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.

Tuesday, May 31, 2005

One thousand residents of the Defense Department-managed Armed Forces Retirement Home in Washington, D.C. filed a class-action lawsuit on May 24, asserting that the cut-backs in medical and dental services imposed by Secretary of Defense Donald Rumsfeld are illegal. The operating budget for the home was reduced from $63 million in 2004 to $58 million for 2005. The residents cite cuts in on-site X-ray, electrocardiogram, physical and dental services, and the closing of the home’s main clinic and an on-site pharmacy.

Chief Financial Officer Steve McManus responded that the changes not only save money but also achieved improved efficiencies. “We’re really trying to improve the benefits to our residents,” he said.

Most of the home’s costs are paid for by a trust fund and monthly fees paid by residents. By law, the Armed Forces Retirement Homes are required to fund, “on-site primary care, medical care and a continuum of long-term care services.”

Sunday, September 12, 2010

The Finnish communications corporation Nokia announced that its Head will change on September 21. The previous chief executive Olli-Pekka Kallasvuo will continue to chair in non-executive capacity. The head of Microsoft Business division Stephen Elop will take the position. It is the first time a non-Finn becomes Nokia president and chief executive.

The change follows Nokia’s fall in world markets. It includes a decrease in Nokia’s American market share to less than ten percent after failed negotiations with a number of leading American phone providers. An analyst at a market analyst company Canalys Pete Cunningham said, “Despite holding 38 percent market share of the smartphone market, Nokia’s failure to compete with the iPhone and high-tier Android devices, combined with its lack of progress in gaining significant traction in the United States, has led to press and investor dissatisfaction.”

Some commenters suggested that Nokia chose Mr. Elop partly because he is a Canadian, following criticism of American candidates by the Finnish press. However a Nokia spokesman rejected this, saying, “Nationality was not a selection criteria.”

Stephen Elop was president and CEO of the graphics and web-development software house Macromedia prior to its acquisition by Adobe in 2005. He then joined Microsoft as President of Microsoft’s Business Division in January, 2008. Commenting on his new role he said, “Nokia has a unique global position as well as a great brand upon which we can build. The Nokia slogan clearly states our key mission: Connecting People, which will acquire new dimensions as we build our portfolio of products, solutions and services.”

In the announcement the Chairman of the Nokia Board of Directors Jorma Ollila stressed an expected shift of focus from hardware to software. “His [Stephen Elop’s] strong software background and proven record in change management will be valuable assets as we press harder to complete the transformation of the company. We believe that Stephen will be able to drive both innovation and efficient execution of the company strategy in order to deliver increased value to our shareholders”.

Nokia stated in an official blog post, “Nokia is transitioning from a hardware manufacturer of mobile devices to a software and solutions business. …Stephen’s background in the software industry is one of his key strengths.”

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Thursday, February 2, 2006

In recent days, there has been a notable increase in nuclear attack drill activities in LA, Houston and the state of South Carolina.

Sources in the Houston Police Department have disclosed that they are running these nuclear disaster drills across the city of Houston, Texas.

“In the last week I have multi-checked with sources of mine in the Houston Police Department and confirmed that HPD has been running nuclear disaster drills,” said Capt. Eric May, as he warned of a possible nuclear attack that might occur in the Texas City or Houston metro area. Capt. Eric May also mentioned that a likely target could be the British Petroleum plant in Texas City, Texas.

Local citizens have also noticed ongoing SWAT exercises involving numerous government agencies in the area, including Homeland Security, the HPD and the Pasadena Police Department.

“After leaving the Texas City police station, I noticed one thing really strange, as I counted at least 11 different types of official police and government vehicles parked in the police lot. I have never seen this before and it has me a little worried. What are they planning?” said local resident John Watkins.

Besides this increased activity in the Houston area, there have been reports that the Bank of America has been in contact with Homeland Security officials discussing the topic of how to deal with customers in the case of a pending “national disaster.” Employees of the bank have been ordered to remain silent, as ones from all levels have been told of the proper procedures to take. Employees in both Houston and LA have disclosed they were recently told not to distribute certain things from safety deposit boxes in the event of a national emergency, including gold, silver and firearms. They were, however, allowed to hand out important papers to asking customers.

It seems as if British Petroleum may also be conducting nuclear disaster exercises in the Houston area, as an email from an alleged BP employee has surfaced on the internet. Although his identity has not been proven as of yet, he states that he holds the position of a “building monitor” and has never had any responsibilities before. However, on Friday, January 27th, he was called into a meeting and told that he had best get his men ready for some disaster drills to be starting in the next week.

The US government is also running a nuclear disaster drill in the Charleston, SC area from January 31st to February 2nd. The organizers said that nuclear drills should not frighten citizens, but should instead encourage them to learn how to protect themselves in the event of an attack. It should be noted that the government has run other nuclear disaster tests before, including one last summer called “Sudden Respond ’05.” Therefore, this increase of disaster drills may just indicate that the government is taking the threat of a nuclear attack seriously and not necessarily that there is one impending.

Friday, March 20, 2009

The United States House of Representatives approved a measure on Thursday to impose a heavy tax on bonuses to executives from companies that have been bailed out by the government. The bill was passed by a margin of 328-93.

Under the bill, executives making over US$250,000 a year would be charged a 90% tax on bonuses. The tax would apply to firms that have been given at least $5 billion in aid from the government.

The move comes after recent outrage at American International Group (AIG), which gave out $165 million in bonuses to its top executives after receiving no more than $180 billion in government bailouts. AIG has said that the bonuses had to be given out, as the company was legally required by contract to do so.

Nancy Pelosi, the Speaker of the House, said that the bill was necessary because of the bad judgment shown by firms who received bailouts from the government.

“We must stabilize the financial system in order to strengthen our economy and create jobs. We must also protect the American taxpayer from executives who would use their companies’ second chances as opportunities for private gain. Because they could not use sound judgment in the use of taxpayer funds, these AIG executives will pay the Treasury in the form of this tax,” said Pelosi to reporters following the House vote.

The Senate is expected to vote upon a similar version of the bill. If approved, the differences between the two versions would have to be bridged before it could be signed into law.