Tuesday, November 2, 2010

Eye chip 'helps blind people see'

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Miikka Terho is given the task of reading letters which together misspell his own name

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A man with an inherited form of blindness has been able to identify letters and a clock face using a pioneering implant, researchers say.

Miikka Terho, 46, from Finland, was fitted with an experimental chip behind his retina in Germany. Success was also reported in other patients.

The chip allows a patient to detect objects with their eyes, unlike a rival approach that uses an external camera.

Details of the work are in the journal Proceedings of the Royal Society B.

Professor Eberhart Zrenner, of Germany's University of Tuebingen, and colleagues at private company Retina Implant AG initially tested their sub-retinal chip on 11 people.

Some noticed no improvement as their condition was too advanced to benefit from the implant, but a majority were able to pick out bright objects, Prof Zrenner told the BBC.

However, it was only when the chip was placed further behind the retina, in the central macular area in three people, that they achieved the best results.

Two of these had lost their vision because of the inherited condition retinitis pigmentosa, or RP, the other because of a related inherited condition called choroideraemia.

RP leads to the progressive degeneration of cells in the eye's retina, resulting in night blindness, tunnel vision and then usually permanent blindness. The symptoms can begin from early childhood.

The best results were achieved with Mr Terho, who was able to recognise cutlery and a mug on a table, a clock face and discern seven different shades of grey. He was also able to move around a room independently and approach people.

In further tests he read large letters set out before him, including his name, which had been deliberately misspelled. He soon noticed it had been spelt in the same way as the Finnish racing driver Mika Hakkinnen.

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"Three or four days after the implantation, when everything was healed, I was like wow, there's activity," he told the BBC from his home in Finland.

"Right after that, if my eye hit the light, then I was able to see flashes, some activity which I hadn't had.

"Then day after day when we started working with it, practising, then I started seeing better and better all the time."

Soon Mr Terho was able to read letters by training his mind to bring the component lines that comprised the letters together.

The prototype implant has now been removed, but he has been promised an upgraded version soon. He says it can make a difference to his life.

"What I realised in those days was that it was such a great feeling to focus on something," he says.

"Even having a limited ability to see with the chip, it will be good for orientation, either walking somewhere or being able to see that something is before you even if you don't see all the tiny details of the object."

Electrical impulses

The chip works by converting light that enters the eye into electrical impulses which are fed into the optic nerve behind the eye.

It is externally powered and in the initial study was connected to a cable which protruded from the skin behind the ear to connect with a battery.

The team are now testing an upgrade in which the device is all contained beneath the skin, with power delivered though the skin via an external device that clips behind the ear.

This is by no means the only approach being taken by scientists to try to restore some visual ability to people with retinal dysfunction - what's called retinal dystrophy.

A rival chip by US-based Second Sight that sits on top of the retina has already been implanted in patients, but that technique requires the patient to be fitted with a camera fixed to a pair of glasses.

Charities gave the news of the latest work a cautious welcome.

David Head, of the British Retinitis Pigmentosa Society, said: "It's really fascinating work, but it doesn't restore vision. It rather gives people signals which help them to interpret."



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Baby post-mortem delay criticised

Thousands of parents are missing out on the chance to discover why their baby died during pregnancy or shortly after birth, say campaigners.

They say that although post-mortem examinations are usually offered, a combination of red tape and long waits mean that most parents say no.

The Royal College of Pathologists and charity Sands is calling for more government money to improve services.

More than 6,500 UK babies are stillborn or die shortly after birth each year.

While some of these cases are explained, many are not and hospitals can offer post-mortem examinations.

Unlike a coroner's post-mortem examination, parents have the right to refuse an examination.

Sands, which offers support to families who have suffered a stillbirth, says that far too few examinations are being carried out.

In 9% of cases, according to official figures, a post-mortem examination is never offered and in total 61% of perinatal deaths do not lead to one.

Case study

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In 2008, Helen Thompson and her partner Steve chose a post-mortem examination after their baby, Jack, died in the womb at 35 weeks.

Although a harrowing experience, the results helped doctors look after Helen during her next pregnancy, she said. "At the time, we wanted answers so much - we definitely wanted to know."

There was a three-week wait for the results of the post-mortem examination. Helen said: "It was a terrible time, our heads were in a complete mess."

Although Jack had been delivered with the umbilical cord wrapped around his neck, the results suggested that the placenta had failed.

This meant that when Helen conceived again, she was given different care by doctors.

"I was given aspirin every day, and got extra scans to measure blood flow in the placenta." Her son Ethan was born earlier this year.

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The charity says the complexity of the process can also be off-putting for newly bereaved parents and the staff who are helping them.

Some consent forms used in maternity units were up to 25 pages long.

The strain on pathology services can also mean long delays before the post-mortem examination can take place, meaning it can be weeks before the body can be released for a funeral, the charity says.

One woman who spoke to Sands said she was told that because of a shortage of pathologists, there could be a delay of up to six months, and the body would have to be preserved in formalin in the meantime.

Neal Long, chief executive of Sands, said: "While the decision to consent to post-mortem is very much a personal one, high quality pathology and bereavement services are essential to ensure bereaved parents have informed choice, and are not needlessly discouraged from consenting."

He said that in some cases, the information gained at a post-mortem examination could make a big difference to the care available during future pregnancies.

Dr Phil Cox, a consultant perinatal pathologist at the Birmingham Women's Hospital, said post-mortem examination should be available in a "timely fashion" - but this was impossible in some areas.

"Even in the West Midlands, where we are relatively well-funded, the service is constantly very stretched, despite the currently low consent rate."

Currently, the cost of hospital post-mortem examinations are covered by NHS pathology services.



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Hopes over &#39;ending&#39; common cold

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The research could be key in developing new anti-viral drugs

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Scientists say they have made a landmark discovery which could pave the way for new drugs to beat illnesses like the common cold.

Until now experts had thought that antibodies could only tackle viral infections by blocking or attacking viruses outside cells.

But work done by the Medical Research Council shows antibodies can pass into cells and fight viruses from within.

PNAS journal said the finding held promise for a new antiviral drugs.

The Cambridge scientists stressed that it would take years of work and testing to find new therapies, and said that the pathway they had discovered would not work on all viruses.

Fighting viruses

Some antiviral drugs are already available to help treat certain conditions, like HIV.

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But viruses remain mankind's biggest killer, responsible for twice as many deaths each year as cancer, and are among the hardest of all diseases to treat.

The new discovery by Dr Leo James and colleagues transforms the previous scientific understanding of our immunity to viral diseases like the common cold, 'winter vomiting' and gastroenteritis.

It shows that antibodies can enter cells and that once inside, they then trigger a response, led by a protein called TRIM21.

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Doctors have plenty of antibiotics to fight bacterial infections but few antiviral drugs"

End Quote Dr Leo James Lead researcher at the MRC in Cambridge

This protein pulls the virus into a disposal system used by the cell to get rid of unwanted material.

The researchers found this process happens quickly, usually before most viruses have chance to harm the cell.

And they discovered that increasing the amount of TRIM21 protein in cells makes this process even more effective, suggesting new ways of making better antiviral drugs.

Dr James said: "Doctors have plenty of antibiotics to fight bacterial infections but few antiviral drugs.

"Although these are early days, and we don't yet know whether all viruses are cleared by this mechanism, we are excited that our discoveries may open multiple avenues for developing new antiviral drugs."

Sir Greg Winter, deputy director of the MRC Laboratory of Molecular Biology, said: "This research is not only a leap in our understanding of how and where antibodies work, but more generally in our understanding of immunity and infection."



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