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.

Friday, November 10, 2006

In an internet-based study published today on the website of the British Medical Journal, Australian investigators tested how well Googling could help to establish a difficult diagnosis. The search results met against their criteria in 15 out of 26 cases.

Previous anecdotes of the use of Google in reaching a difficult diagnosis are presented in the paper. In a case described in the New England Journal of Medicine (NEJM), a physician diagnosed IPEX syndrome after submitting the typical diagnostic clues to the search engine. A patient’s father replied to doctor’s saying that his son had acute subclavian vein thrombosis of unknown origin: “But of course hehas Paget-von Schrötter syndrome.”

Hangwi Tang and Jennifer Hwee Kwoon Ng from the Princess Alexandra Hospital in Brisbane selected clinical cases from the NEJM blind to the correct diagnosis. They selected 3 to 5 rather specific features, searched Google, and selected the 3 disorders from the results that seemed to fit the case best. If one of those was right, Google was said to be “right”.

The scientists admit that an internet search probably works better with specific symptoms rather than with phrases such as “fever ill pain”. Also, the percentage may depend on the operating physician’s knowledge base, and the test was not double-blind.

Experts commented that the internet is not a replacement for doctors, but should be seen as a way of supporting doctors and patients. A spokeswoman for the Patient Association added that “a lot of sites are not credible. There are lots of good sites out there, but we also know that there are many that are not credible.”

Thursday, April 27, 2006

By the decision of the shareholders the “Voxtel” company will be transformed Into “Orange”.

The shareholders of “Voxtel” are: France Telecom – 61%, MMT-BIS – 30%, MobilRom – 4%, IFC – 5%.

“Orange” – is one of the world mobile communication leaders and is a daughter enterprise of the “France Telecom” group. The “Orange” group is present in 17 countries, where it has more than 80 million mobile communication subscribers.

Friday, July 20, 2007

Atlanta Falcons quarterback Michael Vick and three other men were indicted on Tuesday by a federal grand jury on charges of conspiracy related to a dog fighting operation. The charges included buying, breeding and training pit bull dogs, transporting the dogs across state lines to illegally participate in fights, and gambling on the fights.

The indictments stemmed from a search of Vick’s Smithfield, Virginia home in April, in which 54 pit bulls were removed, along with equipment used in dog fighting.

The indictment said that Vick had bought the property in Smithfield for US$34,000 to run the dog fighting under the name “Bad Newz Kennels” with two other people named in the indictment. Purnell Peace, Quanis Phillips, and Tony Taylor were all named in the indictment along with Vick.

The indictment stated that Vick took part in the killing of eight dogs that didn’t pass test fights, called “rolling”. The pit bulls were allegedly killed by hanging, drowning and slamming at least one dog onto the ground.

If convicted of both portions of the conspiracy charge, Vick could face six years in prison and a $350,000 fine. His property, located in Surry County, would be subject to forfeiture under U.S. laws dealing with illegal activities that are carried out at an interstate level. The indictment alleges that the dog fighting operation, involving American Pit Bull Terriers, spilled over into Alabama, North Carolina and New York.

Vick has a court date on July 26 for a bond hearing and to hear the charges. Vick has said that he had a kennel operation on the property, but had no involvement or knowledge of a dog fighting ring.

Thursday, June 15, 2006

One hundred and twenty detainees at an immigration removal centre in Oxford, UK, are on hunger strike. The protest started when some detainees refused breakfast on Wednesday 14th June 2006. A letter from the hunger strikers explaining why they are seeking to draw attention to their plight in this way has been reproduced in full below.

Those detained at the centre are mostly men who have sought asylum in the UK and whose asylum applications have been rejected. These people are then held without knowing how long they will be detained for – some end up being held for many years while awaiting deportation.

The removal centre, known as Campsfield, or Campsfield House is approximately 5 miles north of Oxford and has been in operation since 1993. It was managed on behalf of the UK Government by Global Solutions Limited, until may 2006 when it was taken on by GEO UK, the centre has a capacity of 198. Only males are detained at Campsfield.

According to the campaign group Barbed Wire Britain Over 2,600 individuals, mostly asylum seekers, are detained indefinitely in the UK without trial and with no automatic right to bail.

There have been reports in the UK press of the state taking people to detention centres without notice, in the early hours of the morning using excessively heavy handed tactics, taking children out of schools and separating families.

Many UK people and politicians express their disgust at the way detainees are treated, yet it continues. Perhaps this action by the detainees themselves will further highlight their plight and result in more UK electors writing to their MPs and demanding improvements to the way in which rejected asylum seekers are treated.

“We are detainees at Campsfield removal centre in Oxford. Most of us have been here for a long while now. There are people who have been detained for up to two years and down to three months. We are cramped in here like animals. We are treated like animals and moved around different detention centres like animals. The immigration service have taken husbands from their families and taken people who ran away from persecution in their various countries, and dumped everyone in here.

Once you are put in here the immigration service forget you. There are detainees who have applied to go back to their own countries that are still being held here for months without any news about their cases, just so that the private security companies get more money.

Detainees are asked to seek asylum and then refused. The immigration service also ask detainees to apply for bail. When you get a bail hearing date all of a sudden they serve you with removal papers that are not valid. There are many of these situations. In most cases the immigration service don’t take you to your court hearings. And then they tell the judges you refused to turn up, just so the hearing goes ahead in your absence. Many detainees have been served with removal papers and travel documents but nothing happens on the removal day.

Campsfield has become a slave house. We detainees are treated like slaves, to do odd jobs for officers. Detainees are handcuffed to see doctors or dentists in hospitals or clinic appointments. We have some racist security officers who make racist comments to detainees and go out of their way to make you feel like committing suicide. Detainees have to be at the point of death before they get to see the doctors.

The food is not worth eating. Even dogs would refuse to eat what we eat. But we don’t have a choice; every single day we eat the same food (the food we eat is rice, chicken, sandwiches, and left-over eggs)”.

• “120 Immigration Detainees on Hunger Strike at Campsfield IRC” — Oxford Indymedia, June 14, 2006
• UK Home Office webpage on Campsfield
• Close Campsfield Campaign
• “Dawn raid furore family deported” — BBC, September 29, 2005
• Barbed Wire Britain
• “Asylum seekers on hunger strike” — BBC, July 14, 2005
• “Construction/Building Press Releases” — PR Newswire, Oct 01, 2005

Thursday, June 23, 2011

NASA’s Cassini–Huygens spacecraft has discovered evidence for a large-scale saltwater reservoir beneath the icy crust of Saturn’s moon Enceladus. The data came from the spacecraft’s direct analysis of salt-rich ice grains close to the jets ejected from the moon. The study has been published in this week’s edition of the journal Nature.

Data from Cassini’s cosmic dust analyzer show the grains expelled from fissures, known as tiger stripes, are relatively small and usually low in salt far away from the moon. Closer to the moon’s surface, Cassini found that relatively large grains rich with sodium and potassium dominate the plumes. The salt-rich particles have an “ocean-like” composition and indicate that most, if not all, of the expelled ice and water vapor comes from the evaporation of liquid salt-water. When water freezes, the salt is squeezed out, leaving pure water ice behind.

Cassini’s ultraviolet imaging spectrograph also recently obtained complementary results that support the presence of a subsurface ocean. A team of Cassini researchers led by Candice Hansen of the Planetary Science Institute in Tucson, Arizona, measured gas shooting out of distinct jets originating in the moon’s south polar region at five to eight times the speed of sound, several times faster than previously measured. These observations of distinct jets, from a 2010 flyby, are consistent with results showing a difference in composition of ice grains close to the moon’s surface and those that made it out to the E ring, the outermost ring that gets its material primarily from Enceladean jets. If the plumes emanated from ice, they should have very little salt in them.

“There currently is no plausible way to produce a steady outflow of salt-rich grains from solid ice across all the tiger stripes other than salt water under Enceladus’s icy surface,” said Frank Postberg, a Cassini team scientist at the University of Heidelberg in Germany.

The data suggests a layer of water between the moon’s rocky core and its icy mantle, possibly as deep as about 50 miles (80 kilometers) beneath the surface. As this water washes against the rocks, it dissolves salt compounds and rises through fractures in the overlying ice to form reserves nearer the surface. If the outermost layer cracks open, the decrease in pressure from these reserves to space causes a plume to shoot out. Roughly 400 pounds (200 kilograms) of water vapor is lost every second in the plumes, with smaller amounts being lost as ice grains. The team calculates the water reserves must have large evaporating surfaces, or they would freeze easily and stop the plumes.

“We imagine that between the ice and the ice core there is an ocean of depth and this is somehow connected to the surface reservoir,” added Postberg.

The Cassini mission discovered Enceladus’ water-vapor and ice jets in 2005. In 2009, scientists working with the cosmic dust analyzer examined some sodium salts found in ice grains of Saturn’s E ring but the link to subsurface salt water was not definitive. The new paper analyzes three Enceladus flybys in 2008 and 2009 with the same instrument, focusing on the composition of freshly ejected plume grains. In 2008, Cassini discovered a high “density of volatile gases, water vapor, carbon dioxide and carbon monoxide, as well as organic materials, some 20 times denser than expected” in geysers erupting from the moon. The icy particles hit the detector target at speeds between 15,000 and 39,000 MPH (23,000 and 63,000 KPH), vaporizing instantly. Electrical fields inside the cosmic dust analyzer separated the various constituents of the impact cloud.

“Enceladus has got warmth, water and organic chemicals, some of the essential building blocks needed for life,” said Dennis Matson in 2008, Cassini project scientist at NASA’s Jet Propulsion Laboratory in Pasadena, California.

“This finding is a crucial new piece of evidence showing that environmental conditions favorable to the emergence of life can be sustained on icy bodies orbiting gas giant planets,” said Nicolas Altobelli, the European Space Agency’s project scientist for Cassini.

“If there is water in such an unexpected place, it leaves possibility for the rest of the universe,” said Postberg.

Friday, December 16, 2005

Talks between the MTA and Transit Workers Union Local 100 (TWU) ended this morning at 06:00 EST (11:00 UTC) with no resolution or job action. The latest offer in the now bitter negotiation was from MTA: 3% pay increases per year in a three-year contract with changes in the health benefits and pension plan for new employees.

In a 12:30 EST (17:30 UTC) press conference, MTA President Peter Kalikow told the press that this would be the final offer the MTA would make because “there is no more.” Kalikow continued that the MTA would be in dire straits in 2008 if they were to accept the TWU’s demands, which included a 24% pay increase over three years and a reduced co-pay towards employees’ health care premiums. He continued, “if they [the TWU] don’t accept it, we will go to binding arbitration. This is our last offer.”

Although most New Yorkers were geared up for a strike when the contract expired at 00:01 EST (05:01 UTC), the subways and busses continued to run their routes. An AP report, later confirmed by the TWU, calls for a limited strike with two deadlines: One at 00:01 EST Monday for the Jamaica and Triboro bus lines, and one at 00:01 EST Tuesday for MTA subways and busses.

Because they are run by private companies, a strike by the Jamaica and Triboro bus employees would not be subject to New York’s Taylor Law, which prohibits public employees from striking and fines strikers two times their salary for each day the strike lasts.

Mayor Michael Bloomberg commented that had the union begun its strike this morning, it would not have been as “damaging” as a Tuesday-morning strike. He also added “I thought that the MTA offer was more generous than what the municipal emplyees get offered.” Governor George Pataki reminded the union that the Taylor Law would be applied: “As I said yesterday, I have three words for the TWU: ‘Don’t do it.’ If you strike, there will be very real consequences.”

No talks were held today. Bargaining sessions are scheduled to resume tomorrow morning at the Grand Hyatt Hotel, Manhattan.