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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.

Friday, July 10, 2009

The Saskatchewan provincial government alongside the University of Saskatchewan (U of S) have come together to establish a CA$500 million, 10 megawatts research nuclear reactor to produce medical isotopes.

“In 1949 … cobalt-60 treatment was tried for the first time here in Saskatchewan, where it saved a woman battling cervical cancer. Maybe we can lead again in terms of nuclear medicine,” said Brad Wall, the Premier of Saskatchewan, “Governments should be involved in pure research. We’re dealing with some circumstances as they present themselves”

“We’ve had faculty that are interested in this. We have an issue of national importance, We see a reason why the U of S and the province could assist in this national issue. We see how it could help the country. We see how it could build on the university’s research strength,” said Richard Florizone, U of S vice-president of finance and resources.

The research conducted at the Canadian Light Source Synchrotron on campus would be enhanced by a research reactor.

“In the case of a power reactor, in Saskatchewan we have much better alternatives. In the case of a medical isotopes research reactor, this may be a circumstance where the benefits outweigh the risks,” said Peter Prebble, director of energy and water policy for the Saskatchewan Environmental Society.

The nuclear reactor at Chalk River, Ontario in Canada was shut down on Thursday, May 14 by the Atomic Energy of Canada Limited (AECL) due to a leak of heavy water and will not re-open until late 2009 or spring of 2010.

The repairs of the NRU are complex and challenging. “I’ve heard it described as . . . trying to change the oil in your car from your living room. We’re faced with conducting remote investigations in a radioactive environment with high radiation fields, conducting the examinations and inspections through small openings in the top of the reactor and accessing over great distances,” said David Cox, director of the NRU engineering task force.

“The unplanned shutdown of the NRU will result in a significant shortage of medical isotopes in Canada, and in the world, this summer,” said Leona Aglukkaq, Minister of Health and Lisa Raitt, Minister of Natural Resources.

The Petten reactor in the Netherlands is another of the six extant nuclear reactors globally. It must also be shut down between mid July and mid August.

Medical isotopes are used in diagnostic procedures for cancer, heart disease and other medical conditions. When radioactive isotopes are injected into the body, radiologists can view higher radiation via medical imaging, enabling them to make a more accurate diagnosis.

Saturday, January 24, 2009

Prosecutor Christian Du Four has released more details on the fatal stabbing in a day care center in East Flanders, Belgium, yesterday, in which two children (six and nine months old) and one employee were killed. Ten children and two adults were injured.

The alleged perpetrator, a 20-year-old man from nearby Sint-Niklaas, was arrested in the neighbouring municipality of Lebbeke shortly after the crime. Belgian news website nieuwsblad.be have named the arrested man as Kim De Gelder.

The attacker wore a bullet-proof vest under his clothes and a backpack containing a knife, an axe and a fake pistol. Two other knives were found near the crime scene.

The prosecutor confirmed that the man’s face was painted white with blackened eyes as he committed the crime, which led international media to make comparisons to the Joker, the villain from the Batman series.

“I have a question,” the killer told the first employee he encountered, after which he immediately stabbed her, and started his rampage. One female day care worker attempted to disarm the killer while others locked the doors. The killer stabbed employees trying to carry children to safety.

The arrested man is not cooperating with the investigation and has not confessed. The prosecutor described his attitude as “passive”. “He says nothing to his questioners. He is absolutely uncooperative,” the prosecutor explained. Yesterday, media reported that the killer was laughing at the officers who were questioning him, but the prosecutor today denied these speculations.

According to the crime scene investigation, the man entered the building through an unlocked side-entrance which gave immediate access to the room with the babies. He stabbed several of them, then went to another room where he stabbed other children. He then fled on the bicycle on which he had arrived.

Panic struck in Dendermonde amidst fears that the man would attack more crèches or schools. There were reports that the killer carried a note with names and addresses of other day care centres or schools nearby, something which the prosecutor could not comment on. The Associated Press says three judicial officials anonymously confirmed that the attacker carried addresses of three other nurseries. Following news of the stabbings, all schools in Dendermonde were ordered to keep all gates shut.

Eyewitness Hans Staelens told reporters that he had noticed a suspicious character in the street where the day care centre ‘Fable Land’ was located. He described him as “not too tall, thin, red hair, dark eyes, like make-up”.

The alleged killer lived alone and was unemployed, but does not have a criminal record. “There is no element whatsoever that makes us believe he has a psychiatric history,” the prosecutor told the press at a conference today. He has commissioned three psychiatrists to examine the man. Kim D. was not under the influence of drugs or alcohol.

One child and one woman died in the day care centre itself, with another child dying in hospital. All injured are reported to be in stable condition. Three children and one adult remain in intensive care. Five others also remain hospitalised, although several are expected to be discharged at some point during the weekend.

54-year-old Marita Blindeman, who was killed in the attack, worked in the day care centre, which was sponsored by social services, since she was 18. Since the death of her father, she lived with, and took care of, both her mother and her sister, who has a learning disability. Just two years ago, she started having a relationship with a man, according to her son in a letter to newspapers.

Only six of the 18 children in the crèche, all under the age of three, were uninjured. Meanwhile, the decision has been taken not to reopen the day care centre, but to provide day care in other facilities. Six employees were present during the attack.

Friday evening, the Belgian crown prince and his wife visited the crime scene. The couple, who have four children, were moved deeply by the killings.

Some hundred people have signed a mourning registry in Dendermonde’s city hall, and flowers and teddy bears were left at the day care centre. A silent demonstration is scheduled for tomorrow afternoon and a mourning ceremony will be held on Monday evening.

Several media outlets have discussed the safety of day care centres. Minister Veerle Heeren said she would consider additional safety measures if the investigation suggests it, but also added that, “a day care centre should be a haven, not a prison.”

Tuesday, January 16, 2018

A car accident involving the car occupants and a dentist’s office happened on Sunday night in Santa Ana, California. A white Nissan sedan which was apparently driving too fast hit the raised concrete median on the road, after which it was launched into the air, slamming straight into the wall of the second floor of a two-story dental practice building, where the car got wedged.

According to the police, the car approached from a side street. The room of the dental office penetrated by the sedan was used as a storage space. A fire department crane was used to extract the vehicle from the building, which took several hours.

There were two people in the sedan. One of them managed to escape from the hanging vehicle on his own, while the other one remained trapped inside it for over an hour. They were both hospitalized with minor injuries, according to the Orange County Fire Authority (OCFA). According to the police, the driver of the car admitted narcotics use, and after toxicology tests the case is to be submitted to the Orange County District Attorney’s Office.

The moment of the accident was captured by surveillance video from a bus which the car narrowly missed when becoming airborne.

According to OCFA spokesperson Captain Stephen Horner, there was a small fire after the crash, which was extinguished quickly.

Friday, September 9, 2011

Parts of Texas have been scorched by sweeping wildfires this week. Officials state that a wildfire which swept much of central Texas this week destroyed at least 1,400 homes and forced about 5,000 people to evacuate to safety. An official with the Texas Forestry Services told news sources on Thursday that much of that fire has been contained.

Officials have speculated that this fire alone has destroyed more homes than any other wildfire on record in the state. Officials are welcoming dropping temperatures, stating this will increase their ability to fight the fires effectively. A converted DC-10 aircraft was recently made available to fire authorities, but cannot be used until Friday as workers still need to time to prepare on-board equipment.

One of the two fatalities in the central part of the state has been identified as Michael Troy Farr, 49, who died at his home. Earlier in the week, a woman and her infant died in a related blaze that quickly engulfed their home located near the city of Gladewater, located in the eastern part of the state. On Thursday, officials warned that East Texas has become the center of wildfire activity in the state.

At least 170 wildfires have ravaged much of the state over the past week. On Tuesday, a thick haze of smoke enveloped the city of Tyler for several hours, forcing school officials to cancel all outdoor sports activities. Since late 2010 the overall devastation of wildfires in the state is estimated to cost at least US$216 million (£136 million,€157.5 million) in firefighting expenses. The state’s Lieutenant Governor, David Dewhurst, who is the acting governor in Governor Perry’s absence, indicated he will ask the federal government to declare Texas a major disaster area. President Obama has also promised to provide needed assistance to local officials.

Tuesday, January 23, 2007

New Zealand policeman, Sergeant Gregory Arthur Smith has been caught by a speed camera going 115 kilometres per hour (km/h) in a 50km/h zone. Sergeant Smith has been charged with driving at a dangerous speed, despite having been responding to an emergency, and with his lights flashing.

42-year-old Sergeant Smith was responding to a priority one emergency involving ten school children on a crashed school bus, from Isla Bank School in Winton, Invercargill, New Zealand, and a car. The crash occurred on February 9, 2006.

A priority one emergency means that it requires immediate police attention.

The speed camera he was caught speeding on was hidden in a parked van trying to catch people speeding in school areas. The campaign is titled Speed Kills Kids.

In Invercargill’s district court, the hidden speed camera operator, Paul Mussen, said that he saw the police car 270 metres away with its lights flashing, it is unknown if his siren was on, slow down for a pedestrian crossing to allow pupils of James Hargest Junior College to cross the road. He then accelerated “hard” towards him.

Mr Mussen has said that when he first saw the police car turning onto Queens Drive at the Layard Street and Queens Drive intersection he thought, because of the flashing lights, that he was part of the same campaign. When questioned by Bill Dawkins, Sergeant Smith’s lawyer, Mr Mussen said that “it was too late to activate the stand-by button which we’re not allowed to do anyway,” which he confirmed that he told police. Mr Mussen described the stand-by button as a way to let emergency services off having to do “extra paperwork.”

Craig Power, prosecutor, has claimed that the speed Sergeant Smith was driving at was dangerous because he was driving in a residential zone, school zone, 50km/h speed limit and the school buses and the sidewalks are busy at 8:43 a.m. (NZDT), the time the speed camera caught him.

Later the same day, Sergeant Smith faxed a report to the Invercargill police stating that he had been caught over the speed limit, what speed he was travelling at, and that he was heading for a serious accident.

A witness for the police, former sub area police supervisor for the rural region of Southland, Senior Sergeant Olaf Jensen said that he was the one who called Sergeant Smith to attend to the emergency, giving him brief details about the crash and telling him that it requires immediate attention.

The case has not yet been resolved.

Tuesday, March 31, 2009

Local municipal and provincial volunteers in Manitoba, Canada are exhausted in their efforts to divert the rising waters of the Red River of the North.

It has been hard work with little sleep for the residents who live on the shores of the Red River to shore up their defences with sandbags, build dikes, clear frozen culverts and break ice jams

Volunteers to spell relief for local volunteers and food are desperately needed.

“It’s a week now we’ve been doing this … you’re talking four, five, six public works guys. In my one community we’ve got 25 volunteer firefighters and those guys have been going 24/7, so of course it’s wearing them down.” said Paul Guyader, Manitoba’s emergency measures coordinator.

“We’re dealing with one of the biggest floods the province has ever seen,” said Steve Strang, mayor of St. Clements, Manitoba “We’ve put out hundreds of thousands of bags already. The municipalities are working very well, we’re working with the provincial government, we’ve brought in every possible resource we could to address this issue. The volunteerism within the community has been phenomenal.”

The Portage Diversion has taken some spring waters from the Assiniboine River and diverted the flow to Lake Manitoba.

Roseau River Anishinabe First Nation has been totally evacuated, as well as many homes near the Canada – United States border.

The cold weather is freezing the ice jams into place. Guyader has had 2 Amphibex Excavators operating on the river breaking up ice.

The Red River is right now 16.7 feet (5 metres) above spring ice conditions. The Red River Floodway gates cannot be opened with the current ice jams.

“If we operate now, we can get ice jamming going into the floodway, jamming up against the St. Mary’s bridge, as such, the floodway capacity would be reduced and would cause higher water levels in the city of Winnipeg.” said Steve Topping, Manitoba Water Stewardship spokesman

The floodway was constructed in 1968 following the 1950 flood to divert the overflow spring flooding waters of the Red River. The floodway has been widened the since the 1997 “flood of the century” and the expansion is expected to be completed this spring. As well Manitoba built permanent dikes around communities within the flood plain since the last two major floods..

The Red River waters will crest between the beginning of April to mid April, at which time also the weather should be warming up. Communities are bracing for higher water levels, more ice jams as well as melting snow in the warmer spring temperatures.