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				How to Make a Nose Tissue engineers build a nose, heart muscle, and even a retina from the ground up. (Updated from earlier broadcasts)
		Select text to jump ahead in the clip: ALDA: It's never been hard to put together body parts... in the movies. It's alive. It's alive, it's alive! It's alive! ALDA: But Hollywood better look out, because MIT scientists are getting in on the act. Does he have the nose? Yeah, it's coming. You got it? MAN: Yeah. That's the nose? It's right in the dish here. ALDA: Okay, now, we are not-- repeat, not-- on a movie set. ALDA: Wait, what is this? This is cartilage. It is a scaffold of... You see the nostrils? Oh, yuck, wait a minute. Look, with nostrils and everything. We made a scaffold and there's the little nostrils there, and that's pure cartilage. You could make it in big blocks and carve whatever shape you want. Exactly, exactly, that's the whole idea. Would you mind taking this back? I really don't want to... I mean, it's alive, it's sort of alive. Yeah, sort of alive. We just wanted to give you a flavor for it. ( laughs ) Unbelievable! You bring in a nose! I mean, that's... I can't get over that. ALDA: In MIT's Langer Lab, they're actually figuring out how to make body parts. WOMAN: First we make what we call a polymer scaffold, and that's a piece of synthetic material that we can make into the form of a sheet or other three- dimensional forms. ALDA: Now we're making heart muscle starting with little clumps of synthetic fibers-- the polymer scaffold, as they call it. Then the scaffold is bathed in living heart cells. Bob Langer has pioneered this new field of tissue engineering. LANGER; She's trying to mimic outside the body what actually happens inside the body. She's giving it the kind of food it needs, the kind of structure it needs, and even the kind of mixing, you know, that it may get inside the body. ALDA: If you get the conditions just right, you can grow pieces of living heart tissue. I'm looking at something that's making heart. Does that sort of strike you every once in a while that you're making these things that used to be if you lost it, that would be the end? Yeah, well, that's what we want to do, you know. It does strike us. What we hope is that someday we'll be able to have a whole series of replacement parts for people so if they find a problem, we'll be able to help them. It's like an auto part shop, you know. That's right. I need a new carburetor, and you just go in and you drive out again. I mean, this is... How many years away are we from having a part shop for bodies, I mean, where you really can just get what you need? Is it ten years, 50 years, a hundred years, w-what? Must be hard to guess. Right, I think it may depend on the part, you know. Some of the easier parts like skin or cartilage, I think, you know, that's probably five or ten years. Some of the harder parts, like heart, that may be many, many, years away-- 50 or, you know... it's hard to know. ALDA: Here, after about two weeks of growth, are the pieces of new heart. They're under a microscope, and then you can see it on that monitor? That's right, we have a microscope here, and then basically they're on the monitor and you can see them beating. ALDA: That's not the dish shaking; those are separate cells beating. Right-- say, take a look right down here, for example, or here. And these are individual heart muscle cells and they're just beating. Is there any way you could make use of that right now in a heart? It's too early to do that now, but someday what I expect is that we could make a sheet of this, you know, and make cardiac muscle, and someday, if we have the right type of cells, to actually transplant that onto a patient, you know, if they have, uh... you know, if some of their heart muscle's damaged. ALDA: Right now they're working with animal cells, but Bob Langer's hope is not at all farfetched. Take a look at one of those pieces of heart as they give it an EKG-- like a regular heart checkup you might get from your doctor. ( monitor beeping rhythmically ) The new tissue transmits heartbeats exactly as it should. With tissue engineering advancing rapidly, the search is on for a reliable and ethical source of human cells to grow parts from. Three years ago, I visited Michael West at his company, Advanced Cell Technology. He's aiming to make any kind of cell required, starting from the kind of cell we all came from. They're called embryonic stem cells. Embryonic stem cells are the first cells that grow as an embryo develops-- precursors to all body parts. The idea is to grow these stem cells inside unfertilized eggs, which may pose fewer ethical problems than using fertilized embryos. Go straight in? Yeah, straight in. ALDA: The technique is similar to the one used to clone Dolly the sheep, although I'm actually working with a cow egg here. First I have to pierce it and suck out the nucleus, containing the cow's genetic material. SCIENTIST: Okay, now, turn it. ALDA: There it is, here it comes. Watch this, watch this, guys-- this is good, this is good. Have I got it? Go back a little bit more. Okay, got it, got it. Perfect, right there is perfect. ALDA: Next I pick up a human cell; this one's an adult skin cell-- it could be mine or yours or anybody's. Then I slide the skin cell into the egg. ALDA: This is really fascinating to do, but what are you getting out of this? What do you hope to get out of this? Well, the excitement about cloning isn't that we can make a genetic copy of a sheep or a goat. It's that it teaches us some really fundamental biology, and that's that every cell in our body, like the skin cells, has a genetic potential to recreate life, young life. So our hope is that someday, elderly patients that have heart disease or Parkinson's disease, we could take a little cell from their body they'd never miss and sort of take the cell back in time and recreate young cells and tissues that could be used for treating disease. ALDA: A tiny electric shock will stimulate the adult skin cell to start dividing. Somehow the environment of the egg leads the adult cell to behave like it's young, and begin to make embryonic stem cells. They've tried this with both cow and human eggs, so far with partial success. The number of divisions the implanted adult cell has made has been limited, but it's a start. WEST: The magic is, it's possible to make this sort of mother of all stem cells, the embryonic stem cell that's genetically identical to you, so that you... So I won't reject it, huh? If you make me a new organ or make me, uh... anything I might need because of the disease I have, I won't reject it. It's not coming from another person or another animal. The big unsolved problem, the reason thousands of people die every day, is the lack of transplantable cells and tissues that your body will not reject. And this new technology could be the long-sought means of transplanting cells and tissues that your body will not reject. ALDA: Back at the Langer Lab, they're working on the assumption that human stem cells of all kinds will eventually be available-- eye cells, for example. We're trying to create scaffolds that have pore sizes as low as ten microns on the way up to a millimeter. How small are you talking here? A micron is... What relationship is a micron to a human hair, for instance? Right, so a human hair is about 200 microns approximately. This is extremely tiny. How do you keep track of what you're doing? How do you actually build things that small? ALDA: Erin Lavick is going to teach me how to make a polymer scaffold like the ones used to build the heart tissue and the nose. But my scaffold is going to have the right fine pore structure to repair a damaged retina. LAVICK: This is the polymer dissolved in a solvent. ALDA: So this is what this scaffolding will be made of. Right. You're going to squirt it onto the slide. All of it? Mm-hmm. And then what you're going do is you're just going take that slide and slide it into the water. Oh, there's water there? Yep. Slide it into the water. Yeah, just like that. And so what's happening is when you slide it into the water, all of the solvent starts to come out and go into the water, and that transfers what's creating the pore structure in this case. ALDA: Erin's made thousands of these scaffolds, gradually refining her methods. LAVICK: These are some of the scaffolds that we've made using this technique, and these have all been dried. And so what you can see is they're very thin. You don't want to put something bulky in back of a retina. This looks like a piece of paper. But if you look at it under a scanning electron microscope, it actually has pores. ALDA: The tiny pores, each about 1/20 the thickness of a hair, are channels made by the solvent when it flowed out of the polymer. Next, working with Erin's colleague, Michael Young, I'm going to seed the scaffold with retinal stem cells. Now, I put... Just on... right in the middle of that big polymer. Just a little drop. Yeah, you can use all of that. That should be fine. And that's it. So I've seeded a polymer with stem cells. Yes. ALDA: Now we're going to see how the cells like it inside the scaffold. We're working with mouse retinal stem cells collected from a newborn animal as the eye was developing, so they're already on track to become part of the eye. Human cells like this aren't yet available. Okay... What are we looking at here? So this is the same type of polymer that we just looked at and seeded except I did it yesterday. You can see the pores in the polymer, if I focus. Yeah. But you can't see any cells, okay, because they're very small. ALDA: But when we shine an ultraviolet light on the cells, they burst into life. Now we can see retinal stem cells. ALDA: The cells have been modified to produce a fluorescent material as part of their normal life processes, so bright green spots mean healthy cells. This is beginning to look like a living retina. We're going to see what Michael and Erin are doing with the artificial retina, but first take a look at a normal eye. The retina's at the back. It has a thin cover of nerve cells on top of a thick layer of light-sensitive photoreceptor cells. They react whenever light is focused on them. In one of the first tests, the artificial retina was placed alongside a retina from a special breed of lab animal that has no thick layer of light-sensitive cells. ALDA: So, this layer, these channels-- that's that polymer I made in the dish on the slide. LAVICK: Mm-hmm, right. And now you're looking at it sideways, and these are the pores that the cells are growing in? Right, the darker parts are where the polymer actually is, and then these lighter parts here are actually the pores themselves. ALDA: Here you can see the living retinal cells sheltering inside the artificial retina. This was done just in a dish on the lab bench, but now here's the next step. This is a shot looking into the animal's eye. There at the back you can see the faint shape of the artificial retina, now implanted. Here's the same shot in ultraviolet light, showing that the cells in the implant are alive and healthy. What the researchers think is happening is that the retinal stem cells inside the implant are forming new light-sensitive photoreceptor cells which connect to the existing nerve cells in the animal's eye. It's still too early to tell if there's an actual improvement in vision, but it's a big step nonetheless. ALDA: If you're starting with a retinal stem cell, does that mean it has some properties that already predispose it to becoming a photoreceptor? YOUNG: Exactly, that's what we hope. But it's all... it could become some other part of the eye... Yes. If... if it were placed someplace else or under other conditions? What makes it become a photoreceptor when... when you do this... this procedure? One of the things that we've kind of hit upon is that the host actually instructs the cells at some level. So if we put these cells into an animal who has lost photoreceptors, the majority of these cells actually become photoreceptors. So the injury cue we think is critical. The injury itself somehow creates a cue for the growth of new cells. Now, it's interesting because that sounds like the body is signaling itself and trying to grow new cells. Exactly. But it's only when you supply the... the raw material that the body, for some reason, is lacking... Right. Or is being inhibited from presenting. Exactly. What's... what's going on here? I think... I think that's... So if you look at lower animals-- frogs, for instance, some fish-- they can grow a whole new retina. You take out the retina, they can grow a new one, even in an adult. We've lost that ability. But what we think is still present are some of these injury cues. So maybe these instructions for fixing the retina are actually there, but in higher mammals, for instance, we are simply unable to respond to that. So we're taking advantage, we hope, of these cues that are present and, as you say, adding the raw materials to fix what's wrong. So the cues that are happening could be vestigial mechanisms, vestigial functions... Right. That are useless to us because we've evolved away from them, but you can pick up on them and make use of them. What a fascinating... I mean, if... The cells can. We don't actually know what these injury cues are, but we know... we know they're present. ALDA: If there's a secret to the new science of bioengineering, this is it: If we just provide the right conditions, stem cells will do their thing. We don't have to know everything about how complex cellular systems work. So we may be glimpsing a future with almost limitless possibilities for repairing or replacing body parts. In our next story, we'll meet the scientist who wants to put together a whole system of body parts, functioning like a body, on the lab bench. The sample is in the vacuum chamber. It's like a superhigh vacuum.

				Body on a Bench A tiny, living liver is the first step towards a lab version of the human body.
		Select text to jump ahead in the clip: ALDA: How long have you been...? ALDA: This story is about something called a "liver chip." Three years, three years. Three years? Yeah, and we've actually got it there, so... And it's not just chipped liver. ALDA: You know, at MIT you don't expect a lot of jokes. ( laughing ) You'll see. Oh, "chipped liver," I get it. That's a joke-- I get it. It's a science... a liver science joke. That's even better. Do you make them in here? Yeah, we make them right over here. ALDA: Linda Griffith is a bioengineer who's developing a tiny bioreactor that behaves like a liver. So, Karel, you got everything all ready to set one up? Hi. How are you? DOMANSKY: So, we have a miniature bioreactor here. ALDA: It's called a liver chip because it uses thin, perforated wafers of silicon-- the same material computer chips are made with. Here they use silicon not for its electrical properties, but because we know a lot about making tiny structures with it. Once the chip is sealed in its case, a broth of about a dozen different nutrients and vitamins is pumped through the perforations. Then comes the final step, the one that turns a chip into a liver chip. So now... this is the room where we do all of our cell culture. And so these are sterile cell culture hoods and incubators for the cells. And Anand is now introducing the cells into the sterile bioreactor. ALDA: As with the artificial retina, they seed the chip with stem cells. These cells are already on track to develop into liver. As the chip is incubated over the next few days, the cells will take up residence in the chip's perforations. It's like having a colony of livers living in the lab, and that's kind of how the researchers feel about it. ALDA: How do you keep track? Do you give them little names or...? They do give them little names which I find out when I get the file for a publication or a presentation. It'll have "Here's the data from 'Mandy,' and 'Mandy' was very good, but 'Tom' was really not." ( laughing ) ALDA: But now you can work with "Tom" and "Mandy." You can test drugs or do experiments that would be out of the question with people. ALDA: Why did you make a small liver instead of a small heart or a small kidney? Well, partly just by chance. I happened to join a lab that was interested in liver and I got fascinated by the problems in liver. Liver is your largest organ. It gets almost a third of the blood flow every time your heart pumps. Liver does an amazing number of things. It detoxifies drugs. It keeps track of all the nutrients in your body to make sure the rest of your body gets exposed to almost constant amounts of glucose. It makes almost all the proteins found in your plasma. It synthesizes bile. It... it does so many things and it's so important so that when your liver gets sick, you have to replace it with an organ transplant or you die. And so it's such an essential organ. We got very interested in ways that we could... My first interest was in how we could do replacement livers to implant into people. What we realize now is that, gee, if we understood how liver works better and how disease processes go on in liver, we could develop better drugs and prevent the need for organ transplants in a lot of cases, we hope. Now, why... why do you need this to develop better drugs? Why can't you use... cells from a liver in a dish? Well, cells from a liver in a dish will do some of the things that liver does. But it's been really frustrating for years, and hundreds of people at all kinds of labs and industries have tried to get liver to do things like be infected with hepatitis virus. And when you take liver cells out of the body, they just go, "On strike-- I'm not doing all those things anymore." ALDA: Inside the liver chip, the cells are able to behave much more naturally. We moved over to the electron microscope to take a look. So the... the sample is in the vacuum chamber being bombarded with electrons. ALDA: First, here's how nature makes a liver. And what's this a picture of? This right now is actually a picture of a section of real liver. ALDA: Real liver contains thousands of tiny blood vessels like this, bringing in and taking away the many different chemicals which the liver cells off to the sides are processing. TECHNICIAN: This is a blood vessel that you're looking down into, so it's a cross section of a blood vessel. And they have small holes that sort of act as a filter to the blood. So the blood moves through here, and small molecules can go through and come in direct contact with the liver-functioning cells. ALDA: Without these tissue structures of filter holes and blood vessels, it's tough for the liver cells to function correctly. Now let's look at the liver chip. TECHNICIAN: So we're looking down on the chip and each of these channels is sort of like a tunnel where the medium can flow through, and there's a tissue structure that goes into the channel. So now I'll zoom in closer into one of these channels so that you can see what the tissue looks like. ALDA: The fascinating thing is that the stem cells in the chip grow into structures with many of the key features of real liver. They build channels like blood vessels inside each perforation in the chip, and they even make the little filter holes that real liver blood vessels have. What makes it organize itself as though it were in a real liver with these... with these spaces for the blood? Well, the environment that the cells are in makes them want to function in the way they do in the body so that they reorganize into structures that are like in the body. GRIFFITH: It's the Colonel's special recipe that we have in our secret vault at MIT. ALDA: And that's not just another of Linda's science jokes. There is a special recipe. The chip was designed specifically to keep liver cells happy-- the right size channels, the right nutrient flows, and surface coatings they like to stick to. Linda believes we can do this for many body parts. You know, when you show me these pictures that are enlarged so much, and you were looking at these almost infinitesimally small places in the body, and you say things like, "And they open and close depending on various things," or... or these little parts of the cell, or cells are in communication with other cells or sending out... GRIFFITH: Mm-hmm. It sounds like there are so many millions or billions of things going on in the body-- signals being sent, coming back, sending out, going out again. Is there a hope that we'll be able to untangle this puzzle, I mean, in anybody's lifetime? GRIFFITH: Yes. We started a whole new department, actually, at MIT to address exactly these kinds of problems-- biological engineering-- and bringing together biologists and engineers and really trying to do systems-level biology starting at the molecular level. So it's just really starting to creep out across universities in America, but I... I think it'll happen. ALDA: Making body parts like retinas or livers in the lab depends critically on acquiring the right human stem cells, not the animal cells they're using here right now. One of the biggest hurdles in this is where we're going to ultimately get the cells to do it on a large scale. And so part of our project actually is to try to derive stem cell lines that can be cultured and frozen down out of human tissue. Are these stem cell lines that you're talking about creating here... are they outside of the... the prohibitions placed on stem cell research recently by Washington or are they within those protocols? What we are doing is taking cells out of the adult body and trying to derive cell lines, so they're not under the prohibitions. They're much more readily available to the general researcher. We can even get some from you if you sign the consent form. We'll have the memorial cell line. We'll... we'll talk later about that. ( laughing ) Do you ask most people who come in if they want to give up their stem cells? Um... if we really like them and we want to have them memorialized in the lab. Gee, you mean I could come someday and visit my cells? You could, yeah. Gee, that would be great. I could maybe have my own chip here. You know, you could maybe have your whole body on a chip. You know, if what we're doing really works out, we could take stem cells that circulate in your blood and make a liver, make a heart, make a brain out of those cells. That's our ultimate goal. That's what I want to have done by the time I retire from MIT.

				Search for the Perfect Heart Science continues the quest to replace our most critical organ. (Updated from earlier broadcasts)
		Select text to jump ahead in the clip: ALDA: On July 4, 2001, the papers announced a new kind of independence for heart patients, available now for the first time. The implantable self-contained mechanical heart was the culmination of at least 40 years of research. On Frontiers, we've been following its progress for almost ten years. In 1993, we told the story of Mike Dorsey, whose life was saved by a sort of partial artificial heart, called a HeartMate, that assisted his own failing heart. DORSEY: I was very sick. If I'd have walked from here to you, I'd been out of breath for that time. You know, I couldn't do nothing. It gets a little frustrating when your wife comes and takes things from you, you know, and you can't carry them, you know. She would take them and carry them in for me. I wanted to do it but just wasn't able to do it. ALDA: The artificial heart first hit the world's headlines in 1982. Barney Clark's brave struggle to live and his death after four months cooled the early enthusiasm for his implant, the Jarvik-7. After a few more unsuccessful attempts, the device was abandoned. But research on mechanical hearts continued. The most promising were pumps that weren't intended to replace the heart but boost it, like Mike Dorsey's HeartMate. ( pump chugging rhythmically ) The designers of the HeartMate took a novel approach to a major problem of the Jarvik-7-- blood clots that would form inside it and that could kill when they broke off and traveled to the lungs or brain. The HeartMate's interior was roughened so that a thin layer of blood clots over its entire surface and sticks there firmly. Mike Dorsey's problem, one that he shares with thousands of others each year, was a weakening of his heart muscle so that the main pumping chamber, the left ventricle, could no longer pump blood around his body. Installing the HeartMate begins with cutting a hole in the left ventricle and sewing in a short tube. Then the electric pump itself is implanted in the upper abdomen. Blood flows from the heart through the pump, then back to the patient's aorta. By February 1993, Mike Dorsey's heart was near total failure. His doctors estimated he had just hours to live. Only weeks before, the HeartMate had been approved by the Food and Drug Administration for use at Fairfax Hospital in Virginia to keep a dying patient alive until a heart transplant could be found. ( heart monitor beeping, surgical team speaking softly ) The operation began with sewing into Mike's left ventricle the tube that connected with the pump. Then the HeartMate itself was slid into place. The connection was made between the pump and the heart it would assist. ( monitors beeping ) Finally, the pump's outflow tube was plumbed into Mike's aorta. The pump was switched on. And at this point, no one knew for how long it would need to keep pumping. The HeartMate needed an awkward external battery-powered air pump with an air tube penetrating the skin. It was only intended to be a temporary bridge, to keep the patient alive until a transplant heart became available. After seven months, Mike was still waiting, confined to the hospital. DORSEY: It's not really me. I'd rather be moving where I have a destination to go to instead of standing in one spot looking at the same old scenery. This is the battery charger here. In order to be more mobile, take two batteries, these... and just connect the power source from here. ( shrill alarm sounds ) ALDA: That's the alarm that went off if there was ever a problem. You don't do it right, they do not go. And just drop them into the pouch like this, fold the flap down. Now I'm ready for traveling. ALDA: Mike got his transplant a few weeks after this, and today he's still going strong. Hi, Michael. ALDA: But now we're much closer to being able to offer patients like Mike a permanently implanted artificial heart. About 125,000 of the 700,000 Americans who die from heart failure each year could benefit from an artificial implant. The Abiomed artificial heart is modeled on the human, with two main pumping chambers and valves to control blood flow. ALDA: As the blood goes through there, it pushes its way through, but it can't come back the other way, right? MAN: Correct. ALDA: Can that be relied on after it pumps thousands of times, after... if you pass through... after it flexes thousands of times, to maintain that same resiliency? The answer is yes, and it's not thousands of times, it's approximately 100,000 times per day. ( laughing ): Oh, boy. Which is close to 40 million times per year. 40 million times. You can flex this material 40 million times, and... Without it breaking. Without it... not only breaking, but just weakening and softening and fluttering and that kind of thing? Correct. So, this is where you test the valves. Yes, this is where we test. We have many, many valves under test. And we test them under very severe conditions and at an accelerated rate so that we can demonstrate 20 years' equivalency in one year. ALDA: Just like the HeartMate, the Abiomed heart is designed to avoid the danger of blood clots forming inside it. But while the HeartMate has a deliberately roughened interior surface, the Abiomed heart aims to be completely smooth and seamless. It also keeps the blood constantly swirling-- made visible here with fish scales in water-- to minimize stagnant areas where clots might form. ( water sloshing ) It's not until I get to hold the heart while it's pumping that I really appreciate how powerful it has to be to substitute for a human heart. ( pump rhythmically slurping ) I can really feel the beating. Now interestingly, when you see a heart pumping, the outside of the heart is going like that, you see the motion on the outside. Here all the motion is inside this device. ( water sloshing ) I've held on to this heart long enough. Would you mind holding that for a day or two? ALDA: The Abiomed heart is run by rechargeable batteries that receive their power through the skin. Both Mike Dorsey's HeartMate and Barney Clark's Jarvik-7 had unhygienic and vulnerable tubes penetrating the skin. Over about three years, the entire Abiomed system-- surgical procedures, implanted heart and power supply-- was tested more than a hundred times in calves, animals about the same size that human patients would be. By the middle of 2001, five surgical teams around the country were ready to conduct the first human trials. Bob Tools, a 59-year-old with severe heart failure, was the pioneer. His doctors estimated he had about 30 days to live. The FDA had approved five implants, but only for patients as sick as Bob Tools. He had already been judged to be too sick to receive a heart transplant. In a seven-hour operation, Bob Tools' failing natural heart was removed and replaced by the artificial system. This is the computer control with the battery that will be recharged through the skin. The control and battery will rest directly below the heart in the abdomen. Now the heart itself. It's attached using cloth collars sewn to the arteries. After the implant, Bob Tools began to make a remarkable recovery. He'd been bedridden before, barely able to raise his head, and here he was on his feet. He was even beginning to gain a little weight. ( cameras clicking ) The equipment cart here is just to monitor the heart's operation, it doesn't have to be attached. Chair's over here, Bob. ALDA: Bob Tools made steady progress, mostly confined to the hospital, but with the occasional excursion for the benefit of the press. Bob told reporters he liked to hear the implant pumping away in his chest. "As long as I can hear the sounds," he said, "I know I'm here." Over the next four months, four more equally sick patients received implants. Then, 4½ months after his surgery, Bob Tools suffered a major stroke. He died three weeks later. But he'd lived five times longer than was expected before the implant. To date, two patients are still alive, but there's been one other fatal stroke. Abiomed believes blood clots may have formed around these plastic struts on the heart's attachment collars. They're removing the struts, and ten more implants have been approved. So we'll soon see if this system has the potential for the widespread impact that its inventor thinks it can achieve. ALDA: Are you going to be extending a lot of people's lives because now they'll be able to have an artificial heart? LEDERMAN: We hope, yes. The fact is that 2,000 years ago the average life-span was 30 years, and a hundred years ago the average life-span was 47 years, and today the average lifetime is 75 years, and there are a large number of people who reach 75 and beyond who are neurologically intact, who are very productive, and the only thing that is wrong is a hip, which we replace today, or a muscle like the heart, which we should be able to replace. And there is no reason why the end of life should come prematurely.

				Nerves of Steel Artificial electric stimulation helps the paralyzed stand, walk, and use their hands.
		Select text to jump ahead in the clip: But using artificial electrical muscle stimulation, he can walk. Dr. Byron Marsolais started this project. MARSOLAIS: He has absolutely no control of his legs at all. He is totally and completely paralyzed and every bit of motion that happens is coming through the electrical stim. Don, do you get all your balance from holding on to this walker? Yes, I do, Yes, I do. Does that put a lot of pressure on your arms? No, not really. Most of the pressure's on my legs. Actually, I prefer to let my legs do the work because if I did it with my arms, I would be tired out. Yeah. How tiring is it to take it... uh, every step? Uh, not too bad. It's comfortable, you know? But after the end of the walk, I will breathe heavy. Yeah. Standing takes a lot of energy because you have to stimulate the muscles for a prolonged period? Right-- he is standing by stimulating the flexors and the extensors, the antagonistic muscles, all at the same time. So he's stiff as a board. And that charge just has to be constant. It's constant... If you let up on it, he's liable to tip one way or another. Oh, he would, for sure. And so he looks good standing tall and stiff... ALDA: But you feel the strain? MARSOLAIS: But he's got strain. Yeah, I feel strain. ALDA: My introduction to the functional electrical stimulation or FES, program was eight years ago. What I'm trying to get to is his gluteus maximus muscle-- the big seat muscle. ALDA: Dr. Marsolais showed me how he implants wire electrodes. What you're inserting into the muscle is... that's not the electrode itself? No, this is just a little probe... Right. A very tiny probe. And the reason you're doing this is to see if you can get the muscle to react to give its greatest response? Exactly. And I want just the right muscle. That's the muscle that we want-- it goes right down here into the femur which is the big leg bone. And you see how it's beginning to jump there? It's starting to do what we want. I think I can do better... And in order to do better I have to get it right beside the nerve. ALDA: Dan Kemp, paralyzed in a car accident is on the table. Now, Dr. Marsolais looks like he's found the spot here. That looks pretty good here, yup. That's getting a pretty good, tight... I can see it. See how that... jerks things together there. It looks like about an inch and a half from where you were first searching for it. Yes, that's right, although we're angled a bit down. We started about here, and now we're about here so we were a good inch away. ALDA: Once he's found the best stimulation point for the muscle a hair-thin, permanent wire implant is slid into place. Dan was one of many experimental subjects who volunteered for the program. In his case, he received eight electrodes in each leg. Now we just bring this down to exactly the position that we were before. ALDA: The patients and Dr. Marsolais were literally stepping into the unknown. How do you feel going through this? Do you feel like a guinea pig? KEMP: Yeah, I do, but it's well worth it. You know, down the road, people will be able to look back and say if it wasn't for people like me that they wouldn't have got as far as they've got in the new procedures. So, you know, it goes down the line. Everybody helps everybody else, whether they realize it or not. ALDA: Eric Bellamy, paralyzed in a motorbike accident agreed with Dan that it was worth being a guinea pig. He saw simple, basic ambitions for himself and for the program. BELLAMY: I see being in a chair always but I see being able to go up steps and knock on a friend's door and say, "Hey, I'm down here! " instead of running around the house and screaming, "Hey, I'm here, I'm here! " I see being in a convenience store as one step, you know? Uh, so... Being able to get up and go through a narrow door to go get into the bathroom-- just for them answers. And if they can come up with that right there... Your life's in a chair but being able to overcome difficulties would be a tremendous step and that's what we're working on right now. ALDA: Eric was one of five volunteers who received the most complex of the experimental systems, with a total of 40 implanted and eight external electrodes. The computerized control box could handle 48 electrodes simultaneously with connections made through the skin on his thigh. One big goal was to establish how many muscles needed to be stimulated for effective standing and walking. Working out how to sequence the firing of the electrodes was another challenge. Okay, go ahead and stand up. ALDA: In this trial, 20 muscles per leg were being stimulated compared to the 50 per side that are involved in natural walking. Eric was able to walk relatively smoothly although he still needed to use his arms to balance. Developing an artificial balance mechanism is still one of the goals, but they have been able to reduce the number of muscles needed for walking to only eight per side-- as in the latest system we saw Don Crago using earlier. But Eric's muscles had to work constantly at full blast. MAN: They're using tremendous amounts of muscle mass. Their quadriceps are on 100% their gluteal muscles are on 100% their hamstring muscles are on 100% their back muscles-- everything's just blasted. Whenever they do something they're using 100% of all their strength. Whether it's one step, two steps they're using everything they got. Like when you stand, everything goes right into it, 100%, bam! Okay? ALDA: With tough, motivated subjects like Eric they were eventually able to work out how to reduce the high levels of muscle stimulation and they also figured out the best design philosophy. It's that simpler is better. They realized that even the most complex systems were going to get tripped up by the real world sometimes. Stop! Stop altogether. ALDA: Better instead to go for simpler standard systems that can bring basic benefits to the largest number of people quickly. Many of the pioneers in FES research have now dropped out. Eric got a bad infection. Dan couldn't keep up the long commutes to the hospital. But today, many people with spinal cord injuries have good reason to be thankful for the pioneers' efforts. This is an easy introduction to the real world, I guess you could say. ALDA: Jen Penko is one of the beneficiaries. She's showing me a rehab area at Cleveland Metro Medical Center-- the first of three centers around the country to be working with the simplified standard systems. PENKO: For instance, there's curb cuts and those types of things. It takes a little extra energy to get up that, doesn't it? A little bit, but you'll get curbs in the real world that are a lot more difficult than that. You can just set it right there because I'll get myself set up. ALDA: Jen has a simplified system th just does one thing-- allows her to stand. PENKO: So, the light by the "stand" means that it's ready to stand and all I need to do is press this button to go and it will stand. Ready? Yeah. Are you sure you're ready? Yeah, I'm ready. ( beep ) ( beep ) ( beep ) ALDA: Jen's system has only four implanted electrodes per side but that allows her to stand and get around just enough to really make a difference. PENKO: So, here I can reach up, grab window cleaner and hand it over to you. How long can you stand before you start to feel stressed out or you're breathing heavily? We did a test on that-- 33 minutes and eight seconds was my time breaker right now. So... And that was a few weeks ago, so... Usually when you're in a grocery store one of the tough things when you're in a wheelchair is you can't really see within these big bins. So that way you can reach over, pick up some Weight Watchers because Lord knows I need it. And you can start to see things from a standing level that you really can't see from a sitting level. Whereas if I was at a sitting level I'd be lucky if I'd be able to see what was actually in here. Do you want to go to walking? Is that something you have in mind? Absolutely. Absolutely-- to be able to ambulate is fantastic. I mean, just to be able to stand. We're focusing on the functional things but there's a lot of health benefits to standing as well. I mean, people that are in wheelchairs that don't stand-- you have problems with the shortening of muscles with osteoporosis, with circulation. So, you have to be able to get into... pretty much any kind of a seat. ALDA: Simply transferring from one seat to another is a big benefit. Automobile seat and a booth like this which is different from a chair. Right. ( beep ) One, two, three... ( beep ) Those are three slow seconds. They are. And considering I'm from the Boston area I've had to learn how to count a lot slower... than out here. So it took me a long time to learn how to count. They count slower in Cleveland? I guess they do. ALDA: Another part of the design philosophy is modularity. If Jen and her doctors decide everything is working well she can get another eight electrode implants which will allow her to walk. Now I'll sit. ( beep ) So, you have the same three seconds before it puts you in the seated position? ( beep ) Mm-hmm. Same audio that goes through as well. Same beeping cycle. So it's just like a habit-- training me like a mouse. There you go-- beep. Three seconds later-- beep, and I'm standing up. What do you call the thing that's implanted? What is that? It's my receiver. Yeah... How big is it? Um, it's about that big... it's not very big at all. In fact... ALDA: A big change with the standard systems is that no wires pass through the skin. This here... So, this is the box that holds the batteries that holds the software and circuit boards. ALDA: Instead there's a transmitting coil with an implanted receiver. There's the coil... that goes to my receiver. I have it taped onto the skin so it won't move. So I have this coil that sends the radio waves to the receiver that's right here and you see the little bump in the skin right there? That's the receiver. ALDA: There are now nearly 200 standard systems in use but research is continuing. Jim Jatich received the very first implanted electrodes in 1986, to allow his left hand to grip. JATICH: Since I had this implant once it's put on me in the morning I'm on my own and I can write for myself, feed myself answer the phone, take messages, work on a computer. I do engineering drawings on a computer-- I'm trying to start my own business doing that. That would have been out of the question. I mean, without a tremendous amount of help. ALDA: Jim lives with his family just outside of Cleveland. When we first met him in 1993 he described for us how he had been injured. JATICH: Back in the summer of 1977 I was swimming with several other friends in a lake nearby. They dove into the lake and started swimming away. I was the last one to dive into the lake. I hit something on the bottom. It wasn't anything hard that knocked me out but I felt my neck jam into my shoulders and then I started slowly sinking into the seaweed at the bottom of the lake. I couldn't move anything, my arms or legs when, uh, I felt two arms on my shoulders and they pulled me to shore and right away I knew that I had broken my neck. ALDA: Jim has no lower-body control and only limited upper-body strength. For 23 years he's allowed the researchers to try out new FES systems on him. In 1993, for example, they were perfecting a joystick controller for the eight electrodes that give him his hand grip. The joystick was attached to his right shoulder. So a quick shrug of the shoulder activates the grip. And then a double shrug relaxes it. Jim was also one of the first to try an implanted receiver so no wires penetrate the skin. JATICH: What we have is... like a joystick implanted in the bones of my wrist. ALDA: Today Jim is trying another experimental control system. JATICH: There's a magnet and a sensor and as the wrist bones pass each other that sends a signal to the implant and depending at what angle I'm at whatever is programmed into the computer on back of my wheelchair that's how much strength and how fast my hand closes. So, the magnet and the sensor-- depending on how far apart they are as you move your hand back-- that regulates everything that's going to happen. Right. ALDA: Jim and the researchers have been working with the implanted magnet control for a couple of years. Now, if that were full of coffee and heavy... You can... see how strong I'm holding it. Yeah, you have a really good grip on that. Yeah. Yeah. You're a good actor, too. Looked like you had something in there. Oh, it's hot. ( both laughing ) ALDA: With the magnets controlling his left hand Jim's joystick can now control a new implant system in his right hand so next he'll be working with the researchers on tasks that need two hands simultaneously. Jim's essentially a member of the research team but one perhaps with a special perspective of the benefits of the FES program. You know, I've talked to friends of mine that are paralyzed. They won't go into restaurants when we have meetings, you know, like a support group meeting because they can't feed themselves. They don't want to see anyone feeding them so whenever we have meetings in a hospital or something they show up but when we have it in a restaurant, they won't go because someone has to feed them, you know. So, there's a, uh... there's a series of things that don't get done because of a simple thing like not being able to pick up a fork. I mean, you get less social. That's right. An example is a girl that came into this project to get an implant. When she first came in, you know, her face was down she wouldn't talk to anyone, no eye contact. After she got the implant, you know, she's feeding herself going out to restaurants, she enrolled back in school. Now she's an advocate, talking to everyone about it. She started a support group. And, I mean, you know, it just changes people's lives. And that's the kick I get out of it, to see how people change. How's that feel? Okay? Yeah, that's very nice. Not too tight? No, no, no, I like this. ALDA:

Take a look at these related stories from the Frontiers Archive:

				The Body Magnified Scientists are building fantastic human amplifiers - machines that can augment the body's abilities to lift, pull, and run.
		Select text to jump ahead in the clip: HAVE BEEN FAVORITES OF SCIENCE FICTION FOR YEARS AND THAT'S WHERE THEY'VE STAYED-- IN FICTION. BUT RECENTLY THEY'VE BEEN SHOWING UP IN THE MOST UNLIKELY PLACES. THIS IS THE SPRINGWALKER OUT FOR A BOUND THROUGH A LOS ANGELES SUBURB A LONG WAY FROM ONE OF ITS SOURCES OF INSPIRATION. THE 1988 20th CENTURY FOX MOVIE, ALIENS STARRED BOTH SIGOURNEY WEAVER AND A POWER SUIT BATTLING AND EVENTUALLY BEATING THE ALIEN. THE FILM SUMS UP DECADES OF POPULAR-CULTURE IMAGES OF HUMAN AMPLIFIERS, EVEN THOUGH THIS SUIT WAS MADE OF PLASTIC AND WORKED WITH THE HELP OF A STRONGMAN JUST OUTSIDE THE CAMERA'S VIEW. ( screams ) I CAN SEE WHY YOU CALL IT THE SPRINGWALKER... Alda: I RECENTLY VISITED JOHN DICK AND BRUCE CRAPUCHETTES WHOSE SPRINGWALKER WAS INSPIRED BY ALIENS-LIKE FANTASIES. I REALIZED THAT I HAD LOST FAITH IN MY CHILDHOOD DREAMS OF THE IDEA OF AMPLIFIED MAN. I'D BEEN FOLLOWING THE RESEARCH IN THE FIELD AND IT JUST WASN'T HAPPENING. WHAT WERE YOUR CHILDHOOD DREAMS? I REMEMBER A BOOK I WAS READING AS A CHILD. IT HAD THIS KID GETTING INSIDE THIS LARGE MACHINE WHICH MADE HIM POWERFUL AND STRONG ABLE TO VANQUISH HIS CHILDISH ENEMIES. THAT WAS ALWAYS A VERY POWERFUL IDEA WITH ME AND I THINK IT'S A POWERFUL IDEA IN A LOT OF PEOPLE. I THOUGHT OF TRYING TO DO SPRING SHOES A KIND OF POWERFUL SPRING SHOE, BUT THEN YOU SAY: HOW COULD I POSSIBLY LEAP TALL BUILDINGS WITH A SINGLE BOUND. AND THE IDEA THEN CAME OF SPRING SHOES WITH LEVERS. Alda: THE SPRINGWALKER IS THE LATEST IN OVER A CENTURY OF MOSTLY UNSUCCESSFUL INVENTIONS EMPLOYING SPRINGS TO RUN FASTER. Dick: BRUCE, COULD YOU BOUNCE A BIT SO WE CAN SEE A BIT OF THAT ACTION. SO AS THE LEGS COMPRESS, THEY PULL ON THE CABLES PULL DOWN THE SPRING, AND THEN IT THROWS HIM BACK IN THE AIR FOR ANOTHER STEP. WHEN WE WALK, THE GAIT WE USE-- DOES 20% OR LESS GO INTO MOVING FORWARD? IT WOULD BE 5% OR LESS. INTO MOVING FORWARD AND 95% GOES INTO MOVING UP AND DOWN. THAT'S CORRECT. Alda: THE SPRINGWALKER IS DESIGNED TO CAPTURE MOST OF THIS WASTED ENERGY STORE IT IN THE BUNGEE-CORD SPRING THEN RELEASE IT TO PUSH THE SPRINGWALKER FORWARD AS IT LOPES ALONG. ALAN, WOULD YOU LIKE TO HAVE A GO ON THE SPRINGWALKER? THIS HAS BEEN MY DREAM SINCE I HEARD ABOUT THIS. EITHER A DREAM OR A NIGHTMARE, I'M NOT SURE WHICH. YOU HAVE TO STRAP ME IN, I GUESS. WOULD YOU MIND UNBUTTONING YOURSELF? Alda: NOW, THE INVENTORS KNOW ONLY TOO WELL THAT THEIR CURRENT MODEL ISN'T EXACTLY PRACTICAL. JUST GETTING ONTO IT IS A CHALLENGE IN ITSELF. AH, BUT I FOUND A NEW WAY FOR MY ANKLE TO BEND. I'VE ALWAYS RELIED ON THE COURTESY OF STRANGERS. Alda: AND THAT WAS THE EASY PART. IT'S FUNNY HOW AS SOON AS YOU PUT THIS ON YOU GO BLIND AND YOU CAN'T HEAR. Dick: THERE YOU GO. CAN YOU GUYS TURN AROUND? Alda: JOHN AND BRUCE LIKEN THIS PROTOTYPE TO THE FIRST BICYCLES EVER BUILT-- SLOW, CUMBERSOME... AND DANGEROUS. TURNING IS NOT EASY. I TEND TO START HOPPING WHEN I TURN. OH, OH, I GOT IT LOOSE. NOW IT'S JUST SORT OF A NORMAL WALK JUST DRAG IT ALONG, IS THAT IT? Alda: I BEGAN TO GET THE HANG OF IT AFTER A WHILE. JOHN AND BRUCE'S PLANS INCLUDE A LIGHTWEIGHT VERSION FOR JOGGING AND A POWERED MACHINE THAT COULD CARRY HEAVY LOADS AT UP TO 25 MILES AN HOUR THROUGH ROUGH TERRAIN. BUT JOHN DICK, ITS CHIEF DESIGNER HAS A TERRIBLE SECRET. MIND IF I HOLD ONTO YOU FOR A SECOND? NO, NO GO AHEAD. HAVE YOU EVER BEEN ON THIS? WELL, I ACTUALLY HAVEN'T BEEN ON AS MUCH AS YOU HAVE. I'VE STOOD AT THE WALL AND PRESSED AND FELT THE LEG. WHY... DIDN'T... WHY DIDN'T YOU GET ON IT? WELL, MY FEELING IS THE PHYSICAL INSECURITIES THAT I FEEL ON THE THING GET ALL MIXED UP WITH MY ACTUAL INSECURITIES ABOUT THE VIABILITY OF THE WHOLE VENTURE AND SO INSTEAD I'D RATHER BRUCE DO IT WHO IS A PROFESSIONAL PSYCHOLOGIST AND A VERY SECURE PERSON. IN OTHER WORDS, IT FRIGHTENS YOU. I'M A FRIGHTENED PERSON ANYWAY. BECAUSE I WANTED TO GIVE YOU A MEMBERSHIP CARD TO THE CLUB. WHAT MAKES THE SPRINGWALKER SO MUCH FUN IS HOW SIMPLE IT IS. NO WIRES, NO MOTORS, NO COMPUTERS. WITHOUT WIRES, MOTORS AND COMPUTERS THIS WOULD JUST BE 400 POUNDS OF METAL. BUT WITH THEM... Alda: THIS MASSIVE ARM, BUILT BY STUDENTS OF THE UNIVERSITY OF CALIFORNIA, BERKELEY IS POWERED BY A HUGE COMPRESSOR HIDDEN BEHIND THE CURTAIN. EVEN ON MY FIRST TRY, I COULD MOVE IT EASILY AS IF IT WEIGHED 10 OR 20 POUNDS. MY OWN ARM MOVEMENTS ARE PICKED UP BY SENSORS IN THE RING AROUND MY FOREARM THEN TRANSLATED VIA COMPUTER INTO MOVEMENTS OF THE MECHANICAL ARM. A SIMPLE GRIPPER OPENS AND CLOSES THE HAND. THE ARM IS JUST ONE LIMB OF A COMPLETE POWER SUIT THE BERKELEY TEAM PLANS TO BUILD. THE IDEA IS TO ENABLE PEOPLE TO PICK UP AND MOVE HEAVY OBJECTS INCLUDING THE FAMILY SOFA. WE WILL NOT HAVE A GIGANTIC MACHINE. WE WILL NOT HAVE ANY BIG AND HUMONGOUS MACHINE. WE WANT A LIGHT WORKING MACHINE FOR CIVILIANS AND THAT'S OUR FOCUS. THE REASON FOR MAKING IT SMALL IS WHAT? IF YOU WANT TO CARRY A COUCH UPSTAIRS THE MACHINE HAS TO BE ABLE TO GET UP THE STAIRS? RIGHT, YOU HAVE TO GET THROUGH THE DOOR AND YOU HAVE TO GET THROUGH THE ELEVATOR. WE ARE WORKING ON THIS PROBLEM. DO YOU HAVE A VOICE BOX THAT SAYS "WHERE DO YOU WANT IT, LADY? " NO, BUT WE WILL. THAT'S THE THING-- THE HUMAN INTELLIGENCE IS WITH THE MACHINE. Alda: THE STUDENTS ARE DESIGNING THE WHOLE SUIT PIECE BY PIECE. TANYA SNYDER DESIGNED THE LEGS WHICH, BECAUSE THE SUIT WILL BE HEAVY AND HARD FOR ITS WEARERS TO BALANCE NEED TO BE ABLE TO BALANCE THEMSELVES. Kazarooni: THESE ARE HERE FOR SAFETY... Alda: THE DAY I VISITED THE LAB A TEST LEG HAD JUST RECENTLY BEGUN BALANCING ON ITS OWN. IT'S PRETTY STABLE AND IT RECOVERS ITSELF PRETTY NICELY. Alda: THE LEG BALANCES BY BENDING AT THE KNEE A COMPUTER CONSTANTLY SENSING ITS POSITION AND ADJUSTING THE ANGLE OF THE THIGH. NOW, THIS IS BALANCING JUST ON A PIVOT. THERE'S NO ARTIFICIAL FOOT THERE OR ANYTHING. THERE'S NO PLATFORM FOR IT. Alda: I WAS PRETTY IMPRESSED BUT THE TEAM WAS ECSTATIC. Alda: WHEN DID YOU FINALLY GET IT TO BALANCE? SUNDAY, THREE DAYS AGO. A COUPLE OF DAYS AGO. WERE YOU HERE? YOU HAD DESIGNED THE LEG, RIGHT? THAT'S RIGHT. I'VE ACTUALLY BEEN ON VACATION AND WHEN I LEFT, LIKE ZACH SAID IT WAS JUST BOUNCING ALL OVER THE PLACE. I WONDERED IF THERE WAS ANY HOPE FOR IT. I JUST GOT BACK TODAY AND I SAW IT. I JUST COULDN'T BELIEVE IT. IT'S SO PEACEFUL AND IT'S REALLY WORKING AND I'M REALLY HAPPY ABOUT IT. Alda: BUT LIKE ALL GOOD ENGINEERS THEY COULDN'T RESIST THAT EXTRA PUSH. ( laughter ) IT'S JULY 23, 1993. THE PLAYERS IN THIS VOLLEYBALL GAME ARE DOCTORS, NURSES AND PATIENTS AT FAIRFAX HOSPITAL IN FAIRFAX, VIRGINIA.

				Smart Glasses A legally blind man sees his grandson for the first time thanks to advanced computer and video technology that magnify surroundings.
		Select text to jump ahead in the clip: LEONARD IS LEGALLY BLIND. THAT DOESN'T MEAN HE CAN'T SEE AT ALL BUT HIS SIGHT IS SERIOUSLY DEGRADED. THIS VIDEO EFFECT GIVES A ROUGH IDEA OF WHAT HE SEES. THE SHARP CENTRAL VISION IS MISSING LEAVING ONLY THE LESS DISTINCT PERIPHERAL VISION. LEONARD HAS SEEN THE WORLD THIS WAY FOR TEN YEARS. ONE OF THE GREATEST DISAPPOINTMENTS WITH MY LACK OF VISION WAS NOT BEING ABLE TO SEE MY GRANDSON AND I CAN'T EVEN SEE MY CHILDREN ANYMORE, BUT I'VE SEEN THEM. I HADN'T SEEN MY GRANDSON WHO'S SEVEN YEARS OLD AND I HADN'T BEEN ABLE TO SEE HIM WITH THIS LACK OF VISION. I DON'T KNOW WHAT HE REALLY LOOKS LIKE. Alda: LIKE MANY VICTIMS OF MACULAR DEGENERATION, AS IT'S CALLED LEONARD USES A SERIES OF SIMPLE DEVICES TO HELP HIM COPE. FOR LONG DISTANCE, A SMALL TELESCOPE MAGNIFIES THE LETTERS OF THE SIGNS SO THAT THEY'RE LEGIBLE JUST USING HIS PERIPHERAL VISION. HE HAS TO SCAN ALONG THE LETTERS TO READ THE WORD. FOR CLOSE UP, HE HAS TO CHOOSE A MAGNIFYING GLASS. THE RESULT IS SIMILAR. SIMPLE LOW-VISION AIDS LIKE THESE HAVE BEEN AROUND FOR YEARS BUT JUST AROUND THE CORNER THERE ARE BIG CHANGES. Woman: WE CALL IT "ELVIS. " IT'S A NICKNAME. Alda: THIS IS A PROTOTYPE SYSTEM THAT WILL USE ADVANCED COMPUTER AND VIDEO TECHNOLOGY TO HELP PEOPLE LIKE LEONARD. THE FIRST ATTRIBUTE THAT WE'LL EVALUATE IS THE MAGNIFICATION THAT IT CAN PROVIDE AT DISTANCE. Alda: JOAN STELMACK IS AN OPTOMETRIST AT THE HYNES V. A. HOSPITAL NEAR CHICAGO. LEONARD IS TRYING THE HELMET FOR THE FIRST TIME. THE SYSTEM USES A TV CAMERA TO VIEW THE WORLD THEN PROCESSES THE SCENE ELECTRONICALLY. IN THE SIMPLEST MODE, LEONARD SEES IMAGES THAT ARE LIKE CONVENTIONAL MAGNIFICATION AIDS, ONLY WIDER. IT'S CONVENIENT AND IT WORKS. Perra: R... R... D... F... U... V. U... R... Z... V... H. I CAN SEE, I CAN SEE, AND IT'S JUST WONDERFUL! Alda: THE SYSTEM WAS DESIGNED IN BALTIMORE BY THE V. A. AND BOB MASSOFF OF THE WILMER EYE INSTITUTE. THE ULTIMATE GOAL IS TO TACKLE EVEN THE MOST DIFFICULT PROBLEMS FOR LOW VISION PATIENTS, LIKE REDUCED CONTRAST. TO SHOW YOU WHAT THE PATIENTS MIGHT EXPERIENCE WE'LL REDUCE THE CONTRAST OF MY IMAGE AND IT'S AT LEAST THIS BAD, SOMETIMES WORSE FOR MANY OF THESE PATIENTS. THEY WILL COMPLAIN OF NOT BEING ABLE TO RECOGNIZE FAMILY MEMBERS THEIR OWN SPOUSES AND CHILDREN. BUT THEY WILL TELL YOU THEY CAN RECOGNIZE CARICATURES. FOR EXAMPLE, WE CAN ALL SEE THIS CARICATURE OF BILL CLINTON COMES THROUGH JUST FINE AND THAT'S BECAUSE THE DETAILS THAT DEFINE THE FACE ARE HEAVY CONTRAST. THE DARK LINES THAT OUTLINE THE IMPORTANT FEATURES THAT MAKE THE FACE RECOGNIZABLE. Alda: SO BOB IS DEVELOPING A COMPUTER PROGRAM THAT CAN START WITH A TV PICTURE OF A FACE THEN DERIVE A HIGH-CONTRAST CARTOON VERSION. THIS IS JUST THE KIND OF PROCESSING THAT CAN BE BUILT RIGHT INTO THE HELMET'S ELECTRONICS. AND IT WILL HAPPEN IN REAL TIME, TOO. THE USER COULD, SAY, SCAN AROUND THE TABLE AND INSTANTLY RECOGNIZE EVERYBODY THERE. WHILE THE HIGH CONTRAST MODE SHOULD BE INCORPORATED INTO THE HELMET WITHIN A YEAR BOB'S NOW WORKING ON A MUCH MORE COMPLEX FORM OF IMAGE PROCESSING. THERE'S ONE FORM OF DAMAGED CENTRAL VISION WHERE THE BRAIN RESPONDS LIKE THIS. THE SIDES OF THE HOLE GET PULLED TOGETHER. THE RESULTING DISTORTION SCANS ACROSS THE SCENE AS THE PERSON'S EYES MOVE. OBVIOUSLY THE IMAGE CAN BECOME INCOMPREHENSIBLE. BOB MASSOFF'S RESPONSE IS INGENIOUS. HIS COMPUTER TAKES THE PART OF THE SCENE THAT THE EYE CAN'T SEE AND PUSHES IT OUT TO WHERE THE EYE CAN SEE IT. THE RESULT IS DISTORTED BUT THEN THE BRAIN CONSTRUCTS ITS OWN DISTORTED VIEW OF THAT. Massoff: THOSE DISTORTIONS WILL CANCEL EACH OTHER OUT AND THE PATIENT SHOULD SEE A COMPLETELY SEAMLESS IMAGE WITH NO MISSING INFORMATION AND NO DISTORTIONS. Man: OKAY, YOU WANT TO LOOK UP? Alda: BUT TO MAKE THIS WORK IN PRACTICE THE COMPUTER HAS TO KNOW WHERE THE EYE IS LOOKING SO BOB HAS BECOME HIS OWN EXPERIMENTAL SUBJECT. HE'S BEING FITTED WITH A SPECIAL CONTACT LENS WITH TINY WIRES ATTACHED TO IT. THE METAL CAGE IS GENERATING A MAGNETIC FIELD WHICH CAUSES VERY SMALL ELECTRIC CURRENTS TO BE PRODUCED IN THE WIRES AS THE LENS MOVES-- ENOUGH TO KEEP TRACK OF BOB'S EYE MOTION. NOW WHAT THE COMPUTER SYSTEM CAN DO IS PRECISELY LINE UP ITS DISTORTED VERSION OF THE SCENE BOB IS VIEWING WITH THE DIRECTION HE'S LOOKING. BECAUSE IT'S FOLLOWING MY EYE MOVEMENTS WHEREVER I GO TO LOOK ON THE SCREEN, THERE'S THE BLOB AND YOU CAN'T GET AWAY FROM IT. IT'S ALMOST LIKE A FLOATER OR A SPECK THAT JUST STAYS WHEREVER YOUR EYE IS LOOKING. Alda: THE NEXT STEP WILL BE TO ADAPT ALL THIS EXPERIMENTAL EQUIPMENT SO THAT IT'S SMALL AND RELIABLE ENOUGH TO WORK AS PART OF THE HELMET SYSTEM. SO IS THIS REALLY GOING TO HELP PEOPLE OR IS BOB MASSOFF JUST A WELL-MEANING, HIGH-TECH DREAMER? THIS IS SEVEN-YEAR-OLD JOEL THE GRANDSON LEONARD PERRA HAS NEVER REALLY SEEN. TIME FOR A FIELD TEST. WE'RE HOOKING YOU UP TO THE DEVICE. Alda: YOU CAN TELL IT'S A PROTOTYPE BECAUSE OUR CAMERA CREW HAD TO PROVIDE A HOMEMADE LENS SHADE TO CUT OUT GLARE FROM THE SUN. NOW THIS IS A VERY INTERESTING TEST BECAUSE, AT PRESENT, THE HELMET GIVES A VIEW ONLY MARGINALLY BETTER THAN LEONARD'S CONVENTIONAL AIDS. DOESN'T THIS THING LOOK CRAZY, JOEL? Alda: CRAZY OR NOT, IT DOES SEEM TO WORK. IT'S EASIER TO USE. HE DOESN'T HAVE TO THINK ABOUT IT OR LINE IT UP. HE CAN GET ON WITH WHAT REALLY MATTERS. Lee Perra: GETTING A GOOD PICTURE? ( crying: ) OH, REAL GOOD. ( sniffing ) I CAN SEE WHAT HE LOOKS LIKE. WELL, WHAT DOES HE LOOK LIKE? HE'S BEAUTIFUL! JOEL, COME HERE. ( sobbing ) I FINALLY SAW HIM. STEP ON UP. YOU HAVEN'T LOST YOUR EYESIGHT AND YOU DON'T KNOW WHAT IT IS TO LOSE IT AND THEN NOT SEE THINGS THEN ALL OF A SUDDEN TO SEE THEM AGAIN. AND NOW I CAN SEE, I KNOW WHAT MY KIDS LOOK LIKE AND MY GRANDSON, MY WIFE AND IT'S BEEN A LONG TIME SINCE I SAW THEM. ALL I'VE EVER SEEN WAS SHAPES AND NOT FACES, NO FEATURES AND NOW I CAN SEE THEIR FEATURES AGAIN. ( sobbing ) I'D LIKE YOU TO MEET A NEW FRIEND OF MINE. THIS IS KARA AND WE'VE JUST BEEN HAVING A VERY ENTERTAINING CONVERSATION

				Born Again Nerves Scientists train newborn nerve cells to repair spinal cord injuries.
		Select text to jump ahead in the clip: at a challenge that just a few years ago most scientists would have said is simply beyond our reach. The challenge is to repair broken or damaged nerves particularly in people who have suffered a disabling accident which has left them paralyzed. There's now real progress being made in stimulating nerves to repair themselves although it's still at the lab level and a long way from being applied to people. Then we're going to look at a different kind of approach to the same problem. This is a true marriage of biology and technology in which actual hardware is being implanted in the body to restore functions that no longer work. MAN: Go ahead and stand up. ALDA: Nerves are being replaced with computers and wires. So there's some terrific science going on in these areas but we're not going to lose sight of the fact that this is all for one thing: to help the people who need it. Later on in the program I'm going to be talking with Christopher Reeve who, since his accident, has become an important advocate on behalf of disabled patients. But first we're putting on our white coats and heading into the laboratory. And in the laboratory we find laboratory rats. But what a rat! This one had a crippling spinal cord injury and it's literally back on its feet. This story is about how that was done. I'm with John McDonald, a neurology professor at Washington University in St. Louis. What we're going to look at is an actual transplantation procedure where we're going to take the embryonic stem cells that have been instructed to become nervous tissue, and we're going to put those into the middle of the damaged spinal cord of a rat. ALDA: Repairing damaged nerves is one of the possibilities opened up by an exciting new area of research using embryonic stem cells. ALDA: You have stem cells in here? Yes. Let me show you how we grow the stem cells. What we're looking at here if you look closely... ALDA: Oh, yeah. You can see small clusters of hundreds of cells. In fact, each one of those very closely resembles the early embryo after fertilization. ALDA: The cells have not yet started to differentiate into everything that goes to make, in this case, a mouse like bones, muscles or nerves. ALDA: What kind of stuff tells them to become nervous tissue and how does it work? I don't get... that's an amazing idea. What kind of stuff is it? It's very interesting. In the early embryo, the switches-- the major switches-- are very simple things. And the expression of a chemical called retinoic acid is all that it takes to tell these cells to become nervous tissue. And you synthesize that? You can make retinoic acid, as much as you want? Exactly. And you just squirt it around on that stuff and they start to turn into nervous tissue? Yes. ALDA: The embryos are treated with retinoic acid for four days. Then an inhibiting chemical is used to stop them from developing further while they multiply. McDONALD: If we begin the week with one of these flasks, we end the week with 256. So it's really an unlimited supply. The cells divide almost every 14 hours. So let's take a look at these. ALDA: At this stage, they're called neural precursor cells. They're ready to make any of the three kinds of nerve cells but while the inhibiting chemical is present they just multiply as precursors. What we're seeing here are one individual cell that's now just finishing division. The two dark areas are the DNA. And the cell will cleave across here. ALDA: A single transplant needs a couple of million cells so there's a continuous precursor cell production line running in the lab. Then when the inhibiting chemical is removed the nerve cells themselves grow. These are neurons, with their connecting axons. McDONALD: What we're looking at here is a culture dish filled with cells that have now become neurons. You can see the little round circle is a neuron, a cell body. Uh-huh. And that coming out of it-- is that an axon? This is the axon. There are millions and millions of the axons and connections-- those same ones that need to be repaired. ALDA: Here's another kind of nerve cell, called an oligodendrocyte. Its job is to wrap the axons with insulation. McDONALD: What's showing here in green is a single oligodendrocyte in the culture. And these are all the branches. And you can see that this oligodendrocyte reaches out and wraps only one part of that axon and then it continues, unwrapped. Here's another connection that's wrapped multiple times in multiple segments. So this one oligodendrocyte is wrapping many different axons or connections. That's right. Typically in the spinal cord, an oligodendrocyte will wrap up to 15 different axons, or connections between cells. ALDA: Here's an axon wrapped with its new layers of insulation like a plastic cover on a copper wire. Damaging the insulation is an important type of spinal cord injury in people as with this injured cord of a lab animal. The cord is not severed but there's a serious loss of function mainly because existing axons have lost their insulation. By transplanting about two million nerve precursor cells into the injury an astonishing recovery of function has been achieved. The researchers think the animals' bodies signal the transplanted cells to make oligodendrocytes, which rewrap the exposed axons with the insulation called myelin that they need to work again. ALDA: So, nerves that don't work anymore simply because they've lost their myelin-- you can get them to work again. Right-- if we can just simply replace that then we can get important recovery of function such as recovering bowel and bladder control or improved movement of a hand. Now, to you and I, that might not sound like a lot... Oh, it's gigantic if you're missing that. Exactly. The gains in the level of independence for a person to be able to control their own bowel and bladder function or now to use a hand are the difference between living in an institution and living at home. You know, if I was trying to figure out how to do this I'd say, well, get some cells and stick them in there. You know, get some fully grown cells and stick them in. You... you put them in at the right stage so they'll respond to signals and actually grow on their own and grow into the necessary kinds of cells. Yeah, I think we've taken advantage of the power of development and said, "Jeez, you know "we don't know the myriad of signals. "Let's put them in at an early stage "where we can just throw a few switches "and get them going and let the body and the nervous system do the rest. " ALDA: Remyelination of existing axons using stem cell transplants is a tremendous breakthrough. But for a complete cure, new axons need to grow as well so as to reconnect severed nerves. ALDA: How do they know where to go? How do they know where to grow to? Why don't they just grow in every direction? That's the most difficult question now. It's interesting that if you put in cells they'll tend to migrate towards the injury site because the injury site gives signals to get them to go there. The most difficult thing right now is to get these neurons to make the appropriate connections over long distances. That has not been achieved yet. ALDA: Several hundred thousand Americans could benefit from spinal cord therapy and the pace of research is quickening. Encouraged by Christopher Reeve, eight centers around the world have formed a consortium to swap ideas and results. Everyone is feeling optimistic but here at the University of Miami, a consortium member Mary Bunge doesn't underestimate the challenges ahead. BUNGE: There are many different types of nerve cells. There are millions of fibers in the spinal cord. They are traveling in two different directions. They are ending in different areas of the spinal cord. It's a very complex problem. ALDA: Here they're developing a completely different transplant approach using not stem cells but what are called Schwann cells from peripheral nerves-- the ones found in arms and legs. Unlike spinal cords, peripheral nerves can repair themselves. The Schwann cells are cultured and then soaked up into little plastic fiber cylinders. The cylinders are used to take on the biggest challenge of all-- to make a living bridge between completely severed parts of a spinal cord. A section of cylinder containing about six million Schwann cells is placed across the gap in this lab animal test. The extraordinary result is that new axons-- nerve fibers-- are attracted to grow into the bridge. There the transplanted Schwann cells wrap the new axons with the vital myelin. Once again, the body has been coaxed into doing its own thing. The Schwann cells manage to give the right signals for new axons to grow and then make new myelin as well even though repair doesn't normally happen in the spinal cord. BUNGE: One, two, three, four, five, six. What has happened here is that the fibers grew into the bridge and then the Schwann cells that had been transplanted there then formed myelin around the axon. This is the outline of the Schwann cell here. Here is its nucleus. The Schwann cell became related to this axon. The myelin sheath appears as a dark ring. ALDA: They can get new nerves to grow into the bridge but not out again. BUNGE: A challenge now is to improve the amount of growth of axons from the bridge into the cord. ALDA: The latest approach is to take cells from the nose-- the nose of a lab animal again. In all mammals the nose constantly renews its nerve connections to the brain so the nose cells are injected into the spinal cord close to the bridge. The hope is that the nose nerve cells will somehow attract the new nerves out of the bridge so they can make new connections in the spinal cord. And that's in part what the nose cells did with new axons showing up an inch away from each end of the bridge. But right now, we don't know if there were new connections and disappointingly there was no significant improvement in the experimental animals' function. So, what does all this add up to for people? There's no doubt that practical treatments for injured spinal cords are still years away. But at the same time you won't find a scientist in the field who'll say we're not going to win this battle before long. ALDA: I've come to see Christopher Reeve

				I Might Walk! Christopher Reeve talks with Alan Alda about his 'realistic optimism' that he may walk again.
		Select text to jump ahead in the clip: at his house not far from New York City. It used to be woods. ALDA: Chris is now quadriplegic and confined to a wheelchair. He breathes with the aid of a ventilator. In 1995, Chris suffered a severe fall from his horse during a competitive jumping event in Culpeper, Virginia. With an injury at what's called the C-2 level he lost control of his body below the neck. REEVE: I was injured at the second vertebrae level but my spinal cord was not cut. What happened was I had a hemorrhage right in the middle of the cord at C-2. And then it caused atrophy. So right at C-2 the cord is one-quarter of its normal size. So think of it as a kinked garden hose. ALDA: Chris Reeve, seen here with his wife, Dana, and son Will prepared for a lifetime of paralysis. But soon he was to discover that for the first time, there was hope that science could tackle spinal cord injuries. ALDA: Were you encouraged to have this kind of hope when you first had the accident when you, say, were in rehab? Or were you encouraged to accept and adjust to, uh...? No, at first I was encouraged to accept and adjust. And in fact, I remember one researcher saying that, uh, "Well, in the beginning, one always hopes but over time, hope ebbs. " You know, and this is a researcher who now is at the forefront of the solution to the problem. Now we're at a stage where leaders in the field have discovered that exercise is absolutely essential. Now, for what? Exercise is essential to get you ready for the time when your nerves may be able to be regenerated? Or just in general, just...? Well, there's of course just immediate benefit in that you avoid infections, antibiotics, et cetera. And the other is think of it as the transcontinental railroad-- that the patient starts on the East Coast by doing his exercise and improving and heading west while the scientists start from the west and go from the Petri dish to the monkey or the rat and then into the human and hopefully they meet in the same place, in Utah or wherever. ALDA: Chris exercises three to four hours a day using specialized equipment-- equipment he wants insurance companies to provide for all patients, by the way. There's a bicycle used in conjunction with electrical muscle stimulation and a table that tilts upright. REEVE: We loosen the straps and somebody stands in front of me so that I don't fall over-- but actually I have good equilibrium-- and what we do is I mentally think, "Lean to the right" and my body does it. Wow. And then I mentally think "Lean to the left" and I go left and put all my weight on my left foot. And that is something where the brain is telling the cord to shift weight. ALDA: Work on a treadmill is intended to stimulate the spinal cord's own memory of walking patterns. We'll have a story about this idea later on. Overall, the point is to use to the full the few remaining spinal connections so he's ready to meet the scientists when they get to "Utah. " One short-term goal is simply to breathe naturally. He can already do this half an hour at a time. REEVE: What I'm trying to do is get off the vent and I do that with certain breathing exercises but also the treadmill therapy is helping that. What's the connection? How does that help? Well, you're activating the cord, you're taking advantage. You take advantage of an automatic breathing response? Of what's left. I'm not yet able to breathe automatically. Is your diaphragm working? My diaphragm works which is really a miracle because I'm injured at a level way above the diaphragm but by exercising very hard over the last five years I've improved, so I'm going up rather than down. Now, psychologically and emotionally that makes a tremendous difference. Oh, I can imagine. You know, this old saying: Give me the strength to do something about what I can do something about and to accept what I can't do anything about and the wisdom to know the difference. Your recent life has been kind of a vivid example of how hard it is to strike that balance, to find that wisdom. How do you do it? I mean, you must have to accept a certain amount. I don't buy into it at all. You don't accept any of it? No. Who knows what the horizon is? Yeah. You know, who knows how far we're going to go? Why should we put limits on it? You know, you know that pigs aren't going to fly... but I might walk, you know? ( Alda laughing ) ALDA: Chris Reeve's accident had compromised a highly successful acting career. And he decided that he should use his celebrity for all it was worth to further the cause of research into spinal cord treatments. REEVE: The main idea is to put a vision out there and then I even went so far as to do a commercial last year. I didn't see the commercial. Well, what happens in the commercial is that I'm seen walking to give a prize to scientists who, sometime in the future, had cured spinal cord injuries. And it was very upsetting to some people very uplifting to others but five months after the commercial was on the air people are still talking about it. So that's great. You want that debate you want that controversy, you want people to be agitated. But I checked with all the major scientists in the country that I, you know, have a relationship with and they said, "No, there's no reason "not to put that vision before the public because it will happen. " ANNOUNCER: And in the years since the new millennium the world has seen such progress. In 2004, the tide was turned against AIDS two years later, great strides against cancer and tonight-- tonight we celebrate a remarkable breakthrough in spinal cord injuries made possible by countless researchers and contributors. And to present this award, we have some very special guests. In the future so many amazing things will happen in the world. What amazing things can you make happen? What do you think your main contribution is? Is it raising money? Is it focusing attention? Being the person who gets everybody in the boat to row together? What do you think... what do you think of as your main contribution? Well, my responsibility is all of the above. You know, I'm president of a club I didn't want to join but, uh, nevertheless I have to take some responsibility. Not to do so would be really immoral. And I have the chance to speak up for a lot of people you know, who could never get to a congressman or never testify before a Senate committee or influence a budget. So, I actually... You know, I can't say it's my favorite thing to do but nevertheless, uh, psychologically, emotionally it really helps me that, you know, I can be of some use. ALDA: And when he does get back to work he's still trying to be of some use. In this remake of the Hitchcock classic Rear Window he wanted to help change the widespread stereotype of disabled people as isolated and embittered to something different-- to an image of people who could be, in fact, of some use. Achilles... bring up telephone. Dial 911. OPERATOR: 911 operator. I need to report a domestic altercation. OPERATOR: Can you describe what's happening, sir? ALDA: Christopher Reeve could hardly get much further from the stereotype. He set up a foundation which helps fund and coordinate the world's best research in spinal cord injury and he's a tireless advocate. What was an immensely creative life before the accident only seems to have become more so since in both public and private life. REEVE: You find alternate ways to accomplish and to express... your needs, your desires, et cetera. For example, I taught, when I was on my feet my big kids how to ride a bike and, you know, taking the training wheels off. But my young son, Will, was a little afraid to take the training wheels off. But I actually sat out in our driveway in a wheelchair. Somebody took the training wheels off and I talked him through how to do it. Now, isn't that cool? And who would have thought? It's great, you're relentless. I mean, you really don't give up. No, because now we need a way to connect. Yeah, yeah. And so many ways of connecting have been taken away. You know, I haven't been able to give him a hug since he was two years old, and he's almost eight. But he's got to hear it through my voice and through my eyes and just from being there. So I have to find ways to give him what he needs. And one of my jobs-- and this is the paradox of having a debilitating injury or disease-- is that you have to find a way to be more generous than you ever were before when you were on your feet. And what I mean by that is that you have to set people free so they don't spend their life worrying about you. Do you think about... do you let yourself think about how long it will take before they'll be able to get to the point where you can walk again? No, I don't... I don't measure it in terms of months, days or years. I measure it in terms of how hard people are working. So sometimes if I see a scientist at, you know, too many dinners... or, you know, out at too many meetings I say, "Go back to the lab," you know? "Get out of here. "Go put the white coat on, get to work. " You know, so I have a reputation as sort of an amiable pest. ALDA: We're back at the University of Miami to look at a remarkable study that's just getting under way. Rudolfo Stecco has been partially paralyzed

				Moving Memories Going through the motions sparks remarkable progress in paralyzed patients.
		Select text to jump ahead in the clip: since a car accident two years ago. He's one of 200 patients who, over the next five years will test the effects of intensive exercise but exercise during which only about one-third of the body's weight has to be supported by the legs. Put it at 88. 88? ALDA: There's a fascinating story behind this study. It all began six years ago with a patient who was exercising hard in an attempt to improve his walking which was very limited. Blair Calancie, the study director, takes up the story. CALANCIE: He could walk about 75 feet in one 45-minute session. Clearly it was nonfunctional with such small distances. The fourth year he'd come down, he decided he was going to go all out. He was going to embark on a very strenuous physical conditioning program under his own direction and worked out for four hours on the Monday four hours on the Tuesday standing, exercising, a lot of strenuous work. On Wednesday he comes in and says to one of our therapists "I'm getting these weird spasms when I lie down; it's like I'm walking. " She then responded, as was her way "You're a spinal cord injury, you have spasticity. Get used to it. " ALDA: Fortunately, Blair Calancie decided to take a look for himself anyway and what he found was a completely unknown phenomenon. CALANCIE: Just as he had described to us the moment we took him from his wheelchair and he laid out flat on his back his legs began an involuntary stepping pattern. What was intriguing was and what really set us out on this whole area of research is that at the same time the involuntary stepping started at night his ability to walk in the daytime, volitionally improved by an order of ten. So he went within a week from walking 75 feet in a session to 500 and 600 and 700 feet in one session. ALDA: Conventional therapy after a spinal cord injury is something like this-- mild stretching and gentle movement. But suddenly here was the possibility that intensive exercise would dramatically improve walking even 17 years after the injury in this case. CALANCIE: An important consideration for this study is that everybody has to be at least one year post-injury. And under today's current approach with managed care it's not at all unusual for an individual with an acute-- they've just had a recent spinal cord injury-- to be discharged from hospital at six weeks, seven weeks, eight weeks. Maybe they'll get rehab for another month to six weeks after that and beyond that, it's over. ALDA: Ida Fisher, for example, has been partially paralyzed for four years. CALANCIE: Ready to fire up? Let's go. ALDA: She's testing the treadmill and like all the subjects, she's partially suspended. She'd barely be able to move at all otherwise. Christopher Reeve does his treadmill workout regularly by the way. Nice, smooth steps. ALDA: After six weeks in the study Ida's seen a dramatic improvement. FISHER: Before, I walk less; I walk only half an hour. Now I walk an hour. ALDA: The study is recording many such improvements. The intriguing possibility is that the spinal column itself contains some of the instructions for walking. This central pattern generator, as it's called is known in animals but has never been seen before in humans. Hard exercise-- only possible with these subjects when partially suspended-- somehow restimulates the central pattern generator. CALANCIE: We're seeing dramatic improvements in individuals who are at least one year post-injury and often cases five, six, ten years post-injury which suggests that there's a great deal of untapped potential in these individuals. It's a very strong argument to the managed-care companies, to physicians that the common phrase of "Whatever you have at one year post-injury is what you've got for the rest of your life" needs to be rethought. ALDA: And it's an unexpected new source of hope for people with spinal cord injuries. ALDA: Don Crago is paralyzed from the waist down.

				Mind Over Matter Scientists harness the brain's potential to move objects with the power of thought.
		Select text to jump ahead in the clip: The producers have had me wear these attractive hats before but it's usually in a good cause. And in this case I was presented with a really fascinating challenge. I'm trying to just think about moving the white dot toward the bar while a computer looks at my brain waves and tries to pick up any signals that appear when I succeed. There's only one problem: I'm not succeeding. It's incredibly difficult when you first try it but they say it really can be done although most people need dozens of training sessions to make it work. This is like lifting things with your eyelids. ALDA: But every now and then, I did make it happen and I could see how you could train yourself to succeed consistently. It's more relaxed than being relaxed. It's... it's utter calm, almost nothingness. But there's the sense of doing it, of knowing it'll happen. ALDA: Andrew Junker is the man who first persuaded people to take seriously the idea that minds can control machines. When we filmed this eight years ago he'd been at it for a decade. JUNKER: I pick up the electrical signals from the head connect them to a bio-amplifier-- which amplifies the signal 20,000 times. It sends it to this blue box, which is the radio transmitter. The transmitter sends the signal to a receiver which is connected to the computer. ALDA: The machine Andrew liked to control was his sailboat. It's about to take a turn around the harbor of St. Thomas with neither Andrew nor his wife, Patricia having to lift a finger. ( electric motor humming ) The computer is linked to a motor-driven wheel and it's getting its signals from three electrodes inside Andrew's headband. As with the hat I was wearing the electrodes are picking up the electrical activity of Andrew's brain. Unlike me, he successfully taught himself to increase or decrease one particular component of this activity. His computer was programmed so that an increase turns the boat to the left... ( electric motor humming ) I'm turning left now. ( electric motor humming ) ALDA: While a decrease turns the boat to the right. Now I'll turn right. ( electric motor humming ) That last experience felt fantastic because I felt in a groove. Right here I felt like I was in this slot. And as long as I held that slot I could delicately suppress or intensify the signal and the boat responded, and it's a fantastic feeling. ALDA: Now, I know what you're thinking: "A man sailing a boat in the Caribbean with his brain waves-- that's something they expect us to take seriously? " But in fact Andrew Junker's work was then being taken very seriously by, of all things, the U. S. Air Force. Flying fast combat planes is a very complicated business and the pilot has only two hands and feet to do it. As more and more high-tech systems are added the pilot's in danger of having more controls to operate than ways to operate them... which is where Andrew Junker entered the picture. As an Air Force researcher he set up a laboratory to study brain-machine communication here at Wright-Patterson Air Force Base in Ohio. Pilots like Captain Dave Toomey got pretty good at it and the researchers were able to measure what was happening fairly easily. Everything you look at out in the world produces a measurable response in your brain. In this case it's the response of Dave's brain to that light in the cab that's flickering 13 times a second. ALDA: The flickering produces in the back of Dave's brain what's called an "evoked potential"-- an electrical signal that can be picked up by electrodes on his scalp. Here's the signal. Keep your eye on the white dot in the middle. Dave's task is to try to change the height of the peak marked by the dot either increasing it and holding it there... or decreasing it and keeping it suppressed. TOOMEY: It feels as if you're doing something on a psychic level. It feels like those things you've seen on TV with the Russians bending spoons and moving balls on tables. It feels like that-- it feels like it's purely psychic. But in fact, it's hard science, it's pure science. It's just using something that the brain does naturally with some very high-tech equipment in order to make the link possible-- the human brain-to-machine link. ALDA: The machine Dave's controlling is a simple flight simulator. When he suppresses the signal, the simulator rolls to the left. And when he increases the signal, he rolls to the right. So far, so good. But how does he do it? We don't really know in any detail at all how people do this-- how they actually exercise this kind of brain-actuated control. And what we usually do when people ask us that question is try to give them an analogy: You know, how does a baby learn how to walk? ALDA: The idea has now found a new home with our tireless FES research subject, Jim Jatich. The Air Force eventually gave up not because it didn't work but because they were concerned it wouldn't work quickly and reliably. But Jim has trained himself to become incredibly good at controlling the dot with his mind. JATICH: When I see it down, I'm actually thinking "down," or like a fishing weight sinking down to the bottom of a lake. When I'm thinking up I'm thinking "up" or like a balloon floating. ALDA: It occurred to the researchers that this would make the ideal way to control an implanted FES system. So now instead of thinking about fishing weights and balloons Jim just has to think "close hand"... And it really works. TECHNICIAN: Not too bad. All right, let me change that. Okay, go ahead and close. ALDA: It's almost a miracle. Open. There we go. Okay, Jim, close. There we go. JATICH: The first time that I actually opened and closed my hand-- it didn't hit me when we were doing it in the lab. When I was outside in front of the hospital you know, just sitting there waiting for my ride to come it actually hit me that I actually opened and closed my hand by actually thinking about it, and then tears came to my eyes. That's the closest thing to what I used to have that God actually gave me... you know. I mean, it hit me all of a sudden and then it was overwhelming. But when I was doing it in the lab it was just another experiment. ( chuckles ) So, I mean, you know But it's going to take time and a lot of people's effort. I'm ready to go. ( chuckles ) Yeah. Come visit us at PBS Online. Scientific American Frontiers can be found on the World Wide Web at pbs.