Separating Conjoined Twins with the Aid of 3D Printing.

Surviving birth is already an achievement for them, but separating conjoined twins is only possible if they are not sharing vital organs. This was the situation twin girls Knatalye Hope and Adeline Faith were facing. Until they were 10 months old, they were conjoined at the chest and abdomen, which included their chest wall, lungs, pericardial sac, diaphragm, liver, intestines, colon and pelvis. Surgeons at the Texas Children’s Hospital started planning the highly-complex separation surgery nearly a year in advance. To visualize the intertwined organs, they used Materialise’s Mimics software to design a 3D-printed model based on high-quality CT scans which were designed to generate optimal contrast within the shared organs and the vasculature. Following computerized segmentation of the anatomy, the color-coded output was subsequently exported for 3D Printing and showed in great detail the babies’ heart, lungs, stomachs and kidneys, and where exactly they were connected. “Having a 3D-printed model gives you an insight into what you’re going to encounter,” Dr. Rajesh Krishnamurthy, chief of radiology research and cardiac imaging at Texas Children’s Hospital, said in a video released by the hospital. “This type of surgical planning becomes very important when you decide to assign an organ to one twin or the other.” The key collaborators in this project were Mr. Nicholas Dodd, an advanced visualization expert at Texas Children’s Hospital, and Dr. Jayanthi Parthasarathy of MedCAD in Dallas, who supervised the 3D Printing process. In addition, the surgeons implanted tissue expanders into their torsos, stretching the skin ahead of the separation. The final surgery, which took nearly 30 hours and involved more than 26 clinicians of 13 different specialties, managed to successfully separate the two babies. Contributed by materialise

Mayo Clinic Helps 11-Year-Old with Blount’s Disease by Using 3D Printing.

For 11-year-old Amarachi Austin-Okoh, running, jumping and even walking was a struggle. She suffered from a condition called Blount’s Disease, where the tibia, or shin bone, doesn’t grow properly, causing the legs to develop a bow shape. The disease had progressed so far in Amarachi’s case that even walking caused her great pain, and she explained that “It was very painful and hard, and, then, if people were walking a distance or something, I would start walking slower and slower, because it got harder and harder.” Her family had already noticed the condition when Amarachi was just two years old, but despite having a few corrective surgeries in Nigeria, where the Austin-Okoh family is originally from, her legs continued to worsen. The family approached Mayo Clinic in Minnesota to see if they could make a difference. The doctors at the Limb Lengthening and Regeneration Clinic knew they could help Amarachi if they took a team approach to the problem. By making full use of Mayo Clinic’s 3D Anatomic Modeling Lab, they were able to print out exact models of Amarachi’s leg bones to make crucial decisions prior to surgery. Dr. Todd Milbrandt, the surgeon who operated on Amarachi, was able to use the model to figure out where he would make a cut in the tibia, so that the bones could regrow and align properly. During the operation, he knew what to expect due to the pre-operative planning, and made a cut just below each knee. Dr. Andrew Sems then attached external braces (or “fixators”) to Amarachi’s legs after the operation and carefully adjusted them over the next three months according to computer calculations. By making adjustments to the fixators, Dr. Sems was able to gradually straighten the bones – basically by growing and correcting the bones at the same time. The outcome was everything Amarachi and her family could have hoped for – she gained almost 25cm in height and now walks with straight legs and no pain. She concluded, “I’m excited now, because it has opened a whole new horizon. I can do anything and everything I want to do.” Contributed by materialise

THE RISK OF SNAKE BITE IN FARM ANIMALS.

Areas where cattle graze usually harbor venomous snakes which means the chance for snakebite is ever-present. The after-effects in a snake-bitten cow, horse or dog knows can be fatal unless urgent steps are taken to prevent the effect of the toxic venom . Rattlesnake venom contains two types of toxins—myotoxins and hemotoxins—according to Ginger Elliott, a veterinarian from Guthrie, Texas, who has seen many snake-bitten animals. The myotoxins create rapid swelling, pain and bleeding at the bite site and muscle necrosis, while the hemotoxins damage blood vessels, destroying red blood cells and hindering blood clotting. The damage is often relative to the size of the animal. Small rodents are immobilized by the toxins and die quickly, enabling the snake to eat them. The toxins (and amounts of each) can differ in various bites, and have different effects on the body. “Some rattlesnake venom contains more muscle toxins. Sometimes we see more swelling and lymph issues and more spread of the toxin systemically. Our western diamondbacks have venom containing mostly myotoxins,” explains Elliott. “As a general rule, the prairie rattler has more hemotoxins and we see some swelling but perhaps less tissue destruction. When toxins enter the bloodstream and lymph tissues, they can spread systemically. But many types of venom have several toxic components and consequently there are some unusual cases,” she says. The higher up the leg, such as near armpit or groin, the worse it might be, says Jacques Fuselier, a veterinarian with the Whittington Veterinary Clinic, Abbeville, La. “The toxins can get into the bloodstream quicker. We worry about that with some bites, because there’s more risk for anaphylactic shock. The toxins may rupture red blood cells, which could lead to organ failure, starting with the kidneys,” he says. Try to keep the toxin isolated and minimize its spread this can be achieved if you can get the animal into a pen where it won’t be moving around. Decreasing activity can slow down spread of the toxin, just from decrease in blood flow. A big dose of rattlesnake venom presents risk of it getting systemic and causing organ failure after it gets into the bloodstream. Every animal responds differently to the toxins. The toxin is a foreign protein, so some individuals will have an allergic-type reaction. In some animals, the toxins spread rapidly within the body, and in others they won’t. It’s not common to have two cases that are identical. The toxins don’t have as much negative long-term effects on large animals like adult cattle but could have more serious consequences for a small animal or young calf, according to Rob Callan, head of livestock veterinary services at the Veterinary Teaching Hospital at Colorado State University. The toxins can sometimes be more problem for horses, affecting the heart. Toxins may cause irregular rhythm, or damage the heart which can be fatal although this has not been reported in cattle. Tissue damage at the bite site may be severe enough to result in necrotic areas that slough away. “I don’t know why some bites have a tremendous amount of necrosis and others do not,” says Glennon Mays, a veterinarian with Texas A&M University. “I’ve read that all snakebites do not necessarily inject venom. In some cases maybe the snake is striking defensively, saying ‘leave me alone,’ and saving venom for killing prey,” he says. There is also the possibility that some bites might contain less venom if the snake had recently bitten and killed prey, temporarily depleting its venom supply. Then there’s the possibility that it’s not snakebite at all. Mays says that often a suspected snakebite turns out to be something else. Swelling on a lower leg, for instance, is more often due to foot rot or another infection rather than snakebite. Animal owners over the years have asked me to look at lumps on jaws, faces, necks and other body parts, swollen legs and feet, believing their animal has suffered snakebite. Snakebite wounds have a fairly typical appearance and often some bleeding. Signs vary, depending on the length of time transpired since the bite occurred, the environmental temperature, the amount [dose] of venom and other factors that might affect the appearance of the affected area,” he says. “Often a swelling that the owner is worried about turns out to be an abscess or seroma [collection of fluid] or reaction of body tissue, rather than snakebite. This is why it’s important to have a proper diagnosis and involve your veterinarian. “Most bites [in cattle] are on the lower legs, unless it’s a curious individual that approaches the snake to smell it. Contributed by Beef magazine.

Puppy with fluid on the brain gets second shot at life.

Herbie, a French Bulldog puppy believed to have excess fluid on the brain, is learning to walk and stand on his own at a therapy center. Herbie, a French Bulldog puppy, may be just a few weeks old, but he's already shown he has a big, fighting heart. When Herbie was dropped off at the house of a woman who fosters dogs, he couldn't walk or stand. Handlers suspected Herbie has hydrocephalus, or water on the brain, a condition that often ends in euthanasia for dogs. In Herbie's case, it made his foster mom and rescue group, Road Dogs & Rescue, work harder to help the puppy. The rescue group brought Herbie to Two Hands Four Paws, a large canine rehabilitation center in Los Angeles. Staff there say his progress has been exciting to watch. They fitted him with a tiny wheelchair, and are teaching him how to walk. Staff say Herbie is getting stronger everyday. A neurologist who treated Herbie said when he's 6-months-old, he'll be eligible to have surgery to drain some of the excess fluid on his brain, possibly giving him the happy, healthy life of many dogs. Contributed by USA TODAY.

3D Life Makes High-Quality 3D Printed Medical Models So Doctors Can Save Lives.

3D Life is certainly aptly named. This Greek startup isn’t promoting a fun new lifestyle or arts and crafts in the 3D printing industry—they are involved in the serious business of helping to save lives. Recognizing the value that 3D printing has in the medical arena, the team at 3D Life is committed to making 3D printed models for medical professionals to use, with numerous benefits for all involved. Currently, the Athens-headquartered company makes high-quality, detailed models of the anatomy like teeth, hands, and bones, as well as organs like the heart, liver, brain, and more. 3D Life is encouraging the more comprehensive study of anatomy, mainly in terms of organs. They believe that even better knowledge of organs allows for better preparation for surgeries that are often solving complex physical issues—and the team uses congenital heart disease as a perfect example. “As a result, the doctors can better plan reparative operations based on conventional medical imaging which is suboptimal,” Bilalis told 3DPrint.com. “The human mind can only partially understand trying to create mental images of three dimensional structures so we believe that having this ability will make operations shorter and more efficient, and provide better results.” At 3D Life they believe, and undoubtedly are correct, that the exercise of holding and manipulating a 3D model leads to a better understanding of the client’s condition, as well as allowing for practicing for surgeries that are intricate and may not even have been performed before. This leads to numerous positives, from safety to better client outcomes, along with providing training for students. While there may be other companies around the world making 3D models, 3D Life is unique as the first company to endeavor in such a field in Greece. Offering advanced 3D printing, they are able to make models in a variety of materials and, even better, multiple colors. They are able to offer excellent services to all the professionals who come to them. 3D Life uses Materialise Mimics software, made specifically for medical image processions. This enables the conversion of MRIs or CTs into 3D models, which can then be used in numerous ways. These devices avail, medical professionals and surgeons to find themselves with a much better way to educate patients and their families about medical conditions, handle diagnoses and treatments, and explain procedures. Surgeons can then spend a lot of time themselves with those medical models, considering and practicing for upcoming operations—as well as using the models in the operating room to navigate through surgeries, saving time and allowing for better outcomes with less surprises. In some cases around the world, 3D libraries are being made as these models begin to pile up, and can be of use to other medical personnel. Contributed by 3D Print

Utah Woman Beats Kidney Cancer Thanks to Progressive Doctors & 3D Printing.

The advent of the 3D printed medical model, many patients and their families now are afforded a look at exactly what’s going on, thanks to completely patient-specific models made from MRI or CT data. In Linda Green’s case, not only did the 3D printed model show her the stubborn tumor lodged inside her kidney, but it may be the reason she is alive today, with the tumor that was sneakily tucked underneath her ribs now a thing of the past The 3D model is not of course just a wonderful educational tool for a patient like Green but it can serve as an invaluable guide for surgeons like Dr. Jay Bishoff. This technology and these incredibly customized visual aids previously not available to doctors, treatments can be decided on with more facts and information in front of them, literally, and procedures that have not been tried before are now possible. Not only that, doctors can train on these aids as well, a new quotient in the treatment process which doesn’t leave surgeons or medical students having to be resourceful for training devices, or spending any more time than possible practicing on cadavers. “We could not appreciate the peak of the tumor that was growing up into the drainage system of the kidney until we did the 3D reconstruction and 3D printing,” Dr. Bishoff said. For Green’s impending treatment and surgery at Intermountain Medical Center, Dr. Bishoff had a clear model made of the kidney and tumor. This allows for surgeons to have a comprehensive view and to avoid the major mistake of removing something vital during the surgery. With the intricate and transparent model, however, Dr. Bishoff was able to remove the tumor without issue, leaving all vital parts intact. He used multiple 3D prints as guides to navigate through the operation, something numerous surgeons are doing today if they have access to the extremely helpful technology. “I could’ve ended up with infection across my outer body or bleeding out,” Green said, definitely understanding the gravity of the procedure. “When the surgery was over and he came out to talk to me, I really thought he was going to tell me that he had to take the kidney out,” Green’s husband said. In a wonderful success story, Green is happy back at her home in Utah, cancer free, and her kidney is completely intact and functioning. The doctors have said that she won’t suffer any damage to the kidney or run the risk of failure. Contributed by 3D print

3D Printing Give Baby Born with Severe Cranial Defect a Future.

Bentley Yoder was never expected to survive. His mother, Sierra Yoder of Sugarcreek, Ohio, was well aware, when she went into labor on Halloween night 2015, that she would likely only get to hold her son for a few minutes before he passed away. She had known since the 22nd week of her pregnancy, when she went in for her normal ultrasound, and the doctor told her that something was very, very wrong. Something was wrong with the baby’s head, he told Sierra and her husband, Dustin, and sent them to a hospital for further tests. Neurosurgeons at the Canton hospital told the couple that their baby had a rare congenital condition called encephalocele, meaning that a portion of his brain was growing outside of his skull. About 375 babies, or one in 10,000, are born with the condition each year, according to the Centers for Disease Control and Prevention, and while there are varying degrees of severity, the disease, needless to say, causes serious difficulties for children suffering from it: developmental delays, vision problems, seizures, and more. Bentley’s case fell into the severe category, meaning that he had a very slim chance of surviving long after his birth. Even if he did live, doctors said, he wouldn’t have any cognitive function. The Yoders were encouraged to think about abortion, and they agreed to terminate the pregnancy, not wanting their child to suffer when there was no hope of recovery. The night before the scheduled procedure, however, Sierra realized she couldn’t go through with it. She and Dustin agreed on a name for the baby – Bentley Ross Yoder – and doctors gave them brochures for funeral homes in the area. Nine hours after she went into labor on Halloween night, Bentley was born. His condition was immediately clear from the massive protrusion at the back of his head, but to his parents, he was perfect 36 hours later, however, family members were still holding the baby and passing him around. The doctors, unsure of how much longer Bentley would live, told his parents to take him home and arrange hospice care, which they did. Four weeks later, they took him to a specialist at Nationwide Children’s Hospital in Columbus. The specialist took some MRIs and told the Yoders that Bentley’s brain was too damaged for him to survive much longer. Four months later, the couple took Bentley to the Cleveland Clinic. For the first time, a surgeon gave them a sliver of hope – Bentley was using his brain, which had been already clear to Sierra and Dustin. Their baby, who doctors had said was going to be born a “shell,” unlikely to ever move or even breathe, was acting just like a normal baby – indistinguishable from their first son, Beau, other than the protrusion on his head, according to Sierra. The surgeon told them it was possible that Bentley’s brain could be placed inside his skull, though she didn’t know if he could survive the surgery.. The Yoders were referred to Boston Children’s Hospital, where they met with chief plastic surgeon Dr. John Meara and neurosurgeon Dr. Mark Proctor, who had plenty of experience with cranial deformities – and with 3D printing. The two surgeons were part of a team that reshaped the skull of a baby named Violet in 2014, in a surgery that was carefully pre-planned using 3D printed models. Drs. Meara and Proctor took the same approach with Bentley’s case, 3D printing models of his cranium and planning the delicate procedure that would allow his brain to be encased within his skull. According to Dr. Meara, Bentley had 100 cubic centimeters of brain outside of his skull – a significant amount that would require his cranium to be expanded for the tissue to fit inside. Using the 3D printed models, he and Dr. Proctor devised a plan to make several vertical slices in the cranium and insert biocompatible, dissolving plates to hold it open. The protruding part of Bentley’s brain – the portion that controls vision, motor function and problem-solving, would slip inside where it belonged. yoder On May 24, 2016, Bentley went into surgery. The surgeons drained excess cerebrospinal fluid from his brain, made the cuts in his cranium, and gently eased his brain inside. Then they closed the gap using leftover bone from the cuts. Five hours later, Sierra, Dustin and Bentley’s brother Beau went to see him in the recovery room. The delicate mass at the back of his head was gone, and now, a month later, his blond curls are growing back in. He’s also holding his head up, eating, smiling and chattering like any seven-month-old. It’s uncertain what life will be like for him as he grows up, but he will grow up, and the doctors told Sierra that they believe he will have a “rewarding life,” despite any challenges or complications may arise. Using 3D printing to successfully operate on a condition as severe as Bentley’s is a new phenomenon, and therefore lacks precedence to give doctors a clear idea of what lies ahead. Bentley himself has made it clear that he is a survivor, however, and Sierra said that a part of her always knew that Bentley was going to defy expectations. That’s why she decided not to end the pregnancy. Contributed by 3Dprint