Nerve Glue Treatment for Taiwan's First Lady

Wise Young · 07-31-2001, 04:23 AM

http://www.dpa.org.sg/DPA/news/news_june_2001-4.htm

NERVE GLUE TREATMENT FOR TAIWAN'S FIRST LADY
Hope after sixteen years

A new 'nerve glue' may help the wife of Taiwan's President walk again, but she will need to grow new nerves ï¬?rst as she was injured so long ago

By Koh Chern Phing

THE wheelchair-bound wife of Taiwan President Chen Shui-bian has to re-grow new nerves in her injured vertebra before she can undergo the new 'nerve glue' treatment to get back on her feet.

Madam We Shu-chen, who was in Houston recently with her husband, Taiwanese President Chen Shui-bian, acknowledging supporters.-AP

This is because the spinal nerves in the damaged region have been severed for too long, and the impulse transmissions between the nerve ends must be re-established and revived before glueing can be done to prevent 'leaks'.

A research programme on 'nerve glue' and nerve regeneration headed by Dr Henrich Cheng of the Veterans General Hospital (TVGH) in Taipei has recently ï¬?red up hope that the 47-year-old Madam Wu Shu-chen may walk again after being conï¬?ned to the wheelchair for the past 16 years.

Dr Cheng, the head of TVGH's Neurosurgery Department, has been treating Madam Wu regularly for the past few years.

The revolutionary 'nerve glue' treatment, which may be used to help spinal-injury patients, aims to reconnect damaged or severed spinal cords.

However, a source at TVGH told The Straits Times that such an operation for Madam Wu must be preceded by the regeneration of her spinal nerves and multiple intercostal nerve grafts, which is the grafting of nerves that lie between the ribs.

The 'nerve glue' treatment, a method still not widely used in the world, is more effective only if the patient receives help soon after the injury.

However, because Madam Wu was injured so long ago, her spinal nerves might have been severed and atrophied.

A clinical study of a new nerve-regeneration technique carried out by TVGH has shown encouraging results, reported Taiwan's China Times.

Dr Cheng, who has spent seven years carrying out basic research, even caught the notice of former US President Bill Clinton, who described his ï¬?ndings as the most important scientiï¬?c discovery of the past three years.

The neurosurgeon explained that tissues making up the central nervous system do not regenerate following an injury, leaving patients with spinal-cord injuries in paralysis.

In nerve regeneration, doctors will graft nerve tissues from either the lower leg or from between the ribs onto the spinal cord.

The patient will subsequently receive an injection of a cocktail of growth hormones, which serves to stimulate nerve regeneration.

A doctor from the experimental and clinical research centre of the Singapore General Hospital told The Straits Times that it would be quite some time before the 'nerve glue' treatment could be clinically applied here.

'It is in the basic research stage still. But in Taiwan, the research in this method is obviously more advanced and its medical regime allows controlled experiments on human beings,' he added.

Madam Wu was paralysed from the waist down after a hit-and-run accident in 1985 while accompanying her husband on a walkabout during a magistracy election in Tainan.

Recently, while attending an activity organised by the Association of Spinal Cord Injuries, Madam Wu expressed her wish to walk again.

'A person who has not been in my situation cannot begin to imagine the suffering involved,' she said.

'I would also not hesitate to give up my First Lady title if only to walk again,' she added.

She also declared she was placing all her hopes on Dr Cheng to cure her.

Mike C · 07-31-2001, 05:50 AM

Will Dr. Cheng be able to "save face" if he fails to cure such a high profile patient? Perhaps the doctor has been boxed into a corner here by the high level of media attention this case has attracted. Failure now could send Dr. ChengÂ´s reputation into a tail spin by an un or under informed Taiwanese community. However, success in this case would bring unmeasurable accolades and could even win him the next presidential election.

mk99 · 07-31-2001, 09:00 AM

God I can't wait to get to Taipei. Down to about 10 weeks now!

How can one prevent atrophy & slow death of nerves anyway? I've been doing all kinds of electrical stims, getting fried & zapped with all kinds of different currents, etc since injury. (1 year) Also lots of exercise & long leg brace walking.

I still worry about how much of my nerves have likely died during this time period? I don't think there's anything more I could have done to "keep things alive" during this time period. Wait and see I guess.

Curt Leatherbee · 07-31-2001, 09:27 AM

There is plenty of incentive here to produce the Cure, the question is? is that enough?

etexley · 07-31-2001, 09:33 AM

Does Dr. Cheng plan on taking this treatment to clinical trial in the united states? What can we do as a community to expedite the process of approval and make it widely available to everyone with this injury?

It would seem that effective treatments now exist for chronic spinal cord injury. Paralysis is no longer a permanent thing for those lucky enough to have the resources and aspiration to get better. We must fight to get it to everyone in our positions.

Eric Texley

DA · 07-31-2001, 09:39 AM

save face nothing. dr cheng is trying and he is pushing the field forward. imagine a world without dr cheng dragging a kicking and screaming U.S. sci researchers forward. we would be still talking about a rat toe moving. fail or succeed, he is still the greatest.

" A person who has not been in my situation cannot begin to imagine the suffering involved,' she said.

'I would also not hesitate to give up my First Lady title if only to walk again,' she added."
A person who has not been in my situation cannot begin to imagine the suffering involved,' she said.

'I would also not hesitate to give up my First Lady title if only to walk again,' she added.
A person who has not been in my situation cannot begin to imagine the suffering involved,' she said.

'I would also not hesitate to give up my First Lady title if only to walk again,' she added.

A person who has not been in my situation cannot begin to imagine the suffering involved,' she said.

'I would also not hesitate to give up my First Lady title if only to walk again,' she added.

etexley · 07-31-2001, 10:05 AM

You know, there are alot of other kinds of handicaps and diseases out there besides SCI...I think it's time that we quit throwing ourselves a pity party and started moving this thing forward. A person who has never experienced blindness cannot begin to imagine the horror of no longer being able to see. A person who has not experienced deafness cannot begin to realize what it's like not to hear. The same stuff that'll help us will help those conditions too...(replacement of inner hair cells, fixing the optic nerve.) Stem cell funding is important...UNIMAGINABLY IMPORTANT.

Eric Texley

Birde · 07-31-2001, 10:37 AM

"In nerve regeneration, doctors will graft nerve tissues from either the lower leg or from between the ribs onto the spinal cord.
The patient will subsequently receive an injection of a cocktail of growth hormones, which serves to stimulate nerve regeneration." While Dr. Kao was here, he gave me some papers that Dr. Cheng (along with others) had published. He said that a close collegue of his, Dr. Cheng, was a brilliant surgeon and researcher and is making progress of his own. That he has worked with, taught, and that Dr. Cheng has attended some of his lectures.
"In nerve regeneration, the doctors will graft nerve tissues from the lower leg" (sural nerve) is what Kao will be doing to me, as he has done to his past patients. "The patient will subsequently receive an injection of a cocktail of growth hormones, which serves to stimulate nerve regeneration." Dr. Kao intends to remove the endonerium of the sural nerve, mince it, and treat it in Type IV collagenase in Hank's Balanced Salt Solution for approx. 2 hours at 37 degrees C. until the endoneurium is completely disintegrated into Schwann cells and fibroblasts. These cells are collected by centrifugation. The spinal cord cavity(injury site) is opened by dorsal myelotomy. The cells are placed between the end of the spinal cord and longitudinally implanted sural nerve segments in the spinal cord cavityrostrally and caudally. Thus a cocktail of growth hormones. The pia is closed with 8-0 Prolene. The dura is grafted widely with a piece of fascia lata. Perhaps a form of this "nerve glue" that we are hearing about?!!! Kao mentioned a glue of sorts...I will have to ask again. I n regards to Chengs glue- "aFGF-containing fibrin glue(2.5ml) was applied to stabalize the anastomoses in the grafted are" is what the papers of Cheng say. Much of what these two doctors are researching and doing is a great deal alike.

paulsask · 07-31-2001, 11:20 AM

Birde

Thanks for the explanation (indepth) of what your procedure entails.
I've grown tired as of late, hearing of "cocktails" being used with no definition of ingredients.
I wish you the best of luck.

Thanks,

Paul

07-31-2001, 04:23 AM	#1
Wise Young Administrator Join Date: Jul 2001 Location: New Brunswick, NJ, USA Posts: 37,975	Nerve Glue Treatment for Taiwan's First Lady http://www.dpa.org.sg/DPA/news/news_june_2001-4.htm NERVE GLUE TREATMENT FOR TAIWAN'S FIRST LADY Hope after sixteen years A new 'nerve glue' may help the wife of Taiwan's President walk again, but she will need to grow new nerves ï¬?rst as she was injured so long ago By Koh Chern Phing THE wheelchair-bound wife of Taiwan President Chen Shui-bian has to re-grow new nerves in her injured vertebra before she can undergo the new 'nerve glue' treatment to get back on her feet. Madam We Shu-chen, who was in Houston recently with her husband, Taiwanese President Chen Shui-bian, acknowledging supporters.-AP This is because the spinal nerves in the damaged region have been severed for too long, and the impulse transmissions between the nerve ends must be re-established and revived before glueing can be done to prevent 'leaks'. A research programme on 'nerve glue' and nerve regeneration headed by Dr Henrich Cheng of the Veterans General Hospital (TVGH) in Taipei has recently ï¬?red up hope that the 47-year-old Madam Wu Shu-chen may walk again after being conï¬?ned to the wheelchair for the past 16 years. Dr Cheng, the head of TVGH's Neurosurgery Department, has been treating Madam Wu regularly for the past few years. The revolutionary 'nerve glue' treatment, which may be used to help spinal-injury patients, aims to reconnect damaged or severed spinal cords. However, a source at TVGH told The Straits Times that such an operation for Madam Wu must be preceded by the regeneration of her spinal nerves and multiple intercostal nerve grafts, which is the grafting of nerves that lie between the ribs. The 'nerve glue' treatment, a method still not widely used in the world, is more effective only if the patient receives help soon after the injury. However, because Madam Wu was injured so long ago, her spinal nerves might have been severed and atrophied. A clinical study of a new nerve-regeneration technique carried out by TVGH has shown encouraging results, reported Taiwan's China Times. Dr Cheng, who has spent seven years carrying out basic research, even caught the notice of former US President Bill Clinton, who described his ï¬?ndings as the most important scientiï¬?c discovery of the past three years. The neurosurgeon explained that tissues making up the central nervous system do not regenerate following an injury, leaving patients with spinal-cord injuries in paralysis. In nerve regeneration, doctors will graft nerve tissues from either the lower leg or from between the ribs onto the spinal cord. The patient will subsequently receive an injection of a cocktail of growth hormones, which serves to stimulate nerve regeneration. A doctor from the experimental and clinical research centre of the Singapore General Hospital told The Straits Times that it would be quite some time before the 'nerve glue' treatment could be clinically applied here. 'It is in the basic research stage still. But in Taiwan, the research in this method is obviously more advanced and its medical regime allows controlled experiments on human beings,' he added. Madam Wu was paralysed from the waist down after a hit-and-run accident in 1985 while accompanying her husband on a walkabout during a magistracy election in Tainan. Recently, while attending an activity organised by the Association of Spinal Cord Injuries, Madam Wu expressed her wish to walk again. 'A person who has not been in my situation cannot begin to imagine the suffering involved,' she said. 'I would also not hesitate to give up my First Lady title if only to walk again,' she added. She also declared she was placing all her hopes on Dr Cheng to cure her.

07-31-2001, 05:50 AM	#2
Mike C Moderator Join Date: Jul 2001 Location: Deutschland Posts: 4,894	Can he pull it off? Will Dr. Cheng be able to "save face" if he fails to cure such a high profile patient? Perhaps the doctor has been boxed into a corner here by the high level of media attention this case has attracted. Failure now could send Dr. ChengÂ´s reputation into a tail spin by an un or under informed Taiwanese community. However, success in this case would bring unmeasurable accolades and could even win him the next presidential election.

07-31-2001, 09:00 AM	#3
mk99 Senior Member Join Date: Jul 2001 Location: toronto, canada Posts: 3,494	excitement God I can't wait to get to Taipei. Down to about 10 weeks now! How can one prevent atrophy & slow death of nerves anyway? I've been doing all kinds of electrical stims, getting fried & zapped with all kinds of different currents, etc since injury. (1 year) Also lots of exercise & long leg brace walking. I still worry about how much of my nerves have likely died during this time period? I don't think there's anything more I could have done to "keep things alive" during this time period. Wait and see I guess.

07-31-2001, 09:27 AM	#4
Curt Leatherbee Moderator Join Date: Jul 2001 Location: Florida Posts: 9,341	Sure sounds like There is plenty of incentive here to produce the Cure, the question is? is that enough?

07-31-2001, 09:33 AM	#5
etexley Senior Member Join Date: Jul 2001 Location: Boca Raton, Florida, USA Posts: 1,446	USA? Does Dr. Cheng plan on taking this treatment to clinical trial in the united states? What can we do as a community to expedite the process of approval and make it widely available to everyone with this injury? It would seem that effective treatments now exist for chronic spinal cord injury. Paralysis is no longer a permanent thing for those lucky enough to have the resources and aspiration to get better. We must fight to get it to everyone in our positions. Eric Texley

07-31-2001, 09:39 AM	#6
DA Senior Member Join Date: Jul 2001 Location: beaumont tx usa Posts: 32,390	mike save face nothing. dr cheng is trying and he is pushing the field forward. imagine a world without dr cheng dragging a kicking and screaming U.S. sci researchers forward. we would be still talking about a rat toe moving. fail or succeed, he is still the greatest. " A person who has not been in my situation cannot begin to imagine the suffering involved,' she said. 'I would also not hesitate to give up my First Lady title if only to walk again,' she added." A person who has not been in my situation cannot begin to imagine the suffering involved,' she said. 'I would also not hesitate to give up my First Lady title if only to walk again,' she added. A person who has not been in my situation cannot begin to imagine the suffering involved,' she said. 'I would also not hesitate to give up my First Lady title if only to walk again,' she added. A person who has not been in my situation cannot begin to imagine the suffering involved,' she said. 'I would also not hesitate to give up my First Lady title if only to walk again,' she added.

07-31-2001, 10:05 AM	#7
etexley Senior Member Join Date: Jul 2001 Location: Boca Raton, Florida, USA Posts: 1,446	pedestal You know, there are alot of other kinds of handicaps and diseases out there besides SCI...I think it's time that we quit throwing ourselves a pity party and started moving this thing forward. A person who has never experienced blindness cannot begin to imagine the horror of no longer being able to see. A person who has not experienced deafness cannot begin to realize what it's like not to hear. The same stuff that'll help us will help those conditions too...(replacement of inner hair cells, fixing the optic nerve.) Stem cell funding is important...UNIMAGINABLY IMPORTANT. Eric Texley

07-31-2001, 10:37 AM	#8
Birde Senior Member Join Date: Jul 2001 Posts: 131	"In nerve regeneration, doctors will graft nerve tissues from either the lower leg or from between the ribs onto the spinal cord. The patient will subsequently receive an injection of a cocktail of growth hormones, which serves to stimulate nerve regeneration." While Dr. Kao was here, he gave me some papers that Dr. Cheng (along with others) had published. He said that a close collegue of his, Dr. Cheng, was a brilliant surgeon and researcher and is making progress of his own. That he has worked with, taught, and that Dr. Cheng has attended some of his lectures. "In nerve regeneration, the doctors will graft nerve tissues from the lower leg" (sural nerve) is what Kao will be doing to me, as he has done to his past patients. "The patient will subsequently receive an injection of a cocktail of growth hormones, which serves to stimulate nerve regeneration." Dr. Kao intends to remove the endonerium of the sural nerve, mince it, and treat it in Type IV collagenase in Hank's Balanced Salt Solution for approx. 2 hours at 37 degrees C. until the endoneurium is completely disintegrated into Schwann cells and fibroblasts. These cells are collected by centrifugation. The spinal cord cavity(injury site) is opened by dorsal myelotomy. The cells are placed between the end of the spinal cord and longitudinally implanted sural nerve segments in the spinal cord cavityrostrally and caudally. Thus a cocktail of growth hormones. The pia is closed with 8-0 Prolene. The dura is grafted widely with a piece of fascia lata. Perhaps a form of this "nerve glue" that we are hearing about?!!! Kao mentioned a glue of sorts...I will have to ask again. I n regards to Chengs glue- "aFGF-containing fibrin glue(2.5ml) was applied to stabalize the anastomoses in the grafted are" is what the papers of Cheng say. Much of what these two doctors are researching and doing is a great deal alike.

07-31-2001, 11:20 AM	#9
paulsask Senior Member Join Date: Jul 2001 Location: Saskatoon, Sask. Canada Posts: 154	Birde Thanks for the explanation (indepth) of what your procedure entails. I've grown tired as of late, hearing of "cocktails" being used with no definition of ingredients. I wish you the best of luck. Thanks, Paul

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