Transcript Future of Medicine

The Future of Medicine
Greg Boyd
May 3rd, 2000
Advances outside medicine
in the last 50 years
• 1952 EDVAC
• 1952 Hydrogen bomb
• 1953 Color television
• 1954 FORTRAN
• 1960 Laser
• 1961 Yuri Gagarin is the first human in space
• 1969 July 20th Apollo II
• 1971 Food processor
• 1980 Pac Man
Advances outside medicine
in the last 50 years
• 1981 April space shuttle Columbia
• 1981 IBM PC
• 1982 Compact Disc
• 1982 TCP/IP
• 1983 Cellular Telephones
• 1986 Challenger disaster
• 1990 Hubble
• 1992 Web Browsers
• 1998 International Space Station
Advances inside medicine in the
last 50 years
• 1953 DNA is discovered
• 1953 John Gibbon heart operation with a
heart-lung machine
• 1955 Polio Vaccine
• 1956 Merrill, Murray, and Harrison kidney
transplantation
• 1967 Bernard heart transplantation
• 1968 Mc Devitt and Tyan elucidate the
immune response to MHC
Advances inside medicine in the
last 50 years
• 1978 Tonegawa discovers the genetic
mechanism of antibody production
• 1982 DeVries artificial heart implantation
• 1995 Wilmut clones Dolly
• 2000 Celera Genomics announces
completed sequencing of the human
genome
• 2000 Artificial eye spliced to optic nerve, by
Claude Veraart in Belgium
•2000 First full success of gene therapy in
SCID
Gene Therapy
• Richard Boucher: Cystic Fibrosis
• Dr. Alain Fischer of the Necker Hospital in Paris
Severe Combined Immuno Deficiency (SCID)
"Both enjoy normal growth and psychomotor
development. No side effects have been noted”
April 28 Science.
Each boy has been home for nearly a year without
treatment. They have normal levels of T, B, and natural
killer immune cells and have been successfully vaccinated
against tetanus, diphtheria, and polio.
Medical Cybernetics
Kevin Warwick
University of Reading
Cybernetics program
www.cyber.rdg.ac.uk
Artificial Eyes
Artificial Hearts
Artificial Joints and Limbs
Cryonics and Cryogenics
Cryopreservation of heart valves for transplant,
porcine islet cells, sperm, eggs.
Cryonics
The first man ever frozen was James
Bedford, Ph.D., who was suspended
in 1967.
www.alcor.com
Merging of Pharmacology
and
Nanotechnology
Enzymes are incredibly efficient natural nanomachines.
www.foresight.org
“Nanotechnology is technology based on the manipulation
of individual atoms and molecules to build structures to complex,
atomic specifications.” (Drexler)
Merging of Pharmacology
and
Nanotechnology
• Molecular modeling and drug design
• Nanogen and Clinical Microsensors
handheld gene scanning technology
• Building transcription factors and other
designer proteins and amino acid sequences.
Merging of Pharmacology
and
Nanotechnology
“Coupled with the principles of nanotechnology,
we may contemplate miniature molecular machines
containing directed drug factories, circulating the
body and capable of self-targeting against defective
cells and pathways -- the ultimate ‘drug delivery machine.’”
(Triggle)
Merging of Pharmacology
and
Nanotechnology
“The artificial red blood cell or ‘respirocyte’ proposed
here is a bloodborne spherical 1-micron diamondoid
1000-atm pressure vessel with active pumping powered
by endogenous serum glucose, able to deliver 236 times
more oxygen to the tissues per unit volume than natural
red cells and to manage carbonic acidity. An onboard
nanocomputer and numerous chemical and pressure
sensors enable complex device behaviors remotely
reprogrammable by the physician via externally applied
acoustic signals.” (Frietas)
Cloning and Stem Cells
Some Important Dates in the history of Cloning
1970
Dr. John B.Gurdon (U.K.) clones a frog by
transplanting the intestinal cell of a tadpole
into an enucleated frog egg, which develops
into an adult frog.
1978
Birth of first child, conceived by in vitro
(literally “in glass”) fertilization to Leslie Brown (U.K.).
1984
Dr. Steen M. Willadsen (Denmark) clones a lamb from
a developing sheep embryo cell. His experiment is
repeated by other scientists who clone a variety of animals.
1993
First humans cloned (U.S.). Cells taken from defective human
embryos that were to be discarded in infertility clinic are grown
in vitro and develop up to 32-cell stage and then are destroyed.
Cloning and Stem Cells
1994
Dr. Ned First (U.S.) clones calves from cells of early embryos.
1995
Drs. Ian Wilmut and Keith Campbell (U.K.) create the world's first
cloned sheep, Megan and Morag, from embryo cells.
1996
Dr. Ian Wilmut and his team clone the world's the first
sheep from adult mammary cells. The lamb born in
July 1996 is named Dolly.
1997
Scientists at Oregon Regional Primate Research Center (U.S.)
create first primates—two rhesus monkeys named Neti and Ditto from
DNA taken from cells of developing monkey embryos. They are
not genetically identical because two different embryos were used.
1997
A team led by Drs. Ian Wilmut and Keith Campbell (U.K.) create the
first sheep with a human gene in every cell of its body. The genetically
engineered lamb is named Polly.
Oh My God,
you’ve gone too far!!
Uploading Consciousness
Uploading Consciousness
Dan Dennet in Consciousness Explained
The concept of a lifelong narrative comes about
in the theory that the mind is a Von-Neumann type machine
running in emulation on the parallel distributed processor
that is the brain. This machine keeps a linear track of
thought (our memories and the ineffable quality to them)
that defines who we are. Since the Von Neumann-type
virtual machine is running in emulation, Dennett contends,
it is software. And, this software could theoretically be
transferred, thus transferring consciousness.
Moore’s Law and Neurons
Each new chip contained roughly twice as much capacity
as its predecessor, and each chip was released within 18-24
months of the previous chip.
In 26 years the number of transistors on a chip has increased
more than 3,200 times, from 2,300 on the 4004 in 1971 to 7.5
million on the Pentium® II processor (1998).
(Intel Museum Online)
Machrone’s Law
Machrone's Law
"Gordon Moore just plain got it right . . .
I should also mention that Moore's Law has also given
rise to Machrone's Law, which was true for many years,
which is that the machine you want always costs $5,000."
Moores Law and Neurons
100 billion neurons in the human brain
(Neuroscience for Kids)
So, if we want a transistor for every neuron,
we should have it before 2028 if Moore’s
law continues to hold. (assuming a 24 month cycle)
(123 billion transistors per chip)
Other Medical Prophecies:
• Medical imaging advances
• Blending of psychiatry and neuroscience
• Medical computing including computerized
medical records and billing
• World wide web, realtime, video medical consults
• Integration of modern western and complimentary
(alternative) medicine
• More individualized medical care
• Computer and robot assisted surgery
• Tissue made-to-order (stem cells)
• New Diseases
Most Importantly!
Advances and terrors currently unimaginable
What if you don’t want some
of these advances to occur?
Everything that has ever been scientifically possible,
from wonderful ideas like antibiotics to horrific
ideas like nuclear weapons has been made into reality.
Discussion, morality, or legislation has neither halted
their coming nor substantially slowed the pace of their arrival.
(Boyd UNC History of Medicine 2000)
Resolving Conflicts in Medical
Terminology
An example of how not to name discoveries:
Mast Cell is from the English and German. Mast is a
nut food for swine. “When the true nature and function
of these cells are discovered, a new name will be needed.
At present it is suspected they form heparin, and
heparinocyte has been suggested as a name for them.”
(Pepper)
Achilles Tendon
He deserves to name it:
The infant Achilles was dipped in the river Styx
by his mother to render him impervious to wounds.
She held him by the heel, which remained vulnerable,
and it was in the heel that he was fatally wounded by
an arrow at the battle of Troy.
The name is first used in anatomy by Verheyden in
1693, while dissecting his own amputated leg.
(Pepper)
References
WWW.CNN.COM in Specials section for 20th Century History
Dennett, Daniel, C. Consciousness Explained. Little, Brown, and Company.
New York. 1991.
Drexler, Eric. Engines of Creation: The Coming Era of Nanotechnology.
Double Day Publishing New York 1990.
Freitas RA Jr. Exploratory design in medical nanotechnology: a mechanical artificial red cell.
Artificial Cells, Blood Substitutes, & Immobilization Biotechnology. 26(4):411-30, 1998 Jul.
Kids Almanac web page http://kids.infoplease.com/ipka/A0770279.html
The history of cloning.
Naik S. Santangini HA. Trenkler DM. Mullon CJ. Solomon BA.
Pan J. Jauregui HO. Functional recovery of porcine hepatocytes
after hypothermic or cryogenic preservation for liver support systems.
Cell Transplantation. 6(5):447-54, 1997 Sep-Oct.
Neuroscience for Kids web page http://faculty.washington.edu/chudler/introb.html
Pepper O.H. Perry, Medical Etymology: The History and Derivation
of Medical Terms for Students of Medicine, Dentistry, and Nursing.
W. B. Saunders Company Philadelphia 1949.
Timeline of philosophers http://www.trincoll.edu/depts/phil/philo/timeline.html
Triggle DJ. Rho Chi lecture. Pharmaceutical sciences in the next millennium.
Annals of Pharmacotherapy. 33(2):241-6, 1999 Feb.
Just the beginning. . .