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X-Rays in the News

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How far can cameras go to make the personal into the public? Pretty far, considering how many news stories I've seen in the past year illustrated with x-rays, MRIs, and medical tomography. The idea of seeing inside the human body is strange enough, without seeing the weird things that can happen inside the body of someone on the other side of the world. Some of the images in this story may be disturbing to some people.

77-year-old Jin Guangying suffered from lifelong headaches when she was finally x-rayed at Shuyang Leniency Hospital in China. Doctors were stunned to find a bullet in her head! Jin remembered she had been shot during the Japanese invasion in 1943, but had only used herbal treatments for the wound at the time.
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59-year-old Margaret Wegner had a brain scan in Berlin to find the source of her constant headaches. It was a pencil. She had tripped and embedded the pencil in her skull when she was four years old! The bigger part of the pencil was finally removed, but a smaller part was left, as delicate nerves had grown over the 2cm piece.

More curious cases, after the jump.

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A duck with a broken wing in California was x-rayed and found to have an alien from outer space in its gut. The duck did not survive, and an autopsy found the alien was formed by grain in the bird's digestive system. Still, the x-ray was sold via eBay auction to raise money for the International Bird Rescue Research Center in Fairfield, California. Note: this is the only patient in this story who is deceased.
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31-year-old Luo Cuifen went to a hospital in China complaining of blood in her urine. X-rays showed that she had 26 needles embedded in her body, affecting her lungs, kidneys, brain, and other organs. Doctors believe the needles were inserted when Luo was an infant by grandparents who were disappointed that she was born a girl.
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Then there was a curious case reported in The Lancet last summer of a middle-aged man whose braincase was almost completely filled with fluid. His actual brain was reduced 50 to 75% below normal size, but he held a civil servant's job and was not considered mentally impaired or retarded. This scan shows his brain compared with a typical brain on the right.
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Gavin Docherty was hit by a nail gun in a workplace accident. His co-worker immediately drove him to the hospital, but they were stopped by Canada's finest on the way for speeding. After seeing nails sticking out of Docherty's forehead, the officer allowed them to continue to the hospital, but followed them so he could issue the driver a $167 ticket for not wearing a seatbelt!

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This one isn't exactly an x-ray, but it's a 3D medical image showing how a chair leg went through 19-year-old Shafique el-Fahkri's head during a bar brawl. The Melbourne man survived the incident, and medical intervention saved his eyesight.

Although these images are quite sensational, what struck me about this series of stories was the public nature of these cases. All these were news stories I remembered from the past year or two; I didn't have to search for any of them. Excluding the duck, all but one patient are identified by name, and all are from nations other than the US (with the possible exception of the unidentified patient). In the US, privacy laws allow medical images to be shared with medical personnel, insurance companies, lawyers, law enforcement, and others, but not the press. I don't know what the laws governing such images are in other countries; maybe some of you do. Would you consider allowing pictures of the inside of your body to be published by a news outlet? Or does our concept of privacy only apply to our skin?

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Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation
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Medicine
Bill Gates is Spending $100 Million to Find a Cure for Alzheimer's
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Jamie McCarthy/Getty Images for Bill & Melinda Gates Foundation

Not everyone who's blessed with a long life will remember it. Individuals who live into their mid-80s have a nearly 50 percent chance of developing Alzheimer's, and scientists still haven't discovered any groundbreaking treatments for the neurodegenerative disease [PDF]. To pave the way for a cure, Microsoft co-founder and philanthropist Bill Gates has announced that he's donating $100 million to dementia research, according to Newsweek.

On his blog, Gates explained that Alzheimer's disease places a financial burden on both families and healthcare systems alike. "This is something that governments all over the world need to be thinking about," he wrote, "including in low- and middle-income countries where life expectancies are catching up to the global average and the number of people with dementia is on the rise."

Gates's interest in Alzheimer's is both pragmatic and personal. "This is something I know a lot about, because men in my family have suffered from Alzheimer’s," he said. "I know how awful it is to watch people you love struggle as the disease robs them of their mental capacity, and there is nothing you can do about it. It feels a lot like you're experiencing a gradual death of the person that you knew."

Experts still haven't figured out quite what causes Alzheimer's, how it progresses, and why certain people are more prone to it than others. Gates believes that important breakthroughs will occur if scientists can understand the condition's etiology (or cause), create better drugs, develop techniques for early detection and diagnosis, and make it easier for patients to enroll in clinical trials, he said.

Gates plans to donate $50 million to the Dementia Discovery Fund, a venture capital fund that supports Alzheimer's research and treatment developments. The rest will go to research startups, Reuters reports.

[h/t Newsweek]

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Eye Doctors Still Use This 100-Year-Old Test for Color Blindness

You may have seen them at your ophthalmologist's office: large circular diagrams made up of colored dots. People with normal vision are able to discern a number among the dots of contrasting colors. People who are color blind might see only a field of spots.

These elegant, deceptively modern drawings were published 100 years ago by a Japanese ophthalmologist, Shinobu Ishihara. Thanks to the designs' simplicity and diagnostic accuracy, the Ishihara test is still the most popular and efficient way to identify patients with color vision deficiencies.

Born in Tokyo in 1879, Ishihara studied medicine at the prestigious Tokyo Imperial University on a military scholarship, which required him to serve in the armed forces. After graduating in 1905, he worked for three years as a physician specializing in surgery in the Imperial Japanese Army, and then returned to the university for postgraduate studies in ophthalmology. In his research, Ishihara focused on identifying and recruiting soldiers with superior vision, thereby increasing the overall effectiveness of the military. And that became of prime importance to Japan beginning in 1914.

As World War I spread across Europe, Asia, and the Pacific, the Japanese army asked Ishihara to develop a better way to screen draftees for color vision problems. The most popular method at the time was the Stilling test, invented by German ophthalmologist Jakob Stilling in 1878 as the first clinical color vision test. (Previous tools had asked patients to identify the colors of wool skeins or illuminated lanterns—useful skills for sailors and railway conductors, but an imprecise method for diagnosing vision issues.)

"Though popular, 'the Stilling' retained a distinctly 19th-century flavor, more treatise-like and less diagnostically incisive," according to Eye magazine.


Shinobu Ishihara
Wellcome Images // CC BY 4.0

Japanese army officials requested a new diagnostic tool that was easier to administer and interpret. The test Ishihara began to develop was based, like Stilling's, on the principle of pseudo-isochromatism—a phenomenon in which two or more colors are seen as the same (or isochromatic) when they're actually different. A person with normal vision could easily see the difference, while people with red-green deficiency, the most common form of color blindness, would have difficulty distinguishing those two opposing colors. Those with blue-yellow color blindness, a less common type, would have a hard time discerning reds, greens, blues, or yellows.

Ishihara hand-painted circular designs comprised of small dots of different areas and colors so that variations in the design could be discerned only by color and not shape, size, or pattern. Hidden in the field of dots was a figure of a contrasting color that people with normal vision could see, while those with deficiencies could not. Other plates in the series were designed to show figures that would be visible only to people with deficiencies. When physicians displayed the diagrams, patients said or traced the visible figure within the circle without needing to use ambiguous color names, which standardized the possible results.

The earliest sets of Ishihara plates, produced in 1916, were reserved exclusively for the army's use and featured Japanese characters within the diagrams. In 1917, in an effort to sell the series internationally, Ishihara redesigned it with the now-familiar Arabic numerals and published a set of 16 plates as Tests for Colour Deficiency.

The tests were adopted throughout the world beginning in the early 1920s, and eventually grew into a set of 38 plates. But their popularity almost led to their undoing. Unauthorized publishers printed their own version of the plates to meet demand, throwing the accuracy of the diagnostic colors into doubt. "The plates have been duplicated along with an easily memorized key by cheap color processes in the tabloid press, and exposed in public places, reducing the fifth edition [of the collection] to a parlor game," one psychologist warned in the Journal of the Optical Society of America in 1943.

Despite those obstacles, the tests proved indispensable for both practicing physicians and researchers. Ishihara continued to refine the designs and improve the color accuracy of the images into the late 1950s, while he also served as the chair of the ophthalmology department and then dean of the medical school at Tokyo Imperial University. In addition to Tests for Colour Deficiency, he also published an atlas, textbook, lectures, and research studies on eye diseases. But he is remembered most for the iconic charts that seamlessly blend art and science.

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