Wednesday, April 19, 2017

The Other 3D

In the world of “machines replace workers,” where artificial intelligence looms at the biggest near-term employment challenge, technology is accelerating. My grandfather was a gifted machinist as he worked in what has now become the Rust Belt… Dayton, Ohio. His Teutonic precision allowed him to make just about anything out of metal, machine parts within unbelievable tolerances, from custom fits to the tools needed to make other very precise metallic pieces. He was at the top of his game, a master-craftsman without parallel. But today, his excellence is simply obsolete. Computer assisted design (CAD) has advanced into what is today a world of machines that implement those designs directly: 3D printing.
What started out as a lovely experiment has now resulted in 3D printers well within the reach of ordinary hobbyists to much more sophisticated equipment able to make the most complex parts to tolerances that exceed those humans could match. The machines work in plastics, wood and just about any kind of metal, most recently titanium. The impact of costs is staggering… as workers find themselves replaced with these magnificently-accurate “printers.” The April 11th uses recent advances at Boeing to explain how far we have come:
“Boeing manages to build 144 of its 787 Dreamliner commercial aircraft every year. Each one costs $265 million, with $17 million of that going on strong and lightweight titanium alloy components required to support the carbon fiber fuselage and wings. However, thanks to Norsk Titanium, the Dreamliner is about to get cheaper, saving Boeing as much as $3 million per plane.
“[On April 10th], Norsk Titanium delivered the world's first FAA-approved 3D printed, structural titanium component. These components use Norsk's Rapid Plasma Deposition (RPD) process, and the results are thanks to a close collaboration with Boeing who designed the parts for use in the Dreamliner.
“As reported by Reuters, Norsk's Chip Yates, vice president of marketing, claims the switch to 3D printed titanium parts, ‘means $2 million to $3 million in savings for each Dreamliner, at least.’
“If the $3 million saving is realized, it scales up to a cost reduction of $432 million every year based on current production numbers. Seeing as the Dreamliner only started generating a profit for Boeing last year and already cost the company around $29 billion in ‘production-related losses,’ this is surely welcome news.
“Norsk Titanium President & Chief Executive Officer Warren M. Boley, Jr. commented that, ‘The Norsk Titanium team will continue to expand the portfolio of components supplied to Boeing meeting stringent certification requirements.’ That suggests this could just be the start of the cost savings brought about by replacing traditional and expensive manufacturing with significantly cheaper and faster 3D printing.” Scary and inevitable. Workers are quivering with less than delight.
But what would happen if the manufacturing materials were effectively driven by DNA, cells from the body of persons in need of transplants? Possible? Can we “3D print” body parts and organs? We’ve been using stem cells to regenerate failing body parts or parts that need rebuilding for a while now.
2013: “Many sports fans who hear about this [stem cell regeneration] procedure that uses an athlete’s own cells to treat their injuries immediately think of the treatments [NBA basketball’s] Kobe [Bryant] has been famously flying to Germany to receive. But there are clear distinctions between the treatment Kobe has been getting to help his right knee (a knee which has logged the 12th most minutes in NBA history) and this stem cell therapy procedure.
“‘Kobe has been receiving regenerative treatments including PRP (platelet-rich plasma),’ [Dr. Rajagopalan (Dr. Raj), an orthopedic surgeon specializing in sports and fitness procedures] says. ‘Our treatment has more healing properties than PRP because we get the stem cells from bone marrow instead of blood. PRP has to be done many times and stem cell injections from bone marrow are a one-time treatment.’” (12/6/13). But we’ve progressed a lot since 2013.
Using stem cells for more complex surgical replacements is beginning to be the next phase of American sports injury repair. That technical feat has most recently been utilized to repair baseball pitchers’ throwing arms in lieu of “Tommy John’s” elbow surgery (on the ulnar collateral ligament or UCL) with astounding success.  
“The problem is that the Tommy John surgery recovery timeline is substantial. Weeks to months spent in a splint and then months more of rehab and a whole season lost. Is there a better way? We’ve successfully treated UCL tears using either SCP (our enhanced version of platelet rich plasma) or same day stem cells (for bigger tears). These newer therapies have a much faster recovery timeline than surgery.”
“Recently, MLB’s Los Angeles Angels starting pitchers Garrett Richards and Andrew Heaney were both presumed to be out for the season due to tears in their ulnar collateral ligaments in their respective throwing elbows. This type of injury is what leads to Tommy John surgery.  This surgical procedure consists of extracting a healthy tendon from an arm or leg and then using this to replace a torn ligament in the arm. After the surgery, patients can expect a 12-14 month recovery.” Use stem cells instead of surgery? These pitchers are finding recovery time reduced by as much as two-thirds, and in some cases net throwing power has been enhanced. Wow! But is there a “next” beyond even this phase of stem cell treatment?
What if entire parts were able to be 3D printed (cloned?) to place older damaged, disfigured or worn out body parts.“Bioengineers from the Wake Forest Institute for Regenerative Medicine have spent more than a decade developing a system for 3D-printing tissues and organs that could eventually be used in transplants…  
“‘It is estimated that every 30 seconds, a patient dies from a disease that could be treated with tissue replacement,’ says Anthony Atala, director of Wake Forest Institute for Regenerative Medicine. ‘There are simply not enough donor tissues and organs to meet demand. Regenerative medicine offers the hope of engineering replacement organs in the lab to help solve this shortage. Because these organs would be made with a patient’s own cells, there would be no issues with rejection as there are with organs from donors.’
“Like other 3D printers, the equipment developed by the researchers prints materials in precise layers. But instead of using plastic or metal, the machine uses gels filled with cells and a biodegradable, plastic-like material that holds the tissue in a specific shape. A lattice of tiny, capillary-like channels in the structure takes in nutrients and oxygen when the tissue is implanted, so it stays alive.
In 2016, the researchers announced that they had successfully 3D-printed a baby-sized human ear, a jawbone, and muscle tissue. After implanting them in lab animals, the body parts survived–something that hadn’t happened in many previous attempts to make 3D-printed tissue–and actually grew. The ear began to grow blood vessels after a month.
“We have been able to print human scale constructs that, when implanted in experimental models, developed a system of nerves and blood vessels and were functional,” says Atala. “The research indicates that tissue structures printed with the system have the right size, strength, and function for use in humans.”
“The researchers engineered tissues and organs in the past that were implanted in patients, but those were created by hand. With the use of 3D-printers, they will be able to reach many more people.”, April 12th. Remarkable. We’re going to help people live longer, live healthier even as they may not have the jobs or healthcare! In the meantime, I need a new left knee! Any ideas?!
I’m Peter Dekom, and we need both continued support for medical and technological research coupled with socio-political planning to accommodate the inevitable changes such advancement will cause.

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