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Yearly Archives: 2012

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Learning how cells cross the blood-brain barrier may help with neurological diseases and injuries

Brains have a security system that is similar to that of a plane’s cockpit. Everyday cells can’t enter the control center unless they clear a careful screening process. Blood has to cross through a blood-brain barrier — the body’s equivalent of a metal detector.

Doctors and researchers believed this process kept larger cells from the immune system, which are too big and pack the kind of weapons the blood-brain barrier would filter out, from getting into the central nervous system.

The central nervous system has cells called microglia which are on active patrol, in much the same way as macrophages in the rest of the body. They are looking for potential problems that require immediate correction or attention.

In some neurological diseases, these microglia are especially prevalent and may exacerbate a problem. In other cases, however, a different type of microglia may help stabilize neurological function and signaling.

Stella Tsirka, a professor in the pharmacology department at Stony Brook University, has been studying these special cells to determine what roles they play in disease and in signaling between the immune system and the central nervous system.

Tsirka explained that her lab has divided their research into two areas. The first looks at the pathology of neuro-immune interactions. They are studying a model of stroke, multiple sclerosis and models of spinal cord injuries.

After an injury, “immune cells play an important role in maintaining or modifying the environment around the area of trauma,” she said.

The microglia are thought to be the first line of defense against injury. Later, additional peripheral immune cells infiltrate the central nervous system (when the normally secure blood-brain barrier is compromised) and modify or preserve the injured central nervous system.

At the same time, their more recent work studies the role of microglia to see how they function in the normal central nervous system (CNS).

“We’re trying to find out how neurons behave when there are microglia or not microglia present,” she offered.

Microglia may be something of a neurological stabilizer, she added, although it’s “not established yet.”

During development, microglia are thought to help in the maturation of the CNS by removing unwanted cells from neuronal terminals.

In the normal process of aging, microglia numbers increase, Tsirka observed. Exactly how they are involved in aging and potential neurological regulation with time isn’t clear yet.

Complicating matters further is that there are two different types of microglia: M1 and M2. They have opposite functions. M1 promote inflammation and cell death. M2 are anti-inflammatory and enhance cell repair and regeneration.

Treating microglia with a small beta peptide called Tuftsin has, during neuronal injury, fostered M2 properties. Using this in a model of multiple sclerosis resulted in a reduction in behavioral symptoms associated with multiple sclerosis.

So, if these microglia are relatively large and function like immune cells in the central nervous system, how did they pass through the security system that has such strict restrictions?

The key, Tsirka offered, is that they were in the pre-brain before the body constructed the security system. Indeed, a paper, which has not been verified yet, suggested that microglia migrated into the central nervous system from the human embryo’s yolk sac.
A resident of Setauket, Tsirka has worked at Stony Brook since 1992, when she came to do her postdoctoral research. She is married to Michael Frohman, the chairman of the pharmacology department. She does not report to her husband: she reports to the Dean of Research in the School of Medicine.

Their 18-year-old son Evan recently started college at Northwestern University, where he plans to blaze his own trail by studying mathematical models in social science. Their daughter Dafni, 15, entered Ward Melville in September.

Born and raised in Greece, Tsirka is the local president of the New York chapter of the American Foundation for Greek Language and Culture. Tsirka has supported the university’s efforts to build a Hellenic Studies minor and, eventually, a major.

Tsirka, who met her husband — who does not share her Greek heritage — when they lived in San Francisco, said she can relate to several elements of the movie “My Big Fat Greek Wedding.”

Despite the distance to her parents in Greece, they play an important role in her life. Every morning, she talks to them via Skype.

“If I’m not on by 7 am, my mom is worried something is wrong,” she laughed.
While her family tradition doesn’t include spraying Windex on everything (like the movie), she said family celebrations include food (although not lamb).

She also has been known around her lab for finding the Greek root of words and for sharing Greek expressions. One of her favorites: “It is not the sign of a wise man to commit the same sin twice.”

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Developing an inexpensive device to measure inflammation in the lungs

It’s an all-too-familiar fear. A parent hears a child struggling to breath in the next room, jumps out of bed and wonders whether to grab the child and race to the hospital or call 911.

Researchers from Stony Brook are working to let children (and their parents) breathe a little easier, at least in terms of knowing the severity of an asthma or breathing attack.

Led by Perena Gouma, a professor in the Department of Materials Science and Engineering, along with Milutin Stanacevic, an associate professor in the Department of Electrical and Computer Engineering, and Sanford Simon, a professor in biochemistry and cell biology and pathology, the scientists are developing a nanosensor-based system (i.e., extremely small) that captures, quantifies and displays an accurate measure of the nitric oxide concentration in one exhaled breath.

Nitric oxide is a known marker for measuring airway inflammation.
The scientific trio received a three-year award for $599,763 from the National Science Foundation to develop the monitor.

Creating an affordable, personalized device like this — Gouma estimates the finished product could cost between $20 and $50 — is “urgent” for people who struggle with asthma, she explained. “It’s a matter of working hard and getting this out as soon as possible.”

The group that might use something like this includes young children, the elderly and incapacitated patients.

Hospitals currently employ devices that monitor nitric oxide, but they use gas chromatography, which cost upwards of $10,000 and require considerably more air. They also use chemiluminescence detectors, which cost $30,000.

Through nanotechnology, Gouma and her team hope to screen for nitric oxide in a single breath and at a cost that’s affordable in a home.

“We can measure hundreds of molecules of nitric oxide in billions of molecules of air,” Gouma explained. “We would like to take that sensitivity down one or two orders of magnitude, so that we can measure a few molecules in billions of molecules of air.”

Gouma said the monitor not only could diagnose the severity of an asthma attack, but might also help prevent one.

Users can “exhale once a day and record the concentration of nitric oxide,” she offered.

“If you see that nitric oxide is elevated” you might prevent an imminent attack.
Different concentrations of the signal gas might also lead to different treatments, she suggested. By developing such a diagnostic tool, Gouma and her colleagues believe some patients may be able to take medication only when their body signals they need it.

The concept for the nitric oxide detector is similar to what police use when they administer breathalyzer tests to people as an noninvasive way of determining how much alcohol they’ve consumed. The technology, however, is different.

The breathalyzer uses resistive sensors that are nonselective and respond to all hydrocarbons, while the nanotechnology, which uses crystal nanowires, has a selectivity for one particular gas.

Gouma, who leads the project with her material science background, has teamed up with Stanacevic and Simon on other projects and believes the combination of their skill sets will make a prototype possible in the next year or so.

Stanacevic will work on the microelectronics, while Simon will carry out the trials in the early stages, once the trio has produced a new monitor.

“This is an interdisciplinary approach,” explained Gouma.

A resident of Port Jefferson, Gouma, who is originally from Greece, has been on Long Island for 12 years. She is married to Antonios Michailidis. They have a son in kindergarten.

A world traveler who has spent time in England, Italy, Switzerland, Japan, Australia and Brazil, Gouma calls Long Island the “best place to be.” On the board of the Maritime Museum in Port Jefferson, she praised the region’s smaller museums, including the Whaling Museum in Cold Spring Harbor.

“We really enjoy the lifestyle on Long Island,” she said. “It is so serene, peaceful and safe. At the same time, you get the feeling you are in a metropolitan area.”

She believes Long Island could become the equivalent of Silicon Valley for the rapidly expanding world of bionanotechnology.

“If we were to set up a lot of activity in developing, manufacturing, testing and selling” various nanomedical devices, Long Island could easily become a business hub that would attract investment and industry, she urged.

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Improving on genome sequencing, team studied parrot genome to understand human language development

Humans are constantly at war with our environment. No, not in a cut-down-the-trees-to-build-the-latest-condo way, but in a battle with small pathogens and microbes that would like to set up shop — at our expense — in our bodies.

Our immune system remains on 24-hour patrol, looking for familiar invaders or even for disguised armies that might attack before we can mount a strong enough defense.
While our bodies and medical research have helped weaken and control some predators, scientists like Michael Schatz at Cold Spring Harbor Laboratory believe we can mount another type of defense.

Tapping into the latest technology, Schatz believes researchers can create what David Lipman of the National Center for Biotechnology Information has described as a “digital immune system.” Like a good Terminator, sensors distributed at hospitals, schools, offices, airports and even farms and food processing plants would scan microbial genomes, searching for those that would harm us.

The technology, Schatz suggests, is “right around the corner.” Oxford Nanopore Technologies (a company founded in 2005 on the science of Professor Hagan Bayley of the University of Oxford) announced they would mass produce this type of scanner later this year or early next year. A tougher part of making this a reality, however, is organizing the amount of data that would come in to separate microbial friend from foe.
Schatz doesn’t know when this new surveillance system will be available, but he’s certain medicine will take advantage of the immunological edge computers give us.

“It will take time to develop on a global scale, but everything is pointed in that direction,” Schatz said. It would work like the global weather system that monitors storms, except that instead of watching for hurricanes, it would be on the lookout for emerging disease outbreaks, he suggested.

With a Ph.D. in computer science from the University of Maryland, Schatz said he applies his computational background to areas like sequencing (or putting together the list of DNA base pairs).

He has worked on human genetics to study areas ranging from autism and cancer to plant biology.

“DNA is very much like a computer program, except that instead of ones and zeroes, the digital code is the nucleotide,” he offered. “The sequence is so long that you can’t study it by hand. It’s packed with really important information.”

Indeed, Schatz and his colleagues at the National Biodefense Analysis and Countermeasures Center and the University of Maryland published a paper this summer in which they described ways to improve on third-generation genome sequencing. The biggest problem is that it misreads every fifth or sixth DNA letter about 15 percent of the time.

Each type of sequencing created puzzle pieces or “contigs,” which are connected strands of DNA. “Contigs” are short for contiguous sequences. The second-generation technology created smaller contigs, which made it highly accurate. However, the pieces in the second generation became too small to reassemble.

With third-generation sequencing, the contigs were bigger — making it easier to put the pieces back together. Like a speed reader flipping through a book, however, the third generation technology wasn’t accurate enough. Schatz and his colleagues married the accuracy of the second-generation technology with the speed and size of the third generation. The median size of the contigs in this hybrid model was about twice that of the second generation. It cut the errors down from 15 percent in third-generation sequencing to less than 1/10th of 1 percent.

Using their advanced system, Schatz and his collaborators published the parrot genome, which is more than a third the size of the human genome.

The parrot, he said, is a particularly appealing model for understanding how language develops.

Schatz is a late-night owl, sometimes sending emails as late as 3 am.

“During the day, there’s nonstop interactions,” he explained. “It’s hard to get a long block of time when you can focus. Late at night, that cools off and you can focus.”

Schatz lives in Huntington Village with his wife, art therapist Emery Mikel. They have been on Long Island for two years.

Schatz is thrilled to work at the nexus between computer science and applied biology.

He appreciates the dual advances in biotechnology and computer science, enabling him to participate in and contribute to studies of everything from harnessing biofuels from plants to understanding the genetics of autism.

“I’m trained as a computer scientist and I’m able to apply those skills” in a “really meaningful” way, he offered.

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Diet may be a strong contributor to Alzheimer’s disease

In last week’s article, (dated Sept. 27), I wrote about general dementia prevention. I thought it would be appropriate to follow up with an article on Alzheimer’s disease, one of the most debilitating neurodegenerative diseases. Its incidence continues to rise in lockstep with the fact that we are living longer, for as we age, our risk for the disease increases exponentially (Neurology 1998;51(3):728).

There is more and more evidence that points to an association between diet and Alzheimer’s disease.  Also, there may be a more definitive way to estimate disease risk and progression. This involves white matter hyperintensities (WMH) found in an MRI scan of the brain. These WMH may be tied, at least partially, to diet. Vitamin D levels are also potentially important in Alzheimer’s risk. This article will discuss and explore the potential associations in more detail by looking at the evidence.

The potential significance of white matter hyperintensities

What are WMH and why are they important? White matter hyperintensities represent small vessel cerebrovascular disease. Cerebrovascular disease involves a group of disorders that affect blood vessels, causing a significantly diminished or lack of blood flow to the brain (www.medicalnewstoday.com). For example, atherosclerosis or plaques in the arteries can be a cause, potentially leading to a cerebrovascular accident — or what we typically call a stroke.

One study utilized the Washington Heights/Inwood Columbia Aging Project (WHICAP), an observational study in Manhattan. It found significantly increased risk of Alzheimer’s with WMH, while the atrophy of the hippocampus did not correlate with disease diagnosis (Arch. Neurol. online Sept. 2012). The hippocampus is the part of the brain involved in formation, organization and storage of memory.
The study suggests that these WMH may be important for predicting disease risk and progression, even potentially more so than hippocampal atrophy or shrinkage. Further study is needed for these preliminary findings, though they are very intriguing.

If we are looking at the WMH, then the risk factors for cerebrovascular disease, including high blood pressure, diabetes and obesity, become important. This is where dietary aspects may play a role. The authors suggest that lifestyle modifications would impact cerebrovascular disease risk, which ultimately could reduce Alzheimer’s risk.

Dietary aspects

In an observational study called the Kame Project cohort, a modest dietary change had dramatically beneficial results. Those who drank fruit juice and vegetable juice three times or more a week, compared to those who drank less than once a week, saw a 76 percent reduction in the risk of Alzheimer’s disease (Am. J. Med. 2006 Sep;119(9):751-759). The authors concluded that fruit/vegetable juice may play a vital role in delaying the onset of dementia.

Ironically, at the same time that the WMH results of the previously mentioned study were published, Mark Bittman wrote in a recent article that Alzheimer’s disease has been referred to as “type 3 diabetes” (www.nytimes.com). This phrase has been around since the publication of a 2005 journal article (J. Alzheimers Dis. 2005 Feb;7(1):63-80). The reason for this phrase is that there is potentially an impaired insulin response in the brain of Alzheimer’s disease patients. It is not the phrase itself, but rather the implication of the phrase, that is important. Insulin helps the body regulate and utilize blood sugar. If the brain is not able to metabolize sugar in early Alzheimer’s, this mechanism may contribute to the disease.

To compound this potential lack of insulin response, a recent study focused on macronutrients, or more specifically carbohydrates, and their impact on Alzheimer’s. But what does Alzheimer’s disease have to do with carbohydrates?

The results of the study showed that those who ate a high-carbohydrate diet were at an 89 percent increased risk of developing dementia, such as Alzheimer’s disease (J. Alzheimers Dis. Online July 17, 2012). This should not be shocking, since carbohydrates become sugar when broken down in the body. It seems to fit what the authors are saying in the previously mentioned 2005 study conclusions.

Diabetes

It turns out that type 2 diabetes patients have twice the risk of developing Alzheimer’s (Medscape.org). If we control the glucose (sugar) levels intensely in diabetics, will this reduce their risk of Alzheimer’s? Unfortunately, the ACCORD-MIND trial, a randomized clinical trial, considered the gold standard of studies, did not show a difference after 40 months between the group that had intensive control of sugars compared to standard control (Lancet Neurol. 2011;10:969-977).

The impact of vitamin D

We can’t seem to get away from vitamin D. It appears to be involved in so many different chronic diseases. In the most recent meta-analysis (a group of 37 studies), it was found that those with Alzheimer’s have a lower vitamin D blood level than those without the disease (Neurology. 2012;79:1397-1405). I have a patient with moderately severe Alzheimer’s who is not only insufficient (<30 ng/ml) but deficient (<20 ng/ml) in vitamin D. When I first tested the blood levels, the patient had a vitamin D level of 13 ng/ml.

What is also interesting is that this same patient, after being on a high nutrient, plant-rich diet for a month, had an approximately 45-minute lucid moment, something that had not been seen for years according to the caregiver. This is only anecdotal, and it has only been a month, so that the lucid moment may have been a coincidence. We will have to stay tuned to see what happens.

Ultimately, what is critically important is to realize that Alzheimer’s disease, just like many other chronic diseases, has modifiable risk factors that involve lifestyle choices. Pardon the pun, but I hope this gives you food for thought.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management.  For further information, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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Dementia may be diagnosed when someone experiences loss of memory plus loss of another faculty, such as executive functioning (decision-making) or language abilities (speaking, writing or reading). The latter is known as aphasia. Alzheimer’s disease is responsible for approximately 60 to 80 percent of dementia cases (www.uptodate.com).

This past weekend, there was a torrent of support for Alzheimer’s research through fundraising walks. More research is certainly needed, since there are no definitive studies that show reversal or cure for Alzheimer’s disease. This is why prevention is central to Alzheimer’s — and dementia in general — as I discussed in my May 19, 2011, article.

In terms of dementia, there is good news and some disappointing news.
We will start with the good news. Though chronological age is a risk factor that cannot be changed, biological age may be adjustable. There are studies that suggest we may be able to prevent dementia through the use of both lifestyle modifications and medications.

Telomeres’ length and biological age

Biological age may be different from chronologic age depending on a host of environmental factors that include diet, exercise and smoking. There are substances called telomeres that are found at the ends of our chromosomes. They provide stability to this genetic material. As our telomeres get shorter and shorter, our cellular aging and, ultimately, biological aging, increases.
In a recent preliminary case control study, dementia patients were shown to have significantly shorter telomere length than healthy patients (Arch Neurol. 2012 Jul 23:1-8). Interestingly, according to the authors, men have shorter telomere length and may be biologically older by four years than women of the same chronological age. The researchers caution that this is a preliminary finding and may not have clinical implications.

What I find most intriguing is that intensive lifestyle modifications increased telomere length in a small three-month study with patients who had low-risk prostate cancer (Lancet Oncol. 2008;9(11):1048-57). By adjusting their lifestyles, study participants were potentially able to decrease their biological ages.

Beta-carotene and vitamin C effect

Lifestyle modifications play a role in many chronic diseases and disorders. Dementia is no exception. In a small, preliminary case-control study (disease vs. healthy patients), higher blood levels of vitamin C and beta-carotene significantly reduced the risk of dementia, by 71 percent and 87 percent respectively (J Alzheimers Dis. 2012;31:717-724). The blood levels were dramatically different in those with the highest and lowest blood levels of vitamin C (74.4 vs. 28.9 µmol/L) and beta-carotene (0.8 vs 0.2 µmol/L).

The reason for this effect may be that these nutrients help reduce oxidative stress and thus have neuroprotective effects, preventing the breakdown of neurons. This study was done in the elderly, average 78.9 years old, which is a plus, since as we age we’re more likely to be afflicted by dementia.
It is critically important to delineate the sources of vitamin C and beta-carotene in this study. These numbers came from food, not supplements. Why is this important? First, beta-carotene is part of a family of nutrients called carotenoids. There are at least 600 carotenoids in food, all of which may have benefits that are not achieved when taking beta-carotene supplements. Second of all, beta-carotene in supplement form may increase the risk of small cell lung cancer in smokers (Am. J. Epidemiol. 2009; 169(7):815-828).

Foods that contain beta-carotene include fruits and vegetables such as berries; green leafy vegetables; and orange, red or yellow vegetables like peppers, carrots and sweet potato. It may surprise you, but fish also contains carotenoids. In my practice, I test for beta-carotene and vitamin C as a way to measure nutrient levels and track patients’ progress when they are eating a nutrient-dense diet. Interestingly, many patients achieve more than three times higher than the highest beta-carotene blood levels seen in this small study.

Impact of high blood pressure medications

For those patients who have high blood pressure, it is important to know that not all blood pressure medications are created equal. When comparing blood pressure medications in an observational study, two classes of these medications stood out. Angiotensin II receptor blockers (known as ARBs) and angiotensin-converting enzyme inhibitors (known as ACE inhibitors) reduce the risk of dementia by 53 percent and 24 percent respectively, when used in combination with other blood pressure medications.
Interestingly, when ARBs were used alone, there was still a 47 percent reduction in risk, however ACE inhibitors lost their prevention advantage. High blood pressure is a likely risk factor for dementia and can also be treated with lifestyle modifications (Neurology. 2005;64(2):277). Otherwise, ARBs or ACE inhibitors may be the best choices for reducing dementia risk.

Ginkgo biloba disappoints

Ginkgo biloba, a common herbal supplement taken to help prevent dementia, may have no benefit. In the recent GuidAge study, ginkgo biloba was shown to be no more effective than placebo in preventing patients from progressing to Alzheimer’s disease (Lancet Neurol. 2012;11(10):851-859). This randomized controlled trial, considered the gold standard of study designs, was done in elderly patients over a five-year period with almost 3,000 participants. There was no difference seen between the treatment and placebo groups. This reinforces the results of an earlier study, Ginkgo Evaluation of Memory trial (JAMA. 2008;300(19):2253-2262). Longer studies may be warranted. The authors stressed the importance of preventive measures with dementia.

Fish oil: not the last word

Many of us take fish oil supplements in the hope of preventing dementia. However, in a meta-analysis (a group of three randomized controlled trials), the results did not show a difference between treatment groups and placebo in older patients taking fish oil with omega-3 fatty acids (Cochrane Summaries online June 13, 2012). The authors stress that this is not the final word, since studies have been mixed. The longest of the three studies was 40 months yet may not have been long enough to see a beneficial effect. Also participants in the meta-analysis did not necessarily have low omega-3 levels at the beginnings of the studies. This doesn’t necessarily mean fish oil doesn’t work for dementia prevention, it is just discouraging, as the authors emphasize. Fish consumption, however, has shown an inverse association with Alzheimer’s and dementia overall (Neurology. 2007;69(20):1921).

There may be ways to prevent dementia from occurring, whether through lifestyle modifications or through the selection of medications, if they are necessary. It is great that there is such enthusiasm to raise money for dementia research and, in particular, for Alzheimer’s disease. However, it’s just as important to take action now in the form of preventing this disabling disorder.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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Associate professor and his team look at stages of frog reproduction: egg to tadpole to frog

An attacking snake causes the eggs of most red-eyed tree frogs to hatch immediately, sending young tadpoles that were developing on leaves in the air to plunge into the water below to escape the slithering predator.

This is just one of many life-history strategies frogs have developed over the more than 200 million years since they started snatching insects and hopping and lunging around waterways.

While just over half the frogs in a survey of 720 species of frogs around the world follow the same life history they employ on Long Island — namely, laying eggs in water, hatching as tadpoles and developing into frogs — the others go through a range of reproductive cycles, including laying eggs out of the water (like the red-eyed tree frog) or even developing directly (i.e., hatching as frogs).

Those frogs that develop directly are found primarily in moist, warm regions in the tropics.

Stony Brook Associate Professor John Wiens, in collaboration with Ivan Gomez-Mestre from the Donana Biological Station in Seville, Spain and Alexander Pyron from George Washington University, wanted to know how these different reproductive strategies evolved and why so many frogs continued to employ the aquatic approaches.

“It seems like laying eggs terrestrially is great because the eggs are out of the water and are protected from aquatic predators, but at the same time, that comes with a cost,” Wiens suggested.

Indeed, the frogs that lay eggs out of the water typically produce fewer offspring. There’s a mechanical explanation for this: the eggs are larger but the momma frogs are the same size. The eggs of direct developers also need to contain all the resources necessary to become a frog.

Frogs that lay eggs in the water, on the other hand, can lay more and smaller eggs, because the tadpoles can feed themselves. The squiggly swimmers can eat algae that they scrape off rocks, bacteria at the bottom of ponds or invertebrates like freshwater shrimp. Some tadpoles, Wiens pointed out, eat other tadpoles and, in some species, the mothers feed the tadpoles with unfertilized eggs.

But, as with the red-eyed tree frog, some of these amphibians have stayed with what might be considered an evolutionarily intermediate stage: instead of choosing direct development or aquatic development, they place their eggs outside water, until they hatch into tadpoles.

In South America, for example, glass frogs have been laying their eggs outside of water for over 50 million years. Once they hatch, tadpoles breathe and eat in the water until they become frogs. For glass frogs, this isn’t a true intermediate stage, because they never evolved into direct development.

For some frogs that make the evolutionary hop from aquatic to direct development, however, the intermediate steps may not be necessary.

“In about half the cases in which direct development evolves, it seems to evolve directly from the primitive mode,” Wiens offered. While it is possible that intermediate stages occurred in these frogs, the results “suggest it would have had to do so relatively rapidly.”

Frog reproductive cycles can provide insight into medical questions or problems.
There is an extinct frog that was a gastric brooder in Australia. That frog kept its eggs and young in its stomach. Somehow, during its reproductive cycle, the frog turned off its gastric juices, allowing its young to grow and develop in the relative safety of its mother’s stomach. Scientists have been hoping this frog’s life cycle might provide additional tools to treat ulcers.

In addition to frogs, Wiens studies salamanders, lizards, snakes and turtles.

He studies the interface between evolution and ecology.

“Using the reconstructed or evolutional history of reptiles and amphibians and other groups, we try to understand how biodiversity originates,” he suggested. He looks at questions such as why there are more species in the tropics.

Wiens lives in Stony Brook with his wife, Ramona Walls, a postdoctoral research associate at the New York Botanical Garden. The scientific couple, who have a daughter in college, enjoy visiting beaches on the island and hiking.

As for frogs, the recent study contradicts some of what scientist had believed for years.

“In many cases, rather than going from having eggs laid in water to eggs laid on land to direct development, frogs jumped the queue, going straight from eggs laid in the water to direct development,” he offered.

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Erland was firefighter, commissioner, trustee

Joe Erland served the community for many years, including through the fire department. Photo from Bryant Funeral Home

Joe Erland, a lifelong Port Jefferson resident and longtime member of the Port Jefferson Fire Department, died on Thursday. He was 55 years old.

Erland dedicated much of his time to serving the Port Jefferson community through both the fire department and the local government. He was a fire commissioner since 1992 and once served the village as a trustee and deputy mayor.

“He was the quintessential local kid,” said Fred Bryant, one of Erland’s longtime friends and the best man at his wedding. “He was a nice person — ‘Mr. Port Jefferson,’ as we like to call him.”

According to Steve Erland, 29, the late Erland’s oldest child, his father died from Creutzfeldt-Jakob Disease, a rare and rapidly progressive disease that affects mental function. He had been diagnosed less than a month ago.

For 37 years, Joe Erland worked as a Long Island Rail Road engineer. He retired from the job to care for his wife Patricia, who passed away from cancer less than four years ago.

Patricia had worked for the railroad as well and the couple married in 1979. They also have two daughters: Michelle, 29, and Andrea, 23.

Born on Oct. 19, 1956, Joe Erland was part of a family who had lived in the Port Jefferson area since the early 1800s. Keeping with the family tradition, Erland, whose grandfather worked as a dispatcher, began volunteering with the Port Jefferson Fire Department 38 years ago. He went on to start the Junior Company and became its first captain.

“He was always a kindhearted gentleman that you could always speak to,” PJFD First Assistant Chief Dave Williams said. “He was very well-liked by all of the members.”

Erland had been made an honorary chief of the fire department two weeks ago, Williams said.
Harold Tranchon, chairman of the board at the Port Jefferson Fire Department, said that Erland was knowledgeable and a great asset to the fire department.

Port Jefferson Chief Constable Wally Tomaszewski recalled Erland’s bravery surpassing his duties with the PJFD. The code chief said Erland saved his life after a man in the village attacked him with a sword in the late 1970s. Tomaszewski called Erland “the pillar of the community.”

As a village trustee, Erland ran for mayor in 2009 against Mayor Margot Garant. While he was disappointed that he lost the election, Bryant said, he was tremendously gracious in his defeat.

“I consider Joe to be a Port Jefferson hero,” Garant said. “I just think he really brought the community together. We need a lot more [of] him around, that’s for sure.”

Steve Erland said his father was humble about his achievements, rarely talking about himself, and had a passion for everything he did.

In his spare time, Joe Erland enjoyed playing softball, golfing and camping. For many years, Erland even danced in Harbor Ballet Theater’s annual Nutcracker performance, in which he played the father, his son said.

Even in the face of adversity, Bryant said the elder Erland always handled things with grace.

“You felt that he was at peace with it,” Bryant said. “He was still that wonderful guy right through the end.”

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Eye tremor may be an early indication of this neurodegenerative condition

Eye tremor may be an early indication Parkinson’s disease is a neurodegenerative disease, which means there is progressive breakdown of neurons. Traditional medications that focus on dopamine levels and receptors help improve symptoms, sometimes dramatically, yet they have limitations. Medications can’t prevent the breakdown of the neurons themselves. Also, drug benefits may eventually “wear off.”
Parkinson’s typically affects people who are older than 60. There are over one million people in North America directly affected by this disease, but countless family member caregivers are indirectly affected as well (N Engl J Med 1998;339(15):1044).

This article’s focus is to provide an overview of Parkinson’s, including risk factors, diagnosis and alternative treatments that may enhance traditional treatments.

Significance of eye tremors

The common triad of symptoms for diagnosing Parkinson’s are rigidity, tremor and bradykinesia (slow gait). Parkinson’s tremors typically occur in the limbs, but this may not be the whole story. We may also want to look at the eyes. It appears that Parkinson’s disease patients have ocular fixation instability, meaning that when they focus on a point on a computer screen, their eyes oscillate and may have trouble focusing. This happens to a greater degree in the vertical direction than the horizontal (Arch Neurol. 2012;69(8):1011-1017).

In this case-control trial, which compared Parkinson’s patients with healthy participants, 63 percent of the Parkinson’s patients, in addition to eye tremors, experienced difficulty with vision at some point during the testing. The eye area affected was the fovea — part of the retina (back of the eye) responsible for sharp central vision. The authors believe that eye testing may provide an accurate way to diagnose the disease.

Role of pesticides

It appears in meta-analysis (a group of 46 trials) that pesticides increase the risk of Parkinson’s disease (Environ Health Perspect. 2012;120(3):340-347). Insecticides and herbicides appeared to have more impact, whereas fungicides were not associated with increased risk.

The studies were not completely consistent, even though there was a 62 percent overall increased risk. However, it would be premature to declare that pesticides are definitely associated with Parkinson’s disease. There were no randomized clinical trials, and there were several different types of trials analyzed. Many past studies have had mixed results. Also, it was unclear what type of pesticide exposure occurred and at what level. The authors did not definitively say that it was from consumption of foods, but the results are interesting and may give a boost to the validity of organic foods.

Dairy’s potential negative impact

The National Dairy Council wants you to believe that dairy makes you big and strong. However, in the prospective (forward-looking) Cancer Prevention Study II, men who consumed the most dairy were found to have as much as an 80 percent increased Parkinson’s disease risk compared to those who consumed the least (Am J Epidemiol. 2007 May 1;165(9):998-1006).The risk is higher than the pesticide study mentioned above. There was also an increased risk with women, but not as dramatic. When results combined both sexes, there was an overall 60 percent increased risk. Therefore, if there is a family history of Parkinson’s, it might be wise to consider keeping dairy to a minimum.

Dietary effect

In a meta-analysis that looked at the Nurses’ Health Study and the Health Professionals Follow-up Study, results showed diets that focused on fruit, vegetables, whole grain, nuts and seeds, fish and poultry demonstrated a 30 percent reduction in Parkinson’s disease risk (Am J Clin Nutr. 2007 Nov;86(5):1486-94). This effect may be due to flavonoids, bioactive compounds in plant-rich diets. It is surmised that these compounds may have neuroprotective effects, because of their antioxidant and anti-inflammatory properties (Eur J Pharmacol. 2006;545(1):51-64).

Exercise and Parkinson’s treatment

Exercise may be used in concert with therapeutics in treating Parkinson’s disease, and goes beyond medications in helping with motor function and stability. Two that have shown good results are resistance training and tai chi.

Resistance training — specifically weight training — may have significant benefits, according to preliminary data (AAN 2012 abstract #S02.003). The patients involved in the study had Parkinson’s for a mean of seven years and were not on medication. They exercised twice a week for one hour, and they saw a significant improvement in motor function as they gradually increased the level of resistance. This was sustained for the 24-month study. Though this study was small, these results are encouraging.
Postural stability is important to the functionality of a Parkinson’s disease patient. In an NIH-funded randomized clinical trial, the gold standard of trials, tai chi significantly improved postural stability when comparing it to both resistance training and stretching (N Engl J Med 2012;366:511-519). Tai chi was instrumental also in reducing falls — even three months after patients stopped tai chi. The mild to moderate Parkinson’s patients in the study performed tai chi for one hour twice a week.

It is exciting that there may be a more definitive way to diagnose Parkinson’s disease by testing the eyes for tremors, rather than the traditional compilation of symptoms. Even though it is not clear where pesticide exposure occurred, it may be prudent for people with a high risk of Parkinson’s to lean toward an organic, plant-rich diet for prevention.

In addition, if a Parkinson’s disease patient exercised four times a week, alternating between tai chi and resistance training, they would get the best of both worlds: potential improvement in postural stability and in motor skills.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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In October, a trip to Hawaii aboard the Spirit should add data to the ongoing study

Ernie Lewis likes to play the cloud game, looking for familiar shapes in our puffy white neighbors overhead. While he’s contemplating whether that one resembles a dog and this one looks like a lizard, he wonders how he might capture the clouds mathematically or model them in a climate system.

A researcher at Brookhaven National Laboratory, Lewis can appreciate the aesthetic wonder of the clouds even as he would like to understand them much better than modern science currently does. Clouds are one of the most confounding variables in predicting and understanding climate.

“The ability to accurately represent clouds and cloud properties in climate models is lacking and is one of the largest gaps in our understanding,” explained Lewis.

The BNL researcher is at the beginning of coordinating an effort to understand how clouds transition from the predominantly stratocumulus versions in Los Angeles to the mostly cumulus types in Hawaii. A stratocumulus cloud is white, grey or a mixture of the two and often looks thick and dark and appears in waves or sheets. Cumulus clouds, by contrast, look harmless and often have more defined boundaries and look like puffy balls of cotton.

Starting in October, a team of scientists under his direction will travel the 2,548 miles back and forth from California to Hawaii aboard the Horizon cargo ship Spirit. They will bring with them their own container of sophisticated equipment and will launch weather balloons four times a day. The balloons, which contain equipment housed in a small container Lewis said looks like a Chinese food take-out package, will send back information about the temperature, pressure and relative humidity, as well as wind speed and direction.

The scientists will use the information to figure out how clouds change along the route through the Pacific.

Scientists aboard the Spirit will coordinate their data with NASA, which is collecting information from its satellites. The team aboard the cargo ship will compare their photos of the clouds from below with what NASA satellites see from above. This will help validate NASA’s satellite retrieval.

Clouds absorb outgoing infrared radiation from the Earth’s surface, which warms the planet. At the same time, clouds scatter incoming infrared, visible and ultraviolet radiation from the sun, which cools it.

“As nearly all of Earth’s energy comes from the sun, understanding the behavior of this incoming radiation and how it is transferred is important to understanding climate,” Lewis wrote in an online update of his research. You can follow his efforts through the link: www.bnl.gov/envsci/ARM/MAGIC/updates.php).

Lewis plans to take the two-week trek aboard the Spirit in October. He will also go back and forth in December or January. Others from the project will ride in September to set up the equipment.

On a test voyage, Lewis said the accommodations are quite comfortable, and include such amenities as a weight room and a lounge with movies.

“We are grateful for Horizon Lines and to the captains and crew of the Horizon Spirit,” Lewis offered.

Lewis, who did oceanographic research through Woods Hole in Massachusetts, is especially appreciative of the size and sturdiness of the ship. When he was aboard smaller vessels in the North Atlantic, he’d get seasick, especially during Nor’easters.
Lewis put his oceanographic background to good use when he wrote a book called “Sea Salt Aerosol Production.” Steve Schwartz and Lewis described how the bubbles comprising whitecaps send seawater drops into the air. The drops evaporate and climb into the atmosphere, where some form the seeds of cloud drops.

“It’s a summary of knowledge of how these are produced,” he explained. “It’s a consolidation of the work that has been done” on these white caps.

Lewis, who lives in Calverton, looks to the skies for one of his other passions, birds. An avid birder, Lewis enjoys going to Fire Island in the fall to watch migrating raptors (i.e., predatory birds, like hawks). He also enjoys watching birds at the lab.

Lewis is married to Northeastern University Professor Laura Henderson Lewis. They commute back and forth from Boston to Long Island.

“I hope my research will lead to a better understanding of clouds and their effect on climate,” he explained.

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Diet composition and fitness trump (severe) calorie restriction in benefits

You would think that all of us, if given a choice, would want to live longer. However, in a recent informal survey involving 30,000 participants over the last three years, more than half did not want to live past the 80-year current life expectancy for developed countries (NYTimes.com Aug. 25). This would be surprising, except that the most frequent reason offered had to do with not wanting to be old and debilitated. What if we could propose improving longevity — and health — so that people would feel vivacious throughout their lives, regardless of age?

Calorie restriction impact
Recent thinking has been that if we restrict our calorie intake significantly, by 30 percent, then we are more apt to live longer and healthier lives. That is what we were led to believe by earlier studies in monkeys, like the 2009 University of Wisconsin study (Science. 2009 Jul 10;325(5937):201-4). The problem with the study was that the researchers discounted a number of monkeys who died, claiming this did not have to due with aging.

However, a newly published study with rhesus monkeys reported different results (Nature online Aug. 29). Severely restricting these monkeys’ calories did not increase their longevity, nor did they live healthier lives. These results were disappointing in that calorie restriction is not necessarily the panacea that we thought. This was a 25-year study and the results had been eagerly anticipated.

There were some benefits to calorie restriction, though. For older males and females, heart disease risk was reduced due to lowered triglyceride levels. This was true, ironically, only when calorie restriction was begun when the monkeys were already old.

However, the monkeys — calorie restricted or not — did still experience chronic diseases such as heart disease and cancer.

What about chronic disease?

It appears that chronic disease is the greatest hindrance to achieving or maintaining a better quality of life. Coincidently, the Centers for Disease Control and Prevention has released data that show chronic disease is on the rise, with increasing numbers of patients having two or more diseases. Also, it appears that the United States lags behind European nations in reducing the number of preventable deaths, called “amenable mortality.” Most of these deaths are caused by chronic disorders, such as high blood pressure, stroke and cancers. The U.S. is seeing a decline in its rates of preventable deaths but at half the pace of France and the United Kingdom. So what can we do to slow the rise in chronic disease and accelerate the decrease in our rate of preventable deaths?

Diet composition effect

Dietary choices can have a tremendous effect on health. Not surprisingly, poor diet composition is one of the leading contributors to many chronic diseases such as high cholesterol, diabetes and heart disease, and thus amenable mortality rates (Ann Intern Med 2010;153:736-750). The CDC showed that only about one-quarter of Americans consumed the most basic levels of fruits and vegetables recommended.

However, there are several diets that have been promoted because they are known to have powerful effects on reversing this dismal trend of increasing chronic disease such as the DASH diet and the Mediterranean-type diet. In 2010, the DASH diet was highlighted because of its beneficial effects on prevention and treatment of disease (www.cnpp.usda.gov). At the basis of this diet is the emphasis on nutrient-rich foods, including fruits, vegetables, nuts and seeds, beans and legumes, and whole grains, as well as a modest amount of lean animal protein.

The DASH diet was originally designed to lower blood pressure. In a randomized controlled trial, the gold standard of studies, DASH showed significantly lower systolic blood pressure results compared to those on a standard diet, even though both groups were intentionally given the same level of sodium intake, which is very interesting (N Engl J Med 1997;336:1117-1124). The difference was that DASH increased the amounts of fruits, vegetables and low-fat dairy, while lowering saturated fat.

Subsequent prospective studies, such as the Nurses’ Health Study, have borne out the benefits of the DASH diet in lowering heart disease risk in patients followed for a 25-year duration (Arch Intern Med 2008;168:713-720).

Fitness at any age — a greater impact than expected

We used to think that fitness helped delay disease, but a new study suggests that fitness in middle age, defined as people in their 50s, actually decreased the risk of chronic disease significantly. It didn’t just delay it (Arch Int. Med online Aug. 27). Ultimately, fitness at any age seems to provide us with a higher quality of life. This study involved 18,600 participants. There was an approximately 45 percent reduction across the board for both men and women in incidence of the top eight chronic diseases.
The good news is that you may not have to make yourself miserable by eating a very low calorie diet in the hopes of achieving a longer life.

Rather than suffering — or imagining suffering — through severe calorie restriction, why not focus on consistent, modest fitness routines and diets that are rich in nutrients and high in volume? The potential disease-modifying effects could play a crucial role in preventing what we perceive as age-related decline. Then, you can have a positive attitude toward living longer, since you will be able to maintain, if not improve, your health as you age.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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