ian C. Ellul

As I observe the Maltese Ministry of Health battling with the ongoing out-of-stock sage of medicines within the Pharmacy of Your Choice scheme, my neuronal long-term potentiation recalls my childhood experience of Star Treck. I wonder why …

Essentially, I grew up watching Star Trek. To put it very mildly, the series has influenced the way we think today, even if we do not realise this.

Mobile phones have been invented this way. This has been claimed during an interview by none other than Martin Cooper, who invented the first mobile phone, way back in 1973 (www.youtube.com/watch?feature=player_ embedded &v=wN-_VA5HFwM). Another medical advance heralded by the TV series is hyposprays, whereby Dr McCoy, more commonly known as Bones, administered injections which didn’t involve needles. Yet another example is aptly demonstrated by Geordi La Forge, the blind Lieutenant on the Enterprise-D, who was able to see because of a visor, which consisted of a small strip of metal that went across his eyes like a pair of glasses. Scientists today refer to this technology as the bionic eye and although challenging, its application for blind people may be closer to us than one may think. Monash University in Melbourne is one of its champions (www.monash.edu.au/bioniceye/technology.html).

Interestingly, a recent technology which is also reminiscent of the American science fiction series, is the MR-guided focused ultrasound surgery. InSightec, which is headquartered in Israel, is marketing this innovation as ExAblate®. This personalized, non-invasive, real-time treatment works by using a transducer to transmit ultrasound waves. Its applications may include various conditions including uterine fibroids, breast cancer, prostate cancer, liver cancer and pain palliation of bone metastases. It seems to be particularly promising for Parkinson’s disease and neuropathic pain. In fact videographic footage has evidenced patients suffering from essential tremor leaving the room post-treatment with no tremors (www.youtube.com/watch?v=Ze54lQXtUxo&list=TLmVURADr-4PM)

Its advantages include a short recovery time, the fact that no hospitalization is needed and that it is drug-sparing. Furthermore, no incisions are needed and there is a low frequency of adverse events. Nevertheless there are various challenges for each clinical scenario. One example is the non-uniformity of skulls which needs to be factored in during the treatment of brain tumours.  

 

Innovative applications of this focused ultrasound sonification process include haemorrhagic stroke where it can be used to liquefy clots, and targeted drug delivery, where it can be used to deliver medicines in a reproducible manner through the blood-brain barrier. As reported Etame et al in The Journal of Neurosurgery in January 2012 (PubMed: 22208896), this targeted drug delivery is achieved by increasing the permeability of the blood-brain barrier. Last April, Nanoscale has also published an article by Zha et al who detailed the adaptation of this technology for image-guided microbubble destruction of cancer cells. This is done by incorporating CuS nanoparticles (PubMed: 23467503).

Hopefully we will hear more of this technology soon enough …