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Thread: Live from Working 2 Walk 2011!

  1. #101
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    Most of the sci world is a joke. none cares at the end, only a few.

  2. #102
    Quote Originally Posted by kz View Post
    Dear Dr. Silver ,

    Hi , a question , how do you do the graft on CONTUSION chronic sci (assuming the cord is not broken and is narrowed due to the age of injury and athrophy ,etc ) ? do you actually make a cut in the cord intentionaly and then make a graft inside or do you make the graft from the side , etc , how does it work ? (sorry if i am ignorant about this and you explained this somewhere else before) . also , for now, and for the first time clnical trial with this , do you think the clinical trial should be with chondroitinase alone (saturating the injury site with chonddroitinase ,etc) , or the combination of chondroitinase and graft , or should be both (half of the subjects get chondroitinase and the other half chondrotinase plus graft ,etc )?
    Thank you so much for working so hard in this research .
    This is really great and remarable that a well respected scientice/ researcher like you suggests that , it is time to take this research (chondroitinase plus graft ,etc) to clinical trial right now . YOU have a great weekend.


    Please see our Nature paper (July 14) for a description of the grafting procedure at acute stages. The procedure we use is a modification (with the addition of ch'ase) of that originally published by Cheng and Olson. At chronic stages, we still have a ways to go before we have all the ingredients needed for robust regeneration with good functional recovery. Basically, a very small slit is made in the dura just above the lesion and the autograft is inserted. Axons are allowed to regenerate toward the other end of the bridge which is then inserted into a small slit on the other side of the lesion. Ch'ase is added to both ends of the graft. This is the procedure we use in rodents but will need to be scaled up for use in human. (please see the description below of the work of Henrich Cheng who has done nerve grafting in humans). I'm planning on writing to him to learn if he plans to add the enzyme to his strategy. It is most likely that the first use of chondroitinase in the USA will be for people with some sparing below the level of the lesion coupled with a large amount of rehab. However, both acute and chronic injuries could be treated with just the enzyme.

    Dr. Heinrich Cheng: In 1996, Dr. Cheng and colleagues (Stockholm, Sweden) published a widely cited article on functional regeneration in rat spinal cords after peripheral nerve implantation (Science 273, 1996). Building upon this work, he has since transplanted peripheral nerve segments and injected a mixture of growth factors into the injury site of many patients with both acute and chronic SCI. There is considerable interest in SCI in Taiwan because the country’s “first lady” sustained a SCI.

    Recently, Cheng and colleagues (Tapei, Taiwan) reported a case study of a patient who sustained an injury from a stabbing four years previous to surgical intervention (Spine, 29(14), 2004). Stabbing represents a more unique transection injury compared to the contusion injury that most patients with SCI have sustained. Specifically, the lesion at the T11 level was bridged with sural nerve grafts that redirected specific pathways from white to gray matter. The grafted area was stabilized with fibrin glue containing fibroblast growth factor. Two-and-a-half years after surgery, the patient had improved from C to D on the commonly used ASIA assessment scale.

    Over the 2000–2003 period, Cheng has treated 25 cases with the approach. Of these cases, 10 were cervical injuries of which seven improved in motor score and sensory scores. He has been authorized to carry out an additional 115 patients.

  3. #103
    Wouldn't it be interesting to add chondroitinase to the following strategy (see below).

    J Neurosurg Spine 8:208–214, 2008
    208 J. Neurosurg.: Spine / Volume 8 / March 2008
    FTER traumatic cervical SCI, the immediate surrounding
    areas below the injury site are afflicted by
    an overwhelming loss of neurological function.
    Necrosis and subsequent cell death often follow from the
    primary mechanical injury. In the pathophysiology of SCI,
    however, the primary mechanical damage that occurs triggers
    a delayed secondary sequence of events, and multiple
    neurological systems of the body are subsequently harmed.
    The consequences of necrotic and apoptotic cell death triggered
    by secondary adverse reactions may include vascular
    abnormalities, ischemia–reperfusion injuries, oxidative cell
    injury, homeostatic disturbances, or profound inflammatory
    responses.1
    As a consequence of both the primary injury and the secondary
    adverse reactions, spinal cord degeneration ensues
    and leads to loss of motor function and a very poor prognosis
    for functional recovery. Various investigators, after
    achieving successful results in their respective animal studies,
    3–5 have advocated the adoption of a range of spinal cord
    repair strategies for the recovery of human motor function
    following SCI. The first of such repair strategies in humans
    was reported by Cheng and colleagues6 in 2004, in which
    sural nerve grafting was performed on a young man with
    a penetrating injury using fibrin glue with acidic FGF. To
    date, however, there has been no reported long-term study
    series that investigated spinal cord repair in humans.
    We therefore designed this prospective Phase I clinical
    study to add to the body of research on nerve repair in patients
    with SCI, using strategies that have so far been successful
    in animal models. We chose the strategy of using
    fibrin glue containing acidic FGF for nerve repair in 9
    Nerve repair using acidic fibroblast growth factor in human
    cervical spinal cord injury: a preliminary Phase I clinical
    study
    JAU-CHING WU, M.D.,1,2,5 WEN-CHENG HUANG, M.D.,1,2,5 YUN-AN TSAI, M.D.,2,3,5
    YU-CHUN CHEN, M.D., M.SC.,2,4,5 AND HENRICH CHENG, M.D., PH.D.1,2,6
    1Department of Neurosurgery and 2Neural Regeneration Laboratory, Neurological Institute, Taipei
    Veterans General Hospital; Departments of 3Physical Medicine and Rehabilitation and 4Family
    Medicine, Taipei Veterans General Hospital; and 5School of Medicine and 6Institute of Pharmacology,
    National Yang-Ming University, Taipei, Taiwan
    Object. The aim of this study was to assess functional outcomes of nerve repair using acidic fibroblast growth
    factor (FGF) in patients with cervical spinal cord injury (SCI).
    Methods. Nine patients who had cervical SCI for longer than 5 months were included in pre- and postoperative
    assessments of their neurological function. The assessments included evaluating activities of daily living, associated
    functional ability, and degree of spasticity, motor power, sensation, and pain perception. After the first set of
    assessments, the authors repaired the injured segment of the spinal cord using a total laminectomy followed by the
    application of fibrin glue containing acidic FGF. Clinical evaluations were conducted 1, 2, 3, 4, 5, and 6 months
    after the surgery. Preoperative versus postoperative differences in injury severity and grading of key muscle power
    and sensory points were calculated using the Wilcoxon signed-rank test.
    Results. The preoperative degree of injury severity, as measured using the American Spinal Injury Association
    (ASIA) scoring system, showed that preoperative motor (52.4 6 25.9 vs 68.6 6 21.5), pinprick (61.0 6 34.9 vs
    71.6 6 31.0), and light touch scores (57.3 6 33.9 vs 71.9 6 30.2) were significantly lower than the respective postoperative
    scores measured 6 months after surgery (p = 0.005, 0.012, and 0.008, respectively).
    Conclusions. Based on the significant difference in ASIA motor and sensory scale scores between the preoperative
    status and the 6-month postoperative follow-up, this novel nerve repair strategy of using acidic FGF may have
    a role in the repair of human cervical SCI. Modest nerve regeneration occurred in all 9 patients after this procedure
    without any observed adverse effects. This repair strategy thus deserves further investigation, clinical consideration,
    and refinement. (DOI: 10.3171/SPI/2008/8/3/208)

  4. #104
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    Dear professor Jerry Silver. If you have time (early November) go with dr. Wise Young to Hong Kong.

  5. #105
    Senior Member Leo's Avatar
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    Thanks U2FP,

    I miss being there and miss u all. U Rock

    Dr. Silver, thank you so much for coming to CC to visit with us.

    Hi Leif, Your right we're trying to turn 30 years of mind set one advocate at a time.

    It will take the big break through before the crowd pulls the head out of the sand.

    Having more W2W symposiums are a must, maybe some mini events around the states and up north.

    Just got to read whole thread, a great read. Hey wheres the photos
    http://justadollarplease.org/

    2010 SCINet Clinical Trial Support Squad Member

    "You kids and your cures, why back when I was injured they gave us a wheelchair and that's the way it was and we liked it!" Grumpy Old Man

    .."i used to be able to goof around so much because i knew Superman had my back. now all i've got is his example -- and that's gonna have to be enough."

  6. #106
    Dr. J. Silver and Dr. Wise Young,

    I believe one day have read here on CC. that Dr. Wise Young is a member of the board of Acorda, why not work together
    keep (rolling) Walking

    Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature

  7. #107
    From an earlier post-

    I am not part of the management team for StemCyte. I don't receive and have never received payment from Stemcyte for my advice, consultation, or services. I don't own any Stemcyte stocks and have no options or any kind of arrangement with them to receive stocks. Stemcyte is donating umbilical cord blood (UCB) units for ChinaSCINet and SCINetUSA clinical trials.

    I do give them advice but do not get paid personally for the advice. Several of our discoveries, i.e. that lithium stimulates umbilical cord blood mononuclear cells to secrete neurotrophins, are being patented. Last year, Rutgers University licensed the patents to Stemcyte and the University will receive royalty should the technology result in products and profits. In exchange, Stemcyte also funds some of our spinal cord research, has supported ChinaSCINet and several of our workshops and symposia in China, and they will be donating all the umbilical cord blood units and processing to ChinaSCINet and SCINetUSA.
    Wise
    Last edited by Jim; 10-23-2011 at 04:14 PM.

  8. #108
    Senior Member kate's Avatar
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    Quote Originally Posted by soimumireland View Post
    What can we do, write to the company.
    Hi again . . . a good first step would be to watch Tony Caggiano (from Acorda) giving his presentation at the conference. It's here:

    http://www.unite2fightparalysis.org/2011_w2w_videos

  9. #109
    Oh great - if we come back in a few years Acorda may have solved the chondoitinaise problems - well forget that one I think - no urgency there

    some of us don't have as much time as others

  10. #110
    Senior Member Leo's Avatar
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    Quote Originally Posted by jsilver View Post
    Chondroitinase could have a remarkable effect in combination with rehab and is soooo safe. I suggest unite and encourage the SCI community to barrage Acorda with a continuous stream of letters. I do know that James Fawcett with help from the International Spinal Research Trust (England) are working towards clinical trials. I myself will be pushing for trials as well.
    I could use some help on this draft.

    Dear Mr. Caggiano

    My name is from . I have been paralyzed for xx years and have recently become aware that Acorda holds the patent on a drug that has shown promise in restoring function in spinal cord injured rats.

    I heard that you attended this years working 2 Walk symposium put on by U2FP and want to thank you for doing so.

    I know that SCI seems to be seen as a small market when it comes to profit, however if
    you look at

    I am urging you to reconsider the priority treating SCI has in your companies future.

    Anthony O. Caggiano, M.D., Ph.D.
    Acorda Therapeutics, Inc.
    15 Skyline Drive
    Hawthorne, NY 10532
    http://justadollarplease.org/

    2010 SCINet Clinical Trial Support Squad Member

    "You kids and your cures, why back when I was injured they gave us a wheelchair and that's the way it was and we liked it!" Grumpy Old Man

    .."i used to be able to goof around so much because i knew Superman had my back. now all i've got is his example -- and that's gonna have to be enough."

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