CIMIT blog

Stem Cell Biology and Cell-Rolling Technique

Our upcoming forum is on new advances in Stem Cell Biology and a Cell-Rolling technique for microfluidics. Lynn Osborn gave Dr. Jeff Borenstein and Dr. Rohit Karnik a call to talk about what is new and exciting in their work. Rohit is doing some fascinating work with a phenomenon called Cell-Rolling and how we can utilize this natural occurrence to sort cells in microfluidics. Check out the new podcast here:

For more information on attending the weekly free forum and for speaker bios click here...

DAVID SCADDEN, MD
Gerald and Darlene Jordan Professor of Medicine, Harvard University; Co-Director, Harvard Stem Cell Institute; Co-Chair; Department of Stem Cell and Regenerative Biology, Harvard University; Director, Center for Regenerative Medicine, Massachusetts General Hospital

ROHIT KARNIK, PHD
d’Arbeloff Assistant Professor, Department of Mechanical Engineering, Massachusetts Institute of Technology

MODERATOR: CHARLES A. VACANTI, MD
Anesthesiologist-in-Chief, Leroy D. Vandam/Benjamin G. Covino Professor of Anaesthesia, Harvard Medical School; Director, Laboratories for Tissue Engineering and Regenerative Medicine, Brigham and Women's Hospital

MODERATOR: JEFFREY BORENSTEIN, PHD
Distinguished Member of the Technical Staff at the Charles Stark Draper ; Co-Program Leader, Tissue Engineering, CIMIT

And we'll see you are the forum!

Robopsy Moves Toward Commercialization

Dr. Gupta and Robopsy Credit CIMIT as They Move Toward Commercialization

 

Sometimes a CIMIT moment can be expanded into a multi-year relationship.

Rajiv Gupta, MD, PhD, a radiologist at Massachusetts General Hospital, heads a small company called Robopsy that is preparing its device for commercialization.

In 2005 Dr. Gupta got involved in the CIMIT- MIT 2.75 engineering class, the program in which a doctor with a problem to be solved works with MIT students to get the job done.

With the help of MIT Professor Alex Slocum, PhD, the team developed a remotely controlled robot that aids in image-guided percutaneous medical procedures. The small, lightweight device attaches directly to a patient and remotely aims and inserts a tiny probe at a tumor or other health abnormality. The radiologist is thus able to perform both the diagnosis and treatment, such as essential biopsies (often of the lung) and tissue ablations with pinpoint accuracy.

Dr. Gupta has made use of CIMIT assets in several ways:

• He recognized the value of the 2.75 MIT course, and linked with the bright and energetic Dr. Slocum to develop a plan
• From this class, he recruited thoughtful and energetic graduate students whose immediate careers are tied to the success of the project
• The Robopsy team has received about $100,000 in CIMIT grants and has obtained more than $80,000 in additional grants and awards
• The team has developed a financial relationship with Johnson Electric in Hong Kong and Germany, which is helping to fund the enterprise as Robopsy moves from animal (now) to human tests (next year)

“Without CIMIT, we wouldn’t have gotten off the ground,” said Dr. Gupta. “We started with the 2.75 program, and I realized these bright grad students had ideas that improved upon what I had conceived. We received a CIMIT grant, and a lot of facilitation and guidance from CIMIT Central.

“We were a winner of the MIT $100K Entrepreneurship Competition and we won the first-place award at the 2008 ASME Innovation Showcase. Our science has been validated, and I feel we have a big future.”

Team members on the technical and business side are doctoral candidates Nevan Hanumara and Connor Walsh, and Dr. Slocum. Leading the initiative on the clinical and animal testing side are Dr. Gupta and Jo-Anne Shepard, MD, who is director of the Thoracic Radiology Division at MGH.

Dr. Gupta says the Robopsy team has been talking with venture capitalists but needs more work in the lab before finalizing corporate plans. “At the right time we’ll probably look for a CEO,” Dr. Gupta said. “We have been successful so far, but I think a business executive would be a good addition to the team.

“If we do become a commercial enterprise – and it appears that we will - we will all look back and thank CIMIT.”

Dyke Hendrickson
CIMIT

"Car Part" Incubator at SolidWorks

At the SolidWorks World 2009 Convention keynote speaker Jeff Ray used the CIMIT & Dtm "Car Part" Incubator as an example of innovation and great designs during hard times.

Richard Branson, CEO of Virgin, also said: "Working on a new kind of [baby] incubator is more important than getting drunk every night."

Check out Jeff's Keynote and the "Car Part" Incubator video here...

SolidWorks World 2009 Monday Keynote - Jeff Ray
by SolidWorksCorp

CIMIT Prize Gets Healthy Response in Quality, Quantity

The CIMIT Prize for Primary Healthcare competition has been launched, and this was one case where a full-court (national) press produced a winning result.In our first year, CIMIT got 78 pre-proposals from 44 universities in 21 states. Ten have been chosen as Finalists, and their completed applications will be due May 31. Announcement of the top winners will be made June 30. 

Your Scribe sees several reasons why the applications were numerous and the quality is high: 

• A generous prize structure
• An interest in primary care
• An intense drive to inform engineering schools of the competition 

To start, the CIMIT Prize offers a great opportunity. Rarely do 10 finalist teams get $10,000 each. That amount would be a generous prize for a winner (remember, most team members are undergrad and grad students). But to get $10,000 to work on the final version in pursuit of the $150,000 top prize must have inspired many engineers. 

Secondly, the subject matter is appealing. We all know a little something about primary care; most have pondered about “a better way” while we wait to be seen when we arrive at a medical office. Numerous entries focused on ways to store and access one’s medical information so it can be accessed quickly – and with a guarantee of privacy. Its organizers identified a real need. 

Also, at CIMIT we were pretty busy. We approached all the engineering deans in the country; in addition, we contacted chairpersons of bioengineering and biomedical engineering departments. And we engaged public-affairs officials at the universities to ask them to spread the word of our big contest.  

We sent more than 600 emails to engineering honchos to inform – and then remind - them of the competition. Well, the word got out and many quality applications came in. In sponsoring this exciting event, the Gelfand Family Charitable Trust was sagacious about choosing the focus of the contest and generous about setting the financial parameters. We look forward to June when the winners are announced - and to the months after that when many fine ideas to improve primary care might well be put into action.

Dyke Hendrickson

CIMIT

Engineering Medical Devices @ MIT 2.75 - Part II

Moderator: Alex Slocum, PhD, Pappalardo Professor of Mechanical Engineering and MacVicar Faculty Fellow, MIT, slocum@mit.edu

Design and Testing of a 3-axis Machine Used to Characterize the Performance of Running Shoes 
Clinician: Danny Abshire, Co-Founder, Vice President, Director of Global Marketing, Newton Running, danny@newtonrunning.com 
MIT Student Team: Aaron Gawlik, Mathew Gilbertson, Priam Pillai, Folkers Rojas, Adam Wahab

Current ASTM tests on running shoes are insufficient because they do not reliably capture the loads and displacements applied to shoes during running. This team will discuss a 3-axis machine that can be used to test running shoes that mimic's natural running more accurately than conventional tests. The design is comprised of a phantom foot that replicates the passive properties of a human foot and an actuated base that can impose the relevant kinematics to the running shoe. The shoe is mounted on motor to give a rotational degree of freedom. The shoe and the base are instrumented to measure force and displacement dynamically during the running cycle. The machine can be calibrated to emulate different types of runners by adjusting the trajectories of the base. As a proof of concept we have collected force, displacement and energy data from the machine.

Design and Testing of a Novel Device for Rapid Retrograde Intubation 
Clinician: Joan Spiegel, MD, Instructor in Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, jspiegel@bidmc.harvard.edu 
MIT Student Team: Charlie Ambler, Maria Luckyanova, William Palm 
 

This team will present a suite of novel device concepts that simplify and expedite retrograde intubation. Traditional methods of tracheal intubation employ a laryngoscope for placement of the endotracheal tube (ETT) via the oropharynx. For patients with an acquired or inherited abnormal airway (trauma, tumor, swelling, obesity, etc) these methods may be impractical or detrimental. In such cases, a retrograde approach via the cricothyroid region may be safer and more successful, but the method has not gained widespread acceptance due to the excessive time required and the difficulty in passing the ETT over a retrograde guidewire. The novel concepts presented herein overcome prior limitations by reducing the number of steps required and employing a stylet that guides anterograde placement of the endotracheal tube easily through the vocal cords. Initial testing using a mannequin simulator suggests that the new concepts may offer superior performance over current methods.

Design of a Low-Cost Pressure Monitoring Syringe 
Clinician: Joan Spiegel, MD, Instructor in Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, jspiegel@bidmc.harvard.edu 
MIT Student Team: Sarah Cooper-Davis, Sam Duffley, Ryan King, Adrienne Watral 
 

Endotracheal intubations are performed on thousands of patients every day, part of which is done by inflating a cuff on the distal tip of the tube to seal off the trachea. The air pressure inside the cuff must be sufficient to seal the trachea from unwanted flow of fluids, yet low enough to avoid cutting off capillary blood flow in the surrounding tissues. We evaluated several strategies and concepts to achieve correct cuff pressure and designed a syringe with an internal bellows pressure monitor. Many patents currently exist for pressure monitors external to the syringe; however, none of these devices are regularly used by doctors because they require too many changes to standard intubation techniques. This syringe uses a bellows inside the plunger to measure and display the internal cuff pressure. The bellows incorporates a spring and a seal into a single elastomechanical device, allowing for highly repeatable measurements. The design also maintains much of the traditional syringe design, in that only the plunger is modified. The device was calibrated to an external manometer and successfully tested by doctors at Beth Israel Deaconess Medical Center. This alpha prototype design successfully solves the problem of measuring air pressure in endotracheal tube cuffs and is a viable candidate for low cost mass-production.

Engineering Medical Devices @ MIT 2.75 Part I

With the goal of engaging graduate students and accelerating ideas into prototypes, teams of MIT graduate engineering students spend a semester collaborating with clinicians in CIMIT-affiliated hospitals to develop innovative medical devices. Clinicians (physicians, nurses, and scientists) present clinical problems and initial ideas. Students form teams to work with the clinicians to turn these ideas into reality. The goal is for the students to deliver a working prototype and a journal-quality article in one semester. In its fifth year, the course has been a great opportunity for clinicians to test out new ideas and to stimulate new collaborations. For example, Robopsy, a robotic device to assist radiologists performing tumor biopsies was invented by an MIT team led by Rajiv Gupta, MD, in 2004. The team was awarded the 2007 MIT $100K prize, the world's leading entrepreneurship competition and the 2008 ASME Innovation Showcase.

Moderator: Alex Slocum, PhD, Pappalardo Professor of Mechanical Engineering and MacVicar Faculty Fellow, MIT, slocum@mit.edu

A Novel Catheter Navigation System 
Clinician: Rajiv Gupta, MD, PhD, Director, VCT Lab and Assistant Radiologist, Department of Radiology, Massachusetts General Hospital, rgupta1@partners.org  
MIT Student Team: Jean Chang, Ellen Chen, Kenny Cheung, Alison Greenlee

 
 

There no techniques that allow doctors to quickly and accurately maneuver a catheter during an extravascular procedure. Presently utilized techniques restrict catheters to simple paths and therefore limit a doctor's ability to position the catheter in a poorly constrained environment. The proposed catheter navigation system overcomes these limitations and positions the catheter tip while the overall catheter shape is maintained. The system consists of a disposable set of "Tension Stiffening Guide-Wires," a double-lumen catheter, and an external reusable control system that is used to remotely maneuver the catheter. The "Tension Stiffening Guide-Wires" are composed of a set of beads with spherical bearing surfaces so that when the beads are held in tension, a friction lock forms between each bead. Mathematical analysis was performed to predict contact forces between beads, change in guide-wire conformation due to external forces, tip deflection, and failure modes. The catheter navigation system is not path limited and can make a number of three-dimensional turns inside the body. The goal of this prototype is to present doctors with a working catheter positioning system that will enable faster and accurately extravascular procedures to be conducted faster and more accurately.

Design and Prototyping of a Head Fixation Device for Transcranial Magnetic Stimulation 
Clinician: Alvaro Pascual-Leone, MD, PhD, Professor of Neurology, Harvard Medical School; Director of the Berenson-Allen Center for Noninvasive Brain Stimulation and Attending Neurologist and Director of Research, Behavioral Neurology Unit, Beth Israel Deaconess Medical Center, apleone@bidmc.harvard.edu 
MIT Student Team: Dodd Gray, Lawrence Maligaya, Adam Paxson

 
 

For applications of transcranial magnetic stimulation (TMS) and other cranial procedures involving relatively small instruments, this team will present a device for fixturing these instruments relative to a patient's head. The device consists of an ergonomic base table in which the patient rests face-down. The patient's head is supported by a custom-molded face restraint compliantly fixed to the base table. Indexing of the patient's skull is accomplished with a molded dental insert. Each stage of the design process is discussed with emphasis on a systematic approach based on structural analysis and bench-level experimentation. The performance of the final prototype is evaluated using digital image analysis. Our device achieves a positioning repeatability of 2.5mm, with a maximum displacement of 1.3mm over a five-minute period once the device has been affixed.

Interbody Device and Procedure for Endoscopic Lumbar Fusion 
Clinician: Kevin McGuire, MD, MS, Chief, Orthopaedic Spine Service, Beth Israel Deaconess Medical Center; Co-director, Comprehensive Spine Center and Combined Spine Fellowship Program; Instructor, Harvard Medical School, kjmcguir@bidmc.harvard.edu 
MIT Student Team: Nadia Cheng, Sourabh Kumar, Ryan Slaughter, Maria Telleria 
 
 
 
This team designed an interbody device and procedure that allows for performing minimally invasive lumbar fusion operations. Minimally invasive fusion techniques are currently limited due to non-availability of suitable interbody devices which can pass through an endoscopic tube and still obtain and maintain the required disc height for fusion. Here, a balloon based expandable device is presented which fulfills all the requirements of an interbody device used for lumbar fusion. It consists of an open-ring shaped balloon which is inserted into the disc space through the endoscopic cannula in the deflated state. The disc space is propped open by filling in pressurized saline into another balloon placed inside the ring. Once properly placed in the disc space, the ring shaped balloon is filled with fast solidifying bone cement slurry causing it to expand into the final ring structure. The saline balloon is eventually removed out of the disc space allowing for a large central space for packing bone graft material. The entire technique is described here, highlighting the essential features of the device. A successful device can be designed with a suitable choice of bone cement and balloon material. Available values for material properties suggest that the designed device would successfully allow for a complete lumbar fusion. Future in-vivo studies are needed to fully assess the success of the device.

Inhalation Technology Videos

Inhalation Gases in Biomedical Research 
Warren M. Zapol, MD, Professor of Anaesthesia, Harvard Medical School; Reginald Jenney Professor of Anaesthesia, Harvard Medical School; Director, Anesthesia Center for Critical Care Research, MGH, wzapol@partners.org 


Warren Zapol presents his studies and views of two gases with medical therapeutic interest. Nitric oxide is inhaled by 20,000 Americans per year for neonatal persistent pulmonary hypertension and peri-operative pulmonary hypertension, and Hydrogen Sulfide is being studied in the laboratory for its ability to rapidly create metabolic arrest in rodents.

Aerosols and Aerosol Drug Delivery Systems: Basics and Beyond 
Myrna Dolovich, P ENG, Associate Clinical Professor, Medicine, Faculty of Health Sciences; Head, Firestone Research Aerosol Laboratory/Center for Molecular Imaging of the Lung, McMaster University, St Joseph's Healthcare, mdolovic@mcmaster.ca 

Inhaled medications continue to be the most widely used form of therapy for treating respiratory disease in adults and children. Developments in inhaler technology and design have led to improvements in the production of therapeutic aerosols and with greater efficiencies of delivery and ease of use from the variety of inhalers available. Novel designs continue to be approved by the regulatory agencies and commercialized by manufacturers and, as a result, numerous delivery systems are currently available for drugs administered in aerosol form. Devices range from hydrofluoroalkane (HFA) pressurized metered-dose inhalers (pMDIs) with and without attached spacer devices, dry powder inhalers (DPIs), and nebulizers for providing continuous or intermittent aerosols of liquid solutions or suspensions. Within these three categories are a variety of devices producing aerosols with somewhat similar characteristics but with a range of fine particle lung delivery efficiencies, the current indicator of lower respiratory tract deposition and anticipated clinical advantage.

Delivering aerosolized medications to the lung is a challenge: the combination of   drug formulation properties, delivery system characteristics, patient ventilatory technique and compliance, and the nature of the lung disease all influence the success of therapy.

The dose of drug deposited in the lower respiratory tract is affected by the inhalation technique adopted by the patient (inspiratory flow rate, inspiratory volume, and breath-hold time). Most importantly, the degree of airway narrowing, which varies with the type and severity of the lung disease, further influences the distribution of that dose within the lung and potentially, the response to the therapy.

In the last 10–15 years, major design changes have occurred in all three categories of drug delivery devices. Examples of Innovative features introduced into newer types of inhalers are dose counters and integrated electronic management systems to track treatments and maintain treatment schedules, all designed with a view to improve compliance.

Aerosol products for the treatment of respiratory diseases have the simple advantage of depositing a specific drug directly to the appropriate receptors, thus bypassing GI barriers and general systemic exposure. Inhalers should provide a predictable, consistent dose of drug, operate in a patient friendly manner, and provide a reasonable cost of treatment per day. The patient must be able to use their device easily, maintain it and derive clinical benefit from the drug provided from the system. Physicians and patients must also recognize that if one system does not work, an alternative can be tried.