Clinical research from the heart

Hot on the heels of Valentine’s day, the British Heart Foundation has announced the winners of their images competition “Reflections of Research,” in which UK scientists funded by the foundation were asked to submit the most striking still and video images of their research.

Winners of the video category are Dr Michael Markl of University of Freiburg, Germany, and Dr Philip Kilner of Imperial College London, and their video of blood flowing through the heart. Concentrate hard and you can see, in red/yellow, blood flowing through the left side of the heart, down the aorta, and into the body as the heart rotates. Blood flowing through the right side of the heart towards the lungs is shown in blue. According to the BBC, in the future doctors may be able to use this type of imaging to help simulate the blood flow in a patient’s heart.

looking-through-the-heartWinners of the picture category were Mathieu-Benoit Voisin and Doris Proebstl from London with their remarkable heart shaped cell stain.

The researchers are studying how white blood cells move from the blood into into damaged tissue to cause inflammation; for example, after a heart attack. They were using using fluorescent pigments to stain two key players in this inflammatory process – pericyte cells from the blood vessel wall (stained red and blue) and collagen (green) – when looking through the microscope they noticed that the cells had arranged themselves into a heart shape.

“Through better understanding of how white blood cells interact with the components of the vessel walls, we hope to identify new avenues to treat conditions that underlie heart and circulatory inflammatory diseases,” said Dr Voisin. “Our research is funded by the British Heart Foundation so we were really delighted to see this heart shaped arrangement of cells appear by chance through the microscope!”

I think my favourite image from the competition is this runner up picture of the muscle fibres in the left ventricle of the heart.

heart stringsThe image, from Dr Patrick Hales at University of Oxford, was generated using diffusion tensor imaging of the heart. This magnetic resonance imaging (MRI) technique tracks the movement of water molecules through the heart muscle, which reveals how the muscle cells are aligned.

“This technology allows us to model the structure of muscles in the heart in a non-invasive way, and how diseases can cause it to change,” said Dr Hales. “In the future, we hope that our research might be able to determine how the structure of the heart is damaged during a heart attack, and how the muscle fibres respond.

“We also hope that our computer models of individual hearts will one day be used as a tool for diagnosis, and could even provide patient-specific assessment of treatment options. Imagine your doctor trying out treatments on a ‘virtual’ version of you, before choosing the right prescription.”

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Wellcome Image Awards: shedding light on the microscopic world

This week medical charity the Wellcome Trust presented their annual image awards, which highlight the best new pictures acquired in the past 18 months by their free picture library.

The prizes are awarded to “the creators of the most informative, striking and technically excellent images” on the basis of “the ability of the picture to communicate the wonder and fascination of science.”

Dr Alice M Roberts, who presented the awards, emphasised not only the utility of images in science, but also their value as beautiful work of art.  “Imaging and imagery can help scientists in many ways: to understand structures that are too small to be seen by the naked eye, or perhaps to elucidate the relationship between structure and function,” she said. “But as well as deepening understanding, the art of science can also be – in its own right – beautiful and awe-inspiring.”

My favourite images are those created using microscope techniques like electron microscopy and multiphoton microscopy, which provide an extraordinary insight into the detail of human anatomy.

This first picture is of villi in the small intestine – finger-like structures that absorb nutrients from the food passing through the gut.  Paul Appleton, who produced this image using fluorescent imaging techniques, hopes that it might help researchers identify cancerous change in colon tissue, pointing out that “Scientists have to characterise normal tissue before they can look for changes in abnormal tissue.”

SI villi

Another of my favourites is this vivid picture of capillaries from a structure in the eye known as the ciliary body, which sits either side of the lens.  Capillaries measure 5-10 micrometres in diameter and are only one cell thick, so getting such a clear and informative image of these tiny vessels is quite an achievement.  The bright red colour is the result of a dye – likely to be carmine dye – that was injected into the artery that supplied the capillaries.


Number three is this picture of compact bone – the dense stuff that surrounds the bone marrow.  The structures that look like rings in a tree stump are called osteons, in which lamellae of bone tissue form around canals that house the blood and nerve vessels supplying the bone.  The black specks show osteocytes, the living cells that produce bone tissue.  The cells are lost during processing, however, leaving the holes within the bone that they once occupied.  Unlike the previous images, no false colour was added to this picture.  Your intestines aren’t blue and red like the image of villi above, but your bone definitely looks like this.

compact bone

Last is this image of in vitro fertilization.  The “blazing sun” object is the egg, the “rays” produced by cumulus cells that protect the egg.  This image shows the moment of conception, with a sperm wiggling its way in on one side.


These images and more are available to view on the Wellcome Trust Image Awards website.  They’re also on display until Spring 2010 in a free exhibition at the Wellcome Collection.

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A new way of visualising health data

Are smokers more likely to be obese? Is stroke more common in people with hypertension?  Are old people more likely to have diabetes than young people?

The prospect of trawling through the scientific literature to get the answers to these questions isn’t terribly appealing – reams of tables and risk ratios aren’t helpful if you just want the information at a glance.   Technology and health care company GE have developed a new way to present complex epidemiology data in graphic form.

Taking a New Look at Health allows you to compare various demographics, risk factors and diseases in a random sample of 100,000 patient records from GE’s proprietary database.  Once you’ve picked the two variables you want to look at, legions of tiny men shoot across the graphic and align to show what proportion of people with variable  also have variable y.

In this example, I have looked at smoking and BMI to see whether smokers are more likely to be obese than are non-smokers:


Given that the figures are presented as an image rather than a table of numbers, it’s much easier to get a handle on the proportions and what they really mean.  I can now see at a glance that actually more non-smokers and ex-smokers than smokers are obese (28%, 29% and 27%, respectively); that is, smokers are less likely to be obese.

Here are a couple more examples:

Is stroke more common in people with hypertension?


As well as showing that people with hypertension are considerably more likely to experience a stroke than those without hypertension (5% vs 1%), this particular graphic also allows us to see roughly what the incidence of hypertension is in the GE sample – not huge judging by the slim column on the right hand side.

Are old people more likely to have diabetes than young people?


Yup, look how many little orange people there are in the 65-74 column and the 75+ column!

Why not have a play with the visualisation yourself? Is the link between heart disease and hypertension what you expect? And what was the male:female ratio in this sample anyway? If you like epidemiology you’ll probably have a lot of fun!

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