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Like other neurosurgeons, Cornelius Lam treats his patients suffering
with excess fluid on the brain (hydrocephalus) by implanting a tube
to shunt excess fluid from the brain to the heart or abdomen…but
Lam knew there had to be a better way.
“The problem with these shunts is they have a tendency to malfunction—50
percent fail after two years and have to be revised or replaced,”
says Lam. “It's the best we've got. But the technology for them
essentially has not changed for 50 years.”
Hydrocephalus is a tragic example of too much of a good thing.
Normally, the amount of cerebrospinal fluid, the liquid that circulates
through and cushions the brain and spinal cord, exists in a finetuned
balance. As fresh CSF is produced in chambers deep within the brain,
the old diffuses through tiny projections called arachnoid granulations
into veins just beneath the skull. But in some individuals, due
to a birth defect, illness, or injury, the arachnoid granulations
aren't able to let the fluid through, and pressure builds up. Hydrocephalus
can bcause brain damage and even death.
A couple of years ago, Lam, who is also pursuing a master's degree
in biomedical engineering, started thinking about devising a better
fix. Why not, he wondered, replace the faulty arachnoid granulations
with functioning ones made from a patient's own cells? Unfortunately,
without research funding there wasn't much he could do but wonder.
Then, in late 2004, the Biomedical Engineering Institute (BMEI)
extended an invitation to Medical School faculty to submit proposals
to its new “What If” Medical Device Idea Campaign. Top ideas would
receive seed funding and technical assistance to help turn vision
into reality. Lam put together a proposal to develop a bioartificial
arachnoid shunt, and his project was one of seven chosen for the
first round of “What If” funding. With an $11,000, one-year start-up
grant in hand, he's now working with BMEI collaborators to develop
strategies both for growing arachnoid cells in culture and for convincing
the cells to mimic the exquisitely precise semipermeability of the
natural blood-brain barrier.
“I'm a neurosurgeon who's clinically very active,” he says. “The
‘What If' Campaign really gave me the opportunity to carry out this
sort of research. It would be extremely hard to do otherwise.”
BMEI head Jeffrey McCullough, a physician, says Lam's project was
chosen for the “What If” funding because it deals with tissue engineering,
one of the strengths of the Academic Health Center and the Institute
of Technology (IT). “This is an Important problem for patients,
and Dr. Lam is approaching it in a fundamentally different way,
sort of a paradigm shift in how one might go about dealing with
this situation,” McCullough says. In addition, he says, the project
involves collaboration between Medical School and IT faculty members.
Within a year or two Lam hopes to use the progress he makes through
the “What If” research to leverage a larger federal grant to continue
developing the device. If the device begins to show promise for
commercial application, he will have yet more assistance from the
Patents and Technology Marketing (PTM) office, part of the University's
Office of the Vice President for Research. The PTM staff helps faculty
protect inventions through the patent process and finds companies
interested in licensing the inventions.
“Our goal is to ensure that inventions are transferred from the
lab to application at the bedside,” says PTM senior licensing manager
Susan McFadden Patow.
Lam agrees. Improved treatment is ultimately what it's all about.
“I'm on a mission,” he says. “I'm hoping it will make people better.”
By Mary Hoff
Reprinted with permission from the summer 2006 edition of Pictures
of Health, a publication of the Academic Health Center.
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