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Web-only Exclusives
November 30, 2000

From Our Correspondent: Hirohito and the War
A conversation with biographer Herbert Bix

From Our Correspondent: A Rough Road Ahead
Bad news for the Philippines - and some others

From Our Correspondent: Making Enemies
Indonesia needs friends. So why is it picking fights?

Asiaweek Time Asia Now Asiaweek story

TOMORROW'S WORLD

By Peter Siu


Check-Up Reading Asia's Vital Signs

Challenges Hospitals face up to changing times

Crisis Medical facilities are barely coping in Indonesia

Checklist How hospitals stack up

Rights Patients push for a bigger say

Rural Warriors A humanitarian organization trains an army of doctors in China

The East The future of traditional Asian medicine

The West Americans are turning to alternative therapies

Therapy Sang Lan: The injured gymnast hopes to walk again

Celebrities The "inside" stories of people in the news

Longevity The latest on staying healthy in Asia

FROM LEONARDO TO LASER beams, technology and medicine have always been blood brothers. Scientific advances are quickly pressed into service in hospitals and laboratories as we struggle to understand the most complex machines of all - our own bodies. Ideas that were once the preserve of the Sci-Fi sick-bay are now being beamed into every emergency room. From welding shut wounds with light to injecting drugs with sound: here are a few of the advances that will turn today's techniques into tomorrow's museum pieces:

Soon DIABETICS should be able to dispose of their needles for good. Sufferers of diabetes are deficient in insulin, a hormone that regulates blood-sugar levels, and must inject themselves with it regularly. Researchers in California have begun trials of a dry-powder aerosol system that will allow insulin to be inhaled instead and tests should be complete within three years.

DIABETICS will also benefit from another alternative to injections. Scientists have discovered that acoustic waves created by laser pulses or ultrasound can create temporary pores in the skin large enough for molecules to pass through. That will mean an end to the thrice-daily routine of pricking the skin to testing glucose levels that diabetics currently endure.

Electrical-stimulation is helping PARKINSON'S DISEASE sufferers. A device implanted in the chest sends electrical pulses to the brain via a wire and reminds wayward muscles how to work properly. Initial trials at the University of Kansas have been remarkably successful with some patients dressing themselves and carrying out other mundane tasks for the first time in years.

The debilitating bone-thinning disease OSTEOPOROSIS, which typically strikes post-menopausal women, may now be detected quickly and cheaply in its early stages. Using ultrasound, a portable machine developed in Israel takes just minutes to measure a patient's bone quality and compare it with the average for someone of the same age, sex, height and ethnicity.

Scientists have long known that CANCER is a subtle disease of genes gone bad, but treatment has still been limited to cutting out growths then blasting away with chemical and radiation therapy. Now drugs aimed at fixing the bad genes and leaving healthy cells alone are on the way. The first, a treatment for breast cancer called Herceptin, should be out in the U.S. in the fall.

Women being tested for BREAST CANCER may soon be able to forgo x-ray mammographies or painful biopsies. The "electric bra" sends electric currents through the tissue to create a computer image of the breast and highlight possible growths. The technique is ideal for younger women who respond poorly to mammographies because of the density of their breast tissue.

ULTRASOUND is getting a lift from air bubbles.Injected into the bloodstream, the microscopic bubbles can reflect sound waves back from the tiniest capillaries offering clearer pictures from any part of the body. The hope is that the bubbles can one day be used to identify cancerous tumors by their unique blood vessel branching, and even gauge their size and the chances the growth might spread.

Digital technology is even reaching into the radiology room. Ten years in development, DIGITAL X-RAY PHOTOGRAPHY is now with us, swapping traditional film for a detector that translates the image into pixels on a television screen. That saves both time and money, while the resulting digital images can be easily magnified, enhanced and stored or even transmitted to another hospital.

People with DAMAGED URINARY BLADDERS could soon get a new bladder custom-grown from a lab. Donor tissue for patch-up jobs is in short supply and the only alternative, intestinal tissue, is not elastic enough to do the job well. The new technique, pioneered at Harvard, allows doctors to create an entire healthy bladder from a small piece of tissue grown in a bladder-shaped mold.

The immune system is now being used to fight OBESITY. Antibodies injected into the patient are used to flag fat cells for the body's defenses to kill off. It works on fat rats - apparently a good model for overweight humans - and because the fat cells are actually destroyed, weight loss is permanent. The rats stayed slim despite eating just chocolate and nuts. A good diet and regular exercise still help, of course.

Researchers are learning to limit BRAIN DAMAGE caused by strokes and near drowning. Brain cells do not die immediately when deprived of oxygen, instead they "commit suicide" up to 12 hours later by releasing a protein-shredding enzyme. An enzyme blocker which stops this process has successfully reduced brain damage in rats and human trials could begin soon.

If you avoid the dentist, fearing the whine of his drill, it may now be safe to make an appointment. A new procedure uses LASERS to vaporize cavities. Its use is still limited - the light cannot bend to reach back teeth and can cause damage if it hits existing silver fillings - and it is expensive, too. But it is painless, so at least you can grit your teeth while paying through the nose.

Good news for those with HEART TROUBLE. Radio signals are proving valuable in detecting the risk posed by cholesterol, while a new system (based on burglar-alarm technology) can detect clogged arteries by listening to the sound of blood flow. If you find you have a problem, genetic engineering can now be used to stimulate new blood vessels to grow around your heart.

The difficult search to find perfectly-matched donors for BONE MARROW TRANSPLANTS could soon become unnecessary. Rejection is caused by "T cells" transplanted from the donor ordering an attack on the cells of the patient receiving the transplant. A new technique successfully screens out the T cells, and may be used to help prevent rejection in organ transplants, too.

HIP REPLACEMENT operations are common now, but new developments may make the need for them a little less frequent. Joint implants work loose after a few years, but a new coating to better bond bone with the titanium used for hip and knee implants could provide a fit that stays tight for decades.Surgeons are also handing the tricky job of drilling the bones over to precise robots.

The fight to contain AIDS has been boosted by the development of a urine test for the HIV virus. Only 10% of the 30 million people estimated to be infected with the virus are aware they are carriers. Easier, cheaper and safer to conduct than blood tests, urine tests will be particularly valuable in China, India and Southeast Asia where AIDS is spreading rapidly.

The ubiquitous INTERNET is facilitating consultations between doctors from different hospitals. X-rays and other images can be sent in an instant and discussed via interactive video. The Net is particularly useful for doctors working in very remote areas, who can diagnose and treat patients despite limited equipment and expertise by linking up with specialists at bigger hospitals.

The first large-scale trials of an AIDS VACCINE are underway. In June, 5,000 American volunteers were inoculated with the would-be wonder drug - or given a worthless placebo. Researchers conducting the controversial experiment, must now wait several years to see if any of their high-risk subjects contracts the disease. Inoculations are planned for a further 2,500 volunteers in Thailand.

For those who have DAMAGED CARTILAGE due to sports injuries or arthritis, a transplant could be the answer. The procedure takes cartilage cells from the patient and multiplies them in a lab before putting them back into knees and other joints. The technique has been around for several years but is only now becoming widespread. The next challenge is to make the operation less invasive - and cheaper.

California's Lawrence Livermore Laboratory is best known for developing high-tech weaponry, but recently its scientists have trained their lasers on healing rather than destroying. Using a computer program developed to research nuclear fusion, they are simulating how LASER LIGHT interacts with tissue. Their goal: to weld tissue and eventually eliminate the need for needle-and-thread stitching.


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