Some stroke victims may be aided in the future by a new treatment that pumps an artificial spinal fluid loaded with oxygen and nutrients into injured areas of the brain.
Dr. Jewell L. Osterholm, chairman of the Department of Neurosurgery at the Jefferson Medical College of Thomas Jefferson University in Philadelphia, was honored for this development earlier this month as the 1984 Inventor of the Year. He received a plaque and $2,500 from Intellectual Property Owners Inc., a nonprofit trade association for people who hold patents, trademarks and copyrights.
The IPO also designated two Distinguished Inventors: Ronald Kirk, for electronically generated holography, and Paul A. Porasik, for an improved method of manufacturing detergents.
Strokes, the third-leading cause of death in the industrialized world, account for 10 percent of all deaths in the United States and impose an economic burden of more than $7 billion a year, according to Thomas Jefferson University. Only 10 percent of surviving stroke victims return to full activity.
Osterholm's procedure is designed to solve the so-called "non-reflow phenomenon": Even after arterial blockage is removed, the brain resists reopening capillaries (smaller blood vessels branching off from the affected artery). This prevents the blood from carrying needed oxygen and nutrients to the affected part of the brain.
"We have devised a method to go to the back door," Osterholm said. His method supplies nutrients to stroke victims by pumping an artificial spinal fluid into the brain's cavities, and out the spinal column at the back. The fluid carries oxygen and nutrients, substituting for the blood that cannot get through the blockage. The brain extracts the nutrients from the fluid and releases carbon dioxide and other waste products into it. The fluid comes in contact with the brain for only a second. It is not recirculated, and can be analyzed to indicate the brain's condition.
Osterholm estimated that as many as 20 gallons of fluid would be used in a "normal" treatment. He said the cerebral support system probably would cost about $25,000 and patients would be charged about $6,000. Hospitals with as few as 200 beds and an intensive care unit could purchase the equipment, Osterholm said.
During tests, animals demonstrated significant improvement after 24 hours of Osterholm's treatment. But Osterholm stressed that treatment must start within four hours after a stroke begins to have any effect.
"We think that most hospitals are within four hours of most people," Osterholm said.
He has applied to the Food and Drug Administration for permission to conduct experiment on humans, but the agency has some questions, and the tests may be delayed up to 18 months. The process is not expected to be available commercially before 1990. "This is a complicated material to make. . . . It's a whole new technology that has to be addressed," Osterholm said.
The procedure is believed to aid victims of blockages rather than hemorrhages, and Osterholm said it also might be used to treat head and spinal chord injuries, senility and Alzheimer's Disease. He said anticoagulants could be administered with the fluid to wipe out blockages.
According to Osterholm, the idea of introducing medication into spinal fluid is not new -- antibiotics and chemotherapy already are administered this way. And he said that while his is not the first artificial spinal fluid, it is the first designed to supply the brain with oxygen and nutrients.
Osterholm has obtained a total of 12 patents on the equipment for circulating the artificial fluid, the fluid itself and some of the associated diagnostic methodology.
Osterholm used a traffic-jam metaphor to explain how he came up with his stroke treatment: "If you consider that the primary route is blocked, you drive through the alley." The approach is not complicated, he conceded, but no one else had thought to use it before.
Johnson & Johnson has contributed three-quarters of the $1 million cost of the research, and Thomas Jefferson University, in turn, has licensed the process to the health-care company for development and commercialization.
Osterholm said he believes that working with commercial sources has given him faster access to funds than he would have had under a government grant. He said he also has benefited from the expertise of other Johnson & Johnson researchers: One of Johnson & Johnson's companies developed the oxygenator used in Osterholm's process.
Osterholm has been at Thomas Jefferson University since 1974. Before that, he was at Hahnemann Medical College and Hospital in Philadelphia for 10 years.
Kirk is president of Holotronics Corp. of Findlay, Ohio, which was set up to develop and market his spatial light modulator (as the electronic holographic generator is called). Holotronics is not traded on any exchange, but it is publicly held by some 800 shareholders in 10 states.
Kirk said that predicting the potential for electronic holography -- which he called "an extremely-broad-based technology" -- is like asking the inventor of the transitor to predict all its uses immediately after its inception. He did cite his invention's potential for industrial robotics, medical imaging and holographic television.
He said holographic information would reduce the size and cost of the computer needed to run an industrial robot, increasing its ability to emulate human behavior. "It's going to explode the already existing robotics revolution," he said.
Kirk also said that Holotronics is seeking a general partner to spin off a new company to create a holographic projection system for existing medical imaging equipment. He said this would let surgeons examine a human heart as though it were live and beating isolated on a table, for example, sharply reducing the need for exploratory surgery.
As for holographic television, Kirk said that, if he had the necessary funding today, "We would have a demonstrable system within three years."
Porasik is assistant to the president of Korex Co., a contract and private-label packaging company based in Wixom, Mich. His process involves wetting detergent particles with a fine spray while they are suspended in a gas, which is part of a treatment that prevents caking and increases the detergent's shelf life.