- Coming up on Sci NC, an instrument big enough to walk inside, a grass built for a hotter world, and a prostate treatment that starts at the wrist.

Next.

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- Sci NC is supported by a generous bequest gift from Dan Carrigan and the Gaia Earth Balance Endowment through the Gaston Community Foundation.

[gentle music] ♪ - Hi and welcome to Sci NC.

I'm Laura Smith.

It can fill an entire cathedral with sound and it's big enough to walk inside.

But a pipe organ isn't just a musical instrument.

It's engineering disguised as music.

Those soaring sounds come from thousands of pipes, valves, and carefully controlled pressure, a system perfected over 2,000 years.

Sci NC's Evan Howell takes us inside one of the biggest at Duke Chapel.

[pipe organ music] - [Evan] It's the main organ at Duke Chapel.

It's a machine born out of 2,000 years of engineering updates.

- My favorite organ music is the right organist playing the right piece on the right organ.

♪ - [Evan] It's a system of pressure, valves, and vibration.

It's engineering disguised as music.

[footsteps] - My grandfather was a machinist.

My father was an engineer.

My brother's an engineer.

So just the physical action of it.

- [Evan] There are instruments you play and instruments you step inside.

This one comes with a building.

This is what's called a Dutch tracker organ.

Built by Dirk Flentrop.

And even the divisions keep their Dutch names.

There's a lot of stuff going on.

What are we looking at, I guess, is the question.

- There are four keyboards or manuals and a pedal board.

And the organ is distributed all throughout this case.

The top manual is called the echo.

It's right above us behind doors.

It's rather quiet.

Then we have the bovenwerk.

That's this manual.

And that's way at the very top of the organ.

Then we have the hoofdwerk, which is the main manual with the loudest sounds.

That's right above us above these trumpets here.

Then we have the pedal below us, played with the feet, of course.

And then we have the rugwerk, which is this section of the organ behind us.

- [Evan] Four manuals, one pedal board, pipes distributed from floor to ceiling.

Each division positioned to shape how the sound fills the room.

You've all heard the phrase pulling out all the stops.

Well, here, this isn't a metaphor.

- Well, if you see, there are all these different stop knobs, and each one controls a set of pipes.

And there are different sounds.

For example, there's a typical organ sound.

It's called a principal or diapason, and those are the pipes you see in the facade of the organ.

There are also flutes.

And there are also reed pipes.

Here's a trumpet.

There are different trumpets at different pitch levels.

- [Evan] From here, he'll take us behind him into the rugwerk, the back division, part of the around 5,000 pipes in this organ.

- If you look, you see they're organized from left to right in different ranks or sets of pipes.

Some pipes are open.

Some have caps on them.

Let's take a look at this pipe.

This is a trumpet pipe.

You can see it flares like a trumpet.

And this is the tuning wire.

It changes the vibrating length of the reed tongue, and that's what changes the pitch.

We're looking at the action for the echo division.

And as you can see, when I push down a key, there's a tracker, a thin slip of wood that attaches to a roller arm.

And the roller arm transfers the action over to here.

- [Evan] The ancestor of this machine was called the hydraulus.

It appeared in Hellenistic Greece about the third century B.C.

- And it used water to create pressure to play the pipes.

You'd have one person pumping and one person playing.

♪ You'd have one person pumping and one person playing.

♪ - [Evan] This machine breathes.

It expands and contracts with the temperature and humidity.

And the shift in the weather can nudge it out of alignment.

- The biggest concern for me is if there's a cipher, which is a note that plays when you don't want it.

So we've had very, very cold, dry weather, and that can affect the organ no matter what kind.

So sometimes you'll have a note that will play, and you just might hear a little tiny -- something like that.

- [Evan] Duke is cathedral-sized, but most organs live somewhere smaller.

- We have a great instrument here at Pilgrim.

This is a 1967, I believe, Aeolian Skinner.

About 800 pipes, two manuals, two keyboards to play on, and of course, your pedal board down here.

♪ of course, your pedal board down here.

♪ - [Evan] Fewer pipes, smaller case, same fundamental system, wind, valves, vibration, same need for precision.

- And so sometimes you want to make sure that nothing has fallen out of tune through the week.

I noticed on Sunday that I think there was a note -- ♪ I noticed on Sunday that I think there was a note -- ♪ that if you can hear, is definitely out of tune.

It doesn't sound right.

- It sounds a bit sharp.

- That's right.

That's right.

It's one of those flute stops there.

And so there are different ways that you can work around that.

You may not use that stop.

You may put it in a different octave so that you can avoid the bad note.

- [Evan] Sometimes you adapt.

Shift an octave, change a stop, crawl inside the chamber, and tune the pipe by hand.

- And the first time that I heard a pipe organ might have been at a wedding or something.

And I remember the way that it filled the space.

And even underneath, through the floor, I could feel the vibration in my feet.

It was really neat.

- [Evan] That's the part no blueprint captures, the vibration under your feet, the air pressing against your chest.

It's been around for a long time.

I remember you saying something about it's not just what the organ is playing.

It's also how the parishioners are hearing the music.

What's that all about?

- Well, they say the best stop on the organ is actually the acoustics of the room.

- [Evan] When Duke Chapel was first built, the Dutch builder Flentrop didn't like what he heard.

- He did not like the acoustics.

The chapel was built with Guastavino tile.

If you look at the walls, you can see up to about six, seven feet, there is a darker stone.

And then above that is this tile that when fired ends up with lots of holes.

And these holes help absorb sound.

Duke found some product to put on the walls to seal the holes.

- [Evan] The room stopped absorbing the sound and started carrying it.

- He came back again and he clapped his hands or however he tested the acoustics.

He liked what he heard and he said he would build an organ for the chapel.

- [Evan] Around 5,000 pipes, miles of wooden wire, air under pressure.

It's a 2,000 year old system still powered by wind.

♪ - Each organist can make it sound like a completely different instrument depending on how they use the sounds.

Like if they were a chef, it would be spices and ingredients.

If they were a painter, it would be colors on a canvas.

♪ If they were a painter, it would be colors on a canvas.

♪ - Can you imagine learning to play the organ?

Does not look easy, that's for sure.

Hey, most of us don't give the grass beneath our feet a second thought, but at NC State, scientists have studied it for decades.

Now they're growing grass tough enough to stand up to a warming climate and taking a closer look at how artificial turf might be heating things up.

Take a look.

- [Laura] Look around long enough in North Carolina and you'll see it more and more.

Grass that isn't really grass.

- So synthetic turf grass is just exactly what it sounds like.

It's a man-made material and it's made to somewhat look like and perform like a natural grass, although it is synthetic.

- [Laura] At NC State, Dr.

Grady Miller has watched it evolve for more than 30 years.

It's basically made the same as your carpet in your home.

I mean, it's a lot of it's produced in the same manufacturers that make carpet.

- [Laura] Synthetic turf was born in the 1960s, invented by a team led by David Chaney, who later served as Dean of the Textile College at NC State.

It really took off when the Houston Astros couldn't get natural grass to grow inside their domed stadium.

- When the grass didn't quite make it very well, they went looking for a substitute and they literally put zippers on it and zipped it right over the ground for the Astros and played baseball on it.

- [Laura] Six decades later, synthetic turf is everywhere.

The Carolina Panthers play on it.

Schools are installing it.

You'll even find it in shared spaces around our cities.

The pitch, no mowing, no watering, always green.

- How widespread these will be using the landscapes, I think because of the heat load, there's still going to be a lot of pushback against them.

- [Laura] But Miller says the science tells a more complicated story.

- A number of different concerns there with the climate.

One is natural grass transpires water, so it has a cooling effect.

Synthetic doesn't transpire, so it's mainly a heat sink.

So it actually will build up heat with solar radiation.

- [Laura] Dr.

Miller says studies have shown synthetic turf reaching 150 degrees on a hot summer day.

- It's hot enough to potentially burn feet, even through thin-soled shoes.

So it can get at a dangerous level on really hot days.

- [Laura] And then there's what's underneath the surface, tiny black pellets called crumb rubber that give synthetic turf its bounce and cushion.

- There is this notion that between the heat and the potential contaminants from the crumb rubber, there's environmental concerns and even health concerns.

And that's still an ongoing study area for scientists.

- [Laura] Miller says the heat and the rubber are why he doesn't see synthetic replacing natural lawns anytime soon.

- Natural grass surfaces are still going to be paramount to change that heat load on our home and the environment.

And that's one reason why we continue to lead efforts in producing more drought-tolerant turf grasses that need less water and less inputs.

- [Laura] That work, breeding a better, tougher, less thirsty natural grass is happening at the Lake Wheeler Field Lab led by Susana Milla-Lewis.

- I'm a turf grass breeder.

What that means is that I work in developing new cultivars of turf grasses.

So I develop better, you know, specific plant materials that are going to do better under different environmental conditions.

So green are the ones that flowered three weeks ago, blue is two weeks ago, and purple is this week.

I develop new babies and then I test those little babies for a very long time to kind of find the best ones that can go commercial.

- [Laura] North Carolina, she says, is the perfect place to do this work.

- To a breeder, it's kind of like a dream area to work with because I can work with all these different species and I never get bored because there's always a stress that you're working to develop better grasses for.

- [Laura] When Milla-Lewis started this program in 2009, climate change reshaped her plans almost immediately.

Fescue was kind of like the most widely grown species in this area.

And I remember a few months into my job, somebody came to give a seminar and showed this graph that had the difference on number of days above 90 degrees currently versus predicted.

And you can see a huge difference in that.

- [Laura] Her response?

Shift the program toward warm season grasses that could handle what was coming.

- If you drove around Wake County back then, most of the new construction, most of the new subdivisions would be on fescue.

And now if you drive around, a lot of that is either Bermuda grass or Zoysia grass.

So the market has changed a lot and it's because we're trying to, you know, have these grasses survive better, right?

And use less water.

- [Laura] The science behind a single new grass is staggering.

- We do make crosses artificially.

We have plants growing in the greenhouse, right?

And we will artificially put pollen from one flower into the stigmas of another flower.

And then we see the seed develop through different weeks.

We actually harvest that seed.

We clean it, we germinate it, and we see a new baby plant come up.

- [Laura] From the greenhouse, the baby plants move outside to the nursery.

- We take a look at how aggressive that grass is.

The more aggressive, the faster it's going to be to produce, which is better for farmers.

And we kind of take just like a quick look at how the turf quality is.

- [Laura] In North Carolina, there are three test sites.

- You know, here we look at quality.

We get some disease pressure.

At Sandhills, we're looking at drought tolerance.

We also get very good insect pressure.

And then at the mountains, we're looking at diseases and cold tolerance.

How well do they survive the winter?

How do they come out in the spring?

All together, you might be looking at 15 different traits, and they need to do well for all of them.

- [Laura] Out of thousands of plants, sometimes one survives.

For Milla-Lewis, that one is called Lobo.

- So we develop a new Zoysia grass that was released about three years ago.

Lobo actually was under evaluation for about 11 years, so it went through the whole process, right?

From nurseries, you pick the best lines that did well for all traits, all locations, and those get what we call in breeding, advanced.

I grew this.

Yeah, this is my baby.

This is my baby boy, as I like to call it.

So we have a North Carolina born and bred grass that, you know, is taking a tour of the world and is growing in Australia and Italy and Brazil and, you know, counting.

- [Laura] And it's already growing in yards just minutes from the lab.

David Fuller is a Raleigh homeowner.

Last year, he tore out his old fescue and installed Lobo in his shaded front yard.

- This doesn't take a lot of water versus the grasses we've had before, such as fescue.

So we've already had a huge reduction in water usage with these turfs.

- [Laura] Back at the lab, Milla-Lewis says the work is just getting started.

Climate change isn't slowing down, and neither is her pipeline of new grasses.

- You need to have the best genetics for drought and cold and appearance and aggressiveness.

And if you get that perfect combination in a grass, that's going to be a winner.

- [Laura] As North Carolina gets hotter and drier, the choice is no longer just grass or no grass.

It's plastic or a real living North Carolina born plant bred for the climate that's coming.

- The goal is always how do we develop grasses that are more environmentally friendly, that use as little as possible while still giving you like a minimum standard to consumers.

- Prostate health isn't always an easy topic, but this one's worth talking about.

A new procedure can treat an enlarged prostate without the discomfort men dread.

Reaching it through a simple prick in the wrist, then traveling the arteries like a highway all the way to the prostate.

Take a look.

- I'd rather be able to torque the catheter almost as almost as close to the prostate origin as possible.

- [Laura] What you're looking at is a catheter one millimeter wide, five feet long, threading through a human artery in real time.

- And inside that catheter, we can actually inject materials.

We can even put a wire to navigate the catheter further.

- [Laura] It doesn't require surgery or general anesthesia.

As for the entry point, it's a pinhole in the wrist, then off to target the prostate.

- This is a widespread issue for a lot of men.

And I tell people all the time, 50% of men over the age of 50 have BPH.

Many uncles, dads, grandpas, you name it, they'll have it probably.

At a certain point, it can cause problems like urinary obstruction and overnight, you know, wakings to try to go to the bathroom often.

And it really disrupts people's lifestyle.

- [Laura] That's Dr.

Jeremy Kim, an interventional radiologist in Charlotte, North Carolina, one of a small but growing number of physicians performing a procedure called prostate artery embolization.

- Using an embolization guidance or something along those lines.

Prostatic artery embolization, PAE for short, is a procedure that we do for patients with enlarged prostate glands.

Once we get into the prostate artery that supplies that prostate gland, our objective is to try to shut those vessels down.

- [Laura] The minimally invasive technique is quietly transforming how enlarged prostates are treated.

- There are several operators that are doing it.

I would say that I'm probably the only one using a glue to do the embolization, which is a little bit unique.

- [Laura] The prostate gland is part of the male reproductive system.

As men age, testosterone continues to feed the gland and it slowly enlarges.

- Most of the time, it's more of a genetic thing that causes these things to happen.

- [Laura] Kim says a normal prostate is roughly the size of a walnut.

In severe cases, it can grow to the size of a grapefruit, compressing the urethra.

Medications can help, but can carry side effects.

- And over time, they do lose their effect.

And so then as these things progress, people start to look for alternative options.

[ambulance siren] - [Laura] Traditional surgical options are more invasive, requiring anesthesia and recovery time.

PAE offers a different path.

So there's no risk there going through those major arteries?

- No, no.

I mean, there's always going to be an inherent risk to a procedure, obviously.

But generally speaking, this is a very safe procedure.

There's no risk of injuring those arteries.

- [Laura] Instead of cutting, doctors use the body's own arterial system as a roadmap.

- It's a little catheter.

It's like the size of a spaghetti noodle.

So it's kind of sci-fi-ish in a way.

This will go in through an artery in your radial artery here, and this will kind of go in and feed its way up the body, up the arm and down your chest and down to your pelvis.

- [Laura] Once Kim reaches the prostate artery, tiny particles are injected to block blood flow.

Embolization continues until the tumoral flow capacity is reached.

Starved of oxygen, the prostate slowly shrinks, releasing pressure on the urethra.

- And that's it.

And then that's all you have.

And then once we're done, we put a little band-aid there.

And most patients don't even see a scar after the procedure once everything's healed up.

- [Laura] The procedure takes about 90 minutes, with patients going home the same day.

- Usually the recovery time is another one to two hours after.

During that time, the patients usually have a snack, go to the bathroom, and then they go home.

- [Laura] The device Dr.

Kim uses has a name.

- Sniper is a balloon microcatheter that... - [Laura] The Sniper.

- Which results in complete embolization.

- What's great about it is that it has a special balloon at the tip of the catheter that allows us to navigate into the artery and protect other arteries.

- [Laura] That balloon on the device is key.

It took Michael Allen, a medical device entrepreneur and his team, four years to develop, engineering that demanded precision on a scale that didn't previously exist.

- We had to develop methods to bond things to other materials that you couldn't bond.

There are parts that are the size of an earring on a dime.

It's manufactured under a microscope.

When you inflate a balloon in an artery, you create a blockage.

And that blockage creates a low-pressure zone in front of the balloon.

And that low-pressure zone directs all of the flow away from healthy tissue and then into the tumor or the prostate.

And so it's a much safer procedure because then you don't end up treating healthy tissue.

- [Laura] Allen first tested the device in a prostate embolization case roughly a decade ago at UNC Chapel Hill.

The call that set it in motion.

- We ended up using it in a number of procedures in that month.

So it was the first time it was used.

Immediately when it was used, there was clearly a benefit.

- This is an example of an x-ray of the chest where we can actually see this thin catheter that's tracking from the arm all the way into the large blood vessel in the chest called the aorta.

- [Laura] At Mount Sinai in New York, Dr.

Aaron Fischman has become one of the world's foremost authorities on the procedure, training physicians across the globe and pioneering techniques that have made it faster and safer.

- This is a nice demonstration of all the things that you can do.

Again, it's about the tools in your toolbox.

- [Laura] Lowering radiation and procedure time.

- What excites me the most is really how minimally invasive this is.

One of the best things about interventional radiology in general is that we can do very big things through very small, small holes.

- [Laura] Fischman helped move the procedure's access point from the groin to the wrist.

Now he's pushing the embolization material itself.

- One of the better ways we found to do this is to use essentially a type of medical grade crazy glue, which sounds crazy in a way, right?

Essentially it allows the procedure to be a little bit quicker.

In some ways it's actually much safer to use this material as compared to the older material that we used to use.

And then lastly, we think it actually can last longer.

- [Laura] Dr.

Kim trained under Dr.

Fischman and brought the glue-based approach to Charlotte.

- From personal experience, I find that patients tend to do better and there's lower chances of some of those symptoms recurring when we use the glue versus the particles.

- When he was training, I was thinking to myself, you know, at some point I'm going to need this procedure.

Who am I going to have do it?

And Jeremy's going to do mine.

- [Laura] The procedure is performing well.

- Success rates are around 90%.

- [Laura] As for symptom relief, it's gradual.

- The prostate slowly shrinks over the course of three to six months.

I tell most people that you won't notice a symptom improvement until at least three to four weeks after the procedure.

- [Laura] Kim does all kinds of procedures.

He says this one is the most satisfying.

- Patients come in and they look like completely different people because not only are they able to not just pee normally, but they're able to be more active.

They're able to be more social with their friends and family.

They're able to sleep better at night.

So just all-encompassing is an overall lifestyle improvement.

So I think that's why when I see these patients come in afterwards, it's such a satisfying thing to see that.

- And you would think you'd be able to feel that going through your arteries, but they say, no, you don't feel it at all.

So something cool there.

Hey, we hope you like all these stories.

That is it for Sci NC this week.

If you want more Sci NC, go ahead and check us out online, pbsnc.org.

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We'd love for you to follow us, subscribe and comment.

Let us know what you like.

I'm Laura Smith.

Thank you so much for watching.

We'll see you next time.

[gentle music] ♪ ♪ ♪ ♪ ♪ ♪ ♪ - Sci NC is supported by a generous bequest gift from Dan Carrigan and the Gaia Earth Balance Endowment through the Gaston Community Foundation.

- Quality public television is made possible through the financial contributions of viewers like you who invite you to join them in supporting PBS NC.