Archive for the ‘Wake Forest University’ Category

Penises grown in laboratories could soon be tested on men by scientists developing technology to help people with congenital abnormalities, or who have undergone surgery for aggressive cancer or suffered traumatic injury.

Researchers at the Wake Forest Institute for Regenerative Medicine in Winston-Salem, North Carolina, are assessing engineered penises for safety, function and durability. They hope to receive approval from the US Food and Drug Administration and to move to human testing within five years.

Professor Anthony Atala, director of the institute, oversaw the team’s successful engineering of penises for rabbits in 2008. “The rabbit studies were very encouraging,” he said, “but to get approval for humans we need all the safety and quality assurance data, we need to show that the materials aren’t toxic, and we have to spell out the manufacturing process, step by step.”

The penises would be grown using a patient’s own cells to avoid the high risk of immunological rejection after organ transplantation from another individual. Cells taken from the remainder of the patient’s penis would be grown in culture for four to six weeks.

For the structure, they wash a donor penis in a mild detergent to remove all donor cells. After two weeks a collagen scaffold of the penis is left, on to which they seed the patient’s cultured cells – smooth muscle cells first, then endothelial cells, which line the blood vessels. Because the method uses a patient’s own penis-specific cells, the technology will not be suitable for female-to-male sex reassignment surgery.

“Our target is to get the organs into patients with injuries or congenital abnormalities,” said Atala, whose work is funded by the US Armed Forces Institute of Regenerative Medicine, which hopes to use the technology to help soldiers who sustain battlefield injuries.

As a paediatric urological surgeon, Atala began his work in 1992 to help children born with genital abnormalities. Because of a lack of available tissue for reconstructive surgery, baby boys with ambiguous genitalia are often given a sex-change at birth, leading to much psychological anguish in later life. “Imagine being genetically male but living as a woman,” he said. “It’s a firmly devastating problem that we hope to help with.”

Asif Muneer, a consultant urological surgeon and andrologist at University College hospital, London, said the technology, if successful, would offer a huge advance over current treatment strategies for men with penile cancer and traumatic injuries. At present, men can have a penis reconstructed using a flap from their forearm or thigh, with a penile prosthetic implanted to simulate an erection.

“My concern is that they might struggle to recreate a natural erection,” he said. “Erectile function is a coordinated neurophysiological process starting in the brain, so I wonder if they can reproduce that function or whether this is just an aesthetic improvement. That will be their challenge.”

Atala’s team are working on 30 different types of tissues and organs, including the kidney and heart. They bioengineered and transplanted the first human bladder in 1999, the first urethra in 2004 and the first vagina in 2005.

Professor James Yoo, a collaborator of Atala’s at Wake Forest Institute, is working on bioengineering and replacing parts of the penis to help treat erectile dysfunction. His focus is on the spongy erectile tissue that fills with blood during an erection, causing the penis to lengthen and stiffen. Disorders such as high blood pressure and diabetes can damage this tissue, and the resulting scar tissue is less elastic, meaning the penis cannot fill fully with blood.

“If we can engineer and replace this tissue, these men can have erections again,” said Yoo, acknowledging the many difficulties. “As a scientist and clinician, it’s this possibility of pushing forward current treatment practice that really keeps you awake at night.”

http://www.theguardian.com/science/2014/oct/05/laboratory-penises-test-on-men

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William Gibson’s popular science fiction tale “Johnny Mnemonic” foresaw sensitive information being carried by microchips in the brain by 2021. A team of American neuroscientists could be making this fantasy world a reality. Their motivation is different but the outcome would be somewhat similar. Hailed as one of 2013’s top ten technological breakthroughs by MIT, the work by the University of Southern California, North Carolina’s Wake Forest University and other partners has actually spanned a decade.

But the U.S.-wide team now thinks that it will see a memory device being implanted in a small number of human volunteers within two years and available to patients in five to 10 years. They can’t quite contain their excitement. “I never thought I’d see this in my lifetime,” said Ted Berger, professor of biomedical engineering at the University of Southern California in Los Angeles. “I might not benefit from it myself but my kids will.”

Rob Hampson, associate professor of physiology and pharmacology at Wake Forest University, agrees. “We keep pushing forward, every time I put an estimate on it, it gets shorter and shorter.”

The scientists — who bring varied skills to the table, including mathematical modeling and psychiatry — believe they have cracked how long-term memories are made, stored and retrieved and how to replicate this process in brains that are damaged, particularly by stroke or localized injury.

Berger said they record a memory being made, in an undamaged area of the brain, then use that data to predict what a damaged area “downstream” should be doing. Electrodes are then used to stimulate the damaged area to replicate the action of the undamaged cells.

They concentrate on the hippocampus — part of the cerebral cortex which sits deep in the brain — where short-term memories become long-term ones. Berger has looked at how electrical signals travel through neurons there to form those long-term memories and has used his expertise in mathematical modeling to mimic these movements using electronics.

Hampson, whose university has done much of the animal studies, adds: “We support and reinforce the signal in the hippocampus but we are moving forward with the idea that if you can study enough of the inputs and outputs to replace the function of the hippocampus, you can bypass the hippocampus.”

The team’s experiments on rats and monkeys have shown that certain brain functions can be replaced with signals via electrodes. You would think that the work of then creating an implant for people and getting such a thing approved would be a Herculean task, but think again.

For 15 years, people have been having brain implants to provide deep brain stimulation to treat epilepsy and Parkinson’s disease — a reported 80,000 people have now had such devices placed in their brains. So many of the hurdles have already been overcome — particularly the “yuck factor” and the fear factor.

“It’s now commonly accepted that humans will have electrodes put in them — it’s done for epilepsy, deep brain stimulation, (that has made it) easier for investigative research, it’s much more acceptable now than five to 10 years ago,” Hampson says.

Much of the work that remains now is in shrinking down the electronics.

“Right now it’s not a device, it’s a fair amount of equipment,”Hampson says. “We’re probably looking at devices in the five to 10 year range for human patients.”

The ultimate goal in memory research would be to treat Alzheimer’s Disease but unlike in stroke or localized brain injury, Alzheimer’s tends to affect many parts of the brain, especially in its later stages, making these implants a less likely option any time soon.

Berger foresees a future, however, where drugs and implants could be used together to treat early dementia. Drugs could be used to enhance the action of cells that surround the most damaged areas, and the team’s memory implant could be used to replace a lot of the lost cells in the center of the damaged area. “I think the best strategy is going to involve both drugs and devices,” he says.

Unfortunately, the team found that its method can’t help patients with advanced dementia.

“When looking at a patient with mild memory loss, there’s probably enough residual signal to work with, but not when there’s significant memory loss,” Hampson said.

Constantine Lyketsos, professor of psychiatry and behavioral sciences at John Hopkins Medicine in Baltimore which is trialing a deep brain stimulator implant for Alzheimer’s patients was a little skeptical of the other team’s claims.

“The brain has a lot of redundancy, it can function pretty well if loses one or two parts. But memory involves circuits diffusely dispersed throughout the brain so it’s hard to envision.” However, he added that it was more likely to be successful in helping victims of stroke or localized brain injury as indeed its makers are aiming to do.

The UK’s Alzheimer’s Society is cautiously optimistic.

“Finding ways to combat symptoms caused by changes in the brain is an ongoing battle for researchers. An implant like this one is an interesting avenue to explore,” said Doug Brown, director of research and development.

Hampson says the team’s breakthrough is “like the difference between a cane, to help you walk, and a prosthetic limb — it’s two different approaches.”

It will still take time for many people to accept their findings and their claims, he says, but they don’t expect to have a shortage of volunteers stepping forward to try their implant — the project is partly funded by the U.S. military which is looking for help with battlefield injuries.

There are U.S. soldiers coming back from operations with brain trauma and a neurologist at DARPA (the Defense Advanced Research Projects Agency) is asking “what can you do for my boys?” Hampson says.

“That’s what it’s all about.”

http://www.cnn.com/2013/05/07/tech/brain-memory-implants-humans/index.html?iref=allsearch

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Around 220,000 people worldwide already walk around with cochlear implants — devices worn around the ear that turn sound waves into electrical impulses shunted directly into the auditory nerve.

Tens of thousands of people have been implanted with deep brain stimulators, devices that send an electrode tunneling several inches in the brain. Deep brain stimulators are used to control Parkinson’s disease, though lately they’ve also been tested — with encouraging results — in use against severe depression and obsessive compulsive disorder.

The most obvious bionics are those that replace limbs. Olympian “Blade Runner” Oscar Pistorius, now awaiting trial for the alleged murder of his girlfriend, made a splash with his Cheetah carbon fiber prostheses. Yet those are a relatively simple technology — a curved piece of slightly springy, super-strong material. In the digital age, we’re seeing more sophisticated limbs.

Consider the thought-controlled bionic leg that Zac Vawter used to climb all 103 floors of Chicago’s Willis Tower. Or the nerve-controlled bionic hand that Iraq war veteran Glen Lehman had attached after the loss of his original hand.

Or the even more sophisticated i-limb Ultra, an artificial hand with five independently articulating artificial fingers. Those limbs don’t just react mechanically to pressure. They actually respond to the thoughts and intentions of their owners, flexing, extending, gripping, and releasing on mental command.

The age when prostheses were largely inert pieces of wood, metal, and plastic is passing. Advances in microprocessors, in techniques to interface digital technology with the human nervous system, and in battery technology to allow prostheses to pack more power with less weight are turning replacement limbs into active parts of the human body.

In some cases, they’re not even part of the body at all. Consider the case of Cathy Hutchinson. In 1997, Cathy had a stroke, leaving her without control of her arms. Hutchinson volunteered for an experimental procedure that could one day help millions of people with partial or complete paralysis. She let researchers implant a small device in the part of her brain responsible for motor control. With that device, she is able to control an external robotic arm by thinking about it.

That, in turn, brings up an interesting question: If the arm isn’t physically attached to her body, how far away could she be and still control it? The answer is at least thousands of miles. In animal studies, scientists have shown that a monkey with a brain implant can control a robot arm 7,000 miles away. The monkey’s mental signals were sent over the internet, from Duke University in North Carolina, to the robot arm in Japan. In this day and age, distance is almost irrelevant.

The 7,000-mile-away prosthetic arm makes an important point: These new prostheses aren’t just going to restore missing human abilities. They’re going to enhance our abilities, giving us powers we never had before, and augmenting other capabilities we have. While the current generation of prostheses is still primitive, we can already see this taking shape when a monkey moves a robotic arm on the other side of the planet just by thinking about it.

Other research is pointing to enhancements to memory and decision making.

The hippocampus is a small, seahorse-shaped part of the brain that’s essential in forming new memories. If it’s damaged — by an injury to the head, for example — people start having difficulty forming new long-term memories. In the most extreme cases, this can lead to the complete inability to form new long-term memories, as in the film Memento. Working to find a way to repair this sort of brain damage, researchers in 2011 created a “hippocampus chip” that can replace damaged brain tissue. When they implanted it in rats with a damaged hippocampus, they found that not only could their chip repair damaged memory — it could improve the rats’ ability to learn new things.

Nor is memory the end of it. Another study, in 2012, demonstrated that we can boost intelligence — at least one sort — in monkeys. Scientists at Wake Forest University implanted specialized brain chips in a set of monkeys and trained those monkeys to perform a picture-matching game. When the implant was activated, it raised their scores by an average of 10 points on a 100-point scale. The implant makes monkeys smarter.

Both of those technologies for boosting memory and intelligence are in very early stages, in small animal studies only, and years (or possibly decades) away from wide use in humans. Still, they make us wonder — what happens when it’s possible to improve on the human body and mind?

The debate has started already, of course. Oscar Pistorius had to fight hard for inclusion in the Olympics. Many objected that his carbon fiber prostheses gave him a competitive advantage. He was able — with the help of doctors and biomedical engineers — to make a compelling case that his Cheetah blades didn’t give him any advantage on the field. But how long will that be true? How long until we have prostheses (not to mention drugs and genetic therapies) that make athletes better in their sports?

But the issue is much, much wider than professional sports. We may care passionately about the integrity of the Olympics or professional cycling or so on, but they only directly affect a very small number of us. In other areas of life — in the workforce in particular — enhancement technology might affect all of us.

When it’s possible to make humans smarter, sharper, and faster, how will that affect us? Will the effect be mostly positive, boosting our productivity and the rate of human innovation? Or will it be just another pressure to compete at work? Who will be able to afford these technologies? Will anyone be able to have their body, and more importantly, their brain upgraded? Or will only the rich have access to these enhancements?

We have a little while to consider these questions, but we ought to start. The technology will sneak its way into our lives, starting with people with disabilities, the injured, and the ill. It’ll improve their lives in ways that are unquestionably good. And then, one day, we’ll wake up and realize that we’re doing more than restoring lost function. We’re enhancing it.

Superhuman technology is on the horizon. Time to start thinking about what that means for us.

http://www.cnn.com/2013/04/24/opinion/bionic-superhumans-ramez-naam/index.html?iid=article_sidebar