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Category Archives: Medical Issues

Futuristic Robotic Surgery Is Here

Robotic Device

 

My second Dub Walker thriller HOT LIGHTS, COLD STEEL dealt with the future of robotic surgery. Future as in way down the road. But now it seems it’s not all that far away. Virtual Incision in Lincoln, Nebraska is working on a very clever device that could make space missions safer. Very cool stuff.

 

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Guest Blogger: EE Giorgi: I Am My Mother’s Chimera. Chances Are, So Are You

For years now the concept of a “genetic chimera” has sparked the imagination of writers: from Stephen King to Michael Crichton, from CSI to The Office. The idea that an individual could harbor his/her own twin is creepy and intriguing at the same time, not to mention it offers the perfect escape from DNA testing in a police procedural plot.

But if you think that “chimeras have been done already,” think again. All fictional works written so far have exploited the concept of tetragametic chimeras, which results from combining two or more genetically distinct organisms. In humans, this happens when two fertilized eggs fuse together during the first hours of life in the womb.

Yet Mother Nature has invented many other forms of chimerism.

Some genetic defects/mutations can lead to individuals with genetically distinct cells in their body. Usually these defects involve anomalies in the number of chromosomes, but there are also asymptomatic cases, like for example animals whose coat is a patchwork of different colors, as in tortoiseshell cats. This type of chimerism is called mosaicism. Contrary to tetragametic chimeras, which originate from two or more individuals fused together, mosaics originate from a single individual. People whose eyes have different colors are also an example of genetic mosaicism.

Tortoiseshell cat (Source: Wikipedia)

Tortoiseshell cat (Source: Wikipedia)

 

Scientists claim that chimeras are much more common than we think. Chances are, you could be your own twin. But how surprised would you be if I told you that you are actually far more likely to be your mother’s chimera than your unborn sibling’s?

“Microchimerism refers to a small number of cells (or DNA) harbored by one individual that originated in a genetically different individual” (Gammill and Nelson, 2010).

An individual receiving a donor transplant or a blood transfusion is an example of microchimerism. Yet the most common form of microchimerism happens during pregnancy. There’s an ongoing two-way cell trafficking across the placenta, and these exchange cells can actually proliferate long term in the host’s body: fetal cells can be found in the mother years after she gave birth. In fact, because even spontaneous abortions cause fetal cells to be released into the mother’s body, women who became pregnant but never gave birth can also harbor this form of microchimerism.

Mystery writers are familiar with the “Jane Doe scenario”: an unidentified woman that lands on the medical examiner’s table. One of the many things the ME can learn about this woman with today’s technology is whether or not she was ever pregnant—even if the pregnancy ended with a spontaneous abortion. With a single test the ME can find male DNA in Jane Doe and deduce that at some point she was pregnant with a baby boy. A baby girl can also be detected, but it requires more than one test.

Just like fetal cells can be found in the mother years after she has given birth, the inverse is also true: maternal cells have been found in fetal liver, lung, heart, thymus, spleen, adrenal, kidney, pancreas, brain, and gonads. What’s surprising is that in either case (mother-to-fetus transfer, or, vice versa, fetus-to-mother transfer), the extraneous cells migrate to a certain tissue and, once there, they are able to differentiate and proliferate, acting at all effects as if they were engrafted. One paper found circulating maternal cells in 39% of the study subjects (Loubiere et al. 2006).

But even if you are not your own twin, even if you don’t harbor cells from your mother or your child, even then chimeras are closer than you think. Because we all originated from a chimera: roughly 10% of our DNA is made from viral genes, and how this came to happen is a fascinating story.

A long time ago a virus infected a sperm cell or oocyte of one of our ancestors. Once there, the genetic material from the virus fused with the genetic material of the cell —- that’s an old trick viruses play so they can replicate. Except this particular virus never replicated. The sperm or oocyte was fertilized and became a fetus, and that fetus now carried the bit of viral DNA. The viral genes were “stuck”, no longer able to replicate, and thus effectively silenced.

Finally, the last form of chimerism I would like to discuss is far less known because it belongs to a fairly new field: epigenetics.

Genes are packaged inside the nucleus, some deeply hidden inside, and some exposed so that they can be easily “translated” into proteins. This configuration can change in time, as genes can move from the inside of the nucleus and become exposed, while others previously exposed can become hidden. Life events, changes in the environment or in diet, stress, and traumas can potentially affect these mechanisms, causing some genes to turn on while turning off others.

Epigenetics is the study of all mechanisms that can affect gene silencing (turning the genes “off”) and gene expression (turning the genes “on”). In other words, it addresses the question: what causes some genes to shift from being hidden (silenced) to becoming suddenly exposed (expressed) and other genes instead to suddenly become hidden (silenced)?

The amazing thing is that these epigenetic mechanisms are not encoded in the DNA, yet there have been studies that have shown that epigenetic changes caused by stress or diet can indeed be carried over for the next two-three generations.

You’ve probably guessed it by now: an individual whose cells express distinct genes within the same tissue is called an epigenetic chimera.

From a writer’s point of view, this kind of chimerism lends itself to many more scenarios than the genetic one. For one thing, it is much more complicated to detect as the defects no longer lie in the genes themselves, but rather in which genes are expressed and which aren’t. At the same time, epigenetic disorders can give rise to any sort of dysfunctional phenotypes. And you have a wide range of “life events” that could potentially trigger the “sudden change” in your character(s): viruses can certainly mess up with the cells’ signaling and turn on forgotten genes; an accident or physical trauma can spike new sensations/symptoms (have you ever heard of someone’s sense of smell suddenly spiking after a car accident?); a change in diet/environment; etc.

Vampires and zombies may have been done already. But there’s still a lot of room for chimeras of all kinds.

 

EEGiorgi

EEGiorgi

 

E.E. Giorgi is a scientist, a writer and a photographer. She loves to blog about science for the curious mind, especially the kind that sparks fantastic premises and engaging stories. She has done scientific consultations for writers such as Autumn Kalquist (Legacy Code) and bestselling author Carol Cassella (Oxygen). E.E.’s detective thriller CHIMERAS, a hard-boiled police procedural with a genetic twist, is now available on Amazon.

Link to Blog: http://chimerasthebooks.blogspot.com/

Link to book on Amazon: http://www.amazon.com/dp/B00JI6UNPE

Chimeras Cover

Previous Posts on Chimerism:

 

Q&A: How Could My Sleuth Recognize a Chimera?: http://writersforensicsblog.wordpress.com/2010/07/05/qa-how-could-my-sleuth-recognize-a-chimera/

Organ Creation and Harvesting: Reality Imitating Art: http://writersforensicsblog.wordpress.com/2013/07/18/organ-creation-and-harvesting-reality-imitating-art/

Guest Blogger: Elena Giorgi: Deep DNA Sequencing: http://writersforensicsblog.wordpress.com/2011/09/22/guest-blogger-elena-giorgi-deep-dna-sequencing/

Human Chimerism: Mindboggling DNA Tests Gone Wrong-Guest Blogger: http://writersforensicsblog.wordpress.com/2010/06/24/human-chimerism-mindboggling-dna-tests-gone-wrong-guest-blogger/

 
 

Crime and Science Radio: Sex, Lies, and Crime: An Interview With Sex Crimes Expert and Best-Selling Author Linda Fairstein

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Join Jan Burke and I as we discuss sex crimes with best-selling author Linda Fairstein.

Linda Fairstein is an honors graduate of Vassar College and the University of Virginia School of Law, a former prosecutor, and one of America’s foremost legal experts on crimes of violence against women and children. For three decades, she served in the office of the New York County District Attorney, where she was Chief of the Sex Crimes Prosecution Unit for twenty-five years. She was the lead attorney in the famous the Robert Chambers “Preppy Murder” case. She is an internationally bestselling author of a series of crime novels, which feature Manhattan prosecutor Alexandra Cooper. Linda is also the author of a non-fiction work. Sexual Violence: Our War Against Rape, which was a New York Times Notable Book of the Year. She is a sought-after media consultant on the issue of the criminal justice system and crimes of violence against women for major networks such as CNN, MSNBC, and cable affiliates. She continues to practice law as a pro bono representative of victims of violence. She and her husband Justin Feldman live in Manhattan and on Martha’s Vineyard.

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LISTEN: http://www.blogtalkradio.com/suspensemagazine/2014/02/21/crime-and-science-radio-with-linda-fairstein

LINKS:

Linda Fairstein Website: http://www.lindafairstein.com

Linda Fairstein Facebook Page: https://www.facebook.com/LindaFairstein

Linda on Twitter: @lindafairstein

Alex Cooper Series on Goodreads: https://www.goodreads.com/series/43692-alexandra-cooper

USA Today Interview (2013): http://www.usatoday.com/story/life/books/2013/08/16/linda-fairstein-central-park-sex-crimes/2656599/

Sex-assault Case Puts Focus on Police Unit, Not Quite as Seen on TV: http://www.nytimes.com/2011/05/19/nyregion/strauss-kahn-case-puts-focus-on-real-special-victims-squad.html?pagewanted=all&_r=0

Inside the NYPD’s Special Victims Division: http://www.newsweek.com/inside-nypds-special-victims-division-67761

New York’s DA’s Office Trial Division: http://manhattanda.org/trial-division

Crime Library: A Killing in Central Park: The Preppy Murder Case: http://www.crimelibrary.com/notorious_murders/not_guilty/park/4.html

Jennifer Levin’s Mother Remembers “Preppy Murder” Case: http://newyork.cbslocal.com/2011/09/02/jennifer-levins-mother-remembers-preppy-murder-case/

Murderpedia: Robert Chambers: http://murderpedia.org/male.C/c/chambers-robert.htm

Children Of The Night: http://childrenofthenight.org

Sex Slaves: The Psychology of Mastery: http://www.crimelibrary.com/criminal_mind/sexual_assault/sex_slaves/1_index.html

Joyful Heart Foundation

RAINN: Rape, Abuse and Incest National Network

Cleveland Plain Dealer Series on Ohio’s sexual assault kit backlog investigations

Houston Chronicle article re Houston elimination sexual assault kit backlog

The Guardian’s story on Detroit Prosecutor Kym Worthy’s fight to investigate 11,000 abandoned sexual assault kits

Contra Costa Times: “California bill calls for evidence in unsolved, neglected rape cases to get attention”

Inside the Lives of American Sex Slaves: National Geographic

Coalition to Abolish Slavery and Trafficking

 

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Do Identical Twins Have Different DNA?

twins-1

 

DNA profiling is considered the gold standard for individual identification. DNA-containing bodily fluids found at crime scenes can often be linked to the perpetrator with a high degree of accuracy, often measured in one per billions. It is highly individual and therefore highly accurate for identifying a given individual.

But since identical twins begin as the same fertilized egg, they have identical genetic material (DNA). After fertilization, the fertilized egg divides into two cells. To produce identical twins, these two cells separate and then each progresses forward to produce an individual. This results in two identical individuals with identical DNA. Or does it?

Twins egg:sperm

 

Standard DNA testing uses the concept of Short Tandem Repeats (STR’s). STR’s are simply short segments of DNA that repeat in certain areas of the very long DNA strand found in all of us. The number of these repeats in the various locations are what allow DNA profiling to distinguish individuals so accurately. This is a complex, though not really difficult to understand, technique which is discussed in great detail in two of my books: Forensics For Dummies and Howdunnit: Forensics.

DNA Profile

But scientists have known for years that the DNA of identical twins is not perfectly identical. It might or might not start out that way at that first cell division but for sure as the cells divide and the individual grows within the uterus, minor DNA changes can occur. These are on the level of the base pair sequences that make up the DNA chain.

Another DNA technique called Single Nucleotide Polymorphism (SNP) actually looks at each base in the DNA strand and uses this for comparison with another strand to determine if they came from the same individual. This is the direction that DNA testing is going but for now STR remains the method of choice.

Identical twins would look the same using STR analysis but a deeper analysis using SNP would reveal variations, thus allowing identification and separation of two identical twins. Let’s say, blood is left at a crime scene and that blood is matched to a particular individual. Let’s further say that this individual is an identical twin. STR DNA analysis would not distinguish between these two brothers, But if SNP is employed, the one who left the blood at the scene can be distinguished from his identical twin.

The recent French serial rape investigation involving identical twins Yohan and Elwin would be a case in point. Applying the SNP technique in this situation would likely solve the case.

Pretty cool stuff.

Howdunnit Forensics Cover

 

From HOWDUNNIT: FORENSICS:

SINGLE NUCLEOTIDE POLYMORPHISM

Single nucleotide polymorphism (SNP) is a new technique that will likely see increased use in the future. The major problem at present is that it is expensive. We saw that RFLP fragments were fairly long, a drawback that lessens their value in degraded or damaged samples (discussed later). This problem was circumvented by the discovery of STRs, which are very short fragments. But, what if the DNA examiner could use single nucleotide bases as the standard for matching? This would increase the discriminatory power of DNA even further. This is what SNP does.

Let’s say that two sequenced DNA strands looked like this:

CGATTACAGGATTA and CGATTACAAGATTA

If we searched for an “ATTA” STR repeat, these two strands would be indistinguishable

since both have two ATTA repeats. But, with single nucleotide analysis the strands differ by a single base: The ninth base in the first sequence is guanine (G), while it is adenine (A) in the second one. SNP can be used with restriction enzymes in the RFLP technique, or with PCR, where it can be easily automated. Theoretically, this will allow for discriminating two DNA samples based on a single nucleotide difference.

 

Does a PTSD Vaccine Exist?

Post Traumatic Stress Disorder (PTSD) is an increasingly recognized disorder not only among returning military personnel but in others who have suffered ongoing highly stressful situations. The various forms of psychotherapy that have been used for this disorder have led to mixed results and the numerous medications available have side effects that often prevent their use. Not to mention that they don’t always work.

But what if there was a vaccine that eliminated or reduced the effects of PTSD? One that lessened the fight or flight response these memories often illicit?

A group at MIT believes they might have developed just such a treatment. They discovered that a stomach hormone called ghrelin, which has been implicated in helping generate anxiety responses, is released during highly stressful situations, and the more stressful the situation, the more hormone released. The new “vaccine” tends to block the receptors for this hormone and therefore lessen its effects. It is important to note, that the goal of this treatment is not to alter the person’s personality or memories but rather to blunt the psychological and physiological responses to these stress and panic-producing memories. Hopefully with further study this new form of treatment will pan out.

 

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Stress Fracture, the first in my Dub Walker thriller series, dealt with PTSD and new drugs for its treatment. Not vaccines but rather spinoffs of current forms of treatment. Of course the drug in my fictional story is itself fictional but new drugs are continually being produced for this disorder. If this “vaccine” does indeed prove to be effective and with acceptable side effects, the need for developing new drugs would be decreased. We’ll see.

 
6 Comments

Posted by on February 27, 2014 in Forensic Psychiatry, Medical Issues

 

Nip, Tuck, Jump: An Anesthetic Death?

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Beverly Hills is famous for plastic surgery. And famous plastic surgeons. Like Dr. Brian Novak, one the surgeons to the stars. But recently, things didn’t go so well with one of his patients. Like something from the TV series Nip/Tuck, where odd happenings were common, the recent suicide of a 53 year old woman was bizarre and unexpected. Seems she and undergone a face lift, after which she recuperated at the North Camden Drive clinic. At some point she became agitated, confused, ripped off her gown, and now naked climbed to the 10th floor roof where she threatened to jump. Ultimately she did, despite the efforts of a crisis negotiation team.

 

BH Clinic

 

How and why did this happen? I would suspect her tragic behavior had to do with drugs. Not those kind. The medical kind. Anesthetics and pain meds, drugs that work on the brain, the former to induce deep sleep and the latter to reduce the perception of pain. But these drugs can also cause confusion, disorientation, and bizarre behavior. Even delusions and hallucinations. These reactions can be part of the drug’s effects or a reaction to withdrawal or “coming down” from the drugs’ effects. These reactions are often unpredictable and come on quickly, as seems to be the case here. Sad.

 

 

Q and A: Can My Female Character Cause Her Pregnancy To Become A “Stone Baby” By Shear Will?

Q: I am writing a story about a woman who, through sheer force of will, doesn’t allow her body to complete childbirth. The baby dies and becomes a lithopedia. My questions are:

Will there be bleeding in spite of the labor stopping? What happens to the placenta? Will the body absorb it or will it harden like some kind cocoon? Will the mother lactate? Will it cause the mother pain to carry the stone baby? Will the woman have periods? Is it plausible that the mother’s body will experience contractions years later? Or pains caused by the stone baby that she could believe are contractions? How long does it take the fetus to calcify into the lithopedia?

Nicole Nelson-Hicks, Nashville, TN

A: First of all, there is no way she could stop her pregnancy, labor, or delivery by simple force of will. The body will do what the body does and it will eject the fetus either as a stillbirth or a live child. There is no way to stop this.

Secondly, lithopedia (stone babies—singular lithopedion) tend to occur in abdominal pregnancies as opposed to intrauterine pregnancies, even though it is possible for the fetus to remain within the uterus. Conception actually takes place in the fallopian tube as the egg descends and the sperm rises – at least in most cases. A tubal pregnancy can result where the fetus grows within the fallopian tube and rarely the fertilized egg will escape the end of the fallopian tube and settle within the abdomen. Sometimes the blood supply is established and the child can grow within the abdomen. Rarely to term but it can grow. It would take 12 or so weeks for the fetus to reach a size that would be easily visible.

x-ray

In this situation sometimes the tissues of the dead fetus are not absorbed by the body but rather become walled off with fibrous tissue and this can often then calcify which is where the term stone baby comes from.

Lithopedion

Often the woman will have no knowledge of this whatsoever and women have lived late in life, and indeed very late in life, and not know this has occurred. It is often found on an abdominal x-ray that is taken for some other reason. But she could feel the discomfort or have some sensation of a mass or fullness in her abdomen and it could be discovered as a result of that.

If the pregnancy were outside the uterus and in the abdomen, as is most likely in these exceedingly rare circumstances, she would not lactate because those hormones don’t appear until very late in the pregnancy. She would most likely have normal periods, and could even become pregnant again since the uterus, ovaries, and fallopian tubes would be normal and would continue to function normally.

However, if the fetus remained within the uterus, this could interfere with future pregnancies, though not always. It would be very similar to a woman who had large fibroids, which are muscular masses that develop with in the muscular wall of the uterus and often cause pain and abnormal bleeding. Sometimes normal pregnancies occur despite these and that could be the case here.

It is possible that she could experience discomfort many years later with the fetus being located in either the uterus or the abdomen so that part of your story would work quite well.

In summary, this is an exceedingly rare circumstance and it is nothing that she could force to happen. Most likely it would be with an abdominal pregnancy but it could be an intrauterine pregnancy—though this would be even more rare. If an abdominal pregnancy, she could easily go through life normally and have other children and be completely unaware or she can develop symptoms later as I described above. If the pregnancy were intrauterine, she would likely have more symptoms and more likely be aware that something wasn’t right. But in either circumstance it would be possible for her to have normal periods and even become pregnant again.

 
2 Comments

Posted by on January 28, 2014 in Medical Issues, Q&A

 

Hemingway’s Brain: Creativity: Nature or Nurture?

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The argument has continued for hundreds of years. Is creativity inborn or learned? Or a bit of both? Same can be asked about intelligence, musical talent, math wizardry, and just about every other human skill. 

Kenneth Heilman and his colleagues at Cornell University believe they have nudged nearer the answer. It’s called visual-spatial divergent thinking. Big words meaning, more or less, thinking outside the box. Interesting research and an even more interesting concept. 

 

Brain Graphic 

ORIGINAL PAPER

 

Stupid Criminals: Don’t Swallow Your Booty

Joseph Ramos appears to be a three-time loser. Reckless driving, in a stolen car, and, oh yeah, having a stomach full of stolen merchandise. As part of his booking process at the Pinellas, FL jail, he had to pass through a newly-installed, contraband-detection device—-a RAD PRO SecurPass Whole Body X-ray. Deputies noticed “a dark mass near the suspect’s stomach area.” Busted.

 

The necklaces can be seen resting in the stomach. The clear areas above them are gas in the stomach from his swallowing air along with the necklaces.

The necklaces can be seen resting in the stomach. The clear areas above them are gas in the stomach from his swallowing air along with the necklaces.

 

Life Imitating Art? Murder or Accident?

It’s been said that art imitates life and that often life imitates art? Is the death of “spy” Gareth Williams a murder or a tragic case of autoerotic asphyxia? Is it a true mystery anticipated by an author’s question?

 

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The Story:

http://bigstory.ap.org/article/police-spy-bag-probably-died-accident

The Question:

http://writersforensicsblog.wordpress.com/2011/09/18/q-and-a-can-a-murder-be-staged-to-look-like-an-accidental-death-from-autoerotic-asphyxia/

Two other posts on autoerotic asphyxia:

http://writersforensicsblog.wordpress.com/2009/06/02/autoerotic-asphyxia-a-very-bizarre-case/

http://writersforensicsblog.wordpress.com/2009/06/05/autoerotic-asphyxia-redux-david-carradine/

 

 
 
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