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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.

Sunday, May 31, 2020

SpaceX successfully launched its first crewed mission at 1922 UTC yesterday from Kennedy Space Center in Florida, US with NASA astronauts Bob Behnken and Doug Hurley in a Crew Dragon capsule atop a Falcon 9 rocket. This was the first launch of a crewed spacecraft from the United States since NASA’s final Space Shuttle mission in July 2011 — a mission Hurley piloted.

SpaceX, backed by entrepreneur Elon Musk, is the first private company to send astronauts into space. The company has engineered and operated reusable rockets, potentially reducing the overall cost of future space missions. Shortly after the launch, the Falcon 9 rocket’s first stage disengaged and returned to an autonomous spaceport drone ship off the coast, to be refurbished and reused on a future mission. Behnken and Hurley are slated to catch up to the International Space Station (ISS) for a stay of one to four months, docking today at 1429 UTC.

The originally planned launch on Wednesday afternoon, local time, was scrubbed due to inclement weather conditions less than 20 minutes before scheduled launch time, with the schedule pushed back to yesterday. Unlike Wednesday’s scrub, however, yesterday’s launch proceeded without issue. Hurley, on radio following the minutes-long ride to low Earth orbit, said, “It was incredible”.

SpaceX’s launch is the latest development in a program initiated in earnest by NASA’s 2014 selection of SpaceX, along with Boeing, to be an initial commercial contractor providing transportation for NASA astronauts to the ISS. Boeing’s first crewed mission is reportedly expected to launch next year. Since the retirement of the Space Shuttles in 2011, NASA has relied on Russian Soyuz spacecraft to transport its astronauts to the orbiting space station.

Hurley, along with his fellow crew members aboard the final Shuttle mission, had left a small U.S. flag aboard the ISS, to be retrieved when the U.S. space program was once again able to launch astronauts to the outpost. Hurley and Behnken, when they depart, plan to return this flag to Earth after a nearly nine-year hiatus to commemorate the milestone. The exact timing of their return is not set, however, as it depends on the continued performance of the Crew Dragon spacecraft, and on when the next Crew Dragon mission occurs, which NASA Administrator Jim Bridenstine has said may be ready to launch by late August.

Bridenstine remarked of the remainder of the test flight, “I’m breathing a sigh of relief, but I will also tell you I’m not gonna celebrate until Bob and Doug are home safely.” Hurley, for his part, paraphrased the first U.S. citizen in space, Alan Shepard, commenting before launch on the occasion of the United States’ return to human spaceflight capability: “SpaceX we’re go for launch. Let’s light this candle.”

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Friday, January 14, 2011

Over the course of the last week, fifteen people who have suffered from influenza have died in Wales, as reported to the Welsh Assembly Government. The total amount of flu-related deaths in Wales since October 2010 has now increased to 27.

On Tuesday, 49 people were being treated in critical care beds in hospitals around Wales, according to health officials. With twelve reported admissions, Aneurin Bevan Local Health Board had the highest amount of critical care patients in Wales. Betsi Cadwaladr University Local Health Board has the second highest total number of patients experiencing this critical care in the country, with eleven being cared for. Cardiff and Vale University Health Board and Abertawe Bro Morgannwg University Health Board have nine important care admissions each. Cwm Taf NHS Trust contains five of such patients, while Hywel Dda NHS Trust has three.

The age group of 25–34 years old had the largest amount of meetings with general practitioners; the rate of consultation was 147 people for every 100,000. For all age groups, 93 people out of every one hundred thousand have been consulting with a GP; on January 5, the total figure stood at 85 meetings per 100,000.

“Despite the slight increase in the clinical consultation rate for influenza this week compared to the previous week, the rate of consultations for flu-like illness in Wales still remains within the levels of normal seasonal flu activity,” said Dr. Tony Jowell, the Chief Medical Officer of Wales. “Most healthy people will recover from flu-like illnesses within five to seven days with plenty of rest and drinking non-alcoholic fluids. On the issue of vaccination against seasonal flu, whilst we have been working to make stocks of the vaccine that was developed against swine flu available to be used where supplies of seasonal flu vaccine have run low, we are now well into the flu season.”

According to Media Wales, 13 patients experiencing flu-related symptoms were getting treatment at Withybush General Hospital in Haverfordwest on Tuesday. Meanwhile, five were receiving hospital treatment at Bronglais General Hospital in Aberystwyth. Also, Carmarthenshire NHS Trust in Llanelli and West Wales General Hospital in Carmarthen both had a solitary patient.

Jowell also commented: “People in at-risk groups are at a higher risk of complications from seasonal flu, and the best protection is early vaccination. A press and publicity campaign has been running since October and has included television, radio and bus adverts to let people know if they are in an at-risk group, and that the vaccine is available free of charge to those groups from GPs. We have also encouraged health boards and GPs to ensure that their patients and front line NHS staff are vaccinated against seasonal flu.”

Throughout the United Kingdom, 62 individuals reportedly died in the last week, as the result of suffering from influenza. The majority of these victims were suffering from swine flu. In most of these cases, the sufferers were aged between 15 and 64. However, nine of the fatalities were of children aged below fourteen.

Wednesday, April 1, 2009

General Motors Corporation (GM) announced on Wednesday that it saw a 45% drop in United States vehicle sales for its cars in March.

Executives from several auto firms, however, said that there was some hope for the auto industry to stabilise, as car sales rebounded in the last week of March.

“The market is starting to show small signs of life which need to be nourished like seedlings,” said the vice president and chairman of Chrysler LLC Jim Press. “It’s too early to see a trend, but spring shows signs of hope.”

Other automobile manufacturers also saw their car sales slip: Chrysler and the Japanese Toyota both reported a 39% loss, whilst Ford Motor Company sales fell 41%.

Annualised sales of vehicles in the car industry in the US are predicted to have dipped below nine million in March, compared to February’s 9.12 million, which was the lowest number since 1981.

“Auto makers are pulling every lever in their effort to attract buyers, as evidenced by the new programs from Ford and GM. The typical incentive programs simply do not resonate in today’s economy,” Jesse Toprak, an analyst for Edmunds.

Ford shares gained 2.3% to a level of US$2.69 in early trading at US stock markets on Wednesday, while stocks for Toyota’s US depository increased 5.9% to $67. GM shares slipped 1.6% down to $1.92.