者不能配戴助聽器,因為他們在接受電療後,會引發中耳炎(Otitis Media),造成膿瘡從耳內流出來,如今,此報告結果顯示85%受試的鼻咽癌患者成功藉由配戴BAHA後恢復聽力,對失聰的鼻咽癌患者來說是一項好消息。"他也說,BAHA有一項優點是可以將聲波從聽力缺損的耳朵傳送到另一邊聽力正常的耳朵,避免減少15分貝(dB)的頭影效應(Head Shadow Effect)。

“頭影效應是指當聲波發送到未配戴助聽器的聽力受損耳朵時,因頭顱阻隔聲音的音量,而使傳送到聽力正常耳朵的聲波稍微減弱。換言之,若單邊耳失聰人士配戴此助聽器,當80分貝的聲波發送到聽力受損的耳朵時,另一邊聽力正常的耳朵也可以接收到80分貝的聲波,而並非只接收到65分貝的聲波而已。"

植入BAHA只需半小時

李萬來醫生指出,BAHA植入過程的流血量少,且植入物只佔據骨頭的0.3公分的深度而已,是侵入性最少且只需半小時就能完成的手術。

他表示,BAHA又分為鈦植入物(TitaniumImplant),轉接器(Abutment)和聲音處理器(Sound Processor)3個部份。無論是成人或兒童所使用的鈦植入物和聲音處理器的尺寸都一樣,所使用的轉接器直徑(Diameter)也同樣,但其高度則需視患者皮膚的厚度而定,因轉接器的高度需要能穿透皮膚露出部份外端才能裝上聲音處理器。

他說,成人的植入過程可以一次性完成,且只需要局部麻醉就能進行手術。首先是將鈦植入物植入耳骨內,再把轉接器安裝在鈦植入物的外端,然後在露出皮膚外層的轉接器部份外端裝上聲音處理器即完成植入過程。

由於單邊耳聽覺神經性失聰,以及單邊和雙邊耳傳導性失聰兒童尚處在發育階段,因此他們植入過程與成人有異。他指出,0至5歲的失聰兒童的耳骨還沒有發育完整且比較薄,因此不能植入鈦植入物和轉接器,而是先在頭部綁上軟帶骨定位助聽器(Softband),通過聲音處理器來接收音量,惟所接收的音量比一般人少20至30分貝。

須待6週才能啟用

“若是6至10歲失聰兒童,由於他們的耳骨都已發育完整,因此能通過全身麻醉進行植入手術,植入過程分為兩個階段進行,首階段過程中,鈦植入物先植入兒童的耳骨內,然後在6星期以後,確定耳骨與鈦植入物緊密聯接在一起時才進入第二階段,也就是與成人安裝轉接器以及聲音處理器的過程一樣。“他說,而10歲以上的兒童,則是先植入鈦植入物進耳骨再裝上轉接器,然後待6星期以後才裝聲音處理器。

至於鼻咽癌患者,他們也得進行兩個階段的植入過程,首先是先植入鈦植入物,待6星期後才安裝轉接器和聲音處理器。

他說,無論是成人或兒童的植入過程全部完成後,都得待6星期當鈦植入物與骨頭結合在一起後,才能正式啟動聲音處理器來接收聲音。(光明日報/良醫‧報導:劉楚珊)

星洲日报

突破技術瓶頸‧納米冷凍治癌療效佳

(中國‧廣州訊)近年來,冷凍消融治療已一躍成為重要的非主流治癌手段,原理在於將冷凍探針插入腫瘤部位,通過持續不斷地冷凍及解凍病變組織,從而達到消除病灶的目的,不過冷凍治療普遍存在降溫效果有限、凍結範圍難以適形化、冰球影像監測精度低、周圍健康組織會遭受凍傷等不利因素,為了突破這些技術瓶頸,國際冷凍治療學會主席科班(Nikolai Korpan)教授試驗性展開納米冷凍治療(Nano Cryosurgery),即在冷凍腫瘤時,注入特制的納米顆粒,以提高治癌效果。

科班披露,納米冷凍手術被定義成在低溫下(可達至攝氏零下180度),配合納米大小結構的顆粒及材質,來摧毀惡性腫瘤組織。

“這些納米顆粒是一種選擇性生物藥物,具有標靶作用,能通過超級低溫系統性或局部進入腫瘤。”

他深入淺出地說,納米冷凍手術比一般的冷凍手術多了一個步驟,即在手術時或手術後注入納米顆粒,以在腫瘤處形成納米冰球。

冷凍腫瘤注入納米顆粒

“納米冰球是一個高敏感物質或媒介,能對不同的腫癌起著治療甚至是治癒功效,這是新技術的重點特色。”

早在2009年,科班就開始探討結合納米技術與冷凍治療的可能性,後來經過不斷的嚐試,他終於把此技術實踐化,並以開刀的方式,治療了9名晚期或多重轉移性癌患,如胰腺癌、肝癌及淋巴轉移,初步效果非常樂觀,他不排除未來會嚐試腹腔鏡或經皮治療來操作這項新技術。

來自奧大利的科班教授,是一名外科醫生,編有《冷凍治療基礎》(Basics of Cryosurgery)及《冷凍科學及冷凍醫學》(Cryoscience and Cryomedicine),目前為奧地利國際冷凍治療研究所所長。他在國際(廣州)癌症治療論壇上發表最新論文《納米冷凍手術及科學》,不過由於他欲為新技術申請專利,因此不肯透露太多,讓人無法一窺究竟。

可透過微血管滲入腫瘤

納米化療又稱腫瘤微血管介入治療(Cancer microvascular intervention,CMI),是复大的特色治療之一。擅長於此項治療的复大腫瘤醫院放射科主任朴相浩副教授解釋,腫瘤毛細血管間有很多孔隙,一般化療藥物難以進入其中,但恰好納米(百萬分之一毫米)藥物體積微小,因此可以透過微血管孔隙進入腫瘤,當注入越多,功效就越大,隨之就能將腫瘤細胞包圍並引爆,這就是CMI的機制。

他說,全身行傳統化療時,化療藥物往往會“鎖不住”而遍佈全身,以致滯留在腫瘤組織內的藥物濃度偏低,達不到足夠的腫瘤細胞殺傷力,病患還因藥物全身跑而出現嚴重副作用。

“後來醫藥人員改用介入動脈灌注給藥,即將導管插入腫瘤組織附近的供血動脈內直接給藥,但缺點是藥物很快隨血液流向全身。”

他提及,醫生也可選擇栓塞療法,同樣使用導管插到腫瘤附近的血管,打入藥物,將動脈堵死,這時腫瘤就會因缺乏血液供應而餓死,不過很多時候它也一併把正常的血管給堵住。

“由於納米化療顆粒夠細,能穿過孔隙進入腫瘤,所以配合栓塞治療時,也不會堵住正常血管。”

治療過程更易監測

詢及這些納米顆粒是否為化療藥物,以及所使用的納米療法與复大的納米化療是否一樣時,科班教授直言,這是一種類似化療的顆粒,與复大的納米化療不一樣。

其實,科班並不是首個提出納米冷凍治療學說的學者,早在2003年前後,中國科學院理化技術研究所劉靜研究員指導碩士生於天驊、博士生鄧中山等,首次嚐試在目標組織中引入納米功能溶液以強化冷凍治療的設想,並取得顯著成效。有關結果相繼發表於低溫生物領域的著名刊物《冷凍生物學》(Cryobiology)及相關會議,此後逐步醞釀形成納米冷凍治療學,準備在納米醫學領域中分一杯羹。

研究表明,當將一定劑量且具有特定功能的納米顆粒溶液添加到腫瘤後,可以有選擇性地提高該處的降溫速率及強度,從而大大擴展常規冷凍探針的消融範圍,對腫瘤細胞造成更為徹底的殺滅。

此外,通過引入特定的納米顆粒,可使得冷凍治療過程中的冰球生長過程更易於通過醫學影像設備監測出來,從而引導實現更為精確的腫瘤靶向治療,納米顆粒也可裝載抗癌藥物,在進入腫瘤後再結合冷凍治療對病變細胞產生多重殺傷。

自2007年起,國際上已有數個小組相繼跟進這一方向,並在國際低溫生物學大會及著名期刊上報導了數項進展。(光明日報/良 醫‧特派:唐秀麗)

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