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Battlestar Galactica returns

The final season of Battlestar Galactica begins tonight. Ten episodes now, an undetermined break, then ten more to finish things off. Let it be known that this is the best science fiction television series ever. Star Trek can claim to be the first great television science fiction series, but it can no longer claim to the best.

I'm not linking or reading anything about it. I prefer to be surprised later tonight.

Housewatch episode 4.12

Last night's solution to House was incredibly easy to understand, so I'll focus a bit on physiology instead.

The woman (Sarah Silverman's sister for those of you not watching the credits) had nephroptosis, or floating kidney. Everytime she stood up, her kidney slid down lower into her pelvis. She lost blood pressure, and she fainted and her breathing stopped. It's called orthostatic hypotension. The kidney is suspended in the pelvis by connective tissue. It can move easier than most organs. Since we can bend at the waist, this is a good thing.

So, why were they saying everything was backwards? In a healthy person, when you stand up your heart rate and blood pressure go up a little. If they didn't, you'd faint. With the head now above the heart, it takes more work to get blood to the brain, so the heart pushes a little harder, and then circulatory system tightens up a little, so the blood is less likely to trickle backwards.

Housewatch 4.10

It's been such a long time since a new episode of House, M.D., I almost forgot about my resolution to try and explain some of the science and medicine behind the show.

This week, the woman had breast cancer. But it wasn't in her breasts, it happened to be behind her knee. So how did it get there? It wasn't metastasis. Rather, it was a developmental abnormality that left her with some breast tissue that should have been resorbed before she was born.

So, we have to digress into embryology and teratology, which is embryology gone wrong. Many tissues are created, sorted out, grown, trimmed and pruned as an embryo becomes a fetus and then a baby. In the woman's case, a small patch of breast tissue wasn't properly disposed of during development, and it later became cancerous. 35 is young for breast cancer, but they did mention her mother died of it and that the patient had a prophylactic double mastectomy.

Was that really breast milk House extracted from the knee? Yes. Risperidone can stimulate breast tissue to produce milk.

So the women's treatment became a standard course of surgery and chemotherapy.

Finally, it's worth mentioning osteopetrosis (literally, bonestone). It's rare, basically the osteoclasts, which are supposed to clip and remodel bone, are defective. Or carbon anhydrase deficiency can lead to mildly acidic blood, which alters bone metabolism.

Robotech returns on Space

OMG! Robotech is back on the Space channel, beginning on January 7. I loved this show when I was in grade 7 and 8. I will be curious to see if I still do.

Housewatch - Episode 4.8

A little bit delayed, since I knew this would be an unusual episode to explain. (I have kept it very simple. Many of the dirty immunological details have been ignored.) Anyway, the patient had lupus, which is an autoimmune disease. The body's immune system loses its ability to distinguish self from non-self, and attacks its own tissues.

Why was it so hard to catch? Basically, he didn't show the usual symptoms, including the characteristic "butterfly" rash, which spreads across the face under the eyes. In the patient's case, a transfusion of improperly matched blood was affecting his blood cells, which was causing most of his symptoms, and masking or overlapping many of the lupus symptoms.

The explanation was really rushed at the end, but the ultimate problem was the patient had type A blood, while they thought he had AB. So, when given AB, he had a violent reaction to it, which was causing all the bloody episodes. They gave him type A blood and steroids to control the lupus, and he recovered.

Like I said, a lot of immunological difficulties have been swept under the rug.

Random speculations: Big Love got the axe this week, and was turfed for disloyalty. A little surprising, I thought his religion would keep him in. I think 13 is next. If she has Huntington's, she's out of there. Either way, she appears to have a fatal flaw that will get her kicked out soon. I presume the plastic surgeon will go, due to age, leaving us with Amber and Kutner to form the new team, along with Foreman.

Housewatch - Episode 4.7

A great convergence of ideas this week on House, M.D., but probably not the way the producers intended.

This week's patient had Lyme disease, an infection you get through tick bites. The tick carries a bacteria that it gets from deer and other large forest creatures. It's named for Lyme, Connecticut, and is prevalent throughout New England.

The disease wasn't found very quickly, because the characteristic bulls-eye rash at the site of the bite was hidden under his hair.

Sound familiar? It should. Scrubs used the exact same plot three weeks ago.

Convergent evolution? Two shows of writer independently coming up with the same idea? Unlikely. Most likely, the writers and medical advisers read the same news story or journal article and thought that would make a good story.

One can only imagine the groans from the staff of House, M.D., as they realize Scrubs has beat them to the plot!

If caught in time, Lyme Disease is treatable with antibiotics. If you want to hear an endless "he said, she said" debate, google "post-Lyme syndrome".

Housewatch - Episode 4.4

This week on House, the girl was unfortunate enough to have ergotism, a historically common, but now rare, disease.

Ergotism is a result of poisoning by ergot, a fungus (Claviceps purpurea) that grows in rye, and other cereals. In this episode, the patient was baking her own organic rye bread at home. So, she ate it, and the toxins produced by the fungus caused the illness.

The mold can continue to grow in the rye, and secrete a toxin that causes a variety of neurological effects, which can lead to seizures and hallucinations, both of which the patient had. It's also possible to have vascular effects, such as the bleeding the patient had. In worse cases, limbs can fall off.

There isn't a specific antidote, but it can be controlled with drugs that help the blood flow and sedatives for cases of hallucination.

Recently (OK, 1976), ergotism has been as a suggested cause of the Salem Witch Trials (original scientific journal article here). (I was just in Salem.) Briefly, in 1692 a bunch of girls accused people of being witches. Twenty people (men and women) died, 19 by hanging, and 1 by crushing.

Ergot poisoning has been a suggested cause, which largely, but not completely, accounts for the symptoms demonstrated by the girls. Others think they were just evil bitches.

And now, some speculation on what doctors will remain. Amber (blonde doctor) will survive, because she's been given a lot of lines, seems about as amoral as House, and is very ambitious, all traits that House will like. (Or perhaps she could be too similar, and get turfed like the old guy did this week.) The Indian guy will survive, because I've seen him in other shows, or movies. I don't remember. He's not a nobody. The black guy will probably end up part of the team too, because House can pick on him for religion, and therefore have a few religious dilemmas this season. And they wouldn't want to have a team of all-white doctors. That begs the question, where are the Asian doctors? (I can't recall ever seeing an Asian doctor on the show), who tend to have the highest marks on entering and leaving medical school.

The white guy disappears, because he's hardly said a word. The brunette doctor disappears because there can't be two women on the team, though I could see her staying on because she's the most attractive of the group. And the surgeon goes, because he's already a doctor and can simply return to practice.

Another moment of hilarity: Chase suddenly being a accomplished surgeon. Fine for tv, but in the real world, I don't think people realize just how far apart surgery and medicine are. Surgery is carpentry and sewing, medicine is pills, IVs and tests.

Housewatch, episode 4.2

Last night on House, M.D., the young Air Force pilot was finally diagnosed with Von Hippel-Lindau disease, a rare genetic disorder that causes abnormal growths throughout the body. The process, called angiomatosis, leaves the patient with cysts or tumors scattered throughout the body. The pilot happened to have hers in the liver and brain, although the blood vessels, kidney, pancreas and retina of the eye are common locations too. It occurs worldwide, in about 1 in 32,000 people.

The gene that causes the disease is located on chromosome 3. It is a tumor suppressor gene, which, when lost, lets cellular division go out of control. This can lead to the overgrown blood vessels, which turn into cysts and in the worst cases, cancer. It is an autosomal dominant disorder, which means only one copy is needed for the disease to occur.

Chase showed up to posit that the pilot's panic attacks were caused by a pheochromocytoma, a known early sign of Von Hippel-Lindau. (One researcher has suggested pheochromocytomas aggravated the Hatfield-McCoy feud. ) A pheochromocytoma is a small tumor in the adrenal glands on top of the kidneys that secretes too many stimulating hormones, like adrenaline, into the bloodstream. This is logical, considering VHL can often cause abnormal growths in the kidneys.

The pilot's original complaint was synesthesia, which is a confusion or overlapping of the senses. The most common form is associating sounds with colors. For instance, a flute would be associated with bright red. I searched PubMed for "synesthesia and von" and "synesthesia and hippel". Both came up with zero results, so I wonder if the writers just made that up.

Addendum: Given that Cameron was only onscreen for 60 seconds, she still managed to be quite annoying. House was right, she did look like a cheap hooker. Dark hair and blue eyes is a much better combination.

Lost - Juliet revealed

Who knew Juliet had such a nice body underneath all those layered outfits she's always wearing? Booyakasha!

24 Premiere

I enjoyed the premiere of 24. Not quite as thrilling as other seasons, but it was easy to be hooked.

I have to admit I laughed a few times.

1. When Jack goes all vampire and kills a guy by biting his neck.
2. When Jack kicked the suicide bomber so hard he flew out the back door of the subway. I've only ever seen sliding doors, not hinged, swinging doors on subways.
3. Watching Jack move around rather nimbly after being stabbed in major nerve bundles of the arm and spine. Right.
4. President Palmer v.2: Jack was right. We were all wrong.
5. Seeing Jack punch in the coordinates of the terror cell, then having a Sprint commercial for a phone that can do the same thing immediately after. Nice marketing collusion.

I hope my laughter isn't a sign of continued cheesiness. I want the show to settle into its normal groove.

House and heroin

It's only a guess, but I think this will be a future episode of House. It's got drugs (heroin), medicine, a stinky, deadly wound (botulism) and a large potential for misdiagnosis. We'll have to wait until the fall to see, probably.

Jesse Jackson is crazy

Really, he is. The only thing that not buying the next set of Seinfeld DVDs to protest Michael Richard's recent rantings will help is Jackson's own sense of importance, which clearly doesn't need more inflation.