THE DERBY CITY NSCIA NEWSLETTERMAY 2004 | ||||||||||||||||||||
| The Derby City Chapter of the National Spinal Cord Injury Association Network- Serving Kentuckiana. | ||||||||||||||||||||
| Message From the President Dear Members & Friends- June’s meeting will be held at Kingfish Restaurant on River Road and Zorn at 6:00 p.m. - David Allgood
| The following article is an excerpt of the 2nd part of an article from Paraplegia News, May 2003 WITHIN THE REALM Part I of this article discussed olfactory tissue’s remarkable regenerative potential and the efforts of various scientists throughout the world to harness this potential by transplanting it into the injury site of people with chronic spinal-cord injury (SCI). Part 2 discusses the pioneering work of one of these scientists, Portugal’s Carlos Lima. Olfactory tissue, which covers about one inch of the upper nasal cavity, contains many cells with regenerative potential, including renewable neurons, progenitor stem cells, and remyelinating olfactory ensheathing cells (OECs). Olfactory neurons are comfortable residing in the central and peripheral nervous systems; because they are the body’s only surface neurons, they readily regenerate from a pool of progenitor stem cells. In addition, OECs can produce insulating myelin sheaths around growing spinal-cord axons, secrete various neuonal growth factors, and produce structural and matrix macromolecules that lay the tracks for axonal elongation. (Continued On Page Two)
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THE DERBY CITY NSCIA NEWSLETTER | ||
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| Derby City Area Chapter
The Derby City Area Chapter of the N.S.C.I.A. is a membership organization for individuals with spinal cord injuries, their families, and health professionals. Founded in 1984 as a Charter Member of the N.S.C.I.A., it was incorporated under IRS Section 501 (c) 3 as a not for profit organization. The Board of Directors consists of the Officers, Past President and the Board Members At Large. *** OFFICERS PRESIDENT VICE PRESIDENT TREASURER LIAISON TO FRAZIER INSTITUTE FUNDRAISING CHAIR CORRESPONDING SECRETARY/WEB MASTER PAST PRESIDENT BOARD MEMBERS AT LARGE- NSCIA Editor- Barbara Davis Contributor- David Allgood | WITHIN THE REALM, CONT’D training in Portugal and Germany. In addition to olfactory tissue physiology, he is an authority on the neuropathology of HIV infection and brain disorders similar to mad-cow disease. Lima seemed destined to work on olfactory processes. For example, before he was a medical student, he was a rock-and-roll singer, and, with prescient forsight composed, “Nose, Nose, Nose”, a song based on a poem written by eighteenth century Portugese poet Manuel Bocage. Lima’s guitar still stands out among his home-office computer equipment, and it was only the pleading of his exam-studying son that prevented Lima from giving an impromptu rendition of the song during my visit with him. The incident reminded me again that scientific inspiration reflects the soul’s creativity just as much as the mind’s intellect. Lima’s scientific epiphany came 15 years ago when, after reading about olfactory tissue’s unique neurological properties, he immediately envisioned its potential for bridging injured spinal cords. Since then, he has unswaveringly directed his research toward this goal, carrying out extensive studies in animals as well as human cadavers. Lima emphasizes the project is a multidisciplinary collaboration that also includes Pedro Escada, an ear-nose-and-throat specialist who collects the patient’s olfactory tissue; Prata Vital or Hasse Ferreira, neurosurgeons who implant this tissue into the patient’s spinal cord; and other Egaz Moniz Hospital specialists. Possessing a panoramic vista of the Tejo River estuary, Egaz Moniz Hospital has a historical association with neurological innovation, including being named after a 1949 Portugese Nobel Laureate who developed cerebral angiography for visualizing brain blood vessels. Assessments included the “gold standard” ASIA (American Spinal Cord Injury Association) scales for measuring SCI-related sensory and motor impairment. With these scales, patient improvement due to a specific intervention can be assessed in a consistent fashion and more readily compared to other studies. Patients were excluded if they had psychological disturbances, multiple spinal-cord lesions, confounding medical conditions, arm or leg denervation, or severe spinal cord atrophy. (Continued On Page Four) | |
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| WITHIN THE REALM, CONT’D From July 2001 to the beginning of 2003, Lima’s team has operated on four female and three male patients. Three were quadriplegic and four paraplegic. Six of the seven had ASIA-classified complete injuries. Ages ranged from 11 to 32 (averaging 22), and the time between injury and surgery varied from 1/2 to 6 1/2 years. Spinal-cord lesions ranged from 1 to 6 cm (1 cm = 39 inches) in length, although Lima believes the lesion optimally should be less than 2-3 cm. Most injuries were contusions, similar to those sustained in car accidents.
| Immersed in a small amount of the patient’s cerebrospinal fluid. The pieces are then implanted into the cavity. Lima estimates that a 1 cm cavity filled by this tissue will contain approximately 400,000 stem cells and 4 million each of mature and immature neurons and other supporting cells. Although preliminary results are promising, Lima emphasizes that much follow-up work is needed to document long-term benefits and any delayed side effects. Because only a short time has ensued since surgery for many patients, benefits associated with neurological regeneration are not expected to fully accrue for some time. Although Lima underscores that patients should have realistic expectations and not anticipate an all-encompassing, restoration-of-function panacea, he believes even modest restored function can have profound quality-of-life benefits. Using the ASIA standards, six of the seven patients regained some sensation and muscle control within a month of surgery. Because the seventh patient had a second undetected lesion, he did not improve. Lima suggests this initial recovery may be due to bridging and remyelination of available axons and also perhaps to some post-surgical cord decomposition. Improvement should gradually continue with time as neurons or their axons further regenerate and grow, remyelinate, and make new connections. This gradual improvement is demonstrated by Lima’s first patient, a 21-year-old female who sustained a C7-T1 contusion-type injury six months before surgery. She regained some sensory recovery about one month after the surgery, voluntary abdominal muscle control after two months, some gleuteus and leg abductor muscle control, including standing without leg braces after about nine months, and recently, some bladder control. Lima’s patients have had access to only modest postsurgical rehabilitation. He believes maximal restored function will require much more aggressive rehabilitation. Luis, 29, sustained a 4-cm long, clinically complete, T4-5 injury two years ago while helping a friend paint walls. After misplacing a foot, his life turned upside down. When a friend told him about Dr. Lima’s work, Luis immediately volunteered to be a candidate. “There was much uncertainty, but I had nothing to lose,” he remembers. Luis started noticing improvements two or three weeks after his August operation. He first regained sensitivity immediately below the injury site. Then came control of abdominal muscles and recently (Continued On Page Five) | |
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| WITHIN THE REALM, CONT’D abductor muscles, essential for equilibrium when standing. “Now I can feel the cold and even get goose pimples. Day by day, I rediscover my capacities,” he says smiling broadly. “And to accomplish it, I am ready to do whatever it takes.” Florbela, 32, sustained a 2-cm-long, C6 injury in a car accident six years ago. Her restored function demonstrates the procedure’s potential for those with more long-term injuries. Within several months of her surgery, she recovered abdominal muscle control, left-leg sensitivity, and, most recently, some grasping ability, which occurred at home with her husband. She notes, “We have recorded everything with the digital camera; I want everybody to see it.” At the time this article was written, two American women with C6 injuries from auto accidents in 2001 were being scheduled for olfactory-tissue transplantation. They are considered superb candidates due to their youth, excellent physical health, and commitment to rigorous rehabilitation. To help disseminate this function-restoring surgery, Lima is attempting a collaboration with a U.S. hospital in which Americans will travel to Portugal for olfactory-tissue transplantation, and Portugese patients will come to America for rehabilitation. At a 1995 congressional reception focusing on SCI, a colleague with high-level quadriplegia characterized the state of SCI research by paraphrasing a famous Martin Luther King speech. He believed that after a long trek in the wilderness, we have climbed the mountain and for the first time can see in the distance the Promised Land of restored function; some may complete the journey, and some may not. Times have changed. This Promised Land is no longer a mere vision on the horizon. With ground-breaking physicians and scientists guiding the way, the first pioneers with SCI are beginning to step, in some cases literally, into this Land. Whether it is someone like Luis and Florbela mentioned above; the Shanghai motorcycle driver Huocheng, who can now walk and control bladder function because of a nerve transfer surgery, actor Christopher Reeve, who through innovative rehabilitation therapy can now initiate never-expected movements; or world pole-vault record holder Brian Sternberg, who regained considerable life-enhancing function decades after injury through ometal transposition, an increasing number of such pioneers are in the future. It is a growing reality coalescing in bits and pieces, including the first olfactory-tissue transplantation carried out by Dr. Lima’s team. | FOR SALE!!!!*** 2003 Ford F-250 lift-equipped green/gray van; leather seats, TV, DVD player. Playstation hookup, am-fm radio. Rick Miller, 937-2245. Shower Chair; 2 yrs old, negotiable; 2 RoHo cushions; low profile; $150 each; Invacare 900 Action Power Chair; 4 yrs. Old; $600. Call 448-5296. *Ro Ho high profile 16x16 cushions; $160; 589-6620. *Wheelchair; 20” wide; adjusted petals; standard wheels; asking $2,2500. Quickie wheelchair; 19” wide; asking $2,000; needs batteries. New bedside commode; used; $75.00. Call 502-636-4043. *1984 Dodge Ram; handicap conversion; Crow River lift w/exterior/interior controls; heightened roof/door; captain chairs; exchange driver’s seat; hand controls; AC; AM/FM cassette & CB radios; wheelchair lock down/ties; rear bench; 2 spare captain chairs; 86,584 miles; good condition. Call 859-734-6852. *2002 Dodge Caravan “Entervan” (Braun modification); app 18,000 mi; remote operated oil recently changed; mechanic confirms excellent condition; used only a little more than 2 mos.; $34,000. Call 859-492-7971. *Ford 1997 Econoline Van; 100,140 mi; $16,000. Hunter Green-gray; new tires & brakes; “loaded”; call 270-786-4547; ask for Dale. *1994 Dodge Caravan, equipped with lock down for driving; cruise control; tinted windows; 56,000 miles; good condition; $14,000; contact Ina Hogan at 241-7849. *Hoveround MPV4; used only one year; 36” long; 23 1/2” wide; load capacity 300 lbs.; two direct drive motors; turning radius 17”; speed 5 mph. Asking $5,000 or best offer. Call 671-7656. *Jazzy Electric Wheelchair; $2,000; 812-867-0137. *1985 Komfort Koach Van with Power Lift; V-8; 350 BB; 5 liter engine; wheelchair safety straps; hook; television; power window and door locks; 127,000 mi; excellent condition; new tires; AC/front and rear vents; cruise control; AM/FM radio; tape deck; CB radio; game table and window shades; trailer hitch. Asking $2,995. Call 425-0314. *Heavy Duty Scooter; used less than 50 hours/2 new batteries; $1200. Call (502) 348-9305. *Liberty Stairlift/Set for 13 steps; $1500 soft; 937-9492 *Video tapes for sale. Various topics related to spinal cord injuries. Call David Allgood or Buddy Lawson. ***If assistance is needed to pay for any of the above items, contact Kentucky Assistive Technology Loan Corporation at for information on loans at 5% interest to qualified candidates. | |
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THE DERBY CITY NSCIA NEWSLETTER | |||||||
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| You are cordially invited to join us! The Derby City Chapter of the National Spinal Cord Injury Association We meet: WHEN- Third Monday of every month from 6:30 to 9:00 PM If you wish to be a member, donor, and/or be on the mailing list of the Derby City Chapter of the National Spinal Cord Injury Association please complete and mail the following form to the address below
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