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    Any Help For Ischemia?

    My SCI is as a result of ischemia that took place during surgery to repair a torn aorta. Blood supply was clamped off several times for a total of 37 minutes. Also, there was compression of the T-6 and T-12. My question is: Is there research going on now that could lead to a cure for my condition? If there is something I can do to reverse or aleviate my SCI, I like to know. I realize that the majority of SCI is trauma induced and that most attention to a cure is centered on this type of SCI. Just want to know what the outlook is for me and others with similar SCI.

    Look South,
    Dixie Land
    You C.A.N.
    Conquer Adversity Now

    #2
    Hi,
    I have asked Dr Young to respond ot your question.

    AAd
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


      #3
      Originally posted by Redneck
      My SCI is as a result of ischemia that took place during surgery to repair a torn aorta. Blood supply was clamped off several times for a total of 37 minutes. Also, there was compression of the T-6 and T-12. My question is: Is there research going on now that could lead to a cure for my condition? If there is something I can do to reverse or aleviate my SCI, I like to know. I realize that the majority of SCI is trauma induced and that most attention to a cure is centered on this type of SCI. Just want to know what the outlook is for me and others with similar SCI.

      Look South,
      Dixie Land
      Redneck,

      I am moving this topic over to the cure forum for further discussion. Aortic clamping for 30 minutes or longer will damage the spinal cord. While there is research on the subject, it has mostly been in the area of preventing such injuries in the future. I will try to summarize the research for you.

      Wise.

      Comment


        #4
        My SCI is also as a result of repairing my aorto so, i'm looking forward to Dr. Young's summary.

        Redneck

        What is your injury level? Complete or Incomplete? Any return/function or feeling?

        Comment


          #5
          Originally posted by Redneck
          My SCI is as a result of ischemia that took place during surgery to repair a torn aorta. Blood supply was clamped off several times for a total of 37 minutes. Also, there was compression of the T-6 and T-12. My question is: Is there research going on now that could lead to a cure for my condition? If there is something I can do to reverse or aleviate my SCI, I like to know. I realize that the majority of SCI is trauma induced and that most attention to a cure is centered on this type of SCI. Just want to know what the outlook is for me and others with similar SCI.

          Look South,
          Dixie Land
          Redneck. From this thread Link I investigated further, and from the company Neuralstem Inc which was involved in this study I found a CEO Blog which are thouching subject with some of your question, here is a quote from the CEO;
          I believe that the debate over stem cells will continue until we (in the industry) show real, quantifiable, important improvement in function in patients with a stem cell therapy. We of course (Neuralstem) are on record as targeting 2007 to begin our first human trials (using our spinal cord stem cells to treat Ischemic Paraplegia). Source.
          I have not found anymore info though, maybe others have or that Neuralstem Inc can be contacted due to the above quote? Hope it helps, but it would have been very interesting to know more about the human trials he talks about above here.

          Up North,
          Cold Man
          Last edited by Leif; 19 Oct 2006, 4:51 AM.

          Comment


            #6
            I found this letter;

            Based in Rockville, Maryland, Neuralstem has a mission to cure diseases of the central nervous system (CNS) utilizing patented human neural stem cell technology developed by founding scientist Dr. Karl Johe. Major CNS diseases targeted by the Company with research programs currently underway include: ischemic spastic paraplegia, traumatic spinal cord injury, ALS, and Parkinson’s disease.

            Neuralstem’s patent-protected technology enables, for the first time, the ability to produce neural stem cells of the human brain and spinal cord in commercially reasonable quantities, and to control the differentiation of these cells into mature, physiologically relevant human neurons and glia.

            In collaboration with the University of California, San Diego, Neuralstem believes it has demonstrated compelling proof of principle data in animals for the ability to reverse the paralysis created by Ischemic Spastic Paraplegia (ISP). ISP is a form of paralysis that occurs primarily as a result of human action; it is a direct side effect of an aortic clamping procedure during a surgical operation to treat certain aneurisms.

            Neuralstem intends to complete animal studies for the ISP indication this spring and, on the basis of these studies, file an Investigational New Drug (IND) application during the summer of 2006. Upon approval of the IND, the company hopes to begin a human feasibility study/clinical trial before the end of the 2006 calendar year.
            Source.
            More.

            CELL TRANSPLANTATION

            The highest priority for Neuralstem is to prove safety and efficacy of its human neural stem cell technology in human patients. The Company anticipates its first Investigational New Drug (“IND”) application will be for the treatment of Ischemic Spastic Paraplegia (ISP). ISP is paralysis induced by the localized obstruction of arterial blood flow to the spinal cord. It is often a direct side effect of an aortic clamping procedure during a surgical operation to treat abdominal aortic aneurysm. Patients suffering from ISP are characterized by paralyzing spasticity of the legs.

            The Company has worked to optimize its tissue acquisition and regulatory consent procedures, has demonstrated that it can grow its cells in a robust and reproducible manner, and has recently demonstrated with proof of principle data that it can reverse the paralysis created in the rodent model of Ischemic Spastic Paraplegia (publication pending). In the first quarter of 2007, the Company hopes to file an investigational new drug application (IND) for its stem cell therapy, and, upon its approval, commence human clinical trials to treat patients with Ischemic Spastic Paraplegia.
            Source.

            Last edited by Leif; 19 Oct 2006, 5:30 AM.

            Comment


              #7
              Ischemic

              Shawn: My injury level is T-6. I was able to move toes on right foot, but not now. I can flex aductor muscles in both thighs and I have topical feeling, but nothing below the skin level. I've not been told whether I am complete or incomplete.
              You C.A.N.
              Conquer Adversity Now

              Comment


                #8
                Originally posted by Redneck
                Shawn: My injury level is T-6. I was able to move toes on right foot, but not now. I can flex aductor muscles in both thighs and I have topical feeling, but nothing below the skin level. I've not been told whether I am complete or incomplete.
                Redneck,

                You sound "incomplete" to me. However, the formal definition of incomplete spinal cord injury is whether you have some level below which you have no sensation and voluntary movement. If you have no feeling around your anus and no voluntary contraction of your anal sphincter, you would be classified as an ASIA A. However, the fact that you can adduct both legs and have touch sensation well below your injury site at T6 suggests that you have significant preservation of function below the injury site. This is not unusual in people who have had ischemic injuries to their spinal cord. The rules of spinal cord injury classification are not as easily applied in people with ischemic injuries to the spinal cord or meaningful, because the damage may be widespread instead of being localized to only one level.

                The aorta provides the blood supply to the spinal cord. If you had aorta repair with a clamping time of over 30 minutes, that means that your lower spinal cord was deprived of blood for that period. In general, spinal cord gray matter (where the cells are located) are more sensitive to ischemia than white matter (where the ascending and descending tracts are located). The fact that you have preserved touch sensation is consistent with this. Pinprick or pain sensation, however, passes through the gray matter of the spinal cord and may be absent. This may account for your description of "topical" sensation without deeper sensation. Pinprick sensation is carried by the spinothalamic tract that originates from neurons in the lower spinal cord and ascends the spinal cord in the lateral columns.

                Wise.

                Comment


                  #9
                  A Typical Ischemic

                  Thanks Dr. Young. My comprehension of your explanation of ischemia is that I'm pretty typical in my paraplegia. A question I have is: Does the research and experiments to cure tramatic SCI have a bearing on ischemic SCI? Also, Leif, I appreciate the info on the Maryland corporation. I plan to contact them for additional information. Shawn, I will let you know if I get a response from Maryland.

                  Keep Rolling,
                  Phil Durt
                  You C.A.N.
                  Conquer Adversity Now

                  Comment


                    #10
                    Thanx. I'm diagnosed as being a T10 incomplete paraplegic. I have feeling/sensation below my injury level. I can move my toes downwards on both feet. On my right foot, i can move it slightly upwards as well. I've also got some calf muscle return as well as some on my quadriceps/thighs. With this, i'm able to stand with crutches and even walk but, my knees go badly into hyper-extension so my doctor said i should use my wheelchair more often instead.

                    Comment


                      #11
                      Rednekc. Please do post if you get some info if you contact them, thanks. I also have some neuron deaths to my cord as a result of the ischemia the AVM created. Good to see that more companies and research institutions are planning human clinical trials for SCI, the trial above here I guess none of us was aware of, at least I was not aware of it before I did the search, hopefully there will also be more positive news like this. Btw. I also found this, more collaboration Source. Also found this Research although this seems to be more for the acute phases after spinal cord ischemia.

                      Comment


                        #12
                        Offer an example


                        Please have a look at this link
                        http://www.nrrfr.com/english_nr.asp?...ery%20Syndrome

                        Mark Anthony Carmack (USA)


                        2006-7-24
                        Mark Anthony Carmack (USA)

                        Brief Medical History:
                        This 30-year-old American male patient was admitted to China for treatment of Spinal Anterior Artery Syndrome onJun19th 2006 .He has had two surgeries due to aortic stenosis in 1978 and 1998. In the second surgery, he received serious angiorrhexis resulting in his spinal cord injury; He was rendered an incomplete paraplegic and lost the sensation below the lower chest. It was diagnosed as Anterior Spinal Artery Syndrome. His lower limbs developed muscular atrophy and felt burning in his lower limbs. He had partial sensation and control of the bladder and the bowel. He had been doing physical therapy and acupuncture but there was no any improvement.

                        ADMISSION DIAGNOSIS: Anterior Spinal Artery Syndrome

                        PHYSICAL EXAMINATION:
                        Mentation: Normal. He was examined according to the criteria of the ASIA neurological assessment scale. Muscular power: upper extremities 5/5 bilaterally .Hip flexors 1/5 bilaterally; Knee extensors 0/5 bilaterally. Ankle dorsiflexors 0/5.Long toe extensors 0/5.Ankle plantar flexors 0/5. Light touch: hypesthesia level:T6-S4/5 on his right and T7-S4/5on his left , Pin prick: analgesia level : T6 on his right and T7-T11on his left. Analgesia level: T8-S4/5 on his right and T12-S4/5 on his left. Deep sensation including topesthesia, vibratory sense, and proprioception were normal .Otherwise the sensation to light tough, pinprick and temperature significantly decreased below the lower chest.

                        ASIA motor score was 26points on the right, left26points.
                        ASIA light touch score was 40 points on the right, left 41 points
                        ASIA pin prick score was 27 points on the right, left 31 points.
                        The score of Xishan Hospital Spinal Cord Injury Functional Rating Scale was 33 points.

                        OPERATIVE PROCEDURE:
                        Under general anesthesia, the olfactory ensheathing glial cell transplantation procedure was done on Jun21 of 2006. 50 µliters containing about 1,000,000 cells was injected into the spinal cord of the patient.

                        POST-OPERATIVE COURSE:
                        The course of the operation was good. He recovered well after the operation. Ten days after the surgery, the stitches were taken out. After the surgery he noticed that his edema had lessened. Seven days after the surgery, he began to have a sensory change which resulted in a gain of two spinal levels: T7 sensation moved down to T9 and is still continuing to move down. He felt strong enough in my legs to raise them from the bed and move them in several positions quite easily .His lower limbs pain had relieved .When he went to toilet he had obviously feeling and control, neurology examination: Muscular power: upper extremities 5/5 bilaterally .Hip flexors 3/5 on his right and 1/5 on his left. Knee extensors 2/5 on his right and 1/5 on his left. Ankle dorsiflexors 0/5.Long toe extensors 0/5.Ankle plantar flexors 0/5. Light touch:: T9-S4/5 bilaterally,: analgesia level: No. Pin prick: hypesthesia level: T9-L4, S1-S4/5 bilaterally, Analgesia level: L5 bilaterally, Deep sensation including topesthesia, vibratory sense, and proprioception were normal. The sensation to light tough, pinprick and temperature significantly to recover normal below the lower chest.

                        ASIA motor score was 30points on the right, left 27 points.
                        ASIA light touch score was 43 points on the right, left 43 points.
                        ASIA pin prick score was 42 points on the right, left 42 points.
                        The score of Xishan Hospital Spinal Cord Injury Functional Rating Scale was 37 points.

                        EMG conclusion: Compared with the pre-operative EMG in 20/06/2006: The recruitment of the hard contraction of both sides of Iliopsoas and Anal sphincter L muscles was changed, and its pattern was improved and more intensive than pre-operation.

                        The patient stated: “I am a 30 year old Caucasian male who was diagnosed with anterior spinal artery syndrome following an aorta repair in 1998. I am six feet and three inches tall and weigh approximately 180 pounds. My original condition consisted of complete motor loss at the T-8 level with sensory impairment at the T-6 level. I have had very gradual improvement over the last eight years leading to the ability to stand and take steps with leg braces and forearm crutches; however, it was very laborious and the length of time that I could stand and walk was very short due to using my upper body so much. Also, I had severe pitting edema in my lower legs and feet due to poor circulation in my legs, accompanied by neuropathy in both legs extending up to the level of injury. To relieve the edema as much as possible, I had to use compression stockings with a strong level of compression, and still, the edema would not completely dissipate. I received the OEC transplantation on July 21, 2006 by Dr. Huang. Immediately after surgery I noticed that my edema had completely dissipated, and in fact, I could not even wear my compression stockings any longer because they would actually cut off my circulation, which was now much stronger. Seven days after the surgery, I began to have a sensory change which resulted in a gain of two spinal levels: T-7 sensation moved down to T-9 and is still continuing to move down. The other major change is that I am now strong enough in my legs to raise them from the bed and move them in several positions quite easily. Before surgery, these movements were either non-existent or very difficult. About two weeks after surgery, I put on my braces and forearm crutches and walked an amazing 150 feet with quite a bit of ease because I did not need to use my upper body very much. I am now using my legs to walk! I have not been capable of walking with my legs since the injury. Each day that I walk, my balance and coordination improve, as well as my stamina. I don’t know what to expect in the months to come, but if this recovery is any indication, I plan to be back on my feet at some point in the near-future. In summary, I must say that I have had a very positive experience with Dr. Huang’s procedure and would be happy to answer any questions regarding my experience here.

                        Contact Email Address : ma_carmack@yahoo.com


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