Newsgroup: it.scienza.medicina
Titolo: Due domande!

  Salve,
  avrei due domande da porvi:
  la prima riguarda Huang Hongyuin, il pioniere cinese delle cellule staminali,
sembra che si trovi di passaggio in Italia, e di preciso a Bologna, volevo
sapere se qualcuno sapeva come fare per "contattarlo"!!! o se aveva notizie in
merito!!!
  In poche parole, mio fratello (in carrozzina da 10 anni) vuole sapere se... se
esiste qualcosa di nuovo!!! 
  La seconda domanda e' di natura farmacologica!
  Anni fa usavo l'ATTENTIL ... che ho scoperto essere stato messo al bando nel
'97 (se ricordo bene) dalla sanita' USA (questo non vuol dire nulla lo so... ).
  Oggi ho chiesto in farmacia e mi e' stato detto che non esiste piu'... e non
c'e' nulla di simile... nulla che abbia gli stessi costituenti insomma!
  Mi chiedevo se la messa al bando USA avesse toccato anche i nostri confini!!
  E comunque, per quale motivo?? 
  Una gran fregatura comunque,... ne avrei proprio bisogno!!!! ^___^ 
   Vi ringrazio in anticipo per ogni minima informazione!
Sergio Pomante
www.millenniumlabs.it
Editoria e Ricerca Scientifica

 
alcuni casi di epatite fulminante massiva che richiesero il trapianto di 
fegato
gerca su google "fipexide"

 (non so se sia accessibile senza abbonamento)
No.
Magari ci fai un sunto? O:-)
-- 
         ___
  /\/\/\/ _/  Doctor Diabolicus
/     / /_
\/\/\/\__/   
http://www.sci-med.it

 
non ho tempo :-(
Fetal-cell therapy: Paper chase
Thousands of patients are queueing to be treated by Hongyun Huang at his 
Beijing clinic. But no Western journal editor seems willing to publish 
his research.
Hongyun Huang claims that his technique of injecting fetal cells into 
patients can improve the quality of life for people with spinal injuries.
Renowned German artist Jörg Immendorff is used to causing a stir. But 
when he flew to China this March to receive an unconventional treatment 
for his neurological disease, he provoked uproar at home. His doctor 
scolded him for trying a therapy that was unproven. And newspapers 
warned of the possible rise of medical tourism to China based on false 
hopes.
Immendorff was undeterred. He suffers from ALS, or amyotrophic lateral 
sclerosis, a progressive disease that is slowly breaking down his nerve 
cells and destroying his muscle control. The condition is incurable, and 
Immendorff was willing to try nearly anything to alleviate his symptoms. 
"I see myself as part of an experiment," he told the German newspapers.
The artist's destination was the clinic of Hongyun Huang, a neurosurgeon 
at Chaoyang Hospital in Beijing. It was Huang who developed the 
treatment — and it was Huang who injected two million cells from an 
aborted fetus into Immendorff's brain.
Since 2001, Huang has used cells taken from nasal tissue in fetuses to 
treat some 600 patients with a number of neurological problems, from 
spinal injuries to degenerative disorders such as multiple sclerosis and 
Parkinson's disease. He claims a high success rate, but says he uses the 
treatment only as a last resort. "Many diseases have no cure," he says, 
"and we need to try new methods."
Many of Huang's patients are effusive in their praise for the 
unconventional therapy. But it remains anathema outside China — his 
critics argue that his results are supported by little more than 
anecdotal evidence.
 
This divide presents something of a dilemma. Medical scientists want to 
see new treatments put through rigorously controlled studies and are 
suspicious of claims not backed by scientific evidence. A strong patient 
following is not enough to demonstrate the efficacy of a novel approach, 
particularly given that desperate patients are eager to try anything 
that may help. On the other hand, a physician who believes a treatment 
is working might resist performing placebo controls as these seem 
unethical. This can leave patients caught in the middle — unsure of the 
science, they will often seek the treatment whether or not the research 
has been done.
Among his patients, Huang has treated about 400 with spinal cord 
injuries and 100 with ALS. Some who have received the therapy claim that 
they have improved hand motion and feeling in their fingers. Others 
report better bowel control and greater ease of breathing. Huang admits 
that not all of the patients who receive the US$20,000 treatment 
respond, but he claims that most do. And he says there is no evidence of 
serious side effects. As a result, his reputation among patients has 
spread. Some 3,000 Chinese and 1,000 foreigners are now lined up for the 
fetal-cell injections.
Distracted in an office bustling with assistants, Huang says he is 
confused over why the Western academic world won't recognize him. He has 
published nine papers in Chinese journals, including one written in 
English1. But despite his claims of clinical success, Huang says that 
his latest manuscript has been rejected by several of the top 
international journals, including Nature Medicine, Science, The Lancet, 
The New England Journal of Medicine and the BMJ. Huang says his results 
should be seen as a revolution in clinical treatment, and that rejection 
is pure discrimination — a refusal to take a serious look at a new 
method developed by a researcher in China. "If this came from England or 
the United States, it would have already been published," he says.
Many observers disagree with that assessment. They say that the real 
problem with Huang's work, which he has presented at several 
international meetings, is the difficulty of measuring his results. For 
the most part, they are anecdotal. Huang uses videotapes of individual 
patients and relies on their own assessment of their progress. Such 
self-assessment is not always consistent. German newspapers reported 
that Immendorff, for example, felt he could move his hands better after 
the surgery. But later he said that the treatment hadn't really had any 
effect.
Unlike proposals to use stem cells to treat conditions such as ALS, 
Huang's cell injections are not intended to replace damaged nerve 
tissue. Instead he uses olfactory ensheathing cells (OECs) to promote 
healing through the production of proteins called growth factors that 
stimulate cells to grow and divide. OECs are believed to be responsible 
for the olfactory system's unique and still mysterious ability to sprout 
new connections to the central nervous system throughout a person's 
lifetime2.
Studies in animals suggest that OEC transplants can help to repair 
damaged nerves. This was most dramatically illustrated in 2000, when 
Almudena Ramón-Cueto, a neuroscientist at the Autonomous University of 
Madrid, used the cells to give paralysed rats the ability to use their 
legs3. Geoffrey Raisman, a neurobiologist at London's National Institute 
for Medical Research, has seen similar results. Raisman has been working 
with OECs since the 1980s, and has found that the cells can 
significantly improve breathing difficulties in rats with spinal 
injuries4, 5 — in humans, breathing problems can chain patients with 
spinal damage to a ventilator.
In his office, Huang plays videos of patients taken before and after the 
OEC transplant. Before, one ALS patient moves forward in a jerky motion 
and needs a crutch. His speech is limited to unintelligible mumbling. A 
month after surgery, the same patient gives a clearly enunciated 
introduction and, after a struggle to stand, moves forward without a 
crutch and more smoothly than before. Another who couldn't hold a cup 
for ten years is shown, post-surgery, signing his name with a pen.
More quantitatively, Huang scores some patients on tests designed by the 
American Spinal Injury Association (ASIA) and the International Medical 
Society of Paraplegia. Using the ASIA test, which measures the patient's 
ability to move, and to feel a light touch and pin pricks, Huang has 
reported some improvement after the transplant in patients with 
spinal-cord injury1.
Since Huang began performing the operations, enthusiastic reports from 
patients have been broadcast in news reports and Internet discussion 
groups. Among his champions is Donald Debolt from east central Illinois, 
who was paralysed in an accident in 1994. He says that he is still 
improving following his surgery in May 2004. "I was recently able to 
fasten a button for the first time in 11 years," Debolt says. Increased 
muscle development in his arms, back and abdomen are a great help when 
his wife struggles to get him in and out of his wheelchair, he adds.
Laura Jackson, who was paralysed below the neck in a cheerleading 
accident in May 2003, couldn't breathe on her own for more than five 
minutes before the surgery. Now she can stay off the ventilator for two 
hours at a time, and she has regained some trunk movement and sensation 
in her fingertips. "Was all of it from the therapy? No. Was most of it? 
Yes," says Daryl, Laura's father.
But not all patients are satisfied. Francis Catena, a major in the 
Belgian army until a fall broke his spine, says that despite modest 
improvements in movement and sensation, his therapy was not worth the 
hassle or the money. Reached at his home in Thailand, Catena complained 
of unsanitary hospital conditions in Beijing. He adds that his own 
doctor raised questions about whether the surgery had been done 
properly. "I've seen amazing recoveries from Huang's procedure with my 
own eyes," Catena says, "but I expected more."
Patient testimonials and video tapes hold little sway with Huang's 
research peers. According to Raisman, the fundamental problem with 
Huang's studies is the lack of proper controls or any independent 
analysis of the data. "He needs to carry out studies for a significant 
length of time before and after the surgery with a degree of independent 
assessment," Raisman says. "His studies are not advancing things."
Martin Schwab, a neuroscientist at the University of Zurich, agrees that 
lack of careful quantification of the patients leaves evaluation of the 
procedure reliant on reflex testing and other subjective factors that 
might produce a placebo effect. "Videotapes and anecdotal evidence are 
clearly not acceptable as scientific evidence," he says. More compelling 
evidence might be possible if Huang used magnetic resonance imaging or 
electrical recordings of muscle activity to demonstrate changes in 
neural circuitry, suggests Nature Medicine's editor Juan Carlos López. 
"These would be quite convincing data," he says.
Without such studies, it is difficult to know whether the surgery is 
worth the risks. Although a number of animal studies using OEC to treat 
spinal-cord injury have been published, work in animal models of ALS or 
other neurodegenerative diseases has yet to reach this stage. Such work 
is normally a prerequisite for gauging the safety and efficacy of a 
treatment in humans. Furthermore, as the fate of the cells once they are 
injected is not well understood, there is cause to worry about side 
effects, Schwab notes. "They could trigger inflammatory processes which, 
within the intact central nervous system tissue, would have catastrophic 
consequences," he says.
Huang counters that he has received approval from his hospital's ethical 
review board, and he insists that the safety of the procedure has been 
proven. Although he concedes that there is room for improvement — so far 
he has not used tissue-type matching to reduce the chance of the cells 
being rejected, for instance — he argues that it is time for action, not 
more animal studies. Scientific or not, that argument has a strong 
appeal to patients. "There are more animal and mouse studies than the 
world can take. We're ready for the real thing," says Daryl Jackson.
Huang's detractors say that tissue matching, as well as controlled 
studies, should have been a top priority from the very beginning. They 
add that this gap between Huang's approach and that of the mainstream 
biomedical research community will only make it more difficult for him 
to win general acceptance for his therapy — and to get published.
In the face of the repeated rejections, Huang says he is going to give 
up trying to convince a Western scientific community that, he is 
convinced, is prejudiced against him. "It's their loss. If they believed 
my results, it could dramatically change clinical practice," he says. 
And the patients are lining up whether or not his work is published.