Jozef Cywinski (; born 13 March 1936) is a Polish-American scientist, a specialist in the field of biomedical engineering and specifically in electrical stimulation of living organisms. His work has been the subject of 12 patents, two books and over 100 scientific publications. He developed several first-on-the-market electro-medical devices like cardiac stimulators pacemakers, train-of-four nerve stimulators, PACS, EMS, TENS and Veinoplus calf pump stimulators.
Biography
Early life and education Jozef Cywinski was born in pre-war Warsaw, Poland in 1936. During World War II his family was heavily involved with the underground fighting against the Nazis. Because his family is part of a noble Polish family (using the Puchala coat of arms), the Cywinski family lost their residence and resources in Warsaw and moved to the small city of Bielsko in a mountainous region in the south of Poland. Circumstances like these were common with disastrous effects on millions of Poles. Cywinski, like many others did not receive the typical education most students would receive in school during peaceful times. In 1945, several displaced professors from Lviv and Vilnius Universities settled in Bielsko too, creating an accelerated and highly sophisticated climate in which to learn. They taught Cywinski physics, chemistry and math personally, while he attended the Liceum im. Kopernika. There, he was awarded a Leader in Science and Social Work certificate. Graduating from high school, he won the concourse for admission to the Telecommunications Program at the Warsaw Polytech [Politechnika Warszawska]. At the age of 16 he was one of the youngest students ever admitted there.
Graduate work, 1955–1960 Three years later, in 1955, Cywinski enrolled in a newly created graduate program in Medical Electronics, which was a joint venture between the University of Warsaw Medical School (Akademia Medyczna) and the Warsaw Poytech. Here, Cywinski constructed his first invention: a linear-motor automatic scanner for chromatography of blood samples. The analyzer was the first of its kind and type developed at these times in Poland.
This instrument was also essential for the graduate diploma work and discovery of light and heavy fractions of myosine (muscle cell proteins) of Cywinski's wife, Hanna Zawistowska, a biochemist herself. Cywinski worked as a full-time engineer in the Laboratory of Applied Physics at the Warsaw Pol where he constructed vacuum-tube electrometers. It was thanks to the use of Cywinski's electrometers that the first European semiconductor-charge copying machine was developed. Later, in 1959 he worked at the Laboratory of Computer Science of the Warsaw University of Technology where he built vacuum-tube registers for the first Polish-made computer.
In 1960, Cywinski received a Master of Science degree in Medical Engineering.
Postgraduate work, 1960–1967 For Cywinski's doctorate degree, which began in 1962, he continued the joint endeavor with the Medical University of Warsaw and the Warsaw University of Technology. During this time he became the director of the Electronics Laboratory at the Institute of Cardiology, at the Medical University of Warsaw. He wrote papers on the electro-stimulation of heart and a doctorate thesis on automatic analysis radio chromatograms of blood.
At the Cardiology Institute, Cywinski created the world's first P-wave controlled external cardiac pacemakerCywinski J.K. and Stopczyk M. An external stimulator of the heart controlled by endogenic pacemaker impulses. Digest of the 5th Internatl. Conf. Med. Electron. Biol. Engn. p.91, Tokyo, Japan 8/1965,2 and a new technique for ECG recording.Cywinski J.K., Wajszczuk W.J. The DC and Infra-Low Frequency Components of the Electrocardiograms. p135-138 in Neue Ergeubnisse der Electrocardiologie (in German) ed Schubert E., VEB Gustav Fischer Verlag, Jena Germany 1966 The animal research on this pacemaker was completed in 1964 and Cywinski submitted the project to be presented at the World Congress of Bioengineering in Tokyo, Japan. He was invited to present his paper on P-wave pacemakers in September, 1965 at the plenary session of the Congress. Cywinski was extended an invitation to join the artificial heart program under Professor Leslie Peterson M.D. at the University of Pennsylvania pending the completion of his doctorate studies in Poland.
In 1967, he demonstrated his own construction of a working prototype of a Digital Radiochromatograph. A first of its kind, it computed in binary code fractional ratios of blood proteins. He publicly defended his thesis in front of the joint faculty of the Medical University of Warsaw and the Warsaw University of Technology and received a Doctor in Science (Bioengineering) degree (Ph.D./D.Sc.) from the latter.
Professional career
Poland, 1960–1967 While studying at Warsaw University of Technology, Cywinski co-founded and was partner and R&D Director of the industrial laboratory Ridan Instruments Ltd., where he developed, patented and manufactured Poland's first muscle electro-stimulators (Diadynamic), blood-gas analysers, potentiometric pHmeters and charge-electrometers for diagnostic purposes.
France, 1967 Cywinski spent six months in Paris, France waiting for immigration papers to the United States. During this time, Cywinski completed two projects. Firstly, with Professor Renaud Koechlin, at Hopital Foch in Suresnes, Paris, he developed the first satellite transmission interface device for tele-diagnosis of vectorcardiograms. Telediagnosis was made between the University of Tours, France and Washington University in St. Louis, Missouri, in the United States via satellite and on-line communication with computer systems. He was asked to demonstrate his work to General Charles de Gaulle and members of the French government. He was then asked to join the Electronique Appliquée Laboratoire (ELA) in Montrouge, France. There he developed the first European prototype of an implantable on-demand cardiac pacemaker. The prototype was implanted in Paris in October 1967 for the first time by dr. Mugica at Pitié-Salpêtrière Hospital, during a midnight emergency intervention. Despite the lack of animal trials, the pacemaker saved the patient's life and allowed him to live for several more years. Today, Cywinski-type on-demand pacers are still manufactured by the ELA-SORIN factory and widely used throughout the world.
United States, 1967–1993 In 1967, Cywinski began work on the NIH-sponsored Artificial Heart Project. After only two years and with a team of two surgeons Waldemar J. Wajszczuk M.D. and Ahmed Kutty, M.D., Cywinski developed and published an analog computer model of the physiologic rate and contractility controls for artificial hearts.Cywinski J.K., Wajszczuk W.J., & Kutty A.C.K. Autonomic Nervous Control of the Intrinsic Cardiac Pacemaker and its Analog Simulator. p.32-45 in The Nervous system and Electric Currents. Vol.2 Wulfsohn N.L. & Sanchez Jr. Plenum Publ. Corp. New York, 1971 However, NIH sponsored work did not continue past this point and artificial heart research shifted to private industry.
In 1970, Cywinski accepted a teaching offer as an associate professor of radiology and an associate professor of electrical engineering from the University of Missouri Medical School in Columbia Missouri. He developed and taught a course regarding electro-medical devices for diagnosis and therapy. Additionally, he collaborated with Allan Hahn in the animal laboratory facility developing implantable fuel cells.
A year later, he was invited to join the faculty of Harvard Medical School as a principal associate in anesthesia and bioengineering. Simultaneously, he was invited to join the faculty of a newly created program combining the medical curriculum of Harvard Medical School with the graduate program of electrical engineering at the Massachusetts Institute of Technology (MIT). He developed a new graduate-level course (HST-510) in medical engineering. For students, this was a five-year program that included medical school, medical engineering lectures and laboratory work. This program was carried out at Massachusetts General Hospital (MGH) in Boston. There, in 1974, Cywinski created the first Department of Medical Engineering in the U.S. as well as taking on the position of director. His activities included planning, development, purchase and service of patient monitoring systems in this 2000-bed hospital.Irnich W, Cywinski J K and De Salvo P. Clinical Engineering at Massachusetts General Hospital in Boston (in German) in Biomedizinische Technik, Band 22 s. 207-211, Heft 12/1977
In his MGH lab he developed electrical devices and methods for train-of-four stimulation of depth of anaesthesia monitoring,Cywinski J. K., and Tardieu B. (illustrator) Book. Essentials in Pressure Monitoring: Blood and Other Body Fluids. B. Tardieu series 144 pages; publ. by Martinis Nijhoff Co, The Hague 1980. Cywinski J.K., Mniece J.R., Ledee G.J. Ruskin J. A Technique for Non-Invasive His-Purkinye System Recording. p.49-54 a chapter in Thalen H.J.Th.& Harthhorne J.W, eds. In To Pace or Not to Pace book publ. by Martinus Nijhoff, The Hague, Boston, London 1978 as well the stimulators for pain research and for bone fracture healing.Moyen J-L, Lans D A, Thrasher E L, Cywinski J K. Brighton CT, and Harris W.H. Electro-stimulation of osteogenesis : Studies of Cathode. Trans. Ortoped. Res. Soc., p.203 New Orleans LU, 1976
Concurrently, Cywinski's personal research revolved around applications and safety of electrical stimulation.Cywinski J. Electrical Hazards in the Care of Patients with Cardiac disease. Johnson R.A. Haber E., Austen W.G, Eds. Practice of Cardiology Chapter nr.10; p.272-278; Little, Brown & Co., Boston, MA: 1980; His animal research together with Cardiologist and Professor Paul Zoll at Beth Israel Hospital in Boston has become the basis for the globally accepted Standard for Transcutaneous Electo-Stimulation undersigned by the US National Bureau of Standards (ANBS), AAMI and recognized by the Food and Drug Administration (FDA) of the United States.AAMI / ANSI Standard. Transcutaneous Electrical Nerve Stimulators. Cywinski J and Zoll P. in Chapter B3.2.2.2. : Safety Consideration; Association for the Advancement of Medical Instrumentation AAMI NS4 1986/ (R) 2002.
Cywinski invented and produced devices such as the "train-of-four" method for patient monitoring of depth of muscle relaxation during anesthesia as well as implantable stimulators for brain research and bone fracture healing.
While at MGH/MIT, Cywinski developed bio-galvanic implantable cardiac stimulators.Cywinski J. K., Hahn.A.W., Cooper. Biogalvanic Power Sources. p.216-220 Cardiac Pacing by Thalen H.J.Th., ed. Van Gorcum. Holland 1973; Cywinski J., Hahn A., Nichols M., Easley J. R. Performance of Implanted Biogalvanic Pacemakers. Pacing and Clinical Electrophysiology. Vol 1, Issue 1, p.117–125, January 1978 . In 3- to 5-year tests performed by Professor Allan Hahn and his team at the Animal Research Center of the University of Missouri, the bio-galvanic pacemakers implanted in dogs functioned well with a projected lifespan of over 50 years. This was in the early 1970s when the industry-wide standard was to use mercury batteries in implantable cardiac pacemakers, which lasted only two years. At the same time, the leading manufacturer of pacemakers heavily invested in the development of nuclear batteries with similar projected life spans of 50–80 years. They were quickly abandoned due to nuclear waste handling problems. Cywinski's bio-galvanic pacemakers were not adopted by the industry, either. In the end, all implantable power sources were narrowed down to lithium cells which then became the industry standard.
In 1978, for his pioneering work in the field of cardiac pacing and bio-galvanic batteries, Cywinski was nominated as Fellow of the American College of Cardiology.