Spray-On Skin: New Severe Burn Treatment

Yes, you read that right, spray-on skin. It sounds like something out of a science fiction movie but it’s a real thing. No it isn’t “Dermis-In-A-Can” but it might as well be. The results may look pristine and seem miraculous, but the reality is, it’s just science. No divination necessary. Follow me today as we take a look at how Avita Medical is making huge strides in the world of cosmetic recovery, severe burn treatment and infection control, as well as improving the quality of life for the millions of people worldwide who experience traumatic burn injuries every year.

The Third Degree

Burns are painful. What’s worse is that when an area of tissue is burned it destroys the sites where healthy new cells are produced. Because of this they take much longer to heal than an injury such as a cut. Those of you who have had an open wound before are well aware of two things, they don’t feel good, and they are prone to infection. And the longer a wound stays open, the higher the likelihood of that occurring.

A burn is a special kind of wound and there are varying degrees of it. Most of us have had a sunburn before which is usually just redness and discomforting areas of the epidermis accompanied by peeling as it enters the healing stages. This is the result of dead cells on the skin shedding the necrotic bits to make way for the new healthy tissue growing beneath.

The second degree of a burn is a little more serious. This is usually caused from boiling water or temporary exposure to flame. The trauma leaves the skin reddened but also causes blistering and possible scarring. The third degree of burn is the worst. This involves complete tissue destruction of all layers of skin, sometimes even bone. Without painful and drawn out procedures like grafting, a third degree burn will never heal properly.

Then you get into things like chemical burns and radiation overexposure, (and no you do not turn into The Incredible Hulk). These create all new sets of problems because they cause the cells of the affected area to behave in bizarre and erratic ways. Depending on what chemical or the type of radiation several layers of tissue, muscle, bone, even organ damage can occur. These types of burns, like third degree ones, are usually coupled with much higher risks of infection.

If an infection occurs around a burn site it can be life-threatening. That particular part of the body is already weakened from the trauma and without its first line of defense, the skin, bacteria and other pathogens can quickly enter the bloodstream. Once an infection spreads through the entirety of the circulatory system it can wreak all sorts of havoc including sepsis (infection in the blood or tissue), shock, and eventually, death.

The procedure of skin grafting has been around for quite some time, and for victims of severe burns in which complete tissue destruction had taken place, was the go-to operation. The surgery had its drawbacks. While this process used samples of your own skin to culture and grow new cells to attach back onto you later it typically left behind unsightly scarring on patients that underwent this procedure. While it was preferable to the alternative, it wasn’t perfect.

Luckily there was a pair of genius Australian women working hard to change that.

Feeling Comfortable In Your Own Skin

In 1992 a plastic surgeon working in Australia came across a horrible case rolling into her Emergency Room. A young school teacher had suffered third and second degree burns on over 90% of his body. What’s worse, it was petroleum that had caused the fire. Not only did he have burns from the heat of the fire, but baked into what was left of the skin was the chemical residue. Acting quickly she turned to the North American life-saving techniques (wait…what? America is being credited and not blamed for something? Odd…) of cultured skin. She saved the man’s life.

However she was not satisfied with the results. While his life had been saved and through culturing and grafting some of his livelihood would return, he would never look the way he had again. This deeply troubled her. She knew full well that self-image was important and if someone couldn’t feel comfortable in their own skin psychiatric disorders could potentially set in. It didn’t seem fair.

That year she and a surgeon that had aided on the schoolteacher case named Marie Stoner went to work developing the methods that would later be used in ReCell, or Spray-On Skin. It was much more effective in theory than skin grafting. Waiting for the tissue samples to culture and then to be draped across the body took too long. Infection could too easily set in.

But by taking a sample of the patients melanocytes (pigmentation) and keratinocytes (cells that promote natural healing) and placing them in a special suspension fluid (stem cells basically) and spraying them on the infected areas, the patient could be treated much faster, and instead of using a lab, the patient was his own incubator growing the skin where he needed it. (One time only, this doesn’t make you the Wolverine either…)

So she began a company called Clinical Cell Culture (C3) in 1993 (which would later become Avita Medical) where she and Stoner went hard to work in the field of tissue engineering. And it was a very good thing they did too. Not even ten years later, a terrorist attack in Indonesia would shake the entire Western world. Dr. Fiona Wood, humble plastic surgeon from Yorkshire, was about to rocket to national fame.

And she was going to change thousands of lives forever.

Nightmare in Paradise

In 2002, two nightclubs in Bali, Indonesia became the next in the long string of global attacks that have followed since the United States had been attacked on 9/11. Paddy’s Pub and the Sari Club, frequented by vacationing American couples and European backpackers alike, were bombed. 202 people lost their lives in the attacks, but more suffered severe trauma and burns due to the massive extent of the explosives used.

Even though the attacks occurred in Indonesia, the country that felt the most outrage over it was Australia. Why? Because almost half of those killed and wounded in the attack were vacationing Australian Nationals. A Singapore Rugby team just trying to grab a beer and unwind, an American pair of newlyweds torn apart by this disaster, countless senseless deaths tallied up for no reason whatsoever.

I will say this, if there is one thing those terrorist’s learned the hard way, it was there were two things you don’t do. You don’t blow up and murder innocent civilians, and you certainly don’t want to **** with European sports. The men responsible were eventually found and executed, but this did nothing to help the many suffering victims that were still alive. A memorial was erected in honor of those who no longer were.

That’s when Dr. Fiona Wood stepped up to the plate. The largest group of the survivors was taken to Royal Perth in Western Australia. The degree to which the burns ranged varied depending on where they were relative to the blast, but reports claim victims ranging anywhere from 2% (the fortunate) all the way to 92% (sadly the not so fortunate).

Because of her revolutionary skin-in-a-bottle treatment however, most of the patients survived. What’s more is that most of the patients recovered with some normalcy to them. Infection rates were incredibly low considering the intensity of the trauma and severity of burns in most cases. Dr. Wood was a hero.

In the coming years this incredible technology would make its rounds through the U.K., Germany, France, Canada, and eventually land on America’s doorstep. However, while all these other nations clearly saw the benefits of this wonderful treatment, the United States, to date, is still pending FDA approval. Why you ask? Many superficial reasons I’m sure, but the main one at the root of it all is none other than the nefarious words…

…Stem Cells.                                  

FDA’s Ruling of Nines

If Eminem is considered the king of controversy amongst the Hip-Hop community then he would be the Stem Cells of the medical versus politics world. Nothing can turn a person into a feral monster quicker than talking about a sensitive topic that goes against their personal beliefs. So most people, rather than risk offending someone and opening the door to a possibly enlightening conversation, one that could push us forward as a species, prefer to keep their mouths shut so as to avoid confrontation. To these people I have but one thing to say…

Toughen up. Talk about it. The less resistance the government officials see from the well-educated populace, the more alluring the prospect of pushing it forward becomes to them. After all, keeping the people happy is what keeps them all rich and happy. (I’m not bitter or anything…)

The reality is I can joke a little bit today because we aren’t talking about Embryonic Stem Cells. The Stem Cells we’re talking about are the ones growing inside of you right now, the ones waiting for something to happen so they can get their opportunity to shine. The ones that are removed via a scraping procedure, cultured, and grown right back on the affected area to the degree of nothing ever happened.

Just look at what this product is capable of doing folks. This is a before and after image of a little boy who suffered terrible burns after scalding tea was spilled down the front of him:

Yes, there’s a little bit of post-op inflammations and redness, but if you look at this next photo:

The pictures on the left and in the middle are of the same child. This was taken four months after the procedure. The little boy on the far right did not receive ReCell. That is what a skin graft looks like after third degree burns in the same time frame. The saddest part of all is that boy will have to undergo many more of these painful procedures before he reaches adulthood. Why? Because his skin will keep growing, but the completely dead areas that the graft couldn’t fully repair, will never grow without being replaced.

This is not a pitch for Avita Medical, or ReCell, or Spray-On Skin. This is me asking, no wait, this is me begging that everyone begins paying attention to the subtle differences petty semantics, like the difference between Embryonic Stem Cells and your very own Stem Cells you still have and grow inside you, can make.

Think about it. If that was your son, wouldn’t you want him to look like the boy in middle, (God forbid something so awful happen to your child, I could never imagine.) rather than the young man on the far right? It’s possible. The technology exists and the rest of the world knows it, but because America forbids Stem Cell research, even if it’s victimless, we will remain in the medical Stone Age.

After all, I’ll bet some of you didn’t even know there was any other kind of stem cell than Embryonic. And all I have to say to that is if that’s the case, then I rest mine. We need to get talking about it. Educate each other, and maybe someday very soon, this will be a reality the entire world round, and no little boy or girl, man or woman, will have to suffer like that ever again. Thank you for reading.

-       Ryan Sanders

Thanks for reading TI&IT, your continued support is what keeps me writing these. I hope you enjoyed this article and if you’d like to know anything more about Avita Medical, ReCell, or any of the other subjects discussed in this article follow any of the links below. Happy learning!

-       News article on Spray-On Skin

-       Wiki Entry on Dr. Fiona Wood

-       Time Magazine article on the Bali Bombings

-       How Dr. Wood’s treatment helped the victims of Bali (Video)

-       How Spray-On Skin works, full article used as a source

-       How Spray-On Skin works (For the medical professional) :) 

Nano-Tech: Big Problems, Small Answers - #1 Deep Brain Stimulation

There is a common misconception amongst the general populace that we only use 10% of our brains and the other 90% is a complete mystery. I am here today to assure you that the only mystery is where this myth could have originated because it is just that. A myth. If there’s one thing nature has taught us over our century or so of study in the world of evolution, it’s that nature doesn’t waste energy, (it isn’t human after all), in fact, it conserves it to such a degree its mind blowing.

Take for instance certain species of subterranean mammals like the naked mole rat. While they aren’t completely blind, nature didn’t see fit to give them the same set of photoreceptors as us. Why? Because they didn’t need it. They needed energy for other things, so evolution phased sight out.

Now don’t get me wrong, I’m not saying the human brain is slowly phasing out the human race, but to think there are parts we don’t use is just absurd.

But if you worded that statement a little differently to say we only understand about 10% of the brain, I might be able to rally behind you. And so wouldn’t many other scholars in the world of neuroscience. The scary truth is we really don’t know that much about it. We know what part stimulates breathing, motor function, and emotion. We even know with pinpoint accuracy where and how the pituitary gland influences our growth. But consciousness? Ha! Good luck with that.

While it’s true consciousness and how it works is a mystery unto itself and there are pieces of the brain we can tell are active but don’t know why, it’s not true that only a fraction of it is in use. In fact, just getting up, walking to the fridge, opening the door, and cracking a cold beer open to take a sip causes so many neurons to fire that under the right kind of imaging your brain would like an explosion at a power plant. So why am I telling you all this?

Well because in a world today dominated by Cancer research and a fast paced consumer entertainment market, disorders of the brain sometimes get swept to the wayside. Until those disorders of the brain begin to affect us on a large scale. A large scale like the one we have seen trending in the past decade.

It’s not that these diseases weren’t around before (most of them anyway) it was our way of dealing with them.

With advances in scanning techniques, treatment for once thought manageable yet un-curable diseases were being discovered. Perhaps amongst the most amazing of these advances in the realm of Neurosurgery was DBS, otherwise known as “Deep Brain Stimulation.”

Today we’re going to talk about this incredible surgery and its origins. We’ll also talk about some of the original techniques used to perform this “cutting-edge” (no pun intended) surgery in its infancy. We’ll also talk about the wealth of diseases it can currently cure, the ones they’re aiming it at, and the nano-technology that is going to take them there.

The Enemy

While any disease is the enemy of doctor’s worldwide, Parkinson’s is the Loki to the Neurosurgeon’s Avenger’s. As you can see in the graphic above there are a wide range of areas afflicted by Parkinson’s disease. What’s worse are the areas affected themselves. Because of the combination of misfiring neurons in the variety of locations the spastic micro-seizures accompanied with Parkinson’s disease (among many other disorders) can occur.

There are four symptoms related to motor function that are essential to PD. The first of which is the tremor. While it isn’t necessarily present at onset, this is one of the hallmarks of the disease, involuntarily spasms of the muscles. Bradykinesia, which is slowness of movement, comes next. The final two are rigidity of the muscles which can present in uniform ways or a cogwheel formation (a ratchet-like jerking of the extremity being analyzed as demonstrated in the video here), and then the final sign is postural instability. Postural instability is linked to falls amongst those affected by the disease.

On top of all that, there are neuropsychiatric symptoms linked to this disorder as well. Some are a result of the medications meant to control the symptoms, but some are thought to be resultant of the disease itself. Disorders such as insomnia, loss of appetite, depression, paresthesia (numbness or tingling in the extremities), these can all be warning signs of the onset. Why does this happen?

The short answer is Dopamine. Dopamine works like a messenger in the brain. It’s a neurotransmitter with a variety of tasks but whatever it’s delegated to do, at its core the primary function of Dopamine is to deliver a message. If abnormal levels of dopamine are produced or if production stops in certain areas catastrophic events begin to take place within the brain.

While scientists understand it’s the dopamine producing neurons to blame, when they die off, for the associated motor disabilities, they still don’t understand why the dopamine producing centers are dying. Mitochondrial dysfunction, oxidative stress, even environmental factors such as exposure to certain pesticides can be linked to Parkinson’s disease, but how the cells making dopamine are systematically destroyed is still a mystery.

What they do understand completely are the parts PD, and other diseases like it, are attacking. That’s why in recent years it’s been announced that DBS may be able to treat a variety of psychiatric disorders as well ranging from OCD and depression, to the more severe cases of schizophrenia and psychosis. OCD has been effectively treated in some instances already, giving physician’s the confidence to feel like this isn’t just a claim to get more grant money, this is real science.

Armed with this information and a fortress of cutting edge technology, doctors are now finally ready to suit up for that final confrontation with Lex Luthor. Like Superman, they may not understand Parkinson’s intentions, but they have a plan to put him behind bars.

DBS: Like An Architect For Your Brain

The brain is divided into two hemispheres, the right side and the left side. The left side is the logic center (i.e. math, science, reasoning.) while the right side is the creative cluster (poetry, arts, dance, etc.). But when the neural pathways in either side of the brain begin to deteriorate, as I mentioned before, bad things happen.

That’s where Deep Brain Stimulation (or DBS) comes into play. The way the brain works is extremely complicated and in order to explain it accurately and in full detail it would encompass the entirety of this article. So for the purposes of what we’re talking about today we’ll grossly oversimplify it and just say billions of tiny electrical pulsations are what make the brain do what it does. If you want the full scoop on how your three-pound thought box functions you can read what the guys at How Stuff Works cooked up by clicking here.

In the case of Parkinson’s disease where neurons are dying off, electrical impulses are having difficulty sending communications to other areas of the brain. When this happens the Axon’s that work like cable wires to carry the information don’t know what to say to the Dendrites, the ones who receive and interpret the information. When this happens the body begins to behave in a peculiar manner.

Think of it in terms of your television. The cable company acts like a cell body, gathering all the T.V. shows and arranging them in a digestible format for everyday viewers. The T.V. shows signal is then transmitted down the cable line which in the case of the brain would be the Axon. Its final destination is your cable box which would be the Dendrite, which then interprets that information into a picture for your T.V. or in the case of a Neuron, a command to lift your arm.

When Parkinson’s attacks, the cable company shuts down. There are no signals coming in or out down the wire to reach to your cable box. Because of this the television only displays static and eventually your interest dies out. Think of the Neuron like your interest in waiting for the cable company to fix the T.V. Without a signal it just dies.

The cause of this neuron death is widely unknown but research continues every day. What we do know is how to manipulate the electrical signals that are no longer transmitting. If the neurons function like a cable company to a T.V. then DBS is the Consumer’s Energy to get the lights turned back on. Let’s take a brief look at the history of psychosurgery to put in perspective just how far this truly remarkable science has come.

C’mon…It’s Not Like It’s Brain Surgery…

Psychology and the neurosciences are still in their infancy as far as medical fields go. Neurosurgery is even younger than that. Part of it stems from the limitations of technological advances, but the other part of it is the simple fact that we just didn’t understand the brain. We knew it was essential in diagnosing disorders like schizophrenia and various dyskinesia’s (involuntary muscle movement) associated with disorders like Parkinson’s and Palsy but we had no idea how.

Enter Dr. Gottlieb Burckhardt. In 1888 he performed six brain surgeries. But his instruments were crude and his methods, while good intentioned, were horrifyingly misguided. What ended up happening is two patients showed no change, two patients became catatonic mutes, another one died, but ONE GOT BETTER!!! He tried to publish his findings with a 50% success rate but instead received nothing but haughty laughter and hostility from his peers.

Then in 1910 another doctor in Russia took up the scalpel to three mentally ill patients. He attempted to redo Dr. Burckhardt’s earlier gamble with neurosurgery but collided with the same wall his predecessor had. The surgeries failed and in 1912 a scathing article was published demonizing Gottlieb’s original work quoting, “We have quoted this data to show not only how groundless but also how dangerous these operations were. We are unable to explain how their author, holder of a degree in medicine, could bring himself to carry them out...”

But yet he failed to mention that just two years prior he attempted to do the same thing…

Nonetheless, the Russian physician, Dr. Ludvig Puusepp changed his tune to the sound of retraction sharp in the 1930’s. As medical technology had advanced, as well as an understanding of the human mind, psychosurgery was becoming a viable option. In 1937, apparently forgetting he’d ever laughed Dr. Burckhardt off the world stage, he returned to the surgical theatre to help lead a new era of doctors in this unique field of study.

That’s when Portuguese neurologist (and inventor of the term psychosurgery) António Egas Moniz decided it was time for him to “cut in”. (hee hee). See while Dr. Burckhardt and Dr. Puusepp were trying to dig a trench around the cortex and sever the connections they thought were creating the problem, Moniz was taking a whole different approach. He determined that the only way to cure these patients was to remove the frontal lobe, thus giving birth to the lobotomy or as it was called then, leucotomy.

Now…to say the medical community found the lobotomy to be controversial and crazy to consider a viable treatment option is like saying that, “The Hebrew population in 1930’s Poland had mixed feelings about Hitler.” In short, it’s an understatement.

The problem didn’t stem from the method itself; in fact, lobotomies were performed to the ends of mixed results for quite some time. The problem lied in the fact that the patient receiving the operation didn’t really have a say in the matter. In those days, once you were institutionalized, you were officially at the mercy of your captors. In this case, the doctors.

By the 1950’s antipsychotic medications were becoming available and the lobotomy (thankfully) began seeing a steady decline. It wouldn’t return the livelihood of the some 20,000+ people that had been forced to undergo the surgery, but at least it would prevent anyone else from having to go through the barbarism of it again.

But this raised a new problem. If we can’t cut the bad wires to stop it, and if we can’t remove the fried circuit entirely then what do we do? Ablate the hell out of it course! In the 1940s till the late 80s, Neurosurgeons decided that if removing the parts of the brain that caused these ill effects wasn’t going to work, then maybe slicing and burning them would.

While lesioning (making precise incisions in targeted areas of the brain so as to achieve a desired effect within the patient) may not have been the best thing for patients, by 1987 it had paved the way for a new form of therapy. Deep brain stimulation. This technology would revolutionize the way we viewed the brain, the techniques used to assess, diagnose, and treat psychiatric disorders, and for the first time, it would seem to provide doctors with a means to fight back.

The enemy…the disease, was no longer invincible.

Hey! That Hertz!

 These last few decades have been great ones for science. We’ve seen advances in medicine, climatology, genetics research; in fact, we’ve made such strides in these areas we’ve had to create all new niche areas of study to just be able to properly encompass and give attention to it all. But as scientific disciplines get bigger, it seems the method of delivery gets smaller.

Before Benabid and Pollak in 1987 discovered that targeted electro-currents to the brain could re-fire the damaged neurons thereby alleviating tremor symptoms, our answer was to hack & slash our way through. These two men decided another; more delicate answer was needed to the burning questions of the brain. So what was their solution? Shock the crap out of it.

As we mentioned before the only form of dealing with movement disorders until this time was lesioning and that was dangerous and irreversible. Dr. Benabid wanted to find another method; one that could be undone should unforeseeable consequences take place. What he discovered was the effect of high frequency on the brain.

It wasn’t the first time electricity had been used in direct contact with the brain. In fact, using electrical pulses to render areas of the brain useless was a popular tactic used by doctors for lesioning already. But by changing the output of the current, it was possible to, in a sense; turn the non-working parts of the brain back on without causing permanent damage. However it was unfeasible for a patient to walk around with an open skull and a cattle prod just to keep from falling prey to the tremors of PD. They needed a constant delivery mechanism, one that could be installed through surgery, monitored and taken out should problems arise, and be altered as new technology became available. To say this seemed daunting is to say the Pyramids are big. It doesn’t encompass the scope of it even close to accurately.

Early DBS surgery was terrifying to the patient. First and foremost, it’s brain surgery. The thought of someone chiseling inside my brain with scalpels and drills doesn’t remotely appeal to me. To make matters worse the surgery took around 4 to 6 hours to complete. Now that doesn’t sound so bad until you find out that you have to stay awake the whole time.

In order for doctors to monitor the patient and make sure the leads were doing more good than harm, the patient would have to remain conscious in order to answer questions. In a video of a New York City police officer who underwent this surgery, Mike not only remains conscious, but when asked questions by the doctor, he responds in Russian. When the doctor calls attention to this, Mike jokingly states, “Well you must be doing something right I’m learning Russian!” (I absolutely adore this guy, its brain surgery so parts of the video are a little graphic but his courage is definitely worth the watch! Check out his story hereon YouTube.)

But even though Mike was willing to take the risk to make a change, the thought of being awake while doctor’s installed a car battery in your brain was terrifying to most. First they have to drill a hole in the skull cap. Wire leads are run along the back of the skull and down into the chest cavity. A screw is fixed in the skull in order to hold the leads in place. And that’s just the reader’s digest version of the first surgery.

The second surgery involved a battery pack, like a pacemaker, being installed in the chest to hook the leads to. Luckily this second surgery was one doctor’s were used to and the patient could be anesthetized for this one. But trying to convince patients on undergoing the first one was a tough sell. Because of this the process, while not exactly ignored, wasn’t highly recommended by physicians because medication was able to manage the disease in the early stages. DBS wasn’t readily recommended until the later stages of the disorder.

However thanks to an ever progressing world of technology, DBS fears may fall to the wayside and become a thing of the past. Patients no longer have to be awake during the surgery (which is a huge plus) thanks to new forms of imaging and scanning, and because of nanotechnology and robotics, the big problems doctor’s faced in the past are becoming much smaller as we move into the future.

The Shocking Future of SWCNTs

SWCNT’s (Single-Walled Carbon Nanotubes) and MWCNTs (Multi-Walled Carbon Nanotubes), are rather unique little inventions. Depending on the way you arrange the molecules in them, the structure can be used for a variety of tasks. For instance, a certain arrangement yields a structure stronger than steel but is six times lighter. This would be extremely useful for devices such as body armor for the military or lighter vehicles for the daily commuter. But for the purposes of this article we’re going to talk about SWCNT’s being used a different way, as microprocessors.

While much research is needed on Carbon Nanotubes still, one thing is abundantly clear. They have electrically conductive properties, and what’s more, they have actually been found to repair the damaged links between neurons in the brain. To put it in perspective let’s recycle our original analogy with the cable company.

With early DBS treatments, metal conductors and wire leads were required and had to be attached to a battery pack. This whole process is long, drawn out, and while strides have been made to accommodate those afflicted, having these bulky artificial parts inserted into your body can over time wear on a person. So if we make the pacemaker the cable company, the wires the Axons, and the brain the T.V. screen, SWCNT’s are the electrical tape used to make a patch.

Instead of using the complex procedure of leads and battery packs, Carbon Nanotubes are capable of natural conduction if the atoms are arranged in the right formation. Because of this they are able to slip into the areas that have burned out and respark the connections in order to send signals to the rest of the body once more. The surgery is as minimally invasive as one can imagine given the miniscule size of the Nanotubes. However, there are issues with it. For example…

“There are three fundamental obstacles to developing reliable neuroprosthetics: 1) stable interfacing of electromechanical devices with neural tissue, 2) understanding how to stimulate the neural tissue, and 3) understanding what signals to record from the neurons in order for the device to make an automatic and appropriate decision to stimulate. The new carbon nanotube-based interface technology discovered together with state of the art simulations of brain-machine interfaces is the key to developing all types of neuroprosthetics -- sight, sound, smell, motion, vetoing epileptic attacks, spinal bypasses, as well as repairing and even enhancing cognitive functions.” – Read more here.

While these are all still in the testing phase it’s impossible to deny that the future of this technology is promising. Only time will tell if Carbon Nanotubes will be able to deliver on the theories scientists have proposed for them. One thing is certain though, if disease itself is capable of feeling fear, it should. And the weapon to fear is Nanotechnology.

-       Ryan Sanders

I hope you enjoyed this article on Deep Brain Stimulation. If so please share it around on Facebook and Twitter. If you would like to know more about DBS, SWCNT’s, or anything else discussed in this article, feel free to follow any of the links below. As always, happy learning!

-       The origin andhistory of DBS

-       TimeMagazine article on how DBS works

-       Nanowerk articlepertaining to Carbon Nanotubes in medicine

-       Scholarly article onapplications of Carbon Nanotubes

-       Howa deep brain stimulator is surgically installed

-       Article on the correlations between Dementiawith Lewy Bodies and Parkinson’s

-       Whatcauses Parkinson’s Disease?

From Peg Legs to Exoskeletons: Prosthetic Ingenuity

Amputation to Ambulation: Walking Like an Egyptian

It’s hard to imagine the fake limb pictured above, extending forward to shake your hand. Its cold metal fingers clenching tightly around your warm, skin-protected hand. The unsettling feeling that washes over you as the prosthetic steel unguiculate tendrils dig in and squeak. However, just a few hundred years ago that wouldn’t have been so strange. The prosthetic industry was witnessing a boom, and a new science was on its way to making life livable for those who at one time, their situation would have otherwise been a death sentence.

Some of the first prosthetics that have been unearthed date all the way back to ancient Egypt. In 2000 archaeologist’s found a prosthetic big toe made of leather and wood buried just outside the ancient city of Thebes. This particular type of prosthesis is dated from 1069 to 664 B.C.  This beat out the previous record held by a bronze and copper leg found in Rome dating back to 300 B.C. The other advantage the toe has? It wasn’t destroyed by World War II bombing like the Capua leg was.

Yep…that’s one mummified wooden toe alright. It was found attached to a mummy that was later identified as Tabaketenmut who lived some time during the period from 950-710 B.C. After recruiting some volunteers and making a replica of the toe, researchers discovered that this toe was a functional prosthetic. Therefore the torch was passed from Rome to Egypt for the birth of prosthetics.

The Egyptians were also known to put non-functioning prosthetics on their corpses before burial. In the eyes of their God Osiris, a person was useless in the afterlife if they were not whole. Fake arms, legs, eyes, noses, ears, even genitalia have been fastened on the dead before being entombed. These devices, while they are prosthetics, weren’t functioning medical devices until the discovery of the above Cairo Toe.

While this prosthesis was pretty incredible, it was nothing compared to what would come. Today, we’re going to explore the birth of prosthetics all the way to what they are today. (Trust me, we’ve come a looooooooong way.)

Next, let’s go get a haircut real quick.

Just A Little Off The Top…

In medieval times surgery wasn’t considered a medical practice. In fact, it was considered to be more akin to the profession of a barber than that of an apothecary or an herbalist. (Truth be told, witchcraft was considered to have more medical value than surgery back then if that tells you anything…) In response to the shift in medicine after the sweep of plagues through Europe, the barbers and surgeons were merged.

See, physicians went through academic procedure in order to practice medicine back then and surgeons underwent apprenticeship instead. Therefore they were not recognized as a branch of doctors. Merging with the barbers just made sense. They both used sharp pointy tools right? (Perhaps Sweeney Todd was a medical professional.)

One barber-surgeon of note was Ambroise Paré. He is considered one of the founding fathers of modern surgery and pathology. He was a notable anatomist and his battlefield medicine practices are still taught today. (Not to mention he didn’t conform to the norm and pioneered antiseptics in wound treatment instead of cauterization and eventual death by shock).

In 1529, when Ambroise was only 19 years old, he introduced the practice of lifesaving amputation, and the development of prosthesis took off from there. He developed upper and lower extremity devices. His leg device was revolutionary; it featured an above-knee device that was a kneeling peg leg and foot prosthesis that had a fixed position, adjustable harness, knee lock control and other engineering features that are used in today's devices!

That’s pretty incredible for being almost 500 years ago. There were prosthetics before it but mostly used for cosmetic purposes. Hook hands and peg legs were common but this featured moving parts that mimicked human joints. (Albeit it wasn’t perfect) Paré also developed prosthetic eyes made of glass, jewels, and other materials, (once again, cosmetic only).

While there were many extremely notable advances from that point on in the field of functional prosthetics and amputation for the purposes of article length we can’t hope to cover them all. You can view a brief history of prostheses here. Now, let’s head to the Civil War.

Dr. Frankenstein’s Wars

It’s easy to see why the civil war saw so many amputations and prosthetics. Cleanliness wasn’t well understood and infections often led to amputations. By this point technology had advanced to a point where it was easier to simulate the ambulatory functions of limbs however by mimicking joints. By 1863, the midpoint of the war between the North and South a breakthrough was made.

Dubois Parmelee’s prosthesis was like none had seen. It featured a more comfortable suction cup for the knee and a polycentric joint allowing for full range of motion. The other interesting addition was the functional articulating foot. We commonly forget how important our toes and the bend of our ankles are to our balance. This prosthetic allowed for a less awkward movement. He also employed this method for upper extremities.

The original design called for it to be made of steel. As we all know, steel is heavy and bulky. Five years later a man named Gustav Hermann would suggest using aluminum so as to make the leg lighter. His design would wait until 1912, when Marcel Desoutter, a famous English aviator, lost his leg in an airplane accident, and made the first aluminum prosthesis with the help of his brother Charles, an engineer.

All of this led to World War II. Veterans returning from overseas were torn apart. World War II was famous for its use of artillery and explosives. Infections, while better understood, still weren’t completely unheard of. Amputations were sometimes still necessary as lifesaving measures. The problem was when they got back no advancements had been made. Nobody wanted to walk around with a hook hand so the veterans demanded reform. Uncle Sam responded in kind, (too bad he doesn’t seem to listen anymore…)

Thus the prosthetics industry was born. Modern advancements in the industry have led to lightweight metals, composite materials, and plastics being used in prosthetic devices. The new limbs simulate normal body parts much better and in some instances are even crafted to look completely normal.

From a fake big toe in Egypt, to battlefield amputations in French and European wars, prosthetics have played a major role in human function for centuries. With military funding behind it we have seen some of the greatest advances in history. Let’s take a look at some of these awesome technological leaps we’ve made.

The 6 Million Dollar Man

Below the knee, above the knee, under the elbow, maybe you just need a hand? Perhaps a foot? Prosthetics come in all shapes, sizes, colors, functions, and types these days. But let me ask you this. What’s the first thing that comes to mind when someone mentions prosthetics? It’s a fake limb of sorts isn’t it? Well that isn’t necessarily always the case.

When I did my analysis of how close we were to making the Master Chief from Halo’s suit I did a brief discussion of the HAL (Hybrid Assistive Limb). You can find that blog here. The original plan for HAL was to be used to help paraplegics walk again but they quickly discovered it had vital use as a super-suit of sorts and became implemented for use in disaster cleanup and rescue.

The way the suit works is pretty incredible. Here is the description, directly from Cyberdyne’s website:

§  When a person attempts to move, nerve signals are sent from the brain to the muscles via motoneurons, moving the musculoskeletal system as a consequence. At this moment, very weak biosignals can be detected on the surface of the skin. "HAL" catches these signals through a sensor attached on the skin of the wearer. Based on the signals obtained, the power unit is controlled to move the joint in unison with the wearer's muscle movement, enabling HAL to support the wearer's daily activities. This is what we call a 'voluntary control system' that provides movement interpreting the wearer's intention from the biosignals in advance of the actual movement. It’s not only a 'voluntary control system' "HAL" has, but also a 'robotic autonomous control system' that provides human-like movement based on a robotic system which integrally work together with the 'autonomous control system'. "HAL" is the world's first cyborg-type robot controlled by this unique Hybrid System.

§        "HAL" is expected to be applied in various fields such as rehabilitation support and physical training support in medical field, ADL support for disabled people, heavy labor support at factories, and rescue support at disaster sites, as well as in the entertainment field.

It’s not just power suits like HAL making the headlines. Remember our discussion on 3D and 4D printing and how that works? If not you can catch up here. Well if you combine that technology with a little clever bioengineering, voila! 3-Dimensional Bio-printing! What is this useful for you ask? Take a look at the image below.

Now, imagine that was you. You just had that unsightly tumor removed and a gaping hole was left on your face. Sure, you can cover it with an eye patch but after a while the pirate jokes get old. Now with the aide of this new technology that ridicule is a thing of the past. While the eye may not function, the cosmetic confidence that comes along with these types of prostheses is still worth the effort to develop them.

The way that bio-printing works is instead of loading a non-organic base material into the printer, an organic material (DNA, proteins, so on so forth) are added into the machine. It doesn’t just stop with the development of synthetic skin and bone. Doctors are convinced that this machinery will lead them to the development of working body parts and organs!

It’s also important to note that brain chips have also come a long way since their early development. New tests have shown that they can repair damaged areas in animals and allow them to resume functions once thought impossible. This will be particularly useful for soldiers suffering from traumatic blast injuries and patients that have undergone a stroke or had a tumor removed that damaged a part of the brain.

With more and more soldiers coming home disfigured every day and cancer scarring so many individuals with its horrifying blight further development of this technology is necessary. After all, (and this is especially true in the case of soldiers) doesn’t everyone deserve the chance to feel normal?

-       Ryan Sanders

Thank you for reading! As always feel free to share this around on Facebook and Twitter! For further reading on prosthetic devices and their history, follow any of the links below. Happy learning!

-       History of Prostheses

-       Brief history of the inventors of ancient prosthetic devices

-       “Cyberdyne”’s website, with information on “HAL exoskeleton”.

-       Wiki entry on Ambroise Paré