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    Thats great optimism on ur part !

    Comment


      I'm not talking about a conclusion about if the fundament for a "cure" has been found or even coming within our lifetimes but more in the vain of that there is even a slight amount of effect to be measured that can be related to the use of UCBMC.

      Comment


        Thanks for the train analogy Wise. I admit to thinking we had gone backward not forward after watching the video.


        Originally posted by Wise Young View Post
        Lunasicc,

        I would not conclude that the UCBMC "doesn't really do anything" based on the data to date. In Hong Kong, we saw no white matter crossing the injury site in any subject before treatment. In one subject who did not have treatment, we saw no white matter growth across the injury site over a 2 year period. In 3 of 5 subjects who were treated with UCBMC and had reasonable MRI-DTI images, we saw white matter tracts crossing the injury site. In Kunming, some subjects that have been treated with UCBMC show early locomotor improvement though they did not show changes in motor scores in the legs at 6 weeks. We did not do MRI/DTI in the Kunming subjects but all received the intensive locomotor training.

        Long tract regrowth is a very slow and the axons have a long ways to grow. Axons grow very slowly, no faster than hair growth and that is assuming that they know exactly where to go and have no impediments. A mm per day would be very fast. In order to activate muscles directly, the axons must grow all the way to the lumbosacral spinal cord located at T12 and L1 spine, a distance of over 500 mm from the neck to the bottom of the rib cage.

        So, let me give an analogy. We are waiting in Miami Florida for a train to come from Boston. The train tracks have been disrupted in Connecticut (cervical spinal cord injury). No trains have come from Boston for a long time. We hear on the news that an effort has been made to repair the train tracks. After waiting a day, no train appears. The news, however, tells us that some trains have been sighted in Washington DC and we are seeing increased activity in Atlanta and Alabama. Should we be concluding that the repairs of the train track have been unsuccessful?

        Wise.
        And the truth shall set you free.

        Comment


          Dr wise

          Sorry i just had to ask
          and we know you are a busy man
          What i think Looking at the videos and what the Doctors seem to be saying . Is Well we know this dose not work and that dose work ? But give us time and we will come up with some thing . I am afraid to say looking at it must of us will see nothing For a while . Like most of us we where hoping This was the real deal . I am very disappointed but will have to see what the rest of paper says .
          Can you tell us where you go from here ? If you can would you try to break it down to lay man terms .
          So must of us will understand
          unfortunately i think must of us do ?

          once again thanks for work and effort that you have put into it
          Last edited by skeaman; 13 Nov 2012, 6:33 PM.
          AS I SIT HERE IN MY CHAIR . I LOOK OUT UPON THE GROUND .I WONDER WILL I EVER GET UP AND WALK A ROUND ??


          http://justadollarplease.org

          Comment


            Originally posted by ay2012 View Post
            Sorry Dr. Young but just to clarify: the observation that some patient are walking is from seeing patients six months into the trial whereas the lack of improvement in motor and sensory scores is for six week data. Yet you seem to indicate that people are walking without improvement in these scores...
            We are not the first to report that people are walking without changes in motor or even sensory scores. As I have pointed out, many "walking quads" can walk well with relatively poor voluntary control of individual muscles and poor sensation from the legs below the knees. This is because there is a central pattern generator (CPG) in the lower spinal cord that contains the programs for walking. If you activate the CPG, it tells the rest of the muscles of both legs to walk. Actually, the CPG contains many other locomotor programs including skipping, hopping, trotting, galloping, and cantering.

            We are talking about very early results in the trial, i.e. 6 weeks after transplantation. The axons have not had the time to grow far and connect with structures below the injury site. In fact, our images of the spinal cord in Hong Kong suggest that none of the people have tracts that grow across the injury site before 6 months and some did not until 12 months. So, I have been cautioning people to stop jumping to conclusions. We don't have all the 6 month data yet from Kunming where they have undergone the locomotor training and therefore I am talking only about a quarter of the patients who have shown early locomotor improvement at 6 weeks without changes in motor or sensory scores. This may change by 6 month and 12 months.

            Wise.

            Comment


              Originally posted by Tachtig View Post
              I'm not talking about a conclusion about if the fundament for a "cure" has been found or even coming within our lifetimes but more in the vain of that there is even a slight amount of effect to be measured that can be related to the use of UCBMC.
              Tachtig,

              Our phase II trials have shown that the transplants appear to be safe, at least at 6 weeks after the transplants in terms of "severe adverse events". We are seeing white matter growth in 2 of 5 patients who have adequate MR-DTI and have received the two lower doses of cell injections without lithium. There may be growth of white matter than is below the threshold of resolution of MRI. In 8 subjects in Hong Kong, we are seeing some sensory improvements but little motor score differences so far. We are still awaiting the 6 month data from Kunming.

              It is still very early in the studies. We did not see anybody showing MR-DTI images of white matter growth before 6 months after transplantation. We do not expect substantial recovery of function so early. If such recovery did occur, it would argue strongly against regeneration as the cause of such recovery. The fact that the recovery is coming late and very slowly is consistent with the recovery being due to regenerated axons.

              I don't know how and why people are jumping to the conclusion that umbilical cord blood mononuclear cells and lithium are not doing anything. This is precisely why I have been so reluctant to release any data to the public. People are expecting miracles, misinterpreting the results, and being unduly pessimistic. In fact, some people are prematurely predicting the demise of the trials and therapy without thinking about the consequences of what they are saying and the fact that they have no basis for saying so.

              Wise.

              Comment


                Originally posted by skeaman View Post
                Sorry i just had to ask
                and we know you are a busy man
                What i think Looking at the videos and what the Doctors seem to be saying . Is Well we know this dose not work and that dose work ? But give us time and we will come up with some thing . I am afraid to say looking at it must of us will see nothing For a while . Like most of us we where hoping This was the real deal . I am very disappointed but will have to see what the rest of paper says .
                Can you tell us where you go from here ? If you can would you try to break it down to lay man terms .
                So must of us will understand
                unfortunately i think must of us do ?

                once again thanks for work and effort that you have put into it
                Skeaman,

                I am sorry but I am not sure that I see any reason for you or others to be "disappointed". We should be celebrating for the following reasons:
                1. Transplantation of cells into chronically injured spinal cord is safe.
                2. The cells appear to encourage white matter growth and at least 2 of 5 subjects are showing remarkable white matter growth across the injury site and both up and down the spinal cord. The growth is substantial enough to be detectable on MR-DTI. MR-DTI, on 3T MRI machines, cannot detect structures that are less than a mm in size. We didn't expect see such growth and I am amazed. We need to confirm the presence of these regrowing tracts electrophysiologically. If so, this is the first demonstration of spinal cord regeneration in humans. It is too early and the tracts may not have connected. Don't you think that this is important and interesting?
                3. Some of the subjects are recovering function. Many have recovered some sensation in the dermatomes close to the injury site. In Hong Kong, none of the subjects are able to walk without assistance and this is not surprising since we anticipated that intensive walking exercise may be required for locomotor recovery. In Kunming, some subjects are recovering locomotor function but, to our surprise, without significant changes in motor and sensory scores of their legs. We don't have the 6 month followup studies on the patients yet and therefore these results are very early.

                Most of the people here know more about spinal cord injury than any scientist and are not "laymen". I hope that my language is clear. If there is anything that you do not understand, please ask. What should be very clear to everybody from my posts is that ChinaSCINet has done an incredible amount of work with very little money to carry out the trials to date. We have now transplanted umbilical cord blood mononuclear cells into 28 chronic subjects and 13 subacute subjects. Every weekend, teams of dedicated nurses are going to the homes of the subjects to do the examinations. The participating doctors are excited about these results and we are doing our best to make sure that all the data is properly collected and rigorously analyzed. The data indicate that the procedure is safe and we are seeing some regeneration and recovery. It puzzles me why people are disappointed.

                Wise.
                Last edited by Wise Young; 13 Nov 2012, 10:22 PM.

                Comment


                  Originally posted by Wise Young View Post
                  Tachtig,

                  Our phase II trials have shown that the transplants appear to be safe, at least at 6 weeks after the transplants in terms of "severe adverse events". We are seeing white matter growth in 2 of 5 patients who have adequate MR-DTI and have received the two lower doses of cell injections without lithium. There may be growth of white matter than is below the threshold of resolution of MRI. In 8 subjects in Hong Kong, we are seeing some sensory improvements but little motor score differences so far. We are still awaiting the 6 month data from Kunming.

                  It is still very early in the studies. We did not see anybody showing MR-DTI images of white matter growth before 6 months after transplantation. We do not expect substantial recovery of function so early. If such recovery did occur, it would argue strongly against regeneration as the cause of such recovery. The fact that the recovery is coming late and very slowly is consistent with the recovery being due to regenerated axons.

                  I don't know how and why people are jumping to the conclusion that umbilical cord blood mononuclear cells and lithium are not doing anything. This is precisely why I have been so reluctant to release any data to the public. People are expecting miracles, misinterpreting the results, and being unduly pessimistic. In fact, some people are prematurely predicting the demise of the trials and therapy without thinking about the consequences of what they are saying and the fact that they have no basis for saying so.

                  Wise.
                  Thanks for the clarification Dr. Young and the reminder that what we say, the conclusions we jump to, can have an impact, especially when we don't (nor do many other people) have all the facts at this time.
                  At the same time, and I know you understand this, the community is constantly on pins and needles. We want you, anyone really, to succeed and we, or at least I, will follow you and help out in any way possible to get this going as soon as possible so long as we see progress and remain informed. So please don't stop releasing information to the public! Just take a moment to calm us down every once in a while and remind us, as you have, that progress is a slow process...

                  Comment


                    Originally posted by ay2012 View Post
                    Thanks for the clarification Dr. Young and the reminder that what we say, the conclusions we jump to, can have an impact, especially when we don't (nor do many other people) have all the facts at this time.
                    At the same time, and I know you understand this, the community is constantly on pins and needles. We want you, anyone really, to succeed and we, or at least I, will follow you and help out in any way possible to get this going as soon as possible so long as we see progress and remain informed. So please don't stop releasing information to the public! Just take a moment to calm us down every once in a while and remind us, as you have, that progress is a slow process...
                    You are welcome of course. I hasten to point out that I don't have all the data either and we are doing all of this together. This is science, not magic or religion. The data is what it is. All that we can do is to make sure that the data is reliable and credible. If umbilical cord blood mononuclear cells and the lithium combination do not work, we go on. There are many other therapies waiting in the wings, ready to go. If it restores function in some people, that is great and we can work to improve the therapy and compare it against other therapies.

                    Comment


                      "The data indicate that the procedure is safe and we are seeing some regeneration and recovery"(#1208)
                      Dr.Wise, are you sure that you don't confuse the term "regeneration" with the term "plasticity"?

                      Comment


                        Originally posted by kivi66 View Post
                        Dr.Wise, are you sure that you don't confuse the term "regeneration" with the term "plasticity"?
                        That's exactly what he says in the video. He calls it "white
                        matter plasticity." Put on your listening ears.

                        Originally posted by Wise Young
                        I don't know how and why people are jumping to the conclusion that umbilical cord blood mononuclear cells and lithium are not doing anything.
                        You don't sound to encouraged in the video, to be honest.
                        In the video you said the best that could be said, so far, is
                        that it might be too soon to draw any conclusions. And you
                        mention a couple surprises, such as tissue regeneration without
                        return of motor or sensory. It also sounds like these results
                        have made you uncertain about future treatment.

                        I think people expected the results to look similar as they do
                        in animals. We're used to hearing about the lab rats recovering
                        in a couple weeks.

                        Comment


                          Buck503 ,be nicer or put on your muzzle.

                          Comment


                            Originally posted by Wise Young View Post
                            I don't know how and why people are jumping to the conclusion that umbilical cord blood mononuclear cells and lithium are not doing anything. This is precisely why I have been so reluctant to release any data to the public. People are expecting miracles, misinterpreting the results, and being unduly pessimistic. In fact, some people are prematurely predicting the demise of the trials and therapy without thinking about the consequences of what they are saying and the fact that they have no basis for saying so.
                            Thank you Dr Young for your detailled answer. I was not jumping to any conclusion or saying UCBMC doesn't work at all, that's why I said I would wait for the upcoming results / report. What I was asking for is if we could expect a conclusion about the use of UCBMC besides that if it is safe to use or not.

                            I was asking this question because this is the phase 2 trial and phase 3 is being planned and I read this.

                            Phase I trials: A small group of people is tested. The goal of such trials is to determine the safe dosage range and to identify the side effects of a drug or treatment. Therapeutic benefit, while not excluded, is not the primary goal of this initial phase of clinical testing. If a treatment has unacceptable side effects at this stage, further trials are not initiated.

                            Phase II trials: A larger group of patients is treated based on the findings of the phase I trial. Here, investigators test whether a treatment is effective, while they continue to monitor side effects.
                            Here it says that in phase II the effect of the drug will be tested. That's why I thought we might get some light on this matter in the upcoming results. But as I understand correctly this will take a while before the final phase II results will be available?

                            Whatever the result will be I totally agree that you have created an amazing network for human trials and I'm looking forward to whatever this may bring in the future.
                            Last edited by Tachtig; 14 Nov 2012, 11:17 AM. Reason: Spelling

                            Comment


                              Wise -
                              This post about the study was very exciting. Gives me a reason to be optimistic about research & "cures"....even for chronic injuries. I know it's easy to feel pessimistic especially if you've been paralyzed for years with the all the issues that come along with a spinal cord injury...still, this is really good news.
                              Kyle

                              1. Transplantation of cells into chronically injured spinal cord is safe.
                              2. The cells appear to encourage white matter growth and at least 2 of 5 subjects are showing remarkable white matter growth across the injury site and both up and down the spinal cord.
                              3. The growth is substantial enough to be detectable on MR-DTI. MR-DTI, on 3T MRI machines, cannot detect structures that are less than a mm in size. We didn't expect see such growth and I am amazed. We need to confirm the presence of these regrowing tracts electrophysiologically. If so, this is the first demonstration of spinal cord regeneration in humans. It is too early and the tracts may not have connected. Don't you think that this is important and interesting?
                              Some of the subjects are recovering function. Many have recovered some sensation in the dermatomes close to the injury site. In Hong Kong, none of the subjects are able to walk without assistance and this is not surprising since we anticipated that intensive walking exercise may be required for locomotor recovery. In Kunming, some subjects are recovering locomotor function but, to our surprise, without significant changes in motor and sensory scores of their legs. We don't have the 6 month followup studies on the patients yet and therefore these results are very early.
                              C4/5 incomplete, 17 years since injury

                              "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

                              "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

                              Comment


                                Perhaps the use of the term "white matter plasticity" to describe the retraction seen in one case maybe confusing a few folk. As I understand it (and I maybe wrong), we are potentially seeing long-distance CST axon regeneration rather than plasticity of existing networks.

                                Comment

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