3D printing might save your life one day. It's transforming medicine and health care.
What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
Imagine that a health emergency strikes and you need an organ transplant – say, a heart. You get your name on a transplant list, but you find out there's a waiting period of six months. Tens of thousands of people find themselves in this dire situation every year. But 3D printing has the potential to change that forever.
The technology could usher in a future where transplantable organs can be printed not only cheaply, but also to the exact anatomical specifications of each individual patient.
What other innovations could 3D printing bring to medicine and health care? The sky is the limit, according to Dr. Todd Goldstein, a researcher with the corporate venturing arm of Northwell Health, New York State's largest health care provider and an industry leader in 3D-printing research and development.
"It comes down to what people can think up and dream up what they want to use 3D printing for," Goldstein says. "Ideally, you would hope that 50 years from now you'd have on-demand, 3D printing of organs."
While that's still on the horizon for researchers, 3D printing is already improving lives by revolutionizing medicine in three key areas.
Printing realistic, customized organ models
3D printers can take images from MRI, PET, sonography or other technologies and convert them into life-size, three-dimensional models of patients' organs. These models serve as hands-on visualization tools that help surgeons plan the best approaches for complex procedures.
They also allow doctors to customize patient-specific models prior to surgery. For example, Northwell employs 3D printing in several clinical applications:
- Tumor resection models clearly highlight the tumor and surrounding tissue
- Orthopedic models are useful for pre-surgery measuring and medical device adjustments
- Vascular models identify malformations in organs, tumors, sliced chambers, blood flow, valves, muscle tissue, and calcifications
- Dentistry oral implants and appliances can be created in just one day, significantly reducing wait periods for Northwell dentists and their patients
Using realistic models not only delivers better health results but also shortens operating times. That gives patients less time under anesthesia, and hospitals potential savings of millions of dollars over just a few years.
Being able to visualize procedures before they occur also helps to comfort patients and their families. Take, for instance, the case of Barnaby Goberdhan, a man who discovered that his young son, Isaiah, had an aggressive tumor in his palate. Goberdhan met with Neha A. Patel, MD, a pediatric otolaryngologist at Cohen Children's Medical Center, a Northwell Health hospital, to discuss the procedure and learn about it with help from a 3D-printed model.
"Having a 3D printed depiction of my son was really helpful when talking with the doctor about his surgery," said Mr. Goberdhan. "The doctor was able to do more than talk me through what they were going to do – Dr. Patel showed me. There is almost nothing more frightening and stressful than having your child go through surgery. There were several options Dr. Patel walked us through for the best way to preserve Isaiah's teeth and prevent additional cuts within his mouth. I wanted all of my questions answered so I could be less fearful and more prepared to talk my son through what he was about to face. I wanted Isaiah to feel prepared. With the 3D model, we both felt more at ease."
For years, 3D printing surgical models was prohibitively expensive. Now, more affordable systems such as Formlabs' Form Cell give more hospitals across the country access to the technology in order to produce realistic, patient-specific models, usually within one day.
Credit: Northwell Health
While 3D-printed organs are a long way in the future, today's technology is well suited for manufacturing prosthetics. 3D-printed prosthetics are often remarkably more affordable and personalized than their traditional counterparts. That's a big deal for many families, especially those with children who outgrow prosthetics and are forced to buy new ones.
One recent breakthrough in 3D-printed prosthetics came when Dan Lasko, a former Marine who lost the lower part of his left leg in Afghanistan, wanted the ability to swim with his prosthetic leg. Wearing prosthetics in water has been possible for years, but they typically slow swimmers down. No device had been able to go seamlessly from land to water or to help propel its wearer through the water.
To fix that, Northwell Health recently funded a project that developed The Fin – the world's first truly amphibious prosthetic. With The Fin, Lasko and his family can go straight into the pool from the locker room – or the diving board.
"I got back in the pool with my two young sons and for the first time was able to dive into the pool with them," Lasko said.
3D-printed prosthetics will help improve the daily lives of the nearly 2 million Americans who've lost a limb. That's promising because the increasing prevalence of Type 2 diabetes is expected to greatly increase the number of amputees in the U.S., according to a study published in the Archives of Physical Medicine and Rehabilitation.
For years, 3D printers have manufactured various products: phone cases, toys, and even operational guns. To produce these objects, the machines heat a raw material, typically plastic, and build the object layer-by-layer according to a particular design.
3D bioprinting, a young field developed by researchers with Northwell Health, may someday perform the same process but instead with living cells in a raw material called bioink.
Daniel A. Grande, director at the Orthopedic Research Laboratory in the Feinstein Institute for Medical Research, an arm of Northwell Health, said he and his team first pursued 3D bioprinting by modifying 3D printers so they'd accept living cells.
"My initial concept of 3D printing was early studies that looked at modifying ink-jet printers, where we incorporate a bioink that includes cells within a delivery vehicle," Grande says. "That hydrogel can then be polymerized, or hardened, upon heat or UV-light stimulation, so that we can actually make a complex structure, three-dimensionally, that incorporates living cells. The hardened hydro-gel is then able to keep the cells alive and viable. It's also biocompatible, so it can be safely implanted in humans."
It's a promising enterprise, and it can radically change how we experience medical care.
"3D bioprinting's potential is almost limitless and has the potential to replace many different parts of the human body," says Michael Dowling, president and CEO at Northwell Health, and author of Health Care Reboot. "Researchers envision a future with 3D printers in every emergency room, where doctors are able to print emergency implants of organs and bones on demand and revolutionize the way medicine is practiced."
Dr. Todd Goldstein explains more about 3D bioprinting below:
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They came from different places and with different ideas, which still resonate today
- Early British settlement of the American colonies came in four distinct waves, from different places.
- Puritans, Cavaliers, Quakers and Borderers had their own ideas of what America should be.
- Some of the cultural fault lines in today's America can be traced back to those differences.
Four 'folkways'<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ0MDY2NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzOTAzNzk0OX0.YfBxVdS46dX1eUZhGA_4remlW4YYMIxlZ65wjQ2pyMs/img.jpg?width=980" id="d2108" class="rm-shortcode" data-rm-shortcode-id="2efd697c8c1a31a446da2d4f34168094" data-rm-shortcode-name="rebelmouse-image" alt="\u200bQuaker pioneer William Penn (center) treating with the Delaware Indians for the purchase of what was to become Pennsylvania." />
Quaker pioneer William Penn (center) treating with the Delaware Indians for the purchase of what was to become Pennsylvania.
Image: frieze by Constantino Brumidi (1865) in the Rotunda of the US Capitol; via Architect of the Capitol - public domain.<p>How many Americans are of British descent? It's a surprisingly difficult question to answer. Is that because, in an age of hyphenated identities, the founding one still is the default? Or has that identity become so amalgamated that it is now irrelevant? Perhaps the correct answer is: a bit of both. </p><p><span></span>In the 1980 Census, 61.3 million Americans (32%) self-reported British ancestry; most claimed English descent (26%), followed by Scottish (4%), and tiny amounts of Welsh (<1%) and Northern Irish. In the 2010 Census, that figure had dropped to 37.6 million (14%), with just 8% reporting English heritage, 3% Scottish and 2% Scotch-Irish. </p><p>The precipitous drop in self-reported British antecedents corresponds in part with the rise of those who identify as (unhyphenated) 'American', up from 12.4 million (5%) in the 1990 Census to 20.2 million in 2000 (7%) – the largest growth of any ethnic group in the 1990s.</p><p>However, back around the year 1700, about 80% of the population of what was to become the United States were of English (or Welsh) descent, with about 11% of African origin, and the rest being Dutch (4%), Scottish (3%) and other European. The imprint of the British on early American society was overwhelming, diverse and long-lasting: the regional and cultural differences between the settler groups created distinct regional and cultural identities in America.</p><p>That's the argument made by David Fischer, a history professor who in 1989 published a 900-page treatise on early migration to North America called <em><a href="https://global.oup.com/ushe/product/albions-seed-9780195069051" target="_blank">Albion's Seed</a></em>. He identified four British 'folkways' that came over to the other side of the Atlantic in the 17th and 18th centuries (<em>see map</em>), each with their own ideas about the liberty they wanted to find there.<br></p>
From exodus to flight<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ0MDY2NS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY0NDg1MzczOX0.-LwTLCpuIub9QhTVWL9vhnd8Jlz9j8aRyt9bePqQPuo/img.png?width=980" id="65f97" class="rm-shortcode" data-rm-shortcode-id="4457df0ca7f66fe87026322bad771da6" data-rm-shortcode-name="rebelmouse-image" alt="\u200bMap showing the origin and destination of four British 'folkways' that influenced American society." />
Map showing the origin and destination of four British 'folkways' that influenced American society.
Image: Geni.com<p><strong></strong><strong>1. The Exodus (1629-41)</strong></p><ul> <li>About 21,000 Puritans, migrating from East Anglia to New England.</li><li>These religious fundamentalists believed in 'ordered liberty': everybody had the right to live by their own rules, and the duty to live according to God's law.</li><li>The Puritans were a major influence on the culture of the Northeastern US, especially in terms of business and education.</li></ul><p>These religious fundamentalists are the ones who came over on the Mayflower and gave America Thanksgiving and the self-image of being a 'City on a Hill'. Puritan society was gloomy and repressive: 'exceeding the bounds of moderation' was a punishable offense, and even just 'wasting time' got you into trouble.</p>The other side of the coin: life was very well-ordered. There was little income inequality and crime rates were low. Not only was charity towards poor the rule, being uncharitable was, yes, a punishable offense. Domestic abuse was punished severely. Women had a relatively high degree of equality. And government operated via town assemblies in which all could have a say.<br><br><strong>2. Cavaliers and their Servants (1642-75)</strong><ul><li>Some 45,000 Cavaliers drawn from English nobility and their indentured servants, migrating from the South of England to Virginia and the Lowland South.</li><li>These aristocrats believed in 'hegemonic liberty': dominion over self, and others. In other words: keeping slaves was okay, but domination by others was not.</li><li>The Cavaliers were the foundation of plantation culture in the South. </li></ul><p>The Cavaliers came from the losing side of the Civil War in England, which was now led by the Puritan-inspired Oliver Cromwell. Royalist, Anglican and aristocratic, they brought along with them their indentured servants – more than 75% of the total migration – hoping to recreate in Virginia and environs the socially stratified agrarian society they had left behind.</p><p><span></span>When their servants began dying en masse, they started importing African slaves, laying the groundwork for the race-based slavery system that underpinned the economy of the South until the end of the Civil War.</p><strong>3. The Friends' Migration (1675-1725)</strong><ul><li><strong></strong>Around 23,000 Quakers, migrating from Northern England to the Delaware Valley in Pennsylvania, and later to the Midwest.</li><li>These religious liberals believed in 'reciprocal liberty': granting others the freedoms they wanted for themselves, including the right to vote, to own, to be free, to worship and to a fair trial.</li><li>Quakers had an important impact on the industrial culture of the Mid-Atlantic and Midwestern regions of the US.</li></ul><span></span>Halfway between the fun-hating Puritans and the pleb-hating Cavaliers, the Quakers seem modern and likeable. Believing everybody intrinsically good, they practiced tolerance, pacifism, gender equality and racial harmony. They opposed slavery, the death penalty, and cruelty to animals and children.<p>Quakers replaced a wide range of social acknowledgements according to rank (bows, nods, grovels) by a single, neutral equivalent: the handshake. Quakerism was perhaps one of the first Christian denominations to become indistinguishable from liberal, secular modernity. On the other hand, they were more prudish even than the Puritans. Doctors had a hard time treating Quakers because they described everything from their necks to their waists as their 'stomachs', and everything below as their 'ankles'. </p><p><strong>4. The Flight from Northern Britain (1717-75)</strong></p><ul><li>Some 250,000 'Borderers', migrating from the Anglo-Scottish borderlands and Ulster to the Backcountry of Appalachia.</li><li>These individualists believed in 'natural liberty': freedom to do as one pleases, without interference from society or government.</li><li>Borderers contributed to the rural culture of America's South and the ranch culture of its West. </li></ul><p><span></span>Inhabiting the border regions between Scotland and England, and between protestant settlers and catholic natives in Ireland, the Borderers were used to violence and lawlessness, and to lives that were nasty, brutish and short. </p>It is no coincidence that they ended up in Appalachia, at that time itself a violent border region. It was the kind of world they knew. Borderers were wary of government, prone to violent family feuds and not bothered by traditional morality. By one estimate, in the year 1767, 94% of all 'backcountry' brides were pregnant on their wedding day.<p><span></span>These Borderers were not much beloved by other settler groups in America. One Pennsylvanian writer called them "the scum of two nations". But the Borderers also contributed vigorously to the success of both the American Revolution and America's westward expansion. </p>
'Blue' vs. 'Red'?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ0MDczNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1MzE5MTc4NH0.EtbfEc9BlGG8R4VlyHr2W7kQ0LzvRdAHRRRlsEI01Pg/img.jpg?width=980" id="ce2a3" class="rm-shortcode" data-rm-shortcode-id="ba2cd744238f9a08ce63e85be2860528" data-rm-shortcode-name="rebelmouse-image" alt="Representative Preston Brooks (SC) caning Senator Charles Sumner (MA) on the Senate floor. The attack, on 22 May 1856, symbolised the breakdown of civil discourse between North and South, prefiguring the Civil War." />
Representative Preston Brooks (SC) caning Senator Charles Sumner (MA) on the Senate floor. The attack, on 22 May 1856, symbolised the breakdown of civil discourse between North and South, prefiguring the Civil War.
Image: lithograph by John L. Magee (1856); public domain.<p>It's tempting, and perhaps not entirely unjustified, to see in these four strains of British 'folkways' the antecedents of some of America's current cultural divides. One might for example see Puritans and Quakers as constituting elements of the 'blue' tribe, while Borderers and Cavaliers could be considered the ancestors of the 'red' tribe.</p><p><span></span>But thinking of America as a "death match between Puritan-Quaker culture and Cavalier-Borderer culture", as one commentator put it, is perhaps a bit too easy. There may be plenty of overlap within either pair, there is also much to distinguish each from the other. And then there are other and subsequent migrations contributing to and complicating the picture.</p><p>Nevertheless, a bit of cultural archeology can be illuminating, if only to see where the bodies are buried.<br></p><p><strong><br></strong></p><p><strong>Strange Maps #1049</strong></p><p><em>Got a strange map? Let me know at </em><a href="mailto:email@example.com">firstname.lastname@example.org</a><em>.</em></p>
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