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 26, 2006

In February of 2006, the Savarino Services Construction Corp. proposed the construction of a seven million dollar hotel on Elmwood and Forest Avenues in Buffalo, New York. In order for the hotel to be built, at least five properties containing businesses and residents would have to be destroyed. It was not certain whether the properties were owned by Savarino or by the landlord Hans Mobius. The hotel was designed by Karl Frizlen of the Frizlen Group, and is planned to be a franchise of the Wyndham Hotels group.

Elmwood Avenue is known by the community as a popular shopping center, and Nancy Pollina of Don Apparel (who is “utterly against” the construction) claims it’s the only reason why students from Buffalo State College leave campus. Additionally, Michael Faust of Mondo Video said he did not want to “get kicked out of here [his video store property].”

In 1995, a Walgreens was proposed to be built on the same land, but Walgreens later withdrew its request for a variance because of pressure from the community. More recently, Pano Georgiadis tried to get the rights to demolish the Atwater House next to his restaurant on Elmwood Avenue, but was denied a permit due to the property’s historical value. He has since been an opponent to the hotel construction.

In the process of debating the hotel, it was thought that a hotel had previously existed on the proposed site, however; research done at the Buffalo and Erie County Historical Society had shown that no hotel had previously existed on the site.

Sunday, May 24, 2009

The Saskatoon Health Region in Saskatchewan, Canada recently discovered a fax machine problem which had not relayed almost 1,500 X-rays, Computed tomography (CT) and Magnetic resonance imaging (MRI) scans, ultrasounds, and other medical imaging test results to doctors.

The fax machine is part of the automated Radiology Information System. An audit revealed that medical diagnostic tests involving results dating back a decade have been affected by the broken fax machine.

On May 6, a doctor called the health region officials seeking follow up on a patient’s report. Staff who delved into it, found that the report was not sent from the system.

Now, two weeks later, this same patient has still not been contacted by the health region.

“It has taken some time to work with the patient’s physician. That was important — to get more information and more detail because we want that patient’s physician to be involved in the discussion with the patient,” Dr. David Poulin, vice-president of medical affairs for The Saskatoon Health Region, said. “This is a system error and that’s just what it was — an error. This doesn’t reflect in any way on the quality of work regional staff have done and continue to do.”

An internal review revealed that, of 2.2 million diagnostic tests performed, at least 1,380 had not been sent out by the malfunctioning fax machine.

The health region will embark on contacting each of the 1,380 patients and their physicians to make sure that the results have been received and if any health care was compromised.

Patients can also contact the health region via a newly set up hotline to make enquiries.

“We think it would actually be good practice if physician offices could have a system to check whether they have received important reports,” said Poulin, “The common practice appears to be in many doctors’ offices, particularly family physician offices, that they don’t respond to the report until it arrives. So, they basically are waiting for the report to arrive in their office by fax and it’s at that point that they look at it and decide what action to take.”

City Hospital, St. Paul’s Hospital and Royal University Hospital were the three city hospitals affected. Saskatoon has a population of roughly 233,923, and the hospitals also serve the surrounding rural areas.

Ironically the faulty fax machine was discovered the same week that provincial medical officials began to review approximately 70,000 radiology tests conducted in Yorkton. Officials there doubt the competence of the physician who first interpreted the radiology results.

Tuesday, April 5, 2005Terry Vo, the 10-year old Australian boy who had two hands and a foot reattached by surgeons after losing them in an accident, has had to have the foot re-amputated. He will be given a prosthetic foot in its place.

The operation to re-attach three limbs was thought to have been a first – but was ultimately unsuccessful, with the foot having died inside, and receiving insufficient blood supply following the surgery to reattach it.

“That would lead to the small muscles in the foot actually constricting, the toes bending over and a deformed …. foot that is sort of clawed over and doesn’t have good sensation,” said plastic surgeon, Mr Robert Love today, on Australia’s ABC Radio.

“Even if you can get all of that to survive, he [would be] worse off than having had an amputation.”

“What is very disappointing is that for the first two days after [the operation] the foot looked absolutely magnificent,” he said.

Terry’s hands were healing well, said the surgeon. The prosthetic foot would allow him to walk normally, since his knee was intact.

Friday, February 17, 2006

Buffalo, New York —Savarino Construction Services Corp. has proposed a $7 million hotel project at the Forest and Elmwood Avenue intersection, according to The Buffalo News. The proposal calls for a 5-story, 45,000 square-foot 80-room hotel with underground parking for at least 50 vehicles, and 4,500 square-feet of retail space on the lower level.

Hans Mobius, the owner of the five properties to be purchased in the plan (1109 to 1121 Elmwood), reportedly signed a contract with Savarino to assemble the development.

“We saw a huge opportunity to bring something to the Elmwood Village that will make sense and bring a service that’s currently not available,” said Eva Hassett, vice president of Savarino. “Elmwood is such a wonderful place to eat, shop, walk and spend time. We believe this project will add to that vibrant environment.”

Some business owners in the area see it differently. Wikinews interviewed 2 of the 4 owners whose business’s would be demolished if the development goes through.

Nancy Pollina, of Don Apparel at 1119 Elmwood, who found out about the development only yesterday, said she is “utterly” against the proposal. Her apparel shop has stood at the same location for nearly 14 years. She has volunteered in the community, and helped create several gardens around bus shelters in the city, and served on Forever Elmwood Board for six years as head of Beautification. Patty Morris co-owns Don Apparel with Pollina.

“To say this is a good looking project, I want to say the emperor has no clothes. This [project] does not take into consideration the needs of the college students. I have been told by college students, these shops here, are the reason they leave the campus,” said Mrs. Pollina.

Buffalo State College is 500-feet from the intersection.

Michael Faust, the owner of Mondo Video said, “Well, I do not really want to get kicked out of here. The landlord was very open, and the deal he made with me when I moved in here was ‘the rent is cheap and I [the landlord] will not fix anything and that will not change.'” Faust said he first learned of the development plan, “about 48 hours ago. I found out on Tuesday when the Buffalo News called and asked for my opinion on this.” Faust has not said if he will make plans to relocate. “We have to see if this [house] is going to get knocked down first,” said Faust.

An “informational” meeting, where citizens can voice opinions and learn about the proposal, will be held on Tuesday February 21, 2006 at 5:00pm (eastern), at the Burchfield-Penney Art Center Gallery at Buffalo State College, Rockwell Hall.

Executive director of Forever Elmwood Corporation, Justin P. Azzarella would not comment on whether or not the organization supports the development, saying, “you will just have to come to the meeting.”

Forever Elmwood Corp. is designed to preserve and protect the unique and historic nature of Elmwood Avenue and its surrounding neighborhoods and encourage neighborhood commercial revitalization. The organization was founded in 1994.

Nearly two years ago, the Forever Elmwood Corp. assisted in the blocking of the demolition of the Edward Atwater house at 1089 Elmwood next to Pano’s Restaurant which is at 1081 Elmwood. Owner Pano Georgiadis wanted to expand his restaurant onto the property where the house now stands, but the Common Council denied his permit to demolish saying the house is a historical landmark and needs to be protected. Georgiadis, who has a bleeding ulcer, said that all the court cases landed him in the hospital. “I got a bleeding ulcer, and since then, I don’t care about this house anymore, or this city. I just go to work every day. I think [preservationists] are parasites,” said Georgiadis.

Georgiadis will not be attending Tuesday’s meeting saying, “I will be out of town.”

In 1995 Hans Mobius proposed a plan to develop a Walgreens, that was to be placed in the same location, but residents and business owners shot down the proposal. Walgreens eventually withdrew its request for a variance after pressure from the community.

Wednesday, April 25, 2012

A recent study by the United States Geological Survey (USGS) shows that the oil and gas industry are creating earthquakes. New information from the Midwest region of the United States points out that these man-made earthquakes are happening more frequently than expected. While more frequent earthquakes are less of a problem for regions like the Midwest, a geology professor from the University of Southern Indiana, Dr. Paul K. Doss, believes the disposal of wastewater from the hydraulic fracturing (or “fracking”) process used in extracting oil and gas has the possibility to pose potential problems for groundwater.

“We are taking this fluid that has a whole host of chemicals in it that are useful for fracking and putting it back into the Earth,” Doss said. “From a purely seismic perspective these are not big earthquakes that are going to cause damage or initiate, as far as we know, any larger kinds of earthquakes activity for Midwest. [The issue] is a water quality issue in terms of the ground water resources that we use.”

Hydraulic fracturing, or fracking, is a technique used by the oil and gas industries which inject highly pressurized water down into the Earth’s crust to break rock and extract natural gas. Most of the fluids used for fracking are proprietary, so information about what chemicals are used in the various fluids are unknown to the public and to create a competitive edge.

Last Monday four researchers from the University of New Brunswick released an editorial that sheds light on the potential risks that the current wastewater disposal system could have on the province’s water resources. The researchers share the concern that Dr. Doss has and have come out to say that they believe fracking should be stopped in the province until there is an environ­mentally safe way to dispose the waste wastewater.

“If groundwater becomes contamin­ated, it takes years to decades to try to clean up an aquifer system,” University of New Brunswick professor Tom Al said.

While the USGS group which conducted the study says it is unclear how the earthquake rates may be related to oil and gas production, they’ve made the correlation between the disposal of wastewater used in fracking and the recent upsurge in earthquakes. Because of the recent information surfacing that shows this connection between the disposal process and earthquakes, individual states in the United States are now passing laws regarding disposal wells.

“The problem is that we have never, as a human society, engineered a hole to go four miles down in the Earth’s crust that we have complete confidence that it won’t leak,” Doss said. “A perfect case-in-point is the Gulf of Mexico oil spill in 2010, that oil was being drilled at 18,000 feet but leaked at the surface. And that’s the concern because there’s no assurance that some of these unknown chemical cocktails won’t escape before it gets down to where they are trying to get rid of them.”

It was said in the study released by the New Brunswick University professors that if fracking wastewater would contaminate groundwater, that current conventional water treatment would not be sufficient enough to remove the high concentration of chemicals used in fracking. The researchers did find that the wastewater could be recycled, can also be disposed of at proper sites or even pumped further underground into saline aquifers.

The New Brunswick professors have come to the conclusion that current fracking methods used by companies, which use the water, should be replaced with carbon diox­ide or liquefied propane gas.

“You eliminate all the water-related issues that we’re raising, and that peo­ple have raised in general across North America,” Al said.

In New Brunswick liquefied propane gas has been used successfully in fracking some wells, but according to water specialist with the province’s Natural Resources De­partment Annie Daigle, it may not be the go-to solution for New Brunswick due its geological makeup.

“It has been used successfully by Corridor Resources here in New Bruns­wick for lower volume hydraulic frac­turing operations, but it is still a fairly new technology,” Daigle said.

The United States Environmental Protection Agency (EPA) is working with U.S. states to come up with guidelines to manage seismic risks due to wastewater. Under the Safe Drinking Water Act, the EPA is the organization that also deals with the policies for wells.

Oil wells, which are under regulation, pump out salt water known as brine, and after brine is pumped out of the ground it’s disposed of by being pumped back into the ground. The difference between pumping brine and the high pressurized fracking fluid back in the ground is the volume that it is disposed of.

“Brine has never caused this kind of earthquake activity,” Doss said. “[The whole oil and gas industry] has developed around the removal of natural gas by fracking techniques and has outpaced regulatory development. The regulation is tied to the ‘the run-of-the-mill’ disposal of waste, in other words the rush to produce this gas has occurred before regulatory agencies have had the opportunity to respond.”

According to the USGS study, the increase in injecting wastewater into the ground may explain the sixfold increase of earthquakes in the central part of the United States from 2000 – 2011. USGS researchers also found that in decades prior to 2000 seismic events that happened in the midsection of the U.S. averaged 21 annually, in 2009 it spiked to 50 and in 2011 seismic events hit 134.

“The incredible volumes and intense disposal of fracking fluids in concentrated areas is what’s new,” Doss said. “There is not a body of regulation in place to manage the how these fluids are disposed of.”

The study by the USGS was presented at the annual meeting of the Seismological Society of America on April 18, 2012.

Sunday, December 10, 2006

Harry Doynhoven, minister for transport safety, has called for a ban on using mobile phones (cellphones) while driving in New Zealand. The ban comes just days after a teenager was killed after allegedly driving while texting on their mobile phone.

Mr Duynhoven said that it is time to ban hand-held mobile phones in cars. “I would love to ban it. If I were a benign dictator, it would be gone by lunchtime.” Mr Duynhoven believes that a campaign to educate the public is needed to combat the number of people who die while using their mobile phones while driving. One of the new ways to combat this is suspected to be new road safety measure. The new initiatives will be announced on Wednesday.

“I hope that sufficient parliamentarians who read the reports of another young person who obviously wasn’t concentrating on her driving will say it’s about time something was done,” Mr Duynhoven said, “However such a ban would be very difficult to police.”

A report, prepared by the Ministry of Transport, will be shown to the government on the dangers of using a mobile phone while driving. Peter Burke, spokesman for the Ministry of Transport, said: “There’s no law against using a cellphone at the moment. There’s the whole issue of driver distraction of which cellphone use is a part. But there’s been no decision on it yet. Anyone who texts while you’re driving is pushing the limits. I don’t think anyone would condone texting while driving, it’s a recipe for disaster.”

Every year around four fatal crashes occur because the drivers are using their mobile phones while driving. Around 50 non fatal crashes occur each year for the same reason. However the police expect that the actual number is higher.

“A lot of drivers are unfortunately their own worst enemy – they’re busy talking and texting on the phone and fail to pay attention to what’s going on around them. The results can be, and often are, crashes which cause injury and death,” Rob Lee, spokesman for the police, said.

Sharleen Lloyd, 16-years-old, was killed when she drove her car into a parked trailer after it left the road because she was allegedly texting (SMS) on her mobile phone. Her passenger and boyfriend, Matthew Smit, had non fatal injuries. Andrew Hicks died when he crashed into a powerpole as a result from using his cellphone while driving.

Many countries already have a ban in place of using a mobile phone while driving, including the United Kingdom and the United States of America. Mr Duynhoven said: “But in countries where they have bans, they still have people using cellphones while driving. The issue is changing behaviour.”

However New Zealand does currently have a law which enables police to prosecute someone who doesn’t give attention or care to driving.