U of M News Wire
December 27, 2007
University of Minnesota alumnus Earl Bakken's pacemaker turns 50
By Deane Morrison
U of M News Wire
October 1957 is remembered as the start of the Space Age, but that month also witnessed the birth of a new era in medicine. As the Soviet satellite Sputnik sailed overhead, a power blackout in Minneapolis led University alumnus Earl Bakken to invent a tiny metal box that sparked a revolution: the first wearable cardiac pacemaker.
Earlier this month Bakken, an electrical engineer who graduated in 1948, received the first honorary Doctor of Medicine degree from the University in recognition of his contributions. Last week, at a symposium in his honor, he recounted the tale of the pacemaker's genesis.
The blackout on Halloween 1957 left a legendary University heart surgeon, C. Walton Lillehei, with a tiny patient who needed electricity to stay alive. Lillehei had repaired a hole in the baby's heart, but the electrical signals that control the heartbeat had been blocked. An AC-powered stimulator was standing in for the heart's natural rhythm until the child's heart could recover.
The stimulator plugged into wall sockets, limiting patients and doctors alike.
"It was hard when you had to move a patient," Bakken recalls. "You had to run extension cords, sometimes down an elevator."
Whether the baby survived or not (memories differ on that point), it was clear to Lillehei that there had to be a better way. So the next time he ran into Bakken, who was already in the business of fixing and calibrating medical equipment, he asked if Bakken couldn't rig a battery to back up the stimulator.
Bakken was then working out of a cramped, kerosene-heated garage with business partner Palmer Hermundslie, his wife's sister's husband. Eight years earlier, in that same space, they had created a company called Medtronic.
When Lillehei made his request, Bakken first envisioned a cart loaded with a battery, charger, and inverter--all the necessities for running an AC-powered pacemaker. Then another idea struck.
"I remembered a two-transistor circuit for a metronome," Bakken says. "I plagiarized the circuit and built a pacemaker."
Four weeks later, Bakken brought Lillehei a transistorized, battery-powered pacemaker housed in an aluminum circuit box about the size of a slice of bread. A trial on a research animal was successful, and Bakken assumed many more such trials would be performed.
"Then I walked in the hospital one day and saw it connected to a child," he says.
The device was strapped to patients' chests and was connected to two electrodes: one surgically placed in contact with heart muscle and the other implanted under the skin. The external box had an on/off switch, plus knobs for controlling the stimulus rate and strength. Sure enough, young patients started playing with the knobs, so the first commercial models of the pacemaker had recessed, kid-proof knobs.
"It was a great experience, saving the lives of kids," Bakken muses.
The invention allowed the University to lead the way in short-term pacing of the heart, keeping patients alive until their hearts recovered normal function--usually about two or three weeks. Then the electrodes could be pulled out.
Soon, both Medtronic and pacemaker technology started to take off. In 1959 a Medtronic engineer named Norman Roth teamed up with Samuel Hunter, a surgeon at St. Joseph's Hospital in St. Paul, to design a new pacemaker lead that combined both electrodes inside a plastic patch that could be stitched to the heart. This more permanent pacemaker was first used on a patient, Warren Mauston of St. Paul, in April 1959. Mauston lived with it for more than seven years.
The first successful implantable pacemaker also came along in 1959, the creation of Wilson Greatbatch of the University of Buffalo and William Chardack, chief of thoracic surgery at the Buffalo Veterans Administration Hospital. It was first used in 1960, and in 1966 Medtronic bought the associated patents.
The rest is history. Medtronic has been phenomenally successful; the company now sells medical devices all over the world and reported revenues of $12.3 billion for the year ending April 29, 2007. Among the many spinoff companies founded by Medtronic employees is St. Jude Medical, famous for its mechanical heart valve. Pacemakers have shrunk to the size of two silver dollars stacked atop each other, and more than 400,000 are implanted every year.
In 1984 the pacemaker was named one of the 10 outstanding engineering achievements of the second half of the 20th century by the National Society of Professional Engineers. In 2001 Bakken and Greatbatch were recognized with the $500,000 Fritz J. and Dolores H. Russ Prize from the National Academy of Engineering and Ohio University. The prize recognizes achievements that improve the quality of life and have attained wide application or use.
Today, visitors to the Bakken Museum, sitting on the western shore of Lake Calhoun in Minneapolis, can trace the history of electricity in medicine and hear the life story of the museum's founder and namesake. Its executive director, David Rhees, says he always gets a charge out of watching children tour the museum.
"One of them is going to be the next Earl Bakken," he predicts.
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U of M offers unique chance for suffering children
By Molly Portz
U of M News Wire
"This magic moment...," Theresa Liao sang to her 18-month-old son Nate, holding him as potentially life-saving bone marrow stem cells were infused into his small body. Nate suffers from the most severe type of epidermolysis bullosa (EB), a genetic disease that causes skin to slough off with the slightest friction or movement.
To protect their fragile skin, children with EB must be bandaged from head to toe and often suffer painful wounds that are slow to heal. EB even effects skin on the interior of the body and children need to eat soft foods to protect their intestines. The disease has no treatment and no cure and people with EB die young from skin cancer.
Doctors at the University of Minnesota Children's Hospital, Fairview are hopeful that will soon change. On October 19, a team led by John Wagner, head of pediatric blood and marrow transplantation, transplanted bone marrow and cord blood cells into Nate from his brother Julian, who does not have EB. Julian is a 100 percent match for Nate. Wagner anticipates that Julian's bone marrow and umbilical cord blood will result in a new healthy blood system that produces type VII collagen, the protein missing in children with EB. The physicians don't know for sure if the treatment will work since it has never been tried before.
The Liao family raised funds to support the lab research. The U was the perfect place to do this work because of the close ties between researchers and clinicians, and the atmosphere of collaboration where competition bows to the common good.
University researchers were able to correct the disease in mice through bone marrow transplant (BMT) with a 25 percent success rate. They tested various types of stem cells to determine which would give rise to the development of type VII collagen and produce the anchoring fibrils that bind the skin to the body. The Liao family raised funds to support the lab research. They have four boys--two suffer from EB. If all goes well with Nate, his five-year-old brother Jake will receive a transplant in several months.
"It has been a long road to get here," says Theresa Liao. "We uprooted our lives and we aren't leaving Minnesota until both boys are transplanted. If there is a chance my kids can be better, we have to try. We have the chance to give hope to all the other kids and families who live with EB."
This is the first time doctors have approached EB from a systemic perspective, using transplant as a means to rid the body of its defective blood system and replace it with a healthy blood system.
"Our goal is to determine the usefulness of stem cells whether from the umbilical cord blood or adult tissues like bone marrow in the treatment of human disease," says Wagner. "There are hundreds of thousands of children and adults waiting for new breakthroughs in stem cell research. In two years, the team was able to move this project forward remarkably fast--from testing in animal models to treating patients. Time will tell whether this risky treatment will work as effectively in humans." Doctors anticipate that at 100 days post-transplant they will be able to judge whether Nate has benefited from the experimental treatment.
The pediatric BMT program at University of Minnesota Children's Hospital, Fairview is internationally recognized for its pioneering work in umbilical cord blood and bone marrow transplantation, including the world's first successful BMT in 1968. In 2000, Wagner and his team performed the first umbilical cord blood transplant from a sibling whose embryo was selected for implantation because of its match as a donor. The program leads the nation in the use of umbilical cord blood in the treatment of adults and children and in development of innovative treatments of various rare genetic diseases such as adrenoleukodystrophy (ALD) and Fanconi's anemia.
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Growing Concerns
A question-and-answer column with Dr. Martha Erickson of the University of Minnesota
Editor's note: Dr. Erickson is taking a holiday break, so this column is from the Growing Concerns’ archives. Her regular column will return next week.
Question: Four months ago we adopted a 2-year-old boy. He often wakes up crying in the middle of the night, his moods are unpredictable, and even when he's not fussing or fighting, he rarely smiles. We have given him a stable, loving home, but it doesn't seem to be enough.
Answer: The arrival of a new family member is a challenge and a big adjustment under any conditions but your situation poses some special issues. You do not mention anything about the circumstances of the adoption. Was he removed from an abusive home? Did he lose his parents through death? Was he in a foster home and now has "lost" those parents as a result of his placement with you? Or was he perhaps moved from place to place without any opportunity to form strong relationships?
Whatever his history and whatever the circumstances of the adoption, this little boy brings that history with him. In the first two years of life, children normally are building a sense of trust through their attachments to the adults who love and care for them. When that does not happen, it can take much time and patience to gradually establish that sense of trust. Four months is really not a very long time to undo what happened during the first two years of life. If his experience tells him that people disappear after a while--or that they cannot be counted on to care for him--then he may be very slow to trust in the love you offer him. His crying in the night is an opportunity for you to reassure him that you are there for him.
Beyond the psychological effects of his life history, it is possible that there are physiological effects as well. Poor nutrition, chemical use by parents prior to or during the pregnancy and the general quality of care he received can have an impact on his behavior. Your pediatrician or family physician can work with you to carefully monitor your son's development, making sure that any problems are identified and addressed as early as possible.
Some of what you are seeing in your son also reflects his stage of development. Most 2-year-olds are moody and unpredictable. They are going through rapid changes in motor skills, language ability and learning what they can and cannot do. They swing from wanting to be big and all-powerful to wanting to just curl up and be little babies. It will take time for your son to learn what is expected of him and to know that you will be there to love and guide him.
All parents need support to see them through the ups and downs of children's development. And adoptive parents need and deserve special support to address their unique issues. I suggest you contact your adoption agency or a mental health agency in your community and ask about resources for adoptive parents. Many communities offer support groups or can link you with national networks that provide information and support specifically for adoptive parents.
Dr. Erickson is a senior fellow and director of the Harris Programs in the Center for Early Childhood Education at the University of Minnesota
Want to hear more parenting advice?
Dr. Erickson and her daughter can be heard every Sunday, from 2 - 4 pm, on “Good Enough Moms,” on FM107.1 radio in the Twin Cities or via Webcast at www.FM1071.com
