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, May 19, 2006File:148888main sts121atpad lg.jpg

On Friday in Cape Canaveral, Florida, Space Shuttle Discovery began its 4.2 mile, 7 hour long journey to the launch pad, completing successfully. Discovery weighs approximately 4.5 million pounds.

The launch was supposed to occur in May, but NASA pushed back the date because of a faulty fuel sensor.

This will be Discovery’s second mission since the space shuttle Columbia broke apart during re-entry in 2003. Engineers believed that foam falling from the shuttle and smashing into the wing caused the disaster. After the accident, NASA grounded the shuttle fleet to determine the cause.

In 2005 cameras had shown during launch that a piece of foam being shed from the external tank, as well as smaller tile and foam dings. NASA and the crew decided that mission specialist Stephen Robinson should attempt to pull out the protruding gap fillers. Cameras also detected a small piece of thermal blanket near the cockpit that fell off, but later tests in wind tunnels had shown the piece to be of little concern and Discover landed safely.

NASA is scheduling the launch for Discovery to be between July 1 and July 19, 2006 and Steve Lindsey will Commander of the mission, flying with pilot Mark Kelly, two spacewalkers, Mike Fossum and Piers Sellers and mission specialists Stephanie Wilson and Lisa Nowak. European Space Agency (ESA) astronaut Thomas Reiter is also part of the crew but he will remain on the International Space Station (ISS) for several months.

Wednesday, March 21, 2018

Yesterday, Kenya’s Ol Pejeta Conservancy announced they had euthanised the last male northern white rhino, Sudan, on Monday, after consulting with wildlife officials. Sudan was 45-years-old, and now only two northern white rhinos, both female and descendants of Sudan, remain.

“Sudan was being treated for age-related complications that led to degenerative changes in muscles and bones combined with extensive skin wounds”, the conservancy said. “His condition worsened significantly in the last 24 hours; he was unable to stand up and was suffering a great deal”, they added.

Sudan, who was born in the early 1970s, suffered a wound in his right hind leg in late February. He was born in South Sudan, and at that time around 700 northern white rhinos were alive.

Sudan was in captivity for the last 38 years. Earlier, he was kept at the Dv?r Králové Zoo in Czech Republic before he was moved to Kenya. He stayed in a 90 thousand acre (about 140 square mile, 364 square kilometre) reserve with the only two remaining female northern white rhinos, 27-year-old Najin and seventeen-year-old Fatu. Najin and Fatu are Sudan’s daughter and granddaughter, respectively.

Ol Pejeta said they collected Sudan’s genetic material on Monday. The conservancy said, “The only hope for the preservation of the subspecies now lies in developing in-vitro fertilisation techniques using eggs from the two remaining females, stored northern white rhino semen from males and surrogate southern white rhino females.”

Last year, an account was opened on dating platform Tinder on Sudan’s behalf, to raise money for a fertility treatment after attempts at natural mating proved futile. Suni, second to last male of the subspecies, died four years ago, in October 2014 in San Diego Zoo, US. He was 42.

Ol Pejeta’s CEO, Richard Vigne, said Sudan “was a great ambassador for his species and will be remembered for the work he did to raise awareness globally on the plight facing not only rhinos, but also the many thousands of other species facing extinction as a result of unstable human activity”.

In 2008, the World Wildlife Foundation declared northern white rhinos extinct in the wild.

Wednesday, December 7, 2016

Chemotherapy is usually associated with a collection of side effects ranging from digestive problems to hair loss, but a study published this week in Human Reproduction demonstrated that female cancer patients may find they have something in common with much younger women in one specific area — their ovaries.

Scientists from the University of Edinburgh examined donated ovarian tissue from fourteen female cancer patients, most of whom had Hodgkin lymphoma, and compared it to tissue from healthy women. They found the samples from women who had been treated with a specific chemotherapeutic regimen known as ABVD not only contained greater numbers of dormant ova — egg cells — than those from women treated with harsher regimens but also more than samples from healthy women. ABVD is named for combining several drugs known as adriamycin, bleomycin, vinblastine, and dacarbazine.

These reproductive cells were not merely more plentiful in ABVD patients. They also appeared immature, “new” in the words of lead researcher Evelyn Telfer. This challenges the conventional belief that girls are born with all the ova they will ever have and the numbers can only go down as the cells are either used up by the reproductive cycle or succumb to damage or natural aging. However, further research is needed to confirm this. The study covered relatively few patients by scientific standards, and David Albertini of the Center for Human Reproduction in New York has suggested the cells may not actually be freshly grown. Instead, they may have always been there and were merely rendered more detectable by ABVD treatment.

The ability to grow new egg cells may have significant implications for women in Western societies, many of whom postpone childbearing to establish careers, sometimes into their late thirties or forties. However, Telfer warns against making use of these findings too soon: “There’s so much we don’t know about the ovary. We have to be very cautious about jumping to clinical applications.”

The experiments had been discussed earlier this year at the annual conference of the European Society of Human Reproduction and Embryology.

Wednesday, August 5, 2015

U.S. Republican Party presidential candidate Mark Everson, former commissioner of the Internal Revenue Service (IRS), filed a complaint on Monday with the Federal Election Commission (FEC) to challenge his exclusion from Thursday’s first Fox News Republican Party presidential debate. Everson argues his exclusion violates Title 11 of the U.S. Code of Federal Regulations in that debate hosts must not “structure the debates to promote or advance one candidate over another”, and must “use pre-established objective criteria to determine which candidates may participate in a debate.”

Everson served as Commissioner of the IRS from 2003 to 2007, during the George W. Bush administration. After his departure, he briefly served as CEO of the American Red Cross, worked in the cabinet of Indiana governor Mitch Daniels, and worked for the tax consulting firm alliantgroup. He announced his candidacy this past March with a sixteen-page open letter in which he outlined the six pillars of his campaign: amnesty for illegal immigrants, reinstatement of the military draft, a promise to serve only a single presidential term, and calls for tax reform, deficit reduction, and corporate responsibility.

Fox News claims Everson fails to meet the criteria it established for Thursday’s two debates. Only seventeen candidates meet the criteria, which require a candidate “consistently” be included in “recognized” opinion polls. The prime-time event features the top ten candidates by average polling percentage. The other seven participate in a separate debate just before the prime time event.

In his complaint, Everson urges the FEC to compel Fox News to include him in the second tier debate as the eighth participant.

Everson argues Fox News, in violation of Title 11, “structure[d] the debates to promote or advance one candidate over another” through a July 27 change to its criteria that replaced a pre-existing one percent polling threshold with a threshold admitting those “consistently” included in “recognized” polls. He alleges this was done to ensure the inclusion of the low-polling candidates former Hewlett-Packard CEO Carly Fiorina, former New York governor George Pataki, Senator Lindsey Graham, and former Virginia governor Jim Gilmore, because Fox News recognizes these candidates as “major players.”

Furthermore, Everson argues the Fox News criteria are not “objective,” as Title 11 requires, because they fail to define the terms “consistently” and “recognized” when referring to polls. He asserts he was included in the Republican Party’s online straw poll in May and is the only candidate still listed on that poll who has been excluded from Thursday’s debate.

Election law expert Richard Winger, publisher of Ballot Access News, says Everson is “completely correct” in his challenge. However, he believes Everson only has a chance of success if he actually files a lawsuit rather than simply complaining to the FEC.

Saturday, January 28, 2006

After seven weeks in the Southern Ocean disrupting the Japanese whaling fleet, a Canadian registered anti-whaling ship, the Farley Mowat, has been detained by South African authorities.

The Sea Shepherd Conservation Society vessel, its captain Paul Watson, and his crew, have been detained indefinitely. The South African Maritime Safety Authority (SAMSA) have placed a guard on the gangplank and are patrolling the ship.

The Farley Mowat, which sailed from Melbourne, Australia on December 6, was detained in Cape Town harbour, following a request from the Canadian government. A SAMSA official said the ship did not have the required certification.

“They don’t have the right certificates for the skipper, the first-mate or the chief engineer,” an official said. According to SAMSA, the detention adheres to Canadian maritime laws and followed correspondence from Canada, who requested that the authorities check the ship.

According to Scoop Independent, the ship and crew have been detained due to the International Maritime Organization’s ISPS Code. Under Canadian maritime law, both the captain and first officer should be Canadian nationals. Captain Paul Watson is Canadian, First Officer Alex Cornelissen is Dutch.

SAMSA claims that the Farley Mowat was not in possession of an international ship security certificate or a ship security plan.

This means the ship allegedly does not comply with the International Ship and Port Facility Security Code (ISPS Code) — a comprehensive set of measures to enhance the security of ships and port facilities. The code was developed in response to the perceived maritime threats to ships and port facilities in the wake of the 9/11 attacks in the United States.

The official said the detention was in line with Canadian maritime laws and followed correspondence from Canada requesting the authorities check the ship.

However, Captain Paul Watson says political pressure from Japan is behind the detention of the boat. He says he does not have the necessary documentation required by officials as the boat is registered as a yacht and not a commercial vessel.