Cleveland, Ohio clinic performs US’s first face transplant

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, May 17, 2007File:Francois fillon1.jpg

The new President of France, Nicolas Sarkozy has appointed François Fillon to head the new French government. Fillon’s predecessor Dominique de Villepin stepped down yesterday, and formally handed over the post during a ceremony today.

The nomination did not come as a surprise after the British newspaper the Financial Times had reported on May 8 that Sarkozy had introduced Fillon to Tony Blair in a telephone conversation.

François Fillon (53) has been the political advisor of Sarkozy in the UMP for the past 2 years, and he was Sarko’s campaign leader during the recent presidential elections. Fillon has experience in negotiating with the trade unions, having undertaken controversial reforms of the 35-hour workweek and the pension system. Sarkozy in his inauguration speech on Wednesday reiterated his plans to reform the French labour and social system, and Fillon will have to oversee these reforms as the new Prime Minister. Sarkozy said he wants to make the economy more flexible and lessen social tensions.

The Guardian reported that Fillon is an Anglophile; his wife Penelope Clarke, with whom he has 5 children, was born in Wales. Ideologically, Fillon is being described as a moderate left-leaning member of the conservative UMP party.

Fillon had his first experience as a minister in 1993 when he became Minister for the Higher education and Research under PM Édouard Balladur. He later became Minister for the Post office, Telecommunications and Space, then Minister for the social Affairs, Work and Solidarity, and finally Minister for national Education, the Higher education and Research. At the university, he studied public law and political sciences.

Sarkozy might announce his cabinet of 15 ministers as early as Friday, half of which are going to be women, he said. Fillon will lead the UMP in the parliamentary elections next month. A poll on Wednesday predicted a 1.5% increase in votes for the UMP, up to 40%, compared to 28% status-quo for the allied socialists.

Reports say that Sarkozy has offered the foreign minister post to Bernard Kouchner, co-founder of Médecins Sans Frontières, who is seen as being on the left in French politics.

Saturday, October 5, 2019

In findings published on Wednesday in Science Advances, researchers from the Georgia Institute of Technology (GT) and University of South Carolina Beaufort, both in the United States, reported warming seas appear to decrease the efficacy of the chemical compounds that corals release into the water to defend themselves from bacteria and encroaching seaweed, but these losses may be mitigated if there are large numbers of hungry fish around.

The research was led by Mark Hay, a marine ecologist and Regents Professor at GT, who said “There is a lot of argument now about whether local management can help in the face of global stresses — whether what a Fijian village does matters when people in London and Los Angeles burn fossil fuels to drive to work”. Hay added, “Our work indicates that local management provides a degree of insurance against global stresses, but there are likely higher temperatures that render the insurance ineffective.”

The researchers examined three types of coral in reefs off the coast of Fiji, Acropora millepora, Porites cylindrica, and Pocillopora damicornis. Some of these reefs were in areas where fishing was prohibited and some were not. The researchers found when fish were plentiful, they would eat algae and seaweed off the corals, which appeared to leave them more resistant to the bacterium Vibrio coralliilyticus, a bacterium associated with bleaching.

The researchers suggested the algae, like warming temperatures, might render the corals’ chemical defenses less effective, and the fish were protecting the coral by removing the algae. They reported, “Macroalgae are suggested to disrupt coral microbiomes via transfer of allelochemicals or microbes or release of dissolved organic carbon that affects microbial growth”.

P. cyclindrica and P. damicornis are known to be function under conditions that damage other corals and A. millepora is not.

Each reef-building coral unit is a collection of polyps living in symbiotic partnership with zooxanthellae algae. The polyp, a cnidarian as are jellyfish, provides stinging protection and secretes a calcium shell, and the algae performs photosynthesis, produces oxygen and gives the coral its color. Changing ocean environments have led to a phenomenon called coral bleaching when warmer waters cause the cnidarian to expel the algae from its body, which turns the coral reefs white. This does not kill the cnidarian partner but does leave it badly weakened and vulnerable to disease.

Sunday, May 18, 2008

John Key is the leader of the New Zealand National Party and with the New Zealand General Election this year, Wikinews’ Gabriel Pollard spoke to John Key via email.

Friday, October 5, 2007

Johan Boyden is running for the Communist Party in the Ontario provincial election, in the Toronto Centre riding. Wikinews interviewed him regarding his values, his experience, and his campaign.

Thursday, February 24, 2011

A week after Sunni and Shi’ite youth protesters marched on the capital city of Manama, the Bahrain government informed Formula One Management that it would withdraw from hosting the Bahrain Grand Prix. The decision was made in an effort to focus on the pressing national issues facing the country. Demonstrators, who are still holding Pearl Square, had threatened to target the Media attention if the event went ahead as scheduled. The race is the opening event of the 2011 Formula One racing season.

Bahrain’s Crown Prince, HRH Sheikh Salman bin Hamad al-Khalifa, sent a statement to Formula One Management which said, “At the present time the country’s entire attention is focused on building a new national dialogue for Bahrain. After the events of the past week, our nation’s priority is on overcoming tragedy, healing divisions and rediscovering the fabric that draws this country together; reminding the world of the very best that Bahrain is capable of as a nation once again united.”

The Bahrain Grand Prix was to be held on March 13, with teams coming in within the next few weeks to prepare for the race. Formula One president and CEO Bernie Ecclestone issued a public statement saying, “It is sad that Bahrain has had to withdraw from the race, we wish the whole nation well as they begin to heal their country.” Ecclestone also noted that despite reported rumors, the Bahrain International Circuit would not be charged for their cancellation of the event, citing that he considered the political unrest to be a “force majeure” and that the events that took place could not have been predicted. “What has happened in Bahrain is desperately sad but one month ago everyone was looking forward to the race,” he said. Formula One Management will most likely have to absorb the costs related to the canceled race, estimated at around $40 million, unless it can be re-scheduled later in the season.

With the announcement from the Crown Prince that political issues would be addressed, exiled Shi’ite political leader Hassan Mushaima announced that he would return to the country. Mushaima, leader of the Haq Movement opposition party, was tried in absentia in 2009, accused of attempting to overthrow the government. Other Haq Movement members have also been arrested in recent years, but received royal pardons. While 23 members of the political movement are currently awaiting trial, on Tuesday the Bahrain government released a group of political detainees without comment, meeting one of the demands of the protesters.

Friday, January 8, 2010

With violence against foreigners escalating daily, and after being deluged with various threats and demands from al-Shabaab, a radical Islamic militant group with ties to al-Qaeda, the United Nations World Food Programme announced on Tuesday that, as of the end of this week, they are going to suspend all of their operations within southern Somalia—including the distribution of desperately needed food aid to Somali civilians. This is now the third humanitarian agency, after CARE International and Doctors Without Borders, to evacuate from the war-torn nation.

The pull out, which will include the closing down of all UN offices and the withdrawal of all local staff, is going to effect over one million Somalis—many of whom relay on this food program for their daily meals.

When asked by the New York Times to further explain the UN’s decision, Peter Smerdon, a spokesperson for the program, said via telephone from Nairobi, Kenya, “In the past few weeks there has been a harder line of unacceptable demands and conditions set by armed groups (such as al-Shabaab) in these areas. We sadly had to make the decision to pull our staff out.”

Smerdon also cited the fact that over forty aid workers have been killed between January 2008 and September 2009, and that four volunteers still remain in the hands of their captors.

Furthermore, when asked how this move by the UN will effect the Somali people, Smerdon said simply, “People will go hungry…you could see malnutrition rates rising [as a result].” When asked by a British newspaper, The Morning Star, the same question, another program representative, Emilia Casella, conveyed like sentiments, “[Those] dependent on food assistance in southern Somalia face a situation that is particularly dire.”

In a nation that—due to civil war—has not had a functioning government in over two decades, Islamic extremists groups—such as al-Shabaab—as well as various warlords and pirate gangs control most of the Horn of Africa nation, except for its besieged capital, Mogadishu, which is protected by African Union and NATO troops in addition to UN peacekeepers.

According to the UN, al-Shabaab—which has direct influence over the area that is going to be effected—presented their offices with numerous lists of demands. Among their demands was that the UN pay Shabaab a $20,000 protection fee every six months, seek Shabaab approval for all their projects, fire their entire female staff, and run their operations according to the militant group’s schedule.

When asked by The Associated Press about the UN’s decision to leave southern Somalia—including his own town of Jilib—Somali civilian and father of eight children, Abdullahi Awnur, said that al-Shabaab is responsible for driving the UN food program away, and that what they are doing is “indirect[ly] killing” innocent people.

Awnur went on to say, “We have been forced to flee from our houses and depend on [UN] food aid, and now that it is finished, that means [al-Shabaab] here does not want us to live.”

Despite all that has been said, al-Shabaab spokesperson, Sheik Ali Mohamud Rage, told New York Times reporters that he found these claims to be “baseless” in their origins. He continued by stating that, “All we (al-Shabaab) ordered them (the UN) was to buy food from Somali farmers and distribute it. They (the UN) do not want to do that, and because of that, they have made this very ridiculous justification.” Nevertheless, the UN has noted that even when harvests were good, Somali farmers are only able to supply 30-40% of the food needed to sustain the bulk of the country’s population.

“[Somalia] has been described as the most complex emergency in the world, and perhaps the most dangerous to operate in. However, the world is not hearing this,” say David Gilmour director of CARE International’s Somali branch.

Tuesday, April 2, 2013

Mount Stromlo, Canberra — This Easter weekend, elite mountain bike riders competed in the Australian 24-hour solo championships at Canberra’s Stromlo Forest Park. Jason English from Port MacQuarie rode 33 laps and won the men’s race. Liz Smith from Wollongong rode 25 laps and won the women’s race.

Races are won by riding the most laps. If two riders complete the same number of laps in 24-hours, the winner is the one who has ridden them in the shortest time.

Riders wear lights on their helmets and bicycles during night laps. Due to the time of year, there is roughly twelve hours of daylight and twelve hours of darkness each day.

The event is a curtain raiser for the WEMBO World Solo 24 hour Mountain Bike Championships, which will be held at Stromlo Forest Park on 12 and 13 October 2013. The race was for solo riders only.

The weekend before, the teams of riders took to the track at the Mont 24 hour race at Canberra’s Kowen forest. With over 3,000 riders participating, it is now Australia’s largest cycling race.

The team version of the race was favoured by the weekend warriors, but also attracted more than a few elite athletes. Laps were ridden in relay fashion: each rider handed over the baton (which looked like a credit card) to another member of the team after riding one or more laps.

The track was in excellent condition, running through the trees. Without steep climbs or overly difficult technical sections, it permitted fast lap times.

No injuries were reported.