Mutation - Part Two

VIRAL MUTATION WILL LEAD TO THE END OF HUMANKIND

Thus far, in our examination of I Am Legend, we have established how viruses find opportunity for mutation, and what types of viruses are of interest to researchers for use as oncolytic adenoviruses targeted for cancer treatments. (If that sentence makes no sense to you, go to the Mutation - Part One blog entry, March 6. Or you can just read on.)

Has anyone noticed how many movies starring

Will Smith have medical themes and show off his hunky arms?

Exercise has been clinically proven to enhance immune system function.

THE FUTURE IS NOW

As established, I Am Legend relates events that are about to ruin our lives, happening as I write this... blog! Using the film to read the future, we find that some time last year, in 2009, Doctor Alice Krippin engineered a strain of measles virus (paramyxovirus)(1) in an attempt to cure cancer. According to the film, we should expect to hear any day about Krippin's 100% cure rate for cancer by using this new viral strain in her experimental treatments.

Emma Thompson as Doctor Alice Krippin

If we are on schedule with I Am Legend, this viral cure for cancer will mutate, running horribly out of control, infecting and killing us sometime this year. It seems that this mutated virus has an infection rate between 90 and 100%, depending on your statistical source.

According to Wikipedia, once infected 90% of us will die, 8% will turn into a horribly degenerated vestige of mankind, and 2% are not affected at all, but will be murdered by mutated humans.

Mutant human attempting to murder the uninfected (talk about mood swings!)

So the brilliance of I Am Legend is that the virus used to cure cancer not only mutates its own DNA as it gets out of control and "goes airborne," but also mutates the DNA of the human host. Our entire scenario is a double mutation! For you trivia buffs, run-of-the-mill measles virus is already "airborne."

Spring colors (like blue) are all the rage this

season for the raging pandemic!

According to the movie, at any moment in 2010, we will begin to feel the initial signs and symptoms of viral infection. Many viral infections start in the same exact way, regardless of whether they are lethal, or mutating, or not. Influenza, HIV and polio all start with fever, headache, body aches, malaise. This pattern is commonly described as "flu-like symptoms."

This woman has signs of infection

with a horrible mutating epidemic,

or maybe it's the flu.

But because this is a mutated measles virus, hacking cough, sore throat and runny nose should develop tout suite, or it could just be H1N1(link for photo below.)

Oh my gosh! She sneezed! It's going airborne!

It is not clear if people infected with the mutant virus get a rash like measles,

A measles rash on the back, from an informative

article in the New York Times.

but they do develop a permanent fever (possibly as a result of the mutated adenovirus' hyper-stimulation of the body's immune response) and an accelerated metabolism...

Monitoring metabolism in the film.

...and photophobia, just like measles. I should point out that photophobia affiliated with measles infection does not make the patient's skin smoke and burn.

Double mutation induced photophobia is due to strike

the New York area in 2012 or sooner. Note the smoking epidermis.

People infected by the mutant virus also go on to lose all their hair except for eyelashes, have increased muscular power(2), increased coordination, and display behavioral changes and mood swings.

Patients may be prone to violent outbursts.

Their pets may also experience mood swings.

There also seems to be a bleeding eye thing that presents itself as a sign of infection with the virus. This bleeding eye event should not be confused with the hemolacria experienced by the character Le Chiffre in Casino Royale (blog entry CASINO ROeYeALE).

Infection with Krippin's mutated paramyxovirus

leads to bleeding from the eyes. Now we know it's not H1N1.

Le Chiffre may be infected with evil, but this is

not the result of his hemolacria.

Next time we will track the spread of this virus through the general population.

1. Paramyxoviruses are a group of viruses that cause upper respiratory illnesses like measles, mumps. These are airborne viruses. According to Wikipedia, from Greek para-, beyond, -myxo-, mucus or slime, plus virus, from Latin poison, slime. Ick!

2. Enhanced muscular endurance is not documented in the film.

Star Date: 2253.04

I saw Star Trek last night. Great movie! It has lots of action and aesthetically pleasing blood, which are two of my main priorities for this type of film.

Why am I interrupting the Spider-Man posts to talk about Star Trek? Well, dammit, Jim! This is important, man! It seemed like a good idea to go over a couple medical points that stood out. They were remarkable enough for me to try and take a couple notes in a dark theater, but shouldn't interfere with your enjoyment of the movie, in the least. Minor spoilers (for the extremely sensitive) follow.

Boy Spock: This is not the shot in discussion. I couldn't find that one on the IMDB

RED EARS, GREEN BLOOD

There is so much that is good about this movie, I don't want you to think I didn't enjoy it. The baby delivery scene is a hoot! But I did notice something that seemed like a bit of an oversight in a later shot that could have been corrected easily(1).

What was the problem? Boy Spock's ears. We see young Spock (Jacob Kogan), his lip split from a fight and oozing green blood, as he sits in front of a window, providing a flattering, glowing back light. He is impish and cute and has the look of an emotionless Vulcan school boy who knows he's been bad. The light from the window gently enfolds him and gives his little pointy ears a glowing pink tint.

This is where the record scratch sound that implies, "What the f---!" would come in. Don't get me wrong, the ear-glow is good. They make the prosthetic pointy ear (I assume it's a prosthetic) match its glow to Kogan's real ear, creating a seamless piece. But ears glow pink when light shines through them because of the red blood in the capillary beds of the ears.

I'm okay with green blood oozing from cute Vulcan red lips, this is art after all, but they missed an opportunity for a little finesse when they didn't make those ears glow green. The shot only lasts a few seconds. How hard can that be?

FLU LIKE SYMPTOMS

I just wanted to point out the scene where McCoy (Carl Urban) gives Kirk (Chris Pine) a vaccine so that Kirk will develop symptoms of illness and be taken on the Enterprise. He develops flu-like symptoms such as headache, nausea, fatigue, fever, etc. This is true of many vaccines for many diseases. They also added some colorful symptoms like blindness in the left eye. This sequence is not too far off base, but extremely sped up to keep the plot moving. An injection may be able to get into your bloodstream in seconds, but it is still going to take your body hours or days to react to the pathogens in the vaccine(2).

Kirk has an allergic reaction to the shot. This is a Type I hypersensitivity reaction. His hands and tongue swell. He's lucky he can still breathe. People who get swollen tongues often get swollen lips, and not like they've had a bit too much collagen injected there, either. Think of having a child's football attached to your face. This doesn't happen to Kirk, only his hands are disfigured by swelling, and he can't talk. It may be the severest reaction McCoy has seen to the vaccine, but Kirk is lucky nonetheless.

McCoy orders something that sounds like "cortisone" to be given to Kirk. Epinephrine-like drugs will probably still be the drug of choice in the future over a cortisone-like drug. Epi-pens are used for these types of emergencies, currently. But what do I know, I'm not a pharmacologist by any stretch of the imagination. That stuff is hard.

Vulcan nerve pinch: note the third and fourth finger placement over the area of the right brachial plexus as it emerges from the scalenes.

Brachial plexus

VULCAN PINCHES

This Vulcan nerve pinch thing cracks me up. As a massage therapist I can put people into exquisite pain by squeezing the upper trapezius or anterior and middle scalene muscles, but I have yet to be able to render a patient unconscious. Lord knows I've tried.

Anatomically speaking, the only bundle of nerves in the area is the brachial plexus, which is composed of nerves leaving the vertebrae of the neck. They pass between the two scalenes mentioned above, and then form a number of nerves that innervate the arm and hand.

Squeezing the brachial plexus with the Vulcan nerve pinch won't effect the brain, but could cause someone to develop a bad case of Carpal Tunnel Syndrome, or Thoracic Outlet Syndrome, or in extreme cases paralysis of the upper extremity.

This being said, I assume the nerve pinch is only doable by Vulcans because it involves some sort of telepathy, or mind-meldy thing to make it work.

ROSEY BLUSH

One last thing: Spock (Zachary Quinto) tries to strangle Kirk. When Spock releases him, Kirk has ruddy finger marks on his neck. Nice touch!

Next time we continue our discussion of fibroblasts and Spider-Man's biological web spinning abilities... I swear it!

1. If you have an extra million dollars lying around for things like this.

2. For more on flu-like symptoms, go to the first Spider-Man post.

Spider-Palm: Number 1

THE CHALLENGE

One of my anatomy students has asked me to explain Spider-Man's web squirting ability in one of my posts. How could I resist the opportunity to make jokes about the sticky palms of teenage males? I couldn't. I didn't even try. But I will try to keep myself in check and only crack wise at every fifth opportunity.

The bite

In both the comic and the movie (starring Toby Maguire as Peter Parker and directed by Sam Raimi), Peter is bitten by a genetically altered radioactive spider whose venom transforms Parker physically into the Spider-Man.

As we all know, Spider-Man's biological web making skills are not an issue in the comic book because although Parker was bitten by a spider, he devised a mechanical device that he straps to his wrist, by which to spin a web (any size!)

Steve Ditko drawing from Amazing Fantasy 15

(Being married to a cartoonist comes in handy!)

For this particular film, my challenge is to support the story by explaning the physiology behind the physical metamorphosis that Parker undergoes in teh movie. Let's start with his reaction to the spider's bit.

FLU LIKE SYMPTOMS

Here's a riddle: What do you get when you cross malaria with measles, Lyme disease, AIDS, and the flu? The answer is: Flu like symptoms! Ha! Ha!

Whenever your body is invaded by a pathogen, you fight it off in the best way you know how, which often means an elevated body temperature (fever) and some other events that help to boost up your immune system. The result is headache, malaise, muscle aches, fatigue, chills, etc. It doesn't matter whether the pathogen is something that will kill you or just make you miserable for a week, you body will usually respond the same way to practically anything.

So Parker gets bit by the spider and what happens? He ends up in bed with flu like symptoms or something. He sweats, he's shaky, a little delirious, probably has a headache, etc.

Flu like symptoms

URTICARIA

He also develops some lesions on his skin. Some diseases, like chicken pox or measles cause skin lesions, but can skin eruptions be the result of insect bites? Sure, a common disease caused by an insect bite is Lyme disease(1), which produces a bulls-eye rash at the site of the bite. Come to think of it, Parker gets a tiny bulls-eye rash at the bite, and skin lesions as well. Maybe the spider is also a vector for a radioactive bacteria? No... that's crazy.

Parker's bulls-eye like rash

Sign of Lyme disease: a bulls-eye rash

Parker gets a bunch of other welts over his forearms and not just at the site of the sting. commonly, one would only find a skin lesion at the area of the bite. Perhaps Parker is having an allergic reaction(2) to the radioactive spider venom. As far as make up goes, those hives (urticaria) are good and pronounced, but personally I'd like to see them pinker.

The welts work for allergic urticaria as is, but pink or ruddy skin indicates a perfusion of blood in the tissues' capillary beds. If Parker is undergoing a physical metamorphosis, that process is going to require a lot of oxygen, nutrients, and waste removal, all of which would happen via the blood. A little more rouge would boost authenticity.

Parker's flu like symptoms are not only a sign of his body's attempts to combat the spider's venom, but also a sign of his heightened metabolism, as his cells transform themselves and reorganize his body into that of a super-strong creature able to squirt adhesive fluid from more than the usual places.

How did he do it? How did his body grow a bunch of liquid web that would propel itself out of his wrists? Here's the magic cell that I say did most of the work...

The amazing fibroblast!

For more amazing adventures, stay tuned for the next post!

1. Lyme disease is caused by a tick that carries bacteria in its saliva. The tick is a vector for disease, meaning it does not cause the disease itself, it carries the organism that causes it in its mouth. The bacteria are then transmitted to a new host and the host, if it's a person, develops Lyme Dissease.

2. Allergies to many stings are a Type I hypersensitivity reaction. An allergic victim of a sting can experience a severe reaction at the site of the bite, but also in other areas, such as the airway. Hives and swelling of the respiratory passages are common, and if severe enough can lead to death. It's possible that Parker is having a milder allergic reaction, although the welts would probably happen before he could get home. What an embarrassment! To be all welted up on a school bus, eyes watering, itching like crazy, wheezing, etc. and under the gaze of the girl you have a crush on, Mary Jane Watson (Kirsten Dunst)