Angelina's mastectomy... and other medical stories of 2013

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With a baby cured of HIV and breakthroughs in dementia, it's been a year where two of the great scourges of our time have been put on the back foot.

Meanwhile a vision of the future of medicine has emerged, with scientists growing miniature organs -including brains - and performing the first steps of human cloning.

BBC health and science reporter James Gallagher reviews the year in medical science.

HIV baby cure
HIV virus

One of the most remarkable stories of the year was a baby girl in the US seemingly being "cured" of HIV.

Her mother had an uncontrolled HIV infection and doctors suspected the baby would be infected too, so they decided to give antiretroviral drugs at birth.

Normally the drugs hold the virus in check, but the very early treatment seems to have prevented HIV taking hold.

The baby is now three, has been off drugs for more than a year and has no sign of infection.

However, as this analysis explains, a cure for HIV is still a distant prospect. Yet there have been other developments - two patients have been taken off their HIV drugs after bone-marrow transplants seemed to clear the virus.

HIV was once thought to be impossible to cure; now there is real optimism in the field.

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Post-menopausal pregnancy
Dr Kazuhiro Kawamura Dr Kazuhiro Kawamura of the St Marianna University medical school holding the newborn

Going through an early-menopause used to be seen as the end of a woman's reproductive life.

But this year a baby was born after doctors, in the US and Japan, developed a technique to "reawaken" the ovaries of women who had a very early menopause.

They removed a woman's ovaries, activated them in the laboratory and re-implanted fragments of ovarian tissue.

Any eggs produced were then taken and used during normal IVF.

Fertility experts described the findings as a "potential game-changer".

However, things will not change for women going through the menopause at a normal age as poor egg quality will still be a major obstacle.

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Angelina and Andy
Angelina Jolie and Andrew Marr

The cult of celebrity catapulted two diseases into the public eye this year - breast cancer and strokes.

Hollywood actress Angelina Jolie had a double mastectomy after her doctors said she had an 87% chance of developing breast cancer during her lifetime.

She has a mutation in her DNA, called BRCA1, which greatly increases the odds of both breast and ovarian cancer.

In a newspaper article she said: "I feel empowered that I made a strong choice that in no way diminishes my femininity...for any woman reading this, I hope it helps you to know you have options."

BBC presenter Andrew Marr had a stroke after an intensive rowing machine session and a year of "heavily overworking".

It put a spotlight on the standard of care for stroke patients and raised the question why do healthy people have strokes?

He says he's "lucky to be alive" and is back presenting, although the stroke has affected "the whole left hand side of my body".

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Lab-grown mini organs
Cross-section of miniature human brains termed cerebral organoids

This purple and green image is of a very special human brain which was grown from skin cells entirely in a laboratory.

The pea-sized "cerebral organoid" is similar to the brain of a nine-week-old foetus.

It has distinct brain regions such as the cerebral cortex, the retina, and an early hippocampus, which would be heavily involved in memory in a fully developed adult brain.

Scientists hope the organoids, which are not capable of thought, will transform the understanding of the development of the brain and neurological disorders.

And it's not just brains. Japanese researchers said they were "gobsmacked" at making tiny functioning livers in the same way.

They think transplanting thousands of these liver buds could help to reverse liver failure.

On a larger scale, researchers have made full-sized kidneys for rats which were able to make urine.

Their vision is to take a donor kidney and strip it of all its old cells to leave a honeycomb-like scaffold, which would then be used to build a new kidney out of a patient's own cells.

Expect more from the "grow-your-own organs" field in the coming years.

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Dementia on the back foot
Brain Loss of tissue in a demented brain compared with a healthy one

Understanding the billions of neurons which make up the human brain, one of the most complex structures in the universe, is one of the greatest challenges in medical science.

This year marked a major breakthrough in defeating neurodegenerative diseases such as Alzheimer's.

A team of UK Medical Research Council scientists used a chemical to stop the death of brain cells, in a living brain, that would have otherwise died due to a neurodegenerative disease.

This is a first and a significant discovery. One prominent scientist said this moment would "be judged by history as a turning point in the search for medicines to control and prevent Alzheimer's disease".

Dementia has also become a major global priority in 2013 amid fears it is rapidly becoming the health and social care problem of a generation.

The G8 group of nations have pledge to fund research aimed at curing the disease by 2025.

It is just one aspect of a flood of money entering brain research.

President Obama has dedicated millions of dollars for mapping the connections in the brain and in Europe the billion pound Human Brain Project to simulate the organ using computers is now under way.

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Human cloning
Row of babies

Human cloning was used to produce early embryos which a group of US scientists described as a "significant step" for medicine.

It has been a long struggle to reach this stage, the same technique was used to produce Dolly the sheep way back in 1996.

No-one is considering attempting to let a cloned embryo develop.

Instead the cloned embryos were used as a source of stem cells, which can make new heart muscle, bone, brain tissue or any other type of cell in the body.

However, it is an ethically charged field of research and there have been calls for a ban.

Meanwhile, the first trial of stem cells produced from a patient's own body has been approved by the Japanese government.

Scientists will use the cells to attempt to treat a form of blindness - age-related macular degeneration.

And a new era of regenerative medicine could be opened up by transforming tissue inside a living animal back to an embryonic state.

It's an inherently dangerous thing to do; the tissues became cancerous in the experiments, but if it was controlled then it could be used to heal the body.

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A new role for sleep and body clock resets
Brain in a head

Scientists have found a new explanation for why we sleep - for a spot of housework.

As well as being involved in fixing memories and learning, it seems the brain uses sleep to wash away the waste toxins built up during a hard day's thinking.

They think failing to clear some toxic proteins may play a role in brain disorders such as Alzheimer's diseases.

Meanwhile, a separate group of researchers think it may be possible to slow the decline in memory and learning as we age by tackling poor sleep.

And there is no doubt about the impact a poor night's sleep has on the whole body. The activity of hundreds of genes was altered when people's sleep was cut to less than six hours a day for a week.

Of course you could blame the moon after a "lunar influence" on sleeping patterns was discovered. It showed that the extra light from a full moon makes it harder to sleep.

There may be good news on the horizon for shift workers and jet setters who will be intimately familiar with the pains of having a body clock out of sync with the world around them.

A team at Kyoto University has found the body clock's "reset button" inside the brain.

They tested a drug which let the body clock rapidly adjust to new timezones, instead of taking days. It brings the prospect of drugs to avoid jet lag much closer.

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Deadly infections new and old
Coronavirus

Two new viruses have attracted global attention and concern this year.

A new bird flu, H7N9, emerged in China infecting more than 130 people and causing 45 deaths.

However, most were confined to the beginning of the year when the virus first emerged. Closing live poultry markets in affected areas has largely cut the spread of the virus.

And Saudi Arabia is at the centre of an outbreak of Middle East respiratory syndrome coronavirus. The animal source of the virus has not yet been confirmed, although camels are a likely culprit.

Meanwhile, polio has returned to war-torn Syria for the first time in 14 years.

And in the UK, an outbreak of measles infected 1,200 people - as a result of a drop in vaccination during the completely unfounded MMR-autism scare a decade earlier. The World Health Organization warned Europe risked failing to meet its pledge to eliminate measles by 2015.

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Odds, ends and an impotent James Bond

The mobile app in action: Scanning the back of the eye

There were many interesting one-off stories this year too - some serious, some not...

A modified smartphone is being tested in Kenya to see if it can prevent blindness in some of the poorest parts of the world.

Doctors warned that antibiotics were running out and could lead to an "antibiotic apocalypse".

Scientists claimed a milestone moment for cancer after finding 21 major mutations behind that accounted for 97% of the most common cancers.

There was a shift in understanding psychiatric disorders when it was shown autism, attention deficit-hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia all shared several genetic risk factors.

A surgical knife which can sniff out tumours was developed to improve cancer surgery.

The iKnife

New teeth have been grown out of the most unlikely of sources, human urine.

A treatment to banish bald spots is a step closer after human hair was grown in the laboratory, however, there are still engineering challenges to get the hairs the same shape, size and as long as before.

Another thing to blame your parents and grandparents for...behaviour can be affected by events in previous generations which have been passed on through a form of genetic memory.

A wheelchair was controlled with a pierced tongue.

The UK's first hand transplant took place in Leeds while in China a severed hand was kept alive on an ankle.

Brain scans showed babies could decipher speech as early as three months before birth.

Lullabies may help sick children by reducing pain and improving their wellbeing.

And finally... James Bond's sexual prowess was seriously questioned with doctors describing him as an "impotent drunk".

James Bond Doctors say James Bond, played here by actor Daniel Craig, has a drink problem

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