This means that the new biomarkers identified 6 subjects that had been missed by CA125 (false negatives) and eliminated 2 subjects who would have been told they had the disease but did not (false positives). The results have proven that the addition of the two new biomarkers increase the performance and diagnostic efficiency of OvPlex^TM

Although a larger Phase II biomarker trial is required, the company is confident that the result will be replicated in the larger study. According to the spokesperson of HealthLinx, the study being planned would involve 350 disease samples plus controls across multiple sites to include Asia and Europe. The results would be made available upon completion of the study, and thereafter, the scale up/manufacturing for this new product would commence to enter the market in late 2009 early 2010.

New Center Brings Australian and Chinese Researchers Together to Fight Infectious Diseases

The official opening of the China-Australia Centre for Phenomics Research at the Australian National University (ANU) gives the fight against infectious diseases such as avian influenza a strong booster injection.

Opened on November 24, 2008 by ANU vice-chancellor Professor Ian Chubb and Professor Lu Yongxiang, president of the Chinese Academy of Sciences, the center will bring together some of Australia's and China's high performing immunologists and virologists to work towards new discoveries in this field of research. The center, funded by the Chinese and Australian Governments, will be located in the John Curtin School for Medical Research at the ANU.

The Australian program will be led by ANU researchers Dr Edward Bertram, Professor Chris Goodnow and Dr Steve Winslade, but will also involve some of Australia's top immunologists including Nobel Prize winner Professor Peter Doherty, Dr Stephen Turner from the University of Melbourne, Professor Doug Hilton from The Walter and Eliza Hall Institute of Medical Research and Professor Paul Hertzog from Monash Institute of Medical Research.

The Chinese team will be led by Professor Hong Tang, Director of the Center for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences in Beijing.

Dr Edward Bertram, the University's Program Manager for the China-Australia Centre for Phenomics Research said the center will study the alterations in the genome code that lead to increased resistance or susceptibility to a range of infectious diseases including avian influenza, which would further lead to the identification of targets for designing new treatments to boost the immune system against these diseases.”

Co-developing New Treatment Guidelines for Melanoma

First across the Tasman, Australia and New Zealand have collaborated with a joint approach to the development of treatment guidelines for cancer, which was launched on November 19, 2008 at the Clinical Oncological Society of Australia Annual Scientific Meeting in Sydney.

Emeritus Professor Tom Reeve from the Australian Cancer Network, who is also the convenor of the 51-member working party that produced Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand, said the development marked a new chapter in efforts to achieve consistent best practice in cancer management across both countries with the development of a set of comprehensive, evidence-based yet cutting-edge guidelines which include new areas such as psychosocial issues and new techniques like dermoscopy to refine diagnosis.

The working party, chaired by director of the Sydney Melanoma Unit, Professor John Thompson, and comprising melanoma experts and consumers, took two-and-a-half years to develop the guidelines, which have been approved by the National Health and Medical Research Council and New Zealand Guidelines Group. A practice guide and GP card will also be released for the treatment of non-melanoma skin cancer.

Australia Leads World's First Global Effort to Improve Genetic Disorders Diagnosis

The Human Variome Project, an Australian-led global initiative to improve the diagnosis of genetic disorders and reduce errors in the reporting of genetic variations would be published in the prestigious scientific journal Science.

"There is a staggering error rate of up to 40% in some reporting of genetic variations," said Professor Richard Cotton, lead author of the paper, convenor of the Human Variome Project and honorary researcher at the University of Melbourne. "This means clinicians and specialists cannot solely rely on the research literature to inform the life and death decisions of diagnosis and prognosis of genetic disorders.”

Over 60% of people worldwide will be affected by a genetic change at some point in their lives that can result in a range of diseases such as cystic fibrosis, epilepsy and cancer. Prof Cotton said that the project is a world's first which aims to collect information on every fault in every gene worldwide. Ultimately, the project will provide the first global standardization of the reporting of genetic mutations and their effect on human health so that clinicians can reliably diagnose, treat and inform patients.

The Australian-led global project combines the talents of University of Melbourne researchers and colleagues within the Florey Neuroscience Institutes, the Department of Medicine at the Royal Melbourne Hospital and the Epilepsy Research Centre, as well as international colleagues from around the globe. The project has the support of the World Health Organization (WHO), United Nations Educational, Scientific and Cultural Organization (UNESCO) and Organization for Economic Co-operation and Development (OECD) countries. In early 2000, the completion of the Human Genome Project empowered researchers with the genomic mapping of the human body. But, out of the 20 000 human genes mapped, only 3000 have any information available on their variations.

"In the next few years, it is expected that the number of genes in which disease-causing variations are recognized will increase dramatically," Prof Cotton said. “Currently, there is no standardized way to capture this information and make it of use to clinicians.”

The Human Variome Project will produce standards for the storage, transmission and use of genetic variation information which for many will reduce the enormously time-consuming task of seeking data to assist in providing patients with information. The Science paper details the establishment of a range of pilot projects being organized around the world that will examine how to systematically collect genetic, clinical and biochemical information in either a country-specific or gene- specific manner. Countries already signed on to these pilots include Australia, China, Japan and Kuwait. “Once these pilot projects are complete, we will be able to roll out suitable systems around the globe and improve the health of billions of people," he said.

One of the areas the pilot will be tested is colon cancer. A world leader in colon cancer, Professor Finlay Macrae in the University's Department of Medicine at the Royal Melbourne Hospital is a co-author of the paper. As the secretary of InSiGHT, the International Society for Gastrointestinal Hereditary Tumours, Prof Macrae has been instrumental in establishing some of the first gene-specific pilots for four of the genes predisposing to colon cancer. “Colon cancer is the commonest internal cancer affecting both men and women in the western world," Prof Macrae said. “Genetic predispositions to colon cancer are now well-recognized. Testing for mutations in some of these genes is critical to establishing risk for bowel cancer in some families. However, the information needed to interpret mutations is widely scattered and not readily available. Providing systems to comprehensively and readily access this information is the aim of the worldwide InSiGHT/Human Variome Project pilot," he added.

Neurologist Professor Sam Berkovic of the University of Melbourne and Austin Health, and co-author of the paper explained the significance of gaining better access to genetic variations for diseases affecting the brain. "There is a real challenge for neurologists to ascertain the genetic make-up of the many diseases affecting the brain such as epilepsy, Alzheimer's and degenerative disorders. Access to extremely varied genetic information is critical as patients develop these diseases over a period of time," Prof Berkovic said. "This project opens the doors to earlier understanding and treatment of these complex conditions.”

China

China Bans Illegal Food Additives to Reinforce Food Safety Control

Boric acid, commonly used as an insecticide, is mixed with noodles and meatballs to increase elasticity. Industrial formaldehyde and lye, used in making soap and drain cleaner, are added to water to soak certain types of dried seafood to make the products appear fresher and bigger. Shocking indeed the ruses that unscrupulous manufacturers resorted in order to boost their profits. As part of China's month-long government crackdown aimed at improving the country's shoddy food safety record, 17 substances commonly used as industrial dyes, insecticides and drain cleaners were banned and included on the list of illegal food additives.

A scandal over melamine-tainted infant formula, which killed six babies and sickened 294 000 others as reported in 2008, prompted the government food safety campaign. The list of banned substances was released by a government committee tasked with weeding out the practice of augmenting food products with nonfood additives. Local authorities were also warned to watch out for another 10 food additives that are often used excessively. This list provides clues for relevant departments as they carry out this campaign.

The government had previously banned some of the 17 substances as separate scandals rocked the country and raised concerns over products such as milk and eggs, but the list released on December 15, 2008 appeared to mark the first attempt at compiling the information. Also on the list were various industrial dyes that are added to improve the appearance of food products, ranging from chili powder to tea to cooked meats. The government working group even listed an addictive substance made from the poppy plant and related to opium, which can be used as a painkiller, is actually often used in hot pot, a Chinese dish where meat, vegetables and tofu are cooked at the table.

Along with the banned additives, the government named 10 substances such as colorings, preservatives and artificial flavorings that should not be used excessively. The list will help local inspectors target food products more likely to be problematic. The investigation will focus on food products made by small food factories, which are often poorly regulated, the official Xinhua News Agency reported. Among China's 500 000 food processors, 70% have fewer than 10 employees, based on Xinhua News Agency's report.

Previously banned items on the list were Sudan Red, a cancer-causing industrial dye used to color egg yolks, and melamine, an industrial chemical used in plastics that is added to watered-down milk to fool protein tests measuring nitrogen content. China is also looking into the practice of adding melamine to animal feed after finding eggs spiked with the chemical. China's National Feed Office found 27 cases of contamination among 22 700 samples and forwarded the problematic batches to police, the paper said.

China first banned the use of melamine in animal feed in June 2007, after wheat gluten used in pet food was found to contain excessive melamine. The ingredient was blamed for killing dogs and cats in North America.

China Steps Up Tighter Inspection in Food Safety

As reported on December 9, 2008, China would launch a four-month food safety campaign that will include stringent inspections of food makers to weed out illegal or excessive chemicals in food, in the country's latest move to restore trust hurt by a tainted milk scandal that caused the deaths of six babies and sickened 294 000 infants with urinary problems after drinking infant formula contaminated with industrial chemical melamine.

The Health Ministry said that the drive, jointly conducted by nine central government departments, will target food and additive producers across China.

Such campaigns are part public relations drive, and part crackdown by Chinese authorities as they try to address the country's chronic food product safety woes which turned into the worst food safety crisis at home and abroad in years. In January 2008, the Chinese government claimed success in an earlier four-month food safety drive that sought to ease worries about the safety of the country's food supply ahead of the Beijing Olympics. Despite that claim, the milk scandal broke in September and the government later said the dairy company at the center of the crisis knew as early as 2007 that its products were tainted with melamine and that the company and local officials first covered it up.

The Health Ministry said its newest drive will be conducted in three phases, with companies first asked to conduct internal checks. The authorities will then take two months to inspect producers of meat, dairy and other products rich in protein – deemed “high-risk" – and conduct checks on the markets. The third phase in the final month will focus on stemming the supply of illegal food additives by targeting producers and punishing companies that use such chemicals.

Illegal chemicals from past domestic food scares will be among those targeted, including malachite green, a possibly cancer-causing chemical used to treat fungal infections in fish, and the cancer-causing industrial dye Sudan Red, which was used to color egg yolks. In the recent milk crisis, dairy suppliers were accused of adding melamine, a nitrogen-rich chemical used in the production of plastics, to watered-down milk to make it appear higher in protein content on quality tests. Though melamine is believed to be unharmful to humans in tiny amounts, consumption in higher concentrations would produce kidney stones and in serious cases, cause kidney failure.

In 2007, China ratcheted up inspections and tightened restrictions on food production and other industries for exports, after manufacturers were found to have exported tainted cough syrup, toxic pet food and toys with lead paint. Despite the improvements, China continues to have trouble regulating its countless small and illegally-run operations, which are often blamed for introducing illegal chemicals and food additives into the food chain.

WHO and China to Do More for Chinese with Hearing Impairment

The World Health Organization (WHO) opened a deafness prevention center in cooperation with Beijing Tongren Hospital (affiliated to Capital Medical University) in China on December 8, 2008. This is the first and the only WHO-initiated deafness and hearing impairment prevention center in China.

The objectives of the center are: to raise public awareness about hearing loss prevention in China, particularly in the rural areas, through a variety of media groups and the Internet, and to train more professionals through related formal education, further education and training programs for the country. Dr Shigeru Omi, director of the WHO's Western Pacific Regional Office, said the reason for collaborating with Beijing Tongren Hospital is because its Ear-Nose-Throat department is leading in this expertise in the country.

An official with the Health Ministry said a 2006 survey showed that China has 20.04 million people with hearing impairment, or 24% of the total disabled population, constituting a high incidence rate of hearing disability. The deaf population statistics showed that more than 800 000 children affected are below the age of seven and 30 000 newborns are born deaf each year. Han Demin, president of Beijing Tongren and director of the center, said the age bracket of zero to seven is key to children's language skill development, and hearing impairment within this critical period would not only result in slow language development or even deaf-mutism, but also retard growth in children's psychology and social skills. Hence, early diagnosis of hearing loss would benefit the children so that they could undergo early intervention treatments and surgeries, as well as hearing and speech rehabilitation.

First TCM Drug for Arrhythmia

The Chinese Medical Association (CMA) announced that China has rolled out its first traditional medicine for treating arrhythmia. The new drug, Shen Song Yangxin capsule, developed by Yiling Pharmaceutical and fully tested in 36 large hospitals, including Beijing Fuwai Cardiovascular Hospital, Chaoyang Hospital, Nanjing Medical University No. 1 Hospital, and Shandong University Qilu Hospital, has produced results showing that it is noticeably better than the control group and also the group that used western medicines in treating non-organic ventricular premature beat. In addition to the fine therapeutic effects on chronic arrhythmia, the new drug is able to ease the symptoms, such as palpitation, short breath, fatigue, and insomnia. The new drug has so far produced no side effects, allowing treatment on a long-term basis.

The new drug, having been annually used by 2 million patients, is a high-tech product honored with a first-place award issued by China Association of Chinese Medicines.

First Human-Human Transmission of Tick-Borne Disease Reported in China

According to a study published in Journal of the American Medical Association (JAMA), it appears that human ganulocytic anaplasmosis (HGA) has been identified in China for the first time, and was transmitted between two humans rather than ticks.

The human ganulocytic anaplasmosis (HGA), usually carried by ticks, has symptoms similar to those of influenza. Since 1990, the HGA has been noted in the U.S., and in Europe since 1997. The number of infections reported in the U.S. each year has been increasing, at endemic infection rates as high as 15% to 36% as indicated in previous studies. This relatively high prevalence implies that diagnosis may often be mild or asymptomatic, and thus misdiagnosed. “Because epidemiological, clinical, and microbiological information about HGA is limited, the disease is likely under-recognized and under-reported worldwide," said the authors of the study.

A cluster of cases among healthcare workers and their family members prompted Lijuan Zhang, MD, PhD, of the National Institute of Communicable Disease Control and Prevention, China CDC, Beijing, and colleagues perform the study in which they investigated several subjects whose symptoms were consistent with those of HGA. They sought to determine the origin and transmission of these apparent first Chinese cases, specifically investigating the possibility of human-to-human transmission.

In 2006, nine patients with fever and other consistent symptoms were diagnosed with HGA. Curiously, while all nine patients had been in contact with another symptomatic, suspected HGA patient within 12 hours of her death, none bore tick bites. The initially symptomatic patient, referred to as the index patient, suffered from a fatal illness characterized by fever and hemorrhage, and required endotrachial intubation, in which a plastic tube is inserted into the trachea, to ventilate the lungs at both a primary care hospital and regional tertiary care hospital's isolation ward. Inquiries to the family of the patient later revealed that she had been bitten by a tick 12 days before the symptoms presented.

Suspected secondary cases, who were exposed to the index case, were tested for antibodies against the bacterium responsible for HGA, Anaplasma phagocytophilum, and potential exposure sources were further investigated. These patients indicated that they most likely did not use gloves during wash or after contact with the index patient. A total of 28 individuals reported contact within 20 inches (51 cm) of the index patient in her final 12 hours, and nine of these individuals were infected. A total of 20 individuals reported exposure to the index patient for more than two hours, and nine of them were infected and all of them had made contact with blood, and seven made contact with the respiratory secretions. Those persons, exposed to blood or respiratory secretions, especially those with pre-existing skin lesions or injuries, were more likely to be infected.

The authors noted the unusual method of transmission for the bacterium. "The most remarkable aspect of these cases was that transmission was very unlikely to be tick-borne, but was closely associated with blood or respiratory secretion exposure from an index patient who died of a [sudden and severe] illness with hemorrhage," the authors write. They concluded with recommendations for future prevention of this type of outbreaks. "Although it is likely that routine blood and body fluid precautions will protect against such future events, strict adherence to protective protocols is mandatory even if communicability is deemed unlikely. The lessons of this study remain relevant to the daily hospital and healthcare unit operations to prevent any additional [hospital] outbreaks of HGA. Moreover, as China advances into its future, it must also now become prepared to deal with the increasing threat that tick-borne rickettsial pathogens [parasitic bacteria that live in anthropods (as ticks and mites) and can cause disease if transmitted to human beings] have been already brought to the U.S. and Europe.”

Peter J. Krause, MD, of the Yale School of Medicine, New Haven, Conn., and Gary P. Wormser, MD, of New York Medical College, Valhalla, N.Y., contributed an accompanying editorial, noting that these findings are an important reminder to follow safety precautions regarding disease transmission. They wrote that the investigation by Zhang et al. may represent the first report of human-to-human transmission of A. phagocytophilum and the first report of human HGA infection in China. And also, the importance of adopting standard blood and body fluid precautions for all patients and especially for those with HGA, which are the accepted standard of care in the U.S., was reinforced. They commented that further investigation on the existence of A. phagocytophilum in the region of China where this outbreak originated to be conducted. In addition, they explained that fulfilling the case definition of HGA used for epidemiological surveillance in the U.S. does not provide diagnostic certainty, unless the diagnosis was established by the microbiological gold standard of culturing the microorganism. Hence, they commented that the findings of the study by Zhang et al, while rst time, and was transmitted between two humans rather than

Bird Flu Found in Chickens in Eastern China

In a statement issued by the Agriculture Ministry on December 16, 2008, authorities in eastern China had killed more than 300 000 fowl after bird flu was discovered in chickens.

According to a ministry statement faxed to the Associated Press, veterinary officials in Hai’an county and the city of Dongtai, both in Jiangsu province, said chickens in the two areas tested positive for the H5N1 virus. It was not known when the birds got sick, whether they had died from the virus or how many were infected.

In order to prevent an outbreak, authorities in Hai’an and Dongtai, about 20 miles (30 km) apart, killed 377 000 chickens and other domestic fowl in the surrounding areas, disinfected and quarantined affected zones and banned the transport of fowl and related products from Hai’an and Dongtai, the ministry said. The source of the disease could be attributed to migrating birds which the authority said, without giving details. Experts said wild birds play a role in transmitting H5N1 virus into commercial poultry populations, although they believe the spread is largely related to the trade of birds and their products, including cross-border smuggling.

According to World Health Organization (WHO), H5N1 has prompted the slaughter of millions of birds across Asia since late 2003 and caused the deaths of at least 246 people worldwide, around a third of them in Indonesia. It remains hard for people to catch, with most human cases linked to contact with infected birds.

A week preceding this report, in December, the Hong Kong government ordered the slaughter of more than 80 000 birds after three chickens found dead on a farm were tested positive for the virus. It also imposed a 21-day ban on poultry imports. Twenty countries had outbreaks during the first nine months of 2008, down from 25 during the same period in 2007, U.N. officials said.

Some experts expressed concerns that the public has lost interest and vigilance because the virus has so far not mutated into a much-feared form that could spread easily among people, potentially sparking a pandemic. But the WHO has urged Asian governments not to let down their guard against bird flu because the recent Hong Kong outbreak proved the disease still poses a threat.

First Bird Flu Death Reported for 2009, No Bird-flu Outbreak

As reported on January 8, 2008, China said that no other cases of bird flu have been detected in Beijing and neighboring provinces after a woman died from the avian influenza in the capital on January 5. It was the first such death in the country in almost a year, and the 21st to date in China.

Experts had fanned out to Beijing's neighboring city of Tianjin and Heibei province, which surrounds the capital and where the dead woman had bought ducks, the ministry said in a statement on its website (www.agri.gov.cn).

"After tests for the virus and an epidemiological investigation, no trace of the bird flu virus was found in these three areas," it said.

The 19-year-old died of the H5N1 virus after gutting ducks, which experts say highlights the role and risks of waterfowl in the transmission of the virus to humans.

The World Health Organization (WHO) said the case did not appear to signal a new public health threat. The WHO also said this death case was similar to others reported worldwide in that it does not appear to involve human-to-human transmission.

The virus is generally more active during the cooler months between October and March, although the new Chinese case points to holes in surveillance of the virus in poultry.

Experts also say that many species of ducks are natural reservoirs of the virus and unlike chickens, they show no signs of disease.

China's Agriculture Ministry said it would step up an inoculation campaign and surveillance for the disease to maintain a high state of alert to prevent the spread of bird flu and other animal viruses.

The H5N1 strain remains largely a disease among birds but experts fear it could change into a form that is easily transmitted among people and kill millions of people worldwide.

With the world's biggest poultry population and hundreds of millions of farmers raising birds in their backyards, China is seen as crucial in the global fight against bird flu.

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Hong Kong

Hong Kong Alerts New Bird Flu Outbreak

An official from Hong Kong said on December 11, 2008 that three dead chickens were tested positive with highly virulent H5N1 strain of the avian influenza virus in Hong Kong, prompting a suspension to poultry imports for 21 days and the slaughter of 80 000 birds. It was the first outbreak of H5 bird flu on a Hong Kong farm in about six years.

York Chow, secretary for food and health, said Hong Kong now faced a new alert for bird flu. Chow said the chickens at a farm with 60 000 birds, had the H5 virus and further tests were being done to see if they had the deadly H5N1 strain. The farm and the neighboring poultry operations were declared part of an infected zone, and about 80 000 birds in the area would be killed to prevent the spread of the disease.

Hong Kong's biggest bird flu outbreak was in 1997, when the H5N1 strain jumped to humans and killed six people. That prompted the government to slaughter all 1.5 million poultry in the territory. In 2001, the government also carried out a massive poultry slaughter, killing 306 000 birds in wholesale and retail markets and 951 000 in local farms to eradicate an outbreak of bird flu. The city now has 600 000 birds, Chow said.

According to World Health Organization, at least 246 people have died of bird flu worldwide since 2003. Hong Kong's government has been encouraging retailers to stop selling live birds, and the majority of shops have given up their licenses to sell live poultry. However, eating fresh chicken is ingrained in the food habit and culture of Hong Kong people and many consumers still want freshly slaughtered birds.

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India

India Also Confirmed Bird Flu Incidence

As reported on December 15, 2008, authorities in eastern India triggered the alert and confirmed a fresh outbreak of bird flu after thousands of chickens were found dead. The deadly H5N1 strain of bird flu has been found in samples taken from dead chickens in eastern India. It was the second outbreak of bird flu in India's West Bengal state and came as 250 000 birds had been slaughtered in the neighboring state of Assam, where authorities have been battling to control the spread of the outbreak for several weeks. There were fears of a human case after many people were reported sick. But India has still not reported any human case of the deadly H5N1 strain of the virus.

Health authorities in the West Bengal state had to kill 5 million poultries to control the virus in earlier part of 2008 when India battled its worst bird flu outbreak. The virus spread to 14 of the 19 districts in West Bengal, which has a population of more than 80 million. However, no human case was reported.

The World Health Organization said the H5N1 strain has killed nearly 250 people since 2003, mostly in South-east Asia. Experts fear a virus mutation resulting in severe and easily transmitted influenza in humans could create a pandemic, potentially affecting up to one-fifth of the world's population.

India Plans 20 More Biotech Parks for Life Sciences Research

In a strategic move to promote quality research in the field of life sciences, 20 more biotech parks will be set up throughout India, according to Mr Kapil Sibal, Union Minister of Science and Technology.

At present, besides Lucknow, there are only three “functional" biotech parks at Hyderabad, Pune and in Punjab.

Mr Sibal also announced that the Department of Biotechnology (DBT) would sign an agreement, that will form a 10-year pact, with the Wellcome Trust of Britain in order to produce high-quality human resource, which is one of the key elements for scientific leadership. The minister added further that a regional UNESCO center would be set up in Faridabad in Haryana to help bring academia, industrialists and government officials on a common platform for promoting utility-based research.

Expressing concern over the shortage of the number and quality of human resource needed to take the biotechnology revolution forward, Mr Sibal called the scientists to undertake research projects for countering diseases that are considered a “burden for the poor”, food security, new varieties of crops, vaccines, and to mitigate industrial pollution. He assured the state government that his ministry would seriously consider its proposal to set up five science parks and five agrotech parks in the state and invited the state science and technology minister Mr Abdul Manan to New Delhi for talks.

Although set up in 2002, the Lucknow Biotech Park was officially inaugurated on December 7, 2008. Spread over 8 acres (3.24 hectares), the park is a joint venture of the central and the state governments, with assistance from the Council of Scientific and Industrial Research (CSIR) and the Indian Institute of Technology (IIT), Kanpur, and other educational institutions and industries.

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Korea

An Economic Share in Medical Tourism Market

In an effort to provide and supplement the needed revenue for some hospitals, the South Korean government, along with clinics, is trying to attract medical tourists.

In South Korea, medical fees for the country's residents are determined by the government, but hospitals can negotiate fees with foreign patients on their own. In addition, the government hopes medical tourism will boost the economy by having patients vacation in the country post-procedure. South Korea has revised its immigration policies to allow foreign patients and their families to obtain long-term medical visas and also has changed its laws to permit local hospitals to form joint ventures with foreign hospitals.

Although no government records indicate how many medical tourists come to South Korea hospitals, a survey of 29 hospitals in the country found that 38 822 uninsured foreign patients were treated between January and August 2008, compared to 15 680 in 2007, according to the Korea Health Industry Development Institute. The survey also found that 25% of the patients were from the U.S. and 10% came from both China and Japan.

Yoon Dae-hyun, a psychiatrist at the Healthcare System Gangnam Center at Seoul National University Hospital, said some Koreans are worried that social inequality will result from medical resources and skilled workers migrating from public healthcare to better jobs assisting foreigners. However, he said that the effort to attract foreigners could inspire local hospitals to improve their services. "There isn’t much of a gap anymore between the good hospitals in Asia and the United States," he said.

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Japan

Brain Tissues Made from Stem Cells

Japanese researchers reported in November 2008 that they have created functioning human brain tissues from stem cells, a world's first that has raised new hopes for the treatment of disease.

According to researchers at the government-backed research institute Riken Center for Development Biology, stem cells taken from human embryos have been used to form tissues of the cerebral cortex, the supreme control tower of the brain. The tissues self-organized into four distinct zones very similar to the structure seen in human foetuses, and conducted neuro-activity such as transmitting electrical signals, the institute said.

Research on stem cells holds the potential to save lives by finding cures for diseases such as cancer and diabetes or to replace damaged cells, tissues and organs. The team's previous studies showed stem cells differentiated into distinct cells but until now they had never organized into functioning tissues.

"In regenerative therapy, only a limited number of diseases can be cured with simple cell transplants. Transplanting tissues could raise hopes for greater functional recovery," the institute said in a statement. “Cultivated tissues are still insufficient and too small to be used to treat stroke patients. But study of in-vitro cultivation of more mature cortex tissues, such as those with six zones like in the adult human brain, will be stepped up," it said. The tissues could also serve as "A mini organ" for use in studying the cause of the Alzheimer's disease and developing vaccines.

Embryonic stem cells are harvested by destroying a viable embryo, a process that ethics supporters find unacceptable and oppose. Riken said cortex tissues were also obtained from "Induced pluripotent stem cells" which are similar to embryonic stem cells but artificially induced, typically from adult cells such as skin cells.

The research was led by Yoshiki Sasai at Riken Center for Development Biology in Kobe, western Japan. The cultivated tissues look like miniature mushrooms 2mm in diameter. The team also succeeded in making cortex tissues from the embryonic stem cells of mice. Using mouse tissues, scientists confirmed they had formed a network of neurons that respond to stimulus properly. The tissues can also be selectively induced to different cortex types controlling memories, visual sensation and other tasks.

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New Zealand

Newly Merged Research Institute Leverage Greater Synergy

Integrating New Zealand's leading horticulture, arable and seafood research in a single, focused organization, Crown Research Institute (CRI), the country's newest institute, has begun operations in December 2008.

The New Zealand Institute for Plant and Food Research Limited (which trades as Plant & Food Research) has been formed through the merger of existing CRIs HortResearch and Crop & Food Research. The merged organization has over 900 staff based at sites throughout New Zealand as well as science and business development staff working in the U.S.A., Europe, Asia and Australia. The annual revenues for the new company are expected to be in the region of NZ$120 million (US$71.2 million). The merger follows a move by the boards of both CRIs to bring their organizations together and provide greater depth of capability in nationally significant areas of research including sustainable production, elite genetics and smart breeding, and food and health science.

Plant & Food Research chief executive Peter Landon-Lane, formerly general manager of Fonterra Europe, said the new company would make a key contribution to New Zealand science and to research-based innovation in the primary and food sectors. He further added that at a time of global fiscal concern, it is essential to retain a competitive edge by continuing to innovate and add value in these industries that their science underpins: horticulture, arable farming, seafood and the wider food sector.

Mr Landon-Lane said Plant & Food Research had a clear strategy to align its science with industry needs. The new set-up would generate knowledge and intellectual property that promotes the sustainable and efficient use of primary plant and seafood-based resources to create value for New Zealand. Areas such as new, elite cultivar development for the fruit, vegetable and arable sectors, environmentally and economically sustainable production systems for food crops, as well as the application of primary-sector derived ingredients in new and novel functional foods would be focused.

Both HortResearch and Crop & Food Research had strong international reputations for their science quality and the merged company is expected to develop expanded business and science collaborations in offshore markets.

Kiwi's Green Plastic Well-Acclaimed in International Awards

A new environmentally-friendly biofoam won New Zealand researchers a prestigious annual International Bioplastics Awards in the “Best Innovation in Bioplastics" category.

The Bioplastics Awards – focusing on bio-sourced polymers and the applications to meet the sustainable future of the polymer industry – are organized by European Plastics News, Europe's leading pan-European plastics magazine and organizer of the annual Bioplastics Conference.

The novel low density, polylactic acid (PLA) foam was entered in the awards on account of its green credentials, key performance attributes at low densities comparable to existing oil-based materials such as expanded polystyrene foam (EPS), and its ability to be processed on existing EPS manufacturing lines.

The awards were presented in Munich, Germany and accepted on behalf of the Biopolymer Network, by awards director Mr Steve Crowhurst. The research and product development was undertaken by a team of Scion scientists within the Biopolymer Network – a joint venture between three of New Zealand's Crown Research Institutes, Scion, AgResearch and Plant & Food Research – which has a mission to focus on scientific and technological excellence in the conversion of sustainable natural resources to biopolymers and biocomposite products.

Scion's chief executive, Tom Richardson, said the creation of the biofoam uses a cost-effective, environmentally-friendly process to make molded biopolymer foams from sustainable, renewable resources. “While traditional plastics are primarily derived from oil, polylactic acid (PLA) is rapidly emerging as the world's leading bioplastic and is a sustainable ‘green plastic’ largely derived from corn," he said, also adding that this commercial bioplastic offers similar performance standards to polystyrene, which is made from traditional, oil-based plastic.

Biopolymer Network's acting chief executive, Sarah Heine, said the proprietary process involves expanding PLA beads using a “green" blowing agent, carbon dioxide (CO2), in place of existing high ozone depleting (hydrocarbon) blowing agents. She added that this biofoam meets the sustainability criteria and can potentially be applied in thermal or acoustic insulation and typical building practices that traditionally used polystyrene.

The process has been demonstrated in a commercial polystyrene molding plant in New Zealand to prove the concept is operable on real, existing manufacturing lines, removing many barriers to uptake which may otherwise have existed. Biopolymer Network said that they would continue to develop new biofoam processes and products that are cost-effective, environmentally preferred and offer enhanced performance.

Sea Sponge Indigenous to NZ Could Reduce Chemo Side Effects

A compound under development at Victoria University of Wellington, New Zealand in combination with an existing anti-cancer drug shows promise of reducing side effects for chemotherapy patients.

Anja Wilmes, who graduated from Victoria University with a PhD in December 2008, has been focusing on the secondary effects of peloruside A, a natural marine product developed from sea sponges found only in New Zealand. “Peloruside has a similar mechanism of action to Taxol, which is a chemotherapeutic drug used to treat breast, ovarian and lung cancer. It works by binding to microtubules," she said.

To carry out the research, Ms Wilmes used biological screens to identify other possible targets of peloruside, especially those relevant to cancer, a process which she said is important in drug development to look at possible additional targets of a drug for safety reasons. One of the screens is called “Proteomics" which looks at the proteins being expressed in cells or tissues. Using this screen, she studied which proteins are altered in a cancer cell line when peloruside is administered. Another part of her research focused on chemical genetics.

"This field is a relatively new one, but it's rapidly expanding. Chemical genetics makes use of the nearly complete set of yeast gene deletion mutants that can be used to screen for either drug targets, or for functional interactions between pathways targeted by the drug.”

She said her preliminary research into the chemical genetics of peloruside may have identified a secondary target in yeast—which could be important if it applies to mammalian systems. In addition to looking for secondary targets, the synergy between peloruside and Taxol was also examined. She also found that peloruside and Taxol had a greater effect when used together in two different cancer cell lines. Although the research is in its early stages, this could potentially reduce side effects for chemotherapy patients, because lower concentrations could be used for each compound.

Professor John Miller, Ms Wilmes’ PhD supervisor, said that the findings will significantly contribute to research underway at Victoria University. He commented that peloruside, found only in New Zealand, has great potential as an anti-cancer drug for use during chemotherapy. The scientists are working with Victoria University to find a way of synthesizing the natural product to produce enough peloruside to conduct a clinical trial.

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Philippine

Ebola-Reston Virus Jumped Species

Experts from three U.N. agencies have arrived in the Philippines to investigate an outbreak of the Ebola-Reston virus at two pig farms north of Manila, the World Health Organization (WHO) said on December 23, 2008.

Ebola-Reston, which is only found in the Philippines, had been confined to monkeys and the latest outbreak is the first time it has jumped species.

According to the WHO, the strain is not dangerous to humans, unlike the four deadly Ebola subtypes found in Africa.

The Food and Agriculture Organization and the World Organization for Animal Health are also represented in the mission.

"The fact that this is the first time that the virus has been found outside monkeys, and the first time ever, worldwide, that it has been found in swine, a food-producing animal, makes this mission particularly important," a WHO statement said.

It added the case had “potential implications for animal and human health and welfare.”

The Philippines government quarantined the affected farms in Santo Nino and Pinagpanaan villages and halted pork exports when the virus was first detected in October 2008.

The U.N. team was set to work with its Filipino counterparts over 10 days to establish "The source of the virus, its transmission, its virulence and its natural habitat, in order to provide appropriate guidance for animal and human health protection.

“Preliminary results are expected in a few weeks at the earliest," said the statement.

Local authorities have been unable to find any sign of the virus among farmhands or slaughterhouse workers who handled the pigs.

Ebola-Reston was first detected in 1989 in laboratory monkeys sent from the Philippines to Reston in the United States.

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Singapore

Human Sewage, the Potential Source of Clean Energy

The future is not far that everyone can play a part to generate green energy to power the city through his/her visits to the toilet.

Researchers in Singapore are fine-tuning technology that generates electricity cheaply while cleaning used water flushed down the toilet. The work on microbial fuel cells by National University of Singapore (NUS) scientists has won a S$2.3 million (US$1.55 million) grant from the Environment and Water Industry (EWI) Development Council. These cells, also known as biological fuel cells, use bacteria to generate electricity from organic matter. Bacteria is added to the water as it is treated, consuming the pollutants and shedding electrons in the process. The electrons flow through a circuit and generate electricity.

“Used water contains a huge amount of energy due to the presence of organic matter in it," said Assistant Professor Ng How Yong of the Division of Environmental Science and Engineering at NUS, who led the research effort and won the Singapore Young Scientist Award in 2007 for his research in membrane processes and microbial technology.

In current methods of used water treatment, half the operating cost is taken up by aeration, a process that introduces air to water, and this technique also creates a sludge by-product that is costly to dispose of, said Prof Ng. His team's breakthrough involves developing a technique for treating wastewater without aeration, and which removes half the bacteria present and creates waste sludge that is 25% less.

Technology relating to microbial fuel cells is widely researched in Singapore and many countries such as the U.S. and Australia, but has yet to be commercialized. The power generated by current microbial fuel cells is too low to be useful, and the technology of extracting energy from domestic wastewater is still inefficient, said Prof Ng.

Professor Ong Say Leong, an expert in used water treatment from the Department of Civil Engineering at NUS, commented that most research on such cells is currently restricted to small-scale laboratories. Researchers need to develop an optimized design prototype to be viable for full-scale application, he said. Another problem is that platinum is used in the cathode design, which makes the process expensive and not economically viable unless a low-cost alternative can be found.

Professor Ng's team recently succeeded in developing a cheaper cobalt substitute for platinum, and has also applied for a patent in the U.S. for a cathode design that possesses greater power-generating capacity suitable for large-scale application. "The cell will be less costly and increase power generation, while at the same time recover more of the energy as electricity," he said.

Mr Harry Seah, director of technology and water quality at national water agency PUB, said the technology's greatest potential application was in used water treatment, and could be readily adopted by local agencies and industries.

He said the microbial fuel cells could potentially save up to 25% of current energy consumption at the PUB's six water reclamation plants. Apart from Prof Ng's work, 12 other projects were awarded a further S$14.7 million (US$9.91 million) under the EWI grant, which aims to advance technology in water treatment.

Singapore hopes to position itself as a global technology leader in the water and environment industry. It has targeted value-added contribution from the water sector to reach S$1.7 billion (US$1.15 billion) by 2015. Jobs generated by this sector are expected to double to about 11 000 by then.

No More Heart-stopping Incidents for Heart Patients

A novel, less invasive mitral valve implantation is being developed to significantly reduce operation risk for patients who need to replace the mitral valve in their hearts in case their hearts are stopped during the operation.

The mitral valve, located between the left atrium and left ventricle, stops blood from flowing in the wrong direction in the heart. Professor Theodoros Kofidis from the Department of Surgery in the National University of Singapore (NUS) who is developing a new mitral valve implantation device said the device will lead to new surgical procedures for mitral valve replacement that can reduce operation time by half, the costs of the surgery and lower the surgical trauma and risks. Surgeons need only to insert the device into the heart by turning and clicking it like a light bulb, said Prof Kofidis, who is also a cardiac surgeon of the National University Hospital.

He said: "If this succeeds, it could help thousands of patients in the region and all over the world. This could have immediate health benefits for the patient and reduce costs for the patient and the insurance (provider)." Clinical trials are estimated to take at least five years, said Prof Kofidis, who predicted that all patients who need heart valve replacements will eventually be able to benefit from the device.

Professor Kofidis’ project is one of nine to be awarded funding of up to S$250 000 (US$168 339) each in the first grant call of the National Research Foundation's (NRF) Proof-Of-Concept (POC) scheme, the foundation said. The NRF is a department within the Prime Minister's Office set up in January 2006 to spearhead Singapore's research and development mission. Among other objectives, it aims to coordinate the research of different agencies within the larger national framework to provide a coherent strategic overview and direction. It provides funding to higher learning institutes to help them take projects from research to commercialization.

The nine projects that were awarded funding were selected from 138 submissions based on the criteria of novelty, technical merit and commercial viability. Among the other grant recipients, Professor Freddy Boey, from the School of Materials Science and Engineering in Nanyang Technological University plans, conducts research to use a new material to develop a hernia mesh to improve the treatment of hernia patients. The other research projects include developing technology to enhance the performance of wireless networks and electronics, and microscopes that can improve bio-imaging.

The second call for submissions under the POC scheme will take place in March 2009.

China Milk Products Get All-Clear from Singapore

As announced by the Agri-Food and Veterinary Authority (AVA), with effect from December 18, 2008, Singapore had lifted the ban on the import of milk and milk products, including products which contain milk as an ingredient, from China.

Following the melamine scare in China-produced milk products which had sparked panic among consumers in the world, Singapore had suspended the import of all milk and milk products from China since September 19, 2008.

AVA said it had been working closely with the Chinese authorities to facilitate the resumption of imports while ensuring food safety of imports of milk and milk products from China, including eradicating melamine contamination. An AVA team inspected dairy farms, milk collection centers and food processing establishments and assessed the overall control system in China, the republic's food authority said. AVA said it was satisfied with the control measures in place to ensure that milk and milk products from China imported into Singapore were not contaminated with melamine.

However, AVA imposed three conditions on the Chinese manufacturers before they could export their milk products into the republic. They are:

• Products must be produced by establishments approved for export by the Chinese authorities;
• Manufacturers are required to test each batch of their raw materials and end products to ensure they are not contaminated with melamine; and
• Chinese authorities must inspect and test each batch of products and issue health certificates with results of melamine tests to accompany consignments exported to Singapore.

AVA also assured local consumers that it would continue to monitor the products imported into Singapore to check for any trace of contamination after lifting the ban.

Discovery of New Properties in Imidazolium Salts Yield Multi Applications

Scientists at Singapore's Institute of Bioengineering and Nanotechnology (IBN) have uncovered new properties of imidazolium salts (IMSs), which suggest that they could play a vital role in disease prevention and treatment.

The report on the redox properties of IMSs was published in the Journal of the American Chemical Society. In a separate study published in Angewandte Chemie International Edition , IBN researchers reported the first use of these salts to convert carbohydrates into versatile chemical compounds for biofuel production. IBN researchers successfully used IMS to develop a new catalyst system for converting sugars into 5-hydroxymethylfurfural (HMF), a key compound used in biofuel chemistry and the petroleum industry.

In the Journal of the American Chemical Society, the IBN researchers described how they used IMSs to synthesize successfully uniform gold nanoparticles within seconds at room temperature. The ultrafine (1-2 nm) nanoparticles remained stable for up to 6 months at 4°C.

Unlike conventional synthesis techniques using borane or borohydride reduction processes, IBN's method does not require a strong reducing reagent yet is able to produce gold nanoparticles under very mild reaction condition with remarkable efficiency. IBN's new synthesis protocol could easily be scaled up for industrial applications.

Commonly used as solvents for various organic reactions, IMSs are room-temperature ionic liquids that are chemically stable and have low vapor pressure. While IMSs’ physical properties have been widely studied, their biochemical properties and medical applications have seldom been mentioned in the scientific literature. IBN Principal Research Scientist Yugen Zhang, PhD, said: “Our successful use of IMSs as a reducing agent led us to believe that we might also be able to use this compound as a radical scavenger antioxidant to counter the damage caused by reactive oxygen species in the body.”

Environmental stress triggered by an unhealthy lifestyle, such as excessive alcohol consumption, exposure to toxins and drugs, smoking and lack of sleep, may lead the body to produce superoxide radicals known as reactive oxygen species (ROS) that could cause cell damage through oxidation. Oxidative stress from ROS is implicated in most diseases including cancer, heart disease, liver fibrosis, neurodegenerative diseases, autoimmune disorders and aging. Radical scavenger antioxidants help to trap free radicals in the body's cellular system, thus attenuating the effects of ROS. IMS is a precursor for N-heterocyclic carbenes (NHC). A naturally occurring form of NHC is thiamine or vitamin B, which plays a very important biological role. Vitamin B deficiency has been linked to oxidative stress. While natural antioxidants such as epigallocatechin gallate (EGCG), a green tea extract, have been known to slow down or prevent the oxidative process, they also exhibit low potencies and a rapid turnover in the body's metabolism.

IBN Principal Research Scientist Lang Zhuo, PhD, said: “Our investigations with hepatic stellate cells show that IMSs have more powerful antioxidant properties than EGCG, yet are remarkably less cytotoxic. They significantly decreased ROS levels in liver cells by 11% more than EGCG. In addition, IMSs are simple and inexpensive to produce. Therefore, they show great promise as a new type of antioxidant with potential biomedical applications.”

In a separate study published in Angewandte Chemie International Edition, IBN researchers successfully used IMS to develop a new catalyst system for converting sugars into 5-hydroxymethylfurfural (HMF), a key compound used in biofuel chemistry and the petroleum industry. Diminishing fossil fuel reserves and global warming effects have made the search for sustainable, renewable alternative energy sources a critical global concern. Biofuels are currently the only sustainable source of liquid fuels available, but the lack of highly efficient methods to convert carbohydrates into chemical compounds for biofuel production has impeded the replacement of petroleum feedstock by biomass.

HMF and its 2,5-disubstituted furan derivatives can replace key petroleum-based building blocks, and there are several known catalysts that are active in the dehydration of sugars to form HMF. However, most of them also produce side reactions that form undesired byproducts, and rehydrate HMF to form acid. Therefore, the use of these catalysts has often been constrained to simple sugar feedstock such as fructose. They have not been able to efficiently convert glucose, a more abundant and stable sugar source.

With IMSs as the starting point, IBN researchers developed NHC-metal complexes as catalysts to transform sugars into HMF. These offer a great deal of flexibility as the catalytic activity may be modified by changing specific properties of the NHC. The researchers were able to extract HMF easily as the sole product. IBN's new catalyst achieved the highest reported yields of HMF so far, for both fructose and glucose feedstocks. Dr Zhang said: “Our HMF yields were as high as 96% for fructose and 81% for glucose. As both the catalyst and the ionic liquid can be recycled, our technology is more environmentally friendly and would potentially lead to cost savings in the biofuel manufacturing process."

IBN executive director Professor Jackie Y. Ying added: “We are excited by the tremendous potential of these novel compounds to make an impact on medicine and alternative energy. Our discovery paves the way for more effective treatment of various degenerative diseases, as well as the conversion of biofuels, helping to alleviate some of the pressing concerns facing our global community.”

S’pore Ranked World's Most Prolific for Eye Research Per Capita

Singapore knocks out research heavyweights such as Britian and the United States in eye research, according to the International Ophthalmology Journal's study from 2002 to 2006. When adjusted for population size, Singapore produced 20.49 publications for every one million people.

The U.S. had the highest annual and total contributions, but in terms of per capita, it ranked seventh on the list of countries most prolific in eye research.

Singapore has one of the highest incidences of myopia in the world with 80% of the teenagers being short-sighted. Compared to elsewhere in the world, the children here also become short-sighted at a much younger age.

About 95% of the total amount of eye research done in Singapore is carried out by Singapore Eye Research Institute (Seri), said Professor Donald Tan, chairman of Seri.

The institute partners public hospitals, universities and public science research institutes to study areas such as myopia, glaucoma, corneal blindness and diabetes-linked blindness.

Eye research is one of five areas of focus under Singapore's current biomedical sciences research push, said the executive director of the National Medical Research Council (NMRC), Dr Edwin Low.

Dr Low said Seri has successfully built up a rigorous and positive research environment to bring about better research outcomes, which will eventually be translated to better patient care.

In 2007, Seri appointed an international advisory panel to review its progress and to benchmark it against the top eye research centers in the world – the Johns Hopkins University's Wilmer Eye Institute, the University College London's (UCL) Institute of Ophthalmology; and the University of Melbourne's Centre for Eye Research Australia (CERA).

The first two institutions are leaders in North America and Europe, while the Australian center was picked because it was in Asia-Pacific and had a similar annual budget for eye research as Seri, explained Prof Tan.

The review showed that Seri ranked second among the four in the number of research papers published in top science and medical journals such as Nature and the New England Journal of Medicine.

From the years 2002 to 2006, Seri had 64 such papers in top journals, Johns Hopkins had 54, UCL had 146 and CERA had 33.

But for that same period, Seri published the most number of papers among the four institutes - 428 papers, largely in journals on eye disease.

Professor Tan said the international recognition serves to validate the 10-year-old institute's academic standing and it also helps to map a strategic plan for the institute over the next 10 years.

Outdoor Sun Reduces Incidence of Myopia in Children

An Australian Research Council study has found that exposure to bright light for two to three hours daily, such as during outdoor activity would help regulate the eye's growth and reduce the risk of myopia in children.

If scientists are right in their study, it would be a case of irony for Singapore, an equatorial city-state with plenty of sunshine all-year-round, as up to 90% of students reportedly don spectacles by the time they leave school.

Some Singapore doctors subscribe to the research. Consultant eye surgeon Dr Jerry Tan has been getting his patients’ children to exercise in the sun for at least 10 minutes a day. And he said that going outdoor in the sun seems to be stopping the progression of myopia with a high success rate.

Lead researcher Professor Ian Morgan of the Australian study told Agence France-Presse the team was "Intrigued" by the difference in myopia rates among Australian and Asian students. Just 20% of Australians need to wear glasses when they leave school.

And while 30% of six and seven-year-old Singaporeans had developed the condition, only 1.3% of Australians of the same age did. The figures were similar when comparing children of Chinese descent from both nations, allowing researchers to eliminate ethnicity as a factor.

What was significant: in Singapore, children spend an average of 30 minutes outside every day, compared with two hours for the average Australian.

Both groups spent about the same amount of time reading, watching television and playing computer games, debunking the theory that flickering screens were ruining children's eyes, said Prof Morgan.

So, how does sunlight work its magic?

Dr Tan cited a German professor who patented a technique using ultraviolet light to stop the eyeball from growing longer (which causes myopia). "The best source of ultraviolet light is the sun," he pointed out.

One theory is that just by being outdoors, children are not doing near-work activities – like staring at computer screens – which brings on myopia.

Taiwan

University Hospital in Taiwan Collaborates with Neuralstem

China Medical University & Hospital of Taiwan entered into a collaboration with Neutralstem Inc. to advance development of Neuralstem's human spinal cord neural stem cell therapies. The collaboration will focus on Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's disease) with Dr Shinn-Zong Lin, MD, PhD as principle investigator.

Richard Garr, Neuralstem president and CEO said the goal of this collaboration is to qualify their existing cGMP spinal cord cells into a human trial program to treat ALS in Taiwan. Citing the reason for this collaboration, he added that Taiwan is a substantial and important market in Asia, and China Medical University is the national leader in innovative neurological research and treatments.

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Vietnam

Return of Bird Flu, Vietnam Runs High Risk of Human Infection

On December 3, 2008, a Vietnamese medical official said that bird flu has reappeared in Vietnam, bringing high risk of humans becoming infected with the disease, as reported by the Vietnam News Agency.

The new cases were reported in poultry in southern Ca Mau province and central Nghe An province. No new cases of human contraction have been detected so far, as quoted by Nguyen Huy Nga, Head of the Department for Preventive Medicine and Environment at a meeting in Hanoi. But he warned that there would be a high risk of human case due to the conducive weather conditions and the unpredictable development of the epidemic in poultry.

So far in 2008, Vietnam has reported five human avian influenza fatalities. The most recent case of human infection was in March 2008. The Vietnamese Health Ministry is working with relevant government organizations and institutes nationwide to monitor the development of the disease, particularly in the affected localities and those with a history of epidemic outbreaks, said the report.

Conjoined Twins Successfully Separated

On December 17, 2008, doctors from the Hanoi-based Central Children Hospital had successfully operated on a pair of conjoined twins who were born with their abdomen attached after a two-hour surgery. The operation team, consisting of 20 local and foreign doctors and specialists, was led by Dr Nguyen Thanh Liem.

The twins – named Nguyen Van Cu and Nguyen Van Co, from Quynh Luu District in the north-central Nghe An Province – were delivered by caesarean section on September 2 at the Quynh Luu Hospital.

After the operation, Co received treatment for a digestion abnormality while Cu, born with a heart abnormality, was examined for a possible heart surgery that could take place immediately. Surgeons said the twins had shared one third of their breastbones stretching to their navels, but had separate internal organs. The Central Children Hospital had sponsored the total cost of the operation, estimated at VND100 million (US$5800).

Cu and Co were born to Dam Thi Chuyen and her farmer husband Nguyen Van Loi who live in a rural mountainous hamlet in Nghe An Province's Quynh Luu District. Previous ultrasonography results of the pregnant mother, one at six months of pregnancy and the other prior to the caesarean, hadn’t shown the twins as being joined. The couple has an eight-year-old daughter, who has no abnormality.

In 1988, doctors from Hanoi-based Viet Duc Hospital successfully operated on conjoined twins Nguyen Viet and Nguyen Duc. The two boys from the Central Highlands province of Kon Tum originally shared a leg, an abnormal lower limb, a bladder, a sex organ and an anus. Earlier in May 1986, Viet began to suffer from encephalitis, which led to the surgery to avoid similar complications spreading to Duc. Their condition has been attributed to their parents’ exposure to Agent Orange, a toxic herbicide sprayed on the Vietnamese countryside and its civilian inhabitants during the Vietnam War. After the operation, Viet went into a vegetative state and died in October 2007, while Duc was saved and leads a normal life.

Rise in Off-Season Dengue Fever Cases

Ho Chi Minh City (HCMC) doctors have reported an alarming increase in the number of dengue fever cases, up to three times the number of cases usually reported in November.

Health workers are also reporting an increase in the number of adults falling victim to the mosquito-borne virus. HCMC Hospital for Tropical Diseases deputy director Tran Tinh Hien said the hospital had admitted between 150 and 200 dengue fever patients.

"The hospital receives between 30 and 50 cases a day," Hien said. “Most patients come from District 2, District 7 and Tan Binh District. The number of cases is double or sometimes triple the number we had at the same time in 2007," he said.

Until October 2008, the hospital, the city's main facility for treating dengue patients, had admitted 9600 dengue cases, 70% of which were adults. Hien said patients of up to 50 year-olds had been admitted. Usually the maximum age for dengue patients was 25, he said. “Many patients had thought they had just caught a cold that had gotten worse," he said. Hien warned patients against treating themselves with medicine from pharmacies, which could prove fatal. The most extreme symptoms of dengue fever include hemorrhage, loss of consciousness, respiratory failure and abnormal liver, kidney and brain function. So far in 2008, five adult patients have died from dengue fever after being hospitalized, he said. Symptoms of dengue fever, a common disease in developing countries, include a high flu-like fever, skin rashes and severe pain in the head and limbs.

There is no vaccine to protect against dengue infection. The disease is transmitted by daytime-biting mosquitoes and international health organizations recommend people to use insect repellant and wear long-sleeved shirts and long pants. The increase in the number of cases has been blamed on the extended rainy season in 2008, which usually ended in late October and the increasingly polluted urban environment that has created ideal conditions for mosquitoes to breed.

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Other Regions

North America

Epilepsy Drugs Prescription to Carry Suicide Risk Warning

The U.S. Food and Drug Administration (FDA) announced on December 16, 2008 that it was adding a label warning on heightened suicide risk for users of antiepileptic drugs.

The move, which followed the advice in 2007 summer of an FDA advisory panel, stopped short of slapping the strongest “black box" warning on this class of drugs, which includes widely used medications such as clonazepam (Klonopin), phenytoin (Dilantin) and topiramate (Topamax). “Patients being treated with antiepileptic drugs for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior," Dr Russell Katz, director of the division of neurology products in the FDA's Center for Drug Evaluation and Research, said in an agency news release. But, he added that “patients who are currently taking an antiepileptic medicine should not make any treatment changes without talking to their healthcare professional.”

The warning includes a heightened risk to users of “suicidal thoughts and behaviors (suicidality)," the agency announcement said. The FDA is also requiring that manufacturers draw up Medication Guides handouts that outline the risks and can be given to patients and their families when the medications in question are prescribed.

This move follows recommendations in July 2008 from a 20-member advisory panel that voted unanimously, with one abstention, to back the scientific findings on 11 antiepileptic drugs studied by the agency. In late January 2008, the FDA announced it was considering a black box warning after an agency review of 199 studies comparing the drugs, which are used by millions, to placebos. That review found that patients taking the drugs had about twice the risk of suicidal behavior compared with patients taking a placebo. The absolute risk amounted to about one added case of suicidal thoughts or behaviors for every 500 patients taking the antiepileptic drugs versus placebo. The mechanism linking antiepileptic drugs with potential suicide risk remains unknown, the FDA said. “We have concluded this was a real signal, and the signal applied to all drugs we studied," Dr Katz, told reporters in July. “We propose that labels for all these antiepileptic drugs be changed to include a box warning, and patients should be given a medication guide describing these events with each prescription refill," he said.

The advisory panel appeared to agree with him – up to a point. It voted in favor of sending a medication guide to doctors detailing the suicide risks, but not the boxed warning. A majority of panel members voted against adding the black box warning, saying the studies didn’t show a high enough risk for suicidal behavior. "The general view of the committee was concern that patients or physicians would not prescribe these drugs in certain circumstances where they should," Dr Katz said.

One specialist said that he remained skeptical of any strong link between antiepileptics and suicide. Dr Gholam Motamedi, director of clinical neurophysiology fellowship and epilepsy at Georgetown University Hospital in Washington, D.C., said it was “surprising to attribute suicide to the antiepileptic drugs per se, because a good number of these drugs are used in psychiatry for their positive effects on mood and depression. Nevertheless, this emphasizes the importance of screening for signs and symptoms of depression and suicidal tendencies in the epilepsy clinics." He also pointed to studies that have shown that people with epilepsy tend to have a higher incidence of depression, which is tied to suicide. "Therefore, this increased rate of suicide may tell us patients with epilepsy may have higher rate of suicide, but it doesn’t mean it is ‘caused’ by the anti-seizure drugs," Dr Motamedi said. "The better warning would be, in my opinion, to be sensitive to the depression of other psychiatric symptoms in epilepsy patients and refer them to psychiatrists," he added.

In addition to clonazepam, phenytoin and topiramate, the drugs covered by the new FDA-mandated labeling are: carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR); clorazepate (Tranxene); divalproex sodium (Depakote, Depakote ER, Depakene); ethosuximide (Zarontin); ethotoin (Peganone); felbamate (Felbatol); gabapentin (Neurontin); lamotrigine (Lamictal); lacosamide (Vimpat); levetiracetam (Keppra); mephenytoin (Mesantoin); methosuximide (Celontin); oxcarbazepine (Trileptal); pregabalin (Lyrica); primidone (Mysoline); tiagabine (Gabitril); trimethadione (Tridione), and zonisamide (Zonegran). Some of these drugs are also available as generics.

According to the FDA, antiepileptic drugs are used to treat epilepsy, bipolar disorder, migraine headaches and other conditions.

U.S. Doctors Succeeded Near-total Face Transplant

Doctors in the United States performed a groundbreaking transplant to replace 80% of a woman's face, giving fresh hopes for the severely disfigured to “face the world" without humiliation. The surgery, conducted on December 16, 2008, was the world's first near-total facial transplant and the fourth known facial transplant to have been successfully performed to date.

Few details were released about the patient, doctors could only reveal that she had been disfigured to the point which left her without a nose, right eye and upper jaw as a result of a traumatic injury several years ago, rendering her unable to eat or breathe on her own. Controversies surround the facial transplant – a medical procedure that involves heavy risks and is performed to improve a patient's quality of life rather than as a life-saving operation. There are also ethical concerns that the operation could eventually be used for purely cosmetic purposes or as a means of altering someone's identity.

The hospital said the woman, who did not wish to be identified, had exhausted all conventional reconstructive surgery. They hoped the operation would allow her to regain her sense of smell and ability to smile and said she had a “clear understanding" of the risks involved. The woman is doing well and showing no signs her body is rejecting the new face, doctors said.

The woman received a nose, most of the sinuses around the nose, the upper jaw and even some teeth from a brain-dead donor. Doctors paid special attention to maintaining arteries, veins, and nerves, as well as soft tissue and bony structures, as they recovered the donor's facial tissue. The surgeons then connected facial graft vessels to the patient's blood vessels in order to restore blood circulation in the reconstructed face before connecting arteries, veins and nerves in the 22-hour procedure.

Doctors at the Cleveland Clinic stressed that such operations should be limited to a medical context in order to free severely disfigured people from the suffering associated with social isolation. "The relief of suffering is at the core of medical ethics, and provides abundant moral justification for this procedure," said the clinic's chair of bioethics, Eric Kodish. "A person who has sustained trauma or other devastation to the face is generally isolated and suffers tremendously. The damage to the quality of life cannot even be put into words.”

Leading medical ethicist Arthur Caplan agreed that this suffering was sufficient to “risk possibly killing someone to improve their appearance for a better quality of life. If there is nothing else to be done, it actually makes sense for them to take a risk that involves death," said Dr Caplan, the director of the center for bioethics at the University of Pennsylvania. "It's ethically justifiable.”

Doctors in France performed the first partial face transplant in 2005 on a 38-year-old woman, Isabelle Dinoire, who was disfigured in a dog attack. In 2006, a Chinese man underwent a facial transplant including the connection of arteries and veins, and repair of the nose, lip and sinuses. A bear had mauled the 30-year-old farmer as he looked for stray sheep. A 29-year-old French man underwent surgery in 2007. He had a facial tumor called a neurofibroma caused by a genetic disorder. The tumor was so massive that the man could not eat or speak properly. The Cleveland Clinic became the first U.S. hospital to approve the procedure four years ago. The latest operation was the first facial transplant known to have included bones, along with muscle, skin, blood vessels and nerves.

Vaccinating Pacific Girls against Cervical Cancer

Starting February 2009, the U.S. will fund a mass vaccination campaign to prevent cervical cancer in the Micronesia region of the Pacific, a U.S. official said on January 8, 2008.

Targeting to vaccinate more than 30 000 girls aged between 10 and 18, the campaign will cost US$9 million. The U.S. Centers for Disease Control (CDC) regional epidemiologist Jean-Paul Chaine said the Federated States of Micronesia, the Marshall Islands and Palau will benefit from the program.

In the Marshall Islands, cervical cancer was the second most prevalent cancer in 2007 and is estimated to affect women at a rate six times that in the U.S., Dr Chaine said.

The HPV vaccine prevents the types of genital human papillomavirus (HPV) that cause most cases of cervical cancer and genital warts. The vaccine is given in three shots over six months and costs US$300 per patient for each course.

The HPV vaccine program was supposed to be launched in early 2008, but was delayed by funding problems, Dr Chaine said.

he three north Pacific nations, located between Hawaii and the Philippines, were formerly a United Nations Trust Territory administered by the U.S., but are now independent countries that maintain close relations with Washington through “compacts of free association”, which make them eligible for many U.S.-funded health and education programs.

Manipulating Love and Emotions by Spray

Scientists have a scientific explanation for love that it really could be a drug and all it takes to generate the feelings is by popping a pill or smelling perfume.

Though not deemed as the most romantic gesture, scientists are developing drugs that can boost the most human of emotions.

The team of scientists are studying the brain chemistry responsible for the complex feelings that draw us to a particular member of the opposite sex and remain monogamous.

Animal testing begins to shed light on the complex neural and genetic components of love in the same way they have led to pharmaceutical therapies for anxiety, phobias and post-traumatic stress disorders.

Behavioral scientist Professor Larry Young of Emory University, Georgia, wrote in the journal Nature that “for one thing, drugs that manipulate brain systems at whim to enhance or diminish our love for another may not be far away.”

Experiments have already shown a nasal squirt of the hormone oxytocin enhances trust and tunes people into others’ emotions.

There are products already in the market such as Enhanced Liquid Trust, a cologne-like mixture of oxytocin and chemical scents called pheromones “designed to boost the dating and relationship area of your life”.

Prof Young said: "Although such products are unlikely to do anything other than boost users’ confidence, studies are under way in Australia to determine whether an oxytocin spray might aid traditional marital therapy.”

Prof Young added: "The hormone interacts with the reward and reinforcement system driven by the neuro-transmitter dopamine – the same circuitry that drugs such as nicotine, cocaine and heroine act on in humans to produce euphoria and addiction.

“Dopamine-related reward regions of the human brain are active in mothers viewing images of their child. Similar activation patterns are seen in people looking at photographs of their lovers.”

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Cambridge Pips Oxford in Research

Cambridge finally unsits Oxford's throne in a seven-year race to emerge as the United Kingdom's top university, an evaluation of British research that will decide how £1.5 billion (US$2.26 billion) funding is spent has found.

The research-intensive universities of Oxford, Cambridge, London School of Economics (LSE), Imperial and University College London (UCL) will be granted the lion's share of government funding for academic research, under the rating system. For the first time, the findings also revealed that some of the best universities are burdened with large numbers of low-performing researchers.

Under the Research Assessment Exercise (Rae), every university in the U.K. submit a dossier of their best researchers’ work in 67 disciplines on which they are graded and then ranked by panels led by the top academics in the country. The number of star researchers each department and university has at the end would dictate their research funding for the next five years.

The publication of those rankings revealed that former polytechnics have failed to wrest a significant number of the stars awarded for research away from the research giants of the Russell Group of universities, including Oxford and Cambridge.

Cambridge is top of the tables, followed by Oxford and LSE. York and Essex are the only non-Russell Group institutions in the top 10. York rose to 8th place (from 16th, seven years ago) and Edinburgh from 14th to 10th. Queen Mary, University of London, shot up the rankings to 11th place. In 2001, it ranked at 43. The results showed that a great number of researchers are conducting low-ranking work in some of the top universities. Close to a third of research by the top six universities was rated two-star or one-star. The grade four-star is considered world-leading. Some 28% of Cambridge's researchers scored one and two stars, as did 34% of UCL's researchers.

Cambridge has the highest proportion of outstanding research in the U.K. The university submitted 2040 staff, 71% of whose work was deemed to be “world-leading" or "Internationally excellent”, compared with 70% of 2246 Oxford staff's research. Both universities submitted work in 48 disciplines.

Adapting Car Manufacturing Technology to Produce Synthetic Bone Implants

Techniques normally used to make catalytic converters for cars, are being developed by researchers from Warwick Manufacturing Group (WMG) at the University of Warwick, U.K., to produce synthetic bone. The team is working closely with Warwick Ventures, the University's technology transfer office, to find a suitable partner to help commercialize the technology.

WMG's Dr Kajal Mallick led the project – that could offer substantial clinical benefits to patients – along with his postgraduate researcher James Meredith. The technique involves state-of-the-art extrusion of the implant material through a mold, to produce a 3D honeycomb texture, with uniform pores throughout. The material can then be sculpted by the surgeon to precisely match the defect. After implantation, bone cells will be transported into the implant to form new bone.

The team worked with a Japanese company which manufactures catalytic converters and used their facility to produce samples for testing in the laboratory. Dr Mallick explained the benefit of the technique: “We found that we were able to use calcium phosphates – a family of bioceramics that are routinely used in bone implant operations, but by using this technique we were able to improve significantly both the strength and porosity of the implant." At present, there is no product available in the market place that satisfies both these key properties simultaneously. It is nearly an ideal scaffold structure for efficient blood flow and formation of new bone cells.

The increased strength of the material means it could be used in spinal surgery, or in revision hip and knee operations, where currently non-degradable materials such as titanium or steel may be used. The increased and interconnected porosity allows the implant to be filled with blood vessels quickly, thus expediting the healing process.

Dioxin-tainted Irish Pork Products Recalled

All pork produced since September 2008 in the Republic of Ireland has been recalled over contamination fears, as reported on December 6, 2008.

The Food Standards Agency (FSA) of Ireland said the feed given to pigs contained environmental contaminants called dioxins thus raising health concerns about the safety of the meat produced on Irish farms. Dioxins are environmental contaminants that may be formed during combustion processes and may be present in industrial wastes. It is illegal for dioxins at certain levels to be in food products. Exposure to very high levels of dioxins has been associated with increased incidence of cancer, although officials said any risk posed to consumer health was “extremely low”. Ireland's food watchdog added that laboratory tests showed the products contained between 80 and 200 times the level of dioxins usually considered to be safe. The contaminated feed has been traced back to a single supplier whose customers include 47 farms, of which 38 produce beef. Bacon, ham, sausages, white pudding and pizzas with ham toppings have been recalled from supermarket shelves in Ireland as a precautionary measure.

The U.K.'s FSA said it was looking into whether Irish meat had been exported to the U.K. but stated that it did not believe U.K. consumers faced a “significant risk”.

The recall is likely to hit Ireland's pig industry hard, at a time when the economy as a whole is in recession. The Irish Labour party spokesman on agriculture and food, Sean Sherlock, said: “We don’t want to risk destroying an entire food industry if it can be proved that it can be contained to products that came from a specific number of processors, or contained within a particular geographic area."

He further added that the absolute priority was the protection and safeguarding of the health and welfare of consumers, and the government and the state agencies should act swiftly so that the recall would not amount to a threat to the overall viability of the food industry.

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