Horizons for Medical
Aichi, a prefecture devoted to making things,
has a huge number of manufacturing firms and some
of the best technologies in the world. Interest
in recent years has narrowed in on the prefectures
cutting-edge technologies, of which biotechnology
is one. As Japan is a country with a rapidly graying
population, new products in the fields of medicine
and welfare have been attracting special attention.
For this Feature column, we decided to train a
spotlight on these fields to see what Aichis
manufacturers are up to in the way of innovative
and original endeavors. While listening to the
voices of company executives, let us probe into
the minds of makers who are intent on giving birth
to key technologies for the 21st century.
gears for modern medicine
gear developed by Juken Kogyo, which
weighs just one ten-thousandth of
When we walked in the door of Juken Kogyo
Co., Ltd., in Toyohashi City, right away
we were given a glass bottle with powder
inside it. These are gearwheels
we developed, President Motoo Matsuura
informed us. So we peered more closely
at the bottle, but it still looked like
it just contained some powdery substance.
This is a powder made of plastic,
he explained. The particles in it
all have a diameter of 0.147 millimeters
and weigh a millionth of a gram, and each
single particle has five teeth.
Established in 1965, Juken Kogyo is a
manufacturer of plastic precision parts
for watches, consumer electronics, and
other products. It has the best technology
of any Japanese company for making ultraminiature
plastic gears, and its latest powder
gears, as Matsuura calls them, were
unveiled in 2002 and are the smallest
made anywhere in the world.
Tiny things have always fascinated
me, Matsuura recollects. I
remember taking apart my father's pocket
watch when I was young. During the days
of the oil crises of the 1970s, we decided
to pursue miniaturization seriously. After
all, in the new age of conserving resources
and energy, parts would also need to be
While technology is clearly one of the
advantages that has made this firm strong,
foresight is arguably its greatest strength.
By the second half of the 1980s Juken
Kogyo was making watch gears with a 0.8-millimeter
diameter weighing two-thousandths of a
gram, and it moved on to tinier gears
with a 0.67-millimeter diameter weighing
one ten-thousandth of a gram. Then, in
1998, it announced that it had a system
of mass production for gears with a 0.26-millimeter
diameter weighing one one-hundred-thousandth
of a gram.
None of these advances was in response
to a clients request. Each was made
at the firms own initiative on the
assumption that some day such gears would
be needed. The successive breakthroughs
have prompted makers of consumer electronics
and automobiles to sit up and take notice,
and Juken Kogyos clients have broadened
in scope. The 0.147-millimeter powder
gear is a case in point, since there is
nothing it can be used in yet. It
is the upshot of our review at the end
of the 20th century of what technological
needs would arise over the next 10 to
20 years, Matsuura remarks.
Miniaturization is progressing rapidly
in electronic devices like cell phones,
he notes. After 2010, when optical
devices will be widespread, were
bound to enter an age of nanotechnology,
and parts with a weight of one-millionth
of a gram are sure to be needed in nanotech
medical devices built for use in capillaries.
Were still at the stage preceding
applications, but nanotechnology is moving
steadily into the realm of the possible.
Being able to quickly supply whatever
is requiredthat, Id say, is
the mission of the parts maker.
Cogwheels and medical instruments. To
the layperson, there seems little they
might have in common, but President Matsuura
is confident that a nanotech age is coming
in which microminiature gears will play
a key role in medical applications, and
his company is preparing for the arrival
of that age.
More than 30,000 lives saved
It shows a PTA balloon catheter, the third catheter developed by Tokai Medical Products following the IABP catheter and the PTCA balloon catheter. The PTCA balloon catheter is used to distend coronary arteries at constricted or blocked sites, and the PTA balloon catheter can be used in other arteries as well.
Have you ever heard of the medical instrument
known as the intra-aortic balloon pump,
commonly called the IABP catheter? Inserted
in the thoracic (chest) aorta of victims
of heart attacks or similar disorders,
it inflates and deflates a balloon in
time with the pulse to assist the heart
in circulating blood.
Tokai Medical Products, Inc., which is
based in Kasugai City, was the first company
to make IABP catheters domestically. Set
up in 1981, it developed a balloon catheter
with its original technology in 1989,
and it still has the largest market share
of all domestically made catheters.
When we embarked on the development
of an IABP catheter in 1986, President
Nobumasa Tsutsui states, Japans
medical institutions were all using imported
balloon catheters. But they werent
specifically tailored for the smaller
size of the Japanese body, and there were
also cases of ruptured balloons and complications
like kidney failure. With the cooperation
of a university hospital, Tokai Medical
Products first made a careful study of
the physique of the Japanese to clarify
the correlations with the length and thickness
of blood vessels, and it then designed
three types of balloons for different
combinations of height and weight.
In the pursuit of quality, costs were
disregarded. The doctors at the
hospital who participated in the development
work still tell me how impressed they
were by our enthusiasm, says Tsutsui.
If instead wed approached
them with a proposition to team up with
us in a moneymaking project, I doubt theyd
have tried so hard to give us help.
Earlier, at the time of the firms
foundation, it was research into artificial
hearts that distinguished the firms
R&D program. This came about because
in 1978 the doctor treating Tsutsuis
10-year-old second daughter, who had a
congenital heart defect, informed the
family that the problem was untreatable
and that their daughter probably would
not live for longer than 10 years, whether
she was operated on or not. I really
wanted to make an ideal artificial heart
for her, Tsutsui recalls. But
the costs were just too astronomical,
and the time required too long. Even so,
I still felt I had to do something, and
the IABP project was the result. We had
to start from scratch, but I was driven
by an obsession to save human lives. No
doubt the intensity of my feelings got
through to the doctors at the university
This dedication is also evident in the
composition of the products the firm manufactures.
It turns out a range of 5 sizes from very
small to very large. Some 90% of the demand
is for the medium-sized items, and sales
of the smallest and largest sizes are
very rare. A company interested in making
money would cease to manufacture these
2 sizes, but Tokai Medical Products never
fails to keep a supply of them on hand.
My belief is that in the medical
field in particular, you have to be ready
for the irregular case, Tsutsui
states. My conviction that saving
lives is the most important thing is a
gift I received from my daughter.
The daughter passed away 3 years after
the development of the IABP catheter got
started, but the balloon catheters made
by his company have now saved more than
Walking on your own power
Tims Co., Ltd., is an auto parts maker also
engaged in the planning and development
of auto accessories. Located in Fujioka,
a town to the east of Nagoya, it has specialized
since its foundation in 1959 in the manufacture
of door hinges and other functional auto
parts, and it has acquired a reputation
as a company that does everything by itself,
from material development and designing
to production and delivery.
The artificial hip
joint, made of duralumin, in the Primewalk
developed by Tims. The model shown
has a motor for auxiliary power.
Several years ago it developed a new product,
the Primewalk. Intended for use in the medical
and welfare sector, it has attracted a great
deal of interest as a revolutionary walking
aid for people who have difficulty getting
around because of an injury or illness.
Made of duralumin, it serves as a sort of
artificial hip joint that attaches to the
inner thighs, helping the wearer to assume
an upright position and walk smoothly.
A number of walking aids designed
for rehabilitation have been available for
years, but they arent always all that
easy to use, says Tims President Masaru
Tatematsu. They also arent easy
to attach and detach unaided, since they
were designed on the assumption that an
attendant would be on hand. In the development
of the Primewalk, accordingly, we set our
sights on making it light and easy for the
wearer to attach. We wanted something that
would be of everyday use.
Development was carried out in cooperation
with a university hospital, and began with
a scientific analysis of walking motion
as seen from the users perspective.
To mimic hip joint movement, the firm brought
into play the advanced technologies it uses
for making car door hinges. A trial-and-error
process ensued, but since Tims has a total
system covering material development, design,
and production, it managed to complete the
development with know-how it already had.
Medicine and welfare were unknown territories
to this maker of auto parts, but there was
a reason for its decision to venture so
far afield from its core business, where
no one doubts its abilities. 8 years
ago, Tatematsu tells us, I got
my first experience at being hospitalized
when I went in for surgery to cure back
pains, and I found out for myself how enervated
you can become when youre confined
to bed. I became desperate to get out of
bed and do whatever I could by myself, even
if I couldnt move about easily, but
there werent any support devices suited
to my needs. In that case Ill
make something, I said to myself,
and I broached this idea to my doctor.
On the front lines of clinical practice
these days, an awareness is spreading that
moving the body is extremely important for
recovery and that rehabilitation should
often start right away, even for many victims
of strokes. But when the patient is unable
to walk for some reason, even if his or
her problem is not serious, opportunities
for moving the body become very limited.
Tatematsus legs are in fine shape
today, but he still has vivid memories of
what he went through while hospitalized.
The concept he has been championing ever
since then is one of creating walking aids
suited to whatever ailments patients may
have so that they can get out of their beds
or wheelchairs and move about more freely.
This challenge in development may create
new trends in welfare equipment.
Biotech tools for regeneration
sample of cultured tissues (Photo
courtesy of Japan Tissue Engineering)
"Everything in the body is made
of cells. And everything all starts from
a single cell. This means that regenerative
medicine can be applied to every part
of the body, in theory at least. Progress
in the technology for this is bound to
become a blessing for patients."
Those were the first words out of the
mouth of President Hideo Ozawa of Japan
Tissue Engineering Co., Ltd., which is
located in Gamagori City. Established
in 1999, J-TEC immediately moved into
the vanguard of regenerative medicine,
which has as its goal the complete repair
or restoration of damaged or missing tissues
and organs. Usually when an organ, for
example, becomes injured or succumbs to
disease, medical treatment is aimed at
returning it to health. Regenerative medicine,
by contrast, seeks to replace the organ
with a new one grown in a laboratory.
If this can be realized, it will offer
a truly radical cure.
Regenerative medicine has been a
dream of humankind since the distant past,
Ozawa states. "Tissue engineering
holds the promise of making that dream
come true. The objective of tissue engineering
is to combine cells, growth factors, and
other biological materials in order to
create and supply tissues and organs,
or substitutes for them, that have functions
equal to the body parts they are replacing.
Regenerative medicine should also be able
to solve many of the existing problems
in organ transplantation."
Organ transplants are being performed
in Japan, but one of the problems plaguing
them is that the body of the recipient
often tries to reject the donors
organ in a reaction known as immunorejection.
Suppressing this reaction continues to
be difficult. When the transplanted material
comes from the patient himself or herself,
moreover, there is a limit to what is
available for transplant. As Ozawa observes,
regenerative medicine has the potential
to eliminate these obstacles.
J-TEC has achieved some success with cultured
skin and cartilage, reaching the stage
where they can be transplanted. With this
as a foundation, research will proceed
on to muscles, nerves, and the cornea,
eventually arriving at whole organs like
the liver and kidneys. The development
of tissue with antibacterial properties
through the introduction of genes using
transgenic methods is also
on the schedule.
Ozawa continues, Regenerative medicine
in Japan has reached the point where it
is just one step away from becoming an
industry. The question is how that step
is to be taken. Japans technologies
may be the equal of Western ones, but
our country is lagging behind in the commercialization
of technologies. Unlike in the research
stage, product control techniques become
crucial in the industrial stage. And Aichi,
a manufacturing prefecture, has superlative
product control know-how as well as the
spirit to sustain excellence in quality.
Admittedly a move into a new field entails
risks, but we simply must come up with
the courage to accept the challenge. My
aspiration is to develop regenerative
medicine into a new industry in Aichi.
(Masahiro Ota; photos by Tadashi Aizawa)