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    April 16, 2003 CLEVELAND (featureXpress) -- The innovative breathing device that is enabling actor Christopher Reeve, paralyzed in a horseback riding accident eight years ago, to breath periodically on his own was developed through three decades of research at Case Western Reserve University (CWRU), University Hospitals of Cleveland (UHC) and the Louis Stokes Cleveland Department of Veterans Affairs Medical Center.

    "The design of this device spans decades and stems from 30 years of research under generous funding from the Department of Veterans Affairs (VA), which has been committed to the University and the shared mission to advance applied neural control systems technology," said Thomas Mortimer, the lead researcher and professor emeritus in the department of biomedical engineering.

    Mortimer developed the device with the help of biomedical engineering graduate students. The device has been successfully implanted in two human subjects, including Reeve, with the help of Anthony F. DiMarco and Raymond P. Onders at UHC and with grant funding from the VA, the Food and Drug Administration and U.S. Surgery Corporation.

    Early pioneers in biomedical engineering began work on the device in 1980, leading to an approach that included placing electrodes within a required distance of the phrenic nerve to induce inspiration. By 1984, a renewed approach utilized a laparoscope to peer inside the diaphragm.

    "The turning point in the evolution of this respiratory device came in 1987 when CWRU researchers developed an electrode that could carry a signal to the muscle and induce breathing. The problem was in locating the very limited region around the phrenic nerve that generated a successful breathing response," Mortimer said.

    In 1990, the researchers created a device that made it possible to staple the electrode to the diaphragm. By 1996, they had developed a custom implant tool, which was successful at implanting the intramuscular electrodes in the responsive zone, or "motor point," surrounding the phrenic nerve. They utilized a computer to map the precise location of the spot where the electrode must be positioned to stimulate breathing.

    "Today, the method we have developed to activate the diaphragm reduces the risk of phrenic nerve injury, requires less time to implant than previous technology and can be performed as an outpatient surgical procedure," Mortimer said. "Compared to conventional ventilator therapy, this new device has the potential to reduce a patient's time spent on the ventilator, increase self-induced breathing and a sense of well-being. Patients must still have a ventilator because they remain at risk that the device may fail but the device itself can significantly increase their quality of life.

    "The current standard for patients with spinal cord injuries above the third and fifth cervical vertebrae region is a ventilator to allow them to breathe," Mortimer continued. "However, the majority of patients afflicted with quadriplegia would prefer to live more independently. After 30 years of committed research, this respiratory assist device has emerged as a minimally invasive alternative to the ventilator. Our new device is designed to work in synergy with a laparoscope and looks to offer a fresh new solution."

    Anthony Ignagni, a biomedical engineering alumnus, Mortimer, Onders and DiMarco and their research team are establishing a business approach for the new device, looking into the viability of reproducing it for other patients and providing backup devices for those that may fail in patients over time.

    "We need to be able to maintain the production of the device for a prolonged period of time," Mortimer said. "Our VA funding provided the necessary support and brings us closer to a viable treatment option."

    Mortimer is confident that the new device will be of interest to clinicians in the medical field, who strive to improve the therapeutic outcome for patients, as well as the patients themselves.

    Onders and DiMarco lead the clinical trials at UHC.

    The device is designed for those who suffer chronic respiratory insufficiency resulting from high quadriplegia above the third and fifth cervical vertebrae region in the spinal cord but is exclusively designed for cases in which the phrenic nerve remains intact. The phrenic nerve originates in the upper half of the spinal cord, between the third and fifth cervical vertebrae and extends to stimulate the diaphragm muscle. It is responsible for transmitting the nerve impulses to the diaphragm, which cause it to contract and expand, facilitating breathing.

    "The device utilizes intramuscular electrodes that are surgically implanted into the diaphragm and connected to an electrical stimulator causing the phrenic nerve to release neurotransmitters," Mortimer said. "These neurotransmitters cause the diaphragm to contract, which brings about inspiration."

    Researchers say that this new technology can be life-altering when it is successfully implanted into a patient who depends on a ventilator to breathe. The ventilator, they say, is noisy and requires patients to wait for a breath of air whereas the new device uses the body's respiratory system to draw and release air. For graphics and photographs to accompany this story visit:


    Good news, thanks Max.


      Amid war, Superman makes history

      Amid war, Superman makes history

      With tiny electrodes controlled by a pace-maker-like device stimulating his diaphragm muscles, Christopher Reeve, the actor who played "Superman" in film before 1995, shocked a scarcely unbelieving television audience in March. Though he broke his neck in a horseback-riding accident, becoming a paraplegic unable to move or sense almost instantly, he cannot only breathe again but also talk and even smell. He told the audience: "I woke up and smelled the coffee.''

      Doctors at University Hospital of Cleveland, Ohio, under the direction of Dr. Raymond Onders for the entire treatment so far, are working to strengthen Mr. Reeve's diaphragm muscles, which he hasn't used for eight years. "Superman" is exercising! The procedure is being refined for use by other paraplegics.

      With the United States at war in Iraq and with terrorists recognized as an air, land and water transportation threat, this new procedure is one with which many health care programs should take steps to familiarize their staffs. We can hope they'll not have to be called on to become deeply experienced experts in it.

      Currently, Dr. Onders said 200 to 300 spinal cord patients might be eligible for it once approved. The federal government through the Department of Health and Human Services, the military surgeons general and the Veterans Department will be involved in review and, if the procedure works, approval.

      Much research and work in addition to the health engineering has been committed to treatment of physical injury in agriculture, the armed forces, sports medicine and accident treatment.

      The success that Reeve has had, such as "regular rhythmic breathing from my nose for the first time in nearly eight years" without the respirator's sounds, must encourage all involved -- doctors, engineers, laboratory technicians, patients and physical therapists. His determination, like that of others suffering permanent physical injury, is an inspiring contribution even if unintended.

      Superman says he'll walk again! With determination and medical advances, he must may.

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        "Superman makes history"
        Do not confuse too far an actor,
        with his foundation paying for the spine severing of imprisoned women and men
        of kinds so brain related to us, that straight can be deducted to our ape homo chimp mammal kind from such perversions,
        with some invented figure.

        I regard him & his foundation's financing of atrocious crimes into imprisoned women and men of brain-related kinds among the greatest shames of the history of our mammal kind.

        And I regard no such artificial energies shite to belong there into natural harmonies.



          "With the United States at war in Iraq"
          With US persons attacking Iraquis.
          Having left radiation levels as a gift for still many to come in the future.

          "and with terrorists recognized as an air, land and water transportation threat,"
          It tends to be so if at terrorizing and terrorist acts against a group, destroying and damaging more buildings of them than I am sure anyone counted, that eventually there can come a return ticket for that.

          And be it just so few buildings, that to subtract them from the amount the other way around first, might hardly seem to make a difference in numbers.

          "200 to 300 spinal cord patients might be eligible for it once approved."

          With sense censored Westie scientists, I suspect not even some years of having worked (energetically) magically on trying to upprogram breathing interlinks and capacities have been done first before wanting to cut holes into systems and sticking in artificial energies shite without maybe a second thought to cancer risks or how bad on damaged spine systems such disturbances might impact.



            "The success that Reeve has had, such as "regular rhythmic breathing from my nose for the first time in nearly eight years" without the respirator's sounds, must encourage all involved -- doctors, engineers, laboratory technicians, patients and physical therapists."

            Whatever you Must-around there, did not manage to encourage me.
            To the opposite.
            I have come to regard it as utterly wrong to risk doing whatever that interlinks the damaged in the spine more direction the artificial energies disturbances zones.
            While before in elsewhere mentioned weirdo games I at times found it interesting to on and off run settings to do with thoughts how to reprogram breathing capacities up on the right side there (left I regarded a special case I don't wish to go into here now),
            now I have come to regard these like wrong.

            IMO the more the damaged remain disconnected from the artificial energies shite & disturbances he committed into systems, the better.

            "Superman says he'll walk again!"
            I am not aware of the invented film character having said so.
            Of the actor, he seemed for quite a while into annual illusions at New Year, that seemed to confuse damaged systems with 1-year-time-machines.

            "With determination and medical advances, he must may."
            With the determination of chasing the feet before the stronger side damaged, like right C1, are even far enough for the right arm.
            The ideal reminding of someone at stuff seeming more suited to overload particularily the left damaged like hell, and not caring a fart about if that is healthy for them,
            as if still not really having understood their significance.

            I don't exclude that even if he gets new cells in, he won't even just wait till they settled far enough to an extent and chemically adapted far enough, and be right at trying to force again, caring little to nothing what all he disturbs there, and if it might lower his walking chances.

            It seems to fit his patterings, that he might do exactly that.
            Chase dreams while not heeding enough what is there.


              What point are you trying to make here? Reeve has voluntarily undergone a surgical process that may improve his and others quality of life. The safeguards are in place to "protect" us all from ourselves in this nightmare condition. As for the radiation left behind in Iraq for generations where is that information coming from? I too agree that we are spending a great deal of money in Iraq but what is your proposal instead of that? I would submit to most any clinical process that would advance the knowledge base surrounding SCI CURE. Lets get on with that and quit bashing those that are trying.


                This is important for Christopher whose diaphragm is probably atrophied due to having been on a ventilator for the past 7 years. He needs to have activation of the muscle in order to regain the bulk and strength it needs for voluntary contraction. Wise.


                  We are having very differing opinions on that.

                  ... And to the one with radiation stuff there, do you seriously believe all these mutations at birth, etc., will be completely off when the next generations are born, and this no longer having effects on them?
                  If so, I seriously doubt it.

                  And I don't really feel on Easter day currently like having a serious political discussion on US people attacking Iraq,
                  and on Chris Reve and breathing I had to an extent my opinions I believe in Members Topics under "Chris Reeve" stated.