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.

Thursday, September 13, 2007

A resident of Bruce-Grey-Owen Sound his whole life, Correctional Services officer Paul Johnstone is running for the Ontario New Democratic Party in the Ontario provincial election. Wikinews’ Nick Moreau interviewed him regarding his values, his experience, and his campaign.

Stay tuned for further interviews; every candidate from every party is eligible, and will be contacted. Expect interviews from Liberals, Progressive Conservatives, New Democratic Party members, Ontario Greens, as well as members from the Family Coalition, Freedom, Communist, Libertarian, and Confederation of Regions parties, as well as independents.

Saturday, January 1, 2005

The National Archives of Australia have, as part of their standarddocument release cycle, released thirty year old documents from theWhitlam government.

The centre piece of the 1974 archives are a series of documents fromthe Australian Cabinet and the Treasury pertaining to the attempt toobtain a $US4 billion loan by the Whitlam government from the MiddleEast. The obtaining of these loans and the scandal generated becamecollectively known as the “Loans Affair,” and contributedsignificantly towards the dismissal of the Whitlam government by SirJohn Kerr the following year.

The documents from Treasury, which include descriptions of both theloan itself and the people involved in arranging them, are scathing.The “Points that might be made” document of December 13, 1974 clearlystates that Treasury believed the distinct possibility that the loansmight be part of “a confidence trick of major proportions”. Minutesfrom another meeting five days later state the “incredulity” on thepart of the Bank of England and the Federal Reserve Bank of New Yorkregarding the viability of the loan.

Those documents now available comprise the beginning of the LoansAffair, from the initial offers to the end of 1974. The remainder ofthe Loans Affair documents, as well as everything else from 1975 willbe released on January 1, 2006.

Wednesday, December 21, 2011

Yesterday, the United States House of Representatives voted to effectively reject the Senate version of a bill, passed with bipartisan support, to extend a payroll tax cut two months past its year-end expiration date. The House voted instead to create a conference committee to settle differences between members of both bodies.

Although the tax cut extension itself has support among Republicans and Democrats, lawmakers disagree on how Congress should go about compensating for the cost of extending the cut and the policy changes it would entail.

During an appearance yesterday, President Obama condemned opposition to the Senate-passed version of the bill, accusing Republicans in the House of trying to negotiate on matters unrelated to the bill. Republicans, in response, say there is still time to negotiate the bill, insisting that lawmakers ought to concentrate on a year-long plan rather than a two-month extension. Senate Democratic leader Harry Reid, however, says he will not agree to negotiate the tax cut extension until the Senate-approved bill is passed by the House.

If the tax cut is not extended and instead expires on December 31, approximately 160 million Americans will be affected by the tax increase; President Obama insists the only way to prevent the tax hike beginning January 1 is for the House to pass the Senate bill. In response, House Speaker and Republican John Boehner wants Obama to “call on the Senate to return” to negotiate. The Senate, shortly after passing the bill, adjourned for the Holiday break.

Also included in the bill is a provision that would require President Obama to make a decision regarding the construction of the Keystone XL pipeline, a pipeline that would transport oil from Canada to Texas.

House Democratic leader Nancy Pelosi blamed the congressional year-end impasse on “Tea Party Republicans.” In a letter to President Obama, Speaker Boehner requested he galvanize the Senate to negotiate on the bill’s provisions, writing “The differences between the two different bills can be quickly reconciled to provide the American people the certainty of a full-year bill. There are still 11 days before the end of the year, and with so many Americans struggling, there is no reason they should be wasted. You have said many times that Congress must do its work before taking vacation”.

Saturday, August 2, 2008

A 54-year-old German farmer who lost both arms in a farming accident six years ago has become the first patient to receive a complete double arm transplant. The patient, whose name has not been released, underwent the operation at the Klinikum rechts der Isar, part of the Technical University of Munich (Technische Universität München), last week; he is said to be recovering well.

The operation lasted 15 hours and was performed by a team of 40 specialists in Plastic Surgery, Hand Surgery, Orthopedics and Anesthesiology, under the direction of the head of the Plastics and Hand Surgery department, Prof. Hans-Günther Machens, Dr. Christoph Höhnke (Head of Transplants, Senior Physician; Plastics and Hand Surgery) and Prof. Edgar Biemer, the former Chief of Plastic Surgery at the Clinic.

In a press statement released by the clinic, it was revealed that the patient had been thoroughly physically checked and had psychological counselling prior to the surgery to ensure he was mentally stable enough to cope with the procedure. Since completion of the surgery, the patient has been on immuno-suppressant drugs to prevent rejection of the new limbs.

Following the surgery, the press release from the clinic’s press manager, Dr. Tanja Schmidhofer, included the following statement:

Without the immuno-suppressant drugs given to the patient, the risk of there being a Graft-versus-Host Reaction or GvHR, would have been significant due to the upper arm containing a large amount of bone marrow, consisting of ICC’s or Immuno-Competent Cells, which would have triggered a near total rejection of the new limbs. A GvHR is a condition which results in the cells from the transplant attacking the immune system of the body.

Indications from the clinic suggest that the double attachment went well, although it could be up to 2 full years before the patient is able to move the arms.

The donor arms came from an unnamed teenager, who is believed to have died in a car accident.

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

Tuesday, March 29, 2005A team of Australian surgeons yesterday reattached both hands and one foot to 10-year-old Perth boy, Terry Vo, after a brick wall which collapsed during a game of basketball fell on him, severing the limbs. The wall gave way while Terry performed a slam-dunk, during a game at a friend’s birthday party.

The boy was today awake and smiling, still in some pain but in good spirits and expected to make a full recovery, according to plastic surgeon, Mr Robert Love.

“What we have is parts that are very much alive so the reattached limbs are certainly pink, well perfused and are indeed moving,” Mr Love told reporters today.

“The fact that he is moving his fingers, and of course when he wakes up he will move both fingers and toes, is not a surprise,” Mr Love had said yesterday.

“The question is more the sensory return that he will get in the hand itself and the fine movements he will have in the fingers and the toes, and that will come with time, hopefully. We will assess that over the next 18 months to two years.

“I’m sure that he’ll enjoy a game of basketball in the future.”

The weight and force of the collapse, and the sharp brick edges, resulted in the three limbs being cut through about 7cm above the wrists and ankle.

Terry’s father Tan said of his only child, the injuries were terrible, “I was scared to look at him, a horrible thing.”

The hands and foot were placed in an ice-filled Esky and rushed to hospital with the boy, where three teams of medical experts were assembled, and he was given a blood transfusion after experiencing massive blood loss. Eight hours of complex micro-surgery on Saturday night were followed by a further two hours of skin grafts yesterday.

“What he will lose because it was such a large zone of traumatised skin and muscle and so on, he will lose some of the skin so he’ll certainly require lots of further surgery regardless of whether the skin survives,” said Mr Love said today.

The boy was kept unconscious under anaesthetic between the two procedures. In an interview yesterday, Mr Love explained why:

“He could have actually been woken up the next day. Because we were intending to take him back to theatre for a second look, to look at the traumatised skin flaps, to close more of his wounds and to do split skin grafting, it was felt the best thing to do would be to keep him stable and to keep him anaesthetised.”

Professor Wayne Morrison, director of the respected Bernard O’Brien Institute of Microsurgery and head of plastic and hand surgery at Melbourne’s St Vincent’s Hospital, said he believed the operation to be a world first.