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.

Saturday, September 19, 2009

Six energy companies in the United Kingdom have announced that it is likely that the prices for energy bills could increase over the course of 2010.

The companies, which are nicknamed the “big six” in the United Kingdom, did not pass on information that there would be price cuts in energy bills despite increasing profits. However, the companies have in fact sent a message in response saying that the prices of bills may even increase over the course of the next year. Energy company watchdog the Office of Gas and Electricity Markets (Ofgem) have estimated that energy companies will make gross margins of £170 ($276) per dual fual customer over the course of the next twelve months, due to the recent fall in wholesale energy costs.

Ofgem have said: “Our analysis shows that based on an 18-month hedging strategy and assuming that retail prices remain unchanged, projected gross margin is set to increase by around £80 for dual fuel customers over the next six months.”

The “big six” energy companies in the United Kingdom are British Gas, E-on, Npower, Scottish and Southern Energy, Scottish Power, and EDF Energy. British Gas stated: “Prices [are] likely to remain at historically high levels, and in fact likely to increase as non-commodity costs rise ever upwards.”

EDF Energy said: “[We] would of course be prepared to reduce tariffs if market conditions allowed.” Scottish Power stated: “There are no immediate signals that would indicate a fall in retail prices for this winter, and risks of an increase next year.” Scottish & Southern Energy commented: “With forward annual wholesale prices significantly higher, and with upward pressures in terms of distribution, environmental and social costs, seeking to avoid an increase between now and the end of 2010 is an important goal.”

Meanwhile, a study by Consumer Focus in early September 2009 suggested that “energy companies were overcharging customers by £100 ($162) every year. A spokesperson for Ofgem said that there was no evidence of any cartel in operation, or evidence of profiteering. The spokesperson commented: “It is up to the companies themselves to decide whether to cut their bills. Consumer Focus data suggests that Scottish Power has increased dual fuel prices by the most since 2003 – up 148% – while decreasing prices by 0.6% so far this year. RWE’s Npower has increased tariffs by 132% since 2003, but has reduced bills by 2.7% in 2009.”

Friday, July 17, 2009Following similar threats by workers at New Fabris and Nortel, workers at JLG in Tonneins, France, threatened to blow up several platform cranes. The JLG factory announced in April 2009 that it will fire 53 of its 163 workers by the end of 2009, while the remaining 110 jobs will not be secure over the next 2 years.

JLG Tonneins was acquired in 2006 with its parent JLG Industries, a maker of aerial work platforms, by the U.S.-based Oshkosh Corporation. Despite being hugely profitable in the past, production has been much reduced since 2008 with the contraction of the construction industry and lower demand for its products. Despite excellent past results the new American management demanded sweeping cuts at the company.

In the view of locals, “the company’s actions are a disgrace given the expensive perks, such as official cars, for its corporate fat cats, compared to the sacrifice, silence, and dignity demanded by the company of those it has made redundant.”

The management offered severance pay of € 3,000 (US $4,200), however the workers demanded a severance package commensurate with “the wealth that their labor has generated.” Worker’s delegates requested a “supra-legal” payment of € 30,000, on Thursday 16 of July the management responded with a counter offer of € 16,000. On Thursday night the worker’s actions secured the € 30,000 settlement initially demanded.

Saturday, May 10, 2008

Bruce McCaffrey, who was formerly the vice-president in charge of freight operations in the United States for Australian flag carrier Qantas, has been sentenced to eight months imprisonment and fined US$21,000 by the US Department of Justice (DoJ) for his involvement in a major air cargo price fixing cartel.

McCaffrey is one of six past and present employees of the airline who have been charged over the arrangement, which is thought to have run for six years starting in 2000. He is also the first individual to be sentenced regarding the cartel. He, as well as Stephen Cleary, group general manager for freight in Sydney, Harold Pang, general manager for freight sales in Singapore, Peter Frampton, former group general manager for freight, John Cooper former general manager for freight sales and Desmond Church, a former freight employee, were all charged after being exempt from immunity granted in a plea bargain by Qantas in which the airline paid a US$61 million fine.

In Australia price fixing is not actually a criminal offense, so former head of freight Peter Frampton and three other staff members in Australia will not be extradited to face charges. Meanwhile, the Australian Competition and Consumer Commission is seeking admittances of guilt from airlines whose operations fall under its jurisdiction in exchange for lighter penalties. Qantas is amongst those airlines.

The cartel, which prevented competition in air freight shipments rates, is said to involve almost thirty airlines. As well as Qantas, Japan Airlines, British Airways, Korean Air and Lufthansa have all had their involvement confirmed. Whistleblower Lufthansa, a German airline, was granted immunity from prosecution in exchange for exposing the operation. In August, British Airways and Korean Air pled guilty to their involvement and received fines of US$300 million each. Last month Japan Airlines also admitted to their role and paid a US$110 million fine. Amongst the others alleged to be involved are Air New Zealand, Singapore Airlines and Cathay Pacific. Hundreds of Australian businesses are involved in a class action suit against these seven airlines for AU$200 million that they believe was unfairly charged to them as a result of criminal activity.

McCarthy, who ran Qantas’s Australia-US cargo route for twenty years, entered a plea bargain with the authorities. Under the US Sherman Act he could have faced up to a US$1.06 million fine and up to 10 years imprisonment, but the DoJ says that the maximum fine could actually be double the gain from the offences committed or double the loss of those victimised if either were found to be higher than the normal maximum. According to the case, he was involved with “meetings, conversations and communications in the US and elsewhere to discuss the cargo rates to be charged on certain routes to and from the US”.

In light of the news, shares in Qantas fell 3¢ to AU$3.41.

Monday, September 11, 2006

Pope Benedict XVI went to visit his homeland in Marktl-am-Inn, Germany today. The Pope celebrated Mass in front of 70,000 people, at Kapellplatz square. Benedict had a six-day homecoming tour of his native Bavaria, a state in Germany. He said a prayer remembering 9/11 victims.

Benedict also planned to make visits to where he was born, and to Freising, where he was ordained a priest. He will also visit Regensburg, where he once taught theology; he still has a house in the city, and his brother Georg, a retired priest and choir director, lives there as well.

“This is the mother that generations have come to Altoetting to visit,” he said. “To her we entrust our cares, our needs and our troubles.”

He visited his first house, which he lived till he was two years old. The house had to be cleaned after it was spattered with blue paint early on Sunday. The police described it as vandalism.

“This is a really big thing — I’ve never seen a pope before,” said Juergen Tauer, a 38-year-old computer technician from the Bavarian town of Degendorf who took the day off to travel to Altoetting with his wife and three children. “It’s great that the pope is coming to Altoetting.”

Everyone was excited about the chance to see the pope.

Sunday, August 21, 2005

A robotic system at Stanford Medical Center was used to perform a laparoscopic gastric bypass surgery successfully with a theoretically similar rate of complications to that seen in standard operations. However, as there were only 10 people in the experimental group (and another 10 in the control group), this is not a statistically significant sample.

If this surgical procedure is as successful in large-scale studies, it may lead the way for the use of robotic surgery in even more delicate procedures, such as heart surgery. Note that this is not a fully automated system, as a human doctor controls the operation via remote control. Laparoscopic gastric bypass surgery is a treatment for obesity.

There were concerns that doctors, in the future, might only be trained in the remote control procedure. Ronald G. Latimer, M.D., of Santa Barbara, CA, warned “The fact that surgeons may have to open the patient or might actually need to revert to standard laparoscopic techniques demands that this basic training be a requirement before a robot is purchased. Robots do malfunction, so a backup system is imperative. We should not be seduced to buy this instrument to train surgeons if they are not able to do the primary operations themselves.”

There are precedents for just such a problem occurring. A previous “new technology”, the electrocardiogram (ECG), has lead to a lack of basic education on the older technology, the stethoscope. As a result, many heart conditions now go undiagnosed, especially in children and others who rarely undergo an ECG procedure.

Monday, May 6, 2019

The second International Student Olympiad in Neurosurgery for the prize of the Governor of Tyumen Oblast, Russia took place in the first week of April at the Federal Center for Neurosurgery in Tyumen. The competition was attended by 46 people from cities within Russia as well as from Aktobe, Kazakhstan. Wikinews attended the event, and talked to some of those involved.

This was the second consecutive student Olympiad in neurosurgery. Six of the country’s eight federal district capitals were reportedly scheduled to send contestants. The winners are awarded free tuition at the academic department of Neurosurgery at First Moscow State Medical University (First MSMU), also called Sechenov University.

Madina Bizheva, in her fourth year at Kabardino-Balkarian State University, won this second Olympiad. The other two places at Sechenov University were awarded to Oleg Titov, fifth year at the First MSMU, and Irina Borovikova, fifth year at Ural State Medical University. Bizheva said: “I give my victory to my mother, who inspired me to study at a neurosurgeon. After she had a stroke, the dream of becoming a doctor began to turn into reality. I was seriously preparing for the Olympiad. One hand rocked the child, the other held a book on neurosurgery. If a person strives for and desires something, then everything will work out.” ^{((ru))Russian: ????? ?????? ? ???? ????, ??????? ?????????? ???? ????? ?????? ?? ????????????. ????? ????, ??? ? ??? ???????? ???????, ????? ????? ?????? ????? ???????????? ? ??????????. ? ???????? ?????????? ? ?????????. ????? ????? ?????????? ???????, ?????? ??????? ????? ?? ?????????????. ???? ??????? ? ???? ?????????? ? ????-?? ????? ??????, — ??? ?????????.}

• Contestants came from many parts of Russia and from Kazakhstan. Image: ??????? ???????.

• Participants waiting for the start of the test. Image: ??????? ???????.

• Olympiad participants complete a theory test. Image: ??????? ???????.

The chairman of the organizing committee of the Olympiad and the head physician of the center, Albert Sufianov, is also the head of the academic department of neurosurgery in the First MSMU. The three best performers in this contest are awarded the opportunity to study for free in his department in the residency of the Sechenov University.

The event was supported financially by Tyumen Oblast. The new governor of the region, Alexander Moor, during his message to the regional parliamentarians read out on November 22, just offered to diversify the economy, reducing the focus on oil and gas from the third Baku and cultivating medical tourism: “Now the annual volume of our exports — non-row materials and non-energy — has come close to a billion dollars. In the next year, this must be given priority. And here, too, non-standard approaches will be required, in which trends of various origins will organically merge across the traditional industry nomenclature. For example, it is time to perceive Tyumen medicine as a full-fledged export-oriented industry, while closely associated with the tourism business. Medical tourism is growing rapidly all over the world, and in terms of price and quality, Tyumen is more than competitive — if not on a global scale, then on a scale of the whole continent Eurasia exactly. Here the themes of several national projects intersect at once!” ^{((ru))Russian: ??????? ??????? ????? ?????? ???????? – ??????????? ? ????????????????? – ???????? ??????????? ? ????????? ????????. ? ????????? ???? ???? ??? ???? ?????. ? ??? ???? ??????????? ????????????? ???????, ? ??????? ?????? ???????????? ?????????? ???????????? ????????? ?????????? ?????? ?????????? ?????????????. ??????, ????????? ???????? ??? ???? ???????????? ??? ??????????? ?????????-??????????????? ???????, ??? ???? ????? ????????? ? ????????????? ????????. ??????????? ?????? ????? ?????? ?? ???? ????, ? ?? ?????????? ???? ? ???????? ?????? ????? ??? ?????????????????? – ???? ?? ? ?????????? ????????, ?? ? ???????? ????? ???????????? ?????????? ?????. ????? ???????????? ???????? ????? ?????????? ???????????? ????????!}

According to Professor Sergey Dydykin, who is both co-chairman of the organizing committee and head of the academic department of operative surgery and topographic anatomy of the First MSMU, in the United States and Europe it is not customary to teach manual skills, such as manual surgical techniques, to undergraduates; conducting surgical competitions for students is a Russian practice.

During the Olympiad, students had to perform simulated practical tasks. For example, in the final part of the competition, the contestants had to mill away the shell of a raw egg without damaging the membranes beneath. This exercise simulates endoscopic drilling.

According to Sufianov, the Olympiad shows young people the “social elevators” available to them. He suggesnted student Ibrahim Salamov as an illustration of his words. A year ago, this native of the Dagestan village took first prize, and he is now one of the organizers of the Olympiad.

Regarding which part of the competition was most difficult for aspiring neurosurgeons, Sufianov said it was English language. From his view, this is a nationwide problem in Russia — there are many skilled surgeons in the country, but their knowledge of foreign languages is not very strong. In his opinion, a specialist has almost no chance to become a very high level professional without knowledge of English.

Alexander Gagay of Yekaterinburg, who took third place last year, is currently a fourth year student at Ural State Medical University. This year, he said, he came to support his fellow Yekaterinburgers. In his opinion, the most difficult part was the theoretical tasks, and not English. In his view, the federal neurosurgery centers like Tyumen created within the framework of the national health project are on the same level with their foreign counterparts. In his view, there are strong opportunities to become a very good specialist without leaving Russia.

Several people returned to the Olympiad after attending last year. One is Denis Kovalchuk, a sixth year student at Buryat State University. He said he was interested in neurosurgery from the first year, but in his home region there are no suitably equipped facilities as there are in Tyumen. Kovalchuk also said that, after the first Olympiad, a community of young neurosurgeons emerged on social networks, numbering about 400 people. Students exchange professional literature in it and give each other tips for use in practical situations.

• Ibrahim Salamov, last year’s winner. Image: ??????? ???????.

• Alexander Gagay, who took third place in 2018. Image: ??????? ???????.

• Denis Kovalchuk, a 2-year participant. Image: ??????? ???????.

This year, the jury decided two participants in addition to the official winners performed at such a high level and Albert Sufianov provided them with his personal grant for residency training at First MSMU. These were Ivan Shelyagin and Valentina Sidorenko from Tyumen State Medical University.

Wednesday, March 9, 2005File:Plastic bag stock sized.jpg

They are cheap, useful, and very plentiful, and that is exactly the problem, according to researchers. A report issued on Feb. 23 by a cadre of environment and economics researchers suggested that Kenya should ban the common plastic bag that one gets at the checkout counter of grocery stores, and place a levy on other plastic bags, all to combat the country’s environmental problems stemming from the bags’ popularity.