Student Presentation Handouts

Sam Doyle

3D Printed Biological Materials

What is it?

3D-bioprinting is the process of generating controlled cell patterns using 3D printing technologies,

where cell function and viability are preserved within the printed construct to produce a working

organ/tissue.

Why do we have it?

3D-bioprinting contributes to significant advances in the medical field and helps researchers better

understand the human body and how to reconstruct it. It also helps benefit those people in need of

new organs or organ repair.

How does it work?

-The first step is usually to take a biopsy of the area being copied.

-Then to take which cells out of the piece of tissue you would need copied.

-Then the certain cells would be isolated and manipulated.

-Once they have enough of each cell type, the 3D-printer will organize these cells in a specific pattern.

-While in a safe environment, the cells will create a working piece of healthy tissue that can then be

transferred to the human body.

What can it be used on?

The 3D – Bioprinter can be used to create anything, as long as it gets a good sample of tissue from its

host. Most commonly it’s used on embryonic stem cells, printing skin, blood vessels, heart tissue,

bones, and other vital organs.

It can be used to do cancer research

Printing cancer cells on tissue in a lab to study, test drugs on and to eventually find a cure for.

History

-By the early 1990s, 3D Systems had begun to introduce the next generation of materials-

nanocomposites, blended plastics and powdered metals.

-In 1999, scientists at the Wake Forest Institute for Regenerative Medicine used a 3-D printer to build a

synthetic scaffold of a human bladder.

-In 2002, scientists printed a miniature functional kidney capable of filtering blood and producing urine

in an animal model

-And in 2010, a 3D-Bioprinting company printed the first working blood vessel.

Antibiotics

What Are they?

Powerful medications used for fighting infections caused by biological agents

They are used to fight bacterial infections

They will however, have no effect on viruses.

They can be used to treat some fungi and parasites as well

When are they needed

Needed when suffering from bacterial infection (Strep throat), fungal infection (Blastomyocis) or parasites.

Taken in pill form or as injections

How do they work

Block vital processes in bacteria

Narrow spectrum vs. Broad spectrum: Narrow spectrum antibiotics work only on one type of bacteria or a few,

whereas broad spectrum antibiotics work on many.

Different Antibiotics work in different ways

Where do they come from?

Most antibiotics come from fungi (Penicillin comes from Penicillium mould)

Some come from bacteria (Bacitracin comes from Bacillus subtilis)

Most are now synthesized chemically without need for moulds or bacteria

A brief history of Antibiotics

In ancient times, mould and fungus were used to treat various ailments

1870: It is observed that bacteria does not grow on mould-covered culture

1897: Ernest Duchesne healed infected guinea pigs from typhoid using mould

1928: The enzyme lysozyme and penicillin discovered by Alexander Flemming

Potential Side-effects

Upset stomach

Increased risk of infection from Thrush

Allergic reactions

Bacterial antibiotic resistance

Bone marrow transplant

A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy

bone marrow stem cells. Bone marrow is the soft, fatty tissue inside your bones. The bone marrow

produces blood cells. Stem cells are immature cells in the bone marrow that give rise to all of your

different blood cells.

Description

Before the transplant, chemotherapy, radiation, or both may be given. This may be done in two ways:

Ablative (myeloablative) treatment: High-dose chemotherapy, radiation, or both are given to kill any

cancer cells. This also kills all healthy bone marrow that remains, and allows new stem cells to grow in the

bone marrow.

Reduced intensity treatment, also called a mini transplant: People receive lower doses of chemotherapy

and radiation before a transplant.

There are 3 kinds of bone marrow transplants:

Autologous bone marrow transplant: Stem cells are removed from you before you receive high-dose

chemotherapy or radiation treatment. The stem cells are stored in a freezer. After high-dose

chemotherapy or radiation treatments, your stems cells are put back in your body to make normal blood

cells. This is called a rescue transplant.

Allogeneic bone marrow transplant: The term allo means other. Stem cells are removed from another

person, called a donor. Most times, the donor's genes must at least partly match your genes. Special tests

are done to see if a donor is a good match for you. A brother or sister is most likely to be a good match.

Sometimes parents, children, and other relatives are good matches. Donors who are not related to you,

yet still match, may be found through national bone marrow registries.

Umbilical cord blood transplant: This is a type of allogeneic transplant. Stem cells are removed from a

newborn baby's umbilical cord right after birth. The stem cells are frozen and stored until they are needed

for a transplant. Umbilical cord blood cells are very immature so there is less of a need for perfect

matching. Due to the smaller number of stem cells, blood counts take much longer to recover.

A stem cell transplant is usually done after chemotherapy and radiation is complete. The stem cells are

delivered into your bloodstream usually through a tube called a central venous catheter. The process is

similar to getting a blood transfusion. The stem cells travel through the blood into the bone marrow. Most

times, no surgery is needed.

Donor stem cells can be collected in two ways:

Bone marrow harvest: This minor surgery is done under general anesthesia. This means the donor will be

asleep and pain-free during the procedure. The bone marrow is removed from the back of both hip bones.

The amount of marrow removed depends on the weight of the person who is receiving it.

Leukapheresis: First, the donor is given several days of shots to help stem cells move from the bone

marrow into the blood. During leukapheresis, blood is removed from the donor through an IV line. The

part of white blood cells that contains stem cells is then separated in a machine and removed to be later

given to the recipient. The red blood cells are returned to the donor.

Why the Procedure is Performed

A bone marrow transplant replaces bone marrow that is either not working properly or has been

destroyed by chemotherapy or radiation. Doctors believe that for many cancers, the donor's white blood

cells may attack any remaining cancer cells, similar to when white cells attack bacteria or viruses when

fighting an infection.

Your doctor may recommend a bone marrow transplant if you have:

Certain cancers, such as leukemia, lymphoma, myelodysplasia, and multiple myeloma, A disease that

affects the production of bone marrow cells, such as aplastic anemia, congenital neutropenia, severe

immunodeficiency syndromes, sickle cell anemia, and thalassemia, Or you

had chemotherapy that destroyed your bone marrow

Risks

A bone marrow transplant may cause the following symptoms:

Chest pain, Drop in blood pressure, Fever, chills, flushing, Funny taste in the mouth, Headache, Hives,

Nausea, Pain, Shortness of breath

Possible complications of a bone marrow transplant depend on many things, including:

The disease you are being treated for, Whether you had chemotherapy or radiation before the bone

marrow transplant and the dosages of such treatments, Your age, Your overall health, How good of a

match your donor was, The type of bone marrow transplant you received (autologous, allogeneic, or

umbilical cord blood)

Complications may include:

Anemia, Bleeding in the lungs, intestines, brain, and other areas of the body, Cataracts, Clotting in the

small veins of the liver, Damage to the kidneys, liver, lungs, and heart, Delayed growth in children who

receive a bone marrow transplant, Early menopause, Graft failure, which means that the new cells do not

settle into the body and start producing stem cells, Graft-versus-host disease (GVHD), a condition in which

the donor cells attack your own body, Infections, which can be very serious, Inflammation and soreness in

the mouth, throat, esophagus, and stomach, called mucositis, Pain, Stomach problems, including diarrhea,

nausea, and vomiting

Before the Procedure

Your health care provider will ask about your medical history and do a physical exam. You will have many

tests before treatment begins.

Before transplant, you will have one or two tubes, called catheters, inserted into a blood vessel in your

neck or arms. This tube allows you to receive treatments, fluids, and sometimes nutrition. It is also used to

draw blood. Your provider will likely discuss the emotional stress of having a bone marrow transplant. You

may want to meet with a counselor. It is important to talk to your family and children to help them

understand what to expect.

You will need to make plans to help you prepare for the procedure and handle tasks after your

transplant:

Complete an advance care directive, Arrange medical leave from work, Take care of bank or financial

statements, Arrange care of pets, Arrange for someone to help with household chores, Confirm health

insurance coverage, Pay bills, Arrange for care of your children, Find housing for yourself or your family

near the hospital, if needed

After the Procedure

Most of the time, you stay in a special bone marrow transplant unit in the center. This is to limit your

chance of getting an infection. Depending on the treatment and where it is done, all or part of an

autologous or allogeneic transplant may be done as an outpatient. This means you do not have to stay in

the hospital overnight.

How long you stay in the hospital depends on:

How much chemotherapy or radiation you received, The type of transplant, Your medical center's

procedures, While you are in the hospital, you will be isolated because of the increased risk of infection.

The health care team will closely monitor your blood count and vital signs.

While you are in the hospital you may:

Receive medicines to prevent or treat infections, including antibiotics, antifungals, and antiviral medicine,

Need many blood transfusions, Be fed through a vein (IV) until you can eat by mouth and stomach side

effects and mouth sores have gone away, Be given medicines to prevent GVHD, After you leave the

hospital, be sure to follow instructions on how to care for yourself at home.

Outlook (Prognosis)

How well you do after the transplant depends on:

The type of bone marrow transplant, How well the donor's cells match yours, What type of cancer or

illness you have, Your age and overall health, The type and dosage of chemotherapy or radiation therapy

you had before your transplant, Any complications you may have

A bone marrow transplant may completely or partially cure your illness. If the transplant is a success, you

can go back to most of your normal activities as soon as you feel well enough. Usually it takes up to 1 year

to recover fully, depending on what complications occur.

Complications or failure of the bone marrow transplant can lead to death.

https://www.nlm.nih.gov/medlineplus/ency/article/003009.htm

Q: When was the first non-twin sibling bone-marrow transplant performed?

It wasn't until 1968, in Minnesota, that the first successful non-twin (allogeneic) transplant was performed.

In this case, the donor was a sibling of the patient. By this time, it was known that a key to a successful

transplant was a specific type of genetic matching (known as HLA) of the donor to the patient. Siblings

receive DNA from the same parents, a sibling is the most likely person to be a good match.

Q: Who performed the first successful human bone-marrow transplant?

The first successful transplant was performed by Dr. Thomas in Cooperstown, N.Y., in the late 1950s. The

transplant involved identical twins, one of whom had leukemia

https://www.fredhutch.org/en/treatment/long-term-follow-up/FAQs/transplantation.html

Colonoscopy By: Shayna Barned

What exactly is a colonoscopy?

There ae two different type of colonoscopy procedures.

A procedure in which your physician looks inside your entire large intestine from your rectum/ anus to the beginning of

your small intestine. Your physician will insert a long, flexible, tubular lighted instrument about 1/2 inch in diameter into

your rectum and slowly guide it into your colon. The tube is called a colonoscope. It is used to check for early signs of

colon and rectum cancer. Also used to diagnose the causes of unexplained changes in bowel habits. Takes approx. 30-60

minutes.

Then there is Virtual colonoscopies. Virtual colonoscopy is an X ray test, takes less time, and doesn’t require a doctor to

insert a colonoscope into the entire length of your colon. However, virtual colonoscopy may not be as effective as

colonoscopy at detecting certain polyps. Also, doctors cannot treat problems during virtual colonoscopy, while they can

treat some problems during colonoscopy.

Where did it originate?

Dr. William I, Wolff, his colleague and himself revolutionized the diagnosis and treatment for colon cancer by by

developing the colonoscopy as the procedure is practiced today, died on Aug. 20 at his home in Manhattan. He was 94.

Revolutionized the diagnosis and treatment for colon cancer, by developing the colonoscopy.

He was the forefront of the research to create a full length tube with electric sensors to go in the colon.

Name broken into two words, “Colon” for you colon in which it takes place and

“-oscopycomes from viewing of, normally done with a scope.

Preparing for a colonoscopy.

- Your colon must be completely empty for the colonoscopy to be thorough and safe.

- Take part in a Liquid diet for 1 to 3 days beforehand

- A liquid diet means fat-free bouillon or broth, strained fruit juice, water, plain coffee, plain tea, or diet soda.

Gelatin or popsicles in any color but red may also be eaten.

- Laxatives the night before procedure to clean bowels out completely.

- Arrange someone to take you home afterwards (sedatives)

- Inform your physician of any medical conditions or medications that you take before the colonoscopy.

- A health care professional will place an intravenous (IV) needle in a vein in your arm to give you sedatives,

anesthesia, or pain medicine so you can relax during the procedure.

- The health care staff will monitor your vital signs and keep you as comfortable as possible during the exam.

How is a colonoscopy performed?

you are to lay on the left side of your body (the intestines move from left to right)

The colonoscope is then inserted into your rectum.

The colonscope transmits an image of the lining of the colon so the doctor can pay close attention and examine

it for any abnormalities. Such as inflamed tissue, abnormal growths, ulcers, and bleeding.

-during this the scope also blows air into your colon, which than causes it to inflate the colon and that helps the

physician see the images better.

-during this your physician may have to move you several times on the table to adjust the scope for better

viewing.

What is done if something is spotted/ found in the colon?

If during the viewing anything abnormal is seen in your colon, such as a polyp or inflamed tissue, the physician

may remove all or part of it using tiny instruments passed through the scope.

Polyp is a small growth, typically benign and with a stalk, protruding from a mucous membrane.

Colon polyps are most common in adults. They are harmless in most cases. However, commonly colon cancer

begins as a polyp, so by having it removed early it becomes an effective way to prevent cancer.

The doctor may also perform a biopsy. You won’t feel the biopsy

Once removing a polyp and bleeding occurs in the colon, the physician may pass a laser, heater probe, or

electrical probe to stop the bleeding. Or they may inject special medicines through the scope and use it to stop

the bleeding. Bleeding or punctures are conflicts that may occur, but they are uncommon.

Risk factors for colorectal cancer:

If polyps or cancer of the colon or rectum has been diagnosed in someone else in your family.

having a personal history of inflammatory bowel disease, such as ulcerative colitis and Crohn's disease

•other factors may be, if you are overweight or smoke cigarettes.

Why would your doctor ask for a colonoscopy to be done?

changes in your bowel activity

pain in your abdomen

bleeding from your anus

unexplained weight loss

Difficulty during bowel movements

Sometimes you are just asked to go for one because of family backgrounds in colon rectum cancer.

What should you expect after a colonoscopy?

You will have to stay at the hospital or outpatient center for 1 to 2 hours after the procedure.

You may have abdominal cramping or bloating within the first hour after your procedure.

The sedatives or anesthesia takes time to wear off completely.

You should expect a full recovery by the next day, and you should be able to go back to your normal diet

If you have any of the following symptoms after a colonoscopy, seek medical care right away:

severe abdominal pain

very high fever

continued bloody bowel movements or continued bleeding from the anus

Dizziness

Weakness

Average age for colonoscopy: (If it runs in the family or is heretical there are three risk levels.)

(High risk) patients recommended age for a colonoscopy for people in this category is sometimes as young as 20

to 25 years.

If you are at higher risk for colorectal cancer, your doctor may recommend screening at a younger age, and you

may need to be tested more often.

(increased risk) Persons who are at an increased risk should have a colonoscopy at age 40. If a family member

was younger than age 50 when diagnosed with colon cancer, you should have the colonoscopy 10 years earlier

than the age of that person when diagnosed.

(low risk) Persons of average risk should undergo some type of colon cancer screening at age 50.

If you are older than 75, talk with your doctor about whether you should be screened.

ELECTRO LARYNX

What is it?

A device used to help people talk after a laryngectomy (surgical procedure to remove part/all of the larynx)

A laryngectomy could be needed for various reasons:

o To treat cancer in the larynx

o Had severe trauma to the larynx – ex: severe infection or injury to the larynx

o Radiation Necrosis (damage to the larynx when neck is exposed to radiation)

How does it work?

It is a hand-held device with a vibrating diaphragm

The end of the electro larynx is placed on the neck and stimulates vibrations in

the throat which mimics the work of the vocal cords

User can then simply articulate words as usual

Producing good speech can be difficult because it is hard to find the right

spot on your neck

Also gives off a mechanical sound, however, it is easily understood,

especially with good practice

The design of a pneumatic mechanical larynx uses air from the lungs to

generate sound through an external device. When you exhale, lug air

travels through a vibrating coupling device from the tracheostoma (an opening in the trachea made by a

tracheostomy) into the mouth. Then, words can be formed with the mouth for speech production.

Who invented it?

Takes after the idea of the pneumatic mechanical larynx, created in the 1920s by Western Electric

Electro larynx was not introduced until the 1940s

Where is it found?

Some city healthcare providers have electro larynxes for sale

o Ontario Home Health: 24 Hour Emergency Service provides them

Can be loaned one through a program offered at www.webwhispers.org for up to 90 day (special cases can

have an extension)

Electrosurgical Units

What is it? - Electrosurgical units use high frequency, alternating electrical waves at various voltages to

pass through the tissue and generate heat to cut, coagulate, and alter the tissue.

Who uses them? - Many surgeons use these because it minimizes the risk of blood loss and it allows

surgeons to see clearly in confined areas. - Procedures such as dermatological, gynecological, cardiac,

plastic, ocular, spine, veterinary and many more

Problems? - There is a risk of fire if the proper preparation procedures are not taken. - 56% of all

accidents related to the electrosurgical unit are burns

Benefits? - The ability to perform surgeries in places that you wouldn't usually be able to, like doctors’

offices. These procedures can be done by using a mild anesthetic - Precise control over the open area,

including bleeding, and increased vision.

How are they used? -There is an active electrode and a return electrode -In bipolar electrosurgery the

forceps are both the return and the active -Monopolar electrosurgery consists of an active electrode and a

return electrode that is placed somewhere else on the body

Where can you get them and how much do they cost? - you can buy these units online - prices range

from $400- $1200

History - In 1926, William T. Bovie developed the first electrosurgical unit while he was working at Harvard

University. - On October 1, 1926 the first electrosurgical unit was used in surgery at Perter Bent Brigham

Hospital in Boston. - In 1940 the electrosurgical units designed for office use were introduced.

Skin Grafting (Emma Wheeler)

• Removing heathy skin (donor site) from one part of the body and moving it to another area (usually infected area)

• Health reasons: _________, _______________, or _____________. • Cosmetics: _______________, or _____________. History of Skin Grafting

• 600 BC • Susruta Samhita • Wrote many famous medical journals about plastic surgery and skin transplantation (skin grafting) • Discovered the method of transplanting skin from buttocks and thigh to infected area (Indian

method) • 1823 • Carl Bunger • Preform the first modern skin graft on a human patient • Used skin from the inner thigh and moved it to the patient’s nose which was infected with syphilis. • Learned this method through reading Susruta’s journals

• 1975 • James G Rheinwald and Howard Green • They were the founders of the research in skin growth instead of transplanting • Looked for various substitutes or artificial skin to be used • Both studies are continuing today, with large advancements since the start. • Neither are 100% practical or put to use yet today

Types of Skin Grafting

• Full Thickness Graft • Contains a thin outer layer of skin called the epidermis and a thick inner layer of the skin known as

the dermis • The dermis contains within it blood vessels, nerves, sweat glands and hair follicles • This method is most often used with large or deep burns and the loss of skin due to another

disease. • Has a fast recovery of 7-10 days but will leave visible scaring on skin.

• Split Thickness Graft • A layer of the epidermis and a thin layer of dermis • This method is “shaving” layers of the skin with a dermatome instead of cutting the skin. • Whole sheets of skin are often used for the neck, face, or hand because there are less stitches

involved and will leave less of a scar. • Slits of skin can also be used in a more hidden area of the body • The method is used for deep or widespread skin burns • Skin donor sites can be from the thigh, buttocks, arm, back, or abdomen. • Takes about 2 weeks to heal.

• Free Flap Procedures • This method is used in the removal or neck or head cancer or breast reconstruction • Muscle, skin, or bone can be taken from the donor site along with the original blood supply of the

donor site • Often involves microsurgery • Slow healing time of about 6-8+ weeks

• Microsurgery • This can be used to reattach a finger, toe, ear, or lip

• This method uses a microscope for visual assistance which helps to reconnect small nerves and blood vessels with better precision.

• Tissue Expansion • Used to “grow” extra skin instead of taking existing skin from donor site • Balloon expander is placed under skin and slowly fills with saline solution (salt water) and as it

grows it slowly stretches skin from below. • Colour and texture of the skin is similar if not identical so it is preferable. • There is little scarring • This method is very long due to having to slowly stretch the skin. • This can be used in skin cancer removal, scar revision, or hand surgery.

Fun Facts

• Skin covers the entire external surface of the human body, representing the largest single organ • Pig skin was tried in order to make skin grafts instead of human skin at one point.

Bibliography http://biomed.brown.edu/Courses/BI108/BI108_2007_Groups/group11/history.html

http://ispub.com/IJPS/4/2/8232

http://www.healthline.com/health/skin-graft

http://www.psfk.com/2014/10/skin-graft-technology-3d-printing.html

http://www.webmd.com/skin-problems-and-treatments/plastic-surgery-burns

http://www.ncbi.nlm.nih.gov/pubmed/23788147

http://www.imdb.com/title/tt0119094/plotsummary

Medical Technology – CT/CAT Scan

Computed tomography / Computerized Axial Tomography

Specialized X-ray that results in Cross-sectional images of the body using X-rays Used to look inside of body

Theoretically like taking a random piece of bread out of a whole loaf

Takes pictures from different positions, each rotation provides a small picture Increases visibility to see small things that aren’t visible on X-rays or other tests Very similar to MRI

MRI uses magnetic Field and Radio waves

CT scan uses X-rays and computer Focused on brain, neck, spine, chest, abdomen, pelvis and sinuses Developed by Godfrey Hounsfield and Dr. Allan Cormack in 1972, first installed in1974 Won a noble prize in 1979 Revolutionized medicine because it allowed doctors to see diseases that at the time, could

only be seen during surgery or an autopsy There are a few health risks such as exposure to radiation, allergic reaction to the dye that

is injected, dye may leak outside of vein causing skin to break and a reaction to the sedation (1 in 100,00 reactions are fatal)

No food or drinks a few hours before scan because it could interfere with the dye and upset the stomach

Dye is used to help separate abnormal structures from normal structures and makes it easier to distinguish what is what on the scan

Typically the patient lies on their back and goes through head or feet first depending on the focus of the scan. However, when the focus of the scan is the sinus cavity or ears, patient must lay on their stomach and proceed to go through head first

Must remain motionless during scan approx. 15-45min in length including set up, scan, picture and sending the patient home May have to hold breath up to 20 seconds during the scan Ct Scans are not only done at hospitals, but can be done at clinics and other health care

facilities

Electronic Aspirin

Why was the Electronic Aspirins Made?

People found that regular aspirins did not work as effectively as they would like. This is especially true for

people who are suffering from cluster headaches. Regular aspirins were unable to prevent the excruciating pain

that comes from cluster headaches. A solution for this is the electronic aspirin. Doctors hope that this new

aspirin will help relieve the pain associated with them.

Cluster Headaches

Not a definite cause for cluster headaches has been determined. But doctors believe that abnormalities in the

hypothalamus could play a role. The reason for this is because regular headaches are caused when the

trigeminal-autonomic reflex pathway activates. The trigeminal nerve is seen to be activated by the

hypothalamus. So when abnormalities in the hypothalamus are present, than the trigeminal nerve is unable to

activate properly. Doctors also believe that impulses and signals from the SPG (Sphenopalatine ganglion) can

cause cluster headaches.

Purpose and Location

The electronic aspirin is a device that is about the same size of an almond. As well, it is a nerve stimulating

device that is planted within the “upper gum” side of the head. The device will block SPG (Sphenopalatine

ganglion) signals and impulses. This will prevent or relieve the pain associated with headaches. The SPG main

function is to send impulses to the face, as it is the facial nerve bundle. You can find the SPG in a bony cavity

called the pterygopalatine fossa.

How it Works

In order for the electronic aspirin to work its lead tip is attached to the SPG bundle. This will signal when

impulses are being sent. The remote is than placed against the implant when you feel an oncoming headache. As

a result, the stimulation of the SPG bundle of nerves is blocked. This happens because the remote signals the

electronic device to send an electrical pulse to the SPG bundle stimulating the nerves.

Who Made It?

The electronic aspiring was made by scientist at Automatic Technologies Incorporated in Redwood City

California.

Current Testing

A study is being conducted in Europe to test the effectiveness of the device. There is not a lot of information on

the device yet, as it has not been released to the general public.

Open Heart Surgery

Open heart surgery is any type of surgery where the chest is cut open and surgery is performed on the muscles, valves,

or arteries of the heart.

According to the National Heart Lung and Blood Institute (NHLBI), coronary artery bypass grafting (CABG) is the

most common type of heart surgery done on adults. During this surgery, a healthy artery or vein is grafted (attached) to a

blocked coronary (heart) artery. This allows the grafted artery to “bypass” the blocked artery and bring fresh blood to the

heart (NHLBI).

Open heart surgery is sometimes called traditional heart surgery. Today, many new heart procedures can be performed

with only small incisions (cuts), not wide openings. Therefore, the term “open heart surgery” can sometimes be

misleading.

Why Is Open Heart Surgery Needed?

Open heart surgery may be done to perform a CABG. A CABG may be necessary for patients with coronary heart

disease (CHD).

CHD occurs when the blood vessels that provide blood and oxygen for the heart become narrow and hard. This is often

called “hardening of the arteries.”

Hardening occurs when fatty material forms a plaque on the walls of the coronary arteries. This plaque narrows the

arteries, making it difficult for blood to get through. When blood can’t flow properly to the heart, a heart attack may

occur.

Heart surgery is also done to:

repair or replace heart valves, which allow blood to travel through the heart

repair damaged or abnormal areas of the heart

put in medical devices that help the heart to beat properly

replace a damaged heart with a donated heart (heart transplantation)

How Is Open Heart Surgery Performed?

According to the National Institutes of Health, a CABG takes between four to six hours. It is generally done following

these basic steps:

The patient is given general anesthesia. This ensures the patient will be asleep and pain-free through the whole

surgery.

The surgeon makes an eight to 10-inch cut in the chest.

The surgeon cuts through all or part of the patient’s breastbone to expose the heart.

Once the heart is visible, the patient may be connected to a heart-lung bypass machine. The machine moves

blood away from the heart so that the surgeon can operate. Some newer procedures do not use this machine.

The surgeon uses a healthy vein or artery to make a new path around the blocked artery.

The surgeon closes the breastbone with wire, leaving the wire inside the body.

The original cut is stitched up. (NIH)

Sometimes sternal plating is done for high-risk patients, such as patients of advanced age or patients who have had

multiple surgeries. This is when the breastbone is rejoined after the surgery with small titanium plates.

What Are the Risks of Open Heart Surgery?

Risks for a CABG (Coronary Artery Bypass Grafting) include:

chest wound infection (more common in patients with obesity or diabetes, or those who have had a CABG

before)

heart attack or stroke

irregular heart beat

lung or kidney failure

chest pain and low fever

memory loss or “fuzziness”

blood clot

blood loss

breathing difficulty

According to the University of Chicago Medicine (UCM), the heart-lung bypass machine is associated with increased

risks. These risks include stroke and memory problems (UCM).

How Do I Prepare for Open Heart Surgery?

Tell your healthcare provider about any drugs you are taking, even over-the-counter medications, vitamins, and herbs.

Inform them also of any illnesses, including herpes outbreak, cold, flu, or fever.

In the two weeks before the surgery, your healthcare provider may ask you to quit smoking and to stop taking blood-

thinning medications, such as aspirin, ibuprofen, or naproxen.

The day before the surgery, you may be asked to wash yourself with a special soap. This soap is used to kill bacteria on

your skin and will lessen the chance of an infection after surgery. You may also be asked not to eat or drink anything after

midnight.

Your healthcare provider will give you any other detailed instructions when you arrive at the hospital for surgery.

What Happens After Open Heart Surgery?

When you wake up after surgery, you will have two to three tubes in your chest. These are to help drain fluid from the

area around your heart.

You may have intravenous (IV) tubes in you, supplying you with fluids.

You may have a catheter (thin tube) in your bladder to remove urine.

You will also be attached to machines that monitor your heart. Nurses will be nearby to help you if you need it.

You will usually spend your first night in the intensive care unit (ICU). You will then be moved to a regular care

room for the next three to seven days.

What Is the Long-Term Outlook for Open Heart Surgery?

Expect a gradual recovery. It may take up to six weeks before you start feeling better, and up to six months to feel the full

benefits of the surgery. However, the outlook is good for many people, and the grafts can work for many years.

Nevertheless, surgery does not prevent artery blockage from happening again. You can help improve your heart health by:

eating a healthy diet

cutting back on foods high in salt, fat, and sugar

leading a more active lifestyle

not smoking

controlling high blood pressure and high cholesterol

Open Heart Surgery Timeline

Jan 1 1948, First Corrective heart surgery

Sept 2 1952, First open heart surgery. Was performed on a 5 yr. old girl who had a whole in her heart.

Jan 1 1958 First solution to stop the heart was made by Dr. Dennis Melrose (Stopped the heart from beating

during surgery)

Jan 1 1958 Heart-Lung Machine invented (doctors didn’t need to worry about time because of the lack of oxygen

to the brain)

Dec 3 1967 First heart transplant. Performed by Dr. Christiaan Barnard (was successful for 18 days until the

patient died from pneumonia.

Jan 2 1968 First successful long term heart transplant by Dr. Christiaan Barnard (patient lived for 19 months)

Jan 1 1969 Cyclosporin (fungus that prevents bodies from rejecting organ transplants) was discovered by Jean-

Francois Borel.

Jan 1 1994 Dr. Randas Batista developed a new surgery to repair oversized hearts. (cut open the heart and take out

a section of the left ventricle to help blood pump)

Fun Facts About The Heart

The More education you have the lower risk of heart disease,

A normal heart valve is about the size of half a dollar.

The first pacemaker had to be plugged into a wall

Happiness helps lower your risk of heart disease

The amount of heart attacks peaks on Christmas day, Boxing Day and new years.

The first heart cell starts to beat as early as 4 weeks old

A blue whale has the largest heart weighing over 1,500 lbs.

Heart disease has been found in 3,000 yr. old mummies.

Your heart beats 100,000 times a day.

Heart disease is the human bodys greatest threat ( Greater danger than breast cancer in women and prostate cancer

in men)

Each minute your heart pumps 1.5 gallons of blood

Heart cancer is rare because heart cells stop dividing early in life

A women’s average heart beat is faster then man’s by almost 8 beats/minute.

Electrocardiograph:

SNC 4M Medical Technology Presentation

Electrocardiography: the measurement of electrical activity in the heart and the recording of such activity as a

visual trace (on paper or on an oscilloscope screen), using electrodes placed on the skin of the limbs and chest.

Electro- relating to electricity

Kardio- Greek, relating to the heart

Graph- Greek, to write

o The electrocardiograph was officially invented in 1901 by Willem Einthoven, by using his string

galvanometer.

o Electrodes are attached to wires and hooked-up to a machine, which responds to the hearts

electrical impulses, drawing out the hearts rhythm.

o One electrode is placed on the right side of the chest, five are placed along the heart, one is

placed on each arm, and one is placed on each ankle.

o People may need an ECG if:

-suspected heart attack/ pulmonary embolism

-fainting

-heart mummers/ irregular heart beat

-seizures

-monitoring heart medication

Sydney Woodhouse

Due: February 19, 2016

Radiation Therapy for Cancer Treatment

History of Radiation Therapy

1896 Wilhelm Conrad Röentgen, a German physicist, announced his discovery of a new type of ray. He

called it the X-ray

Not long after the discovery of X-ray, Marie Sklodowska Curie and her husband Pierre Curie discovered the

first two radioactive elements Polonium and Radium

This sparked the scientific movement and X-rays began being used worldwide as a diagnostic and

therapeutic tool

After three years of research, physicians began to use X-ray to treat cancerous tumours

In the beginning of the 20th Century, it was discovered that exposure to some types of X-rays could cause

cancer

Early forms of Radiation Therapy Machines could not penetrate through thick layers of tissue and

therefore could not treat deeply seeded tumours

In the 1920s Brachytherapy was invented. This is a process that involves implanting radioactive material

into deeply seeded tumours

Types of Radiation

External Beam, most often combined with other forms of cancer treatments; surgery, chemotherapy,

medications

Brachytherapy, used most often to treat head, neck, breast, cervix, eye, and prostate cancer

Liquid Forms, most commonly used to treat thyroid cancer

Treatment is dependent upon…

The type of cancer

The size of the cancer

The location of the cancer in the body

How close the cancer is to normal tissues that are sensitive to radiation

How deep into the body the radiation needs to penetrate

The patient’s general health, co-morbid factors and medical history

Whether the patient will have other types of cancer treatment

Other factors, such as the patient’s age, access to treatment and social supports

Why is Radiation Used?

Primary treatment, when radiation is used as a main treatment

Adjuvant therapy, when radiation is used in conjunction with other forms of cancer treatment

Palliative therapy, when radiation is used to control pain or long term symptoms of cancer to improve

quality of life

When is Radiation Used?

When radiation is used in conjunction with surgery it can be used:

Before the surgery, to shrink the tumour as much as possible and to reduce the possibility of

complications

During the surgery, if the tumour is deep within the tissue

After the surgery, to kill any remaining cancerous cells that may not have been excised during the surgery

Side Effects

Tiredness and fatigue

Loss of energy and weakness

Sore and irritated skin,

Dry mouth and difficulty swallowing, mucositis

Shortness of breath

Loss of hair (sometimes permanent)

Nausea, vomiting, diarrhea

Tommy John Surgery Handout

Also known as Ulnar Collateral Ligament Reconstruction

First performed in 1974 by Dr. Frank Jobe

First person to have the surgery was Los Angeles Dodgers pitcher Tommy John

The surgery is for people who have damaged their UCL in their elbow

The arm is opened up around the elbow

Holes are drilled through the Ulna and Humerus bones in the elbow for the new tendon

The 2 tendons, usually harvested from the forearm or opposite elbow are woven in a figure 8 pattern

through the holes and then anchored

The elbow is then sewn back up

Entire procedure only takes 60-90 mins

Although some patients come back and throw harder than before it is not a side effect of the surgery

itself

This surgery has saved the careers of countless MLB players

Ultrasounds

What are ultrasounds?

• An ultrasound scan, also known as a sonography, is a medical test that uses sound waves to capture

live images from inside the body.

• It allows doctors to see organs and vessels without performing a surgery.

• Ultrasounds do not use radiation and so it is frequently used to view a developing baby in the womb.

3D and 4D Ultrasounds:

• 3D scans show still pictures of the baby but in 3 dimensions and instead of seeing right through the

baby, you see the skin and shape of the mouth, nose, etc.

• 4D scans show moving 3D images such as the baby yawning.

Why is an Ultrasound is performed?

• Ultrasounds have many uses:

a) Ultrasounds are very beneficial during pregnancy where a mother can view her unborn child and also

detect birth defects and gender of the baby.

b) They can be performed up to the third trimester.

c) Ultrasounds also assist doctors in viewing parts of the body such as the bladder, kidneys, liver, blood

vessels, and many others.

How is an Ultrasound performed?

• An ultrasound technician, called a sonographer, will apply a lubricating jelly to the skin which prevents

friction and transmits the sound waves.

• The ultrasound transducer will be rubbed on the area examined and

sends high-frequency sound waves through the body.

• These sound echoes are then transmitted to a computer.

Who Invented Ultrasounds and are they safe?

• Obstetrician, Ian Donald, and Engineer, Tom Brown, developed the first ultrasound and it was used in

Glasgow in 1956 for clinical purposes.

• They are noninvasive but at high power, ultrasounds can cause damage to human tissue.

• Ultrasound scans should only be done for clinically justified reasons.

Social Implications:

• Ultrasounds have been a helpful tool in the pro-life movement to support that the fetus is fully alive

and therefore should not be aborted.

• They can be used to diagnose potentially fatal abnormalities in a fetus which can encourage the

termination of the child.

• In some East Asian countries, ultrasounds are used to detect the gender of the baby, deliberately so

that a fetus of less desirable sex (usually female), can be aborted.

Pericardiocentesis

What is it?

* Medical procedure where a needle is inserted into the pericardial sac (sac surrounding the heart),

to remove excess fluid

* Extra fluid in the pericardial sac can be very dangerous due to the amount of pressure it puts on

the heart

* A pericardicentesis is performed when the patient has a cardiac tamponade, it can be fatal if not

caught and treated right away

* Cardiac tamponade can be due to many factors such as tuberculosis, viral infection, heart attack,

or trauma to the chest

* Complications can include heart attack, puncturing of arteries (causing excessive bleeding),

laceration of organs, lungs or heart

* Patient is under general anesthesia, can be done at their bedside (no operation room needed)

How it’s Performed

* A needle is inserted carefully by a doctor or physician into the ribcage under the 5th intercostal

space at a 30-45 degree angle

* An ultrasound or echocardiogram is used to help guide the needle and reduce the risk of

puncturing other organs/arteries

* Fluid is drained from pericardial sac and sent off for testing to determine what caused the build

up of the fluid

Vocabulary

* Cardiac Tamponade- accumulation of excess fluid in pericardial sac

* Echocardiogram- sonogram of the heart, machine created two and three dimensional images of

the heart

* Ultrasound- uses sound and vibration to produce an image