A short-term, very-high dose regimen of the immune-suppressing drug cyclophosphamide seems to slow progression of multiple sclerosis (MS) in most of a small group of patients studied and may even restore neurological function lost to the disease, Johns Hopkins researchers report. The findings in nine people, most of whom had failed all other treatments, suggest new ways to treat a disease that tends to progress relentlessly.

“We didn’t expect such a dramatic return of function,” says Douglas Kerr, M.D., Ph.D, associate professor of neurology at the Johns Hopkins University School of Medicine. “Although we’re very early in the game, we think this approach could be the linchpin of a significant advance for MS treatment.”

Researchers have used the so called HiCy treatments with some success at Johns Hopkins for a variety of other immune system disorders, including aplastic anemia, lupus and myasthenia gravis.

Cyclophosphamide kills immune-system cells but spares the bone marrow stem cells that make them. The usual method of delivering it in pulsed, small doses, however, can cause the drug to build up to toxic concentrations in patients’ bodies, causing a variety of side effects, including a greatly increased risk of infection.

Seeking an alternative way to use the drug, Kerr and his colleagues reasoned that HiCy might clear out the majority of a patient’s immune system in one fell swoop, then allow it to ‘reboot,’ giving nerve cells a fresh start and an opportunity to repair themselves. In the current study, nine MS patients got a total single infusion of 200 milligrams per kilogram of cyclophosphamide intravenously over four days, a dose several times higher than that given in pulsed regimens but significantly lower than the total amount usually given patients over time.

Before treatment, Kerr says, the study participants were “the worst of the worst” among MS patients. Eight of the nine patients had failed conventional MS treatments, and several of them were wheelchair-bound.

A new report shows that a non-ambulatory (unable to walk or stand) child with a cervical spinal cord injury was able to restore basic walking function after intensive locomotor training. The case study, published in Physical Therapy (May 2008), the scientific journal of the American Physical Therapy Association (APTA), evaluated the effects of locomotor training in a 4 ½ year-old-boy, who had no ability to walk following a gunshot wound sixteen months earlier.

A new study from the University of Alabama at Birmingham indicates that the OtisKnee Custom Fit Knee™ Replacement system may have a positive impact on length of hospital stay, range of motion, pain level and patient satisfaction immediately following total knee replacement surgery. The study abstract, titled “MRI-Guided Custom-Fit Total Knee Replacement: The First Six Weeks,” was presented at the joint Alabama Orthopedic Society and Mississippi Orthopedic Society annual meeting on May 3, 2008 in Sandestin, Fla. by Herrick Siegel, M.D., associate professor of surgery at the University of Alabama at Birmingham and lead investigator of the study.

May 27, 2008 (Nice, France) — In the largest European stroke research program ever undertaken, countries in the European Union are joining forces in a unique effort to structure, integrate, and advance stroke research.

Announced at the recently held 17th European Stroke Conference, the initiative, which is known as the European Stroke Network (ESN), will receive €21 million over the next 5 years — funding that is over and above research initiatives supported at the national level individually by each of the 14 participating European Union member states.

“Pooling of competencies and resources promotes cooperation and collaboration among European teams, helps to avoid duplication of effort, and increases our chances of making discoveries that can benefit human health. Research like this will give hope to reduce and eventually prevent strokes and future suffering of patients and their families,” Manuel Hallen, MD, director of health research at the European Commission, told reporters attending a press conference here.

Newswise — Florida Atlantic University has filed a provisional patent for a unique robotic device to assist with the physical rehabilitation process of patients suffering from neurological damages to their upper extremities such as those due to stroke or Parkinson’s disease. Inventors, Dr. Oren Masory, chair and professor of mechanical engineering in the College of Engineering and Computer Science, and Melissa Morris, FAU engineering graduate student, designed and built the device to aid physical therapists and their patients to retrain injured muscles.

The invention is composed of moving parts, including motors, cables and spools, enclosed within an acrylic case with a handle [joystick] that is indirectly connected to the system through magnetic attraction. This device is the first-known cable driven robot to utilize a barrier between the operator and the moving mechanisms of the system. The system does not contain any rigid parts that could suddenly harm or injure the user, and the device can be used in a physical therapy office or at home without supervision. In addition, the system has a safety button embedded in the handle and if released during operation, a signal is sent to the controller that the patient has lost contact with the handle and the system immediately shuts down.

The device is designed to operate in various modes which guide the patient through a series of routine exercises. One mode enables the patient to begin his/her training by following a preprogrammed path which corresponds to “repetitions” done in traditional physical therapy. Another mode assists the patient as he/she attempts to follow the path, and the robot corrects them if they move outside of the path in much the same way a therapist would do by providing gentle resistance. It also offers varying resistance at all points within the platform to simulate contact with objects and increase muscle strength. An additional mode offers a significant advantage over traditional physical therapy by providing absolutely no resistance to the patient, allowing movement anywhere within the platform for the purpose of diagnostic measurements. Furthermore, this device allows the physical therapist to make changes or modify the program to create new paths or change the level of resistance. The device also assists physical therapists by taking over the tedious work of repeated training.

In every town in every part of this sprawling country you can find a faceless sprawling strip mall in which to do the shopping. Rarely though would you expect to find a medical miracle working behind the counter of the mall’s hobby shop.

That however is what Lee Spievak considers himself to be.

“I put my finger in,” Mr Spievak says, pointing towards the propeller of a model airplane, “and that’s when I sliced my finger off.”

It took the end right off, down to the bone, about half an inch.

The photos of his severed finger tip are pretty graphic. You can understand why doctors said he’d lost it for good.

Today though, you wouldn’t know it. Mr Spievak, who is 69 years old, shows off his finger, and it’s all there, tissue, nerves, nail, skin, even his finger print.

How? Well that’s the truly remarkable part. It wasn’t a transplant. Mr Spievak re-grew his finger tip. He used a powder - or pixie dust as he sometimes refers to it while telling his story.

Mr Speivak’s brother Alan - who was working in the field of regenerative medicine - sent him the powder.

For ten days Mr Spievak put a little on his finger.

“The second time I put it on I already could see growth. Each day it was up further. Finally it closed up and was a finger.

“It took about four weeks before it was sealed.”

Now he says he has “complete feeling, complete movement.”

The “pixie dust” comes from the University of Pittsburgh, though in the lab Dr Stephen Badylak prefers to call it extra cellular matrix.

MONDAY, April 28 (HealthDay News) — Patients having decompression surgery within 24 hours of a cervical spinal cord injury may have a better outcome than those who have the procedure later, according to new research.

Surgical decompression of the spinal cord involves the removal of various tissue or bone fragments that are being squeezed and comprising the spinal cord. While commonly done after an injury occurs, the timing of the procedure varies widely.

The study looked at 170 patients with cervical spinal cord injuries, graded as A (most several neurological involvement) to D (least severe), who underwent decompression surgery.

Six months after the surgery, 24 percent of the patients who had the surgery within 24 hours showed two-grade or greater improvement in their condition compared with only 4 percent in the group that had the surgery more than a day later.

The overall amputation rate in northern Illinois is declining due to improved care for diabetes and peripheral vascular disease, new research shows.

But not everyone is reaping the benefits.

A new study from Northwestern University’s Feinberg School of Medicine has found people in African American communities on Chicago’s South and West Side have a five times higher rate of lower limb amputations than people in the predominantly white suburbs and exurbs.

“Amputations are the canary in the coal mine for quality of care,” said Joe Feinglass, lead author and research professor of medicine at the Feinberg School. “Many amputations are preventable. This means the primary care for minority people may not be very good. ”

Feinglass said the high rate of amputations means people are not being closely monitored. “They come in with gangrene or a skin ulcer that comes to the attention of a doctor really late and nothing can be done,” he said. “They have to take their leg off.”

Newswise — Every year, nearly 12,000 individuals in the United States and Canada, mostly young adults, sustain a spinal cord injury (SCI). According to the Centers for Diseases Control and Prevention (CDC), SCI costs an estimated $9.7 billion each year in the United States alone. Although there are some surgical interventions, such as decompression, which neurosurgeons administer to SCI patients after injury, these procedures have not dramatically improved overall recovery and outcome. “This is an area of medicine that has not seen tremendous scientific advances, so there remains an urgent need to improve upon current interventions to help restore neurological function in patients with acute SCI,” said Michael Fehlings, MD, PhD, FRCSC, FACS, head of the Krembil Neuroscience Center at the University Health Network in Toronto and professor of Neurosurgery at the University of Toronto.

WASHINGTON (Reuters) - Teams of university scientists backed by U.S. government funds hope to grow new skin, ears, muscles and other body tissue for troops injured in Iraq and Afghanistan, the Defense Department said on Thursday.

The $250 million effort aims to address the Pentagon’s unprecedented challenge of caring for troops returning from the war zones with multiple traumatic injuries, many of which would have been fatal years ago.

“We’ve had just over 900 people, men, some women with amputations of some kind or another since the start of the conflicts in Afghanistan and Iraq,” said Ward Casscells, assistant secretary of defense for health affairs. Many have also suffered burns, spinal cord injuries and vision loss.

“Getting these people up to where they are functioning and reintegrated, employed, able to help their families and be fully participating members of society, this is our task,” he said.

Under the initiative, the Pentagon launched the Armed Forces Institute of Regenerative Medicine made up of two teams — the first led by Wake Forest University in North Carolina and the University of Pittsburgh and the second led by Rutgers University in New Jersey and the Cleveland Clinic.