Day 1 :
Northwestern University, USA
Time : 10:00 - 10:30
Todd A. Kuiken received his MD and Ph.D. in biomedical engineering from Northwestern (1990) and his residency in PM&R at the Rehabilitation Institute of Chicago (1995). He is a Professor in the Depts. of PM&R, Biomedical Engineering and Surgery of Northwestern University.
Dr. Kuiken currently is the Director of the Center for Bionic Medicine (CBM). This is a large multidisciplinary team that is focused on translational research in the areas of rehabilitation engineering and surgery. Key projects have include the development of Targeted Muscle Reinnervation, Pattern Recognition Control for powered prosthetic arms, the development of novel robotic arm and leg prostheses and unique wheelchair designs.
Providing adequate control of a powered artificial arm is difficult, especially with high levels of amputation where the need is greatest. We have developed a new technique to create a bi-directional neural interface for artificial limbs called ‘targeted muscle reinnervation’ (TMR). With TMR, it is possible to take the residual nerves in an amputated limb and transfer them to spare muscle and skin in or near the limb. The nerves grow into this muscle and then the surface EMG over this muscle can be used as an additional control signal. For example, if the median nerve reinnervates a small region of surface muscle, then when the amputee thinks ‘close hand’ this muscle will contract and the myoelectric signal can be used to close the powered hand. Since physiologically appropriate neural pathways are used, the control is intuitive, thus easier and faster for the amputee. Similarly, sensory nerves can be transferred to the residual nerves so that skin of the chest or arm is reinnervated-targeted sensory reinnervation (TSR). Then when the amputee is touched on this reinnervated skin, it feels like he or she is being touched in the missing arm or hand. TSR can provide a pathway for true sensory feedback of light touch, graded pressure, sharp/dull and thermal feedback. Research is presented showing how the skin of residual limbs has been reinnervated by hand afferents and our early attempts to provide closed loop feedback. TMR also is proving to be a very successful treatment for painful neuromas and it is likely an effective treatment to prevent neuromas. Essentially when a cut nerve or cut off neuroma are transferred to a small section of denervated muscle (by cutting a local motor point for example), the regenerating nerve now has a volume of muscle to grow into and many functional connections are formed. Thus the nerve is treated in a physiologically appropriate manner, more like a primary nerve repair. Compelling animal model data and a thorough review of neuroma pain in TMR patients will be presented.
LifePharm Global Network, USA
Keynote: Pilot study showed C-reactive protein was significantly reduced in subjects with progressive osteoarthritis consuming a proprietary dietary supplement for 4 weeks
Time : 10:30 - 11:00
Edward Andujar has received his Medical degree from Harvard Medical School and did his Residency at Temple University Hospital in Philadelphia, PA. He had a general practice for 20 years. With the growth of the dietary supplement industry and his interest in the field, he joined LifePharm Global in 2011 as a Research Scientist. He designs protocols with clinical physicians to investigate safety and efficacy of various dietary supplements. His preliminary work of investigating Laminine® and other dietary supplements appears in the Physician’s Desk Reference. He is devoted to educating consumers and other health care professionals in the clinical efficacy of nutritional supplements and their potential benefits.
Statement of the Problem: Osteoarthritis (OA) is a major cause of disability. It causes pain due to inflamed knee joints, involves cartilage degeneration and loss of collagen fibers. Current therapies have little influence on disease progression and are associated with adverse side effects. There is merit for use of safe compounds derived from natural sources for the treatment of OA. Increased serum levels of C-reactive protein (CRP) are observed in patients with OA. A low-level increase in CRP occurs in early disease and is predictive of progressive loss of joint space. CRP levels at presentation may help physicians identify individuals at risk of progression who may be suitable for intervention.
Methodology & Theoretical Orientation: Five subjects experiencing joint stiffness and pain were recruited by the physician. They signed voluntary informed consent for routine blood sampling and supplement ingredients. Subjects consumed one supplement (Laminine®, LifePharm Inc. Lake Forest, CA) in the morning and one in the evening for 4 weeks. Subjects were not asked to modify behaviors or medical regimens.
Findings: A t test for related samples was performed comparing baseline and 4 week final CRP values (p=0.02562). A sign test (p=0.03125) and Wilcoxon matched-pairs signed-ranks test (p=0.03125) were performed to confirm results as sample size was small.
Conclusion & Significance: This pilot study indicated the supplement supported a reduction in CRP in subjects with mild to moderate OA symptoms. The supplement contains proprietary fertilized chicken egg extract, fish and pea proteins. Recent human skin fibroblast experiments showed the unprocessed egg used in Laminine®, contained active Platelet Derived Growth Factor, Transforming Growth Factor β-1, Lysyl oxidase, Fibroblast Growth Factor 2 and chondroitin. When the proprietary egg was added to the cells there was highly significant up-regulation of collagen, elastin and fibronectin production compared to controls. These receptors and mechanisms are also found in connective tissues. Results warrant further studies.