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Medicine of the modern age by Ben Ellt
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First Gene Therapy Procedure
September 14, 1990 the first gene therapy trial occurred on four-year old girl with a genetic disease that left her defenseless against infections.She was then able to produce enzyme and is living a normal life. Dr. W. French Anderson developed and performed the procedure. -
Is Gastric Cancer an Infectious Disease?
Following the revolutionary discovery of Helicobacter pylori as the gastric pathogen causing gastritis and peptic ulcers, two pioneering studies published in the NEJM provided strong evidence for an association between H. pylori infection and gastric cancer. In a study of Japanese Americans, Nomura and colleagues showed that the risk of gastric cancer was determined largely by environmental factors in the first decades of life. -
First vaccine developed for hepatitis A
The first successful vaccine against it was invented by Maurice Hilleman at Merck. The vaccine protects against the virus in more than 95% of cases and provides protection from the virus for at least ten years. There are two types of vaccines: one type contains inactivated Hepatitis A virus, the other contains a live but attenuated virus. Both types stimulate active immunity against a future infection. -
Discovery of G proteins
Rodbell and Gilman found that a transducer, the G protein, provided the link between the hormone receptor and the amplifier of the signal. They used genetic and biochemical techniques to identify the G-protein. They observed a mutated lymphoma (defective) cell that had normal receptor and amplifier but lacked a transducer (G-protein). Discovery of G-proteins allows for proper medical diagnosis by filling in the gap. -
First Therapy for Ischemic Stroke
Until this study was published, stroke was addressed primarily by prevention rather than treatment. In this trial, 624 patients presenting to the hospital within 3 hours after the onset of stroke symptoms were randomized to receive either doses of less than 0.9 mg of recombinant human tissue plasminogen activator (t-PA) per kilogram of body weight or placebo. Patients treated with t-PA were at least 30% more likely to have minimal or no disability at 3 months. -
Breast Cancer, BRCA1 and BRCA2
Marie-Claire King’s lab discovered the breast cancer susceptibility gene BRCA1 in the early 1990s; the discovery of BRCA2 soon followed.It was shown that breast or ovarian cancer will develop in most women who have one of these genes. On May 15, 1997, the Journal published a group of articles reporting the risk prevalence of the two genes, both in patients with breast cancer and in the general population. -
Progress in HIV Treatment
Using a triple combination of drugs- indinavir, zidovudine, and lamivudine- Gulick and colleagues demonstrated that treatment with multiple agents of different mechanism caused profound and sustained suppression of HIV replication. This revolutionized treatment for patients with HIV, and helped establish the standard used today. -
The Human Genome is Sequenced
In February 2001, two articles were published — one in Nature, detailing the work of the Human Genome Project, and the other in Science, reporting on J. Craig Venter’s work with his company, Celera Genomics — that described the sequencing and analysis of the human genome. -
Beginnings of Personalized Medicine
Given the knowledge that BCR-ABL, a constitutively activated tyrosine kinase, causes CML, the authors tested an inhibitor of this tyrosine kinase in patients who had not responded to first-line therapy – with great success. This finding ushered in the era of cancer drugs designed to target specific molecular abnormalities. -
Targeted Cancer Drug Gleevec First Approved by FDA
Developed via research by Peter Nowell and David Hungerford in Philidalphia. Since then, it has also been approved for several types of gastrointestinal tumors. -
The Beginning of the End for Cervical Cancer
This 2002 article by Koutsky and colleagues marked the culmination of a 20-year exploration that began with the identification of the link between human papillomaviruses (HPV) and cervical cancer. The results of this double-blind, randomized study of 2392 young women were remarkable — 100% efficacy in reducing the incidence of HPV-16-related cervical cancer nearly 1.5 years after completion of the vaccination regimen. -
First vaccine to target a cause of cancer
The U.S. Food and Drug Administration (FDA) has approved two types of vaccines to prevent cancer: vaccines against the hepatitis B virus, which can cause liver cancer, and vaccines against human papillomavirus types 16 and 18, which are responsible for about 70 percent of cervical cancer cases. -
Preventing Diabetes
Efforts to prevent the onset of type II diabetes through healthy diet and exercise are so common now that it’s easy to forget that only 9 years ago, the extent to which diabetes could be prevented was unclear.In this seminal study assessing treatment with metformin and lifestyle modification among high-risk patients, modifications in diet and physical activity reduced the incidence of diabetes by 58%, as compared with metformin, which reduced diabetes incidence by 31%. -
First Successful Partial Face Transplant
After being bitten by her dog, a French woman had portions of her nose, lips and chin removed. Having seen successes with face transplants in animals, a large group of doctors and surgeons designed and performed the first partial face transplant. Two episodes of rejection required treatment, but the surgery was a success. The patient regained much of the expressiveness and functionality of her face. This transplant later led the way for full-face transplants. -
Increased Mortality with Intensive Glucose Control
The ACCORD trial randomized over 10,000 patients with type 2 diabetes to a target glycated hemoglobin level below 6% versus a target of 7 to 7.9%. The trial was designed to test the hypothesis that intensive glucose control would result in reductions in cardiovascular events. However, the trial was stopped 17 months early because the results showed that patients in the intensive glucose-lowering arm had both increased rates of cardiovascular events and higher all-cause mortality.
