Texts for written translation Text 1 The age of genes

The winsome, sable-haired 4-year-old didn't even know she was making history, or care. By the time of the injection last year, she had been poked and prodded so often that she could not be bothered to take her eyes off the cartoon she was watching on TV.

The injection marked the first human trial of gene therapy, a revolutionary means of treating a disease by giving a patient new genes. The girl suffers from an extremely rare, inherited disorder in which faulty genes have crippled her immune system, leaving her vulnerable to the slightest infection or illness. To treat it, her doctors removed immune cells from her blood, fitted them with a new gene, and reinjected them into her body. Today, four months after her last dose of the groundbreaking therapy, the girl's immune system appears to be fending off infections normally.

In the nearly 40 years since James Watson and Francis Crick elucidated the twisting structure of DNA, scientists have probed deeply the workings of the molecule that governs all living cells. Just in the last month, researchers have announced the discovery of at least four new human genes responsible for ailments ranging from deafness to sterility. And while finding a new gene is only a step toward vanquishing a disease, says Nobel laureate David Baltimore, president of Rockefeller University, "every disease we know about is either being attacked with genetics or is being illuminated through genetics."

Experiments with gene therapy represent a giant step into the medicine of the future.

Yet for all the good molecular medicine will do, the ethical dilemmas are grave. The advances bring closer the day when parents can endow children not only with health but also with genes for height, good balance or lofty intelligence. Of more immediate concern is the possibility that health insurers, employers and the government will gain access to genetic information and unfairly discriminate against people on the basis of their genes. (Charlene Grable, U.S. News & World Report) [1]

Text 2 Heart disease: an alternative to transplant

For the many people who wait futilely each year for heart transplants, researchers are looking at a new option: an experimental operation that wraps the failing heart with a back muscle that contracts to help boost the heart's ability to pump blood.

Known as cardiomyoplasty, the procedure is undergoing evaluation at five medical centers.

"It is a very interesting new technique that may have some use," said Sidney Levitsky, chief of cardiothoracic surgery at the New England Deaconess Hospital in Boston and a member of the American Heart Association's Council of Cardiovascular Surgery. In certain patients with heart failure, "it may be the solution for the transplant problem," he said.

Now, doctors report that death rates range from 0 to 20 percent within one month of surgery at the different hospitals involved.

Many of the deaths are attributed to a range of problems that reflect other underlying heart conditions not corrected by the surgery, including irregular heartbeats and ventricular problems. Some patients have also died from other illnesses, including pneumonia.

George McGovern, the surgeon who first performed the operation at Allegheny General, said about 50 percent of the patients there have survived for five years after surgery.

In comparison, approximately 80 to 85 percent of hearttransplant patients survive one year after surgery.

The concept of cardiomyoplasty has been discussed by physicians for more than 50 years. But there were two major hurdles to overcome.

The first was how to condition a skeletal muscle not to tire during 24 hours of daily contraction. Wayne State University thoracic surgeon Larry Stephenson developed the technique using electrical current to overcome this obstacle.

The second was how to get a large enough contraction to boost the heart's production. Standard pacemakers produced small contractions, not enough to help the failing heart. But a researcher, Ray C.-J. Chiu, at McGill University in Montreal developed what is called a burst pacemaker to stimulate the back muscle.

One of the patients to benefit from the surgery was 74-year-old Reaugh Bonn, a retired business executive who developed congestive heart failure suddenly in 1988.

Despite extensive treatment, Mr. Bonn continued to deteriorate. His age disqualified him for a heart transplant.

"It was terribly discouraging," he said from his home in Vancouver, Washington. "The only story that I really got out of any doctor was that there was no cure and that I would progressively go downhill until it was all over.

Then Mr. Bonn read an item about cardiomyoplasty in a tabloid newspaper and sought out the operation.

On July II, 1991, Mr. Bonn became the first patient to undergo cardiomyoplasty at St. Vincent Hospital and Medical Center in Portland, Oregon. He spent 11 days recovering in the hospital, two and a half of them in the intensive-care unit, before being discharged. "The day I got out of the hospital I went home, took a nap and then went out to dinner with my wife," he said. (Sally Squires, International Herald Tribune) [1]