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High-tech Medicine

Practically every day a new medical innovation hits the news. For example, in July, surgeons at Louisville’s Jewish Hospital removed a patient’s defective heart and replaced it with a plastic and metal pump driven by an internal electrical motor.



We may not have reached the sophistication of the Six Million Dollar Man or the Bionic Woman of television fame, but technology today is helping discover what ails us—and often, helping fix it. Here are some of the newest uses of technology being used to treat three major diseases affecting Kentuckians.







Cancer


Promise in treating cancer is coming in various forms, including new technology that helps shrink tumors.
A type of radiation treatment developed at the UK Chandler Medical Center has been found to reduce the size of large, very advanced tumors.



Mohammed Mohiuddin, M.D., professor and chair of the Department of Radiation Medicine in the UK College of Medicine, developed Spatially Fractionated Radiation Therapy (GRID therapy) to treat large cancers that tend to not respond to conventional treatment. GRID therapy allows for a larger dose of radiation that also has a “bystander” effect.



“Using this technique, we’re finding that not only is the direct effect of the radiation good, but it also produces in tumors products that act as agents to kill other cancer cells,” Mohiuddin says. Such an effect is not found with conventional treatment.



UK Chandler Medical Center is also one of only a few centers in the country equipped with a Gamma Knife, a type of surgery that doesn’t involve actually cutting. The non-invasive procedure gives hope to patients with brain tumors and other brain disorders where standard therapy has proven difficult or minimally effective.
Gamma Knife is used to treat brain tumors, lesions, and other functional disorders by using exact beams of radiation that intersect to form a precise tool. These beams intersect on the target area and are designed to injure or kill the cells or their supporting blood vessels, while minimizing injury to surrounding normal tissue.







Heart Failure,


Only a decade ago, heart failure was seen as a disease that only gets worse, offering patients little hope.



That’s changing, thanks to new monitoring technologies and therapeutic devices, many of which are being evaluated at the Linda and Jack Gill Heart Institute at UK.



An example is new in-home heart failure monitoring systems. These devices assess patients’ symptoms and collect data, such as weight, blood pressure, heart rate, blood glucose levels, and oxygen levels. The information then can be transmitted over the Internet.



“Such devices work for a couple of reasons,” says William T. Abraham, co-director of the Gill Heart Institute and chief of the Division of Cardiology at the UK Chandler Medical Center. “They are more accurate than most measuring devices, and they ensure compliance from the patients.”



Such technology allows health care professionals taking care of heart failure patients to keep an eye on their status, even from hours away.



New technology is also coming of age to help heart failure patients live better and longer. “There has been an absolute revolution in therapeutic devices for heart failure,” Abraham says.



Devices to remove fluid effectively and to assist the heart in pumping are already available, and continue to improve.



“These devices give tremendous hope to patients. Thanks to these devices and new drugs being developed, heart failure has gone from being seen as a disease that causes only progressive deterioration to one that’s seen as manageable,” Abraham says.







Diabetes


Advances in technology are helping people who have trouble managing their Type I diabetes get a better handle on their condition. One such new device in use at UK Chandler Medical Center is a constant glucose monitoring sensor that a patient can wear for up to 72 hours. The pager-like device, connected to a small sensor placed under the patient’s skin, takes a glucose reading every 15 seconds.



“Normally, a diabetic would do a finger stick four or five times a day, but this device gives 288 readings every day, so we get a much better picture of the patient’s highs and lows,” explains L. Raymond Reynolds, M.D., associate professor of internal medicine/endocrinology in the UK College of Medicine.



When the information is downloaded into a computer at the physician’s office, the data is graphed, giving the physician a wealth of information. The patient also keeps a record of what he eats, how much he exercises, etc., so that, based on all of that information, the physician can determine how best to control the patient’s glucose levels.



Recently the FDA approved the Gluco-Watch, a wristwatch-looking device that uses tiny electric currents to monitor diabetes. And still another new device allows people with diabetes to use their forearm rather than their fingertips to obtain blood samples.
In terms of treating diabetes, insulin pumps have improved blood glucose control and given people with diabetes much more flexibility in timing their meals. New injection pens are making insulin shots much more convenient, accurate, and painless.



Inhaled insulin and oral insulin will soon be available to further enhance convenience and flexibility. Implantable insulin pumps can also serve as an “artificial pancreas.”



“Many new devices are helping people with diabetes manage their diabetes more painlessly and more effectively,” says James W. Anderson, M.D., professor of medicine and clinical nutrition in the UK College of Medicine. “This decade will provide incredible advances in technology for those with diabetes.”



Medical technology continues to dazzle and amaze us, but it’s important to remember that it’s also changing lives each and every day. Whether it’s an artificial heart sustaining life, lasers correcting vision or making skin pigmentations disappear, or cochlear implants that allow deaf people to hear again, the world of medical technology is exploding with possibility and promise for a healthier future.









SURGERY TECH: MIS



Imagine having a major operation, such as a kidney removed or a hernia repaired, and going home the next day with minimal discomfort and just a few scars.
Sounds futuristic, but that’s exactly what’s going on now in the field of minimally invasive surgery, known as laparoscopic or “keyhole” surgery.



At the University of Kentucky Center for Minimally Invasive Surgery, surgeons like Adrian Park, M.D., director of the center, use a laparoscope—a lighted tube with a magnifying camera—to guide skewer-like instruments into the abdomen, allowing surgeons to remove gall bladders, appendixes, kidneys, and colons routinely.



“It’s a revolution in surgery,” Park says. “It’s really changing the delivery of medical care.”



Thanks to the availability of minimally invasive surgery techniques, kidney donation has become much easier for the donor. Through laparoscopic live-donor nephrectomy, a kidney is removed with quicker recovery, less pain, and a few small incisions for the donor. In the past three years, live kidney donation at UK’s Transplant Center has more than quadrupled as a result.



“It’s just as safe, and the donor is able to leave the hospital in one to two days,” says Michael Mastrangelo, M.D., assistant professor of surgery in the UK College of Medicine.

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