Singularity Hub

Wow!  Physorg.com reports that an artificial retina has achieved real success in bringing limited sight to the blind.  The Department of Energy estimates that 6 million Americans are blind because their retinas have been damaged by diseases like macular degeneration.  Worldwide they estimate that 25 million people have been made blind and that this number will rise to 50 million by 2020.

A company called Second Sight Medical Products in partnership with a large consortium headed by the Department of Energy is currently testing its second generation model, called the Argus II, on more than 20 individuals.  Patients that were completely blind are able to see moving objects, read very large print, and recognize several other visual cues once implanted with the Argus II artificial retina.  From the article:

A patient named Terry spotted the shadow of his 18 year-old son as he passed
by on a sidewalk. “It was the first time I’d seen anything of him since
he was 5 years old,” Terry told Artificial Retina News, a publication
of the Artificial Retina Project.

Read the rest of this entry »

Did you know that re-attaching severed limbs is a routine procedure that was pioneered in the 60’s and has been commonplace since the 80’s?  Well, we didn’t know this either until we stumbled upon an amazing story of a man in England who accidentally chopped his arm off just below the elbow with a chainsaw and had it surgically re-attached hours later.   After just a few months he could move his arm and fingers again and he was back to work.  See the image of his repaired arm to the right.

After reading this article our curiosity was ignited and with a few searches we were shocked to see how common these types of procedures are.  According to this article:

“A severed finger can survive for at least 12 hours in a warm environment and up to a couple of days if refrigerated. .”

“The first step in reattaching a body part is to restore blood flow by reconnecting the arteries. For the procedure to work, the severed tissue must be alive, and the severed arteries must be large enough to manipulate using microsurgical techniques…You also need to reattach the veins, or blood won’t be able to flow out of the severed part. Without a conduit for outflow, the body part will swell, which can cause tissue damage…Tendons, bone, and nerves must also be reattached. In general, the cleaner the cut, the more simple the operation. Ears, which have small arteries and which, when severed, are often ripped off or bitten off, tend to be tricky.

Fingers are one thing, but entire arms, feet, and legs too?  Yes indeed!  An article from the Telegraph claims that in England hundreds of fingers are re-attached every year and larger limbs such as arms are re-attached perhaps a dozen or more times a year!

The key to successful re-attachment is microsurgery, which is surgery that is performed on very small structures, such as blood vessels and nerves, with specialized instruments under a microscope.  According to this article:

“The first successful replantation (reattachment of an amputated body part) was reported in 1964 by Harry Bunke. This replantation of a rabbit’s ear was significant because blood vessels smaller than 0.04 in (0.1 cm)—similar in size to the blood vessels found in a human hand—were successfully attached. Two years later, the successful replantation of a toe to the hand of a monkey was made possible using microsurgical techniques. Soon thereafter, microsurgery began being used in a number of clinical settings.”

The Short:

It still seems like science fiction to many, but for more than a decade now mankind has had the technology to regenerate human tissue to repair large or complex wounds resulting from burns, gashes, and surgery.

Earlier we reported on a product from Lifecell called Alloderm that is one of the leaders in this space. Today we would like to introduce you to Cook Biotech, another player in the fascinating field of tissue regeneration medicine. Cook Biotech offers a family of tissue regeneration products that it markets under the name of Surgisis Biodesign.

Cook’s Biodesign family of products have been used to treat nearly one million patients worldwide, aiding in the regeneration of tissue for hernias, large wounds, plastic surgery, colon and rectal surgery, and a slew of other applications.

I found an excellent article here that clearly explains the Biodesign product for those of us that are not tissue experts. Also, here is a clean, short description of Biodesign from the Purdue Research Park. A few cool quotes follow:

“Once in place, Surgisis Biodesign provides a scaffold-like structure and communicates with the body, signaling surrounding tissue to grow across the scaffold. Over time, Surgisis Biodesign is remodeled into fully vascularized tissue, and becomes as strong as the patient’s own tissue. As part of the complete healing process the scaffold is slowly replaced by human tissue and becomes undetectable — providing a permanent repair without a permanent material.”

“According to the American Association of Tissue Banks, one of 20 people will need some sort of soft tissue transplant in their lifetime.”

The Long:

The human body is great at healing itself in the case of small wounds or incisions, but in the case of a severe burn or surgery, the wound is simply too large or complex for the body to regenerate the required tissue properly. For these situations you need a product like Biodesign, which is a thin sheet (called matrix) that serves as a scaffold for new skin to grow and regenerate upon. In the past, synthetic materials such as nylon have been used as a scaffold. These materials are quite limited in their ability to help new tissue grow, are highly susceptible to infection, and stay in the body forever which can cause future complications for the patient. Cook Biotech’s Biodesign product represents a new generation of products based on biological materials that are more capable and more versatile than the synthetic products of the past.

Surgisis Biodesign is a porcine (pig) derived acellullar matrix that can be purchased in different sizes and with different properties based on the desired application. The Biodesign acellular matrix is tissue taken from a very special part of a pig’s intestine that has had its cells removed, leaving behind a valuable collection of proteins, chemical signals, and structural material that human skin cells can populate and vascularize.

Inserting matrix derived from pigs into your body might seem a bit creepy, but keep in mind that the other major competitor in this market, Alloderm, comes from human cadavers! Whether from pigs or cadavers, these matrix products have an amazing ability to help the body regenerate tissue and they have saved or greatly benefited the lives of millions of people. Acellular matrix is a very safe product: it is sterilized through a vigorous process and devoid of any potentially harmful cells, dna, or microbes that may have resided in the originating host.

An advantage of the porcine based matrix from Biodesign is that it is cheaper and the supply is virtually unlimited as compared to human cadaver based solutions such as Alloderm. In order to be more competitive on price and quantity of supply Lifecell has recently launched a porcine based product called Strattice to compete with Cook Biotech’s Biodesign, yet Biodesign appears to be leaps and bounds ahead of Strattice. The secret behind the success of Biodesign is that it comes from a very special part of the pig’s intestine (submucosa) that has just the right chemical makeup to serve as an incredible tissue regeneration matrix in humans. Strattice, on the other hand, is obtained from pig dermis (skin) and although logically it seems as though this should be a superior strategy, it turns out that pig dermis is not nearly as versatile or as effective as intestinal submucosa when it comes to creating the ideal matrix.

The Short:

The Harvard Crimson and the LA Times offer some of the better articles reporting that researchers have genetically reprogrammed mice pancreas cells directly into a completely different type of cell called a B cell. B cells are responsible for creating the blood sugar regulating hormone insulin in humans, and it is the absence of these B cells that causes humans to suffer from type 1 diabetes, a currently un-curable disease that requires burdensome lifelong treatment.

With this breakthrough, the Harvard researchers have apparently offered “the first conclusive evidence” that it is possible to genetically convert one type of adult cell or tissue into another type of cell or tissue. Although still years into the future, this research could pave the way for major advances in the field of regenerative medicine where people’s bodies have lost certain types of cells or tissues to injury or disease.

The Long:

Mice suffering from type 1 diabetes were treated with a virus that
specifically infected their pancreas cells and converted them into B
cells. Ten days later, up to 20% of the pancreas cells had ceased
their normal function and instead begun producing insulin at levels comparable to
B cells from healthy, non-diabetic mice.

Although this is apparently the first demonstration of direct conversion of one adult cell type to another cell type, it should be noted that this is not the only route to creating a desired cell or tissue type. Therapies derived from stem cells and pluripotent cells have been used to create all sorts of cell types in numerous studies and in fact this breakthrough from the Harvard researchers complements rather than competes with these therapies. What is notable here is the proof of concept that mature cells such as pancreas cells can be genetically reprogrammed to do almost anything through the technique of intentional viral infection, changing their behavior or even changing their entire identity.

Human applications for this type of genetic reprogramming are still many years into the future. Not only will effort be required to apply this breakthrough to humans instead of to mice, but also the proteins required to induce the reprogramming, called transcription factors, require years of effort to pinpoint and are specific to the type of reprogramming desired.

Image from Royan Institute

The Short:

In January 2008 University of Minnesota Researchers reported that they were able to grow an entire rat heart from scratch. The story is available here at npr, and there is also an audio clip of a segment that was run on npr radio.

The associated press reports that “An estimated 5 million people live with heart failure and about 550,000 new cases are diagnosed each year in the United States. Approximately 50,000 die annually waiting for a heart donor.” If we can learn to grow hearts we could save the lives of millions of people and also extend the lives of healthy people, giving them new hearts as their old hearts wear out.

There is still much work to be done before we can grow a human heart, but the University of Minnesota breakthrough shows that researchers are making significant progress towards this lofty goal. Below is a cool video documenting the development of the rat heart:

The Long:

Growing heart tissue and many other tissues of rats and other organisms is commonplace in laboratories across the globe, but growing tissue with the complex configurations and interconnectedness of organs is still a rare achievement. We recently reported on the progress being made at a company called Tengion and also in the lab of Anthony Atala at Wake Forest.

The University of Minnesota researchers offer a unique breakthrough in organ creation by creating a scaffold on which the heart can be grown. The researchers took a dead rat heart and removed the cells, leaving behind a matrix, or scaffold, of proteins and other materials. This scaffold was then injected with new cells and these cells self directed their own growth over the scaffold into a fully functioning heart.

The researches next plan to repeat their success with a pig heart. Successfully growing a pig heart would be a major breakthrough because a pig heart is very similar to a human heart in anatomy, size, and function. The hope is that the scaffold from a pig heart could be injected with cells from a human needing a new heart. The human cells would grow over the pig derived scaffold into a fully functional human/pig hybrid heart. This hybrid heart would not be rejected by the human immune system because its cells would have originated from the human that was receiving it.

Many will claim that success in growing a heart is still a dream that is many decades or more away. Perhaps they are right, but here at the Hub we argue that people too often underestimate the accelerating nature of human innovation and technology. Maybe custom grown hearts are not as far into the future as people think.

The Short:
News outlets are reporting that researchers from Advanced Cell Technology, Inc have been able to differentiate human embryonic stem cells into red blood cells. This could be a major breakthrough in mankind’s quest to find a safe, unlimited source of blood that can be used for blood transfusions and other medical needs.

Currently the world’s blood supply is obtained from human donors in a system that is short on supply and fraught with complications related to sterilization, contamination, disease, storage life (typically less than 42 days), and collection logistics.

The Long:
First off, one can’t help but be a little skeptical here because of the financial condition of Advanced Cell Technology, which reportedly is on the brink of bankruptcy. Their website appears not to have been updated in several months, perhaps symbolizing the malaise that is happening over there.

Let us hope that this research truly is legit, however, because it would be a fantastic breakthrough for mankind. Other researchers have been able to derive red blood cells in the past from sources such as cord blood and bone marrow, but these sources are still donor limited. They are also rarely of type O(-) which is the universal blood type that virtually every person can accept. Embryonic stem cells can be multiplied infinitely, allowing for the generation of unlimited blood supply and theoretically can be developed into type O(-).

This breakthrough is still nowhere near to producing a clinical trial and has many technical hurdles to overcome, so don’t expect anything to come of it for many years. Still, it is exciting to see a breakthrough that might be taking us that much closer to an improved blood supply. Now, if someone could just make us a respirocyte then we would really be in business!

The research paper was published in the journal Blood at http://bloodjournal.hematologylibrary.org/papbyrecent.dtl

Earlier we reported here at the hub that growing tissue and organs is not a science fiction story about the future, but instead is a technology that exists today. A company called Tengion is at the forefront of this emerging field of growing custom organs. Tengion is essentially a corporate vehicle for the commercial development of the major breakthroughs that have been made at the leading institutions in the field of organ and tissue regeneration. Most notably Tengion has rights to develop the research of Dr. Anthony Atala from Wake Forest where the most stunning results in the field of regenerative medicine have been achieved to date. Anthony Atala’s lab has grown a whole host of human organs including bladders, blood vessels, and heart valves.

Tengion does not have a commercially available product yet, but they have a serious arsenal of technology and patents and they are focused on bringing a long list of custom grown organs to the market. Tengion’s lead product candidate is a custom grown bladder called the Neo-Bladder which is currently in phase II clinical trials. Since Tengion’s organs are grown from the patient’s own cells these organs are not rejected by the body’s immune system, a common and serious problem for the typical organ transplant from a foreign donor. Below is a video of Anthony Atala giving an inside look at his lab which is simply amazing (although the reporter clearly doesn’t know a thing about science):

Eye To Eye: Tissue Engineering (CBS News)

The Short:

Lifecell is a company that offers a suite of tissue regeneration technologies that have been used for more than 1 million successful implants and grafts in the last decade. Their flagship product, Alloderm, is an acellular dermal matrix that contains a framework of biochemical and structural components that allow for the regeneration and replacement of human skin.

Severe burns, skin grafts for your gums, and abdominal wall reconstruction are just a few of the countless applications for this amazing product. Interestingly, an investing site called wikinvest has one of the most readable descriptions of Lifecell’s technology for those of us who are not tissue experts. A new product from Lifecell, called Strattice, derived from pig skin will open the doors to new applications and cheaper implementation of tissue regeneration.

The Long:

If you are still confused as to how it all works, here is a more in depth explanation: The human body is very good at recovering from damage such as small scrapes or small burns. However, when the damage is more severe the body cannot fully repair itself back to normal, resulting in loss of functionality, deformation, scarring, and other complications. In the case of these severe injuries or in the case of an abnormal need for skin (as
in the case of gum disease) the body needs a helping hand to “show” it
where and how it needs to grow. The matrix called Alloderm serves as
this helping hand. It is inserted into the place where new skin is
desired and your body will grow onto the matrix good as new!

Lifecell’s Alloderm product is a matrix of chemicals, proteins, and other vital components of the human skin that has been extracted from human donated skin, usually cadavers. This matrix is sterilized by Lifecell’s proprietary process and then preserved through a freeze-drying process until it is ready for use. Once
implanted into a patient, AlloDerm is revascularized (blood flow restored) and
repopulated (grafted) with the patient’s own cells.

Lifecell was recently acquired by KCI.

Growing new organs to replace old or damaged organs is no longer science fiction or something we will do in the future. It is happening now and real patients are having real organs that have been grown with their own tissue transplanted into their bodies. It is shocking that such an amazing revolution continues to remain virtually unnoticed by society!

Organs grown from a person’s own cells are the holy grail of medicine and human longevity. These organs are not rejected by the body’s immune system as foreign invaders because they actually originate from the patient. Here at singularity hub we will be following this field intensely as it may be one of the most revolutionary and game changing developments ever to beset mankind. Is your heart getting too old sir? No problem…lets just grow you a new one! The implications are stunning!

Below is a video from recent CBS coverage on regenerative medicine that is a must see if you are out of the loop on this amazing development:

Regeneration of cells - CBS Cutting Edge

Intuitive Surgical introduced its Da Vinci robotic surgical system to the world in 1999, converting surgeons into “super surgeons” by giving them eyes with 3D HD vision and digital zoom and giving them hands with ultra precision, motion scaling, and tremor reduction.  Take a look at this beauty:

Early adopters have been promoting the virtues of the Da Vinci for nearly a decade now, but only in the last year or so has the Da Vinci gained the critical mass to leap from fledgling technology to revolutionary game changer. The Da Vinci robot is being massively adopted by hospitals across the nation as its virtues to the patient including faster recovery, less blood loss, less risk of infection, and less pain have become overwhelming. Below is a promotional video from Intuitive Surgical that explains this amazing game changing innovation in the field of human health and medicine:

da Vinci Surgical System

In the United States there are countless regulatory hurdles that must be overcome for new drugs and new medical treatments to make their way to the masses. Not so in China!

Check out Beike BioTech, a bio-technology company in China that has “…treated over 2,000 patients with stem cell injections for diseases like Alzheimers, Ataxia, Autism, ALS, Brain Trauma, Cerebral Infarction, Cerebral Hemorrhage, Cerebral Palsy, Guillain-Barre, Encephalatropy, and Spinal Cord Injury”.

In the engineering world there is a common and powerful custom of developing solutions to problems simply by trying lots of things and seeing what works. Because of intense regulation in the United States it is not possible to just try random procedures or drugs on people to see what happens. In many cases this is for good reason, but a huge price is paid for this as valuable treatments are delayed or not even attempted.

In China, on the other hand, we are witnessing the power of trial and error medicine when it is not denied by regulation. People from all over the world are flying to China to companies such as Beike to pay for experimental and unproven medical treatment for some of the world’s most terrifying diseases. Beike even admits on its own website that the benefits of their stem cell treatments may be questionable for many of their patients. But if you have the money and you have no other options to treat your severely debilitating illness then Beike is happy to give you that small glimmer of hope.

Using humans as laboratory mice certainly has its moral hazards, but it also holds great power as a tool for medical innovation. The United States might win the game of morals, but we can increasingly expect many of the greatest achievements in the game of medical breakthroughs to come from places like China where morals are seen differently.

On a related note I was recently speaking to my neighbor who is a specialist in developing drugs for cancer treatment. He will soon be moving back to China after living in the United States for 20 years. Why? Because he says he can’t get anything done here in the United States. By going to China he will have an ample supply of patients to try his drugs on and few regulations to limit his ability to experiment.

In Feb 2008 IEEE Spectrum released a fantastic special report on some of the latest work being done on prosthetic arms.

The special report covers a lot of ground, but mostly focuses on DARPA’s Revolutionizing Prosthetics program:

“The program was created in 2005 to fund the development of two arms. The first initiative, the four-year, US $30.4 million Revolutionizing Prosthetics contract, to be completed in 2009, led by Johns Hopkins Applied Physics Laboratory in Laurel, Md., seeks a fully functioning, neurally controlled prosthetic arm using technology that is still experimental. The latter, awarded to Deka Research and Development Corp., Kamen’s New Hampshire–based medical products company (perhaps best known for the Segway), is a two-year $18.1 million 2007 effort to give amputees an advanced prosthesis that could be available immediately “for people who want to literally strap it on and go.” Kamen’s team designed the Deka arm to be controlled with noninvasive measures, using an interface a bit like a joystick.”

Because there are only about 6,000 prosthetic arms needed per year, the market has not been big enough to justify the large investment required to make next generation prosthetic arms. As a result it is amazing to note that commercially available prosthetic arm technology has not changed much in 100 years and is stuck in the “stone age”! Meanwhile prosthetic legs have seen significant investment and are extremely advanced and capable today.

The DARPA funding has literally changed the game by providing the investment necessary to propel prosthetic arms into the current era and beyond. In subsequent posts I will highlight some of the more notable aspects of this report.

Michael Chorost published an article in MIT Technology Review about a networked pill from a company called Proteus Biomedical. The pill, called Raisin, releases a sand grain sized microchip into the body in addition to releasing the prescription.

This microchip is activated on contact with water in the body and sends electrical currents through the body as its form of communication. That’s right…no wireless signal, just electrical currents that are picked up by a receiver that is patched onto the body or as a subcutaneous insert.

There are two major advantages that this networked pill will offer. First, it will allow doctors to monitor whether patients are actually taking the medication in the quantity and frequency that they are supposed to by checking the logs from the receiver. Second, doctors can monitor physiological parameters such as heart rate before, during, and after taking the medication to better understand the impact of the medication on the patient. Some quotes from the article:

“…the dosages of drugs used for heart failure are derived from large
clinical trials and may not meet a particular patient’s needs. “Imagine
a situation where drug ingestion is tracked, and heart pressure before,
immediately after, and later are known,” says Saxon. “That represents
real, individualized, tailored drug therapy.”

“So far, Proteus has raised $60 million from investors including the
Carlyle Group and Kaiser Permanente Ventures, and it has filed more
than 250 patents. Clinical trials with human users began earlier this
year, to test the functionality of the IEM and sensors. The company
hopes to have the system on the market in 2011.”

Below is an interesting video of Michael Chorost speaking at Google June 30, 2008. Michael spends about half of the video explaining the amazing cochlear implant that has enabled himself and more than 100,000 deaf people around the world to regain their hearing. In the other half of the video Michael explores the future of man and machine, which is the focus of his upcoming book “World Wide Mind: The Coming Integration of Humans and Machines”. A few interesting themes from the video:

1.  There are only 100,000 people with cochlear implants in the world, yet there are 500,000 deaf people in the United States alone. It really is a shame that the gift of hearing is technically available yet not being given to the millions of deaf people around the world for due to cost and other reasons.

2. Michael describes the internet as a worldwide mind that we are all able to access and update. He explains how he felt disconnected from this “mind” when his blackberry was not functioning for a short period of time. This idea is one of the centerpieces of his upcoming book and is a major theme for all of us to consider as we envision the future of mankind.

3. Michael shows video clips of the incredible advances that are being made in interfacing the human brain with prosthetic limbs. Michael asks us to consider the implications and capabilities that will be unleashed for mankind as our ability to interface directly with the neurons of the brain improves in the coming years. The ability to read minds and the ability to purposely enhance the human body is considered.

Authors@Google: Michael Chorost

The University of Texis at Austin reports that Professor Adela Ben-Yakar and colleagues have developed a femtosecond laser “microscalpel” that is so precise that it can destroy a single cell while leaving nearby cells intact.  According to the article:

“Within a few years, Ben-Yakar expects to shrink the probe’s 15-millimeter diameter three-fold, so it would match endoscopes used today for laparoscopic surgery. The probe tip she has developed alsocould be made disposable — for use operating on people who have infectious diseases or destroying deadly viruses and other biomaterials.”

“Femtosecond lasers produce extremely brief, high-energy light pulses
that sear a targeted cell so quickly and accurately the lasers’ heat
has no time to escape and damage nearby healthy cells. As a result, the
medical community envisions the lasers’ use for more accurate
destruction of many types of unhealthy material. These include small
tumors of the vocal cords, cancer cells left behind after the removal
of solid tumors, individual cancer cells scattered throughout brain or
other tissue and plaque in arteries.”

“A commercially available femtosecond laser system and microscope was
developed recently for LASIK and other eye surgeries, but the system’s
bulk limits its usefulness. Ben-Yakar’s laboratory has overcome
technological challenges to create a microscope system that can deliver
femtosecond laser pulses up to 250 microns deep inside tissue. The
system includes a tiny, flexible probe that focuses light pulses to a
spot size smaller than human cells.”

Adela Ben-Yakar has had success using similar laser devices to cut the connections (the axons) between individual nerve cells in a hunt for genes that control nerve regrowth after injury.