175 Years, 175 Stories: Part 4
Big ideas drive big changes in medicine
Inventions and innovations have a long history at Michigan Medicine, including the first hygienic laboratory (1887), the first department of bacteriology in the United States (1901), and, of course, the revolutionary ECMO system. Here are some of the noteworthy inventions by Medical School faculty and alumni.
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Dissolvable pills
William Upjohn (M.D. 1875) founded the Upjohn Pharmaceutical Company in Kalamazoo, Michigan, to manufacture friable pills — a type of dissolvable pill that he invented. He was president of the company for four decades.
Source: National Inventors Hall of Fame
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Oscillating electric saw
Homer Stryker (M.D. 1925) founded Stryker Corporation, whose medical technologies are ubiquitous throughout Michigan Medicine and other hospitals and health centers around the world. The oscillating electric saw, used for the removal of casts, is considered by many to be his most important invention.
Source: “The history of cutting blades,” Stryker Corporation
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Vacuum-assisted closure
Louis C. Argenta (M.D. 1969, residencies 1977 and 1979) and colleagues at Wake Forest Baptist Medical Center designed a suction device in 1990 that would become known as vacuum-assisted closure, a common wound closure that minimizes hospitalization. Since it was first used in 1991, the negative-pressure wound closure technique has been used on millions of patients for diabetic ulcers, C-section wounds, burns, traumatic wounds, and more. While it is best known for its usage in adults, VAC is also used in animals, including an injured Komodo dragon in Singapore.
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Low-tech respirator
Stephen John (M.D. 2020) and Joseph Barnett, M.D., Ph.D., teamed up as undergrads at Western Michigan University after John asked one of the founders of Respiratory Therapists Without Borders if he knew of a problem that needed an engineering solution. He learned that inexpensive ventilators for premature babies could prevent countless deaths in the developing world. This led to their invention of NeoVent, a low-tech respirator for low-resource areas, which has since been validated in preclinical and clinical trials and is currently on the market treating infants in Africa and Asia. John is now a cardiology fellow at UTHealth Houston.
Source: “NeoVent: Global Low Cost, Low-Tech Respiratory Support for Infants,” Michigan Journal of Medicine, April 2018
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3D printed airway splint
Glenn Green (M.D. 1991) still marvels that something as small as a thimble, something “made of dust,” has saved and improved so many children’s lives. Green, professor of otolaryngology-head and neck surgery, and then-colleague Scott Hollister, Ph.D., a biomechanical engineer now on the faculty of Georgia Tech, teamed up to create a bioresorbable human airway splint using a 3D printer. The first splint implantation was performed in 2012 on a patient with severe tracheobronchomalacia, a rare condition that caused his airway to collapse routinely. In March of this year, the 3D printing manufacturing company Materialise and Michigan Medicine announced they had entered a U.S. Food and Drug Administration pivotal clinical trial for the splint device.
Source: Medicine at Michigan, Fall 2018
The dome of the Judy and Stanley Frankel Detroit Observatory, built in 1854, sits against the backdrop of the University of Michigan Health D. Dan and Betty Kahn Health Care Pavilion. The Detroit Observatory is the second oldest building still standing on the U-M campus (the President’s Residence is the oldest). The Kahn Pavilion is one of the newest and opened its doors to patients this fall.
Photo: Scott Soderberg, Michigan Photography
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The spherocentric knee
Orthopaedic surgery professors Herbert Kaufer (M.D. 1959) and Larry S. Matthews, M.D. (Residency 1970) joined forces with engineering professor David Sonstegard, Ph.D., to develop and patent the “spherocentric” knee, one of the original total knee replacements. The knee was featured on the cover of Scientific American in 1978.
Source: “The Surgical Replacement of the Human Knee Joint,” Scientific American Magazine, January 1978
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Military and COVID-19 inventions
Kevin Ward, M.D., professor of emergency medicine and biomedical engineering, has collaborated with the military on numerous inventions, including the military’s major hemostatic bandage and a commonly used product to endoscopically control life-threatening gastrointestinal bleeding, saving thousands of lives. Early in the COVID-19 pandemic, Ward — director of the Weil Institute for Critical Care Research and Innovation — helped develop several personal-protective-equipment solutions at Michigan Medicine that used negative-pressure technology.
Source: “Kevin Ward named Distinguished University Innovator of the Year,” University Record
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Extracorporeal membrane oxygenation (ECMO)
As a surgery resident in the 1960s, Robert Bartlett (M.D. 1965) had an idea to improve pediatric heart surgery. The heart-lung machine, a new device at the time, made the surgery possible, but if it was used for more than an hour it caused lethal blood damage. Bartlett, now professor emeritus of surgery, hypothesized a membrane oxygenator would make it possible to circulate blood outside the body for days and could be applied to heart failure, lung failure, and chronic kidney failure. He was right — it’s now standard practice to put patients with severe heart and lung failure who are not responding to conventional treatment on ECMO. [It has also been used to treat thousands of the most severe cases of COVID-19.]
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Histotripsy
In 2002, Zhen Xu, Ph.D., first began researching how to kill tumor cells non-invasively. The Li Ka Shing Professor of Biomedical Engineering spent two decades developing what is now known as histotripsy, a completely noninvasive way to destroy target tissue. Instead of traditional methods, histotripsy functions mechanically. Ultrasound waves are pinpointed inside the target tissue or a tumor to generate a cluster of microbubbles, which expand and contract repeatedly to adjacent cells. Eventually, the cell walls get destroyed. Because it’s mechanical, the cell death is irreversible. In 2023, the FDA approved histotripsy to treat liver tumors.
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Gastroduodenal fiberscope
Basil Hirschowitz, M.D. (Fellowship 1956) earned a medical degree in his home country of South Africa before spending some time in England and eventually moving to the U.S. He was briefly part of the faculty at the Medical School, where he developed an improved optical fiber that made it possible to create a useful flexible endoscope. The Hirschowitz gastroduodenal fiberscope revolutionized the field of gastroenterology, and his optical fiber technology has been used in multiple industries. A Hirschowitz gastroduodenal fiberscope is even part of the Smithsonian collection.
Sources: Wikipedia, Smithsonian American History Museum
Academic medicine involves teaching, research, and clinical care, each with its own joys and rewards. For me, infectious diseases was the most joyful and rewarding, especially at the VA, where I was able to teach students, residents, and fellows, work in my research lab, and care for truly wonderful patients.”
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Carol Kauffman (M.D. 1969, Residency 1971), professor emerita of internal medicine at U-M, who spent more than four decades as chief of infectious diseases at the Ann Arbor VA. Kauffman was presented with the Veterans Affairs Society of Practitioners of Infectious Diseases Lifetime Achievement Award in 2015.
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Discovery opens new field of cancer research
How prostate cancer develops was a mystery that puzzled scientists for many years. But in 2005, Arul Chinnaiyan (M.D. and Ph.D. 1999) published an enlightening discovery. In the 2000s, he helped build a database that allows scientists to share their knowledge about genes and cancer. At the same time, he was studying prostate tumors. Comparing his data to that of the database, Chinnaiyan discovered that in about half of the patients with prostate cancer, there was a fusion gene, which forms when chromosomes break apart and two genes join together. This particular fusion resulted in male sex hormones causing extra cell growth, which can lead to prostate cancer.
Chinnaiyan’s discovery opened a new field of research where scientists are now looking for fusion genes in other cancers. This has already led to a new treatment for lung cancer. For prostate cancer, the discovery has been a game-changer in early diagnosis, which can now be done with a urine sample.
In 2022, Chinnaiyan, who is the S.P. Hicks Professor of Pathology, and professor of urology, received the prestigious Sjöberg Prize for this work.
Chinnaiyan (center) in his lab with colleagues
Credit: Michigan Photography
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DEAN OF WOMEN
Eliza Mosher (M.D. 1875) graduated from the U-M Medical School only five years after the school opened its enrollment to women. In the 1890s, she was working as a physician in New York when then U-M president James Burrill Angell appointed her to be a professor of hygiene and the first dean of women. In her role, she acted as liaison to the 600 women at the university at a time when they were far outnumbered by male students. Mosher was the first female faculty member at the Medical School.
Credit: U-M Bentley Historical Library
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SPORTS NEUROLOGIST
Jeffrey Kutcher, M.D. (Residency 2002), is an internationally recognized neurologist who specializes in diagnosing and managing concussions, post-concussion syndrome, and other neurological conditions in athletes. Prior to starting the Kutcher Clinic for Sports Neurology, Kutcher was the team neurologist for Michigan Athletics. He founded and directed the U-M NeuroSport Program and established a sports neurology fellowship at U-M in 2012. He is the team physician for U.S. Ski and Snowboard, traveling with the team to the Olympic Games in 2014, 2018, and 2022. He is director of the NBA concussion program and has helped develop concussion policies for the NCAA.
Source: kutcherclinic.com
FIRSTS
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Hockey and neurosurgery pioneer
In January 1923, Edgar “Eddie” Kahn (M.D. 1924) scored the first goal in the U-M hockey program’s 102-year history. He also was a pioneer in neurosurgery and served as chief of the neurosurgery department at U-M for 22 years.
Team captain Kahn sits front and center in this 1924 photo. Courtesy of the U-M Bentley Historical Society.
The inaugural Inteflex class of 1972 was propelled from high school to residency via a unique and accelerated transformative process that forever changed our lives and careers by focusing on patient-centered care in a collaborative way without the distractions of a competitive environment to successfully reach the next milestone. I will be forever thankful for Inteflex. Go Blue!
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Richard Paul Bonfiglio (M.D. 1978), a physical medicine and rehabilitation specialist who was part of Inteflex, an alternative six-year curriculum that blended undergraduate and medical classes with clinical clerkship. Students earned both a bachelor’s degree and an M.D. The program was intended to train more humane doctors. Inteflex officially ended in 2002, but Bonfiglio still feels the positive effects of his education. “The greatest joy in medicine is a lifetime of sharing miracles with those that we serve,” he said in 2022.
Sources: Medicine at Michigan, Winter 2022 and Winter 2023
Surgery and anatomy class, circa 1890s. On the far right is James Fleming Breakey (M.D. 1894), the second of five Breakeys to graduate from the Medical School.
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A dynasty of doctors, all at one university
From an early age, Robert Breakey (M.D. 1981) remembers hearing captivating stories about the exploits of his illustrious ancestors, the “Breakey Boys.” Four successive generations of Breakeys had earned degrees from the Medical School before Robert, starting with his great great grandfather, William Fleming Breakey (M.D. 1859). In wartime, Breakey doctors risked injury and death to care for the sick and wounded on the battlefields and front lines of the Civil War, Spanish-American War, and World War I. They also served their country in the military during World War II and the Korean War. In peacetime, the Breakey Boys ushered the practice and pedagogy of medicine into contemporary times by pioneering new medical specialties and modernizing the curriculum and teaching methods at U-M. The other Breakey Boys include James Fleming Breakey (M.D. 1894), Robert Stevens Breakey (M.D. 1924), and Barry Austin Breakey (M.D. 1953).
Source: “The Breakey Boys” Michigan Today
Credit: U-M Bentley Historical Library