ChinaSCINet Update

[fti]

Originally Posted by Wise Young

Kyle,

In human, the phrenic nucleus is located at C3, C4, and C5. In rat and most subprimate species, it is located at C4 and C5. It is very plastic. Just the part of the nucleus at C3 is able to do much of the breathing. For that reason, most people who have had C4/5 injuries often are able to wean off the ventilator.

In our clinical trials, because we are injecting the cells into the spinal cord above and below the injury site, we did not want to inject cells into the phrenic nucleus and potentially damage it. That is why we have limited the cases to C5 neurological level (the subjects should have good biceps).

Let me illustrate. A person has an injury to the C5 spinal cord, that person may have a C4 neurological level (i.e. the lowest "intact" level). In such a case, we would be injecting into C3 or into the margin between C3 and C4 for the transplant above the injury site.

We didn't want to take the risk of damaging the remaining phrenic nucleus. If our trials show that the cell transplants are safe and beneficial, we plan to propose a clinical trial for C4 tetraplegics or higher by injecting into the injury site and below the injury site but not above the injury site.

Wise.

KOFQ I'm not c4 my ASIA-tests but deltoids and biceps works normally and all the muscle of C5 sensitivity including. my right wrist
extension is to 2/5 my sensitivity on my arms is diffuse sensitivity.
sensitivity my thumb and my index finger right.
no motor function and sensitivity below C6 including anal

[Jim]

fti, what do you not understand? Dr Leung will not inject above your lesion which is at C4. You do not fit the inclusion criteria to be in the clinical trial.


"I meant the upper limit of your lesion on MRI is at C4. The level of injection would be higher than I am comfortable with. I am very sorry." GL.

[fti]

JIM

I wanted to know how he sees that my upper lesion on MRI and c4
and that Professor Young said keel and not possible to say exactly where and the lesion on MRI without doing the test neurological

[keeping on]

fti, I'm in the same boat on the trials taking place now. My condition doesn't fit the criteria for the c urrent trials. I've been told, the trial therapies might lend progress to my condition. All three trials indicated that. what I'm hoping that wise's trials and stem Cell inc trials will show some efficay and then the trials might expand for more of us. we need efficay to show from these trials, although safety in the first premise of th etrials. good luck and keep posting

Anthony

[Wise Young]

Originally Posted by fti

Professor young I Am very sorry I me repete because I am really frustrated I just want an explanation for this............

you had said me this

MRI's are not appropriate for determining location or extremity of a spinal cord lesion. Particularly in chronically injured spinal cords, there is often increased signal intensity in the spinal cord long distances from the original injury site. You often cannot tell the original site of the injury from an MRI. Nor can you tell the severity of the injury from MRI scans. That is why I am telling you that spinal cord injury level cannot be assessed from MRI For the clinical trial, we determine injury level from the neurological findings, not the MRI.

I understood well your message do not can determine the neurological level or the extremity of a injury with one MRI it forgery to make tests ASIA and in your clinical trials you determined level of wounds with test ASIA not with one MRI for the recruitment. Then how makes doctor Leung to say that the extremity of my injury and c4 without the test ASIA??

fti,

I agree that your neurological level must be determine by a careful neurological examination. In order for you to have a C5 level, you must have an motor score of your biceps (C5) at least 3 on both left and right sides, as well as normal pinprick and touch sensation in the C5 dermatome.

The surgeon has to make the decision of where the cells should be injected. From what you have posted, it seems that Dr. Leung is uncomfortable with the level of your lesion as he sees it on MRI. The neurosurgeon has to decide where the laminectomy should be done. It appears that he believes that lesion may involve C4 to some extent and he does not want to inject there.

In any case, this is his decision.

Wise.

[Barrington314mx]

Dr. Young, for your trials, is there a cut off for how long one has been injured? i know it just says greater than 12 months post injury.

[Wise Young]

Originally Posted by Barrington314mx

Dr. Young, for your trials, is there a cut off for how long one has been injured? i know it just says greater than 12 months post injury.

There is an upper age limit of 60 for our current trial. We are likely to move that to 64 in the coming trial. Wise.

[comad]

Dr. Wise,
Thanks for vivid journey explanation that should blow good wind into my sails and help me doing even more mentally focused exercises .... just about to avoid SCIlla & Haribda

[fti]

Originally Posted by Wise Young

fti,

I agree that your neurological level must be determine by a careful neurological examination. In order for you to have a C5 level, you must have an motor score of your biceps (C5) at least 3 on both left and right sides, as well as normal pinprick and touch sensation in the C5 dermatome.

The surgeon has to make the decision of where the cells should be injected. From what you have posted, it seems that Dr. Leung is uncomfortable with the level of your lesion as he sees it on MRI. The neurosurgeon has to decide where the laminectomy should be done. It appears that he believes that lesion may involve C4 to some extent and he does not want to inject there.

In any case, this is his decision.

Wise.

thank you for the answer professor young

I did with my neurologist tested the ASIA I know I'm c5c6 ASIA A
I hope that the United States clinical trials will be first tested ASIA before to watch MRI.as you had said you can not determine the exact levels of a chronic injury prior to the testes ASIA no on IRM.
Yet in this criteria indicated
(The neurological level of the subjects is between C5 and T10) LINK http://clinicaltrials.gov/ct2/show/NCT01046786

[keeping on]

fti, there was a tv segment on medical costs between US, Switzerland , and China. It brought clarity to why wise is conduting trials in china and Stem Cell INc is conducting trials in Switzerland. I know that any of us would probably travel anywhere to get an EFFECTIVE treatment. My hope is that we will see somethng of promisde from anywhere and you and others will be eligible to participate in a trial anywhere.