ndab Ah Yes, Medical School: December 2004

Sunday, December 05, 2004

Swallow. Doctor's Orders.

Throughout the first year and a half or so of medical school, our curriculum has been organized into blocks arranged around studying certain organ systems and their diseases, and threads arranged around subjects that are relevant to all the blocks, like genetics or ethics. One such thread is entitled "Clinical Reasoning and Epidemiology", and this has basically been a scattered series of lectures trying to teach us a) how to search for scientific journal articles on-line and b) how to analyze statistics in such journal articles.

While I am nowhere near mastering (b), I'd like to think I have a firm grasp on (a) - it's really not that hard to think of what you want to look up, then type the words, and then wait for the search engine to spit out the results. Why should you care? Well, recently we were assigned to do quite possibly the most ridiculous set of busy work ever inflicted upon hapless medical students. In order to study nutrition (and justify the job of this one lady who's sole purpose is to take away our time from actually learning medicine, including...nutrition), we had to pick some random topic that had not been written about in the past few years and write a 5-page review article on it. I have decided to write mine on gastric bypass surgery in kids, but if that were the end of this post you'd probably be thinking "man I remember when this guy at least tried to be funny". Lucky for you, there's much more where this came from - please enjoy the steamy dramatic portrayal that follows:

It was a Saturday night. I was alone, betrayed by a friend who I thought was coming to relieve me of my boredom. I relegated myself to the world of computer socializing, where one of my friends came to me and said "Fuck, just thinking about having to do this nutrition paper makes me angry, and I have no idea what to do it on." I agreed with him and his saucy language, and then I delved into the depths of my brilliantly academic mind, searching for a topic that not only reached towards the higher echelon of pure science but also deftly worked to cure the diseases that afflict mankind, thus making this world a better and more pure place. After struggling mightly for approximately 14 seconds, my genius displayed itself once again as I offered this monumental suggestion:

"Perhaps you could study whether there is a benefit to swallowing rather than spitting during oral sex."

Yes, this was truly a man amongst boys when it came to potential sources of scientific discovery. Shockingly, my friend was not impressed. "Umm...I think finding any articles on that might be just a little difficult", he sighed. Fear not, for as I previously mentioned, I was thoroughly skilled in the art of literature searching. Wielding my weapon upon the keyboard, I went to PubMed and entered in the key words that would seal my fate:

"oral sex, swallowing"

The computer churned, yearning for a chance to break free from the bounds of chastity (I challenge you to make any sense out of that sentence). I waited anxiously, my pulse rising, my breathing become more rapid, all the while wondering if I would ever feel the large firm breasts of victory. In a matter of seconds something emerged on screen. It appeared to be a list. It started small, but then it kept growing. And growing. And growing! Soon it was rigid and firm, and I have to stop this analogy before I barf all over my keyboard.

I looked at the potential papers, seeing nothign to my liking. But then it struck me. Finally, the proof all men have needed for eternity stared at me. Yes, ladies and gentlemen, I had found the holy grail:

Correlation between oral sex and a low incidence of preeclampsia: a role for soluble HLA in seminal fluid?

Yes, here I had found a paper that proved once and for all that there was an actual health benefit to swallowing. I read on and discovered the abstract:

The involvement of immune mechanisms in the aetiology of preeclampsia is often suggested. Normal pregnancy is thought to be associated with a state of tolerance to the foreign antigens of the fetus, whereas in preeclamptic women this immunological tolerance might be hampered. The present study shows that oral sex and swallowing sperm is correlated with a diminished occurrence of preeclampsia which fits in the existing idea that a paternal factor is involved in the occurrence of preeclampsia. Because pregnancy has many similarities with transplantation, we hypothesize that induction of allogeneic tolerance to the paternal HLA molecules of the fetus may be crucial. Recent data suggest that exposure, and especially oral exposure to soluble HLA (sHLA) or HLA derived peptides can lead to transplantation tolerance. Similarly, sHLA antigens, that are present in the seminal plasma, might cause tolerance in the mother to paternal antigens. In order to test whether this indeed may be the case, we investigated whether sHLA antigens are present in seminal plasma. Using a specific ELISA we detected sHLA class I molecules in seminal plasma. The level varied between individuals and was related to the level in plasma. Further studies showed that these sHLA class I molecules included classical HLA class I alleles, such as sHLA-A2, -B7, -B51, -B35 and sHLA-A9. Preliminary data show lower levels of sHLA in seminal plasma in the preeclampsia group, although not significantly different from the control group. An extension of the present study is necessary to verify this hypothesis.

Victory was mine! I quickly returned to my friend to show him teh results. He laughed at me, then wondered what kind of jackass takes time to actually look up something like that. I smiled, turned my eyes towards him (or the computer version of him on IM), and said, "This jackass, my friend. This jackass." My finger was pointed directly at my face.

The End.

(If you would like to actually read this article, the full citation is:
Koelman CA, Coumans AB, Nijman HW, Doxiadis II, Dekker GA, Claas FH. Correlation between oral sex and a low incidence of preeclampsia: a role for soluble HLA in seminal fluid? J Reprod Immunol. 2000 Mar;46(2):155-66.)