Thursday, November 19, 2015

Genes for antibiotic resistance?

gizmodo story for later reading

discusses how the bacteria evolve and even exchange genes to help survive antibiotics.

Then it notes:

New drugs are in development, such as teixobactin, which might delay the apocalypse, but are not yet ready for medical use.
Teixobactin, if you haven’t heard of it, is a new class of antibiotics discovered in soil bacteria earlier this year. When teixobactin was first published, it waslauded as a “game-changer” in the fight against antibiotic resistance. Here’s an excerpt from an article I wrote back in March explaining why:
It’s the first new class of antibiotics we’ve discovered in nearly thirty years, and so far, it’s killed every pathogen we’ve thrown at it, including several highly drug-resistant strains of staph. Unlike most antibiotics, which target critical bacterial proteins, this drug attacks the lipid molecules bacteria use to build new cell walls. Vanomycin, another antibiotic that targets cell wall precursors, worked for over 40 yearsbefore bugs started to develop resistance.

Tuesday, November 17, 2015

Plastic surgery in World War II

Gizmodo has an article on the pilots who had severe facial burns from crashing during WWII.

One of those pilots, Richard Hillary, wrote a book about his time there: The Last Enemy (or sometimes published as Falling Through Space).

Project Gutenberg Australia has it on line.

Shortly after my arrival at the Masonic the Air Force plastic surgeon, A.
H. McIndoe, had come up to see me, but as I had been blind at the time I
could recollect his visit but vaguely, remembering only that he had
ordered the gentian violet to be removed from my eyes and saline
compresses to be applied instead, with the result that shortly afterwards
I had been able to see.

He was expected this time at about eleven o'clock, but I was ready a good
hour before, bathed and shaved and dressings elaborately correct. The
charge nurse ushered him in fussily. Of medium height, he was thick-set
and the line of his jaw was square. Behind his horn-rimmed spectacles a
pair of tired friendly eyes regarded me speculatively.

'Well,' he said, 'you certainly made a thorough job of it, didn't you?'

He started to undo the dressings on my hands and I noticed his
fingers--blunt, capable, incisive. By now all the tannic had been removed
from my face and hands. He took a scalpel and tapped lightly on something
white showing through the red granulating knuckle of my right forefinger.

'Bone,' he remarked laconically.

He looked at the badly contracted eyelids and the rapidly forming
keloids, and pursed his lips.

'Four new eyelids, I'm afraid, but you're not ready for them yet. I want
all this skin to soften up a lot first. How would you like to go to the
south coast for a bit?'

He mentioned the official R.A.F. convalescent hospital on the south
coast, generously supplied with golf courses, tennis and squash courts.
But as I could not use my hands, and abhorred seaside resorts in winter,
I wasn't very enthusiastic. I asked instead whether I could go down to a
convalescent home a couple of miles from his hospital. He raised no
objection and said that he would fix it with the Commandant.

'And I'll be able to keep an eye on you there,' he added. He had got up
to go when I asked him how long it would be before I should fly again. I
had asked the same question on his previous visit, and when he had said
'Six months' I had been desperately depressed for days. Now when he said,
'Next war for you: those hands are going to be something of a problem,' I
wasn't even surprised. I suppose I had known it for some time. I felt no
emotion at all.

He took his leave and I went off to have lunch with my mother.

Two days later, after the disentangling of a few crossed wires in
official circles, Air Ministry permission came through and I was driven
down to Sussex.

The next day McIndoe took down the dressing from my eyes and I saw again.

'A couple of real horse blinkers you've got there,' he said; and indeed
for a day or so that is what they felt like. In order to see in front of
me I had to turn my face up to the ceiling. They moulded in very rapidly,
and soon I could raise and lower them at will. It was a remarkable piece
of surgery, and an operation in which McIndoe had yet to score a failure.

Shortly afterwards I was allowed to have a bath and soak the bandage off
my arm from where the graft had been taken. This laborious and painful
process had already taken me half an hour when Sister Hall came in. I was
down to the last layer, which I was pulling at gingerly, hurting myself
considerably in the process.

'Well, really, Mister Hillary!' she said; and taking hold of it she gave
a quick pull and ripped the whole thing off cleanly and painlessly.

'Christ!' I started involuntarily, but stopped myself and glanced
apprehensively at Sister's face. She was smiling. Yes, there was no doubt
about it, she was smiling. We said nothing, but from that moment we
understood each other.

Tony's graft had been a success, and within a few days we were allowed
out for a fortnight's convalescence before coming in again for further

As I was getting ready to go, Sister took me on one side and slipped a
small package into my hand.

'You'll be wanting to look your best for the girls, Mr. Hillary, and I've
put in some brown make-up powder that should help you.'

I started to protest but she cut me short.

'You'll be in again in a couple of weeks,' she said. 'Time enough for us
to start quarrelling then.'

We returned after a short but very pleasant convalescence--Tony for his
last operation, one top lid, and I for two lower ones.

This time when the dressings were taken down I looked exactly like an
orang-outang. McIndoe had pinched out two semicircular ledges of skin
under my eyes to allow for contraction of the new lids. What was not
absorbed was to be sliced off when I came in for my next operation, a new
upper lip. The relief, however, was enormous, for now I could close my
eyes almost completely and did not sleep with them rolled up and the
whites showing like a frightened negro.

Once again we retired to our convalescent home, where our hostess did
everything possible to relieve the monotony of our existence. She gave a
large party on Christmas night, and every few weeks brought down stage or
screen people to cheer up the patients.

there is more at the link.

Much of the story is about flying, and later the recovery from wounds of both the body and the soul. It is a classic on many levels.

I lent my hard copy of the book to my son in law, a helicopter pilot, when he was visiting (and bored). He loved it and asked if he could take it home with him.