How babies’ lives were saved by 3-D printing

May 3, 2015

 

Three babies all had the same life-threatening condition: a terminal form of tracheobronchomalacia, which causes the windpipe to periodically collapse and prevents normal breathing. There was no cure and life-expectancies were grim.

The three boys became the first in the world to benefit from groundbreaking 3D printed devices that helped keep their airways open, restored their breathing and saved their lives at the University of Michigan’s C.S. Mott Children’s Hospital. Researchers have closely followed their cases to see how well the bioresorable splints implanted in all three patients have worked, publishing the promising results in today’s issue of Science Translational Medicine.

“These cases broke new ground for us because we were able to use 3D printing to design a device that successfully restored patients’ breathing through a procedure that had never been done before,” says senior author Glenn Green, M.D., associate professor of pediatric otolaryngology at C.S. Mott Children’s Hospital.

“Before this procedure, babies with severe tracheobronchomalacia had little chance of surviving. Today, our first patient Kaiba is an active, healthy 3-year-old in preschool with a bright future. The device worked better than we could have ever imagined. We have been able to successfully replicate this procedure and have been watching patients closely to see whether the device is doing what it was intended to do. We found that this treatment continues to prove to be a promising option for children facing this life-threatening condition that has no cure.”

The findings reported today suggest that early treatment of tracheobronchomalacia may prevent complications of conventional treatment such as a tracheostomy, prolonged hospitalization, mechanical ventilation, cardiac and respiratory arrest, food malabsorption and discomfort. None of the devices, which were implanted in then 3-month-old Kaiba, 5-month-old Ian and 16-month-old Garrett have caused any complications.

The findings also show that the patients were able to come off of ventilators and no longer needed paralytics, narcotics and sedation. Researchers noted improvements in multiple organ systems. Patients were relieved of immunodeficiency-causing proteins that prevented them from absorbing food so that they no longer needed intravenous therapy.

Kaiba Gionfriddo made national headlines after he became the first patient to benefit from the procedure in 2012, and the procedure was repeated with Garrett Peterson and Ian Orbich. Using 3D printing, Green and his colleague Scott Hollister, Ph.D., professor of biomedical engineering and mechanical engineering and associate professor of surgery at U-M, were able to create and implant customized tracheal splints for each patient. The device was created directly from CT scans of their tracheas, integrating an image-based computer model with laser-based 3D printing to produce the splint.

The specially- designed splints were placed in the three patients at C.S. Mott Children’s Hospital. The splint was sewn around their airways to expand the trachea and bronchus and give it a skeleton to aid proper growth. The splint is designed to be reabsorbed by the body over time. The growth of the airways were followed with CT and MRI scans, and the device was shown to open up to allow airway growth for all three patients.

Doctors received emergency clearance from the FDA to do the procedures.

“We were pleased to find that all of our cases so far have proven to improve these patients’ lives,” Green says. “The potential of 3D-printed medical devices to improve outcomes for patients is clear, but we need more data to implement this procedure in medical practice.”

Authors say the recent report was not designed for device safety and that rare potential complications of the therapy may not yet be evident. However, Richard G. Ohye, M.D., head of pediatric cardiovascular surgery at C.S. Mott who performed the surgeries, says the cases provide the groundwork to potentially explore a clinical trial that could help other children with less-severe forms of tracheobronchomalacia in the future.

Kaiba, now a curious, active 3-year-old who loves playing with his siblings and who recently saw his favorite character Mickey Mouse at Disney World thanks to the Make-a-Wish Foundation, was back at Mott in April for a follow-up appointment.

The splint is dissolving just how it’s supposed to and doctors expect that eventually, his trachea will reflect that of his peers with no signs of the tracheobronchomalacia that nearly killed him as a newborn.

“The first time he was hospitalized, doctors told us he may not make it out,” Kaiba’s mom April Gionfriddo remembers. “It was scary knowing he was the first child to ever have this procedure, but it was our only choice and it saved his life.”

Now an energetic 2-and-a-half-year-old with a contagious laugh, Garrett is able to breathe on his own and spend his days ventilator-free. Ian, now 17 months old, is known for his huge grins, enthusiastic high fives and love for playing with his big brother, Owen. Ian had the splint procedure done at Mott exactly one year ago this month.

“We were honestly terrified, just hoping that we were making the right decision,” his mother Meghan Orbich remembers. “I am thankful every single day that this splint was developed. It has meant our son’s life. I am certain that if we hadn’t had the opportunity to bring Ian to Mott, he would not be here with us today.”


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The above story is based on materials provided by University of Michigan Health System. Note: Materials may be edited for content and length.

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Muscle-powered bio-bots walk on command

July 3, 2014

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Tiny walking “bio-bots” are powered by muscle cells and controlled by an electric field. Credit: Graphic by Janet Sinn-Hanlon, Design Group@VetMed

 

A new generation of miniature biological robots is flexing its muscle. Engineers at the University of Illinois at Urbana-Champaign demonstrated a class of walking “bio-bots” powered by muscle cells and controlled with electrical pulses, giving researchers unprecedented command over their function. The group published its work in the online early edition of Proceedings of the National Academy of Sciences.

“Biological actuation driven by cells is a fundamental need for any kind of biological machine you want to build,” said study leader Rashid Bashir, Abel Bliss Professor and head of bioengineering at the U. of I. “We’re trying to integrate these principles of engineering with biology in a way that can be used to design and develop biological machines and systems for environmental and medical applications. Biology is tremendously powerful, and if we can somehow learn to harness its advantages for useful applications, it could bring about a lot of great things.”

Bashir’s group has been a pioneer in designing and building bio-bots, less than a centimeter in size, made of flexible 3-D printed hydrogels and living cells. Previously, the group demonstrated bio-bots that “walk” on their own, powered by beating heart cells from rats. However, heart cells constantly contract, denying researchers control over the bot’s motion. This makes it difficult to use heart cells to engineer a bio-bot that can be turned on and off, sped up or slowed down.

The new bio-bots are powered by a strip of skeletal muscle cells that can be triggered by an electric pulse. This gives the researchers a simple way to control the bio-bots and opens the possibilities for other forward design principles, so engineers can customize bio-bots for specific applications.

“Skeletal muscles cells are very attractive because you can pace them using external signals,” Bashir said. “For example, you would use skeletal muscle when designing a device that you wanted to start functioning when it senses a chemical or when it received a certain signal. To us, it’s part of a design toolbox. We want to have different options that could be used by engineers to design these things.”

The design is inspired by the muscle-tendon-bone complex found in nature. There is a backbone of 3-D printed hydrogel, strong enough to give the bio-bot structure but flexible enough to bend like a joint. Two posts serve to anchor a strip of muscle to the backbone, like tendons attach muscle to bone, but the posts also act as feet for the bio-bot.

A bot’s speed can be controlled by adjusting the frequency of the electric pulses. A higher frequency causes the muscle to contract faster, thus speeding up the bio-bot’s progress as seen in this video.

“It’s only natural that we would start from a bio-mimetic design principle, such as the native organization of the musculoskeletal system, as a jumping-off point,” said graduate student Caroline Cvetkovic, co-first author of the paper. “This work represents an important first step in the development and control of biological machines that can be stimulated, trained, or programmed to do work. It’s exciting to think that this system could eventually evolve into a generation of biological machines that could aid in drug delivery, surgical robotics, ‘smart’ implants, or mobile environmental analyzers, among countless other applications.”

Next, the researchers will work to gain even greater control over the bio-bots’ motion, like integrating neurons so the bio-bots can be steered in different directions with light or chemical gradients. On the engineering side, they hope to design a hydrogel backbone that allows the bio-bot to move in different directions based on different signals. Thanks to 3-D printing, engineers can explore different shapes and designs quickly. Bashir and colleagues even plan to integrate a unit into undergraduate lab curriculum so that students can design different kinds of bio-bots.

“The goal of ‘building with biology’ is not a new one — tissue engineering researchers have been working for many years to reverse engineer native tissue and organs, and this is very promising for medical applications,” said graduate student Ritu Raman, co-first author of the paper. “But why stop there? We can go beyond this by using the dynamic abilities of cells to self-organize and respond to environmental cues to forward engineer non-natural biological machines and systems.

“The idea of doing forward engineering with these cell-based structures is very exciting,” Bashir said. “Our goal is for these devices to be used as autonomous sensors. We want it to sense a specific chemical and move towards it, then release agents to neutralize the toxin, for example. Being in control of the actuation is a big step forward toward that goal.”

The National Science Foundation supported this work through a Science and Technology Center (Emergent Behavior of Integrated Cellular Systems) grant, in collaboration with the Massachusetts Institute of Technology, the Georgia Institute of Technology and other partner institutions. Mechanical science and engineering professor Taher Saif was also a co-author. Bashir also is affiliated with the Micro and Nanotechnology Laboratory, the department of electrical and computer engineering and of mechanical science and engineering, Frederick Seitz Materials Research Laboratory and the Institute for Genomic Biology at the U. of I.


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The above story is based on materials provided by University of Illinois at Urbana-Champaign. Note: Materials may be edited for content and length.

Artificial eyes, plastic skulls: 3-D printing the human body

April 17, 2014

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Wake Forest School of medicine in the United States is developing a printer that will print skin straight onto the wounds of burn victims. Pictured, a researcher works on a prosthetic “burned” hand.

The 21st century has seen the growth of 3-D printing, with well-known applications in architecture, manufacturing, engineering, and now increasingly in medicine.

The birth of 3-D scanning technologies combined with organic inks and thermoplastics has enabled the “bioprinting” of a range of human body parts to accommodate a wide range of medical conditions. Let’s start form the top.

Skulls

Doctors at University Medical Center Utrecht, in Holland, have reported successfully performing the first surgery to completely replace a patient’s skull with a tailor-made plastic version that was 3-D printed.

The patient had a chronic bone disorder that caused her skull to be 5cm thick. The hospital said the condition had caused her to lose her vision and ultimately would have killed her, but that three months after the operation the patient regained her vision and was able to return to work.

Eyes

Batch-printing of up to 150 prosthetic eyes an hour has become a reality according to UK-based company Fripp Design and Research. The mass-production technique promises to speed up the manufacture of eye prostheses and drive down the cost. Printing each eye with slight variation in color is intended to produce better aesthetic results.

The aim is to ensure more affordable eyes for the developing world with countries such as India reportedly showing interest in the products. The company, in collaboration with the UK’s Manchester Metropolitan University, hopes to implement the use of its printed eyes within the next year.

Noses and Ears

Fripp Design has also collaborated with the University of Sheffield, in the United Kingdom, to produce facial prostheses such as ears and noses. 3-D facial scans of patients are used to print out prosthetics using pigments, starch powder and silicone for replica facial parts closely matching the patient’s original nose or ear. The real benefit here is that once parts begin to wear, they can be re-ordered at a fraction of the cost as the technology and design will already be in place. The simpler process of scanning a patient’s face, rather than more invasive face molds needed for traditional prostheses, also makes the process a lot more patient-friendly.

A team at Cornell University, in the United States, is doing things differently. It’s printing 3-D molds of a patient’s ear using ink gels containing living cells. The printed products are injected with bovine cartilage cells and rat collagen and incubated until they are ready three months later. Human transplants could be possible within three years, say researchers.

Read: Carpenter cuts off fingers, prints new ones

Synthetic Skin

James Yoo at the Wake Forest School of Medicine in the United States is developing a printer that will print skin straight onto the wounds of burn victims. The “ink” they’re using consists of enzymes and collagen which once printed are layered with tissue cells and skin cells which combine to form the skin graft. The team plans on developing portable machines to print skin directly onto wounds in remote and war-torn settings.

The ideal synthetic skin graft needs to match the coloration of the patient as accurately as possible in order for the graft to look natural. Dr. Sophie Wuerger and her team at the University of Liverpool in the UK are working on using 3-D cameras, image processing and skin modeling to ensure the tone and texture of printed skin match up to the real thing.

Limbs

Thermoplastics have led the way in the growth of printable hands, arms and even individual fingers. Richard Van As is one of those producing affordable hand and finger prostheses with his company Robohand, based in South Africa. The team is creating functional fingers for use on amputated hands by combining the printing of the thermoplastic polylactide with aluminum and stainless steel digits to create a functioning mechanical finger.

Robohand recently collaborated with U.S. entrepreneur Mike Ebeling on a project providing affordable printed arms to war amputees in Sudan. The collaboration is known as “Project Daniel,” named after 14 year-old Daniel Omar who lost both his hands and part of his arms after a bomb was dropped near his family home in Sudan’s Nuba mountains. The team is enabling Robohands to reach the masses at costs as small as $100 for a basic hand.

Bones

One of the more established fields of 3-D printing is the bioprinting of human bone implants, and now replacement bones.

In 2011, researchers at Washington State University announced they had printed a bone-like structure that acts as a scaffold for new bone cells to grow on, before it degrades. The structure was printed using calcium phosphate and has been successfully tested in animals. The hope is to print customized grafts for use in patients with bone fractures.

http://edition.cnn.com/2014/04/17/tech/innovation/artificial-eyes-3d-printing-body/