Brain tumors are among the most deadly and difficult-to-treat cancers. Glioblastoma, a particularly aggressive form, kills more than 10,000 Americans a year and has a median survival time of less than 15 months. For patients with brain tumors, treatment typically includes open-skull surgery to remove as much of the tumor as possible followed by chemotherapy or radiation, which come with serious side effects and numerous hospital visits.

What if a patient’s brain tumor could be treated painlessly, without anesthesia, in the comfort of their home? Researchers at Stanford Medicine have developed, and tested in mice, a small wireless device that one day could do just that. The device is a remotely activated implant that can heat up nanoparticles injected into the tumor, gradually killing cancerous cells. In mice with brain tumors, 15 minutes of daily treatment over 15 days, as the animals went about their normal activities, was enough to significantly increase survival times. The researchers published their work in August in Nature Nanotechnology.

“The nanoparticles help us target the treatment to only the tumor, so the side effects will be relatively less compared with chemotherapy and radiation,” said Hamed Arami, PhD, co-lead  author of the paper, a former postdoctoral fellow at Stanford Medicine who is now at Arizona State University.

Arami, trained as a bioengineer, came to focus on brain cancer as a postdoctoral fellow in the lab of the late Sam Gambhir, MD, former chair of radiology at Stanford Medicine and a pioneer in molecular imaging and cancer diagnostics who died of cancer in 2020 . Five years prior, Gambhir’s teenage son, Milan, died of a glioblastoma.

Source: https://scopeblog.stanford.edu/

A cornea implant made out of collagen gathered from pig skin has restored the vision of 20 volunteers in a landmark pilot study. Pending further testing, the novel bioengineered implant is hoped to improve the vision of millions around the world awaiting difficult and costly cornea transplant surgeries. More than one million people worldwide are diagnosed blind every year due to damaged or diseased corneas. A person’s vision can be easily disrupted when this thin outer layer of tissue surrounding the eye degenerates. A person suffering corneal blindness can have their vision restored by receiving a corneal transplant from a human donor. However, a lack of cornea donors means barely one in 70 people with corneal blindness will ever be able to access a transplant. Plus, the surgical procedure can be complex, amplifying the lack of access to this vision-restoring procedure for people in low– and middle-income countries.

This new research first looked to develop cornea implants that didn’t rely on human donor tissue. Over a decade ago the researchers first demonstrated biosynthetic corneas were effective replacements for donor corneas. But those earlier studies still relied on complex lab-grown human collagen, molded into the shape of corneas. This new study demonstrates the same biosynthetic cornea can be effectively produced using medical-grade collagen sourced from pig skin. Not only is this a cheap and sustainable source of collagen, but improved engineering techniques mean these bioengineered corneas can be safely stored for almost two years, unlike donated human corneas which must be used within two weeks of harvesting.

A pilot study saw bioengineered implants restore the vision of 14 volunteers who were completely blind before the experimental procedure

“The results show that it is possible to develop a biomaterial that meets all the criteria for being used as human implants, which can be mass-produced and stored up to two years and thereby reach even more people with vision problems,” explained Neil Lagali, one of the researchers working on the project. “This gets us around the problem of shortage of donated corneal tissue and access to other treatments for eye diseases.”

The other innovation demonstrated in the study is a new surgical approach for implanting the bioengineered cornea. Instead of needing to surgically remove a patient’s pre-existing cornea, as would be done when transplanting a donor cornea, the new method leaves that tissue intact. Only a small suture is necessary to insert the novel implant.

The new study, published in Nature Biotechnology, describes the results of a pilot trial that tested the implant in 20 volunteers, 14 of whom were completely blind before the experimental procedure. At the two-year follow-up the study reports all 20 volunteers had completely regained their vision and experienced no adverse effects from the surgery.

The first brain-computer interface device was implanted in a patient in the US earlier in July by a doctor at the medical center, Mount Sinai West, in New York, in an investigatory trial of the startup Synchron’s procedure to help patients suffering from ALS (amyotrophic lateral sclerosis) text by thinking. The procedure involved the doctor threading a 1.5-inch-long implant comprised of wires and electrodes into a blood vessel in the brain of a patient with ALS. The hope is that the patient, who’s lost the ability to move and speak, will be able to surf the web and communicate via email and text simply by thinking, and the device will translate the patient’s thoughts into commands sent to a computer. Synchron, the startup behind the technology, has already implanted its devices in four patients in Australia, who haven’t experienced side effects and have been able to carry out such tasks as sending WhatsApp messages and making online purchases.

The implant was a major step forward in a nascent industry, putting the Brooklyn-based company ahead of competitors, including ahead of Elon Musk’s Neuralink Corp.

“This surgery was special because of its implications and huge potential,” said Dr. Shahram Majidi, the neurointerventional surgeon who performed the procedure.This was the first procedure the company has performed in the US.

The brain-computer interface (BCI) has caught the attention of many in the technological field because its device, known as the stentrode, can be inserted into the brain without cutting through a person’s skull or damaging tissue. A doctor makes an incision in the patient’s neck and feeds the stentrode via a catheter through the jugular vein into a blood vessel nestled within the motor cortex. As the catheter is removed, the stentrode, a cylindrical, hollow wire mesh opens up and begins to fuse with the outer edges of the vessel. According to Majidi, the process is very similar to implanting a coronary stent and takes only a few minutes.

A second procedure then connects the stentrode via a wire to a computing device implanted in the patient’s chest. To do this, the surgeon must create a tunnel for the wire and a pocket for the device underneath the patient’s skin much like what’s done to accommodate a pacemaker. The stentrode reads the signals when neurons fire in the brain, and the computing device amplifies those signals and sends them out to a computer or smartphone via Bluetooth.

The stentrode then uses sixteen electrodes to monitor brain activity and record the firing of neurons when a person thinks. The signal strength improves over time as the device fuses deeper into the blood vessel and gets closer to the neurons. Software is used to analyze the patterns of brain data and match them with the the user’s goal.

Source: https://synchron.com/
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A Northwestern University-led team of investigators has developed a small, soft, flexible implant that relieves pain on demand and without the use of drugs. Described in a study published in Science, the first-of-its-kind device could provide a much-needed alternative to opioids and other highly addictive medications.

The biocompatible, water-soluble device works by softly wrapping around nerves to deliver precise, targeted cooling, which numbs nerves and blocks pain signals to the brain. An external pump enables the user to remotely activate the device and then increase or decrease its intensity. After the device is no longer needed, it naturally absorbs into the body — bypassing the need for surgical extraction.

The scientists believe the device will be most valuable for patients who undergo routine surgeries or even amputations that commonly require post-operative medications. Surgeons could implant the device during the procedure to help manage the patient’s post-operative pain.

A Northwestern University-led team has developed a small, pain-relieving implant that could provide a much-needed alternative to opioids and other highly addictive medications.

“Although opioids are extremely effective, they also are extremely addictive,” said John Rogers, PhD, Professor of Materials Science and Engineering, Biomedical Engineering and Neurological Surgery, who led the device’s development. Jonathan Reeder, former postdoctoral fellow in the Rogers laboratory, is the paper’s first author.

“As engineers, we are motivated by the idea of treating pain without drugs — in ways that can be turned on and off instantly, with user control over the intensity of relief,” said Rogers, who is also the founding director of the Querrey Simpson Institute for Bioelectronics. “The technology reported here exploits the mechanism that causes your fingers to feel number when cold. Our implant allows that effect to be produced in a programmable way, directly and locally to targeted nerves, even those deep within surrounding soft tissues.”

While other cooling therapies and nerve blockers have been tested experimentally, all have limitations that the new device overcomes. Previously, scientists have explored cryotherapies, for example, which are injected with a needle. Instead of targeting specific nerves, these imprecise approaches cool large areas of tissue, potentially leading to unwanted effects such as tissue damage and inflammation.

At its widest point, the tiny device is just five millimeters wide. One end is curled into a cuff that softly wraps around a single nerve, bypassing the need for sutures. By precisely targeting only the affected nerve, the device spares surrounding regions from unnecessary cooling, which could lead to side effects.

“You don’t want to inadvertently cool other nerves or the tissues that are unrelated to the nerve transmitting the painful stimuli,” MacEwan said. “We want to block the pain signals, not the nerves that control motor function and enable you to use your hand, for example.”

Source: https://news.feinberg.northwestern.edu/

In what the company is calling a “groundbreaking reconstructive procedure,” 3DBio Therapeutics has transplanted a 3D-printed ear made of living cells. The reconstruction is the first in-human phase of the clinical trial for the implant, called AuriNovo, and appears to be the first 3D-printed implant made of living tissues.

The implant is specifically for patients with microtia, a rare congenital ailment where the outer ear is either underdeveloped or doesn’t exist at all. According to the Centers for Disease Control and Prevention, it’s hard to estimate just how many people are impacted because of the range of the ailment varies, but estimates show that the birth defect impacts about 1 in every 2,000 to 10,000 in the U.S. The cause, in most cases, is unknown, although some cases are caused by genetic changes or the use of isotretinoin, or Accutane medication, during pregnancy.

The patient who received the transplant is a 20-year-old woman from Mexico whose right ear is impacted by the ailment. She received the surgery in March, and will continue to be monitored for five years, a spokesperson for 3DBio said.

Dr. Arturo Bonilla, a pediatric surgeon at the Congenital Ear Institute, the largest pediatric microtia center in North America, led the transplant. In a statement, he said that he’s “inspired” by what the advancement could mean for microtia patients.

Traditionally, doctors have to harvest rib cartilage or use porous polyethylene (PPE) implants to do this kind of transplant, both of which come with a set of challenges. Using rib cartilage, for example, requires a substantial harvest from at least three ribs and typically must be done in at least two separate hours-long procedures. It could result in a chest deformity, and the implants are rigid and can cause discomfort. PPE implants typically requires taking a large section of skin from a patient’s scalp, and because the implant is not made of biological material, there is early risk for infection and later risk of implant changes, discomfort and even a risk of the implant shattering.

Using a patient’s own cartilage cells is less invasive, and according to Bonilla, will allow for a more flexible ear. He also said that for those who have microtia, getting such a surgery can drastically help with their self-esteem. While it is not believed to impact hearing, it does offer an aesthetic relief.

This image shows what the 20-year-old patient’s ear looked like both before and after she received the 3D-bioprinted transplant. 

“An issue that becomes more prominent is bullying or teasing. Children don’t understand that they’re hurting somebody else’s feelings, but it really does affect them in a major way. And that’s usually when they start coming to my office, so that I can start taking care of them and helping them and advising them as far as what are the next options,” Bonilla said. “…The new technology with AuriNovo is exciting. I’ve actually been waiting for this my whole career.”

To create the new appendage, doctors conducted a biopsy on the ear of the patient that was impacted and extracted chondrocytes, the cells that create cartilage. Those cells were then expanded and mixed with what the company calls ColVivo collagen-based bio-ink before being molded with a 3D bioprinter into the size and shape of the patient’s opposite ear.

Source: https://www.cbsnews.com/

An international research team led by Monash University has uncovered a new technique that could speed up recovery from bone replacements by altering the shape and nucleus of individual stem cells. The research collaboration involving Monash University, the Melbourne Centre for Nanofabrication, CSIRO, the Max Planck Institute for Medical Research and the Swiss Federal Institute of Technology in Lausanne, developed micropillar arrays using UV nanoimprint lithography that essentially ‘trick’ the cells to become bone. Nanoimprint lithography allows for the creation of microscale patterns with low cost, high throughput and high resolution.

When implanted into the body as part of a bone replacement procedure, such as a hip or knee, researchers found these pillars – which are 10 times smaller than the width of a human hair – changed the shape, nucleus and genetic material inside stem cells. Not only was the research team able to define the topography of the pillar sizes and the effects it had on stem cells, but they discovered four times as much bone could be produced compared to current methods.

Novel micropillars, 10 times smaller than the width of a human hair, can change the size, shape and nucleus of individual stem cells and ‘trick’ them to become bone

“What this means is, with further testing, we can speed up the process of locking bone replacements with surrounding tissue, in addition to reducing the risks of infection,” Associate Professor Jessica Frith from Monash University’s Department of Materials Science and Engineering said. “We’ve also been able to determine what form these pillar structures take and what size they need to be in order to facilitate the changes to each stem cell, and select one that works best for the application.”

Researchers are now advancing this study into animal model testing to see how they perform on medical implants. Engineers, scientists and medical professionals have known for some time that cells can take complex mechanical cues from the microenvironment, which in turn influences their development.

However, Dr Victor Cadarso from Monash University’s Department of Mechanical and Aerospace Engineering says their results point to a previously undefined mechanism where ‘mechanotransductory signalling’ can be harnessed using microtopographies for future clinical settings. “Harnessing surface microtopography instead of biological factor supplementation to direct cell fate has far-reaching ramifications for smart cell cultureware in stem cell technologies and cell therapy, as well as for the design of smart implant materials with enhanced osteo-inductive capacity,” Dr Cadarso said.

The findings were published in Advanced Science.

Source: https://www.monash.edu/

People with chronic diseases like arthritis, diabetes and heart disease may one day forego the daily regimen of pills and, instead, receive a scheduled dosage of medication through a grape-sized implant that is remotely controlled.

Researchers from Houston Methodist successfully delivered continuous, predetermined dosages of two chronic disease medications using a nanochannel delivery system (nDS) that they remotely controlled using Bluetooth technology. The nDS device provides controlled release of drugs without the use of pumps, valves or a power supply for possibly up to year without a refill for some patients. This technology will be tested in space next year.

A proof-of-concept paper recently published in Lab on a Chip (online June 25) explains how the Houston Methodist nanomedicine researchers accomplished long-term delivery of drugs for rheumatoid arthritis and high blood pressure, medications that are often administered at specific times of the day or at varying dosages based on patient needs.

Nanomedicine scientists at Houston Methodist Research Institute created a remote-controlled implantable nanochannel drug delivery system (nDS) the size of a grape

“We see this universal drug implant as part of the future of health care innovation. Some chronic disease drugs have the greatest benefit of delivery during overnight hours when it’s inconvenient for patients to take oral medication. This device could vastly improve their disease management and prevent them from missing doses, simply with a medical professional overseeing their treatment remotely,” said Alessandro Grattoni, Ph.D., corresponding author and chair of the department of nanomedicine at Houston Methodist Research Institute.

Grattoni and the Houston Methodist researchers have worked on implantable nanochannel delivery systems to regulate the delivery of a variety of therapies for medical issues ranging from HIV-prevention to cancer. As basic research progresses with the remote-controlled device, the Houston Methodist technology is planned for extreme remote communication testing on the International Space Station in 2020. The team hopes that one day the system will be widely available to clinicians to treat patients remotely via telemedicine. This could provide both an improvement in the patients’ quality of life and a reduction of cost to the health care system.

Source: https://www.houstonmethodist.org/