TED2009
Daniel Kraft: A better way to harvest bone marrow
ダニエル・クラフトのより良い骨髄採取法の開発
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ダニエル・クラフトが彼の骨髄採取器（メローマイナー）をデモンストレーションします。 この新しい装置は骨髄液を素早く採取し、ドナーの痛みを最小限に抑えることができます。彼は成人骨髄液中の幹細胞は、パーキンソン病から心臓病までの多くの末期症状の治療に利用可能と説いています。
Daniel Kraft - Physician scientist
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine. Full bio
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine. Full bio
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00:18
So I am a pediatric cancer doctor
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私は小児ガンの医師で
00:21
and stem-cell researcher at Stanford University
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スタンフォードで幹細胞の研究もしていますが
00:25
where my clinical focus has been bone marrow transplantation.
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そこでは主に骨髄移植に携わってきました
00:28
Now, inspired by Jill Bolte Taylor last year,
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ジル ボルト テイラーが去年人間の脳を
00:30
I didn't bring a human brain,
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持ってきた事に刺激され
00:32
but I did bring a liter of bone marrow.
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1リットルの骨髄液を持ってきました
00:35
And bone marrow is actually what we use
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骨髄液は実際多くの患者さんを救うために
00:38
to save the lives of tens of thousands of patients,
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私達が使用しているものです
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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その患者さんのほとんどは 白血病 リンパ腫
00:43
and some other diseases.
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その他の進行した悪性腫瘍を抱えています
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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数年前 私はスタンフォードで移植の研修生をしていました
00:49
I'm in the operating room. We have Bob here,
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私は手術室にいて
00:51
who is a volunteer donor.
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そこにはドナー志願のボブがいました
00:53
We're sending his marrow across the country to save the life
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私達は国内のある白血病の子供の命を救うため
00:55
of a child with leukemia.
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彼の骨髄液を送ろうとしていました
00:57
So actually how do we harvest this bone marrow?
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実際どうやって骨髄液を採取するのでしょう？
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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手術室のメンバーはそろっているし 一般的な麻酔設備 看護士
01:03
and another doctor across from me.
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そして 私の前には他の医者もいます
01:05
Bob's on the table, and we take this sort of small needle,
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ボブは手術台にいます このような小さい針
01:07
you know, not too big.
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それほど大きくない針を使います
01:09
And the way we do this is we basically
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やり方はこうです
01:11
place this through the soft tissue,
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基本的にこれをやわらかい組織に貫通させ
01:13
and kind of punch it into the hard bone,
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固い骨に穴をあけるのです
01:15
into the tuchus -- that's a technical term --
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尻の中に--これは専門用語です
01:17
and aspirate about 10 mls of bone marrow out,
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そして骨髄液を10ml吸引します
01:21
each time, with a syringe.
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毎回 注射器で
01:23
And hand it off to the nurse. She squirts it into a tin.
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それを看護師に渡します 彼女はそれを容器に入れ
01:26
Hands it back to me. And we do that again and again.
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私に返します これを何度も繰り返します
01:29
About 200 times usually.
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大体200回くらい
01:31
And by the end of this my arm is sore, I've got a callus on my hand,
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最後には腕は痛み始め 手にはタコができます
01:33
let alone Bob,
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ボブは言うまでもありません
01:35
whose rear end looks something more like this,
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彼のお尻はこんな
01:37
like Swiss cheese.
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スイスチーズの様になってしまいます
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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私が思ったのは この処置は40年間変わっていない
01:43
And there is probably a better way to do this.
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もっといい方法があるだろうということでした
01:45
So I thought of a minimally invasive approach,
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そこで考えたのは 器具を最小限に挿入する方法です
01:48
and a new device that we call the Marrow Miner.
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新しい装置 メローマイナ―（骨髄採取器）です
01:50
This is it.
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これだけです
01:52
And the Marrow Miner, the way it works is shown here.
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ではメローマイナ―の機能をお見せしましょう
01:55
Our standard see-through patient.
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患者の模型です
01:57
Instead of entering the bone dozens of times,
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骨に何十回も針を挿入する代わりに
01:59
we enter just once, into the front of the hip or the back of the hip.
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腰の前か後ろに一回だけ挿入します
02:01
And we have a flexible, powered catheter
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それから弾力性のある電動カテーテル
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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それには針金の輪が先端に付いていて
02:07
and follows the contours of the hip, as it moves around.
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腰の固い骨の内側の輪郭に沿って動きます
02:10
So it enables you to very rapidly aspirate,
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こうして とても速く たくさんの骨髄液を
02:12
or suck out, rich bone marrow very quickly through one hole.
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1つの穴から吸い出すことができます
02:15
We can do multiple passes through that same entry.
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同じ穴からいくつもの経路も作れます
02:17
No robots required.
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ロボットも必要ありません
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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ボブは1つ穴をあけるだけで 非常に素早く
02:22
and do this harvest as an outpatient.
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局所麻酔で外来で 骨髄液採取ができるのです
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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スタンフォードで少額の交付金をいただいたので
02:29
And played around with this a little bit.
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試作品を作り 少し実験をしてみました
02:31
And our team members developed this technology.
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私達のチームはこの技術を発展させ
02:33
And eventually we got two large animals, and pig studies.
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最終的に2匹の大きな動物 つまり豚での研究をしました
02:37
And we found, to our surprise, that we not only got bone marrow out,
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驚いたことに結果は 普通の採取器に比べ
02:39
but we got 10 times the stem cell activity
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骨髄液だけでなく 10倍もの幹細胞の活動を含んだ骨髄液を
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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このメローマイナ―で採取することができたのです
02:44
This device was just FDA approved in the last year.
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この方法は昨年FDAによって認可されました
02:47
Here is a live patient. You can see it following the flexible curves around.
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実際の患者です 針金が柔軟にカーブに沿っていますね
02:50
There will be two passes here, in the same patient, from the same hole.
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同じ患者の同じ穴から2回吸引します
02:53
This was done under local anesthesia, as an outpatient.
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これは局所麻酔で外来で行われました
02:55
And we got, again, about three to six times more stem cells
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そして私達はまた従来より3倍から6倍も多くの
02:58
than the standard approach done on the same patient.
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幹細胞を同じ患者から採取出来ました
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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これは私たちに重要な物でしょうか？骨髄液は成体幹細胞の宝庫です
03:04
You all know about embryonic stem cells.
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皆さんは胚性幹細胞をご存じですね
03:06
They've got great potential but haven't yet entered clinical trials.
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大きな可能性がありながら まだ臨床試験はされていません
03:09
Adult stem cells are throughout our body,
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成体幹細胞は私達の骨髄の中に
03:11
including the blood-forming stem cells in our bone marrow,
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造血幹細胞も含め 体中にあります
03:13
which we've been using as a form of stem-cell therapy
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私達はそれを40年以上
03:15
for over 40 years.
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幹細胞治療に利用してきました
03:17
In the last decade there's been an explosion of use
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ここ10年間で 骨髄幹細胞の利用は激増し
03:20
of bone marrow stem cells to treat the patient's other diseases
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様々な病気を治療しています
03:23
such as heart disease, vascular disease,
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心臓病 血管の病気
03:25
orthopedics, tissue engineering,
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整形外科 再生医学の患者の治療
03:27
even in neurology to treat Parkinson's
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また神経病学ではパーキンソン病や
03:29
and diabetes.
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糖尿病にまで
03:31
We've just come out, we're commercializing, this year,
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私達は今年
03:33
generation 2.0 of the Marrow Miner.
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"メローマイナ―2.0"を商品化しました
03:35
The hope is that this gets more stem cells out,
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これがより多くの幹細胞を採取する手掛かりとなり
03:37
which translates to better outcomes.
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よい成果をあげられることを心待ちにしてます
03:39
It may encourage more people to sign up to be
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これのおかげでより多くの人が骨髄ドナー登録し
03:41
potential live-saving bone marrow donors.
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人命救助をしてくれることでしょう
03:43
It may even enable you to bank
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さらに あなたが自分の骨髄幹細胞を若くて
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your own marrow stem cells, when you're younger and healthier,
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健康な時に預け 将来利用するという事が
03:47
to use in the future should you need it.
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可能になるかもしれません
03:50
And ultimately -- and here's a picture of our
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最後に-- ここに骨髄移植成功者たちの
03:52
bone marrow transplant survivors,
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写真が一枚あります
03:54
who come together for a reunion each year at Stanford.
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こうして彼らはスタンフォードで毎年集っているのです
03:56
Hopefully this technology will let us
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この技術により将来この写真の中に
03:58
have more of these survivors in the future.
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より多くの人々を見られることを望んでおります
04:00
Thanks.
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ありがとうございました
04:02
(Applause)
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（拍手）
ABOUT THE SPEAKER
Daniel Kraft - Physician scientistDaniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine.
Why you should listen
Dr. Daniel Kraft is a Stanford and Harvard trained physician-scientist with more than 25 years of experience in clinical practice, biomedical research and innovation. He is Faculty Chair for Medicine at Singularity University and is the founder and chair for Exponential Medicine, a program which explores convergent, rapidly developing technologies and their potential to reshape the future of health and biomedicine.
After medical school at Stanford, Kraft was board certified in both Internal Medicine and Pediatrics following residency at the Massachusetts General Hospital & Boston Children's Hospital, and he completed Stanford fellowships in hematology/oncology & bone marrow transplantation. He is a member of the inaugural class of Aspen Institute Health Innovators Fellows.
Kraft has extensive research in stem cell biology and regenerative medicine with multiple scientific publications, medical device, immunology and stem cell-related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the pediatric bone marrow transplantation service at University of California San Francisco.
Kraft recently founded IntelliMedicine, focused on connected, data-driven and integrated personalized medicine. He is the inventor of the MarrowMiner, an FDA-approved device for the minimally invasive harvest of bone marrow, and he founded RegenMed Systems, a company developing technologies to enable adult stem cell-based regenerative therapies. He is an advisor the XPRIZE (having conceived of the Medical Tricorder XPRIZE and is helping lead a new Cancer focused prize), and advises several digital health and technology companies.
Kraft is an avid pilot and served for 14 years as an officer and flight surgeon with F-15 and F-16 fighter squadrons in the Air National Guard. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.
Daniel Kraft | Speaker | TED.com