New model may help scientists better predict and prevent influenza outbreaks

Each year, the influenza virus evolves. And each year, public health officials try to predict what the new strain will be and how it will affect the population in order to best combat it.

A new study by an international team of researchers, led by assistant professor Andrew W. Park, who holds a joint appointment in the University of Georgia Odum School of Ecology and in the College of Veterinary Medicine, may make their task a little easier. The study breaks ground by working across scales and linking sub-molecular changes in the influenza virus to the likelihood of influenza outbreaks. The paper, published in the Oct. 30 edition of the journal Science, shows the relationship between the evolution of the virus and immunisation rates needed to prevent an outbreak in the population.

Park explained that these findings can help inform efforts to prevent future outbreaks. “Public health officials will be able to assess the usefulness of a vaccine based upon its relationship to the current influenza strain and the population’s immunity level,” he said.

Through previous vaccinations or infections with earlier strains of the influenza virus, many individuals already have some level of immunity, Park noted. The influenza virus is continually evolving, however. By substituting different amino acids at key molecular points, the virus increases its chances of evading the immune system’s defenses, allowing it to reproduce and spread.

As the number of amino acid differences between a new strain and the strain an individual was vaccinated against increases, the likelihood of becoming infected increases, Park said, as does the likelihood of becoming infectious and the length of time they will remain infectious. These factors combine to increase the chance of an outbreak in a population.

Working with equine influenza, the research team looked at the likelihood of an influenza outbreak in a population that had all been vaccinated with the same strain of the virus. They found that outbreaks began occurring when there were two or more amino acid differences and that the size of the outbreak increased with the number of amino acid differences. They also found that large outbreaks were more likely to occur if the virus and the vaccine were from different antigenic clusters – meaning that a host's immune system perceives the two strains as different. Comparing these results with an earlier human influenza study revealed similar trends.

Another key factor in determining the risk of an outbreak in real populations, however, is the individual variation of immunity in the population. Because the virus keeps changing, so do the vaccines used against it. This causes the immunity of the population to be heterogeneous – some individuals have been infected with or vaccinated against last year’s influenza strain, some against strains from previous years, and some have no immunity at all. Park and his colleagues found that the degree of variability of immunity in the population plays a crucial role in determining the risk of an outbreak.

Park added that in measuring for the first time how the difference between the population’s immunity status and a new virus strain influences the risk of an epidemic, the team has taken a critical step toward linking these relationships with the dynamics of epidemics, not just for influenza but for a wide range of infectious diseases.

Identifying molecules in infrared could lead to new medicines

For the first time, researchers can use infrared spectroscopy to determine what type of bonds protein molecules contain and to identify materials. The new technique has been sought to overcome several limitations of the current, standard technique. Photo: Hatice Altug, Electrical Engineering Department, Boston UniversityAn interdisciplinary team of researchers has created a new, ultra-sensitive technique to analyse life-sustaining protein molecules. The technique may profoundly change the methodology of biomolecular studies and chart a new path to effective diagnostics and early treatment of complex diseases.

Researchers from Boston University and Tufts University near Boston recently demonstrated an infrared spectroscopy technique that can directly identify the "vibrational fingerprints" of extremely small quantities of proteins, the machinery involved in maintaining living organisms.

The new technique exploits nanotechnology to overcome several limitations of current, conventional techniques used to study biomolecules. "It allows identification of a protein by directly analysing its vibrational fingerprint signatures," said team leader Hatice Altug, an assistant engineering professor at Boston University. "It may lead to a new toolkit for studying biomolecules."

The advance is reported in this week's edition of the Proceedings of the National Academy of Sciences. The National Science Foundation supports the research.

Previous bio-molecular study methods commonly use fluorescence spectroscopy, where biomolecules are labeled with very bright fluorescence tags to track how efficiently they interact with each other. Understanding interactions is important for medical drug research.

Fluorescence spectroscopy is quite sensitive at the single molecule level. However, the tags can be as big as the biomolecules themselves and interfere with the biomolecular interactions.

"There is currently a need to develop label-free bio-detection technologies," Altug said. "Infrared spectroscopy is a label-free method, because if you tune your ‘eye' to the infrared frequencies, you can directly see the bio-molecules without any labels."

Molecules consist of atoms bonded to each other with springs. Depending on the mass of atoms, how stiff these springs are, or how the atoms' springs are arranged, the molecules rotate and vibrate at specific frequencies similar to a guitar string that vibrates at specific frequencies depending on the string length. These resonant frequencies are molecule specific and they mostly occur in the infrared frequency range of the electromagnetic spectrum.

The sensitivity of infrared spectroscopy previously had been too low to detect these vibrations, particularly from small quantities of samples. The new method demonstrated by Altug's graduate student Ronen Adato and her post-doctoral fellow Ahmet Ali Yanik combines the strengths of nanotechnology and nanophotonics and overcomes the problems that prevented past use of infrared spectroscopy.

"We use arrays of tiny gold nanoparticles as efficient plasmonic nanoantennas to greatly amplify the ability to detect a molecule's inherent frequency," says Yanik. With their technique, the team obtained vibrational signatures from nearly 145 silk proteins deployed at the tip of each nanoantenna.

"Our technique gives researchers an ability to enhance inherent vibrational signatures more than 100,000 times," says Altug. "This allows us to sensitively study molecular structures and biological functions of extremely small quantities of molecules."

Altug anticipates that these new tools someday will help researchers design drugs, minimising the complications of life-altering diseases such as cancer and Alzheimer's. "This advancement is fundamentally important for bio-chemistry," she says.

"Our plasmonic method is quite general and can also be adapted to enhance the infrared fingerprints of other molecules than proteins" said Altug. "It therefore provides a general purpose toolkit and may help amplify chemical sensing capabilities that are of particular concern to national defense."

EU double standards threaten to leave poor countries without medicines

New report by Oxfam International and Health Action International Europe.

The European Union is contradicting world trade rules by putting the interests of big drug companies before the 2 billion people in the world who cannot access essential medicines, according to a new report issued today by Oxfam International and Health Action International Europe.

The EU’s actions also undermine its obligations to achieve the Millennium Development Goals, as well as World Trade Organisation agreements.

The report coincides with recent news that India and Brazil are filing a complaint against the European Commission at the WTO after the Netherlands seized anti-HIV and other medicines earlier this year. The medicines were going from India via Europe to Brazil, Colombia and Nigeria.

The report says that, since late 2008, Germany as well as the Netherlands has made customs seizures together totaling 19 shipments of generic medicines bound for developing countries. Oxfam and HAI (Europe) say the generic shipments were legitimate under WTO rules.

The EU is increasing pressure on developing country governments to surrender their rights to obtain affordable, generic medicines in order to protect public health, even though these rights are guaranteed under global trade rules, the groups say.

The EU is also insisting on tough new intellectual property rules in bilateral free trade deals that go beyond the WTO’s existing TRIPS agreement.

The EU is pushing these measures that will result in higher medicine prices in developing countries at the same time it is trying to reduce domestic medicine prices. Twenty-four out of 27 EU Member States have taken steps to implement price controls for medicines.

Furthermore, the European Commission is carrying out a high profile investigation into the pharmaceutical industry for intellectual property abuses in the European Union, and is contemplating action against these companies.

Elise Ford, Oxfam head of EU advocacy, said: “The EU is guilty of double standards. One rule for the rich and another for the poor. A crackdown on European pharmaceutical prices is happening alongside a concerted effort to further push intellectual property rules that prevent poor countries from buying affordable medicines.

The EU’s policies are increasing the cost of medicines. This is hitting the poorest people in developing countries disproportionately hard, as 20-60 per cent of their health budgets are spent on medicines.

“Millions of poor people have to pay for medicines out of their own pockets so even a small price rise can make them unaffordable. Europe’s policies are directly responsible for this scandal,” Ford said.

The EU’s trade policies demand that developing countries protect the interests of drug companies above public health priorities, and the EU demands exceed even those made by the much-criticised US administration of President Bush.

Sophie Bloemen, Projects Officer for Health Action International Europe, said: “The EU must accept its moral and legal obligations. There is growing evidence that the EU’s trade agenda is causing severe damage to public health in developing countries.”

The report details a number of other EU policies that are damaging access to medicines in developing countries including:
•promotion of a new global framework to enforce Intellectual Property rules which delay access to generic medicines in developing countries, including through seizures of legitimate medicines;

•obstructing progress at the World Health Organization towards new models of research and development that meet health needs in developing countries;

•and spending on R&D for developing countries that remains insufficient in spite of increases in recent years.

These policies lack coherence and undermine broader EU development objectives to promote access to health care. While the EU is increasing funding to improve health care for European citizens, it is denying developing countries the affordable medicines they need to ensure good health, the report says.

“It’s time that the EU joins up its policies. Both the EC and Member States must promote access to health care in their development policies and access to affordable medicines through their trade policy,” Ford said.

Anti-oxidants can cause diabetes: new research

Professor Tony Tiganis and Kim LohAn international team of scientists, led by Monash University researchers, has found that anti-oxidants commonly touted for their health-promoting benefits, could contribute to the early onset of Type 2 diabetes.

The team, led by Professor Tony Tiganis from the Monash Department of Biochemistry and Molecular Biology, has found that molecules known as Reactive Oxygen Species (ROS) may play a protective role in the early stages of Type 2 diabetes by enhancing insulin action. Anti-oxidants prevent the beneficial effects of ROS.

The team showed that when ROS levels were elevated in muscles of genetically-modified mice they could prevent the onset of insulin resistance and diabetes that is induced by a high-fat diet.

However, when these animals received anti-oxidants, which 'mop up' ROS, the improved insulin response was lost and the mice became more 'diabetic'.

The findings, published today in the journal Cell Metabolism, challenge the widely-held view that ROS are always harmful and that anti-oxidants are always beneficial.

"ROS molecules, such as hydrogen peroxide, are important for normal cell function. We have shown that ROS present in muscle enhance insulin action and help lower blood sugar levels," Professor Tiganis said.

"However, our studies do not negate the role of ROS in late-stage disease. There's a 'yin and yang' relationship that takes place, wherein ROS are beneficial in the early stages of Type 2 diabetes and shift to being harmful at later stages of the disease. We are now trying to find out when ROS make the switch from being 'good' to 'bad'.

"Although we need to undertake further studies in humans, our results indicate that the widespread use of anti-oxidants by the general public as a preventative measure is something that should be discouraged, particularly if you are otherwise healthy," Professor Tiganis said.

"Eat healthy and exercise as this is a natural source of ROS that promotes insulin action."

Professor Tiganis led a team of 12 Monash researchers, scientists from the Baker IDI Heart and Diabetes Institute, University of Melbourne, and Cold Spring Harbor Laboratory in the US.

Bayer sued over unsupported prostate cancer claims

Photo: Jeff CroninDrug giant tries to silence whistleblower with threat of libel suit

The Center for Science in the Public Interest (CSPI) has sued the German drug company Bayer for falsely claiming that the selenium in Men’s One A Day multivitamins might reduce the risk of prostate cancer. The lawsuit is filed in the Superior Court of California in San Francisco.

CSPI first contacted Bayer in June to demand that the drug maker alter its marketing of Men's One A Day because the largest prostate cancer prevention trial ever conducted found eight months earlier that selenium supplementation does not prevent prostate cancer. More alarmingly, that study and another found that selenium supplements may increase the risk of diabetes.

A day after CSPI contacted Bayer, the FDA issued a letter containing qualified health claim language for use on labels that said, in part, that it was "highly unlikely that selenium supplements reduce the risk of prostate cancer." That forced Bayer to alter much of its marketing, but it pointedly refused to recall existing packages bearing the false claims. The company also refused to remove all false prostate claims from some marketing for Men's One A Day, and failed to put in writing that it will not make those claims in the future.

"Given Bayer's long history of wrongdoing in other cases, CSPI is acting to ensure that Bayer is permanently stopped from deceiving consumers about selenium," said CSPI litigation director Stephen Gardner.

The largest prostate cancer prevention trial ever conducted found that the mineral selenium was no more effective in reducing prostate cancer risk than a placebo. That trial, the Selenium and Vitamin E Cancer Prevention Trial, known as SELECT, was halted early when it became clear that the men were not benefiting from selenium and may have developed more cases of diabetes than men in the control group. Another study of selenium and prostate cancer found an alarming three-fold increased risk of diabetes among men taking selenium.

Writing about the SELECT trial in the Journal of the American Medical Association, Dr. Peter Gann of the University of Illinois at Chicago cautioned that "physicians should not recommend selenium or vitamin E, or any other antioxidant supplements, to their patients for preventing prostate cancer." Hopes that selenium might be beneficial to the prostate were further dashed when a 2009 study of men with prostate cancer found more aggressive cases of the disease in men with high selenium blood levels and a common genetic trait shared by three out of four men.

"Bayer has been giving American men false hope about the selenium in One A Day multivitamins," said CSPI executive director Michael F. Jacobson. "Bayer continued to run deceptive ads even after SELECT found that selenium supplements weren’t helping and might even be hurting."

In a recent letter to CSPI, Bayer threatened to sue CSPI for libel for calling attention to Bayer’s selenium claims. Much of Bayer's courtroom experience, however, comes as a criminal or civil defendant.

Evidence of corporate malfeasance galore

In 2001, Bayer paid USD14 million to US and state governments to settle allegations that the company's actions helped health care providers submit inflated Medicaid claims for drugs.

In 2003, Bayer pleaded guilty to a criminal charge and paid USD257 million in fines and penalties after a whistleblower exposed a scheme by the company to overcharge for the antibiotic Cipro. Media accounts at the time described it as the biggest recovery for Medicaid fraud.

In 2004, Bayer pleaded guilty to a criminal charge and paid a USD66 million fine after a Justice Department investigation into Bayer’s role in a price-fixing conspiracy involving a chemical used to make rubber products. Two Bayer executives separately pleaded guilty and were sentenced to prison for their role in the scandal.

In 2007, Bayer paid USD8 million to resolve allegations by state attorneys general that the company failed to warn physicians and consumers about safety issues surrounding its cholesterol-lowering drug Baycol, which is no longer on the market.

Bayer has even gotten into hot water with the federal government in the past over its One A Day marketing. In 2007, it paid a USD3.2 million civil fine as part of a consent decree reached with the Federal Trade Commission and the Department of Justice. The case centered on weight-loss claims that the FTC said violated an earlier order requiring that all health claims for One A Day be supported by competent and reliable scientific evidence. CSPI says that Bayer's prostate claims for Men’s One A Day violate the consent decree, which could compound the company's legal problems.

And this year, Bayer was required to run a USD20-million corrective advertising campaign about its birth control pill Yaz, and to submit its ads for FDA approval, as part of a legal settlement secured by a number of state attorneys general and the FDA.

"Bayer's threat to sue CSPI is clearly designed to have a chilling effect on free speech and to intimidate us into silence," Jacobson said. "I'm confident, however, that the FTC, the FDA, and the courts will all take careful note of the facts of this case, as well as Bayer's long history of flouting the law. It takes a lot of chutzpah for a company with such a long record of corporate malfeasance to level libel charges against a nonprofit organisation."

CSPI is suing on behalf of itself and its members, and is represented by its in-house litigators Stephen Gardner and Katherine Campbell, alongside Harry Shulman of The Mills Law Firm of San Rafael, Calif., and Washington, D.C.-based lawyers Steven N. Berk and Chris Nidel.

India rejects patents on two HIV drugs

India has rejected patents on two life-saving HIV/AIDS drugs, tenofovir and darunavir. Tenofovir is a key HIV/AIDS drug recommended by the World Health Organisation for improved first-line treatment of HIV/AIDS. Darunavir is one of new class of expensive HIV/AIDS drugs that are needed by patients failing on their existing treatments. Access to both medicines is currently limited by their high price.

"This is a really important day for HIV patients in developing countries. The rejection of the patents on tenofovir opens up the market for new generic competitors to drive down the price of this key HIV/AIDS drug," says Michelle Childs, Director of Policy at Medecins Sans Frontieres' (MSF) Access to Essential Medicines Campaign.

"Gilead now needs to remove any remaining contractual provisions that stop some generic companies from supplying tenofovir to other countries where there is no patent, for example Brazil where the patent on tenofovir has also been rejected."

"The decision regarding darunavir is significant because the drug is one of the newest and most expensive of HIV/AIDS drugs.These decisions highlight the success and importance of Section 3(d) and opposition procedures in India's patent law to safeguard public health. Other countries which need access to affordable essential drugs should look at India and build similar public health safeguards into their own patent law."

Section 3(d) of India's patent law prohibits 'evergreening' - the practice of multinational pharmaceutical companies of making small, trivial changes to existing medicines in order to extend the period of patent monopoly on a drug, thereby preventing the entry of generic competitors into the market and keeping drug prices high.

Wonder drug from tick's saliva

A fully engorged female tick, species Amblyomma variegatum,from which Variegin was isolated Photo: CEHScientists from Centre for Ecology & Hydrology (CEH) are among those tapping into nature’s medicine to develop a new drug from tick saliva that controls blood flow and prevents clotting. Their discovery is now the subject of an international agreement between leading research organisations in the UK, Singapore, and Slovakia.

Dr Maria Kazimirova from the Slovak Academy of Sciences and Professor Patricia Nuttall’s team from the CEH, isolated a thrombin inhibitor (an anticoagulant, or anti-clotting agent) from the salivary glands of ticks, which they called Variegin.

They believe that the ticks secrete the anticoagulant to keep their host’s blood flowing while they feed.

Recognising the potential for this natural anti-clotting agent, the researchers teamed up with experts in snake venom peptides from the National University of Singapore.

In Singapore, Professor Manjunatha Kini and Dr Cho Yeow Koh used chemical methods to reproduce Variegin and make it more potent. They discovered that Variegin appears to be a new class of thrombin inhibitor, which may be more efficient and longer-lasting than the direct thrombin inhibitors currently on the market.

Professor Nuttall, Director of CEH, said, "By synthesising and modifying the anticoagulant our partners in Singapore were really able to understand how it works, and to improve its functions. As well as enabling blood to flow freely, we may now be able to stop the effect so that clotting is restored.

"This is an important breakthrough as it will potentially enable the development of new blood-controlling drugs with a much better performance level – and therefore fewer adverse side effects – than some of those currently available."
Professor Kini explained that during the course of evolution ticks had developed very potent and specific molecules that stop blood clotting and enable their blood-feeding lifestyle and survival.

He continued, "Although such natural compounds are close to perfection, sometimes there is still room for improvement. By understanding how Variegin works, we were able to reduce its size and at the same time improve its potency with suitable modifications."

The team now have molecules with different sizes, potency and mechanism and duration of action, providing a solid platform for further development of an anti-clotting agent. Dr Koh revealed, "One of them has 70 times more potency and long lasting anti-clotting effect than a drug that is currently available in the market."

The scientists have carried out initial tests on zebrafish to see if Variegin can prevent venous thrombosis. The tests are a model for preventing deep vein thrombosis in humans.

"The tests were a huge success and completely inhibited thrombus formation," said Professor Nuttall. "We need to do more studies like that to get Variegin into clinical trials."

This translational research could have potential applications for coronary diseases such as narrowed arteries and heart attacks, as well as deep-vein thrombosis and drug-induced blood clotting. It could be applied during major surgery to control bleeding. There is also evidence that, by controlling blood flow and clotting, the spread of some cancers could be diminished or prevented.

The international partners have filed patent applications to protect their development of this technology. They have also drawn up a commercialisation agreement through the Natural Environment Research Council (NERC), with a view to getting Variegin from the laboratory bench to the bedside. NERC's commercialisation and innovation team is now actively seeking commercial partners or licensing deals to take this forward.

Bill Barnett, business development manager, said, "This is a really exciting opportunity to take research that has potential health benefits and develop it to a stage where it will make a real difference to the man on the street."

Scientists develop rare medicine plant's substance

These are "Devil's claw" hairy root cultures from Milen Georgiev's laboratory. Photo: Milen I. GeorgievDeep in Africa's Kalahari Desert lies the "Devil's claw," a plant that may hold the key to effective treatments for arthritis, tendonitis and other illnesses that affect millions each year. Unfortunately, years of drought have pushed the Devil's claw toward extinction, so scientists are scrambling to devise new ways to produce the valuable medicinal chemicals of the Devil's claw and other rare plants.

One group of scientists reported a major advance toward that goal at the 238th National Meeting of the American Chemical Society (ACS). They described the first successful method of producing the active ingredients in Devil's claw, ingredients that have made the Devil's claw a sensation in alternative medicine in Europe. Their technique may eventually lead to the development of "biofactories" that could produce huge quantities of rare plant extracts quickly and at little cost.

Milen I. Georgiev, Ph.D., who delivered the report, pointed out that for thousands of years, native populations in Southern Africa have used the Devil's claw as a remedy for a huge number of ailments, including fever, diarrhea and blood diseases. Today, there are dozens of medicinal and herbal products around the world that are based on chemicals derived from the Devil's claw.

In particular, studies suggest that two chemicals, the so-called iridoid glycosides harpagoside and harpagide, may have beneficial effects in the treatment of degenerative rheumatoid arthritis, osteoarthritis, tendonitis, and other conditions, Georgiev said.

"In Germany, 57 pharmaceutical products based on Devil's claw, marketed by 46 different companies, have cumulative sales volumes alone worth more than USD40 million." Georgiev noted. In the US, Devil's claw extracts are in phase II clinical trials for the treatment of hip and knee arthritis. Other promising uses are not far behind. But while the demand for these beneficial compounds is increasing, the supply of natural Devil's claw is dwindling.

"The Devil's Claw faces significant problems with its natural renewal, especially low rainfall," Georgiev notes. "These problems are driving efforts to find alternative ways to produce high value compounds from the plant, independent of geographical and climatic factors," he says.

Currently, more than 25 per cent of all prescribed medicines used in industrialised countries are derived either directly or indirectly from plants, many of which are rare and sometimes endangered. "Hairy root," an infectious plant disease caused by the soil bacteria Agrobacterium rhizogenes, is at the core of a promising new technique that could one day lead to "biofactories" that produce medicines derived from rare plants in huge quantities at a low cost. Georgiev notes that hairy roots are a big improvement over traditional, greenhouse-based plant culturing.

"The transformed root cultures possess fast growth rates, genetic and biochemical stability and the capacity for synthesis of plant metabolites. It should be also mentioned that the amount of active metabolites in naturally grown plants in greenhouses significantly vary seasonally," notes Georgiev. Hairy root biofactories, on the other hand, could produce consistently high levels of plant metabolites year round.

Georgiev and his team are the first to induce hairy root cultures of Devil's claw.
They took the roots of the Devil's claw and infected them with the A. rhizogenes soil bacteria, a natural genetic engineer, to create a system of hairy roots to produce the plant's key medicinal chemicals. Their studies demonstrated stable growth and high production of both iridoid glycosides harpagoside and harpagide. Previous studies were only capable of producing one of these two compounds.
Georgiev notes that there is a long way to go before hairy root biofactories become commercialised, but he hopes to make the technology ready for use within a few years.

"Our target aim is to develop such technology, so we are paying attention not only to fundamental scientific tasks, but also to those related to some of the technological problems associated with hairy root biofactories," Georgiev said. "It is the desire of each scientist is to see the fruits of his work. In the current case, we hope to be able to develop cost-effective laboratory technology for production of these pharmaceutically-important metabolites within the next five years."

Artificial intelligence to diagnose metastatic cancer

When doctors are managing care for women with breast cancer, the information available to them profoundly influences the type of care they recommend. Knowing whether a woman's cancer has metastasised, for instance, directly affects how her doctors will approach treatment -- which may in turn influence the outcome of that treatment.

Determining whether a tumour has metastasised is not always straightforward, however. Radiologists often start by using diagnostic ultrasound to non-invasively probe the nearby lymph nodes -- tissues where cancer cells first migrate once they metastasise. But in the early stages of cancer, lymph nodes often appear completely normal even if the cancer has metastasised.

Now a team of researchers at the University of Chicago has designed a computer program that uses artificial intelligence to analyse the features of ultrasound images in order to help doctors predict earlier whether a woman's cancer has metastasised. The team will discuss the first preclinical results obtained using this program at the upcoming meeting of the American Association of Physicists in Medicine (AAPM), which takes place from July 26 - 30, 2009 in Anaheim, California.

Currently there are no automated methods approved by the Food and Drug Administration for diagnosing cancer, but on Wednesday the team will report the results of a preliminary pilot study that retrospectively reanalysed the diagnostic ultrasounds of 50 women with suspected breast cancer who all had lymph nodes that appeared normal in the ultrasound -- suggesting that their cancers had not metastasised.

All 50 women later underwent surgery to remove their cancers and axillary lymph nodes, and tissue biopsies of the lymph nodes revealed that 20 of them had metastatic cancer and 30 of them had cancer that remained localised at the time of surgery.

The pilot study aimed to determine if the computer would have accurately identified the 20 metastatic cases based on analysing the ultrasound images of the tumours.

The program performed promisingly well, says medical physicist Karen Drukker, a research associate and assistant professor in the department of radiology at the University of Chicago, who will be presenting results in Anaheim that demonstrate the program's potential for diagnosing metastatic disease.

"We discovered that a computer analysis of breast ultrasound could potentially predict with promising accuracy which patients had metastasis and which did not," says Drukker.

Next they plan to start an observer study in which several radiologists will use the computer program to see if it enhances their ability to diagnose metastasis -- again, based on retrospective cases for which the answer can later be revealed.