ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Sunday, January 19, 1997 TAG: 9701170026
SECTION: EXTRA PAGE: 8 EDITION: METRO
DATELINE: NEW YORK
SOURCE: STEPHEN SMITH KNIGHT-RIDDER/TRIBUNE
For just a moment, store your vanity on the medicine cabinet shelf, right next to the wrinkle remover and the hair dye.
And now consider this:
You are a machine, a marvelous artifact of ancient engineering, a latticework of levers and pulleys and fulcrums, ligaments and muscles and bones. It is a notion as old as the Acropolis, a vision da Vinci conveyed in his art, rendering man as blueprint.
It took medicine a few centuries to catch on. Now, physicians and engineers enter into medical matrimony, students of the human body collaborating with scholars grounded in the principles of bridge building and metal strength.
At Columbia University in Manhattan, there's a whole lab devoted to studying the engineering of the human body. At HealthSouth Doctors' Hospital in Coral Gables, Fla., a professor with a doctorate in mechanical engineering sits in the same office suite with the surgeons who reassembled the battered bodies of Dan Marino and Deion Sanders.
It's all about healing broken bones and torn ligaments with more precision and greater speed. And it's proof that what's inside really does count.
``Let's say you have an injury and the surgeon is off by half a millimeter when he has the knife in his hand,'' says Van C. Mow, the gregarious engineer who presides over Columbia's Center for Biomedical Engineering. ``Disaster! That's the reason we strive for such precision.''
And that's the reason John E. Zvijac, M.D., is so happy Loren Latta, Ph.D., sits across the hall in Coral Gables, Fla.
They have merged the fundamentals of orthopedics with the basics of engineering, creating, for instance, an ersatz pitching mound where infrared cameras monitor athletes to figure out if their throwing stance contributes to arm and shoulder injuries.
The human body is viewed as a mobile erector set, with the distinctive ability to respond to - and be crippled by - changing environments.
``I spend much more time now asking patients what they do in life,'' Zvijac says. ``Are they a secretary sitting at a desk? I have a lot of women coming in with shoulder pain and a lot of it could be where they sit at their computers.''
These riddles have threaded through the life work of Latta, for nearly three decades. When he joined the University of Miami medical school, he was a curiosity, an expert more accustomed to adjusting the spine of a bridge than the bones of a human.
Resentment from surgeons singed his early days.
``Many of the orthopedic surgeons would say things like, `Why are you here? Why aren't you in the engineering school?''' Latta says. ``I had the feeling many times they would prefer I go to the engineering school, and they would call me when they needed me.''
Today, the University of Miami counts four engineers among the medical-school faculty.
They watch surgeries and consult during patient examinations, making observations about the engineering of the human body - insights pivotal to creating replacement parts that work better and last longer.
``It's a pretty natural thing for an engineer to become involved in the design of orthopedic devices,'' Latta says. ``But the thing that has really catapulted the development of orthopedic devices is incorporating engineers hands on. It's important that we understand how to make devices that will work with the body, not against it.''
Take joint replacements, for instance. Pick the wrong material, position it the wrong way, and you've got something worse than the original.
So engineers with experience in medicine were involved from the beginning in building the latest generation of joint replacements. There were materials to select, positions to be calculated, sizes to be measured.
In short, this was the mission: They needed to invent devices that would help the body do its work without simultaneously undermining it.
``The device,'' Latta says, ``has to be able to get along with the bone so that the bone doesn't melt away and disappear, because then the device won't be attached to anything.''
The same kind of rigorous review is applied to orthopedic devices straddling the outside of the body. University of Miami researchers have equipped about 10 patients with knee braces hooked up to a svelte computer hidden in a pouch nestled on their waist.
The computer will aid doctors and engineers in figuring out what causes stresses and strains on the brace while the patients go about the business of life - a test that previously would have been carried out in the artificial environment of a lab.
``So it takes it out of that setting to where people would actually be using them,'' Zvijac says. ``And that's the kind of data that really counts.''
On the Uptown campus of Columbia, they're studying the knee, too - but on a computer screen. The knee pivots and spins, every ligament and bit of bone rendered in sharp relief.
It's designed so surgeons can better figure out where they should cut - before they begin cutting.
``Sometimes, they're not sure how much to cut or where to cut,'' says Daniel Kwak, a doctoral candidate in bioengineering at Columbia. ``By using this, they can maximize their time in the operating room.''
Pass through a doorway in the laboratory labyrinth and you're confronted with a contraption that resembles something from a medieval torture chamber.
This, says the operator of the hulking blue machine, is the joint tester. So far, they have tested knees and shoulders from skeletons. Hands are next. (``Of course,'' bioengineer Tom Gardner says, ``we don't use live humans. That would be kinda painful.'')
They're trying to figure out, for example, how the kneecap moves and how a surgical procedure would affect its movement. They do that by subjecting it to various forces applied by the menacing blue machine.
In other corners of Columbia's Center for Biomedical Engineering, scientists endeavor to understand why cartilage dies and what makes it thrive again. Just as they might study a bridge to figure out why the innards can rot away, they want to know what makes the human body ebb away - and use that knowledge to develop the best synthetic replacements and most efficient drug therapies.
And Edward Guo, an assistant professor in mechanical engineering, examines bones, what causes them to crumble, what can keep them healthy.
``The skeletal muscular system is like a bridge,'' Guo says. ``If I tell you just what the bridge is made of, it doesn't tell you the whole picture. One bridge might just have cars commuting on it. The other bridge has trucks commuting on it.
``So there's one with greater risk of fracture. We do the same thing with a human's bones - what puts them at greater risk of fracture?''
What they discover could be vital in the campaign to reduce osteoporosis in older women.
LENGTH: Long : 123 lines ILLUSTRATION: PHOTO: KRT. John E. Zvijac M.D. (right) tries to solve jointby CNBriddles with Dr. Antonio Flores. color.