Archives February 2019

Thursday, December 18, 2008

A team of eight transplant surgeons in Cleveland Clinic in Ohio, USA, led by reconstructive surgeon Dr. Maria Siemionow, age 58, have successfully performed the first almost total face transplant in the US, and the fourth globally, on a woman so horribly disfigured due to trauma, that cost her an eye. Two weeks ago Dr. Siemionow, in a 23-hour marathon surgery, replaced 80 percent of her face, by transplanting or grafting bone, nerve, blood vessels, muscles and skin harvested from a female donor’s cadaver.

The Clinic surgeons, in Wednesday’s news conference, described the details of the transplant but upon request, the team did not publish her name, age and cause of injury nor the donor’s identity. The patient’s family desired the reason for her transplant to remain confidential. The Los Angeles Times reported that the patient “had no upper jaw, nose, cheeks or lower eyelids and was unable to eat, talk, smile, smell or breathe on her own.” The clinic’s dermatology and plastic surgery chair, Francis Papay, described the nine hours phase of the procedure: “We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve.” Thereafter, another team spent three hours sewing the woman’s blood vessels to that of the donor’s face to restore blood circulation, making the graft a success.

The New York Times reported that “three partial face transplants have been performed since 2005, two in France and one in China, all using facial tissue from a dead donor with permission from their families.” “Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers, the rest of her face comes from a cadaver; she could not eat on her own or breathe without a hole in her windpipe. About 77 square inches of tissue were transplanted from the donor,” it further described the details of the medical marvel. The patient, however, must take lifetime immunosuppressive drugs, also called antirejection drugs, which do not guarantee success. The transplant team said that in case of failure, it would replace the part with a skin graft taken from her own body.

Dr. Bohdan Pomahac, a Brigham and Women’s Hospital surgeon praised the recent medical development. “There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Leading bioethicist Arthur Caplan of the University of Pennsylvania withheld judgment on the Cleveland transplant amid grave concerns on the post-operation results. “The biggest ethical problem is dealing with failure — if your face rejects. It would be a living hell. If your face is falling off and you can’t eat and you can’t breathe and you’re suffering in a terrible manner that can’t be reversed, you need to put on the table assistance in dying. There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Dr Alex Clarke, of the Royal Free Hospital had praised the Clinic for its contribution to medicine. “It is a real step forward for people who have severe disfigurement and this operation has been done by a team who have really prepared and worked towards this for a number of years. These transplants have proven that the technical difficulties can be overcome and psychologically the patients are doing well. They have all have reacted positively and have begun to do things they were not able to before. All the things people thought were barriers to this kind of operations have been overcome,” she said.

The first partial face transplant surgery on a living human was performed on Isabelle Dinoire on November 27 2005, when she was 38, by Professor Bernard Devauchelle, assisted by Professor Jean-Michel Dubernard in Amiens, France. Her Labrador dog mauled her in May 2005. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient. Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant.

In 2004, the same Cleveland Clinic, became the first institution to approve this surgery and test it on cadavers. In October 2006, surgeon Peter Butler at London‘s Royal Free Hospital in the UK was given permission by the NHS ethics board to carry out a full face transplant. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six month intervals. In March 2008, the treatment of 30-year-old neurofibromatosis victim Pascal Coler of France ended after having received what his doctors call the worlds first successful full face transplant.

Ethical concerns, psychological impact, problems relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Iain Hutchison, of Barts and the London Hospital, warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon‘s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”

In Wednesday’s conference, Siemionow said “we know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street.” “Our patient was called names and was humiliated. We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted,” she added.

In response to the medical breakthrough, a British medical group led by Royal Free Hospital’s lead surgeon Dr Peter Butler, said they will finish the world’s first full face transplant within a year. “We hope to make an announcement about a full-face operation in the next 12 months. This latest operation shows how facial transplantation can help a particular group of the most severely facially injured people. These are people who would otherwise live a terrible twilight life, shut away from public gaze,” he said.

Monday, June 29, 2009

A crash has killed nine people on a turnpike (toll road) northeast of Miami, Oklahoma. The accident occurred on Friday when a semi-trailer truck struck a line of stationary traffic from behind on the Will Rogers Turnpike near state lines with Missouri and Kansas.

Traffic had come to a standstill as a result of an earlier accident eastbound when the accident occurred. The road has a speed limit of 75 mph, and it is currently thought that the truck driver made no attempts to stop his vehicle. He was hospitalised. A spokesperson for the nearby Freeman Hospital said eight people were treated there, and it is reported a twelve-year-old girl is among the injured.

The girl had to be cut free from the wreckage of her car, and was taken to the Children’s Mercy Hospital in Kansas City where she was in critical condition. Her parents were both killed. The accident occurred at 1p.m., and it was four hours before any eastbound lanes re-opened, leaving vehicles stranded in high temperatures and prompting emergency services to distribute water to motorists.

Also killed are an Oklahoma City family of four and a seven-year-old Texas girl and her father. The mother from that family is in a critical condition, and another woman was also killed in the same car.

Lt. George Brown of the Oklahoma Highway Patrol described the scene: “It looks like a war zone. There’s mangled metal everywhere. There’s debris, fluids, dead bodies.” A man who has worked thirty years as a tow truck driver said the crash was “the worst one I’ve ever worked.”

A number of other smaller incidents occurred in the area afterwards. At least three accidents were caused by vehicles slowing down in response to the crash, and four cars collided with each other westbound. No-one was killed in the other accidents.

It took hours to locate the last fatality, who was in a car pinned under the semi-trailer. Two tow trucks were required to separate the vehicles. A total of seven vehicles were involved, including three cars which were beneath the truck by the end of the accident sequence.

A criminal investigation has been launched. A blood sample has been taken from the truck driver, 76-year-old Donald Creed, who has been released from hospital after treatment. There is no indication alcohol was a factor in the accident.

Monday, February 4, 2008

The Church of Jesus Christ of Latter-day Saints named Thomas Spencer Monson their 16th president at a press conference on Monday after being ordained the day before.

Monson, at 80 years old, succeeds Gordon B. Hinckley, who died January 27 and was buried on Saturday.

“Hinckley’s passing has affected all of us,” Monson said at the press conference held at the Church Office Building in Salt Lake City, Utah. “We shall miss him, yet he has left us with a wonderful legacy.”

Monson says he intends to continue Hinckley’s legacy, and that he expects “no abrupt changes from the courses [the church] [has] been pursuing.”

Monson named Henry B. Eyring and Dieter F. Uchtdorf the First and Second Counselors, respectively, of the First Presidency, which is the highest governing body of the church.

“I learned quickly in the church that we’re not representing a nation or country or ethnic group,” said Uchtdorf, a native German. “We are … representing the Church of Jesus Christ.”

The LDS church follows a pattern of succession in choosing a new president. When the president dies, the President of the Quorum of the Twelve Apostles is handed the position. Boyd K. Packer will now serve as President of the Quorum, after years of serving as the Quorum’s acting president.

Monson simultaneously served as both First Counselor and President of the Quorum under Hinckney’s administration due to his seniority. He also served as Second Counselor under the previous two presidents of the church. He was first called to be an apostle in 1963 at the age of 36.

Tuesday, March 29, 2005A team of Australian surgeons yesterday reattached both hands and one foot to 10-year-old Perth boy, Terry Vo, after a brick wall which collapsed during a game of basketball fell on him, severing the limbs. The wall gave way while Terry performed a slam-dunk, during a game at a friend’s birthday party.

The boy was today awake and smiling, still in some pain but in good spirits and expected to make a full recovery, according to plastic surgeon, Mr Robert Love.

“What we have is parts that are very much alive so the reattached limbs are certainly pink, well perfused and are indeed moving,” Mr Love told reporters today.

“The fact that he is moving his fingers, and of course when he wakes up he will move both fingers and toes, is not a surprise,” Mr Love had said yesterday.

“The question is more the sensory return that he will get in the hand itself and the fine movements he will have in the fingers and the toes, and that will come with time, hopefully. We will assess that over the next 18 months to two years.

“I’m sure that he’ll enjoy a game of basketball in the future.”

The weight and force of the collapse, and the sharp brick edges, resulted in the three limbs being cut through about 7cm above the wrists and ankle.

Terry’s father Tan said of his only child, the injuries were terrible, “I was scared to look at him, a horrible thing.”

The hands and foot were placed in an ice-filled Esky and rushed to hospital with the boy, where three teams of medical experts were assembled, and he was given a blood transfusion after experiencing massive blood loss. Eight hours of complex micro-surgery on Saturday night were followed by a further two hours of skin grafts yesterday.

“What he will lose because it was such a large zone of traumatised skin and muscle and so on, he will lose some of the skin so he’ll certainly require lots of further surgery regardless of whether the skin survives,” said Mr Love said today.

The boy was kept unconscious under anaesthetic between the two procedures. In an interview yesterday, Mr Love explained why:

“He could have actually been woken up the next day. Because we were intending to take him back to theatre for a second look, to look at the traumatised skin flaps, to close more of his wounds and to do split skin grafting, it was felt the best thing to do would be to keep him stable and to keep him anaesthetised.”

Professor Wayne Morrison, director of the respected Bernard O’Brien Institute of Microsurgery and head of plastic and hand surgery at Melbourne’s St Vincent’s Hospital, said he believed the operation to be a world first.

Sunday, February 13, 2005

New York –”Buy cheap Viagra through us – no prescription required!” Anyone with an active email account will recognize lines like this one. According to some reports, unsolicited advertisements (spam) for Viagra and similar drugs account for one in four spam messages.

Ever since pharmaceutical giant Pfizer promised to cure erectile dysfunction once and for all with its blue pills containing the drug sildenafil citrate, spammers have tried to tap into male anxiety by offering prescription-free sales of unapproved “generic” Viagra and clones such as Cialis soft tabs. Legislation like the U.S. CAN-SPAM act has done little to stem the tide of email advertising the products.

Now Pfizer has entered a pledge with Microsoft Corporation, the world’s largest software company, to address the problem. The joint effort will focus on lawsuits against spammers as well as the companies they advertise. “Pfizer is joining with Microsoft on these actions as part of our shared pledge to reduce the sale of these products and to fight the senders of unsolicited e-mail that overwhelms people’s inboxes,” said Jeff Kindler, executive vice president at Pfizer.

Microsoft has filed civil actions against spammers advertising the websites CanadianPharmacy and E-Pharmacy Direct. Pfizer has filed lawsuits against the two companies, and has taken actions against websites which use the word “Viagra” in their domain names. Sales of controlled drugs from Canadian pharmacies to the United States are illegal, but most drugs sold in Canada have nevertheless undergone testing by the U.S. Food and Drug Administration. This is not the case for many of the Viagra clones sold by Internet companies and manufactured in countries like China and India. While it was not clear that CanadianPharmacy was actually shipping drugs from Canada, Pfizer’s general counsel, Beth Levine, claimed that the company filled orders using a call center in Montreal, reported the Toronto Star.

For Microsoft’s part, they allege that the joint effort with Pfizer is part of their “multi-pronged attack on the barrage of spam.” As the creator of the popular email program Outlook, Microsoft has been criticized in the past for the product’s spam filtering process. Recently, Microsoft added anti-spam measures to its popular Exchange server. Exchange 2003 now includes support for accessing so-called real-time block lists, or RTBLs. An RTBL is a list of the IP addresses maintained by a third party; the addresses on the list are those of mailservers thought to have sent spam recently. Exchange 2003 can query the list for each message it receives.

Monday, April 6, 2009

Over 1,600 volunteers registered to help build approximately 65,000 of the 500,000 sandbags to create dikes 20.5 feet (6.2 meters) high to protect the City of Winnipeg, Manitoba in the war against the Red River of the North flood.

700 volunteers answered at the rural municipality of St. Andrews alone. Once sandbags are filled for West St. Paul, St. Andrews, and Selkirk, then frozen culverts must be cleared.

The height of the river is expected to be Thursday, and predictions are that it will be less than Flood of the Century of 1997. There is no precipitation in the forecast, and snow in the province should be melted by the end of the week.

“The fear right now is we have to get that ice out of the river. The Amphibex [Excavators] are still working and breaking the ice apart, and everyday we buy with the warm weather and the current, it is thinning the ice down a bit, so when it does start to move, the better chance it’ll move right out into the lake,” said Paul Guyder, the emergency coordinator for the RMs of St. Andrews and St. Clements.

“I feel that we’ve done everything humanly possible to get ready,” said Gary Doer, Premier of Manitoba, “But … there are fallibilities with human behaviour. We can take every preventative measure as human beings possible and we can still get Mother Nature proving again she is superior.”

Communities with ring diking will partially or fully close their dikes at the beginning of the week. Provincial officials are considering opening the Red River Floodway gates around mid-week before ice is fully melted.

Ice jams could cause flooding within the city, however opening the gates could spare neighbourhood flooding when the river rises to the estimated 6.3 meters (20.7 feet) height. The province does have back up plans for dealing with ice jams within the city if they do occur. The unpredictability of ice jams and the ensuing water level rise may cause neighbourhood flooding. The city is raising dikes where the river has jammed with ice in the past such as on tight curves and past bridges. Likewise there are excavators and backhoes positioned at these points.

Vulnerable neighbourhoods on the river banks have been reinforced with sandbag dikes at vulnerable areas from the massive volunteer effort over the weekend. Guyader feels no more extra volunteers are needed, however volunteers are still being asked to leave their names and number in case of unpredicted need. Existing personnel will assess roads, and help with clean up.

Approximately 400 of the 800 people who evacuated the Roseau River Anishinabe First Nation have returned to their homes.

Former Premier, Dufferin Roblin, brought forward the floodway as a protection for Winnipeg residents and economy following the 1950 Red River Flood. The Red River floodway, “Duff’s Ditch” was finally finished in 1968, and its floodway gates have been opened 20 times saving Winnipeg from an estimated CA$10 billion in damages. The floodway expansion began in 2005 at a price of $665 million.

Polish and Chinese experts have come to survey the Red River Floodway, and Dennis Walaker, mayor of Fargo, North Dakota recognises the need for Red River flood defences down river. “Every town that you drive by from the Canadian line up to Winnipeg is either elevated or ring-diked,” said Walaker.