The Future of Medicine

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The Future of Medicine
Greg Boyd May 3rd, 2000
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Advances outside medicine in the last 50 years

• 1952 EDVAC
• 1952 Hydrogen bomb
• 1953 Color television
• 1954 FORTRAN
• 1960 Laser
• 1961 Yuri Gagarin is the first human in space
• 1969 July 20th Apollo II
• 1971 Food processor
• 1980 Pac Man

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Advances outside medicine in the last 50 years

• 1981 April space shuttle Columbia
• 1981 IBM PC
• 1982 Compact Disc
• 1982 TCP/IP
• 1983 Cellular Telephones
• 1986 Challenger disaster
• 1990 Hubble
• 1992 Web Browsers
• 1998 International Space Station

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Advances inside medicine in the last 50 years

• 1953 DNA is discovered
• 1953 John Gibbon heart operation with a
  heart-lung machine
  
• 1955 Polio Vaccine
• 1956 Merrill, Murray, and Harrison kidney
  transplantation
  
• 1967 Bernard heart transplantation
• 1968 Mc Devitt and Tyan elucidate the immune
  response to MHC

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Advances inside medicine in the last 50 years

• 1978 Tonegawa discovers the genetic mechanism
  of antibody production
  
• 1982 DeVries artificial heart implantation
• 1995 Wilmut clones Dolly
• 2000 Celera Genomics announces completed
  sequencing of the human genome
  
• 2000 Artificial eye spliced to optic nerve, by
  Claude Veraart in Belgium
  
• 2000 First full success of gene therapy in SCID

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Gene Therapy

• Richard Boucher Cystic Fibrosis

• Dr. Alain Fischer of the Necker Hospital in
  Paris

Severe Combined Immuno Deficiency (SCID)
"Both enjoy normal growth and psychomotor deve
lopment. No side effects have been noted
April 28 Science. Each boy has been home for
nearly a year without treatment. They have normal
levels of T, B, and natural killer immune cells
and have been successfully vaccinated
against tetanus, diphtheria, and polio.
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Medical Cybernetics
Kevin Warwick University of Reading Cybernetic
s program www.cyber.rdg.ac.uk Artificial Eyes
Artificial Hearts Artificial Joints and
Limbs
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Cryonics and Cryogenics
Cryopreservation of heart valves for transplant,
porcine islet cells, sperm, eggs.
Cryonics The first man ever frozen was James
Bedford, Ph.D., who was suspended
in 1967. www.alcor.com
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Merging of Pharmacology and Nanotechnology
Enzymes are incredibly efficient natural
nanomachines.
www.foresight.org
Nanotechnology is technology based on the
manipulation of individual atoms and molecules to
build structures to complex, atomic specificatio
ns. (Drexler)
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Merging of Pharmacology and Nanotechnology

• Molecular modeling and drug design
• Nanogen and Clinical Microsensors
• handheld gene scanning technology
• Building transcription factors and other
• designer proteins and amino acid sequences.

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Merging of Pharmacology and Nanotechnology
Coupled with the principles of nanotechnology,
we may contemplate miniature molecular machines
containing directed drug factories, circulating
the body and capable of self-targeting against de
fective cells and pathways -- the ultimate drug
delivery machine. (Triggle)
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Merging of Pharmacology and Nanotechnology
The artificial red blood cell or respirocyte
proposed here is a bloodborne spherical 1-micron
diamondoid 1000-atm pressure vessel with active p
umping powered by endogenous serum glucose, able
to deliver 236 times more oxygen to the tissues p
er unit volume than natural red cells and to mana
ge carbonic acidity. An onboard
nanocomputer and numerous chemical and pressure
sensors enable complex device behaviors remotely
reprogrammable by the physician via externally
applied acoustic signals. (Frietas)
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Cloning and Stem Cells
Some Important Dates in the history of Cloning
1970 Dr. John B.Gurdon (U.K.) clones a frog by
transplanting the intestinal cell of a
tadpole into an enucleated frog egg, which devel
ops into an adult frog. 1978 Birth of first
child, conceived by in vitro (literally in gla
ss) fertilization to Leslie Brown (U.K.).
1984 Dr. Steen M. Willadsen (Denmark) clones a
lamb from a developing sheep embryo cell. His ex
periment is repeated by other scientists who clo
ne a variety of animals. 1993 First humans clo
ned (U.S.). Cells taken from defective human
embryos that were to be discarded in infertility
clinic are grown in vitro and develop up to 32-c
ell stage and then are destroyed.
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Cloning and Stem Cells
1994 Dr. Ned First (U.S.) clones calves from
cells of early embryos. 1995 Drs. Ian Wilmut a
nd Keith Campbell (U.K.) create the world's
first cloned sheep, Megan and Morag, from embryo
cells. 1996 Dr. Ian Wilmut and his team clone
the world's the first sheep from adult mammary
cells. The lamb born in July 1996 is named Dolly
. 1997 Scientists at Oregon Regional Primate R
esearch Center (U.S.) create first primatestwo
rhesus monkeys named Neti and Ditto from
DNA taken from cells of developing monkey
embryos. They are not genetically identical beca
use two different embryos were used.
1997 A team led by Drs. Ian Wilmut and Keith Ca
mpbell (U.K.) create the first sheep with a huma
n gene in every cell of its body. The
genetically engineered lamb is named Polly.
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Oh My God, youve gone too far!!
Uploading Consciousness
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Uploading Consciousness
Dan Dennet in Consciousness Explained
The concept of a lifelong narrative comes abou
t in the theory that the mind is a Von-Neumann ty
pe machine running in emulation on the parallel d
istributed processor that is the brain. This mach
ine keeps a linear track of thought (our memories
and the ineffable quality to them)
that defines who we are. Since the Von
Neumann-type virtual machine is running in emulat
ion, Dennett contends, it is software. And, this
software could theoretically be
transferred, thus transferring consciousness.
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Moores Law and Neurons
Each new chip contained roughly twice as much
capacity as its predecessor, and each chip was re
leased within 18-24 months of the previous chip.
In 26 years the number of
transistors on a chip has increased
more than 3,200 times, from 2,300 on the 4004 in
1971 to 7.5 million on the Pentium II processor
(1998). (Intel Museum Online)
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Machrones Law
Machrone's Law "Gordon Moore just plain got it r
ight . . . I should also mention that Moore's La
w has also given rise to Machrone's Law, which wa
s true for many years, which is that the machine
you want always costs 5,000."
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Moores Law and Neurons
100 billion neurons in the human brain
(Neuroscience for Kids) So, if we want a tr
ansistor for every neuron, we should have it befo
re 2028 if Moores law continues to hold. (assumi
ng a 24 month cycle) (123 billion transistors per
chip)
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Other Medical Prophecies

• Medical imaging advances
• Blending of psychiatry and neuroscience
• Medical computing including computerized
• medical records and billing
• World wide web, realtime, video medical
  consults
  
• Integration of modern western and complimentary
• (alternative) medicine
• More individualized medical care
• Computer and robot assisted surgery
• Tissue made-to-order (stem cells)
• New Diseases
• Most Importantly!
• Advances and terrors currently unimaginable

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What if you dont want some of these advances to
occur?
Everything that has ever been scientifically
possible, from wonderful ideas like antibiotics t
o horrific ideas like nuclear weapons has been ma
de into reality. Discussion, morality, or legisla
tion has neither halted their coming nor substant
ially slowed the pace of their arrival.
(Boyd UNC History of Medicine 2000)
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Resolving Conflicts in Medical Terminology
An example of how not to name discoveries
Mast Cell is from the English and German. Mast
is a nut food for swine. When the true nature a
nd function of these cells are discovered, a new
name will be needed. At present it is suspected t
hey form heparin, and heparinocyte has been sugge
sted as a name for them. (Pepper)
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Achilles Tendon
He deserves to name it
The infant Achilles was dipped in the river Styx
by his mother to render him impervious to
wounds. She held him by the heel, which remained
vulnerable, and it was in the heel that he was fa
tally wounded by an arrow at the battle of Troy.
The name is first used in anatomy by Verheyde
n in 1693, while dissecting his own amputated leg
. (Pepper)
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References
WWW.CNN.COM in Specials section for 20th Century
History Dennett, Daniel, C. Consciousness Expl
ained. Little, Brown, and Company.
New York. 1991. Drexler, Eric. Engines of Cr
eation The Coming Era of Nanotechnology.
Double Day Publishing New York 1990. 
Freitas RA Jr. Exploratory design in medical nan
otechnology a mechanical artificial red cell.
Artificial Cells, Blood Substitutes,
Immobilization Biotechnology. 26(4)411-30, 1998
Jul.   Kids Almanac web page http//kids.infopl
ease.com/ipka/A0770279.html The history of clonin
g. Naik S. Santangini HA. Trenkler DM. Mullon C
J. Solomon BA. Pan J. Jauregui HO. Functional rec
overy of porcine hepatocytes after hypothermic or
cryogenic preservation for liver support
systems. Cell Transplantation. 6(5)447-54, 1997
Sep-Oct. Neuroscience for Kids web page http//
faculty.washington.edu/chudler/introb.html
Pepper O.H. Perry, Medical Etymology The Histor
y and Derivation of Medical Terms for Students of
Medicine, Dentistry, and Nursing.
W. B. Saunders Company Philadelphia 1949.
Timeline of philosophers http//www.trincoll.edu
/depts/phil/philo/timeline.html
Triggle DJ. Rho Chi lecture. Pharmaceutical scie
nces in the next millennium. Annals of Pharmacoth
erapy. 33(2)241-6, 1999 Feb.
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Just the beginning. . .