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parasite-driven illness that,
time and unless treated early,
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when blood flow to a part of the brain
A stroke is sometimes called
a "brain attack."
when blood flow to a part of the brain stops.
A stroke is sometimes called
a "brain attack."
hemispatial neglect UK
caused by brain damage USA
Too much cholesterol in the body
causes coronary disease such as angina, heart attack and
Dr Jonathan Morrell explains who is at risk and the treatments
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high blood pressure (...)
is a major risk factor
for a variety of health problems,
including heart attacks,
strokes and heart failure.
lower blood pressure
blood pressure cuff USA
Stents are tiny scaffolds
inserted into blood vessels
to prop them open
after blockages have been cleared.
Stents are attached
to the end of thin plastic catheters in crimped form
and then delivered to the target blood vessel
by threading the catheter through
the circulatory system.
Stents made out of shape-shifting metals like nitinol
naturally expand into
place when heated by the blood,
but most are made out of other metals that are expanded
by briefly inflating
tiny balloons at the end of the catheter.
Dies at 92
The New York Times
By BARNABY FEDER
Greatbatch, a professed “humble tinkerer” who, working in his barn in 1958,
designed the first practical implantable pacemaker, a device that has preserved
millions of lives, died on Tuesday at his home in Williamsville, N.Y. He was 92.
His death was confirmed by his daughter, Anne Maciariello.
Mr. Greatbatch patented more than 325 inventions, notably a long-life lithium
battery used in a wide range of medical implants. He created tools used in AIDS
research and a solar-powered canoe, which he took on a 160-mile voyage on the
Finger Lakes in New York to celebrate his 72nd birthday.
In later years, he invested time and money in developing fuels from plants and
supporting work at the University of Wisconsin in Madison on helium-based fusion
reaction for power generation.
He also visited with thousands of schoolchildren to talk about invention, and
when his eyesight became too poor for him to read in 2006, he continued to
review papers by graduate engineering students on topics that interested him by
having his secretary read them aloud.
“I’m beginning to think I may not change the world, but I’m still trying,” Mr.
Greatbatch said in a telephone interview in 2007.
He was best known for his pacemaker breakthrough, an example of Pasteur’s
observation that “chance favors the prepared mind.”
Mr. Greatbatch’s crucial insight came in 1956, when he was an assistant
professor in electrical engineering at the University of Buffalo. While building
a heart rhythm recording device for the Chronic Disease Research Institute
there, he reached into a box of parts for a resistor to complete the circuitry.
The one he pulled out was the wrong size, and when he installed it, the circuit
it produced emitted intermittent electrical pulses.
Mr. Greatbatch immediately associated the timing and rhythm of the pulses with a
human heartbeat, he wrote in a memoir, “The Making of the Pacemaker,” published
in 2000. That brought to mind lunchtime chats he had had with researchers about
the electrical activity of the heart while he was working at an animal behavior
laboratory as an undergraduate at Cornell in 1951.
Back then, he had surmised that electrical stimulation could compensate for
breakdowns in the heart’s natural circuitry. But he did not believe the
electronic gear of that era could be bundled into a stimulator for continuous
use, much less into a device small and reliable enough to implant.
After the unintended circuit rekindled his interest, Mr. Greatbatch began
experiments to shrink the equipment and shield it from body fluids. On May 7,
1958, doctors at the Veterans Administration hospital in Buffalo demonstrated
that a version he had created, of just two cubic inches, could take control of a
Mr. Greatbatch soon learned he was in a race with other researchers in the
United States and Sweden to perfect a practical implant for humans. Relying on
$2,000 in savings and a large vegetable garden to help feed his growing family,
he went to work full time on the device in the barn behind his home in Clarence,
N.Y. He was assisted by his wife, Eleanor, who administered shock tests for the
pacemaker’s transistors by first taping them to a bedroom wall.
His major collaborator was Dr. William C. Chardack, chief of surgery at the
hospital where he had first tested the device on dogs. Mr. Greatbatch’s device
was implanted in 10 human patients in 1960, including two children. The device
was licensed in 1961 to Medtronic, a Minneapolis company that had developed an
external pacemaker. Buoyed by the new implanted devices, Medtronic went on to
become the world leader in cardiac stimulation and defibrillation.
The American Heart Association says that more half a million pacemakers are now
implanted every year.
Mr. Greatbatch profited handsomely from his invention and invested in other
projects. In one, he adapted for human use equipment he had designed to monitor
the health of test monkeys launched into space by the government. But he soon
returned to address a crucial limitation in his pacemaker: its zinc-mercury
batteries, which could drain in as little as two years.
Mr. Greatbatch acquired rights to a lithium iodine design invented in 1968 by
researchers in Baltimore, and by 1972 he had re-engineered the device — it had
been potentially explosive — into a compact sealed package that could be
implanted in the body for a decade or more.
A company he founded in 1970 to make the batteries, today called Greatbatch
Inc., became a leading power-component supplier for the entire medical device
industry and later expanded into related businesses.
Mr. Greatbatch often told students that 9 out of 10 of his ideas failed, either
technically or commercially. His last major interest, helium fusion experiments,
may be the longest shot of all.
The reaction is theoretically attractive; unlike nuclear fusion, it produces no
radioactive materials. But the raw material for it is an isotope of helium that
exists only in trace amounts on earth. For the fusion to generate significant
amounts of power, the isotope would have to be mined on the moon.
Wilson Greatbatch was born on Sept. 6, 1919, in Buffalo, the only child of
Warren Greatbatch, a construction contractor who had immigrated from England,
and the former Charlotte Recktenwalt, who worked as a secretary and named him in
honor of Woodrow Wilson.
As a teenager, Mr. Greatbatch became fascinated with radio technology. He put
his skills to use in the Navy during World War II working on shipboard
communications and guidance systems before being assigned to fly combat
missions. Mr. Greatbatch, a Presbyterian, cited the seeming randomness of death
in wartime as the inspiration for his religious faith.
Returning from the war, Mr. Greatbatch married Eleanor Wright, his childhood
sweetheart, and worked for a year as a telephone repairman before entering
Nothing in Mr. Greatbatch’s grades foretold success, but that was partly because
he was also working at outside jobs to support his family. The jobs kept him
abreast of developments in the electronics industry. After earning a master of
science degree in electrical engineering at the University of Buffalo, he became
manager of the electronics division of the Taber Instrument Corporation in
When Taber was unwilling to take on the risk of his pacemaker implant
experiments, he began his life as an independent inventor and entrepreneur.
Eleanor Greatbatch died in January. Besides his daughter, Anne, of Sarasota,
Fla., Mr. Greatbatch is survived by three sons, Warren, of Buffalo, Kenneth, of
Swanzey, N.H., and John, of Paris, Ky.; 12 grandchildren, and eight
great-grandchildren. Another son, Peter, died in 1998.
Mr. Greatbatch saw a divine hand in much of what he did. When experiments bore
no fruit, he wrote, it was impossible to know whether what looked like failure
had not been intended by God as a contribution to success in the future. And he
saw invention as an end in itself.
“To ask for a successful experiment, for professional stature, for financial
reward or for peer approval,” he wrote in his memoir, “is asking to be paid for
what should be an act of love.”
Slotnik contributed reporting.
Wilson Greatbatch, Pacemaker Inventor, Dies at 92,
Dr. Adrian Kantrowitz,
Dies at 90
November 19, 2008
The New York Times
By JASCHA HOFFMAN
Dr. Adrian Kantrowitz, who performed the first human heart transplant in the
United States in 1967 and pioneered the development of mechanical devices to
prolong the life of patients with heart failure, died Friday in Ann Arbor, Mich.
He was 90.
The cause was complications of heart failure, said Jean Kantrowitz, his wife of
nearly 60 years and a longtime colleague in developing the devices.
On Dec. 6, 1967, when he removed the heart of a brain-dead baby and implanted it
into the chest of a baby with a fatal heart defect, Dr. Kantrowitz became the
first doctor to perform a human heart transplant in the United States. The
patient lived for only six and a half hours, but the operation was a milestone
on the way to the routine transplants of today.
Along with Dr. Michael E. DeBakey of Texas and a few others, Dr. Kantrowitz
helped open the new era in care for seemingly terminally ill heart patients,
using both surgery and artificial devices. His work at Maimonides Medical Center
in Brooklyn and Sinai Hospital in Detroit had a lasting impact, starting with
his first headlines in 1959, when he gave a healthy dog a booster heart muscle.
Over six decades of surgical practice, he designed and used more than 20 medical
devices that aided circulation and other vital functions.
Although his 1967 transplant was the first in the United States, it was not the
first in the world, following by three days Dr. Christiaan Barnard’s in Cape
Town. But Dr. Kantrowitz had been methodical in laying the groundwork for the
procedure. He practiced hundreds of heart transplants in puppies over the
previous four years, and had planned a human operation the previous year, but
was prevented at the last minute because the donor infant had not been declared
“Although Dr. Kantrowitz had the dedication and perseverance to accomplish this
remarkable surgical tour de force, it was the notion that, for the first time,
science could view the heart as yet another organ that could be fixed that was a
revolutionary concept,” Dr. Stephen J. Lahey, director of cardiothoracic surgery
at Maimonides Medical Center, said in a statement on the 40th anniversary of Dr.
While many doctors have worked to replace failing hearts altogether with
artificial ones, Dr. Kantrowitz concentrated on finding ways to supplement the
work of the natural heart with an impressive array of circulatory devices of his
own invention. The most influential was the “left ventricular assist device,” or
LVAD, which, for the first time in 1972, allowed a patient with severe chronic
heart failure to leave the hospital with a permanent implant.
Another of his inventions was the intra-aortic balloon pump, described in The
New York Times in 1967 as “a long, narrow gas line” inserted through the
patient’s thigh that inflated “a six-inch-long sausage-shaped balloon” in the
aorta. The device deflated when the heart pumped blood and inflated when it
relaxed, thereby reducing strain on the heart, according to Dr. Kantrowitz’s
theory of “counterpulsation.” The device has been used to treat about three
million patients since it went into general use in the 1980s.
He also invented an early implantable pacemaker, designed with General Electric
in 1962, and captured the first film of the mitral valve opening and closing
inside a beating heart in 1951.
His inventiveness extended beyond cardiology. In 1961, inspired by the way the
muscles in the heart were stimulated, he was the first doctor to enable
paraplegic patients to move their limbs by electronically triggering their
Adrian Kantrowitz was born on Oct. 4, 1918, in New York City, to a mother who
designed costumes for the Ziegfeld Follies and a father who ran a clinic in the
Bronx that charged its patients 10 cents a week.
“My mother told me from the age of 3 that I wanted to be a doctor,” he told The
New York Post in 1966.
As a boy he worked with his older brother Arthur to construct an
electrocardiograph from old radio parts. The brothers later collaborated on the
left ventricular assist device.
After graduating from New York University with a degree in mathematics in 1940,
Dr. Kantrowitz enrolled in the Long Island College of Medicine (now a part of
SUNY Downstate Medical Center) and completed an internship at Brooklyn Jewish
Hospital. He earned his medical degree early, in 1943, as part of an accelerated
program to supply doctors for the war effort. After serving two years as a
battalion surgeon in the Army Medical Corps, Dr. Kantrowitz began a career in
cardiac research and became a major figure in the first generation of cardiac
From 1948 to 1955, he practiced surgery at Montefiore Hospital in the Bronx.
From 1955 to 1970, he held surgical posts at Maimonides Medical Center in
Brooklyn, where he led a team that devised many influential devices with support
from the National Institutes of Health, including an electronic heart-lung
machine and a radio transmitter that allowed paralyzed patients to empty their
In 1970 Dr. Kantrowitz left Maimonides when “it became apparent that a small
community hospital in Brooklyn was not the proper environment for the
development of innovative cardiac surgical techniques,” according to a recent
profile in the journal Clinical Cardiology. Remarkably, he was able to move his
entire team of 25 surgeons, engineers and nurses — and with them a nearly $3
million research grant — to Detroit, where he taught at Wayne State University
School of Medicine and held surgical posts at Sinai Hospital for the rest of his
Besides his wife, Jean, who helped him start a medical device company, LVAD
Technology, in 1983, his survivors include three children, Dr. Niki Kantrowitz,
a cardiologist in Brooklyn; Dr. Lisa Kantrowitz, a radiologist in Newport Beach,
Calif.; and Dr. Allen Kantrowitz, a neurosurgeon in Williamstown, Mass.; and
Dr. Kantrowitz received a lifetime achievement award from the American Society
for Artificial Internal Organs in 2001. He did not rest on his laurels. This
year the Food and Drug Administration approved a clinical trial of his latest
cardiac assistance device, which promises to allow seriously ill patients to
move around and even exercise.
Dr. Adrian Kantrowitz,
Cardiac Pioneer, Dies at 90,
Creates Rat Heart
Using Cells of Baby Rats
The New York Times
By LAWRENCE K. ALTMAN
dream of growing new human hearts and other organs to repair or replace damaged
ones received a significant boost Sunday when University of Minnesota
researchers reported success in creating a beating rat heart in a laboratory.
Experts not involved in the Minnesota work called it “a landmark achievement”
and “a stunning” advance. But they and the Minnesota researchers cautioned that
the dream, if it is ever realized, was still at least 10 years away.
Dr. Doris A. Taylor, the head of the team that created the rat heart, said she
followed a guiding principle of her laboratory: “give nature the tools, and get
out of the way.”
“We just took nature’s own building blocks to build a new organ,” Dr. Taylor
said of her team’s report in the journal Nature Medicine.
The researchers removed all the cells from a dead rat heart, leaving the valves
and outer structure as scaffolding for new heart cells injected from newborn
rats. Within two weeks, the cells formed a new beating heart that conducted
electrical impulses and pumped a small amount of blood.
With modifications, scientists should be able to grow a human heart by taking
stem cells from a patient’s bone marrow and placing them in a cadaver heart that
has been prepared as a scaffold, Dr. Taylor said in a telephone interview from
her laboratory in Minneapolis. The early success “opens the door to this notion
that you can make any organ: kidney, liver, lung, pancreas — you name it and we
hope we can make it,” she said.
Todd N. McAllister of Cytograft Tissue Engineering in Novato, Calif., said,
“Doris Taylor’s work is one of those maddeningly simple ideas that you knock
yourself on the head, saying, ‘Why didn’t I think of that?’ ” Dr. McAllister’s
team has used a snippet of a patient’s skin to grow blood vessels in a
laboratory, and then implanted them to restore blood flow around a patient’s
damaged arteries and veins.
The field of tissue engineering has been growing rapidly. For many years,
doctors have used engineered skin for burn patients. Engineered cartilage is
used for joint repairs. Researchers are investigating the use of stem cells to
repair cardiac muscle damaged by heart attacks. Also, new bladders grown from a
patient’s own cells are being tested in the same patients.
Dr. Taylor is a newcomer to tissue regeneration. She began her professional
career at the Albert Einstein College of Medicine in the Bronx investigating
gene therapy and then cell therapy. She said she switched to tissue regeneration
when she realized the limiting step in trying to generate an organ was not the
number of cells needed, but the complexity of creating a three-dimensional
“The heart is a beautiful organ,” Dr. Taylor said, “and it’s not one that I
thought I’d ever be able to build in a dish.”
Her view changed about three years ago when she recalled that cells were removed
from human and pig heart valves before they were used to replace damaged human
ones. As she contemplated replacing the old rat cells with new ones, Dr. Taylor
followed another of her mantras: “Trust your crazy ideas.”
Progress came in fits and starts. “We made every mistake known, did every
experiment wrong and had to go back and do them right,” Dr. Taylor said.
She poured detergents like those in shampoos in the rat’s arteries to wash out
the heart cells and then injected neonatal cardiac cells. The first two
detergents she tested failed. But a third concoction led to a clear, translucent
scaffold that retained the heart’s architecture.
After injecting the young rat heart cells into a scaffold, she stimulated them
electrically and created an artificial circulation as the equivalent of blood
pressure to make the heart pump and produce a pulse. The steps also helped the
cells mature. Tests like examining slices of the heart under a microscope showed
they were living cells.
To test the biological compatibility of the new hearts, the team transplanted
them into the abdomen of unrelated live rats. The hearts were not immediately
rejected. A blood supply developed. The hearts beat regularly. And cells from
the host rats moved in and began to reline the blood vessels, even growing in
the wall of the hearts.
Dr. Taylor is now conducting similar experiments on pigs as a step toward human
work. “Working out the details in a pig heart made a lot more sense” because the
anatomy of the porcine heart is the closest to humans and pigs are plentiful,
“The next goal will be to see if we can get the heart to pump strongly enough
and become mature enough that we can use it to keep an animal alive” in a
replacement transplant, Dr. Taylor said.
As for human hearts, the best-case situation would be to obtain them from
cadavers, remove their cells to make a scaffold and then inject bone marrow,
muscle or young cardiac cells from a patient. The process of repopulating the
scaffold with new cells would take a few months, she said.
The body replaces its proteins every few months, so the hope is that the body
will create a matrix that it recognizes as its own.
One potential problem is that antirejection drugs might be required to prevent
adverse immune reactions from the scaffold. In that case, Dr. Taylor hopes such
therapy would be needed only temporarily.
Many things that work in experiments on animals fail in humans because of the
species barrier. Dr. McAllister said that in Dr. Taylor’s case “the principal
problem in escalating it to humans is one of scale, not of cell biology, and
that is an easier problem to solve potentially.”
Dr. Taylor said, “If it works, it means that there will be many more organs
available for transplants.”
Because the components of the biologic matrix differ for every organ, Dr. Taylor
expects that scientists will be able to do tests to answer two fundamental
questions: Can a stem cell be placed anywhere in the body and still produce a
heart, kidney or other organ? Or must a stem cell be placed in its anatomic
position to do so?
Such tests might include taking stem cells from one organ, for example a kidney,
and putting them in a kidney, liver or heart to begin to understand if the stem
cells are innately committed to produce kidneys or whether they will convert to
produce livers or hearts.
Beginning Jan. 15, Adam Liptak’s column, “Sidebar,”
will appear on Tuesdays.
Barry’s column, “This Land,”
will return on Monday, Jan. 21.
Team Creates Rat Heart Using Cells of Baby Rats,
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