Copy That Aug 3, 2013

by RICK RADER, MD * EDITOR-IN-CHIEF

One of the most intriguing, novel and exciting applications of 3D printers is in biotech, namely human tissue replacement.

One of the attributes of aging (okay getting geezer-like) is the opportunity to experience the evolution and transition of ideas, technology and innovation. Take copying.

Granted I wasn't around to see how Gutenberg put legions of scribes into the unemployment lines but I did see (and use) carbon paper to make a duplicate copy of typewritten reports. I also remember taking tests on copies made by blue "mimeograph" machines and I can still smell the alcohol aroma that lingered and permeated the exam room. I remember when "copy machines" were debuted and the term Xerox became the generic phrase for any photocopied sheet. Today the modern "copy" machine rivals the electronics of an F-16 fighter jet. They can copy front and back, in color, collate, staple themselves, scan, fax, diagnose faults and perform a number of functions that require a "glove box manual" of several hundred pages. I'm glad to be able to copy a handful of pages on my own (and in fact that's the only thing I am permitted to use the machine for without consulting Susan, my administrative assistant, who has a black belt in office technology).

Like all technologies, the "printer" has not only been refined but has gone where no other machine has gone before. It can literally copy, duplicate and replicate itself. Enter the 3D Printer and the world of Additive Manufacturing.

The term 3D printing refers to the process of making a three-dimensional solid object of virtually any shape or configuration from a digital model. The term "additive" describes the process of successive layering of materials in different shapes. This process ("layering") is distinct from the traditional process of "machining," where material was either cut away or drilled.

I can recall working as an apprentice mechanic in a vintage auto restoration shop where we were required to "create" unobtainable engine parts for 80-year-old cars. You would literally hand a block of aluminum to the machinist and say, "Cut away everything that doesn't look like a piston from a 1915 Crane Simplex." Several days later he would hand you the finished product, leaving bits and scraps of aluminum shavings on the milling machine. He, in fact, machined a 3D "copy" of the non-existing part. He needed reference material to "print" the part, either an old piston or blueprints that were originally used to manufacture the part back in 1915. The use of computer design engineering software can now be used when the original part or plans are unobtainable.

The technology for 3D printing can be used for both prototyping (creating a first working conceptual model) or in actual manufacturing. There are now applications for these Buck Rogers printers in architecture, construction, industrial design, automotive, aerospace, military, engineering, civil engineering, dental and medical industries, fashion, footwear, jewelry, eyewear, education, geographic information systems, food and many other fields.

One of the most intriguing, novel and exciting applications of 3D printers is in biotech, namely human tissue replacement.

Organovo, a San Diego-based biotech company recently announced a new milestone in the field of "human tissue replica printing" by assembling functioning sections of human liver tissue. While the tissue scaffold is currently too thin (at this point) to actually build a new liver, they were successful in layering both types of liver cells necessary for liver physiology. The two "mandatory" cells are "hepatocytes" (key cells that perform many of the liver's jobs) and "stellate cells" (which provide both structure and repair capabilities). And if that wasn't enough to order in several pizzas to celebrate, they also printed a batch of necessary blood vessel tissues to stabilize the viable liver tissue. Obviously still in the experimental stages, the ultimate (obtainable) goal is to print implantable liver tissue and ultimately replicated organs to go.

Against the backdrop of the viable liver tissue milestone, researchers at Princeton and Johns Hopkins have begun to "print" an ear. Using stem cells and advanced synthetic cell microdroplets, there is every reason to believe the "printing" of replacement organs is within reach in our lifetime. With 3D printing we won't have to rely on handing a block of tissue to a "biomachinist" and say, "cut away everything that doesn't look like a 78-year-old male's mitral valve." We will simply be able to press "print".

For readers of Exceptional Parent magazine, many who have been sucked into this world as a result of faulty organs, out-ofwhack wiring or impaired inter-organ communications, the prospect of having access to a bench of ready-t- play first string organs is worthy of a national holiday. But, for now, the reality remains what it is today— a promising field without any solution we can turn to next Monday. Until that changes, exceptional parents (and exceptional professionals) have to rely on the current generation of printers—printers that can make photo copies of their written demands, needs, values, services, hopes, dreams and plans and distribute them to anyone in a position to help realize them. In the clarifying jargon of military, police and aviation radio communications, we can simply say, "Copy that."

ANCORA IMPARO
In his 87th year, the artist Michelangelo (1475 -1564) is believed to have said "Ancora imparo" (I am still learning). Hence, the name for my monthly observations and comments.
— Rick Rader, MD, Editor-in-Chief, EP Magazine Director, Morton J. Kent Habilitation Center Orange Grove Center, Chattanooga, TN

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