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  1. Version 1.1.0

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    3D printing, Ultrastructure of the Glomerular Filtration Barrier and the Nephrotic Syndrome Nephrotic syndrome (NS) is a clinical condition with high morbidity and mortality, this condition is caused by a failure of the glomerular filtration barrier (GFB) leading to massive proteinuria. In clinical practice, diagnostic, prognostic and therapeutic decisions are based primarily on NS own clinical and histological patterns of each case. The background above underscore the need for a proper understanding of normal and pathological structure GFB. In contrast there are major constraints for obtaining human samples intended for academic teaching today. In this sense, printing three-dimensional (3D) offers the opportunity to solve this deficiency, allowing manufacture teaching materials with the required characteristics and a high degree of detail, at a low cost. In this work, we have developed two 3D printed models of the GFB ultrastructure, a normal and an altered one by nephrotic syndrome. We hope this tool will improve teaching-learning on one of the most common syndromes in clinical nephrology and allow to subsane the lack of teaching materials. The work has been divided into three stages: First one consisted in the production of two figures, based on the representations of human GFB, both normal and pathological according to what is described in the literature*. During second stage the 3D modeling was performed in this structure, using "Tinkercad ©" software, obtaining an ".stl" file. Finally, we proceeded to print the two parts, using a 3D printer: "KREABOT". References Perico, L., Conti, S., Benigni, A., & Remuzzi, G. (2016). Podocyte-actin dynamics in health and disease. Nature Reviews Nephrology. Satchell, S. (2013). The role of the glomerular endothelium in albumin handling. Nature Reviews Nephrology, 9(12), 717-725. G. Bartolozzi. I MECCANISMI DELLA PROTEINURIA (PARTE PRIMA). Medico e Bambino pagine elettroniche 2006; 9(5) http://www.medicoebambino.com/_fenestrato_diaframma_nefrina_glomerulare_proteinuria_proteine_sindrome Comments These 3d files were presented at the XIX National Scientific Meeting of Students of Medical Sciences, USACh 2016 and X Fair of educational material, as a presentation of congress.

    $7.50

  2. Casey Steffen has a background in video game animation and a Master’s degree in biological visualization but he describes himself as a “medical illustrator and a type I diabetic” in the video introduction to his RocketHub crowdfunding page, that raised money to support a project to make educational models of the protein hemoglobin, that has 4,659 atoms. The proposal was completely funded two years ago. The project addresses confusion surrounding the common hemoglobin A1c (HbA1c) test. Unlike the blood sugar measurement, it represents the average over three months (the lifetime of a red blood cell) of the fraction of bloodstream HbA1c (hemoglobin with sugar molecules attached as shown in the the models). If this number is above a certain range (7% for people with diabetes, according to WebMD) it means blood sugar has not been well controlled. A higher number is indicative of prolonged elevated blood sugar. It’s used for long term tracking of how patients manage their blood sugar. The hemoglobin models provide patients with a physical and visual representation of what the test means, so they can better understand what’s going on in their body, and why it’s important to control their blood sugar. An elevated blood sugar causes damage to certain tissues, like the eyes and blood vessels in the feet, slowly, over a long period of time. To get the hemoglobin models right, Steffen collaborated with Patricia Weber, a structural biologist and Mary Vouyiouklis, his endocrinologist. When Steffen met Michael Gulen, who was a prototype development director at a company that makes action figures, a collaboration was born. Wired Magazine covered their story about five years ago. Steffen’s company, Biologic Models, makes models of proteins for scientific and medical education. The physical models of proteins are created from x-ray crystallography data sets. For some of the models, like the hemoglobin ones, 3D printing from a Form 1 3D printer serves to make the prototype for plaster molds, to finally cast the models in silicone. The company partners with the 3D printing company Shapeways to print several proteins including the Zika virus shell and the Ebola virus ectodomain (the part that fuses to the cell membrane). Digital preview of Zika virus shell Ebola virus ectodomain Customers can also choose to have the company provide a plan for 3D printing their favorite protein by providing its PDB ID from the protein data bank, a resource of protein structure x-ray crystallography data. Customers can then have it 3D printed or print it themselves. Based on a post from formlabs.
  3. This week cdmalcolm posted a great article here at Embodi3d.com on how 3D-printed replicas of patient’s organs are helping surgeons plan for complicated operations. Today I'd like to supplement this topic by talking about the advances 3D printing can bring to medical education, specifically by recreating human models for students to study and dissect. Currently, the golden standard for teaching medical students the anatomy (overall structure) of the human body involves dissecting and observing cadavers – recently deceased humans who have given their bodies to science. However, obtaining and storing these bodies can be difficult for a number of reasons. For example, many cultural and religious beliefs preclude people from donating their bodies, and even in countries with strong donation programs bodies with rare diseases (by their very definition) are hard to find. Even when sufficient cadavers are donated, the process of preserving them to prevent natural decomposition can be costly. New technology comprising a mixed approach of 3D printing and traditional manufacturing can solve many of these problems by recreating accurate and numerous replicas of human anatomy with minimal expense. A recent publication in the January/Februrary edition of the journal “Anatomical Sciences Education” highlighted a prototype for this technology; the team from The University College Dublin in Ireland were able to recreate a portion of the hip, with 3D-printed bone and blood vessels surrounded by a flesh-like filler and covered in a synthetic skin. On top of this, they were able to connect a pump to the blood vessels to mimic the typical human circulatory system. The result wasn't fancy - the components were placed in a Tupperware container with holes for the tubing - but it had most of the necessary components for students to learn, and more importantly, obtain valuable practical experience. The advantage of using 3D printing for these models is that they can be changed to reflect the anatomy of specific diseases. For example, atherosclerosis occurs when blood vessels narrow, and it is an important factor in heart disease. In the prototype above, the team were able to 3D-print replicas of blood vessels from a healthy patient, and one with atherosclerosis - the vessels with atherosclerosis were a lot thicker, and students were able to assess this using ultrasound. The students were also able to perform basic techniques to locate the vessels via syringe, similar to how they may be required to set up an IV drip. And since the models only need to mimic the qualities of human organs rather than making functional tissue (see my previous article on the challenges of this), the models can be made relatively simply, and from materials that do not degrade over time like human flesh does. It might seem like a reconstruction of the human body would never be able to replicate the experience of learning from a true human body, however the results of the study above and previous work by The Centre for Human Anatomy Education in Australia showed that 3D printed models are just as good as cadavers for teaching students the principles of anatomy. And thus the future of manufactured lifelike bodies for teaching seems bright - indeed, one could imagine that many trending technologies could be integrated with these models to provide teaching experiences that surpass the current standard delivered by cadavers. Digital sensors are rapidly becoming cheaper and more ubiquitous in technology, and these could be incorporated into anatomical models to provide feedback to students during practical tasks. Virtual reality (VR) and augmented reality (AR) are also trending with many potential application for medicine. Perhaps in the future, manufactured human anatomical models will be integrated with AR, in a way that replicates the experience of operating on real-life patients. And so, 3D printing technology seems poised to replace the long-standing use of cadavers for medical education, and soon many medical students will be able to sigh with relief at not having to prepare themselves to touch and dissect decomposing, smelly bodies. The inexpensive production of realistic bodies will give students better access to practical hands-on education, better preparing them for their eventual roles dealing with real patients. Image Credits: Simulab The Verge Pacific Vascular
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