Balls, great huge balls

Dogs are, or boxers, or at least our boxer is obsessed with balls. As everyone knows bigger balls are better. It was a challenge to photograph her big Boomer ball because she just wouldn't leave it alone for more than ten seconds. So here she is with her 10 inch Boomer ball.


And here is the rest of her collection. A month-old red Kong ball, and its predecessor the year old red Kong ball. The pink 4 1/2 inch Boomer ball, and two no-name balls that lasted less than a week each. They're still usable from a boxer's perspective though.

I can only suggest getting a boomer ball for your ball obsessed boxer, she plays herself into a stupor in 15 minutes and it is dirt cheap. Plus they guarantee the balls for one year unless you have a tiger. For throwing outside and playing with indoors (yes I know they shouldn't play indoors, but she's so cute) the Kong rubber ball is better.

I know there is rather a thin cover of science on the blog at the moment. I hope to make up for that soon. I just have to think of something.

Computer down, computer gone.

Shite, the computer to the powerlab went straight to hell during an experiment on Thursday. I thought I saved the day when I ran and got my main laptop. It's got the software and all, but windows update has replaced the drivers with something it likes better. So, while it can start up Chart, and read files, and do analysis, it can't communicate with the powerlab. All in all a really bad day.

So now I'm at home and have just made some nice photos to show you, and the computer is still in the lab. All I have here is my little netbook, and it doesn't have Lightroom. Sorry about that.

There are some other nice blogs that actually have content today, or recently anyway.

There's Isis with Your graduate school application as seen by Dr. Buttercup.

Then we have Ethan at Starts with a bang who is showing a hilarious t-shirt reading:

"Sorry, you have reached an imaginary number. If you require a real number, please turn your phone by ninety degrees and try again."

Finally we have PhDamned (aren't we all) who is overcommitted, which makes me happy, because it means I am not all alone in that predicament.

Rejections

Being in science is kind of like being a little boy. You and some of your pals get together and decide that you are just the best thing to happen to girlkind since the colour pink.

Specifically, to that impossibly cute girl with freckles and a ponytail. After fretting nervously, like little boys, for a very long time (anything from 10 to 20 seconds), you send forward one of your number to the coven of small girls in pink. While you stand there puffing your chests out and smiling broadly, you see the ears of the poor envoy turning red. Then you hear the sound of laughter like little bells in the wind, and the girls skip away to do what ever it is little girls in pink do.

The red eared envoy returns to explain that they (the girls in pink) liked the idea, and they agreed that, for being little boys, we weren't the worst they had ever seen. For all that, they still thought we were too much like little boys for them. They want real men, like Patrick Swayze, who can sing and dance and play hockey.

So, there you were, having thought that reading comic books, and building monsters out of lego was the way to go. What to do: Do you start to play hockey and learn how to sing? Or, do you just go looking for another girl, someone who likes comics and appreciates lego the way lego is supposed to be appreciated?

Maki

Today I'm making sushi. In preparation I have charged two sets of batteries for the flash and exchanged the 35mm for the 90mm f/3.5 Voigtländer lens. Half the point of making sushi today is photographing sushi being made.



The quality of the sushi depends almost only on the quality of the fish. Salma salmon is a farmed salmon that is killed and filleted immediately to prevent any gut parasites from entering the meat. Therefore you don't have to freeze it before using it for sushi, which makes for much better fish. For variety I usually make two kinds of maki; salmon, and shrimp. Getting other kinds of sushi grade fish in Norway is all but impossible unless you are a resturant.

Once you have the fish, you need to make rice. Very easy, do as it says on the sushi rice bag. Wash, cook, add sugar and vinegar, spread out on a plate to cool down. Spread a thin layer of rice onto a sea weed sheet, or sushi-nori. It should be really thin otherwise it will just taste rice, which kind of defeats the purpose.



Cut pretty pieces of fish, shrimp and some avocado in this case. Don't give it all to the dog, even though she's so cute when she begs.



Add a string of fish and some wasabi paste on the rice and roll it up tight. The special maki sushi bamboo mats are ideal for rolling, but anything flexible will do in a pinch.



The difficult part is to roll the maki hard enough, so that it holds together. Wet the end of the sea weed to glue the roll shut, and make some three or four rolls per person.



Cut into bite sized pieces and serve with more wasabi, japanese soy sauce and pickled ginger (called sushi gari). A cheap Danish beer is never wrong, otherwise a Sancerre or just water is also fine.

This week in pictures

Who am I fooling?

I have tried, diligently, to make at least a single measly frame of a photography every day for seventeen days and nights. I have failed, not gloriously or valiantly, not even miserably, but in the most inglorious way, by lazyness and insufficient will.

There are now twelve photos in the flickr set where there should have been seventeen.



Madicken thought it was rather too cold as it hit -17°C last weekend, but now its around zero and everything is a salty slush. More snow is falling, melting and feeding the slow, muddy, avalanche through the town. The winter is not even pretty any more; the snow doesn't sparkle when it is wet and muddy.



The scientific weather is about the same as the actual weather. That is, I am waiting inside, as if in front of the open fire, in hope of hearing the wind turn so that I may venture out again. I am waiting for a, now rather late, review. It's frustrating because they obviously had problems finding reviewers. That took them almost three weeks (over Christmas), and now it's been another two weeks under review.



Meanwhile, I try to solve the Rubix cube, and when I get bored I take a picture of it to at least do something productive (for some definition of productive). Now it's snowing less, and it might be time to venture out, so that the Madicken gets to run around and do the things that dogs do. Maybe the review will be finished tomorrow, maybe I'll only miss these first five days of photography.

Despondently (kind of like Eeyore) yours,

Michael

IgA-nephropathy and progression

IgA nephropathy is the most common of the glomerulonephropathies but has a highly variable out come for the individual patient. While about 30% progress in to end-stage renal disease (ESRD) in about twenty years, the rest can live with their IgA nephropathy for a long time without clinical progression

The new Oxford classification of IgA nephropathy was published recently (1, 2). It identifies histopathological signs for mostly predicting the out come for patients with IgA nephropaty. The first part of this study was the establishment of reproducability of different pathological lesions. Then these were used to study biopsies from patients with known out-come (6.5 years follow up time) to find lesions that predict progression.

What they find is that mesangial and endocapillary hypercellularity and the classic markers of chronic renal damage (tubular atrophy/interstitial fibrosis and segmental glomerulosclerosis) predict the loss of 50% of baseline GFR or progression to ESRD, independently of clinical parameters, such as blood pressure, proteinuria and GFR. Tubular atrophy and interstitial fibrosis are grouped as one because they correlate with an R = 0.99. In addition this entity correlates with other signs of advanced chronic renal damage: interstitial inflammation R = 0.9, and global glomerulosclerosis R = 0.8.

It is important to note here that the correlations were made for quite pronounced lesions. For example, tubular atrophy/interstitial fibrosis of <25% of the biopsy area had an out-come similar to those with out any lesion, and a quantitative measure for mesangial hypercellularity was comparable to just determining if more than 50% of the present glomeruli were affected.

An all new study by Tsuboi and others in the Journal of the American Society of Nephrology (3) presents an interesting correlation between glomerular density and progression. The selection of IgA nephropathy patients with a only slightly reduced renal function (>60 ml/min/1.73 m²) is the main strong point of the study. This includes patients with early IgA nephropathy, something which has not been so well studied before. In this way it complements the Oxford classification where GFR >30 ml/min/1.73 m² was the inclusion criteria.

A striking result is that in these patients with a mildly reduced renal function, none of their histopathological scores or clinical parameters predicted anything within five years, only after ten years did they manage to show significant correlations. In comparison with the Oxford classification study this can be interpreted as if progression accelerates; with an inclusion of patients with GFR >30 ml/min/1.73 m² and six years follow up 22% of the patients reached end points (-50% GFR or ESRD), while Tsuboi et al. found that from GFR >60 ml/min/1.73 m² and ten years follow up 25% of the patients reached those same end-points.

What is interesting is that several of the significant variables in the Oxford classification does not appear to correlate with progression in these patients with only slightly reduced GFR. For example interstitial fibrosis and mesangial hypercellularity, as well as well studied clinical parameters such as proteinuria and hypertension.

The main finding, as can be read in the title, was that glomerular density (the number of non-globally-sclerotic glomeruli per area of biopsy) is an independent predictor of progression in IgA-nephropathy with a mild decrease of renal function. This means that a low nephron endowment is bad for you, in IgA nephropaty as well as in many other diseases . Something the authors discuss quite thouroughly.

In the Oxford classification they did look at the number of glomeruli, but only in relation to the other scores, where no correlation was found. Nothing is written about the possible correlation with out-come in these patients, and a formal measure of glomerular density was not calculated. This means that glomerular density may still be a good predictor in patients with a more advanced disease.

This gives me the impression of a two step determination of progression:

1. A low nephron number makes you more likely to progress from an IgA nephropaty with mild renal function impairment.
2. Progression to a GFR <60>2 with clinical features such as high blood pressure and proteinuria, together with signs of chronic renal damage on biopsy (interstitial fibrosis, tubular atrophy, global sclerosis, segmental sclerosis, inflamation and mesangial proliferation) makes you even more likely progress further.

In short, if you don't progress it's good, if you do it's a Bad Thing(tm). This should mean that a decrease in GFR is prognostic for further decreases, which sounds logical.

1. The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. Working Group of the International IgA Nephropathy Network and the Renal Pathology Society, Cattran DC, Coppo R, Cook HT, Feehally J, Roberts IS, Troyanov S, Alpers CE, Amore A, Barratt J, Berthoux F, Bonsib S, Bruijn JA, D'Agati V, D'Amico G, Emancipator S, Emma F, Ferrario F, Fervenza FC, Florquin S, Fogo A, Geddes CC, Groene HJ, Haas M, Herzenberg AM, Hill PA, Hogg RJ, Hsu SI, Jennette JC, Joh K, Julian BA, Kawamura T, Lai FM, Leung CB, Li LS, Li PK, Liu ZH, Mackinnon B, Mezzano S, Schena FP, Tomino Y, Walker PD, Wang H, Weening JJ, Yoshikawa N, Zhang H. Kidney Int. 2009 Sep;76(5):534-45. Epub 2009 Jul 1. PubMed PMID: 19571791.
2. The Oxford classification of IgA nephropathy: pathology definitions,correlations, and reproducibility. Working Group of the International IgA Nephropathy Network and the Renal Pathology Society, Roberts IS, Cook HT, Troyanov S, Alpers CE, Amore A, Barratt J, Berthoux F, Bonsib S, Bruijn JA, Cattran DC, Coppo R, D'Agati V, D'Amico G, Emancipator S, Emma F, Feehally J, Ferrario F, Fervenza FC, Florquin S, Fogo A, Geddes CC, Groene HJ, Haas M, Herzenberg AM, Hill PA, Hogg RJ, Hsu SI, Jennette JC, Joh K, Julian BA, Kawamura T, Lai FM, Li LS, Li PK, Liu ZH, Mackinnon B, Mezzano S, Schena FP, Tomino Y, Walker PD, Wang H, Weening JJ, Yoshikawa N, Zhang H. Kidney Int. 2009 Sep;76(5):546-56. Epub 2009Jul 1. PubMed PMID: 19571790.
3. Glomerular Density in Renal BiopsySpecimens Predicts the Long-Term Prognosis of IgA Nephropathy. Tsuboi N, Kawamura T, Koike K, Okonogi H, Hirano K, Hamaguchi A, Miyazaki Y, Ogura M, Joh K, Utsunomiya Y, Hosoya T. Clin J Am Soc Nephrol. 2009 Nov 19. [Epub ahead of print] PubMed PMID: 19965542; PubMed Central PMCID: PMC2801658.

Beef with some stuff, some sauce and pasta

Here's the much awaited (by all of my about zero readers) nephrophysiologist cooking column.

Rochefort stuffed roast beef on a bed of oyster mushroom, celleriac and turnip, with a hot balsamic vinegar sauce and spaghetti.



The vegetables were fried in butter with a drop of black truffle oil. Then the beef was fried in butter, peppered and salted, and allowed to rest for a minute before it was stuffed with all the Rochefort I had available, and some other similar cheese that was found in the refrigerator.

The vegetalbles and the beef were put in a dish and covered with foil and cooked for an hour and a half at just above a hundred degrees centigrade. The last 15 minutes the temperature was turend up and the foil removed to get some proper heat into the outerpart of the beef.



Spaghetti was boiled in salted water.

For the sauce, the bottom of a small pot was covered with sugar, which was melted. As the sugar started turning brown balsamic vinegar was poured in. Nothing too fancy, just your ordinary bulk balsamic vinegar. To this was added some hot chili and ground white pepper, veal stock, and quite a bit of cream. It was then allowed to boil for a while, and some more butter was added before serving. Don't boil it too long, it'll turn into caramel.



The butt-ends weren't fit for human consumption and were given to the dog. It was served with a cheap Danish beer while watching The Hunt for Red October.

/M

Saturday mix

Madicken going for the ball.

In Sweden it's very much a tradition that you're only allowed candy on Saturdays. There's a (or several probably) special bag of assorted sweets called Saturday mix. In honour of this staple of my childhood I'm going to post all sorts of shit here today.

Friday provided some really exciting new science. I was writing my abstract for ESH 2010 (to which you should go, deadline on Jan. 15th). When my pathologist (who I keep in a box) sent me a message on facebook and said that she had a surprise for me. Just then the abstract went from being a good abstract to being an exciting abstract. If you come to Oslo, I'll tell you (or show you on the poster).


My desk at home as it looks when I am analysing data and writing abstracts all at once. It always looks like that but that just an ugly truth.

Then I had a really good chat with a post-doc from a lab where I would like to work. With some encouragement I sent an e-mail off, and lo and behold, got a swift and guardedly postitive answer from the PI.

So, today I'm in a good mood and fixed the first batch of pictures. They're not as good as I would like them, and I already missed two days, but they do make the blog prettier. I'm all for pretty blogs.


Madicken welcoming my fiancee back home.

Have a nice week end, don't eat too much candy, and remember to register for ESH2010.

Michael

Worst or best job ever?

I picked this up off of A Photo Editor. The Wall Street Journal Online has a story about the best and worst jobs in 2010. He's obviously interested in things like "photojournalist" at 189th out of 200.

I had to check where us medical science kind of people fall.

8th Statistician
41st Physiologist
54th Chemist
128th Physician
136th Surgeon

Biologist was fourth, but it was meant for green biologists, not the lab kind. According to this I guess I should be happiest when doing statistics, and the least happy when doing surgery. That doesn't sound right. Honestly, physiologist at place 41 doesn't seem too bad. But what does it mean?

Luckily there is a methods section. Each job out of the two hundred were scored in five different categories. Most are pretty straight forward.

• Environment: Is it hazardous, confined, etc.
• Income: Is it high?
• Outlook: Can you get a job?

Then the problem starts.

• Physical Demands: sedentary = best??? heavy lifting = worst.

I can agree that heavy lifting isn't good in too large amounts, but is sedentary work good? It is bad for people to sit still, that much we know. Do people want work where they don't have to move at all? I don't think so, most people I know would probably want some moderate level of physical work.

The real problem is the category:

• Stress

It is made up of a number of things that I can agree causes stress (risk of dying anyone?), but then we get to: "Initiative required" and "Outdoor work". Can those really be bad things? I don't think so.

In conclusion, it's nice that they try to investigate this kind of thing, but it makes no sense to rank them in order of a composite of these different categories. It might make sense from a publicists perspective, but certainly not from any job seekers perspective.

Michael

That was a short run

Day 6: Already day three of the new year I missed to take a picture, and pretty much all the other have been last minute things.

I do have some now so I'll try to put them up tomorrow.

Supporting undergraduate research

Go over to Isis the goddess's blog. She's donating January's proceeds to an undergraduate award to be presented at Experimental Biology in Anaheim. Fantastic initiative, especially when you have traffic enough to provide for an extra awardee of the David Bruce Award, as Isis does.

In her honour I'm posting a shoe today. It's my favourite shoe. I wear it almost all the time. Every day at work, and every summer from April through September. Its simple design and stylish looks makes it the perfect shoe for daily casual wear as well as for jacket and tie occasions.

I present the Birkenstock!


Birkenstock sandals, new and one that's a year old. I don't know what it is but they wear out fast when I use them.

Yours,

Michael

Widening scope for more posts

It wasn't so easy to motivate myself to post regularly. My initial idea was to stay closely within the field of renal physiology and try to post meaningful posts. Most days this demanded more brain power than I had to spare. I'm going to branch out, and post some more personal stuff, i.e. stuff that interests me and doesn't strain my mental capacity as much.

Photography will be a new staple. I have started a one-picture-per-day project for 2010. If it works out I will have something to post regularly, which will be a positive development even if the pictures aren't all that.


Madicken, my boxer, sleeping after a long new years eve's night. Picture 1/365.

After the boxer picture, you may have guessed that there will be some dog posts. Like everyone else I know you will just have to live with them. I like dogs. I also play judo when I have time. I don't know how much material that will provide, but some film clips off of youtube should be doable. Then, I'm a sucker for food and drink so I might throw in some cooking, some wines and some restaurants. Finally, being a bit of a nerd, there might be some general nerdery, books, films, computers. I don't know.

What ever I come up with, I will try to keep the main focus on the science. Last year ended a bit on a down, science wise. Two rejected manuscripts, but once they are reworked and resubmitted maybe I can find some motivation to talk science again. Hopefully my new exciting projects will start providing some interesting things to talk about.

Oh, it seems that I will get to try my hand in the clinic this spring so there might be some deep and interesting observations (or some serious whining) on the impossibility of combining scientific work with being on call.

It's a brave new year that still has lots of time to get worse (or better, but I don't want to set the expectations too high).

Happy New Year,

Michael Hultström