The Life of Mammogram Inventor Stafford L Warren

Stafford L. Warren was one of the most significant contributors to radiology during his lifetime. He not only was the first doctor to perform a mammogram, but was also had a hand in turning UCLA into one of the most prestigious medical universities in the country, was a special assistant on mental disabilities to Presidents John F Kennedy and Lyndon B Johnson, and aided the U.S. government in testing of nuclear weapons before speaking out about the dangers of nuclear fallout from weapons testing, which were controversial at the time. However, his strong opinions would eventually be considered, leading up to the Partial Nuclear Test Ban Treaty in 1963.

Born in New Mexico in 1896, Stafford L. Warren attended the University of California, Berkeley, and graduated with his Bachelor of Arts degree in 1918. Heading to the University of California, San Francisco, he graduated with his Doctor of Medicine degree in 1922 and later did post-doctoral work at John Hopkins School of Medicine and Harvard University.

Warren became an Assistant Professor of Medicine at the University of Rochester School of Medicine in 1926. Since the Department of Radiology was brand new at the time, Warren was one of the original group of medical professionals that Dean George Whipple chose to staff the school. By 1930, Warren was an Associate Professor of Medicine. He began to study the work of Albert Salomon, a sociologist from the University of Berlin who produced over 3,000 images of mastectomy specimens and extensively studied the many forms and stages of cancer in the breast. Since Salomon wasn’t keen to recognize the life saving aspects of his discoveries, Warren expanded on his research, using radiology to track changes in breast tissue and developing a stereoscopic technique in which the patient would lie on her side with one arm raised while being X-Rayed. This was a huge breakthrough for breast cancer detection, as it allowed diagnosis of breast cancer to be possible without surgery. Warren subsequently published “A Roentgenologic Study of the Breast” in 1930. Today Warren is cited as the inventor of the mammogram for his breast imaging technique. Each year mammograms are responsible to diagnosing millions of breast cancer cases, effectively saving the lives of women the world over.

Warren, having now tackled a major milestone in his career and developing a new life saving technique, then went on to take on a new project: overseeing the health and safety of thousands during the Manhattan Project. His new role meant being responsible for the safety aspects of the detonation of the Trinity nuclear test in Alamogordo, New Mexico on July 16, 1945. He later handled radiological safety when he led a team of surveyors to Japan, and to the Bikini Atoll in 1946, where more nuclear testing was done. Warren was in charge of assessing the radioactive contamination of the environment and atmosphere, which he was appalled by.

In response to this, in a piece for LIFE magazine in 1947 he wrote, “The development of atomic bombs has presented the world with a variety of formidable scientific, moral and political problems, nearly all of them still unsolved.” He went on to write an in depth analysis of the effects of the bombs, people and environment affected, the time length in which the effects of the bomb lasted, safety measures used during the Bikini expedition in which “a month passed before men could stay on some of the ships for more than an hour”, and “300 men of the safety section lived and worked in the contaminated area to protect some 42,000 other members of the Bikini expedition. Every group which entered the target area was accompanied by a safety monitor who determined how long it could stay.” The men were then bathed carefully when they returned, and if their Geiger counters indicated radioactive contamination they had to be bathed again. “Occasionally when a man had taken off his protective gloves in the ‘hot’ area, the safety section had to dissolve the outer layer of skin from their hands with acid.” Clothes and other materials found too contaminated were sunk into the ocean a mile below the surface, because there was literally “no other way to keep them permanently away from human beings.”

In the article, Warren concluded that atomic weapons can never be prepared for by anyone involved, and that “no defense would have been effective. The only defense against atomic bombs still lies outside the scope of science. It is the prevention of atomic war.”

Warren left his position in 1946, becoming the Chief of the Medical Section of the Atomic Energy Commission, which is a civilian agency that succeeded the Manhattan Project; and later he was awarded the Army Distinguished Service Medal and the Legion of Merit for his contributions to radioactive and atomic weapons safety.

In 1947, Warren was once again at the helm of a brand new medical university, this time UCLA, which had been voted on to establish a medical school for Southern California. He was appointed as the school’s first dean. In 1951 the first students, 28 in total, were enrolled, and there were 15 faculty members. By 1955, when the class graduated, there were 43 faculty members. The UCLA Medical Center officially opened in 1955, and Warren oversaw many milestones and achievements while there, including the addition of schools for Dentistry, Nursing, and Public Health.

Importance of Right Glassware

Eating and drinking may be just another imperative thing to do for humans for their survival, but they are impacted by a lot of things. One of the factors that has a direct effect on the manner in which the food is targeted and absorbed by the body is the psychology with which one consumes their food and drinks and this psychology is majorly affected by the cutlery and the utensils in which we do this repetitive task. Eating proper is not just about eating the right food in the right manner, but it is also about eating it in the right kind of dishes. The plates and glass in front of us can either make or kill the mood to eat food (no matter how good it is or how well it has been cooked). For example, a normal steel plate can be an immediate mood killer as compared to one made out of some great quality glass. Same goes for the glasses; be it for drinking water, serving alcohol to guests, or just gulping down some wine or beer when you are in the mood.

The entire paragraph can be paraphrased to basically say that the crockery, cutlery, and glasses used for food intake should be swanky and attractive to not only make the food look more good and presentable, but also to add a touch of chic and décor to your kitchen and also leave a good impression on the guests (if and when they come).

BUYING THE RIGHT TYPE OF GLASS DISHES

So far we saw how the type of dishes used can be a buzzkill for many which is why in all sorts of setups (be it your home or a professional environment such as a restaurant or a bar, etc.), following are some factors that one may consider in order to ensure that your crockery and glass dishes always appear at their best:

If plates are the concerned department, it is best advised to stay simple yet elegant and the best way to do so is to go with plain white plates reason being that they are conveniently inexpensive, present the food in the best manner possible, and also do not fade away easily.

For wine glasses, it always suggested to go with those that have a relatively sturdy build to them for them slipping away from your or your guests’ hands are always a great flight risk not worth taking.

For red wine, go with glasses with a wide bowl
For white wine, go with a glass that has a comparatively narrow bowl

Chemistry teaches us that “symmetry leads to stability” and the same should be applied to your crockery. The balance between normal and ornate design plates should be perfect.

For champagne and martini and other types of alcohol glasses, there is no fixed trend you can follow. There are quite a bunch of options to choose from depending upon the alcohol and your taste and preference when it comes to your glassware. For example, the champagne flute is the most common champagne glass, the brandy balloon is the most common glass used to serve brandy, etc.

Cancer Immunotherapy Use on Cancer Patients

Recent advances in treating cancer patients have resulted in the development of biological therapies that can prove to be a promising alternative to conventional cancer therapies. Immunotherapy harnesses the body’s immune system to identify and fight effectively against cancer cells.

Immunotherapy works by attacking the growth of cancer cells or stimulating the immune system to kill cancer cells. Contradictory to the standard cancer treatment regimes such as chemotherapy, radiation therapy, which act on both normal and cancerous cells, immuno-therapeutic treatments are highly specific. A wide range of cancer immuno-therapy approaches exists such as immune checkpoint blockers, cancer vaccines, immune-modulators, monoclonal antibodies and cell based immuno-therapies have demonstrated to be effective against cancer patients.

The most commonly targeted form of cancer chemotherapy is the use of monoclonal antibodies as they can be tailor-made in the laboratory. They have unique antigen specificity thereby allowing themselves to attach to specific epitopes on cancer cells. This flags the cancer cells and makes it more visible to the immune system so that it can find and destroy those cells. Currently, most of the monoclonal antibodies are undergoing phase 3 clinical trials or awaiting FDA review process. Unlike monoclonal antibodies, non-specific immuno-therapy approaches such as administration of immuno-modulatory cytokines are also being used to treat melanoma. Cytokines are hormones that are endogenously produced by the body to enhance or suppress T-cell response against cancer cells. IFN-α and IL-2 are most commonly characterized cytokines used in cancer immuno-therapy.

The primary cell-based immuno-therapy strategy which is successful these days is the use of T-cell therapy, wherein cancer T cells removed from blood are modified with chimeric antigen receptor (CAR) and is then infused back into the patients to treat metastatic cancer. Another form of cell-based immuno-therapy used is tumor-infiltrating lymphocytes (TIL) therapy, wherein TIL is surgically removed from tumor tissue and is considerably increased in the laboratory by adding cytokines to it and is then re-infused back into the patient.

A promising treatment that has emerged in recent times for treatment of melanoma is the use of immune checkpoint inhibitors. They act by inhibiting the checkpoint receptors on T cells that act as brakes to the immune system thereby mediating anti-tumor responses. Some of the commonly used antibody inhibitors that have been commercialized are PD-1, PDL-1, and CTLA-4. Another more focused approach to cancer immuno-therapy is the use of vaccines to encourage the immune system to generate antibodies that can target tumor specific antigens, thereby eradicating cancerous cells. Cancer vaccines include peptide-based, dendritic cell-based, tumor cell-based and DNA cell based. Cancer vaccines can be broadly classified as preventive or therapeutic. Preventive vaccines are commercially available for against cervical and liver cancer causing viruses such as human Papillomavirus and Hepatitis B virus, respectively.

However, in spite of these advances, limitation such as tumor heterogeneity, unpredictable efficacy and identification of potential markers still exist in the field of cancer immuno-therapy. Therefore, new more targeted cancer immuno-therapies and preventive strategies are being developed and tested, which will deliver novel efficacious therapy against relapsed or refractory cancer patients.

The Present and Future of Radiotherapy

The radiotherapy market is growing due to several factors, such as an increase in the number of new cancer cases and technological advancement in the hardware and software used in radiotherapy. The current international markets are underequipped to address new cases of cancer. In low- and middle-income countries, only 10% of the population has access to radiotherapy. Therefore, there exists a wide gap between the demand and the installed base of equipment, which offers a huge opportunity for the companies to grow in the radiotherapy market. Expansion of the radiotherapy market can be both lifesaving and profitable.

Effective planning for the treatment

It is necessary, and continuous technological developments are taking place to minimize the exposure to radiation of healthy tissue, in order to avoid any side effect. This goal is a driving force of R&D for radiotherapy. Software plays an increasingly significant role in cancer care. Population growth and increased life expectancy are adding to the incidences of cancer. The software & services segment includes software, which is used for treatment planning, analysis, and services, which are needed for the maintenance and efficient use of radiotherapy devices. The software & services segment of the companies are expected to grow, as software products help improve physician engagement and clinical knowledge-sharing, patient care management, and the management of cancer clinics, radiotherapy centers, and oncology practices for better performance. Companies like Varian are continuously increasing their software portfolio. Software plays an increasingly significant role in cancer care. At the same time, healthcare systems are subject to harsh budgetary constraints in nearly every country. As a result, healthcare providers face the challenge of achieving more while using fewer resources. To achieve this goal, hospitals have a strong need for software platforms that make radiotherapy treatment cost-effective. The development of effective software will improve the delivery of advanced radiotherapy in the future.

Introduction of new technology
Technology is another salient feature. Radiation therapy remains a significant modality for cancer treatment, which is the primary driving factor for the designing of new techniques to improve the survival rate of cancer patients. New technologies, like proton beam therapy, are available in developed countries like the United States, Germany, and United Kingdom, due to well-established reimbursement policies. Proton therapy can be used on tissues that are highly sensitive, like brain, spine, and eye tumors. It is more accurate, as compared to other X-ray radiation therapies.

Advancement in the technology is also helping to execute the planning of the radiation therapy.

Technological advancement in existing technologies, such as CT imaging, is making imaging more accurate and consistent. This can give a better representation of a tumor and help in better planning. Already-existing technology, such as IMRT, SBRT, IGRT, conformal 3D, VMAT, and others that are used for radiation therapy treatment is undergoing various advancements. For example, Varian is developing a software, which can be used to develop better planning tools, in which statistical models can be used to calculate the quality of an IMRT treatment for a patient. This is expected to increase the usage of IMRT for treating cancer. IGRT is the type of radiotherapy. Research is more focused on IGRT, in order to prove its fewer side-effects. IGRT may include electronic portal imaging, fluoroscopy, ultrasound, CT scan reconstruction, and respiratory gating technology. SBRT is also growing as an option for treating cancer. SBRT is used to escalate the dose to the targeted tumor, which can increase local control while limiting the dose to nearby critical structures and normal tissues. This will cause minimum damage to the surrounding tissues and hence, will experience strong growth in the forecast period.