Engineer & Entertain

Ideas I grapple with

Archive for the category “Biology”

Cobalt F. Milanowski, M&M

He wrote hit Ke$ha songs

Situation

On 09 Dec 2013 at 1200 MST, Cobalt Foxunit Milanowski, my greyhound, died at a kennel. A staffer at the kennel passed the hound before letting some other dogs out and noticed he was laying around like greys typically do. A few minutes later he returned and noted blood was coming from Cobalt’s mouth. The kennel called several veterinarians and determined Cobalt died quickly and peacefully in a matter of minutes. The kennel called me immediately. I was mid-flight, returning home from a vacation and planning on picking up the dog that day.

The kennel offered to cover a necropsy. The logical side of me that wants to know what happened also told me to let go and let Cobalt have peace. The idea kept turning over in my head; ultimately, my clinical compulsion won and I ordered the autopsy.

Background

Cobalt had swelling on his right rear ankle on 12 Nov 2013. He saw a veterinarian on 16 Nov. The vet’s differential diagnosis included valley fever, a tick borne disease, and osteosarcoma.

A blood panel came back negative for valley fever. Rather than run a tick panel, doxycycline was given prophylactically to treat any tick borne illnesses. A radiograph displayed cortical bone loss which is a sign of canine osteosarcoma. The vet recommended we periodically x-ray the site to insure the loss did not become greater.

The swelling reduced some, but resumed a day before the vacation. My plan was to make a vet appointment for him upon my return, but death intervened.

Cobalt’s past medical history includes a heart murmur when dehydrated, a bout of vomiting (which was never diagnosed, but resolved itself), and cryptorchid which was resolved surgically before we adopted him.

Assessment

Another vet performed the necropsy. Upon gross examination the vet observed petechiae on the abdomen and free blood in the abdomen and thoracic cavity. He found a tumor on the left atrium (hemangiosarcoma). The disease typically begins around 8-10 years of age. Cobalt was 7; he was detrimentally precocious.

The vet reported Cobalt likely had an underlying malignancy which triggered an autoimmune storm.  A cascade of events occurred in a matter of hours and Cobalt’s death occurred in a matter of minutes.  His end was sudden, quick, and peaceful.

Recommendation

A hemangiosarcoma would not show up on radiographs and would only be visible on an ultrasound. If the disease was detected in its very early stages, then treatment might have been a possibility. Chemotherapy would be performed in addition to a very vexing and delicate surgery to remove the tumor from Cobalt’s atrium. Even with surgery and chemotherapy the hound’s life is only extended by 8-9 months. Furthermore its treatment is generally limited to the expertise of a veterinary cardiologist, something not found in Flagstaff. Cobalt’s life might have been extended, but at what cost to the dog’s quality of life?

Given there were no outward signs nothing could have been done. Even if the disease was detected, at this stage the animal’s death could occur at any time. Early detection is the key to cancerous conditions in both humans and animals.

I am grateful for Cobalt. I am also grateful he did one last thing for me and expanded my knowledge of canine health. I miss my hound. Hopefully his dog brain was able to understand that my wife and I love him dearly.

Ricin to the finish

One of the greatest series in the history of television ended a few weeks ago. Before you continue reading this post, please note there will be Breaking Bad spoilers in this post.
While I am not surprised by debates of its meaning and other post game analysis, I was surprised to see people question the logistics of Walt poisoning a nervous, stevia addicted, tea fancying, methylamine supplier. This is the guy who built a meth empire, destroyed several ring leaders, had ten people killed in prison in two minutes, and jump started a RV with science.
Ricin is a poisonous protein from castor beans. It kills by shutting down the protein factories in your cells called ribosomes. The signs and symptoms a person experiences depends on how the poison is introduced to the body. If it is inhaled then the person will die of respiratory failure, while ingestion will terrorize the GI tract. Eating 5-20 castor beans can cause nausea, vomiting, diarrhea, tachycardia, and seizures for 4 days until your inevitable the death. There is no antidote and treatment typically focuses on treating symptoms and organ failure.
A stevia packet contains 1 gram of stevia. If you wanted to poison a 120 pound executive of a German conglomerate which owns a fast food chicken company, then you would need roughly 109 mg of ricin. With a LD50 of 20 mg/kg, if Lydia weighed 180 lbs you would only need 1.6 grams.
180 lbs * 1 kg/2.2 lbs * 20 mg/kg = 1636 mg
There is clearly enough space to accommodate the poison and sugar substitute. So how do you get the poison in the packet and reseal it?
I am not a sucrologist so I could not tell what the packet was made from. If it is plastic then you could cut it open, add the poison, and reseal it using an iron or other heating element. Not all that different than how it was made.

If it is a paper sachet then the glue keeping it closed could be dissolved with acetone or goo gone, the poison added, and then resealed.
So what would hinder this plan (aside from having the ethics to not kill people)? Not a whole lot. Ricin is very stable over a wide pH range and does not break down when exposed to UV light. If it is exposed to 80*C temperature for over one hour though it will denature and become nontoxic. Depending on the tea, it should be prepared 76*C to 100*C. The temperature is hot enough to render the ricin useless, but the tea is not likely to be at the temperature for a long enough time.
The biggest issue with the plan is making sure Lydia received a packet with ricin. There might be one stevia packet at the table or a waiter could be bribed to bring her a specific packet.

In conclusion, poisoning Lydia was a minor task for Walt. Let us go back to discussing color and its meaning in Breaking Bad.

Ignaz to know you

I am participating in No Shave November, but since it is also flu season I am also participating in Wash Your Hands To Reduce Communicable Diseases. This is actually something I participate in frequently through out the day, but now seems as good as any time to celebrate it – unless you count Global Hand Washing Day on Oct 15th.

I digress. I cannot stress the importance of hand washing enough; however, Ignaz Semmelweis can.

In the mid-19th century, 25% of women who caught puerperal fever while delivering their baby would die.  Dr. Semmelweis was an obstetrician in Vienna and worked between two clinics run by the Vienna General Hospital.  The first clinic had an average mortality rate of 10% from puerperal fever.  The second clinic had a rate of 4%.  The clinics admitted delivering women on alternate days.  Some women opted to give birth at home or in the streets rather than go to the first clinic.  These women had lower rates of puerperal fever.  How could the streets of Vienna be a better place to give birth than a hospital?

Ignaz compared the two wards and took into account the population, techniques, even religious practices.  The only difference were their students.  The second clinic trained midwives only.  The first clinic trained medical students and they were required to perform autopsies and learn from cadavers.  The med students and their instructors would go from handling dead, decaying bodies to delivering infants. To our modern eyes this is clearly a horrible idea, but the germ theory of disease would not be proven for another 30 years.

Semmelweis was not the only person to hypothesize doctors could transmit disease to their patients.  There were many reasons why physicians did not immediately wash their hands.  Semmelweis and the other physicians only had anecdotal evidence and they lacked a clear explanation of what was being transmitted.  The thought that disease and cleanliness are linked went against medical training at the time.  Also not helping matters, was that Semmelweis bullied other doctors and hospital staff into washing their hands.  Furthermore, washing your hands did not involve soap and water at the time, it involved a bleaching agent would could irritate the skin.

Ignaz was obsessive about puerperal fever and hand washing. It consumed his life.  Eventually he was committed to an asylum where, in tragic irony, he would die of an infection.  Works by Dr. John Snow, Joseph Lister, and Louis Pasteur would vindicate Semmelweis’s observations and recommendations.

Physicians should have listened to him. Ignaz was money.

Tinkle Trope

After watching several hours worth of medical shows like House, M.D., Scrubs, and Doc Martin I have come to observe a diagnostic trope: If a urine sample is left out or misplaced, it will turn purple and the patient will be diagnosed with a porphyria*.

Considering most hospital labs are not likely to have the necessary tests for porphyria, exposing the urine to UV light to see the color change is not a bad idea per se. Most medical shows; however, have the urine change as a result of dumb luck rather than testing for the disease.  In fact, the title of the Scrubs episode featuring porphyria is called “My Dumb Luck”.  In the US, 1 in 25,000 people have porphyria, so it’s a rare disease and it’s being diagnosed by happenstance on TV.

I was going to link to the clips of various episodes of doctors diagnosing porphyria but I was unable to find the appropriate clips.  Instead, here are Penn & Teller performing a trick on Jimmy Fallon.

*Saying you have porphyria is akin to saying you have cancer.  Like cancer, there are many variations of porphyria (acute intermittent porphyria, congenital erythropoetic porphyria, variegate porphyria, etc) but saying porphyria is generally easier and gets the point across.

Chemical Love

This song works on many levels.  The levels I appreciate the most are the catchy-yet-scientifically sound lyrics and the ukulele.  Why isn’t there ukulele hero?

Parkinson’s Disease is related to insufficient amount of, and lack of action from, dopamine.

Norepinephrine works with epinephrine (adrenaline) during the fight or flight response.

Species Circular

Who wants to do me a favor?  I would love to get my hands on a copy of Ray Comfort’s edition of On The Origin Of Species.  I know groups of creationists are freely handing out Darwin’s work with a foreword from Ray Comfort on college campuses.  If any one comes across one and is willing to part with it let me know and I shall reward you handsomely.  You do find me handsome right?  Oh, well, in that case I guess I will have to reward you homely.

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