Broken Cyborg (was Re: "Transcending the Human, DIY Style")

[Lee Nelson]

 We're in it for human enhancement, synthetic biologies, longevity, nootropics, software, prosthetics,

As you can see from the x-rays (most clearly in the fourth picture), I have a titanium full knee replacement with a broken rod that takes the place of a tibia.

http://picasaweb.google.com/technologiclee/ProstheticImplantXRays#



History:

This started as an ostogenic sarcoma in the tibia at age 15.
http://www.google.com/search?q=ostogenic+sarcoma

There was a year of chemotherapy.
The knee was replaced with a cadaver bone that was shattered a year later.

The knee was then replaced by the hardware shown in the x-rays.
I had good mobility for about 10 years. Then one day the rod just broke in mid step.
This is probably due to metal fatigue.

The rod has been broken for over two years now.


My options:

I have not found a doctor that is interested in attempting to replace this hardware yet. Maybe my new health care will bring help this year.

At the time of the surgery this was a fairly new procedure. Since then it has become more commonplace, but it is still a fairly complex surgery. There would be no guarantee of improved mobility and the possibility of infection, amputation and or death.

Honestly, I do not think that the procedures currently available are what I want.

I would like something more 'natural', like having a replacement knee printed by a bone printer and installed. There is already nerve, muscle and skin damage, so for an ideal solution, stem cells would be used to regenerate the damaged tissues.

http://www.google.com/search?q=bone+printer

What would be better is to augment the knee with robotics internally or as an external brace, like they are working on at MIT Leg Lab.

http://www.ai.mit.edu/projects/leglab/


Best Solution:

Now that the future is here, the hardware and software for 'medical nanobots' is almost ready. What would this entail? Removing the hardware. Directing stem cells to sites of damage and allow them to organize into appropriate tissues. This means that a 3-D model of the leg would be made and a set of instructions prepared to direct the robots. This is the next 'Killer App'. I would like for this to be the start of a thread about medical hardware and software in terms of radical reconstruction. What is the best medical and machine control software available to base this off of? For a start there is EMC machine control software and Google Body.

http://www.google.com/search?q=medical+nanobot
http://www.google.com/search?q=EMC+machine+control
http://www.google.com/search?q=google+body

Do you remember the 'tissue processing' scene from the movie The Fifth Element? Watch the hardware and software in this clip. This is the goal. This is something that is coming together from every corner of research.

http://en.vidivodo.com/183936/the-fifth-element-part-1




Trans-dermal Implant:

During the chemotherapy I had a "port (or portacath)" installed and later removed.

http://en.wikipedia.org/wiki/Port_%28medical%29

In terms of size and considering modern electronics, that is enough volume to place something like a low power processor.

http://www.google.com/search?q=low+power+implantable+computer
http://www.google.com/search?q=implantable+computer



P.S.
Did you see the new spray on skin technique??

http://www.google.com/search?q=spray+on+skin

[mitchell porter]

On Jan 3, 11:53 am, Lee Nelson <technologic...@gmail.com> wrote:
> As you can see from the x-rays (most clearly in the fourth picture), I have
> a titanium full knee replacement with a broken rod that takes the place of a
> tibia.
>
> http://picasaweb.google.com/technologiclee/ProstheticImplantXRays#

...

> The rod has been broken for over two years now.

...

> I would like something more 'natural', like having a replacement knee
> printed by a bone printer and installed. There is already nerve, muscle and
> skin damage, so for an ideal solution, stem cells would be used to
> regenerate the damaged tissues.

I think brainstorming how to grow a replacement knee is at about the
right level for this group. "Medical nanobots" are an ultra-high-tech
item, pure vaporware at the moment. But growing tissues on a shaped
scaffold is something that's been done for years.

According to Lee, first he had a cadaver bone graft to replace the
knee surfaces, and then later the titanium rods. So it seems like the
thing to do is to make a bone graft from his own tissue, by producing
an appropriately shaped scaffold, initiating the growth of a new bone
on the scaffold using his stem cells, and then implanting that.

I find this enlightening to think about; it offers a way to think
about quite radical procedures like the regrowth of missing limbs, or
even the addition of new ones. The elementary insight is that the
bones are the key element around which everything else is organized
(and muscles would be next). So if you were growing someone a whole
new arm, maybe you'd start by growing a long, boneless arm (it would
be like a long glove made of skin), then you'd make incisions to
implant proto-bones and proto-muscles, then you'd stitch it up and
finetune the process of tissue differentiation and integration. (And
all this might occur either in vivo - with the proto-arm attached from
the beginning - or in vitro - with the arm being surgically attached
only once it's properly formed.)

A more advanced procedure would not involve any surgical implantation
of proto-bone, it would just regulate tissue formation in situ in a
way which recapitulates natural growth, i.e. you would induce the
growth of bones within the limb.

Or maybe I have this wrong, you'd start with proto-bones inside
artificial skin, and then you'd grow real skin at the last step...

So what does everyone think? It's one thing to blithely talk about
growing artificial organs using tissue scaffolds and stem cells. But
to even think about doing this in reality, for any specific organ, is
going to involve taking on board a boatload of anatomical,
histological, and genetic facts. So far as I know, the only existing
example of a full *organ* being grown is the bladder, and these "neo-
bladders" (as they are actually called in the literature) are rather
simple, consisting of just two integrated tissue types (muscle and
nerve, as I recall). If we were going to make Lee into the "Kneeo" of
DIYbio, we'd have to learn anatomy and biophysics of the knee, issues
of tissue integration such as appropriate growth of veins and nerves,
we'd have to think about the surgery and implantation procedure for
the replacement knee, nature and timing of postoperative regimes such
as rest of the patient and regrowth of the knee... A whole other issue
that I'd forgotten about is the hormonal control of bone growth. You
probably can't just count on Lee's tibia to automatically fuse with a
replacement surface that has been surgically implanted, there might
need to be injections to temporarily induce a state of growth and
readiness for fusion on both sides.

Anyway, what I'd like to know is whether there's any interest in this
group in pressing ahead on this path. Growing new organs for
subsequent surgical implantation is a lot more out there than anything
I've heard of diybiologists doing so far. It's almost guaranteed,
given the current level of knowledge, that if any garage-biotech
outfit attempted this right now (with the patients / experimental
subjects either being animals, perhaps pets, or themselves), that
*something* would go wrong. But like it or not, we are already at the
stage where, even if we don't know what we're doing, we're able to
conduct even *this* sort of experiment. After all, that's what the
people in the funded research centers are doing - conducting hundreds
and thousands of experiments. They're rather more informed and better
equipped experimenters than Internet amateurs who just spent an hour
reading about the organ of interest at Wikipedia. But it's still very
much a trial-and-error process - looking for the recipe that will
bring some technical vision into reality. (How many hundreds of cloned
sheep died before birth, before Dolly came along?)

All I'm proposing for now is a little conversation, a little
brainstorming, a little study of how tissue scaffolds and integration
of histocompatible implants work. I think it should be well within the
collective research abilities and technical competence of this group
to, say, develop an imaginary protocol for the growth, implantation,
and functional integration of a replacement knee; and it would be very
instructive to do so, on many levels. Of course, if such a procedure
has already been outlined in the speculative medical literature, we
may as well just find it and study it; and in any case, in drawing up
such an imaginary protocol / procedure, we should try very much to
learn the details of how it works in the real case of neo-bladders,
and we should also study speculative procedures describing the growth
of more complicated neo-organs, if such descriptions can be found.

Mitchell

[Meredith L. Patterson]

3d printing is already used for medical and dental prosthetics. There's a company here in Leuven that makes hardware and software for it (will dig up the link when I'm not on a train). Prosthetics, including joints, are customized to the individual user based on extensive X-ray and MRI imaging, and IIRC they use fused deposition modeling to produce the prosthesis.

Cheers,
--mlp

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[Cathal Garvey]

During embryogenesis, the development of different organs takes place according to spatial gradients of different growth factors and hormones, most of which are probably entirely specific to pregnancy.

The gross shape of a limb emerges from a complex fractal interplay of a relatively small (though I don't know enough to say *how* small) pool of factors, with finer details being sorted out at a smaller scale.

Fine detail is often achieved by subtractive methods: to create fingers, a paddle-shape is grown with alternating sections destined to either develop into fingers, or those destined to commit apoptosis and destroy themselves, leading to separation of the tissue into a classic pentadactyl (five-fingered) limb. I have a personal suspicion that, as with many things in nature, there are parallel systems that achieve the same end result, such as endogenous-retrovirus-mediated killing of cells instead of apoptosis.

Because this setup is initiated by a (relatively speaking) simple set of preconditions, and the outcome is ultimately based on the fractal interplay of cascading growth and death factors, it's conceivable that you could induce the growth of an entirely new limb from a fairly dull patch of skin by implanting a bunch of stem cells that have been treated or grown on a scaffold to induce this embryonic limb-development program. It would be nowhere near as simple as just injecting stem cells with a few hormones mixed in, but I believe there is a threshold of complexity beyond which the growth will start to take care of itself, supported by a few external factors.

It may be that these factors will include awkward things like including human growth hormone or the like systemically until the limb has attained full development, but once you're at this level of understanding and technology anyway, you should be able to engineer the stem cells pre-implantation to accept a substitute that won't affect the rest of the body.

Will this sort of technology emerge in parallel to tissue printing? Probably not. It's  a long-term thing, for two reasons:

Firstly, I don't think there's enough research being done into natural systems of vertebrate limb/organ regeneration (newts, for example), and all the big funding goes to conditions that appear up-front to be "single cause, single cure", such as HIV.

Secondly, while tissue printing is an in-vitro procedure until implantation of the new organ (at which point it's passed off as "just another organ transplant"), the in-situ regrowth of an organ would be an entirely new procedure. And the medical establishment is very hidebound and cautious about new things.

If it got loads of funding suddenly and seemed plausible, I actually think this approach might be more practical than tissue printing; once you understand the process of limb development intimately (and we don't yet, at least in humans), stimulating regrowth would be a matter of marrying our current developments in induced-pluripotency, genetic engineering and scaffold regrowth (probably even tissue-printing, in fact). I'm not saying it'd be trivial, but I would see it as an achievable engineering feat in a medium time-frame.

Now, getting your brand-new-and-ready-to-rock limb to connect to the rest of the body meaningfully, that part might be more challenging than simple regrowth..

--
letters.cunningprojects.com
twitter.com/onetruecathal
http://www.indiebiotech.com

[Ruediger Trojok]

I could imagine a combined approach:
First build a artificial bone scaffold( just some thin metal sticks or
maybe even a material that will be deconstructed/eaten up by body
cells in vivo) to provide the shape in vitro.
Then cultivate some of Lees osteoblasts. Genetical engeneer them to
get a kill switch, to prevent uncontrolled later growth. Start growing
them on the artificial scaffold. Take care of proper cell density and
growth rates
by adding growth factors. Wait untill an adequate stage of
differentiation.
Implant the overgrown scaffold, wait untill the tissues connect and
then start a physiotherapy and proper medication
to guide bone growth - to my knowledge the bone growth is perfectly
customized to the pressure it experiences.
Have a look at the complicated inner structure of bones. It is a
really light construction with arbors and arcs exactly oriented into
the direction of force put on them by the body.
The danger with stem cell therapie is the development of cancer. Stem
cells are tightly controlled by the body
to prevent blastomas and carcinomas. If you want to grow stem cells in
the body at a high rate,
you have to promote them to survive, because the body will tell them
to do apoptosis.
But on the other hand you have to prevent cancer building.
This will be really difficult to set up a homoiestasis away from the
bodies own without doing harm.
It might be neccessary to do an immune suppressive therapie to achieve
this, because T-killer cells will start a war on
uncontrolled and unmasked stem cells....
well interesting topic. If there is enough interest in it, we should
transfer the discussion into a wiki to work on it for longer.

[John Griessen]

On 01/03/2011 06:55 AM, Cathal Garvey wrote:
> It may be that these factors will include awkward things like including human growth hormone or the like systemically until the
> limb has attained full development

and that would cause problems for the rest of the patient.

How do lizards do it? Their tails look drastically
different right at the break line as they regrow. Something about those cells at the break, with nothing but skin
on one side of themselves, initiates growing more tail joints. Absence of neighboring tail joints triggers growth
of new tail joints.

JG