SPECIAL
REPORT FROM BUSINESS WEEK
Mechanical body parts could
someday
make disabilities irrelevant in the workplace
Getting a makeover is about to
take on a whole new meaning. In the not-too-distant future, doctors will be able
to do as much under the skin as beauticians now do on top. For the many people
with disabilities or chronic diseases, technology is on the verge of unlocking a
whole new world.
Scattered across the globe, dozens of research teams are working on computer
chips that will be implanted in the brain or spinal cord to give artificial
vision to the blind, hearing to the deaf, and speech to the victims of stroke.
Other laboratories and companies are developing products that will regulate
bladder function for the incontinent, restore movement to the paralyzed, and
give back muscle control to people with amyotrophic lateral sclerosis (ALS, or
Lou Gehrig's disease). Artificial kidneys and blood vessels are being tested in
several labs, including the McGowan Center for Artificial Organ Development at
the University of Pittsburgh. At the University of New Mexico's Artificial
Muscle Research Institute, scientists are developing polymer-metal composites
that could serve as replacement muscles for patients suffering such afflictions
as muscular dystrophy.
SILICON RETINAS. Name almost any disability, and there's probably
research under way to overcome it. Most magical of all, though, is the drive to
restore vision in the blind. Already, Dr. Mark S. Humayun, a researcher at Johns
Hopkins University Medical Institutions in Baltimore, has implanted
light-sensitive chips in the eyes of some 15 patients. These tiny silicon
retinas provide a very crude, 15-pixel image. A somewhat better, 64-pixel image
is provided by an artificial-vision system that relays scenes from a miniature
video camera to a small electronic-circuit card inside the skull of Jerry, the
blind man wearing the strange-looking eye glasses in the picture above. (He asks
that his last name not be used.) Jerry's vision system was developed over four
decades by William H. Dobelle, CEO of Dobelle Institute Inc. in Commack, N.Y.
''My next version will be better still,'' he says--with 512 pixels. Still,
that's a far cry from the hundreds of thousands of pixels on a TV screen or
computer monitor.
Image quality will keep getting better as semiconductor technology continues to
pack silicon chips with more power. In 10 years it might be good enough that
users will blend into the crowd. In 20 years, the acuity of artificial vision
might rival that of a biological eye, says Dr. William J. Heetderks, head of a
National Institutes of Health program focused on developing electronic implants.
In fact, fully functioning artificial eyes should be ready by 2024, predicts Ian
D. Pearson, a researcher at British Telecommunications PLC's BT Laboratories in
England.
Long before then, other manmade body parts will be helping people to overcome
disabilities. Artificial hearing implants, offering better sound than today's
cochlear implants, may arrive sooner--perhaps within a year. Electronic implants
to stimulate the muscles in paralyzed limbs should be ready by 2002, says
Pearson of BT Labs. Artificial lungs and kidneys may follow by 2015, although
some researchers optimistically predict 2010, when a permanent artificial heart
may be ready.
Advanced prototypes of all these spare body parts already exist in research
labs. The history of such efforts, after all, goes back almost six decades to
the kidney dialysis machine, which was invented in 1943 in the Netherlands by
Dr. Willem J. Kolff. Known today as the father of artificial organs, he came to
the U.S. in 1950, developed an artificial heart at the Cleveland Clinic in the
mid-1950s, and in the 1960s formed an artificial-organ research program at the
University of Utah. Many others followed; Dobelle, for one, started his
artificial vision work under Kolff's tutelage.
Probably the Utah group's most famous product was the Jarvik heart, named after
Robert K. Jarvik, who developed the original design in the late 1970s while he
was an engineering student at Utah--building on the work of at least 147 of
Kolff's students. Since then, mechanical-heart designs have leaped into the
Space Age. Several of the latest versions have tiny turbines for pumping
blood--borrowed from the turbines that pump fuel in the Space Shuttle.
Supercomputer simulations at NASA and the Pittsburgh Supercomputing Center honed
the turbine designs to make them superhumanly efficient. For now, these pumps
are used only as ''bridge'' devices to sustain a patient until a human heart is
available for transplant. But researchers are confident they'll eventually be
permanent replacements.
Moreover, artificial organs no longer need a connection through the skin to an
outside power source. In 1991, researchers at the University of Ottawa Heart
Institute developed a so-called inductive system that ''broadcasts'' electrical
power through the skin. Patients can move about freely using a battery pack. A
similar system also transmitted signals through the skin, activating an
artificial-vision brain implant. So blind people may not need a hole in their
head like Jerry has.
Americans who want Dobelle's system may have to fly to Zurich, where he has a
clinic. Stringent U.S. Food & Drug Administration safety rules make it
uneconomical to introduce artificial-organ technology at home, he says. That's
why Dr. Bartley P. Griffith, director of Pittsburgh's McGowan Center for
Artificial Organ Development, will head to Israel to perform the first human
implant of a new turbine heart. ''The U.S. standard is that we're not going to
use devices that might do harm, no matter how gravely ill the patient is,'' he
says. To Kolff, who's now 89, that doesn't make sense, and he has been lobbying
Washington for a change. Some 95,000 people will die this year ''without a
chance,'' he laments, because only a couple thousand donor hearts will probably
be available. Dr. Steven J. Phillips, an assistant research director at the
National Institutes of Health, also believes the FDA could ease up. ''Europe's
safety record with our new devices is actually better than our own--and they're
saving more lives,'' he notes. He also worries about so much of the research
migrating to Europe because of its encouraging climate.
Yet ultimately, most of these gadgets may be replaced. Biotech engineers will
figure out how to tinker with genes and prevent or cure blindness, heart
disease, and other afflictions. But it won't happen for at least 20 years, says
Griffith. That leaves a big gap for mechanical body parts to fill. Soon,
''making a new you'' could take on a whole new meaning.
By Otis Port in New York
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