StemCell Therapy

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Integrative Therapies - Middlesex Hospital Connecticut ...

Message from the Chairman:

In accepting the positions of Chairman of the University of Pittsburgh School of Medicine Department of Ophthalmology and director of the UPMC Eye Center, I have discovered that one of the most exciting aspects is the opportunity to interact across the entire spectrum of the field. In a typical week, I have the opportunity to work with students, residents, fellows, faculty, the community, and the population at large. Each of these groups' needs defines the purpose of the UPMC Eye Center and its mission.

As Chairman, driving new developments and striving for excellence in patient care, research and teaching are my top priorities.

Patient Care: UPMC Eye Center is rated among the top ophthalmology programs in the United States in the delivery of patient care. Our most fundamental function is to serve the community through patient care. As we see patients daily by referral, our primary goal is to offer them quality care and provide needed information to the referring doctors as soon as possible so that patients may return to their care.

We continue to expand our subspecialty areas by adding new faculty and positions, leading to a higher quality of oveall care.

Research: The Department of Ophthalmology recently ranked eighth in the country for National Institutes of Health funding for departments of ophthalmology and has one of the top basic and clinical research programs in the country. Research focuses on ocular immunology, infectious disease, molecular genetics, molecular biology of retinal disease and glaucoma, and advanced diagnostic imaging technology development.

Teaching: The Department of Ophthalmology has an outstanding residency program, training six residents each year in a three year program. Graduates have gone on to clinical, research, and combined clinician-scientist careers. The department is at the forefront of continuing medical education and provides both ongoing and specialized educational opportunities. This year, in addition to our 18 residents, we trained retina, cornea, glaucoma, oculoplastic and pediatric ophthalmology fellows.

Innovative changes will steadily filter through to each area of service. In view of these accomplishments, I can safely say that I am very proud of the department, and I look forward to keeping you up to date on future progress.

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Department of Ophthalmology

Abstract

Stem cells play an essential role in cellular specialization and pattern formation during embryogenesis and in tissue regeneration in adults. This is mainly due to a stem cell's ability to replenish itself (self-renewal) and, at the same time, produce differentiated progeny. Realization of these special stem cell features has changed the prospective of the field. However, regulation of stem cell self-renewal and maintenance of its potentiality require a complicated regulatory network of both extracellular cues and intrinsic programs. Understanding how signaling regulates stem cell behavior will shed light on the molecular mechanisms underlying stem cell self-renewal. In this review, we focus on comparing the progress of recent research regarding the roles of the BMP signaling pathway in different stem cell systems, including embryonic stem cells, germline stem cells, hematopoietic stem cells, and intestinal stem cells. We hope this comparison, together with a brief look at other signaling pathways, will bring a more balanced view of BMP signaling in regulation of stem cell properties, and further point to a general principle that self-renewal of stem cells may require a combination of maintenance of proliferation potential, inhibition of apoptosis, and blocking of differentiation.

Stem cells are the key subset of cells functioning as ancestor cells to produce a variety of types of functionally specialized mature cells in a given tissue, while at the same time undergoing self-renewal, a process of reproducing themselves without losing their developmental potentiality. This self-renewal process is controlled by intrinsic genetic pathways that are subject to regulation by extrinsic signals from the microenvironment (called niche) in which stem cells reside. Stem cells play essential roles ranging from embryonic development and organogenesis (embryonic/fetal stem cells) to tissue regeneration (adult stem cells) (Lin, 2003, Spradling et al., 2001, Watt and Hogan, 2000andWeissman, 2000). To maintain homeostasis, a precise balance between self-renewal and differentiation of stem cells is essential. Loss of this balance tends to lead to uncontrolled cell growth or pre-maturation and thus results in tumors, cancers, or tissue defects. Therefore, understanding the complex signal regulation of stem cell development is crucial for future therapeutic applications. In this review, we will focus on progress that has been made in research studying the bone morphogenesis protein (BMP) signaling pathway in regulation of stem cell properties.

BMPs belong to the transformation growth factor beta (TGF) superfamily. They are involved in regulation of cell proliferation, differentiation, and apoptosis and therefore play essential roles during embryonic development and pattern formation ( Massague, 1998). To maintain homeostasis in adults, the BMP signal also participates in tissue remodeling and regeneration, in which regulation of stem cell behavior is prominent.

There are more than 20 BMPs. Some BMPs have a distinct function while others have overlapping functions, depending on the specificity of their interaction with different types of receptors and the tissues in which they are differentially expressed (Mishina, 2003). Accumulated evidence indicates that BMPs play an important role in regulation of stem cell properties; however, their functions are different in the different stem cell compartments. For instance, in Drosophila germline stem cells (GSCs), Dpp (homolog of BMP2/4) is essential for the maintenance of stem cells ( Xie and Spradling, 1998); in embryonic stem cells (ESCs), BMP signaling appears to be required for ESC self-renewal but this is owing to its ability to block neural differentiation ( Ying et al., 2003a) in addition to its ability to promote non-neural (mesoderm and trophoblast) differentiation ( Xu et al., 2002andYing et al., 2003a); in mesenchymal stem cells, the BMP signal induces osteoblastic differentiation through Bmpr1b but inhibits osteoblastic differentiation through Bmpr1a (Chen et al., 1998); in intestinal stem cells (ISCs), BMP signaling inhibits stem cell activation and expansion (He et al., 2004); and in hematopoietic stem cells (HSCs), BMP signaling through Bmpr1a restricts stem cell number by controlling the niche size (Zhang et al., 2003). A critical and comparative review of the roles of BMPs in different settings and in different stem cell compartments is necessary for a balanced view towards BMP function in the regulation of stem cell properties, and thus will provide important insight into understanding the complex signaling regulation of stem cell self-renewal and fate determination.

The molecular mechanisms that control stem cell self-renewal remain largely unknown, albeit a large body of literature has been published with regard to stem cell self-renewal and the related signaling pathways. In the literature, self-renewal is generally described as a parallel cellular event of proliferation, differentiation, and apoptosis. However, accumulated evidence suggests that self-renewal of stem cells requires a combination of events: maintenance of their proliferation potential, inhibition of apoptosis, and blocking of differentiation.

Multiple signaling pathways have been reported to contribute to the regulation of stem cell self-renewal. However, different molecules and the underlying pathways may play different and overlapping roles in this regard. Maintaining proliferation potential is an obvious principle required for self-renewal of stem cells. However, it is worthwhile to point out that proliferation potential (defined as the capacity of stem cells to undergo continuous division) is different from proliferation per se in that the more the stem cells undergo active proliferation, the more they tend to lose their potential for proliferation. Therefore, stem cell proliferation potential is a functional property which can only be measured by continuous in vitro cell culture, or in vivo repopulation functional assay, rather than by measurement of the rate of proliferation. Recently, several lines of evidence have suggested that the Wnt signaling pathway through -catenin is important for self-renewal of HSCs (Austin et al., 1997, Brandon et al., 2000, Murdoch et al., 2003, Reya et al., 2003, Van Den Berg et al., 1998andWillert et al., 2003), hair follicle stem cells (DasGupta and Fuchs, 1999, Gat et al., 1998andHuelsken et al., 2001), ISCs (He et al., 2004, Sancho et al., 2003andSancho et al., 2004), and ESCs (Sato et al., 2004). In addition to its function in lineage fate determination, the prominent role of Wnt signaling favors cell proliferation and promotes cell growth. Abnormal activation of -catenin leads to over-proliferation of stem cells and results in tumors in the intestines and in hair follicles (Gat et al., 1998andSancho et al., 2004). In contrast, deletion of a Wnt downstream factor, Tcf4, leads to loss of stem cells in the intestines (Korinek et al., 1998). These observations suggest that Wnt/-catenin signaling is important for the proliferation potential of stem cells as -catenin may stimulate Tert (encoding the catalytic subunit of telomerase) expression via activation of Myc (He et al., 1998, Wang et al., 1998andZou et al., 2005). The idea that limiting the proliferation potential affects stem cell self-renewal has been well demonstrated by studies of telomerase (Morrison et al., 1996), HoxB4 (Antonchuk et al., 2002, Helgason et al., 1996, Kyba et al., 2002andSauvageau et al., 1995), p18 (Yuan et al., 2004), P21(Cheng et al., 2000), and Bmi (Lessard and Sauvageau, 2003, Molofsky et al., 2003andPark et al., 2003).

Recent reports indicate that suppression of apoptosis plays an essential role in stem cell self-renewal (Domen and Weissman, 2000, Domen et al., 2000, Opferman et al., 2005andYamane et al., 2005). This idea is further enforced by the fact that the role of -catenin in promoting HSC self-renewal is prominent in the Bcl2-transgenic mouse (Reya et al., 2003), indicating that a coordination between Bcl2, which inhibits apoptosis, and -catenin, which is important for proliferation potential, is required for stem cell self-renewal. Likewise, transgenic expression of the activated form of -catenin alone tends to lead to crypt cell apoptosis, as shown in the intestinal system (Wong et al., 1998). It is also reported that Akt is activated during intestinal stem cell activation and division (He et al., 2004), as well as during hair follicle stem cell activation (Zhang and Li manuscript, submitted). As Akt is a cell survival factor in general, activation of Akt during stem cell activation and division may be necessary to protect stem cells from apoptotic stress including that from partial anoikis, a phenomenon caused by detachment from the extracellular matrix during cell division (Khwaja et al., 1997). Consistent with this conclusion, activation of PI3K/Akt, as a consequence of the loss of PTEN-function, has been reported to result in expansion of embryonic and neural stem cell populations (Groszer et al., 2001andKimura et al., 2003).

More here:
BMP signaling and stem cell regulation - ScienceDirect

anon950526 Post 156

Is there any impact due to this?

Obviously, some of you dont have kids. The life of a child is worth so much more than any adult. You got to live. What if that embryo happened to be you? Would you then feel that it is OK to conduct this research?

I am a mother of two, soon to be three. I don't care about any of that just long as my kids at least get a chance at living and there is a God. I had a 50 percent chance of having babies because of a huge benign tumor that grew on my left ovary and killed my left fallopian tube.

I prayed for my babies and got them every time. Besides that, everybody has their

I watched this gruesome abortion video and the lady was 12 weeks along. You could see the child trying to fight for its life. Murder is murder. Helping to save other people or not -- that's like you seeing a man trying to rape a woman and you shoot him dead. It's the same if you were trying to save her life but you get persecuted and convicted for taking matters into your own hands. I am sorry for those people who are sick and have sick babies. I know what it is like to lose loved ones over untreatable diseases. Im against embryo research and I'm not thinking about me. It is about a baby. Sure, it isnt completely formed, but it's still a child, or at least will grow into one, I wish harm on nobody. There is no harm meant and Im not trying to make someone mad. Im just trying to throw some new views into the situation.

Stem cell research can only benefit society and advance us as a species. If your argument is religious, the you are not thinking. You are letting your emotions and beliefs speak for you, not your logic or common sense. A bunch of cells is not a baby, and helping the living is not against "God's will". This is a good thing and it will continue regardless of religious views, because it makes sense.

I'm still kind of learning about this topic, but abortion is something I feel strongly against, but if a baby was taken from it's mother with the mother's okay and they were trying to save people's lives, I would be completely okay with that.

I believe that God does not exist, and that stem cell research is truly phenomenal. This research should not be controversial, nor should it be banned; it is helping the living.

Most of the people who say that stem cell research is bad are religious, but people living in the real world and believe in this thing called 'science' actually make a difference. Religion has only held back society and science. I wonder how many religious people would get angry if they knew that I was a homosexual, atheist physicist who believes in evolution and the big bang theory.

I am writing a persuasive essay on whether stem cell research should be legal or not (even though it already is in the U.S.). I was never a really religious person and stuck mainly to things that I knew for sure were happening. The thing is, most of the stem cells they are using for research are going to be discarded anyway. No one is claiming them, no one is caring about them, and they are just going to be thrown away. It is better for them to be used for a greater cause than just being thrown away and losing the chance to create treatments and cures for cancer and neurodegenerative diseases.

Without trying to offend anyone, please don't

bring God into this, like if you're going to simply take the stem cells and create babies with them. The cells could be considered early life, but you lose cells every day and no one gives it a second thought. I am thirteen years old and sorry if you believe that I am wrong.

This is a terrible thing. Stem cell research is just an excuse for making us Americans pay for other peoples' abortions. This stem cell research crap may have fooled my friends who claim abortion is when the baby isn't fully developed and that it's murder to kill a baby after it's born. What's the difference? Abortion is murder.

This country is so corrupt it will probably start killing the elderly and calling it abortion, or calling every day murder of people abortion. Well, I have had enough of this crap Obama is trying to trick us with. God says life is precious and an undeveloped baby is made of many cells and cells are alive. Think about that, America. Not only that, but abortion is unnecessary. If a girl gets raped, she can put the baby up for adoption instead of murdering the baby. Studies show many women who had abortions regret it.

So what you are all arguing about is if god exists and whats his plan for us, and why or why should we not use pre-embryo stem cells. It's completely your own opinion, but when does life start for a baby -- when the sperm reaches the egg or when you hear his heartbeat?

I, for one, say we should not use embryo stem cells because they are a living being. Also for all of you who say its gods plan for us, who created god? He could not just have created himself out of nowhere. These are just my thoughts. But these are all still questions we do not know the answer to.

I've been researching this Stem Cell subject for a long time, and I'm so amazed at everyone's stories from the news and sites on how stem cells has helped them recover from so many types of sicknesses and diseases. Even cancer can be cured by this type of treatment.

One big factor is that it's not a drug but it will just treat your body in a nice and natural way. Stem cell therapy is nice but I found this Laminine on the market. People keep on talking about it, saying it's the new science breakthrough and that I should give a try. It's not a literal stem cell but it is a stem cell enhancer, and safer than the usual way of Stem Cell Therapy.

I gave it a try and in just a few weeks I felt its proven power that I also recommend it to everyone out there.

How is that clump of cells considered a newborn? Those cells aren't a newborn because there's still a chance that once you implant those embryos they don't hold, so it's not a child. They don't take these people's cells then say, nope you can't have your child -- we're going to use them for someone else. They're leftovers. No one is going to use them and they are going to get discarded. If you consider it a human how is it humane to let it sit there frozen forever, discarded and unloved? People throwing god around are ignorant. Not everyone believes in your "creator" and don't throw it in my face. Believe in your beliefs, but don't force mine.

@post 52: If there is no God, who do you think made the universe? Your dad didn't make it, I didn't make, you didn't make, nor did any person. Only an eternal being must have made the universe.

Look. What none of you guys are realizing is that embryonic stem cell research doesn't focus solely on embryos.

I'm a student getting my masters degree in pediatric nursing, so you guys can't say I don't know this. But maybe if you did some research instead of arguing that everyone except yourself is wrong, you would realize there are valid points to both sides.

Embryonic stem cell research also focuses on umbilical cords and placentas, which does no harm to the baby whatsoever. Now none of you can say that's "murder" or against your religion because I'm Roman Catholic, which is one of the main religions against stem cell research and I am personally all for it.

Now if embryos

Enough about manipulating death and being religiously wrong. Enough said, simple as that.

A novel called "Living Proof" just came out in stores this week that explores the life and death issue of embryonic stem cell research for the first time as a story. It's getting a lot of buzz online and pertains directly to this discussion.

Most say stem cell research is bad because scientists are trying to pay God, but that's a bunch of crap. Like what others have said, God created us, knowing that one day we would come up with this knowledge to maybe find cures. Somebody else stated that we are ungrateful because we want to use this research, but that's not entirely true, because we are grateful for this new research to cure people like me. Yes I said me. I'm a 16 year old diabetic. I may not suffer as much as others with other diseases, but I have.

Also, this same person said that we should be the ones serving overseas. Well, if you've paid attention, we can't because

Anyway, most don't know what it's like to stick a big needle into their own skin every day, but I do. They also don't know what its like to wake up very weak due to a low blood sugar, or to throw up because you get ketones due to not having any more insulin going through their body.

Lastly, most of you probably aren't scared to go to bed, knowing that you might not wake up because you went low, with no one knowing and died. Yes, I know diabetes isn't the worse disease out there, but it's not easy either. I don't really like abortion, but at least the fetus could help cure many people, and not just get thrown away.

In a way, the government not allowing stem cell research, and the people against it can be considered murderers too, because they are standing in the way of curing people, which could save their lives. This is how our country is going downhill, not the other way around.

Finally, you say how a human life is so important, and yes it is, but who's to say that an animal's life isn't? People abuse animals, use them to test new products, that most people use, but I don't see you caring about that. Yes, some people do, but most don't give a crap. And I mean, didn't God create animals too, so shouldn't they be just as important as humans?

Yeah, so that's all I have to say. Hopefully this will make people use their brains a little more, because the people who are against it only really seem to care about themselves, not the people who are actually suffering!

The controversy surrounding the morality of stem cell research is centered around the creation, usage, and destruction of the human embryos. Currently, the limits of technological advancement require the destruction of the human embryo in creating the human embryonic stem cell. Various groups view an embryo as an early-aged human life. As a result, they are concerned with the rights and status of the embryo, and often go so far as to equate such research with murder because of the embryos destruction. However, despite scientific evidence suggesting that the early-stage embryos being used are not early-aged human life, the importance of these embryonic stem cells and their contribution to scientific advancement is tremendous.

Stem cells are cells in the human

John Stuart Mills principle of Utilitarianism also supports the morality of stem cell research. Utilitarianism states that an actions moral worth is determined solely by its contribution to the happiness of all parties involved. The phrase the greatest good for the greatest number of people is often used to describe this principle. But more precisely, the true morality of such research is exhibited in the concept of Negative Utilitarianism. Negative Utilitarianism requires us to promote the least amount of harm, or prevent the greatest amount of suffering for the greatest number of people.

Since science has established that are embryos not yet human, any harm inflicted on them does not weigh in on the moral worth of the action. However, the development of treatments that could potentially cure conditions such as Parkinsons disease and Alzheimers would weigh in on its moral worth. As a result, the prevention of suffering made possible by stem cell research and its potential medical advancements far outweigh any harm inflicted on the embryos, even if the embryos were given moral standing. Thus, by means of Negative Utilitarianism, the morality of stem cell research cannot be called into question.

This is modern day fascism. You shouldn't choose what life has more importance. Speaking as a veteran, people like this make me regret serving an ungrateful country, full of morally degraded people. These people who believe in this should have been the ones overseas. Then tell me how easy it is to choose one life over the other. Those people make me sick, and will be the downfall of this country.

Fundamentalists never fail to amaze me with their ability to only read half the story. The embryos used in stem cell research would be discarded anyway - stem cell research isn't denying them a chance at life, they had no chance at life in the first place. It isn't the same thing as abortion.

And I hope the fundies who are making comments along the lines of "We suffer because God wills it" never take antibiotics when they are sick - surely that would be messing with God's plan for you to die from a disease that modern science can easily cure?

Any opponent to stem cell research on the grounds of all this embryo is a human life crap is nothing but a ignorant idiotic hypocrite and the same goes for anti abortionists.

Why claim to give a crap at all about so called life when none of you seem to give a crap about the starving millions in underdeveloped countries, the starving on the street, those on death row etc.? What about those lives? Aren't they more convincing examples of 'life' than a pile of embryonic goo? Are they not deserving of all the fuss you make over the value of human life?

You people seem more concerned with spouting your ignorant, selfish beliefs and halting progress that could one

Is there any difference between you people in regards to this and those that shared the same beliefs that used to carry out witch hunts all those many years ago? one has to wonder.

i think that stem cell affords advancements to the medical industry. people should stop trying to use the phrase "who are we to play god". if that is the case then don't take medication to relieve pain because under those conditions would that also be playing god?

Remember that some stem cells are taken from the umbilical cord and adult tissue, not just embryos. You wouldn't call it murder if the cells were taken from an inanimate piece of flesh, would you?

I have been reading comments and "playing god" is stupid. Getting and giving shots are playing god implants and anything like that is playing god. you're not letting what happens happen. I read about a wife with four kids with Cystic Fibrosis. finding a cure for that would be playing god. That would be taking his power to save a child.

I think it's all right. People are going to abort fetuses no matter what you say or how you feel. You can say it's wrong and waste it or you can use it to support something new and know you helped to save a life. Would you honestly say that because of what you think you should throw away something that could help people just because its from something not even alive yet?

O.K. so it might be alive, but at an older age in the pregnancy. And people are right: if someone you love was dying, you would not just sit there and watch and say, oh well, too bad for you. You would try to help no matter what the cost.

I don't know what is so bad about trying to save life. Stem cell research has advanced into the stages of using actual cells from adults, (Somatic cells) and this is pushing research today. Take some time and do the "current" research about stem cells and educate yourselves.

As far as the religious perspective goes I am a Christian and "God" gave me the cells in my body and if those cells that "God" gave have a way of saving my life, then that is his will. Helping your body heal is not playing God, it is using what God gave you!

I'm curious; What defines something as "live"? When does life begin? Well, does it not begin at fertilization when the cells go through meiosis? And the DNA is replicated? Well here's what I have to say.

Again, what defines something as a "Live" human? Is it size? Level of development? Environment?

Degree of dependency?

If it's based on size, then isn't that size-ism? Does that mean our society is saying that the unborn aren't human because they aren't as big as us? Yes, an unborn baby isn't as big as a toddler, but a toddler isn't as big as a full grown adult. So does that mean that they toddler isn't human either? Or in any way less human

Level of development: Some argue that since the unborn aren't fully developed yet, they aren't human. I'm 15 and I'm not fully developed; does that mean I'm not human? No. I'm still growing. Development doesn't stop at birth. It starts at conception.

The most common argument in this category is the baby can't think, or feel pain, or even know that they exist. I beg to differ. There was an article published in a newspaper that said a doctor was performing an abortion, and on the screen, you could see the baby trying to get away from the tool trying to pull it out. In another, there was a case where the baby stuck its hand out and held onto the doctor's finger. Look it up.

We say that they can't feel pain, so they aren't human. But what about those with Sepa disease? They are born unable to feel pain; can we go and kill them too? They can't feel pain so they aren't human, so it's okay, right? Wrong.

Environment: Most common argument: The unborn baby isn't in the world yet, it's in the mother's body, and it doesn't even breathe air. This argument seems to be saying that the unborn child isn't human because it's in a different environment then we are. But, since when does where we are, determine who we are? In our day to day lives, we change our environment multiple times. But it doesn't change who we are as a person, unless you have a multiple personality disorder.

So here's a question; How does the eight-inch trip down the birth canal change who you are as a blob of tissue, into a valued human being with rights? Truth be told, it doesn't. Another argument is the unborn baby is in the mother's body, which is her body, so the mother should be able to do what ever she wants with that baby. So what's the difference between a baby the day before it's born, and one day after?

A day before: Not fully developed; dependent on the mother; in the mother's body -- her property.

A day after: Not fully developed; dependent on the mother; in the mother's house -- her property

What makes it okay to kill the one but not the other?

There was a case where a man went and murdered a pregnant woman and was charged with double murder. In that case, the government and court are considering that fetus is a life with value. However, in the same time, something like 32 abortions were performed under the protection of the law. How come those babies don't get the same justification? Is it because they aren't wanted? If an orphan was murdered, would no one care because they weren't wanted? Of course not. It's absurd to me the double standard in our society.

Degree of Dependency: Arguments are that if the unborn baby is still dependent on the mother, and can't survive on their own yet, they aren't human. Even a one week old baby is still dependent on the mother. It will be for a while.

Once again, I'm 15 and I can't survive on my own. I depend on my parents. I depend on my government and school system, I depend on my friends. I'm dependent. But do I not have value and rights?

What about those who depend on medical instruments? And life support?

Parents depend on others to provide them with jobs, food and money, with places for their children to go to get an education. Our classrooms are getting smaller and smaller due to the number of abortions each year. But again, does this affect a person's humanity in some way because they depend on someone? You're going through a divorce and you need someone to lean on; you're depending on them. Oh, yeah, sorry for the bad timing, but oh geez this is tough, you're not human, so we're going to have to kill you. No, I don't think so.

What about those on welfare? Can we kill them too because they depend on the government to provide them with money? I don't think so. We are all dependent on someone to a degree. But who goes around saying that those who depend on someone are less human or not human at all? No one. Why? Because it's hypocritical and illogical. But somehow, our society is able to accept this argument when it comes to unborn children. The faces of tomorrow. We are the people are today, and we're killing tomorrow's people.

So if we use these arguments to allow the killing of the unborn, then we should be allowed to kill: Any child; those on welfare; those with medical tools and medications; those with mental disabilities. They aren't what people consider "the norm"- are very dependent, usually have a difference in size, aren't developed as much as those who are not disabled, and depending on the case, their environment may be different then ours. And so on and so forth.

Of course not. We would never dream of doing that. It upsets many many people even using those cases as examples. So it should be clear that the unborn are human, as well as those with developmental disabilities, differences, different circumstances- welfare, etc., and the sick.

For people who don't understand, here is what I'm saying. I am pro choice- that women should have choices to do what they want in life from the unimportant (what flavor of ice cream I want) to the extremely important (what career I want to pursue) but should not have the "right" to make a choice about another person's life. You don't get to decide who lives or dies.

I do not believe we should use stem cells. If we can cure all diseases and grow back body parts then we will evidently live a very, very, very long time. This could potentially result in an overpopulation problem which we are currently starting to experience.

Humans were not meant to live forever, and maybe you should ask yourself: do you really want to live forever?

To those people who say that it's okay for scientists to do stem cell research, yes it's okay for them to do research to improve other people's lives without using stupid, dangerous chemicals on the cells. Some aspects of stem cell research, is not just against religious values, but also against our morals in general.

Thank you anon332, for trying to knock some sense into these people, who think that science always does good things. Wake up!

Religion is a vessel of our hopes, fears and a face of the unexplained. Without religion, science would grow like a cancer, and without science the other way around. Balance is what is needed.

For those who believe in God, it would not be that with stem cells we are playing God. The man or woman will live because God had willed it.

For those who don't, embryos are lives. A full life. Of course, this is only my opinion.

The world makes us what we are. It influences our choices and our minds. Everything around us at every moment is changing us.

In short, the world makes us what we are, but we make the world as how it is.

Science without religion is blasphemous. Religion without science is idiocy.

I believe stem cell research is definitely a good thing for people that are sick. I don't think people should be allowed to use a fetus for the research, but embryonic research is ethical. The embryo isn't yet developing human characteristics the way a fetus is.

I will begin by saying that I am a 14 year old girl of undecided religious beliefs. I have read many of these comments, and I have a few ideas which may help/clear up some misconceptions.

As of now, I do not officially believe in God. I do, however, understand many religions and I have accepted religious beliefs and ideas, especially those pertaining to abortion and stem cell research. Here are some of my views on the subject. I have tried to incorporate all the different positions on the subject:

1. Embryos are not fetuses and stem cell research is not the same as abortion. Fetuses are developed forms in which the cells have begun to specialize. Embryos are clusters

2. If an embryo is not used, it can be donated, either to research or to another parent, or it can be thrown away. Based on the dilemmas that seem to be arising, i am assuming that no one is of the belief that throwing away the embryos is in the best interest of anyone. That leaves donation to a parent or donation to research. If the decision is made to donate to another parent, then I think that is fine. If that idea is declined, then I don't see why a group of cells shouldn't be used to potentially help others. If a leftover embryo is just going to be thrown away, then why would the people throwing it away care if it were used. Remember, an embryo does not have even the most remote form of a brain or a heart.

3. If the argument is about whether or not the embryo has a soul, I cannot help. I do not believe that a random grouping of cells has a soul. I do not even necessarily believe in souls.

4. In this article, it says that the most common argument against stem cells is the belief in man not manipulating human life. I cannot say whether or not this is actually the big argument, but for those people who do believe that i will ask, "Have you been vaccinated? Have you ever taken any medicine for an illness? Is this not manipulating life?". If one believes that Man should not be allowed to manipulate life, then they should also believe that medicines and known cures should not be used. if a person gets pneumonia, should the doctors just let them die because they don't believe in manipulating life? Isn't that murder?

As for manipulating the embryo, I can only repeat that I do not personally believe that a group of unspecialized cells should be treated as humans.

5. I do not believe that stem cell research should be used for cloning. As for "creating another you" in case you get diseases later in life, watch or read "My Sister's Keeper".

6. As for the ethics, there are generally five ethical approaches: utilitarian-whatever does the most good and the least harm, Rights-whatever considers the rights of everyone involved, Fairness of Justice-treats all equally and proportionally, Common good-the values of Confucianism or putting the group before the individual, and Virtue-what will make me more of the person i want to be? If using an organism that is displaying the characteristics of life, but that is not developed into a fetus will help others, I don't see how it contradicts any of the ethical approaches.

6. If I decidedly believed in God, I would say, "God made us. I believe he made us for a reason. He gave us prayer and life. He also gave us doctors and medicine. we should use them".

7. For those who say "if your loved one was dying, then your view would change" you are correct. Their view would change, but do we really want a society where people make official decisions based on the health status of their loved ones, when they are stressed and not thinking clearly?

These are the things I have come up with. I didn't mean to offend anyone with my statements, and if I did, I am sorry.

Yeah, they are not using a fetus. they are using an embryo, which there is a huge difference.

Number one, they are not using a fetus; which i agree is human. The embryos used for stem cell research are four to five days old and have no specialized tissues, no nervous system, or heart. Each embryo contains about one-hundred cells, the cells of which are still undifferentiated (meaning that the cell has not decided what it is going to be).

For those of you saying that we are playing god. Is not God's greatest gift the gift of life? After IVF a woman has limited choices what to do with her leftover embryos. She may donate to another couple, donate to research, keep the embryos for maybe future implantation, or she may discard them.

Read more:
What Is Stem Cell Research ? (with pictures) - wiseGEEK

At a microscopic level, we are all composed of cells. Look at yourself in a mirror -- what you see is about 10 trillion cells divided into about 200 different types. Our muscles are made of muscle cells, our livers of liver cells, and there are even very specialized types of cells that make the enamel for our teeth or the clear lenses in our eyes!

If you want to understand how your body works, you need to understand cells. Everything from reproduction to infections to repairing a broken bone happens down at the cellular level. If you want to understand new frontiers like biotechnology and genetic engineering, you need to understand cells as well.

Anyone who reads the paper or any of the scientific magazines (Scientific American, Discover, Popular Science) is aware that genes are BIG news these days. Here are some of the terms you commonly see:

Gene science and genetics are rapidly changing the face of medicine, agriculture and even the legal system!

In this article, we'll delve down to the molecular level to completely understand how cells work. We'll look at the simplest cells possible: bacteria cells. By understanding how bacteria work, you can understand the basic mechanisms of all of the cells in your body. This is a fascinating topic both because of its very personal nature and the fact that it makes these news stories so much clearer and easier to understand. Also, once you understand how cells work, you will be able to answer other related questions like these:

All of these questions have obvious answers once you understand how cells work -- so let's get started!

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How Cells Work | HowStuffWorks

A stem cell transplant is a procedure that replaces defective or damaged cells in patients whose normal blood cells have been affected by cancer. Transplants also are used to help patients recover from aggressive radiation and chemotherapy treatments.

Stem cells are immature cells that begin life in the bone marrow and eventually develop into the various types of mature blood cells:

There are three types of stem cell transplantation:

Autologous transplant: cells are harvested from the patient's own bone marrow before chemotherapy and are replaced after cancer treatment.

Allogeneic transplant: stem cells come from a donor whose tissue most closely matches the patient.

Umbilical cord blood from newborn infants is extracted from the placenta after birth and saved in special cord blood banks for future use. MDAnderson's Cord Blood Bank actively seeks donations of umbilical cords.

Stem cell transplants commonly are used to treat leukemia and lymphoma, cancers which affect the blood and lymphatic system. Transplants also can be used to help patients recover from or better tolerate cancer treatment, and to treat hereditary blood disorders such as sickle cell anemia.

Stem cell transplant patients are matched with eligible donors by human leukocyte antigen (HLA) typing. HLA are proteins that exist on the surface of most cells in the body. HLA markers help the body distinguish normal cells from foreign cells, such as cancer cells.

HLA typing is done with a patient blood sample, which is then compared with samples from a family member or a donor registry. It can sometimes take several weeks or longer to find a suitable donor.

The closest possible match between the HLA markers of the donor and the patient reduces the risk of the body rejecting the new stem cells (graft versus host disease).

The best match is usually a first degree relative (children, siblings or parents). However, about 75% of patients do not have a suitable donor in their family and require cells from matched unrelated donors (MUD), who are located through registries such as the National Marrow Donor Program.

Because the patients immune system is wiped out before a stem cell transplant, it takes about six months to a year for the immune system to recover and start producing healthy new blood cells. Transplant patients are at increased risk for infections during this time, and must take precautions. Other side effects include:

Read more:
Stem Cell Transplantation | MD Anderson Cancer Center

A current view of hematopoiesis is that of a hierarchically organized system, with a rare population of hematopoietic stem cells (HSCs) residing at the top of the hierarchy, giving rise to all blood cell lineages. See MoreHSCs possess the ability of multipotency (i.e. one HSC can differentiate into all functional blood cells) and selfrenewal (i.e. HSCs can divide and give rise to an identical daughter cell, without differentiation).1 Through a series of lineage commitment steps, HSCs give rise to progeny that progressively lose self-renewal potential and successively become more and more restricted in their differentiation capacity, generating multi-potential and lineage-committed progenitor cells, and ultimately mature functional circulating blood cells.

The ability of hematopoietic stem and progenitor cells (HSPCs) to self-renew and differentiate is fundamental for the formation and maintenance of life-long hematopoiesis and deregulation of these processes may lead to severe clinical consequences. HSPCs are also highly valuable for their ability to reconstitute the hematopoietic system when transplanted and this has enabled their use in the clinic to treat a variety of disorders including bone marrow failure, myeloproliferative disorders and other acquired or genetic disorders that affect blood cells.2,3 Given these pivotal roles of HSPCs, much research effort has been directed at developing tools for their detection, enumeration, identification and isolation, and understanding the mechanisms underlying their behavior and fate decisions.4 Exploiting key findings of such research is highly relevant for developing novel methods to obtain clinically relevant numbers of normal HSPCs and to eliminate or inhibit cancer stem cell growth in hematopoietic malignancies.

Read the original here:
Hematopoietic Stem Cells, Cell Culture Media, CFC Assays

Knee Replacement Surgery through WorldMed Assist is affordable through our partnerships with state of the art Hospital Clinica Biblica in Costa Rica. Medically trained case managers provide patient advocacy to ensure you receive the best medical care available for your procedure. Clinica Biblica, officially recognized by the Joint Commission International (JCI), was thoroughly investigated prior to selection. Your procedure, including travel to and from Costa Rica, is managed by registered nurses from beginning to conclusion, guaranteeing you the optimum experience.

Most importantly, we provide you with a personal touch from start until well after your return home.

Knee Replacement Surgery through WorldMed Assist is a unique approach to first-class medical care. Our association with high quality Hospital Clinica Biblica (which has a partnership with Baylor University) makes surgical procedures at reasonable rates and very high quality possible for everyone. Our case managers, all medically trained, organize every aspect of your procedure in Costa Rica and have helped many patients receive medical intervention very quickly.

Hospital Clinica Biblica in San Jose, Costa Rica

Other options for quality Knee Replacement Surgery include:

We also provide information on costs:

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Knee Replacement Surgery in Costa Rica | Cost of Knee ...

What Do We Make?

Gene Tools makes Morpholino antisense oligos. Morpholino oligos bind to complementary RNA and get in the way of processes; they can knock down gene expression, modify RNA splicing or inhibit miRNA activity and maturation. Morpholinos are the premier knockdown tools used in developmental biology labs, the best RNA-blocking reagents for cells in culture and, as Vivo-Morpholinos, the most specific delivery-enhanced oligos available for other animal models. We are the sole commercial manufacturer selling research quantities of Morpholinos world-wide.

Morpholino oligos are short chains of about 25 Morpholino subunits. Each subunit is comprised of a nucleic acid base, a morpholine ring and a non-ionic phosphorodiamidate intersubunit linkage. Morpholinos do not degrade their RNA targets, but instead act via an RNAse H-independent steric blocking mechanism. With their requirement for greater complementarity with their target RNAs, Morpholinos are free of the widespread off-target expression modulation typical of knockdowns which rely on RISC or RNase-H activity. They are completely stable in cells and do not induce immune responses.

With their high mRNA binding affinity and exquisite specificity, Morpholinos yield reliable and predictable results. Depending on the oligo sequence selected, they either can block translation initiation in the cytosol (by targeting the 5' UTR through the first 25 bases of coding sequence), can modify pre-mRNA splicing in the nucleus (by targeting splice junctions or splice regulatory sites) or can inhibit miRNA maturation and activity (by targeting pri-miRNA or mature miRNA), as well as more exotic applications such as ribozyme inhibition, modifying poly-A tailing, blocking RNA translocation sequences or translational frameshifting. Morpholinos have been shown effective in animals, protists, plants and bacteria.

We are continually developing novel cytosolic delivery systems like our 'Endo-Porter' for cultured cells and our Vivo-Morpholinos for both cultures and in vivo delivery. With established delivery technologies it's easy to deliver Morpholinos into cultures, embryos or animals -- making Morpholinos the best tools for genetic studies and drug target validation programs.

What Sets Us Apart?

Morpholino oligos have excellent antisense properties compared to other gene knockdown systems. Microinjection or electroporation of Morpholino oligos into the embryos of frogs, zebrafish, chicks, sea urchins and other organisms successfully and specifically shuts down the expression of targeted genes, making Morpholinos an indispensable tool of developmental biologists. Morpholinos have also proven their versatility and efficacy in cultures of primary or immortal cells when delivered by Endo-Porter, electroporation or Vivo-Morpholinos. Usually, Vivo-Morpholinos are used to bring the specificity and efficacy of Morpholino oligos to experiments requiring systemic delivery in adult animals. The list of over 7500 publications using Morpholinos is growing daily and is maintained on-line in a browseable database.

Besides providing the best knockdown and splice modification tools, we also provide the best customer support available in the gene silencing industry. Our customer support team includes three Ph.D.-level scientists with hands-on Morpholino experience who are available to: 1) discuss your experiment design, 2) design your oligos for you, and 3) help you troubleshoot your experiments, all at no additional cost.

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Home | Gene Tools, LLC

Chicago Diabetes Project

1 week ago

We invite you to join us as we go "All In for a Cure" at this year's third annual Poker Tournament on Friday, September 16th at The Estate by Gene & Georgetti. The exciting evening will include open bar, premium dinner buffet, prizes and a No Limit Texas Hold 'Em poker tournament. Register now at http://www.cdppoker.com or make a donation to support a functional cure. Seating is limited to the first 180 poker players. Check out these photos from last year's event! ...

Chicago Diabetes Project

1 week ago

Chicago Diabetes Project added an event. ...

All In for a Cure Poker Tournament

September 16, 2016, 6:00pm - September 16, 2016, 11:30pm

The Estate

Youre invited to the third annual All In for a Cure Texas Hold Em Tournament benefitting the Chicago Diabetes Project in partnership with the Special Kids Network. The event will be held on Friday, September 16th at The Estate by Gene & Georgetti. This exciting evening will include an open bar, premium buffet dinner and poker tournament. Space is limited and open to the first 180 paid poker players. Registration is now open at http://www.cdppoker.com. Sign up now to reserve your spot at the tables! View pictures from last years event: http://www.facebook.com/Impact365/photos/?tab=album&album_id=1188293404519421. Interested in sponsoring the event? Download sponsorship opportunities (www.chicagodiabetesproject.org/wp-content/uploads/2016/07/2016-POKER-SPONSORSHIP-DECK.pdf) and contact Michelle Le at 312-413-3011.

Read more:
Chicago Diabetes Project | Researching to Cure Diabetes

At Chicago Arthritis, next-generation stem cell therapy and platelet procedures are available today. Our focus is on thorough evaluation and non-surgical treatment of arthritis, tendinitis, joint injuries and pain. Our core beliefs include a patient dedicated approach, faith in evidence based treatments, continuous improvement in everything we do at work, and pursuit of better treatments. If you are in need of treatment for your pain, or are considering elective surgery for your condition, please contact us first to learn about the most advanced regenerative procedures available in the United States today.

Welcome to Chicago Arthritis

As a provider of the Regenexx Orthopedic Stem Cell and Platelet Procedures, the regenerative treatments we offer are at the cutting edge of medical science and are backed by more research than any other stem cell or platelet procedures for orthopedic conditions. For our inflammatory arthritis and autoimmune patients, we incorporate advanced imaging and the most effective biologic treatments when appropriate.

Our goals are to accurately diagnose your condition as well as utilize treatments that have the potential to minimize pain and maximize your functional ability.

Read more:
Stem Cell Therapy, Platelet Rich Plasma / PRP - Chicago

The specialty of Preventive Medicine provides an exciting opportunity for physicians who are interested in developing skills in epidemiology, biostatistics, health policy and management, planning and evaluation of health services, social and behavioral determinants of health and disease, environmental and occupational health, and clinical prevention. Preventive Medicine specialists are trained to promote health and reduce the risks of disease, disability and death in individuals and populations.

The University of Massachusetts Preventive Medicine Program offers a two-year training program that is fully accredited by the Accreditation Council for Graduate Medical Education. In order to be eligible for enrollment, applicants are required to complete at least one year of clinical trainingin an ACGME accredited residency program in the United States. The clinical training must include at least 11 months of direct patient care; six of these months must be primary care rotations (e.g., family medicine, internal medicine, pediatrics, obstetrics/gynecology).

Preventive Medicine faculty and trainees in the Department of Family Medicine and Community Health are generating new knowledge about prevention through research on tobacco control, cancer prevention, delivery of clinical preventive services, cultural inequalities in health care, risk reduction in the elderly, mental health issues in underserved populations, addiction medicine, occupational health,domestic violence, lifestyle modifications in the treatment of diabetes, control of sexually transmitted diseases, and health care access among homeless populations.

The goal of the training program is to produce graduates with the requisite knowledge, skills and experience to assume leadership roles in the field of preventive medicine and public health. In order to meet the challenge of providing trainees and fellows with appropriate focus in a field that is very broad, trainees are encouraged to pursue one or two areas in depth while developing basic analytical and problem-solving skills applicable to all areas. Trainees have ample opportunity to develop expertise through experiences in clinics, community health centers, city, state and federal public health agencies, community-based organization, health maintenance organizations, and research groups that abound in Massachusetts.The UMass Preventive Medicine Training Program is designed to be a two year program in which academic and practicum experiences are offered concurrently throughout the two years.

The Program attempts to strike a balance between the diversity of residents educational interests and the need for a common core of skills and knowledge. The Program provides flexibility in resident schedules and a wide array of training sites along with a clearly defined set of core requirements and performance expectations.

The majority of successful applicants complete 2-3 years of clinical training in primary care before enrolling in the Preventive Medicine Training Program.Interested applicants should apply through ERAS. If you have questions, please contact theAdministrative Coordinator, Linda Hollis, can be reached at 774-442-6499 or linda.hollis@umassmed.edu.The Program Director, Dr.Jacalyn Coghlin-Strom, can be reached at 774.442.5615 or jackie.coghlin-strom@umassmed.edu.

Continued here:
Preventive Medicine - Residencies - Family Medicine and ...

What is Genomic Medicine?

NHGRI defines genomic medicine as "an emerging medical discipline that involves using genomic information about an individual as part of their clinical care (e.g., for diagnostic or therapeutic decision-making) and the health outcomes and policy implications of that clinical use." Already, genomic medicine is making an impact in the fields of oncology, pharmacology, rare and undiagnosed diseases, and infectious disease.

The nation's investment in the Human Genome Project (HGP) was grounded in the expectation that knowledge generated as a result of that extraordinary research effort would be used to advance our understanding of biology and disease and to improve health. In the years since the HGP's completion there has been much excitement about the potential for so-called 'personalized medicine' to reach the clinic. More recently, a report from the National Academy of Sciences [dels.nas.edu] has called for the adoption of 'precision medicine,' where genomics, epigenomics, environmental exposure, and other data would be used to more accurately guide individual diagnosis [nimh.nih.gov]. Genomic medicine, as defined above, can be considered a subset of precision medicine.

The translation of new discoveries to use in patient care takes many years. Based on discoveries over the past five to ten years, genomic medicine is beginning to fuel new approaches in certain medical specialties. Oncology, in particular, is at the leading edge of incorporating genomics, as diagnostics for genetic and genomic markers are increasingly included in cancer screening, and to guide tailored treatment strategies.

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It has often been estimated that it takes, on average, 17 years to translate a novel research finding into routine clinical practice. This time lag is due to a combination of factors, including the need to validate research findings, the fact that clinical trials are complex and take time to conduct and then analyze, and because disseminating information and educating healthcare workers about a new advance is not an overnight process.

Once sufficient evidence has been generated to demonstrate a benefit to patients, or "clinical utility," professional societies and clinical standards groups will use that evidence to determine whether to incorporate the new test into clinical practice guidelines. This determination will also factor in any potential ethical and legal issues, as well economic factors such as cost-benefit ratios.

The NHGRI Genomic Medicine Working Group (GMWG) has been gathering expert stakeholders in a series of Genomic Medicine meetings to discuss issues surrounding the adoption of genomic medicine. Particularly, the GMWG draws expertise from researchers at the cutting edge of this new medical specialty, with the aim of better informing future translational research at NHGRI. Additionally the working group provides guidance to the National Advisory Council on Human Genome Research (NACHGR) and NHGRI in other areas of genomic medicine implementation, such as outlining infrastructural needs for adoption of genomic medicine, identifying related efforts for future collaborations, and reviewing progress overall in genomic medicine implementation.

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For more examples of genomic medicine advances, please see Notable Accomplishments in Genomic Medicine

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At NHGRI, the Division of Genomic Medicine administers research programs with a clinical focus. A number of research programs currently underway are generating the evidence base, and designing and testing the implementation of genome sequencing as part of an individual's clinical care:

Within NHGRI's Division of Policy, Communications, and Education, the Policy and Program Analysis Branch (PPAB), and the Genomic Healthcare Branch (GHB) are both involved in helping pave the way for the widespread adoption of genomic medicine.

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Last Updated: March 31, 2015

See the original post here:
What is Genomic Medicine? - Genome.gov

Imagine how important a shoulder is to a wide receiver or a fullback...Or how important a knee is to a pro hockey player... For professional athletes, their whole career - their life - depends on their bodies performing at their peak. That's why they're so very particular about their doctors - and why so many athletes choose the Michigan sports medicine specialists at Beaumont.

Your shoulders, knees and elbows are just as important to you. That's why you should choose your sports medicine doctors as carefully as the pros do. Beaumont's Michigan sports medicine physicians are some of the most respected in the country and perform the latest therapies and leading-edge procedures. The goal of the doctors, therapists and athletic trainers of Beaumont Sports Medicine is to get you back in the game and keep you there.

Commonly thought of as "athlete's medicine," sports medicine is really a unique approach to the care of injuries and conditions that occur not only in athletes, but also normal, active people.

As a matter of fact, anyone with an injury or condition that limits their activity level can benefit from a sports medicine approach. Whether you are a collegiate athlete, weekend warrior, or sedentary person wishing to get more active, sports medicine applies to you.

The purpose is simple - Get you back into the game - whatever your game may be.

One of the main goals of sports medicine is to put off major orthopedic surgery (such as joint replacement) as long as possible or even remove the need altogether with physical therapy, minimally invasive arthroscopic surgery and timely care.

In an effort to put off or eliminate the need for orthopedic surgery, Beaumont's sports medicine physicians are experts in the field of minimally invasive arthroscopy. Arthroscopy is a surgical procedure where a small incision is made near the site of the injury and a small scope is used to make repairs. With smaller incisions and advanced surgical procedures, arthroscopy has patients active sooner and with less pain.

Some procedures are unique to sports medicine. These can be broken down into categories which include:

Minimally Invasive Arthroscopic Treatments

Ankle

Elbow

Hip

Knee

Shoulder

Wrist

Treatment of Shoulder and Elbow Problems in Athletes

Minimally invasive shoulder stabilization for recurrent instability

Labral (SLAP) repair

Elbow ligament reconstruction (Tommy John Surgery)

Treatment of complex shoulder separations

Advanced techniques to repair clavicle fractures

Rotator Cuff Repair

Minimally invasive techniques

Revision surgery, patches, and muscle transfers for complex cases

Shoulder Replacement

Advanced Cartilage Restoration

Knee Ligament Reconstruction including

Knee Replacement Surgery including:

Read more here:
Sports Medicine in Michigan | Michigan Orthopedic Surgery ...

Want a sports job? There are many jobs and career opportunities in fields related to sports and sports medicine. The two major specialty areas for those looking for a sports medicine career involve working with athletes or the general population to improve fitness and sports performance or to work with those to prevent or recover from sport injuries. Most sports medicine professionals will have some overlap between these two areas and strive to help individuals achieve optimal health and sports performance goals.

Choosing a job or a career in sports and health promotion is possibly the easiest career decision you might make.

But deciding exactly where to focus your career goals can be challenging. There is an endless number of possible jobs in sports and the career choices can include higher education and degrees that require years of study or basic certifications that require a few month of hands on training. If you love sports, determining what path to take can be excruciating. One of the best ways to sort it all out is to talk to people doing what you think you may want to do, and find out what the day-to-day job is really like. Volunteering at local facilities can also help you gain a bit of focus.

Also See

Volunteering is a great way to immerse yourself in a chosen field without any long-term commitment. What better way to discover if that is really the way you want to spend 40 hours a week? Check the following links for schools and career information:

Sports Medicine Jobs and Employment Schools and Education Programs

Visit link:
Sports Medicine Jobs and Careers - Verywell

Because our team is trained in pediatrics, we understand that young athletes must be treated carefully to avoid long-term damage. Our multidisciplinary team includes sports medicine physicians, orthopaedic surgeons, physical therapists, certified athletic trainers and a registered dietician. We work together to develop specialized, effective treatments that return young athletes to playing their sport as safely and quickly as possible. We treat athletes with a wide range of sports-related injuries and conditions:

Our athletic trainers are present on the sidelines at high schools and sports venues to help ensure the safety of athletes and provide immediate care when injuries occur. Our pediatric-trained team of sports medicine physicians and orthopaedic surgeons evaluate injured athletes to determine the best course of treatment to get them back on the field. Our physical therapists teach athletes proper exercises to improve range of motion and strength, and use motion analysis technology to examine mechanics and identify flaws that may contribute to injury. Working together as a team, we provide high-quality care for our athletes with the goal of returning the athlete to their sport as quickly and safely as possible.

For more information, call 404-785-KIDS (5437).

Visit link:
Sports Medicine | Children's Healthcare of Atlanta

Not to be confused with cortisone, a metabolite from cortisol, with a similar name, genesis, and function. Cortisol Systematic (IUPAC) name

(11)-11,17,21-trihydroxypregn-4-ene-3,20-dione

O=C4C=C2/[C@]([C@H]1[C@@H](O)C[C@@]3([C@@](O)(C(=O)CO)CC[C@H]3[C@@H]1CC2)C)(C)CC4

Cortisol is a steroid hormone, in the glucocorticoid class of hormones, and is produced in humans by the zona fasciculata of the adrenal cortex within the adrenal gland.[1] It is released in response to stress and low blood-glucose concentration.

It functions to increase blood sugar through gluconeogenesis, to suppress the immune system, and to aid in the metabolism of fat, protein, and carbohydrates.[2] It also decreases bone formation.[3]

Hydrocortisone (INN, USAN, BAN) is a name for cortisol when it is used as a medication. Hydrocortisone is used to treat people who lack adequate naturally generated cortisol. It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.[4]

In the early fasting state, cortisol stimulates gluconeogenesis (the formation of glucose), and activates anti-stress and anti-inflammatory pathways.[5] Cortisol also plays an important, but indirect, role in liver and muscle glycogenolysis, the breaking down of glycogen to glucose-1-phosphate and glucose. This is done through its passive influence on glucagon.[clarification needed] Additionally, cortisol facilitates the activation of glycogen phosphorylase, which is necessary for epinephrine to have an effect on glycogenolysis.[6][7]

In the late fasting state, the function of cortisol changes slightly and increases glycogenesis. This response allows the liver to take up glucose that is not being used by the peripheral tissue and turn it into liver glycogen stores to be used if the body moves into the starvation state.[citation needed]

Elevated levels of cortisol, if prolonged, can lead to proteolysis (breakdown of proteins) and muscle wasting.[8] Several studies have shown that cortisol can have a lipolytic effect (promote the breakdown of fat). Under some conditions, however, cortisol may somewhat suppress lipolysis.[9]

Cortisol prevents the release of substances in the body that cause inflammation. It is used to treat conditions resulting from over activity of the B-cell-mediated antibody response. Examples include inflammatory and rheumatoid diseases, as well as allergies. Low-potency hydrocortisone, available as a non-prescription medicine in some countries, is used to treat skin problems such as rashes, and eczema.

It inhibits production of interleukin (IL)-12, interferon (IFN)-gamma, IFN-alpha and tumor-necrosis-factor (TNF)-alpha by antigen-presenting cells (APCs) and T helper (Th)1 cells, but upregulates IL-4, IL-10, and IL-13 by Th2 cells. This results in a shift toward a Th2 immune response rather than general immunosuppression. The activation of the stress system (and resulting increase in cortisol and Th2 shift) seen during an infection is believed to be a protective mechanism which prevents an over activation of the inflammatory response.[10]

Cortisol can weaken the activity of the immune system. Cortisol prevents proliferation of T-cells by rendering the interleukin-2 producer T-cells unresponsive to interleukin-1 (IL-1), and unable to produce the T-cell growth factor (IL-2).[11] Cortisol also has a negative-feedback effect on interleukin-1.[12]

Though IL-1 is useful in combating some diseases; however, endotoxic bacteria have gained an advantage by forcing the hypothalamus to increase cortisol levels (forcing the secretion of CRH hormone, thus antagonizing IL-1). The suppressor cells are not affected by glucosteroid response-modifying factor (GRMF),[13] so the effective setpoint for the immune cells may be even higher than the setpoint for physiological processes (reflecting leukocyte redistribution to lymph nodes, bone marrow, and skin). Rapid administration of corticosterone (the endogenous Type I and Type II receptor agonist) or RU28362 (a specific Type II receptor agonist) to adrenalectomized animals induced changes in leukocyte distribution. Natural killer cells are affected by cortisol.[14]

Cortisol stimulates many copper enzymes (often to 50% of their total potential), probably to increase copper availability for immune purposes.[15]:337 This includes lysyl oxidase, an enzyme that cross-links collagen and elastin.[15]:334 Especially valuable for immune response is cortisol's stimulation of the superoxide dismutase,[16] since this copper enzyme is almost certainly used by the body to permit superoxides to poison bacteria.

Cortisol counteracts insulin, contributes to hyperglycemia-causing hepatic gluconeogenesis[17] and inhibits the peripheral utilization of glucose (insulin resistance)[17] by decreasing the translocation of glucose transporters (especially GLUT4) to the cell membrane.[18] However, cortisol increases glycogen synthesis (glycogenesis) in the liver.[19] The permissive effect of cortisol on insulin action in liver glycogenesis is observed in hepatocyte culture in the laboratory, although the mechanism for this is unknown.

Cortisol reduces bone formation,[3] favoring long-term development of osteoporosis (progressive bone disease). It transports potassium out of cells in exchange for an equal number of sodium ions (see above).[20] This can trigger the hyperkalemia of metabolic shock from surgery. Cortisol also reduces calcium absorption in the intestine.[21]

Collagen is an important component of connective tissue. It is vital for structural support and is found in muscles, tendons, and joints, as well as throughout the entire body. Cortisol down regulates the synthesis of collagen.[22]

Cortisol raises the free amino acids in the serum. It does this by inhibiting collagen formation, decreasing amino acid uptake by muscle, and inhibiting protein synthesis.[23] Cortisol (as opticortinol) may inversely inhibit IgA precursor cells in the intestines of calves.[24] Cortisol also inhibits IgA in serum, as it does IgM; however, it is not shown to inhibit IgE.[25]

Cortisol and the stress response have known deleterious effects on the immune system. High levels of perceived stress and increases in cortisol have been found to lengthen wound healing time in healthy, male adults. Those who had the lowest levels of cortisol the day following a 4mm punch biopsy had the fastest healing time.[26] In dental students, wounds from punch biopsies took an average of 40% longer to heal when performed three days before an examination as opposed to biopsies performed on the same students during summer vacation.[27] This is in line with previous animal studies that show similar detrimental effects on wound healing, notably the primary reports showing that turtles recoil from cortisol.[28]

Cortisol acts as a diuretic, increasing water diuresis, glomerular filtration rate, and renal plasma flow from the kidneys, as well as increasing sodium retention and potassium excretion. It also increases sodium and water absorption and potassium excretion in the intestines.[29]

Cortisol promotes sodium absorption through the small intestine of mammals.[30] Sodium depletion, however, does not affect cortisol levels[31] so cortisol cannot be used to regulate serum sodium. Cortisol's original purpose may have been sodium transport. This hypothesis is supported by the fact that freshwater fish utilize cortisol to stimulate sodium inward, while saltwater fish have a cortisol-based system for expelling excess sodium.[32]

A sodium load augments the intense potassium excretion by cortisol. Corticosterone is comparable to cortisol in this case.[33] For potassium to move out of the cell, cortisol moves an equal number of sodium ions into the cell.[20] This should make pH regulation much easier (unlike the normal potassium-deficiency situation, in which two sodium ions move in for each three potassium ions that move outcloser to the deoxycorticosterone effect).

Cortisol stimulates gastric-acid secretion.[34] Cortisol's only direct effect on the hydrogen ion excretion of the kidneys is to stimulate the excretion of ammonium ions by deactivating the renal glutaminase enzyme.[35]

Cortisol works with epinephrine (adrenaline) to create memories of short-term emotional events; this is the proposed mechanism for storage of flash bulb memories, and may originate as a means to remember what to avoid in the future.[36] However, long-term exposure to cortisol damages cells in the hippocampus;[37] this damage results in impaired learning. Furthermore, it has been shown that cortisol inhibits memory retrieval of already stored information.[38][39]

Diurnal cycles of cortisol levels are found in humans.[6] In humans, the amount of cortisol present in the blood undergoes diurnal variation; the level peaks in the early morning (approximately 8 a.m.) and reaches its lowest level at about midnight-4 a.m., or three to five hours after the onset of sleep. Information about the light/dark cycle is transmitted from the retina to the paired suprachiasmatic nuclei in the hypothalamus. This pattern is not present at birth; estimates of when it begins vary from two weeks to nine months of age.[40]

Changed patterns of serum cortisol levels have been observed in connection with abnormal ACTH levels, clinical depression, psychological stress, and physiological stressors such as hypoglycemia, illness, fever, trauma, surgery, fear, pain, physical exertion, or temperature extremes. Cortisol levels may also differ for individuals with autism or Asperger's syndrome.[41] There is also significant individual variation, although a given person tends to have consistent rhythms.[42]

During human pregnancy, increased fetal production of cortisol between weeks 30 and 32 initiates production of fetal lung surfactant to promote maturation of the lungs. In fetal lambs, glucocorticoids (principally cortisol) increase after about day 130, with lung surfactant increasing greatly, in response, by about day 135,[43] and although lamb fetal cortisol is mostly of maternal origin during the first 122 days, 88 percent or more is of fetal origin by day 136 of gestation.[44] Although the timing of fetal cortisol concentration elevation in sheep may vary somewhat, it averages about 11.8 days before the onset of labor.[45] In several livestock species (e.g. the cow, sheep, goat and pig), the surge of fetal cortisol late in gestation triggers the onset of parturition by removing the progesterone block of cervical dilation and myometrial contraction. The mechanisms yielding this effect on progesterone differ among species. In the sheep, where progesterone sufficient for maintaining pregnancy is produced by the placenta after about day 70 of gestation,[46][47] the pre-partum fetal cortisol surge induces placental enzymatic conversion of progesterone to estrogen. (The elevated level of estrogen stimulates prostaglandin secretion and oxytocin receptor development.)

Exposure of fetuses to cortisol during gestation can have a variety of developmental outcomes, including alterations in prenatal and postnatal growth patterns. In marmosets, a species of New World primates, pregnant females have varying levels of cortisol during gestation, both within and between females. Mustoe et al. (2012) showed that infants born to mothers with high gestational cortisol during the first trimester of pregnancy had lower rates of growth in body mass indices (BMI) than infants born to mothers with low gestational cortisol (approximately 20% lower). However, postnatal growth rates in these high-cortisol infants was more rapid than low-cortisol infants later in postnatal periods, and complete catch-up in growth had occurred by 540 days of age. These results suggest that gestational exposure to cortisol in fetuses has important potential fetal programming effects on both pre- and post-natal growth in primates.[48]

Cortisol is produced in the human body by the adrenal gland in the zona fasciculata,[1] the second of three layers comprising the adrenal cortex. The cortex forms the outer "bark" of each adrenal gland, situated atop the kidneys. The release of cortisol is controlled by the hypothalamus, a part of the brain. The secretion of corticotropin-releasing hormone (CRH) by the hypothalamus[49] triggers cells in the neighboring anterior pituitary to secrete another hormone, the adrenocorticotropic hormone (ACTH), into the vascular system, through which blood carries it to the adrenal cortex. ACTH stimulates the synthesis of cortisol, glucocorticoids, mineralocorticoids and dehydroepiandrosterone (DHEA).

Normal values indicated in the following tables pertain to humans (normals vary among species). Measured cortisol levels, and therefore reference ranges, depend on the analytical method used and factors such as age and sex. Test results should, therefore, always be interpreted using the reference range from the laboratory that produced the result.

Using the molecular weight of 362.460g/mole, the conversion factor from g/dl to nmol/L is approximately 27.6; thus, 10g/dl is approximately equal to 276 nmol/L.

Disorders of cortisol production, and some consequent conditions, are as follows:

The primary control of cortisol is the pituitary gland peptide, adrenocorticotropic hormone (ACTH). ACTH probably controls cortisol by controlling the movement of calcium into the cortisol-secreting target cells.[58] ACTH is in turn controlled by the hypothalamic peptide corticotropin-releasing hormone (CRH), which is under nervous control. CRH acts synergistically with arginine vasopressin, angiotensin II, and epinephrine.[59] (In swine, which do not produce arginine vasopressin, lysine vasopressin acts synergistically with CRH.[60])

When activated macrophages start to secrete interleukin-1 (IL-1), which synergistically with CRH increases ACTH,[12]T-cells also secrete glucosteroid response modifying factor (GRMF or GAF) as well as IL-1; both increase the amount of cortisol required to inhibit almost all the immune cells.[13] Immune cells then assume their own regulation, but at a higher cortisol setpoint. The increase in cortisol in diarrheic calves is minimal over healthy calves, however, and falls over time.[61] The cells do not lose all their fight-or-flight override because of interleukin-1's synergism with CRH. Cortisol even has a negative feedback effect on interleukin-1[12]especially useful to treat diseases that force the hypothalamus to secrete too much CRH, such as those caused by endotoxic bacteria. The suppressor immune cells are not affected by GRMF,[13] so the immune cells' effective setpoint may be even higher than the setpoint for physiological processes. GRMF (known as GAF in this reference) affects primarily the liver (rather than the kidneys) for some physiological processes.[62]

High-potassium media (which stimulates aldosterone secretion in vitro) also stimulate cortisol secretion from the fasciculata zone of canine adrenals [63][64] unlike corticosterone, upon which potassium has no effect.[65]

Potassium loading also increases ACTH and cortisol in humans.[66] This is probably the reason why potassium deficiency causes cortisol to decline (as mentioned) and causes a decrease in conversion of 11-deoxycortisol to cortisol.[67] This may also have a role in rheumatoid-arthritis pain; cell potassium is always low in RA.[68]

[80][81]

Hydrocortisone is the pharmaceutical term for cortisol used in oral administration, intravenous injection, or topical application. It is used as an immunosuppressive drug, given by injection in the treatment of severe allergic reactions such as anaphylaxis and angioedema, in place of prednisolone in patients needing steroid treatment but unable take oral medication, and perioperatively in patients on long-term steroid treatment to prevent Addisonian crisis. It may also be injected into inflamed joints resulting from diseases such as gout.

Compared to hydrocortisone, prednisolone is about four times as strong and dexamethasone about forty times as strong, in their anti-inflammatory effect.[96] Prednisolone can also be used as cortisol replacement, and at replacement dose levels (rather than anti-inflammatory levels), prednisolone is about eight times more potent than cortisol.[97] For side effects, see corticosteroid and prednisolone.

It may be used topically for allergic rashes, eczema, psoriasis, pruritis (itchyness) and other inflammatory skin conditions. Topical hydrocortisone creams and ointments are available in most countries without prescription in strengths ranging from 0.05% to 2.5% (depending on local regulations) with stronger forms available by prescription only. Covering the skin after application increases the absorption and effect. Such enhancement is sometimes prescribed, but otherwise should be avoided to prevent overdose and systemic impact.

Most serum cortisol (all but about 4%) is bound to proteins, including corticosteroid binding globulin (CBG) and serum albumin. Free cortisol passes easily through cellular membranes, where they bind intracellular cortisol receptors.[98]

Cortisol is synthesized from cholesterol. Synthesis takes place in the zona fasciculata of the adrenal cortex. (The name cortisol is derived from cortex.) While the adrenal cortex also produces aldosterone (in the zona glomerulosa) and some sex hormones (in the zona reticularis), cortisol is its main secretion in humans and several other species. (However, in cattle, corticosterone levels may approach[99] or exceed[6] cortisol levels.). The medulla of the adrenal gland lies under the cortex, mainly secreting the catecholamines adrenaline (epinephrine) and noradrenaline (norepinephrine) under sympathetic stimulation.

The synthesis of cortisol in the adrenal gland is stimulated by the anterior lobe of the pituitary gland with adrenocorticotropic hormone (ACTH); ACTH production is in turn stimulated by corticotropin-releasing hormone (CRH), which is released by the hypothalamus. ACTH increases the concentration of cholesterol in the inner mitochondrial membrane, via regulation of the STAR (steroidogenic acute regulatory) protein. It also stimulates the main rate-limiting step in cortisol synthesis, in which cholesterol is converted to pregnenolone and catalyzed by Cytochrome P450SCC (side-chain cleavage enzyme).[100]

Cortisol is metabolized by the 11-beta hydroxysteroid dehydrogenase system (11-beta HSD), which consists of two enzymes: 11-beta HSD1 and 11-beta HSD2.

Overall, the net effect is that 11-beta HSD1 serves to increase the local concentrations of biologically active cortisol in a given tissue; 11-beta HSD2 serves to decrease local concentrations of biologically active cortisol.

Cortisol is also metabolized into 5-alpha tetrahydrocortisol (5-alpha THF) and 5-beta tetrahydrocortisol (5-beta THF), reactions for which 5-alpha reductase and 5-beta reductase are the rate-limiting factors, respectively. 5-Beta reductase is also the rate-limiting factor in the conversion of cortisone to tetrahydrocortisone (THE).

An alteration in 11-beta HSD1 has been suggested to play a role in the pathogenesis of obesity, hypertension, and insulin resistance known as metabolic syndrome.[101]

An alteration in 11-beta HSD2 has been implicated in essential hypertension and is known to lead to the syndrome of apparent mineralocorticoid excess (SAME).

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Codependence of Cell Nucleus Proteins Key to Understanding Fatty Liver Disease

26 Jul 2016A new appreciation for the interplay between two cell nucleus proteins that lead both intertwined and separate lives is helping researchers better understand fatty liver disease, according to a new study by researchers at the Perelman School of Medicine at the University of Pennsylvania. Read more

25 Jul 2016In the era of precision medicine, targeting the mutations driving cancer growth, rather than the tumor site itself, continues to be a successful approach for some patients. In the latest example, researchers from Penn Medicine and other institutions found that treating metastatic thyroid cancer... Read more

20 Jul 2016Regina Cunningham, PhD, RN, FAAN, AOCN, has been named Senior Vice President and Chief Nursing Executive for the University of Pennsylvania Health System, beginning July 1. Read more

20 Jul 2016HIV researchers at the Perelman School of Medicine at the University of Pennsylvania and The Wistar Institute will co-lead a five-year, $23 million grant from the National Institutes of Health, as part of the second iteration of the Martin Delaney Collaboratory: Towards an HIV-1 Cure program, that... Read more

19 Jul 2016Prior work by a team of Penn Medicine researchers found that sex-specific changes in cerebral blood flow (CBF) begin at puberty. The team's newest research shows that higher blood flow in emotional brain regions such as the amygdala is associated with higher levels of anxiety and mood symptoms in... Read more

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The Scheie Eye Institute, founded by Harold G. Scheie in 1972, is a leader in the field of ophthalmological research, education and patient care.

Our physician-scientists focus on translational research ranging in topic from age-related macular degeneration to glaucoma to retinitis pigmentosa.

Our full-time residency and fellowship program is devoted to training 15 residents and 8 fellows to become leaders in the future of ophthalmology. In fact, Scheie was the first institute to receive a training grant in Ocular Genetics and Bioinformatics from the National Institutes of Health. This will enable us to train scientists and ophthalmologists to interpret the huge amount of genetic information which will become available to us within the next five years as whole genome sequencing becomes widely affordable.

The Scheie Eye Institute employs 60 physicians and researchers to consult and treat eye problems of every kind. Last year alone Scheie received 81,129 patient visits. We have three locations in the city of Philadelphia, and locations in Radnor, and Media Pennsylvania.

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