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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.

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Sunday, March 22, 2009

After an early morning fire began, four out of the nine people living at the Riverview Individual Residential Alternative group home located in Wells, New York were killed by the blaze. The Sunmount Developmental Disabilities Services Office, which supervises the home, told the media that the fire started at approximately 5:30 AM Eastern Daylight Time. Two staff members were at the home at the time, who safely evacuated four of the five survivors.

The names of the residents killed in the fire were not able to be released due to New York’s Mental Hygiene Law, but are able to be identified as two adult men, aged 32 and 52, and two adult women, aged 43 and 60. A 71-year-old male was injured in the fire, and was taken to a hospital in Utica, a nearby city. The other four residents have been relocated to an unnamed group home. Both staff members are also being examined at the hospital.

“On behalf of all New Yorkers, I wish to extend my heartfelt condolences to the families, loved ones and friends of the four victims and to continue to pray for the full recovery of those five people and two staff members who survived this incident. I also want to express my thanks and appreciation for the first responders and volunteers who worked swiftly and diligently to respond to this tragedy,” David Patterson, the governor of New York, said to the media.

The exact cause of the fire has yet to be determined. However, the New York Civil Liberties Union stated that “the blaze appears to have been an electrical fire and the sprinkler system was knocked out immediately.” They also called for “an immediate investigation into the causes of and contributing factors of the fire.”

The New York State Department of State Office of Fire Prevention and Control is currently investigating the causes of the blaze, with help from New York State Police Bureau of Criminal Investigation and the New York State Commission on Quality of Care and Advocacy for Persons with Disabilities.

Tuesday, June 27, 2006

Ikeda Kanako, a 21-year-old senior student of the Meiji Gakuin University and the first daughter of celebrity surgeon Yuko Ikeda, was kidnapped at about 1225 (UTC+9), June 26, 2006, in Shibuya, Tokyo.

A bullet was fired and one officer slightly cut when police stormed a Kawasaki apartment to rescue the girl.

Kanako was dressed in a white light half-sleeved cardigan, blue jeans with a bistre belt made of leather, a spring green camisole and carried a bag of Vuitton when she was abducted at a bus stop.

She was found unharmed 13 hours later by Japanese police at a condominium located in Nakahara-ku, Kawasaki, Kanagawa. The young woman’s make-up was not disordered; Kanako’s long brown fringe was not disheveled at all and she was wearing what she had been when she was kidnapped.

The kidnapping of Kanako was a big story in Japanese media in June, 2006. The story appeared in many newspapers as the front-page news on June 27, 2006.

Kanako and her kidnappers had been in touch with her mother using Kanako’s mobile phone. The effort to free her was helped greatly by a woman who witnessed the moment Kanako was taken; she wrote down the license plate of the van and other details.

Police traced mobile phone calls and were able to locate the van in Kawasaki where they detained two of the kidnappers as they went shopping.

One conspirator Li Yong, 29, from China, led the policemen to the apartment and tricked Kaneo Ito, 49, from Japan, to open the door. Ito managed to discharge one bullet before being restrained by an assistant police inspector, the first man in the room.

The other man involved in the kidnap of Kanako was Choi Gi Ho, 54, from South Korea. Kanato was freed unharmed.

The Tokyo Metropolitan Police Department arrested three men on suspicion of conspiring to kidnap a woman and hold her to a reported 300 million yen ransom.

Wednesday, February 18, 2009

The United States auto manufacturer Chrysler, which has been badly affected by the ongoing recession, has asked the US government for an additional US$5 billion in aid on top of the four billion it has already received, saying that it plans to fire three thousand employees. At the end of last year, the auto maker had just over 54,000 employees, meaning that the layoffs will equal about six percent of its total workforce.

In addition, Chrysler will cut the Chrysler Aspen, PT Cruiser, and Durango from production.

Another automaker, General Motors (GM), announced that it seeks $16.6 billion in loans from the government, in addition to the $13.4 billion that it has already received. GM plans to lay off 47,000 employees and close five factories. GM says that it might need as much as $30 billion from the US Treasury Department, an increase over their previous estimate of $18 billion. The company has warned that it might run out of money by March if more aid was not given.

Rick Wagoner, GM’s chief executive, described the firm’s plan as “comprehensive, responsive, achievable, and flexible”. “We have a lot of work in front of us, but I am confident it will result in a profitable General Motors,” he said, adding that “today’s plan is significantly more aggressive because it has to be.” GM says that it could be profitable in two years’ time, and might be able to repay all its loans by 2017.

A third US car manufacturer, Ford Motor Company, has said that it can make it through this year without any government aid.

The US Treasury Department will review the car makers’ survival plans for several weeks before a decision is made on whether or not to extend the loans. That decision is due by the end of next month.

Sunday, April 24, 2011

The California Controller’s office reports that eleven state agencies have given US$13.3 million in pay and travel advances that have not been collected.

Governor Jerry Brown issued an executive order to recover uncollected loans by the agencies. A press release from the governor’s office states, “The Governor’s Executive Order seeks to recover taxpayer dollars by directing state agencies and departments to clear salary and travel advances within 30 days through an expense claim.” Any outstanding balance will be deducted from employees’ paychecks under the governor’s order after the 30 days.

Under California state law, state employees are permitted to receive advances for hardship, travel, and other circumstances. These advances cannot be collected by agencies after three years without the employee’s consent.

State Controller John Chiang said in a statement, “The state’s poor debt collection and accounting practices are fleecing public coffers at a time when vital public programs are being decimated by unprecedented budget cuts.” Chiang’s office expects there will be more money unaccounted for, including some from the California Highway Patrol (CHP). California state law mandates that anyone convicted of driving under the influence of alcohol is required to pay for the investigation. The CHP has not collected this money.

The California Department of Transportation, also called Caltrans, has the largest debt of the eleven agencies: $3.2 million. Cal Fire, or the California Department of Forestry and Fire Protection, “had an outstanding balance of $1.44 million as of June 30, 2008. An overwhelming portion of that balance was related to employee salary and travel advances,” according to a controller’s office audit.

Chiang’s office had informed former California governor Arnold Schwarzenegger there were outstanding debts, but Schwarzenegger’s administration did not take action.

All eleven agencies have agreed to hand over any delinquent accounts to the controller’s office, who will collect these debts.

Sunday, October 8, 2017

In a study scheduled for publication in the December 1 issue of Forest Ecology and Management, scientists from the University of California, Davis; USDA Forest Service Pacific Southwest Research Station; and University of Washington have found a way to resolve the conflict that has sprung up between protecting forests from increasingly frequent wildfires and droughts and preserving sufficient habitat for the endangered spotted owl, Strix occidentalis. The study was performed in two national parks in California, United States.

For the past twenty-five years, spotted owl habitat preservation has focused on keeping 70% or more of the total ground area covered by natural tree canopy, a tree density that leaves forests prone to wildfires and trees more likely to die during droughts. Both wildfires and droughts have become more frequent in the years since the program began.

However, the previous studies upon which the 70% figure was based only measured overall canopy coverage. In this work, researchers used aerial LiDAR (Light Detection And Ranging) imaging technology to scan areas within Kings Canyon National Park and Sequoia National Park in California. The regions were analyzed by distribution of foliage, tree height, and the sizes of the spaces between trees and stands. These data were then cross-referenced with decades of field studies showing the locations of hundreds of owl nests. They found that spotted owls clustered in areas with very tall trees and stands almost exclusively, over 150 feet (48 m), avoiding areas that only had moderate or low canopy, regardless of how dense or wide.

“This could fundamentally resolve the management problem because it would allow for reducing small tree density, through fire and thinning,” said lead author Malcolm North, of UC Davis and the USDA Pacific Southwest Research Station. “We’ve been losing the large trees, particularly in these extreme wildfire and high drought-mortality events. This is a way to protect more large tree habitat, which is what the owls want, in a way that makes the forest more resilient to these increasing stressors that are becoming more intense with climate change.”

The spotted owl gained national prominence in the United States during the 1990s, when environmentalists’ efforts to preserve its habitat resulted in federal measures forbidding logging on large swaths of land, as well as federal limits on the sales of harvested wood. There was a 1995 U.S. Supreme Court case which was preceded by lawsuits on the part of timber companies and by years of large protests by timber workers and their communities who feared job losses. For a time, it seemed that the spotted owl was also threatened by competition from the faster-breeding barred owl, which had moved west into its territory.

This is not the only major study of spotted owls to reach the public eye this week. On Thursday, the U.S. Fish and Wildlife Service released the California Spotted Owl Conservation Objectives Report, which analyzes the past several decades of research on the California spotted owl and provides recommendations for ecologically and economically viable conservation.

Tuesday, January 12, 2010

The United Nations High Commissioner for Refugees (UNHCR) has said that 200,000 people in Yemen have been displaced by ongoing violence, and that the growing number of refugees is straining the ability of aid agencies to shelter and care for those forced to flee their homes.

The refugee agency reports that thousands of civilians in north Yemen are fleeing to neighboring provinces in a desperate search for safety, shelter and assistance, as the current wave of fighting between the government and the al-Houthi rebel group is entering its sixth month. It added that it is fast running out of space and money to care for them.

“We now estimate that some 200,000 people have been displaced by the conflict in Yemen since 2004, including those displaced by the latest escalation which erupted in early August last year,” said UNHCR spokesman Andrej Mahecic.

“These newly displaced people bring stories of intense clashes in Razeh, Saqain and Sahar districts and report dozens of civilian casualties as a result of air strikes and heavy fighting,” Mahecic added, as quoted by Voice of America. “UNHCR is not present in the conflict area and has no independent confirmation of these reports.

“We now estimate that some 200,000 people have been affected by the conflict in Yemen since 2004, including those displaced by the latest escalation which erupted in early August last year,” he continued.

The spokesman noted that camps for the displaced are stretched to capacity, and aid resources are quickly becoming depleted. News24 reports that one camp at Al Mazrak in the Hajjah province is now home to 21,000 people, double its intended capacity, and others were also being populated quickly and in dire conditions.

“The shelter situation is equally dire in Amran province where most of the arriving IDPs are staying with host families or renting places. Over the New Year’s week alone, more than 5,000 IDPs arrived to Amran City,” Mahecic said. “The acute lack of shelter and accommodation is creating tensions between the displaced and the local population. In the absence of an immediate and feasible camp option, UNHCR is planning to set up a transit center in Amran as an interim and temporary solution,” he concluded.

The UN has issued a US$177-million appeal on behalf of all UN agencies working in Yemen; so far, less than one percent of that has been received.