Number 9..Number 9..Number 9* December 17, 1999

The newspapers are full of 'end of the year', 'end of the century', 'end of the millennium' stories (and I will not get into an argument about when the century or millennium actually ends). It is really interesting to read about how different the world is today compared to 1899. In my opinion, the biggest change this century has been our acceptance of change. It used to be that you were nostalgic for a time in the distant past, during some Golden Age. Now we have TV shows dealing with the good old '80s. Alvin Toffler wrote a provocative book in the '70s called Future Shock. One thing I remember he wrote was the ability to adapt to change, to even enjoy it, would be the necessary trait to survive the coming years. How right he was.

We see this as scientists all the time, we accept that ideas change--and this is a really profound change. Compare this to 100 years ago. Max Planck wrote "A new scientific truth does not triumph by convincing it's opponents and making them see the light, but rather because it's opponents eventually die, and a new generation grows up that is familiar with it." Great scientific ideas, such as Natural Selection or Relativity, took many, many years to convince the majority of scientists. Many vehemently opposed them throughout the rest of their scientific careers. But then, in those good old days, there might only be one revolution in scientific thought in a generation. Maybe not even that. We, on the other hand, having embraced change so thoroughly, seem to see a major revolution in some field of science every few years. Computers double in speed every 2 years. The double helix is the structure of DNA. Ceramics can be made that are superconducting at near-room temperature. Men land on the moon. The reflection of another star's light on a planet in a distant solar system is seen.

We must be careful, though, that we do not fool ourselves, that we do not accept a new fact or theory simply because it is new. Novelty does not equal truth. Even good scientists such as Pons and Fleischmann can be fooled -- remember Cold Fusion. (Although, maybe they were right after all. Arthur C. Clarke wrote an essay in Science regarding this and there is even a journal dealing with Cold Fusion.)

There should be some really good neologism for accepting change so complacently. Although some try to discuss it in some sort of neo-Luddite way, most of us do not seem to even think about the many changes happening, many of them quite beneficial. It's like informing everyone that the sky is blue. But every once in a while someone will ask why it gets red at sunset or where the stars are during the day, and we all stop to ponder. Why hadn't anyone thought of that before?

Thomas Kuhn wrote a very influential book called The Structure of Scientific Revolutions. He described a term that is now a cliché, 'paradigm shift'. It entails a compete change in a view of the natural world, so dramatic that it is virtually impossible to even imagine how people viewed the world prior to the shift. When world views shift, when paradigms change, we do notice it.

This is a long introduction that leads to a personal experience that will, it is hoped, lead to some examinations of recent research. First, the personal stuff. I spent Thanksgiving morning in the emergency room at Evergreen hospital (If we had no holidays, would the number of emergency room visits decrease?). My wife, Margit, was in a lot of pain with, as it turned out, a kidney stone. Now, I have had a lot of experiences with hospitals, and the procedures here, while fairly quick (we did beat the holiday rush), were within my expectations. What impressed me were the diagnostic tools used. The initial theory was a kidney infection. They took a urine sample and in less than 10 minutes knew it was not an infection. The next step was a CAT scan to look for a stone. Now, my expectation was that, given the holiday and the need for technicians to work such a large diagnostic tool, this would take several hours to get arranged and performed. Well, the doctor came back to the examination room in 10 minutes with the diagnosis. There was a 5 mm stone in her right ureter. Not only what it was but where it was. In 10 minutes. And the pictures were really cool to look at!! I knew that the diagnostic tools that we have today are incredible. The fact that they are so accessible required me to change my view.

Now, being a scientist, I naturally checked out kidney stones. Turns out 10% of men and 6% of women will get one in their lifetime. Although most are passed, many require removal and many times the techniques used today are able to do this without surgery. We can attest to that. The wonders of artheroscopy, miniature cameras and painkillers.

What causes kidney stones? Well, could be diet, could be lifestyle but there is an interesting theory that has been proposed that, if true, would also require us to change a lot of our ideas about the smallest organisms.

Most people now know that peptic ulcers are caused by bacteria, not by diet or by lifestyles. Helicobacter pylori is the causative agent. The CDC has a nice page about this and the accompanying timeline demonstrates that, sometimes, change does come slowly, even in today's world. The idea that bacteria cause ulcers required a complete alteration in the way doctors diagnosed it. Twelve years after the first observations, only 5% of the sufferers were receiving antibiotics, even though this would cure 90% of all patients. Only recently do most ulcer-sufferers even know that they can be cured by antibiotics.

There is now convincing research indicating that oral bacteria may be responsible for a significant number of heart attacks. These bacteria cause platelets to clump and can easily enter the blood stream in people suffering periodontal disease. So, once a new paradigm has been established, it becomes easier to find occurrences of similar events. Bacteria are responsible for more than infections. They may be responsible for an assortment of disorders that have been linked more to lifestyle than to disease. This now brings us to kidney stones and a potential causative agent, nanobacteria.

Kidney stones are crystals formed from the precipitation of oxalate, phosphate, calcium or uric acid salts. No one is really sure what causes these minerals to crystallize out of solution or whether there is a genetic link. A very provocative theory has been proposed by E. Olavi Kajander in Finland. He believes that ultra-small organisms, ranging in size from 50-500 nanometers, may serve as accretion centers for the formation of kidney stones. And if bacteria cause kidney stones, antibiotics could control them. Just like peptic ulcers. "Not a lifestyle. Not dietary. It's caused by bugs."

Kajander has observed these so-called organisms in many different settings. Their main characteristic is a hard coating of hydroxyapatite, which could serve as condensation points to generate crystals. He has looked at kidney stones and found such nanobacteria in almost every one. The controversy is whether these particles are alive or not.

The size of these particles makes them smaller than some viruses, smaller than any other free-living form of life, yet they are supposed to be fully self-sufficient organisms. They can be endocytosed into mammalian cells, resulting in apoptosis. They may be a major problem with tissue culture. They are too be difficult to work with and grow very slowly. This has lead some to suggest that they are either contaminants or just non-living crystals. The arguments have gotten so heated that the specter of scientific fraud is now being raised. It kind of looks like Cold Fusion again. The true believer vs. the infidel.

Why is there so much invective being thrown around? So many other things change. The tools we use and the techniques we adopt today are incredibly different from those used even a few years ago. Why don't scientists just do the work and determine whether nanobacteria really exist or not? Well, the idea of nanobacteria represents more than just normal change. It would require a lot of scientists to look at some things in a different light. Much as the idea that bacteria could cause ulcers, the idea that such incredibly small objects could be capable of sustaining independent existence is mind-boggling.

It could represent a paradigm shift and, according to Kuhn, they are always surrounded by controversy. People do not change their view of the world without a lot of pushing and shoving and yelling. Scientists are now in the process of determining whether nanobacteria do exist or are artifacts. If nanobacteria do exist, they will have far-reaching ramifications for life on Earth (maybe they are responsible for mineral formation) or on other planets (rocks from Mars may have nanobacteria in them). Science in the middle of extreme change can be messy. Look at what happened with Cold Fusion. But if nanobacteria really do have a role in kidney stones or really are found on other planets, well, this is one revolution you can count me in.

*think the Beatles.