The World's First VR Brain Surgery Is Here

iStock
iStock

A lot of consumers are focused on virtual reality as a means of immersing themselves in games or traveling to exotic locales, but the technology holds some incredible potential as a learning tool. One recent—and graphic—example is VR brain surgery, which allows viewers to examine the amygdala like they never thought possible.

In the experience, which was produced and overseen by Fundamental VR at the Royal London Hospital, users will be able to follow along with surgeons as a patient is wheeled into the operating room and undergoes a real neurosurgical procedure to repair two aneurysms (balloon-like bulges in an artery that can rupture). Cameras installed in the OR and GoPro units on the surgeons provide a first person-perspective; you can also switch to the POV of the patient as instruments enter and exit your field of view.

The idea was embraced by surgeons at Royal London, who see it as having the potential to be a valuable training tool for neurosurgeons by mimicking "hands on" experience. Although the footage is best seen using a VR headset, you can get a feel for the experience in the YouTube footage below. Did we mention it's very, very graphic?

More sophisticated versions of the program—including tactile feedback for users—are expected to be implemented in Fundamental VR's surgical training programs in the future. Currently, programs like Surgical Navigation Advanced Platform (SNAP) are being used at major institutions like Stanford University and University of California, Los Angeles to map the brain prior to incision.

If this whets your appetite for witnessing brain operation footage, don't forget we filmed and broadcast a live brain surgery in partnership with National Geographic. You can still check it out here.

[h/t Wired]

12 Facts About Kidney Stones

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

Kidney stones are more common than ever. According to Harvard Medical School, every year more than 3 million people see a doctor for relief from these hard mineral and salt deposits, which form in your kidney when urine becomes too concentrated. Here's what we know about the condition formally called nephrolithiasis.

1. KIDNEY STONES TYPICALLY CAUSE REALLY PAINFUL SYMPTOMS.

At first you may notice your urine is cloudy, bloody, and foul smelling. Your back may begin to ache, and nausea may come over you. Then, as the stone moves from your kidney into your urinary tract or bladder, sometimes becoming trapped, there’s often an intense, stabbing pain that many people say they wouldn’t wish on their worst enemy.

2. MOST PEOPLE DEVELOP ONE TYPE OF STONE …

What kind of kidney stone you get depends on your diet, fluid intake, genetics, hereditary disorders, and even whether you take certain medications, but the vast majority of people get calcium oxalate stones. They're formed from a mix of calcium in urine and the compound oxalate, which is found naturally in food like nuts, chocolate, and some vegetables, including beets and spinach; oxalate is also produced by your liver. There's some evidence that people who take the seizure medicine topiramate can develop these stones in the form of calcium phosphate.

3. … BUT THERE ARE THREE OTHER KINDS TOO.

Struvite stones are fast-growing mineral deposits that typically develop in response to a urinary tract infection, and can grow large enough to block the kidney, ureter, or bladder before you notice any symptoms; they affect women more than men. Uric acid stones turn up in people who eat a lot of red meat, shellfish, and organ meats, which contain hefty doses of an organic compound called purine that can lead to more uric acid than the kidneys can excrete. Cystine stones are caused by a rare hereditary disorder called cistinuria in which your kidneys excrete excessive amounts of the amino acid cystine.

4. THEY'RE EXTREMELY COMMON—ESPECIALLY IN MEN.

There's a solid chance you could end up with a kidney stone. The National Kidney Foundation notes that one in 10 people will develop one during the course of their life. And if you’re male, take note: Your gender alone is considered a kidney stone risk factor. Men are twice as likely as women to develop them. Another factor is age: Although stones are most common from ages 20 through 50, they tend to peak around age 30.

5. IF YOU’VE HAD A KIDNEY STONE, YOU’LL PROBABLY DEVELOP ANOTHER ONE …

Sorry to say, but simply having a kidney stone puts you at risk for a recurrence. If you’ve had one, the U.S. National Library of Medicine notes that there’s a 30 to 50 percent chance more stones will form within five years.

6. … BUT YOU CAN TAKE STEPS TO PREVENT THEM.

Cutting back on sodium (i.e. deli meats, packaged soups, and processed foods) can help, because a stone can form from excessive salt consumption. You should also avoid too much animal protein—it produces urine containing more acid, which is known to increase your risk for kidney stones—and increase your intake of fruits, vegetables, whole grains, and low-fat dairy. And be sure to drink plenty of fluids, especially water—at least 12 glasses a day. (That's good advice for everyone, not just those prone to kidney stones.)

Don't drink much apple or cranberry juice as both contain oxalates and are linked to an increased risk of developing calcium oxalate stones. High doses of Vitamin C may boost the concentration of oxalate in urine; the Cleveland Clinic recommends a daily maximum of 500 milligrams.

7. IT'S A MYTH THAT CALCIUM CREATES SOME KIDNEY STONES.

Despite the fact that the word calcium is part of the most common kind of kidney stone, you don’t need to treat calcium as the enemy. In fact, having too little calcium can actually increase the odds you’ll get these types of stones. According to the Cleveland Clinic, eating about two or three servings of calcium-rich foods daily reduces oxalate absorption, helping to keep calcium oxalate stones away. So get out the cheese.

8. IF YOU PASS A STONE, CONGRATULATIONS! NOW TAKE IT TO A DOCTOR.

Ninety percent of kidney stones are passed through urination. Getting one out this way may hurt a lot, but once the stone has finished causing you agony, it could provide clues that could help you avoid developing another one. If you’re able to retrieve the stone, bring it to your doctor, who can order an analysis. Identifying its components can reveal the kind of stone it is and potentially point to a treatment or prevention plan.

9. IF YOU CAN’T PASS A STONE, TREATMENTS ARE AVAILABLE …

In an attempt to exit the body, a stone travels from the kidney to the bladder through a narrow tube called the ureter. If the stone is larger than a quarter-inch, it's simply too big to pass through the ureter, and will get trapped there. (If it can make it through to your bladder, it's small enough to pass out out of your body through the urethra.) This causes intense pain, blocked urine flow, and possible bleeding from urinary tract walls. That's when it's time for treatment.

There are several methods for getting rid of a kidney stone, all of which aim to break the stone into smaller pieces so they can leave the body. In an extracorporeal shock wave lithotripsy (from the Greek for "crushed stone"), high-frequency sound waves are applied externally to break stones up, allowing them to pass when you pee. Laser lithotripsy takes a similar approach: Stones in the ureter are broken up with a laser and also leave the body naturally. More invasive is percutaneous ultrasonic lithotripsy, which involves passing narrow instruments (including a fiberoptic camera) through your back to your kidney; ultrasound breaks the stones up, and then fragments are removed by an instrument. Finally, a ureteroscopy is a treatment option in which a small scope is inserted in the ureter towards the bladder to determine the stone's location. Then it's broken up for natural passage or removed altogether. Luckily, you're unconscious under general anesthesia during the last procedure.

10. … AND THEY'RE FAR SUPERIOR TO THOSE USED IN THE PAST.

Kidney stones are nothing new—mentions of the painful formations go back more than 5000 years, to Mesopotamian medical texts—and medical interventions have occurred for just as long. Stones made it into the Hippocratic Oath, in which physicians swore they would "not use the knife, not even on sufferers from stone," leaving the procedure to "such men as are engaged in this work" [PDF]. Surgeons in ancient Greece and India were attempting stone removal as far back as the 7th century BCE.

The 16th to 18th centuries were a heyday for stone surgeons, who were largely self-taught. The most notorious of them was Frere Jacques Beaulieu. He pioneered the lateral perineal lithotomy—which involved making an incision in the perineum, inserting a terrifying cutting instrument into the bladder, cutting up the stone, and then extracting the pieces with the instrument or his fingers—in the late 17th century. Unfortunately for his patients, he had no technical training, and his method was often deadly; in 1698, after 25 of his 60 patients died, he was banned from doing the procedure—but he didn't stop. He's thought to have performed more than 5000 lithotomies. (And no, the song doesn't seem to be about him.)

11. IF ALL ELSE FAILS, TRY RIDING A ROLLER COASTER.

If you’re a thrill seeker who happens to have kidney stones (and some vacation time), you may be in luck. After a "notable number" of patients reported that riding the Big Thunder Mountain roller coaster at Walt Disney World in Orlando helped them to pass their kidney stones, Michigan State University urologist David Wartinger decided to investigate. He created a kidney replica—complete with kidney stones—put it in a backpack, and let it ride the roller coaster 60 times. It worked—but passing the stones depended on where the backpack was placed in the coaster. Rides in the last car were the most effective, with the stones passing 64 percent of the time, while the front few cars yielded only a 16 percent success rate.

Big Thunder Mountain was the only ride in the theme park that was effective. Neither Space Mountain nor Aerosmith's Rock 'n' Roller Coaster did the trick, likely because they were too fast, with a G-force that pinned the stones in place. Of course, while this is an interesting finding, if you suspect you have kidney stones, speak to your doctor before you high-tail it to Walt Disney World.

12. A KIDNEY STONE THE SIZE OF A MOUSE WAS REMOVED FROM A MAN IN 2004.

The stone measured 5.11 inches at its widest point—a world record. Five years later, a whopping 2.5-pound stone was surgically removed from a man in Hungary in 2009. Perhaps seeing a bunch of kidney stones in one place other than originating from your own body will put you at ease. If that’s the case, check out the International Museum of Surgical Science in Chicago, where a collection of stones is on display in glass jars.

What Happens When an Astronaut Gets Sick in Space?

NASA/Getty Images
NASA/Getty Images

Astronauts are among the fittest and healthiest people in the world. They're rigorously trained, vetted, and quarantined before they’re allowed up in space—and yet, despite all those precautions, they do sometimes get sick. Apollo 13's Fred Haise, for example, had to deal with a painful kidney infection during the dangerous mission that gave us the phrase "Houston, we have a problem," and one-time astronaut Jake Garn, a Utah senator, got so motion-sick during a 1985 Discovery mission that astronauts now rate their nausea levels on the Garn Scale. And because space missions are on a strict schedule planned far in advance, sick astronauts on a space mission can't just pop down to Earth to see a doctor.

But when astronauts fall ill, they don't have to worry—NASA and other space agencies that have missions aboard the ISS are prepared.

SPACE ADAPTATION SICKNESS

Zero gravity can change a lot of normal bodily functions. One effect it has is to make the fluids inside the body float, which confuses the inner ears and makes them unable to tell up from down. This causes space adaptation syndrome (SAS), a common illness that's kind of like seasickness in space. Motion sickness, the most frequently reported ailment, is a subset of SAS; it affects 67 to 75 percent of astronauts.

It takes a few days for astronauts' bodies to adjust to weightlessness, during which they may experience symptoms ranging from headaches to vomiting. And though it might seem like a nightmare to deal with puke, NASA has a system: Astronauts carry special barf bags with attached face wipes and Ziploc seals that they can use during launch or while in orbit if they get the urge to hurl. Once used, the bags are tossed in the trash.

COLDS AND SNIFFLES

Because astronauts are quarantined before spaceflight, the likelihood of being exposed to a pathogen in space is rare. But if an astronaut does come down with the sniffles, they can expect an Earth cold on steroids: Sinuses don't drain in zero gravity, so congested astronauts feel even stuffier than we do here on the ground. To make matters worse, germs seem to thrive in weightless environments—pathogens can develop “thicker cell walls, greater resistance to antimicrobial agents and a greater ability to form so-called biofilms that cling to surfaces” in zero gravity, according to TIME.

Luckily, colds and even the flu tend to go away on their own, even in space—so astronauts just need to wait it out.

BUMPS, BRUISES, AND OTHER MINOR INJURIES

Astronauts floating around in zero gravity have a tendency to bump into things, which can sometimes cause an injury. When they want to check on a wound, abrasion, or another condition, they place a phone call to a physician on the ground, who will advise them what to do.

“We get calls for bumps, and bruises, and little lacerations or cuts,” Shannan Moynihan, deputy chief of space and occupational medicine at the NASA Johnson Space Center, said at a health tech conference in March 2018. “A typical scenario might be a newbie, somebody who just got up there, trying to Superman through a hatch and not quite making it. So we get a call for a little bump on the forehead and we help them figure out how to take care of that.”

A doctor on Earth can walk an astronaut through how to use and read a modified ultrasound machine on the ISS, for example, or give them additional training in response to a specific medical condition occurring on board. That happened with spaceflight-associated neuro-ocular syndrome, a condition in which ISS astronauts developed visual and structural changes in their eyes during space missions. They were subsequently trained to conduct a series of eye tests on themselves.

FROM EVACUATION TO SURGERY

If there’s anything too serious to deal with on board, astronauts can get back to Earth via the the Soyuz spacecraft that brought them to space—there’s always one docked at the ISS in case of emergency. Medical evacuation has only happened once, in 1986, when a Soviet astronaut named Vladimir Vasyutin had to leave the Salyut-7 Orbital Lab [PDF] because of a prostate infection. His trip back to Earth took about six hours; these days, astronauts can land in less than three and a half.

In the case of a true medical emergency—one that requires surgery—evacuation to Earth is currently the only way for astronauts to get treatment. Surgery in zero gravity isn't yet possible; blood would float straight out of a wound and contaminate the whole cabin. As deep space travel gets more feasible, however, it’s possible that one day a space O.R. might be necessary, and technology is being developed to make potential surgeries easier and cleaner. Scientists are testing a device called the aqueous immersion surgical system (AISS), a saline filled dome that, when placed over a wound, could keep blood and bodily fluids in place.

As humanity pushes further into deep space, medical technology will need to become even more sophisticated. When it comes to deep space missions, NASA representative Stephanie Schierholz tells Mental Floss, “NASA is specifically looking at five hazards of human space travel: space radiation, isolation and confinement, distance from Earth, gravity fields (or lack thereof), and hostile/closed environments that pose the greatest risks to the human mind and body in space.”

Currently, NASA is working on several research and development projects to address the hazards posed by deep space travel, including no-drill dentistry and emergency wound closure, which would need to be usable by astronauts with no formal medical or dental training. And because not all potential illness is physical, Mars settlement simulation projects are helping researchers understand what the psychological, emotional, and social effects of long-term isolation might be on astronauts.

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