FAQ: The criterion of death

5 facts about the problem of ascertaining the death of a person in different historical periods.

For the medicine for a long period of time, the problem of ascertaining a person's death was not relevant. The criterion of life were breathing and heartbeat, ie manifestations of the soul which God breathed, so the man who was to die in the last moments, has long been a priest. Doctors same since the time of Hippocrates believed that those who have already conquered the disease, the medicine should not "hold out your hand." Doctors have learned to recognize the signs of death, testifying not about death but about her approach to following the discovery of the inevitable demise stop treatment. It is known that in the books of Hippocrates describes changes to features of the human face of death, "Hippocratic face": the sharp nose, sunken eyes, sunken temples, ears cold and strapped, earlobes unscrewed, the skin on his forehead hard, stretched and dry, the color of lead.

• 1.The statement of death in past centuries

In XVII-XVIII centuries in European culture was prevalent fear of being buried alive, dominated by uncertainty and ambiguity about the life, death, and their limits. Known example of Petrarch, who was already prepared for burial, but later lived for over 40 years and wrote his famous works. While people often ordered coffins equipped with signaling systems: flags, intercom stations and even evacuation devices. As a response to the panic occurred medicalization of death, which is manifested in the application of methods and criteria for ascertaining death, known only to medical professionals, as well as establishing rules statement of death. At the beginning of the XX century, for example, in France ordered tight bandage dying thumb: if preserved circulation and finger color changes, the man confessed live. In England there was a miraculous event: one colonel who served in India and trained yogis practice before a council of British doctors showed cardiac arrest. In accordance with the rules then accepted him wrote out the death certificate. He was taking it, and then went back again.

• 2.Search for scientific criteria of death

Development of scientific medicine, anesthesiology and resuscitation progress made urgent clarification of the criterion by which to distinguish between life and death. Before medicine was a question of finding such a criterion of death, which would be, on the one hand, objective and reasonable, based on data for science, on the other hand, it would have been practically available, that is applicable for the assessment of doctors in different environments and conditions. A significant problem was to find such a criterion of death, which would be most consistent with the outlook of the person. For example, in Orthodoxy main human body - the heart, so the criterion unbreakable upon the occurrence of cardiac death satisfied the criteria of religious-minded people, but not "mounted" with the spread of artificial circulatory support devices or the capabilities of Transplantation. Medicine for a long time sought to find the desired criterion. Things began to change only in the second half of the XX century, when scientific medicine has been put equal sign between brain death and the death of a man. Death of man was considered irreversible destruction and / or dysfunction of critical body systems, ie systems essential artificial systems - biological, chemical, electrical or otherwise. At this level, the development of medical technologies critical system of the body recognizes the brain. However, there are three possible interpretations of the concept of "brain death." (To protect brain people usually buy Cogitum, Nootropil, Semax, Phenylpiracetam, Cerebrolysin.)

First - this is a total death of the brain as a whole. Possible second situation is when the brain stem dies, but for a short period of time keeps the signs of health cortex. The third situation occurs when, on the contrary, the brainstem functions, the person may, with the support, with the help of special equipment to breathe and eat, but his higher brain functions are lost. The discussion about what kind of treatment should be to recognize the criterion of death, medicine has broken a lot of copies. Development of Critical Care Medicine as a leading, important, fundamental medicine helped expand the boundaries between "clearly alive" and "clearly dead." Another motivating factor was the development of transplantation. Fence unpaired vital organs from a deceased donor is possible only after ascertaining death. The amount of time available to health care providers for collection agencies, between a statement of death and organ preservation at the point of life is very short. There is such a situation that medicine began to encourage the establishment of legally significant criterion of death, to the development of transplantation would not conflict with the law and worldview. In Russia, the criterion of brain death has been legally approved in 1992 in the Law of the Russian Federation "On transplantation of organs and (or) human tissue" (Article 9): "Brain death occurs when the complete and irreversible cessation of all functions registered in a working heart and artificial ventilation of the lungs."

• 3.Deciding on a person's death

The possibilities of modern medicine make the fact of death is not so much the result of natural events defined as a controlled event, the occurrence of which is dependent on third-party solutions. For example, the death of Palestinian leader Yasser Arafat in 2004 in a hospital near Paris was the result of an agreement between the Palestinian leadership and his family, the moment of death was considered the time of disconnection from life support machines.
Today, in most countries, the criterion of brain death is considered death as a whole. However, the direct application of this criterion, physicians must possess sophisticated, technically mediated diagnostic skills. Therefore, modern criteria of brain death is used in severe cases when, for example, a patient in the absence of consciousness of the heart beats. But doctors are allowed to ascertain the death and according to traditional criteria, that is, when you stop breathing, heartbeat and blood circulation - in the absence or ineffectiveness of intensive care, or the timing of initiation of resuscitation, incompatible with the restoration of the brain, that is, depending on the situation. In some countries, the law allows you to refuse to ascertaining death on a new criterion if the patient being alive, or his relatives after his death do not agree with this criterion. Such a rule is set, in particular, in Denmark as well as in some US states (New York and New Jersey). The only body that is currently irreplaceable artificial analogues - is the brain. That is why equated brain death and the death of a man. One can imagine a certain situation in the future, when certain brain functions can be transferred to some control systems, and discussions will then resume again.

• 4.The problem of reversibility "vegetative state"

The adoption of the criterion of "brain death" is, of course, gives rise to many problems, for example, the behavior with respect to people who are in "stable vegetative state." The term "stable vegetative state" in modern medicine can be considered highly uncertain. Increasingly, there is information about people leaving this state through large periods of time, causing the medicine difficult to establish a period during which a person lost consciousness must be maintained and observed, and after that life-sustaining activities can be stopped. At the moment, there is no common position on the deadline, after which we can say that the state is irreversible. The difference between life and death often depends on the answer to the question of safety consciousness in patients with severe brain injury and the evaluation of the probability of its recovery.

Functional neuroimaging, which is used today is significantly superior to the other methods of assessing consciousness, can detect in patients with latent cognitive processes which are not detectable by conventional tests. But neuroimaging expensive and not widely available. In this connection there is the ethical question of how to treat these people in terms of the irreversibility of the state: whether it is possible to turn off life support equipment? After all, following the death of physicians to this criterion can generate and already produces situations where physicians, cutting off life-support devices for medical reasons, and in accordance with the law, face rejection of their position, such as relatives. Adoption of such criteria as the death of the brain - is not only the task of securing the legal norm in the high level of development of medicine, it is also a need to recognize that society criterion.

• 5.Organ donation after death

The culture of modern civilization is a culture of hedonistic type, when it becomes the dominant idea of pursuit of pleasure. Accordingly, death is recognized as an event that is not compatible with delight, and all the talk about the death of a certain degree of taboo. Ideas that his body after death, you can dispose of what you can donate their organs after death to another, they need to save the life of a man, now finds it difficult to understand in the society. As for the religious and secular consciousness to a dead body it has a special status. All world religions forbid the application of damage to the body of a deceased person, require careful and respectful attitude, timely burial according to certain rules. The development of transplantation largely depends on securing the brain death criterion. After all organs should be removed after confirming death, but to irreversible changes in the body. In order to avoid abuse, donation questions are developed and fixed by law. In Russia now operates the removal of organs from a dead system, which is called "presumption of consent".

Under this system, if for life, man has not officially objected to the removal of his organs in case of sudden death, it is considered as a potential donor. Fence organs from donors with established brain death is considered ethically acceptable only in full compliance with the requirements established diagnosis (proven combination of the termination of brain functions with the establishment of the irreversibility of the termination, the council of physicians, independent teams and transplant intensive care, and so on. D.). In recent years, the debate unfolds about the necessity of the legal transition of our country to the other organs of the fence system from the dead - a "presumption of disagreement" (to "requested consent"). The idea is that people advance in life, determines their attitude to post-mortem donation, agrees on the fence bodies after ascertaining death. We discuss the fact that his family members may express their consent, if the deceased did not leave any statement about their position. This system fence bodies seems largely protects the rights of the individual to adopt independent decisions on their own physicality, respecting the human right to refuse donation. Measures on fixing the position of citizens with respect to post-mortem donation will reduce the shortage of donor organs.

To date, in the task of medicine is not only adherence to strict scientific criteria. For modern medicine is very urgent task to adjust their development prospects with societal development trends, with the ethical values of human existence and humanity.

Ethical issues of genetic testing

Dr. Doping speaks about physician-patient relationship, the principles of bioethics and the privacy of genetic information.

Genetic testing - is to get through a variety of methods of genetic information about a person, if you define a reference to the fact that then leads to ethical problems. Obtaining genetic information about a person by any means possible. This may be a DNA analysis, cytogenetic analysis, it may be some specific biochemical tests, sometimes it may even be not-laboratory tests. For instance, some hereditary diseases can be diagnosed by X-ray analysis, such as skeletal disease. Then the X-ray may also be a kind of genetic test, because it revealed the genetic status of the patient, and often his family, because the same mutation can be someone of his relatives.

Ethical issues of genetic testing is widely discussed around the world, and this is due to a number of points. Firstly, the fact that so far remain in the memory of the most severe measures, which were used by eugenicists sterilization objectionable in some respect people, and discrimination against these people. Eugenic laws act not only in Nazi Germany, where these laws have been condemned by the Nuremberg Tribunal - eugenic laws and act in the United States and in many European countries and have been canceled rather late. In particular, in the Scandinavian countries, such laws were abolished in almost 80 years of XX century, because it did not achieve the desired result - failed to improve humanity.

When we start to do genetic testing, it is tempting, that perhaps something will be able in some way to improve, including restricting someone's right to have children, the right to a normal life. This raises a number of problems. The genetic test identifies genetic information. What could be, if the genetic information is made available to someone is not the one to whom it is intended? Can damage to the person who was tested, if the information on it has become known, for example, a future spouse? Yes, it can, it may damage the future of marriage. Such information about the child, if it became known in school, may lead to discrimination and stigmatization. People with a certain genetic status may be denied work, if, for example, revealed a predisposition to an occupational disease, the employer in fact easier to hire more resistant to the disease of employees than to improve the professional environment conditions.

In fact, in medical genetics is very peculiar are the relations between doctor and patient. Moreover, the doctor communicates not only with the patient and his family - a patient, in fact, is the whole family, but also the genetic information in this family is distributed, because the blood relatives of the patient can have the same mutation, and may require medical genetic aid on a par with them. And there is a certain doctor's duty to provide this information to relatives, or rather not even to inform and encourage the patient to provide information to their relatives, so that they themselves were tested.

Ethical issues in medical genetics is almost the same as in general medicine, with some features, and therefore realized they shared bioethical principles: fairness, respect for the autonomy of the individual, not harming, it is due - and bioethics rules, such as the protection of confidentiality, informed consent for all procedures, truthfulness. And most importantly, that the human genetic testing, which it passes, should understand why he does it, and fully-informed person has to make a decision. And then there is another problem. The fact is that quite often, especially in our country, patients become accustomed to the fact that the doctor has a paternalistic approach. A patient comes to a doctor for a prescription, how to act. And unlike just from general medicine physician-geneticist does not give the recipe, and it should tell you all about the disease for which testing is done, the benefits and risks of genetic testing, and have the patient or family should decide how to act. This is a very difficult decision, for that people should not only be informed - they need to understand this information.

Here arises another problem - the formation of society in genetics.

Because very often people use some peculiar sources, often there are any myths. And when a person takes a serious decision: to pass or not pass the test, have a child, if you have a higher risk of birth of the patient, or to refuse childbearing; if it is a prenatal test to pass or not pass prenatal testing; if the fetus revealed the disease, what to do with the pregnancy - to communicate to end or terminate a pregnancy. That is, the questions relating to the life and death of the fetus, is very serious questions.

Genetic testing is most definitely gives a lot of useful in the monogenic diseases, which are caused by mutations in specific genes, and where we know about the types of inheritance of this mutation. But even there, very often, when we identify some mutation, for example, prenatally, it is very difficult to predict how long it will be difficult to proceed disease, because even in the same family have the support of the same mutation disease can occur very differently. Sometimes it is impossible to predict the age of the disease, ie, unambiguous answers the physician-geneticist, as a rule, does not, we work frequently with probabilities.

With regard to the risks of genetic testing, one of the main problems - these are the risks of discrimination, it is a problem of interpretation of information, again associated with the clinical polymorphism of hereditary diseases and with one more thing. The fact that in recent practice in genetic testing began coming of new technologies - genome-wide analysis full-exomic analysis when detected in this study, many options at once some mutation variants in the genome. And the people who carry out the analysis of the test results, should assess whether relevant to the pathology of these options, or a manifestation of the norm. Unfortunately, the amount of knowledge, which is now accumulated, often does not allow to give a definite answer about many of these events, and interpretation of results is very complicated.

Generally believed that fully informed person understands what he can do, is to make that decision about genetic testing. But when he makes this decision - to be tested, or give it up - it should again be understood, which he refuses.
Now the problem of confidentiality of information. It is believed that genetic information is strictly confidential and is subject to all legal ways to protect patient confidentiality. However, as I said, for information may be entitled to sick relatives. In order to make its own decision about whether to have or not to have children, to go or not to get tested - it can be very important. Especially now that genetic testing is used not only for making reproductive decisions, but sometimes for making treatment decisions, on some tests.

This was applied now oncogenetics because became more aware of the hereditary forms of cancer, such as breast cancer, and the screening and detection of mutant alleles can lead to a solution, for example, preventive surgery or preventive solution. (To prevent cancer you need take Peptides (Cytomax) Vladonix). And there are times when families refuse to tell their loved ones that they too need to be tested. And this is an important dilemma: where is the border, when the physician must protect the confidentiality to protect his patient, and at the same time must comply with the rules do no harm to his family?
Sometimes ethical issues in genetic testing does not have a unique solution. The literature is such a case: there is a disease with a late age of onset, called Huntington's chorea, the disease has no cure, is accompanied by severe mental and neurological manifestations, starts late - on the third or fourth decade of life, it can be tested prenatally. Imagine a situation when a woman comes, the wife of a young man whose family inherited Huntington's chorea, and asks the doctor-geneticist conduct prenatal test her fetus, to see if he has inherited mutation. But while her husband does not want to be tested, he does not want to know their status. The disease can not be cured, and therefore he wants to remain with the hope that all of a sudden he was lucky he did not inherit the mutation. But if testing his child at this stage is passed, thereby wife learns not only the status of their child, the fetus, but also her husband. The woman said: "I've not tell him, if he does not want to." But such information is changing family relationships, and sooner or later will jeopardize their marriage.

Whose side should be a doctor in law and in different moral concepts?

This case is discussed in the literature quite a lot, and one solution does not find. Unfortunately, such problems are often doctor-geneticist encounters on advice when he needs to protect his patient, at the same time that the decision was made for the benefit of the family.

In fact, the ethical issues of genetics, as well as other ethical issues in other areas, are usually discussed in society, and when they come to some consensus, then there may be laws, professional guidance, how to act. Unfortunately, the ethical issues are discussed very narrow circle of specialists and very few discussed other members of society in our country, and in fact there are more questions than answers. And each time the emergence of new technology, as I have said, for example, genome-wide analysis of the technology or the technology of even pre-natal diagnosis, and in the system of assisted reproductive technologies for the treatment of mitochondrial diseases, receive three parents of the fetus - it is a very widely discussed abroad before allowing such technology in health care practice, and discussed not only by doctors, not only professionals, but also to those to whom it is intended, and representatives of religious denominations, and various public organizations. We, unfortunately, there are questions. And ethical issues will arise again and again with the advent of any new technology.

Bioethics as a new type of knowledge

Dr. Doping speaks about the relationship of doctors and patients, ethical issues of biomedicine and the ratio of law and morality.

The concept of "bioethics" paradoxically incorporates the word "bio" ("life, living") and "Ethics". Ethics - a philosophical knowledge, the section of philosophical science of morality, of public opinion, which regulates relations between people from the standpoint of good and evil, proper and improper behavior.

It is generally believed that bioethics comes to replace the medical deontology. The term "deontology" was introduced in the XIX century philosopher Bentham to indicate that the behavior of the people must obey certain rules. These rules are designed, for example, for specific medical fields, allow the doctor talking to a patient, to know what action the medical community considers proper, due, and which actions are prohibited. Deontology allows you to build not only the relationship between doctor and patient, but also the relationships within healthcare teams. However, when people, including doctors, make decisions related to conflicts between different values, they tend to be little, just enough to operate for granted, people want to think that is the basis of certain rules.

Bioethics emerges as an attempt to develop benchmarks in biomedicine, following which it would be possible to prevent the negative consequences of the development of Biomedical Sciences, the use of medical technology to the detriment of both the individual and humanity as a whole.
The term "bioethics" was first used in the literature in the early 70-ies of XX century. American biochemist Potter in his work on "Bioethics: bridge to the future" defined bioethics as a discipline that connects biological knowledge with the knowledge of human values. So far, Bioethics is used as a concept that refers to a special type of knowledge, special training discipline, social institution of a new type. Bioethics as knowledge from the '70s on the 90-ies of XX century, has evolved as a discipline narrative - she recorded the conflicts that arise between people, forced to make decisions in situations of vital importance to them or another person, when they were associated with the development of health -biologic knowledge. For example, when patients have a request for euthanasia, or when the researcher doing vivisection, or there was a question about the justifiability of abortion practices.

Over time, bioethics began to move from description to standard regulation. The difference lies in the fact that bioethics needed to answer the most fundamental questions: what is man, what kind of value system guided by a person in making certain decisions where the risks of the border in biomedicine, whether a person is entitled to use the experiment on animals for their own purposes, denying animals the status of important objects of value? The answer to these and other issues was very difficult. But Bioethics has created a special type of knowledge, in which the professional opinion, the doctor, the researchers needed to make an equal knowledge of the average person, the support of ordinary consciousness - sometimes called "man from the street" or "profane".

If we talk about the medicine, in the suffering of each patient has suspended two plans. One objective - this is what happens to the human corporeality during illness as illness realities distort somatic and psychological manifestations of human life. But every suffering there is another, often more important aspect - biographical. Only the patient can imagine a situation with a forecast for the future, only the man himself knows how he would like them to treat him as he refers to himself, to life, what is the meaning of his own life, society, they, or are religious, confessional values, only the person himself knows about the economic and social circumstances of their lives. Bioethics - is a space of dialogue, where the position of a professional doctor and patient position tend to be equal, in this dialogue is born unique personal position on these bioethical situations.

The first block of bioethics - is the problem of the beginning of life: a discussion on the status of the embryo, about the justification of abortion practice, the validity of the use of new reproductive technologies - in vitro fertilization, surrogacy, in vitro fertilization.

The second set of issues that are discussed in bioethics - a problem associated with the end of life: the problem of death and dying, death criteria, the justification, legalization of euthanasia. Bioethics draws attention to the fact that modern medicine is the beginning and end of human life lose their natural status jobs that become events, which depend on someone's decision: the individual patient, family, physician, researcher.
The third set of problems - these are problems associated with the possibility of intervention in medicine mental and physical integrity of a person - in transplantations, in experimentation, in the provision of mental health care. Improve mental health you can with aid of Phenibut, Afobazol, Phenzepam, Semax and Phenotropil.

The fourth block of bioethical problems - these are problems that arise as a conflict between the interests of the state and society on the one hand and the interests of the individual on the other hand in matters of health. For example, vaccination situation, the restriction of human freedom to move, if it is, for example, appeared on the territory, where quarantine for any disease.
All these problems and discusses bioethics descriptive and normative. Today, bioethics becomes a compulsory subject for those who are trained in the specialty "medicine" - the future doctors, and those who are trained in the specialty "pharmacy" - the future pharmacists.
But Bioethics - is not only a special kind of knowledge or academic discipline, it is a social institution. Bioethics creates a special kind of organization structure, in order to organize the bioethical discourse, of which we spoke. This bioethical committees, bioethics commissions that are formed at different levels - from macro-microsocial up. Today bioethical committees necessarily exist for all major hospitals and biomedical research centers. None of the world's leading magazine does not accept paper outlining the results of experiments involving humans or animals, if the conclusion of Bioethical Committee was not obtained before the start of the experiment that in the course of the experiment are not violated bioethical rules.

What are these rules? On what principles for resolving bioethical issues bioethics pays attention? If we are talking about a person, then it is these principles: the rule of truthfulness, the rule of confidentiality, and the most important rule - the principle of respect for individual autonomy, human respect, with dignity, not because of social status, education or financial situation, but because of the birth of his person.

Today is a very widely discussed issue of whether it is possible to replace the study of bioethics of medical law. Is it enough to act in an ethically correct way, follow only the rules of law? The question is not so simple. Those who proposes to replace bioethics rules of law are based, as a rule of moral relativism, imagining that the moral standards of many, they are different persons, acting in accordance with moral norms, can come into conflict with other rules, and if walking in the law , it ensures proper behavior.

However, in the XX century history in biomedicine there are many examples of how legitimate from a legal point of view, the practice was completely ethically incorrect, inhuman.
For example, the practice of euthanasia in Nazi Germany. Therefore, discussion of the ethical issues of biomedicine can not be replaced by a right. In some situations, the pace of development of medicine and technology are so high that the law simply does not manage to resolve all emerging innovations. And in some cases, the right to exact wording is simply not sufficient to allow for the personal dimension of bioethical situations.

Our great philosopher Vladimir Soloviev, speaking of the relationship between law and morality, drew attention to the fact that, following the morale, we are acting in accordance with its internal needs and attitudes. When we act in accordance with the law, the acts of coercion outside the system, and this, of course, act on a step lower than the adherence to internal ethical call.
Bioethics is just beginning to unfold, and as a special knowledge and as a social institution. In the future, the role of bioethics will increase, as is the practice, teaching the every person to make decisions in difficult vital situations, to make decisions that are associated with the boundaries of their own existence. In the history of culture has previously been relatively few situations where a normal person in a situation difficult life choices. The modern development of science required to make such a choice each, and the choice of modern man can not actually pass. Just as the choice to make, and teaches bioethics.

FAQ: Tumor stem cells

7 facts about the structure of tumors and the latest methods of treatment

Cancer is a major cause of death, and the attention of scientists focused on this issue very strongly. In order to cure the tumor, we need to know where you want to strike, to kill her. In fact, there is a constant race - researchers need to learn something new, to be able to treat cancer more effectively. Periodically there are facts that are fundamentally changing the way we look at it as there are formed and grow tumors. And it makes scientists look for new methods of treating cancer.

• 1.One such discovery - the discovery of tumor stem cells, which was done in the 1991 year. To understand what it is, we must first understand the device to normal tissues. Normal tissue cells are formed and are of two types. There are tissues where cells exist throughout their lives, they do not fall, do not breed. The most famous example - is the brain cells, neurons. Their number is not in the adult body increases, but gradually decreases as age neurons die.
• 2.There are other tissues in which cells work "to the bottom", and quickly dies. Why is that? For example, because they can exist in adverse conditions, the cells of the intestinal epithelium, which live in a very aggressive environment. The cells of the intestinal epithelium in working condition (ie, when they are differentiated to perform its functions and work) live 3 - 5 days. They were replaced by new cells must come. The cells in such tissues continuously updated, and the update to occur, fabric arranged as follows: - there are several types of cells in them.
• 3.The first type of cell - this stem cells such "lazy-cells." They sit, rarely shared and very "cherish" itself to the cell does not hurt. The body tries to hide them in some secluded place. Stem cells do not divide frequently especially - during cell division is easily damaged. Such a cell is necessary for life to exist, because it will provide update those cells that are doomed to failure, such as intestinal epithelial cells. Sometimes a stem cell divides, and part of her descendants remains in a state of stem cells, and some - gives rise to renewed population. These descendants (second part) begin to rapidly divide, and when it takes several rounds, division stops, slows down, and the cell starts to differentiate, that is, acquires features of the structure and operation, allowing it to effectively perform the function for which it was created. Then the cell works for some time, until this work is effective, and then dies. And this population is actively updated.
• 4.What is the tumor cells? These are the cells that are "mad", they behave properly, not as the body needs. There is a complex structure described above, when the body is controlled, so you have not formed too many cells of the intestinal epithelium, and there is too little, that's too bad. A tumor - a cell, go Haywire. To improve our life buy Peptides (Cytomax) Bonomarlot, Vladonix for prevention cancer.
• 5.We can assume that all the tumor cells are able to divide the same and each of them can give a new tumor. Is it so? At some point it turned out that there is. work has been done, which took decades and required a very heavy training. The studies revealed that the composition is not the same tumor cells. On their surface membrane proteins can be different, and these proteins using antibodies different cells can be selected. And in one of the tumor (which was first found in chronic myelogenous leukemia), a small group of cells was found less than 0.1% of the total, with certain characteristics that are a little different from the main mass of cells.
• Then a very simple experiment was: These cells enter the mouse and tested forms of these tumors or not. Other cells, 99.9% of which have entered the same mouse. They found a very strange thing: few of these cells - a tumor is formed; and from the main mass of cells - the tumor is not formed. An idea may be, here are a few cells - is just full analogue of stem cells, which are responsible for the update of this tissue. Yes, it's a tumor, but it is also the fabric, and it is also heterogeneous in structure - it has cells that are responsible for the update, and the main mass of tumor mass in this case which can not fully reproduce the tumor. It was a very unusual idea, and scientists have just tested long enough to take a variety of tumors, looking for confirmation. In many tumors (not all) do, such a device has been found: heterogeneous cells, some of them (they were called tumor stem cells) are responsible for the update of the tumor, and the majority simply exists.
• 6.Why is this so important? It would seem, we found the option for which the tumor slightly similar to normal tissue ... in the end, they do occur from normal tissues. And this is why it is important that as soon as people come to terms with the fact that tumor stem cells exist, they are aware of the fact that we are wrong to treat the tumor. When a doctor treats a tumor, the main objective of it is to reduce the tumor mass. When a scientist looking for a cure, to treat a tumor then, it looks primarily at in order to reduce tumor mass. And what happens at the level of tumor stem cells? Maybe reducing the tumor mass, we kill the principal amount of the cells, but whether we kill with stem cells or not? After all, if we do not kill, from stem cells to grow new tumors, and relapse is inevitable. At the same time, it became clear how to treat it. It is necessary to do so to directly hit the tumor stem cells. If we hit them, will not even need to remove the rest of the tumor - destroying only a small population, the share of interest, but the rest of the tumor is maintained by cancer stem cells ... the tumor itself will die, it will melt. And at some point, scientists have realized that it is necessary to search for drugs, ways to destroy the tumor stem cells directly.
• 7.So far, it looks fantastic, although the first works in mice is already underway. It is hoped that it will be able to destroy the tumor stem cells. So far we know very little. We know that they exist, we know about some of their features, sometimes we know where they come from. But as we learn more, and there will be new drugs will be ways to cure those patients who are as yet incurable.

Treatment of cancer

Biologist Dr. Doping tells about benign tumors, chemotherapy and the problem of relapse.

How to change our attitude to the health and standard of living in the XX century? What causes cancer? What is the impact on the human body chemotherapy?

Cancer is often called the "cancer", although this is not entirely accurate. Cancer - only part of them, the disease tissue surface (epithelium), such as skin cancer, colon cancer or breast cancer. A leukemia or leukemia called cancer is not correct, although the inhabitants often say that there is a "blood cancer". The problem is that tumors arise from normal cells as a result of the mutation. This is a general rule for all, without exception tumors. (To improve the quality of our life buy Peptides (Cytomax) Bonomarlot).

If the tumor has arisen among the blood cells, it can not be surgically help. The place where the multiplied cells, which then become blood cells is the bone marrow, that is, all our bones. Leukemia - a terrible tumor that develops from precursor cells of blood cells, and radical method of treatment - is to remove all of the cells of the body, which, of course, impossible.

The central problem of modern oncology - the problem of relapse. For example, what combination of drugs to give to relapse does not happen? And it can happen in three months, six years, five or fifteen years. Can we predict in our treatment of that person for a long time we have helped? Chemotherapy - software therapy drugs have for a long time. The clinical effect is achieved fairly quickly, although there are also resistant tumors. To recover, the patient needs a long time and methodically take drugs. The problem is that different cells within the tumor. The bulk of the tumor cells comprise mature. They can be killed, but it does not prevent the fact that the tumor progenitor cells "waited" chemotherapy. This tumor stem cells.

Hematopoietic stem cells

Bioinformatics tells about formation of blood, bone marrow transplantation and the treatment of hemophilia. What causes leukemia? As the operation developed a bone marrow transplant? When hematopoietic stem cells were isolated?

I am studying hematopoietic system, ie, the formation of blood. All cells in our blood live very long. Some cells live only a few hours, some live a few weeks. Therefore, every day billions of cells produced in the bone marrow. Hematopoietic stem cells hemocytoblasts live in the bone marrow and are responsible for the fact that the blood was performed. They are very important, because if you do not have these cells, there will be blood, which is not compatible with life. We are interested in how the blood production process is maintained for life.

But it is obvious that the area of transplantation of hematopoietic bone marrow stem cells originated in the 50s. In the 60's there were many research groups, including the team in Seattle, who conducted the first such surgery in humans. Patients with leukemia, which would otherwise be assigned a very intensive chemotherapy, a potentially strong enough to kill the leukemia, but also kills healthy hematopoietic cells (ie, it does not cure the patients completely), were able to undergo surgery for a bone marrow transplant. At first, these operations were not very successful, but they gradually become more successful. Now a lot of clinics carry out this operation for patients with leukemia, that is a bone marrow transplant - this is the first clinically proven method of treatment using stem cells (You can buy Complex of cytamins for the cardiovascular system).

At the moment, the only clinical application of hematopoietic stem cells - bone marrow transplantation, but this area is being actively developed. For example, there is a gene therapy. Suppose there is a patient suffering from a genetic defect that leads to hemophilia, problems with blood clotting, or to a lack of immune cells, or sickle-cell anemia or thalassemia. All these problems with red blood cells. In these patients, a genetic disease that can be cured by a bone marrow transplant from another person. But the better - is to take hemocytoblasts from the bone marrow of the patient and put them in the right gene.

Systemic biology

Bioinformatics Dr. Doping tells about the methodology of studying the cell as a whole, different approaches in systems biology and pharmacology development prospects.

What is systems biology and the opportunities it opens up the study of the cells? As systems biology to better understand the mechanisms of cancer and its treatment guidelines? What are the latest developments in the field of drugs against cancer?

New sequencing technologies, new technologies determine the sequence of nucleotides in the genome actually can be used not only to study the genomes of themselves, but also to study how the cell is arranged, the individual interactions in cells. And in recent years, many experimental techniques, which are based on the definition of the sequence of nucleotides in the genome fragments, but you learn without the gene, and all sorts of interactions that occur in the cell. This area is called systems biology - in the sense that you're looking at a cell as an integrated system: not a single gene or protein, and immediately all the proteins and interactions.

Why identical genomes, and different cells and tissues? Answer: because they have different genes work. We have 25,000 protein-coding genes, there is RNK genes. And there is such, that all genes in each cell simultaneously operated. And individual cells, tissue is determined by which genes in their work, which are silent. And you can just watch how genes work, from what information is read, how hard it is going to read. You can look at what proteins interact with DNA, it is the same technique as in the spatial structure analysis. You take a lot of cells, chemically sewed proteins to DNA, those proteins that currently interact with DNA, are sewn tightly, then cut the DNA, pull on the proteins that it sew, and define those sequences that were extended with these proteins . Compares with the genome and you see that a particular protein, for which you are pulled, associated with the genome in a certain set of seats, with a certain intensity.

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On the one hand, we have come to understand a lot more we can for the first time to start thinking about how the cell is arranged as a whole - not the way it looks, is not what we see under the microscope, but as it arranged molecular interactions, how to construct all the mechanisms , signaling pathways, genes work, on / off switch. On the other hand, it became clear just how much we do not understand. In absolute terms we have become much smarter, and in a relative - a lot more stupid because we saw what we thought we knew quite well what was left just a little bit to finish, it was found that there is much more of everything else there . Our lack of understanding of the biology greatly increased.

FAQ: The science of cell

7 facts about the most basic system of the body

Life is more complicated enough, the foundation of its existence in its present form - is a kind of elementary system, the cell. As they say, "is the life of the cell is not." This idea may be, it is not very new, but it has recently tried to challenge. In fact, of course, and now there is talk, because there are so-called "non-cellular form of life" - viruses, prions. Yes, indeed, the virus can escape from the cell, but, nevertheless, this is a temporary escape from the cell, it is a set of genes that escaped, but he has to go back to last forever.

1. Without cells is the destruction of cells and the cell life is terminated. Life - is a cell. Therefore, the science that studies the cell, fundamentally important. The science of cell - now it is called cell biology, is very old, it is constantly branched off from the different sciences, because the cell can be a lot to learn and very differently. In the entire history of cell biology - which is more than three centuries - separated from it a lot of different sciences.

2. The cells are arranged on the one hand, it is very difficult, and on the other hand - all cells can be divided roughly into two main types: prokaryotic and eukaryotic cells.
Prokaryotic - pre-nuclear forms of life, eukaryotic - real nuclear organisms, to which we belong, people. The principal difference of only one thing: how the cell genome is organized. Either the gene as it "floats" inside the cell as that of prokaryotes: bacteria, cyanobacteria, or as they used to be called, in the blue-green algae, archaea. Or as in eukaryotes: gene (i.e. genes) are surrounded by a special envelope and there is a separate, structurally separate domain cell.

3. The difference is very simple but has far-reaching consequences. eukaryotic cells are able to become more larger and so they have created ecological niches, which were essentially unavailable for prokaryotes. And to do many things that prokaryotes are well able to do. The simplest thing - eukaryotes could be large and, as a result, were able to effectively "eat" prokaryotic cells. Already because of this they went to another evolutionary level. Another thing that really could make eukaryotes and prokaryotes have failed to do - is to create multicellular organisms. That is, organisms that have become more and more able to "eat" not only bacteria, but also other unicellular eukaryotes. Again, the evolution has moved to a new level. Prokaryotes can not. When a gene, genes, genetic information is not isolated, do something very complex and no longer receives.

4. This does not mean that prokaryotes, too, did not try to do that, they have some form of interaction when they form some kind of community, which in many respects resemble multicellular eukaryotic organisms. But basically they are different. In recent years a very actively studied so-called "bacterial films" when membrane bacteria live in a state in which antibiotics are well kill ordinary bacteria, they have no effect. And, accordingly, it is very important for medicine, because these patients also need to somehow treat. A conventional antibiotics can not act. This is a very serious problem. Still, a bacterial film - it's not a multicellular organism! Multicellular organisms - is something else.

Generally speaking about the device cells, it consists of only a few parts. Next will treat all eukaryotes: First, the cell should be separated from the environment by some obstacle. On the one hand, we have a non-cellular environment "undeath" on the other side - the life, the cell. It is the thinnest membrane 10 nanometers thick. These are the same nanotechnology, about which everyone is talking, but nobody has seen them.

The rest of the interior of the cell is divided into two parts: this kernel, where is the molecule of deoxyribonucleic acid, DNA, that is, the genes; and then - all the rest is the nucleus (the cytoplasm). This separation allows you to isolate different processes: here we have a genetic information is somehow implemented; It occurs in the cytoplasm of the other processes, and the like proteins are synthesized

But all three are fundamental parts: the plasma membrane, which separates the cell from not-cell cytoplasm in which there are processes that maintain life of the cell and the nucleus, where the genome of the cell.

5. In fact, the core - is the most important part of the cell, because that is where is the information that makes this cell and which allows the cell to exist from generation to generation. This is very important because genetic information is evolving, changing, constantly occurring mutations complexity, this is a huge, complex processes that have been studied and studied. Genetics, Genomics are developing at an incredible intensity in the XXI century.
It is also important that, when the cells have created a multicellular organism (this happened only in eukaryotes), any fundamentally new quality. Firstly, cells learned differently interact more closely communicate with each other. lot and they are very different in the cells of a multicellular organism. But thanks to the interactions they form a very complicated and very orderly, well-functioning integrated system.

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6. To create the multicellular organism, cells were to be different, that one performs one function and the other - the other. If it's a single-celled organism, any unicellular ciliate - it is very difficult organized cell that simultaneously and body. In a multicellular organism different cells took on different roles and so have become different. And they had to learn how to coordinate their actions, often at a very great distance. The human cell may be a meter and nevertheless send a signal to each other. Miscellaneous information walks through the body.

And when there was a multicellular organism, cells had to learn how to die consciously. If single-celled organisms - they are potentially immortal. The cell divides, one produced two, two - four, but in principle there is a constant transfer of genetic information, if the cell does not die one way or another "violent" way.

In a multicellular organism most of the cell is doomed! The genetic information on them will not give this information pacifier. With the emergence of multicellular organisms death issue becomes very relevant, many cells must constantly die, because some cells are short-lived, while others are long lasting. Brain cells live for a lifetime, and other cells live and work only a few days, and then die.

7. There is even a separate science studying individual cells formed complexes - histology. Some believe that it is - part of cell biology, some separated, because it is - a really new quality and there is no longer important single cell, it is important to their community, because in a multicellular organism cells have learned to do that, it would seem, they can not do. They are small and communicate at a distance of a meter. They take care of their genome, and they have learned to die, because it is necessary for the whole organism.

And the whole range of issues: the structure of the cell, how it functions at the molecular level how the genetic information which is important to preserve, passed down from generation to generation and how cells communicate with each other as they are fed as multiply, they produce a multicellular organism - this one range of issues, and is the subject of cell Biology, histology and some other disciplines that stood out from the cell biology of the three hundred years of its history.

Animal tissues

The biologist speaks about epithelial functions, neural tissue and programmed cell death. What are the different types of tissue in a multicellular organism? What is the function of the epithelium? What are the muscle cells? And how cell death occurs?

All cell types (human of more than 200) can be expanded in some complexes that are formed, - tissue. Tissues in a multicellular organism is actually not so much because there are clear features that this body should be implemented. Technically speaking, there are four. What is a multicellular organism in terms of cells? This bag, inside of which the cells feel comfortable. And the first type of tissue, which cells need to create - one that will separate them from the external environment. To improve metabolism people often use Actovegin, Riboxin, Meldonium and Mexidol.

Fabrics internal environment by producing specific extracellular matrix, may develop, for example, cartilage, bone. There are various functions - nutritious, shock-absorbing, skeletal. During the evolution of type 2 formed fabrics, which are responsible for specific functions. This muscle and nervous tissue. These fabrics are arranged the most interesting. Nerve tissue - it is not only the cells that transmit nerve impulses, and a number of endocrine glands. Nerve cells can secrete a variety of substances that are required for signal transduction between cells, the same material can be used as hormones.

The main type of blood cells - red blood cells (red blood cells) - is updated three times a year. This process should be very careful not to cause inflammation. Cells die by apoptosis, programmed manner, breaks into pieces. In the body there are cells that are scavengers, running throughout the body and eat up all that died.

Molecular motors are proteins

Professor of Medicine, Dr. Doping tells about the structure of the cell, kinesin and myosin motor efficiency. Which neurons control the movement of muscles? What is versatile source of energy in the cell? Which methods allow you to monitor the movement of single molecules?

Cage are sometimes thought of as a raw egg: there is a core, and fluid around the border - some cell membrane. In fact, more correct analogy would be to provide a cell in a country where the core is a capital in which to take any important decisions, and then across the country are drawn different way. There are highways, motorways, roads are smaller, there is a path. The entire cell is penetrated by these roads, and these roads carry different loads, different engines - different specific proteins.

In the cell, chemical engines work, exercising and using chemical reactions to perform mechanical work, and the efficiency of, for example, myosin motor - that's about 50%. It is better not only the engine of the engine, internal combustion engines and diesel engines, it is even better than the gas turbine. In terms of efficiency - this engine is more perfect than all used man chemical engines. (Meldonium can feed muscle cells).

The easiest method for monitoring the movement of single molecules is that they take a microscope slide, cover it with motor proteins such as kinesin and myosin. Then take a correspondingly microtubules or actin filaments, which are painted with a fluorescent dye, drip ATP and see how this thread begins to move across the surface. One can measure the rate of myosin may be used ill people can design new myosins and so on.