Melanoma Update: Yehey for Yervoy!

The drug company Bristol- Myers Squibb has gained approval from the Food and Drug Administration (FDA) for Yervoy (ipilimumab) for the treatment of Melanoma, a very aggressive and often fatal form of cancer which is also the leading cause of death from skin cancer.

Although the complete course of treatment is quite expensive at the moment, we can only hope that in the near future it will become more affordable and be accessible to the majority of the population.

Here's the recent article from the New York Times: Yervoy, a Melanoma Drug, Wins F.D.A. Approval.

CPR Simplified

G Spot: Hit or Miss?

Love or Lust. Naked Truth or Bull Crap. Agree or Disagree.

Believe it or not, I'm putting the "G" on the spot.

Read on...


CNN) -- Ladies (and gentlemen): Can you find the G-spot?

Women everywhere have read or heard that they may possess a secret pleasure zone inside their bodies that, if stimulated correctly, yields intense pleasure and even orgasm.

But this so-called G-spot has never been precisely identified as a concrete biological entity. Scientists are still arguing over what it is and whether it exists at all.

Researchers at King's College London in the United Kingdom have brought the elusive G-spot to the forefront with a study of more than 1,800 female twins.

The study suggests that there is no genetic basis for the G-spot and that environmental or psychological factors may contribute to whether a woman believes that she has a G-spot.

No physical examination

The new study is published in the Journal of Sexual Medicine.

But the lead study author, clinical psychologist Andrea Burri, isn't sure that the question was asked in a way that accurately got the information the researchers were seeking, as reflected in the study's discussion section.

Her team did not physically examine the women for the presence of G-spots but instead gave participants a survey asking whether they believed that they had a "so called G-spot, a small area the size of a 20p coin on the front wall of your vagina that is sensitive to deep pressure?" (A 20p coin is about the size of an American nickel.)

They found that 56% of respondents answered "yes" and that there was no genetic correlation.

But only about 30% said they were able to achieve orgasm during intercourse, which may indicate that women were confused by the G-spot question because stimulation of the G-spot is supposed to induce orgasm, she said.

The definition of G-spot in the study is too specific and doesn't take into account that some women perceive their G-spots as bigger or smaller, or higher or lower, said Debby Herbenick, research scientist at Indiana University and author of the book "Because It Feels Good."

"It's not so much that it's a thing that we can see, but it has been pretty widely accepted that many women find it pleasurable, if not orgasmic, to be stimulated on the front wall of the vagina," said Herbenick, who was not involved in the study.

Arousable women

The study also found correlations with personality components in women who did report having G-spots: For instance, these women tended to be more extroverted, arousable and open to experience, which may indicate a psychological component to the G-spot, Burri said.

More research is necessary to make more conclusive statements about whether the G-spot has a physiological basis, experts say.

"I don't think that these are invented experiences at all," Herbenick said. "And if at the end of the day, someone's invented something and they feel pleasure from it, then I think that's great."

The G-spot has been so difficult to identify because it is more of a physiological change -- akin to swallowing or urinating -- than an anatomic structure such as a nipple, said Dr. Irwin Goldstein, director of sexual medicine at Alvarado Hospital in San Diego, California, who oversees the peer review process for the Journal of Sexual Medicine.

Evidence

But a recent study that adds credence to the G-spot concept.

French researchers Odile Buisson and Pierre Foldès did ultrasounds of a small number of women having intercourse with men.

By looking at the changes in the vagina, the researchers found physiological evidence of the G-spot. This study is under review at the Journal of Sexual Medicine, Goldstein said.

The G-spot is named after Dr. Ernst Grafenberg, a gynecologist known for his research on female genitalia. He described this pleasure zone of the vagina in a 1950 paper.

The 1982 book "The G Spot: And Other Discoveries About Human Sexuality" made the term "G-spot" popular.

A small study by Italian researchers in the Journal of Sexual Medicine in 2008 found that women who were able to achieve vaginal orgasms had thicker tissue between the vagina and the urethra, where the G-spot is said to reside.

A minority of women say they ejaculate when they have a G-spot orgasm. Some sex researchers say this fluid comes from a gland that's near the G-spot area.

Men have G-spots too

Men also have a G-spot of sorts, below the scrotum and above the anus, Goldstein said, although it has not gotten as much attention as the more mysterious female G-spot.

Experts agree that the idea of the G-spot has put pressure on both women and their male partners to find some kind of hidden treasure that leads to orgasm from the penis alone.

"Initially, it was a good concept, because who wouldn't like the idea of 'push a button and get the best orgasm ever?' " Burri said.

But those women who can't orgasm from vaginal intercourse may feel inadequate, and knowing that the G-spot may not exist can take some pressure off.

Women should explore their bodies, find out what they like, and communicate that information to their partners, Herbenick said.

"Whether you call it your G-spot or the front wall of your vagina, or if you make up a silly name for it ... at the end of the day, it's what you like and how your body works," she said. (Elizabeth landau/ CNN)

How Sweet It Is?

By Claire Suddath – Tue Oct 20, 2:20 pm ET
TIME

Too much sugar will make you fat, but too much artificial sweetener will ... do what exactly? Kill you? Make you thinner? Or have absolutely no effect at all? This week marks the 40th anniversary of the Food and Drug Administration's decision to ban cyclamate, the first artificial sweetener prohibited in the U.S., and yet scientists still haven't reached a consensus about how safe (or harmful) artificial sweeteners may be. Shouldn't we have figured this out by now? (See the top 10 bad beverage ideas.)

The first artificial sweetener, saccharin, was discovered in 1879 when Constantin Fahlberg, a Johns Hopkins University scientist working on coal-tar derivatives, noticed a substance on his hands and arms that tasted sweet. No one knows why Fahlberg decided to lick an unknown substance off his body, but it's a good thing he did. Despite an early attempt to ban the substance in 1911 - skeptical scientists said it was an "adulterant" that changed the makeup of food - saccharin grew in popularity, and was used to sweeten foods during sugar rationings in World Wars I and II. Though it is about 300 times sweeter than sugar and has zero calories, saccharin leaves an unpleasant metallic aftertaste. So when cyclamate came on the market in 1951, food and beverage companies jumped at the chance to sweeten their products with something that tasted more natural. By 1968, Americans were consuming more than 17 million pounds of the calorie-free substance a year in snack foods, canned fruit and soft drinks like Tab and Diet Pepsi. (See nine kid foods to avoid.)

But in the late 1960s, studies began linking cyclamate to cancer. One noted that chicken embryos injected with the chemical developed extreme deformities, leading scientists to wonder if unborn humans could be similarly damaged by their cola-drinking mothers. Another study linked the sweetener to malignant bladder tumors in rats. Because a 1958 congressional amendment required the FDA to ban any food additive shown to cause cancer in humans or animals, on Oct. 18, 1969, the government ordered cyclamate removed from all food products. (See the 10 worst fast-food meals.)

Saccharin became mired in controversy in 1977, when a study indicated that the substance might contribute to cancer in rats. An FDA move to ban the chemical failed, though products containing saccharin were required to carry warning labels. In 2000, the chemical was officially removed from the Federal Government's list of suspected carcinogens. (Read TIME's 1974 article on cyclamate and saccharin.)

In 1981, the synthetic compound aspartame was approved for use, and it capitalized on saccharin's bad publicity by becoming the leading additive in diet colas. In 1995 and 1996, misinformation about aspartame that linked the chemical to everything from multiple sclerosis to Gulf War syndrome was widely disseminated on the Internet. While aspartame does adversely effect some people - including those who are unable to metabolize the amino acid phenylalanine - it has been tested more than 200 times, and each test has confirmed that your Diet Coke is safe to drink. Nor have any health risks been detected in more than 100 clinical tests of sucralose, a chemically altered sugar molecule found in food, drinks, chewing gum and Splenda.

The fear-mongering and misinformation plaguing the faux-sweetener market seems to be rooted in a common misconception. No evidence indicates that sweeteners cause obesity; people with weight problems simply tend to eat more of it. While recent studies have suggested a possible link between artificial sweeteners and obesity, a direct link between additives and weight gain has yet to be found. The general consensus in the scientific community is that saccharin, aspartame and sucralose are harmless when consumed in moderation. And while cyclamate is still banned in the U.S., many other countries still allow it; it can even be found in the Canadian version of Sweet'n Low. Low-calorie additives won't make you thinner or curb your appetite. But they help unsweetened food taste better without harming you. And that's sweet enough.

Swine Flu Away?

US firm makes 1st batch of A(H1N1) vaccine

Agence France-Presse
06/24/2009

WASHINGTON DC, United States—A US company that on Tuesday was awarded a $35-million contract to develop an influenza vaccine using insect cell technology has produced a first batch against (A)H1N1 flu, company boss Dan Adams said.

"We turned out our first batch of doses—about 100,000—against (A)H1N1 flu last week and we're continuing to manufacture it," Adams, chief executive officer of Connecticut-based Protein Sciences Corporation, told AFP.

The US Department of Health and Human Services on Tuesday announced that it has awarded a $35-million contract to Protein Sciences, which could be extended for another five years to reach $147 million.

The insect cell technology "has advanced in recent years to a point that we believe it could help meet a surge in demand for US-based vaccine for seasonal and pandemic flu," Health Secretary Kathleen Sebelius said in a statement.

A(H1N1), or swine flu, which emerged in Mexico in April, has been declared a pandemic by the World Health Organization, killing 231 people worldwide and infecting more than 52,000 people in 100 countries.

As the novel strain of swine flu spread, scientists around the world scrambled to develop a seed strain, a necessary first step in developing a vaccine using either chicken eggs or mammalian cells—the way most vaccines are produced.

They warned that the virus could mutate during the southern hemisphere's flu season before returning north in a more lethal form in autumn, in a pattern similar to that seen in the deadly 1918 flu pandemic, which claimed an estimated 20 to 50 million lives around the globe.

Protein Sciences makes flu vaccine by infecting caterpillar cells with a baculovirus carrying the gene for hemagluttinin, a molecule that sticks out of the surface of the influenza virus.

"Using this method, vaccine candidates, clinical investigational lots, and commercial-scale vaccine production may be available faster than by using traditional vaccine production methods," the health department said in a statement.

The method does not need a seed strain to develop a vaccine, Adams said.

"While everyone else was waiting to get a seed strain, we worked with the genetic code from the virus," said Adams.

"The CDC (Centers for Disease Control and Prevention) sent us a dead virus, which is perfectly safe, and then we extracted genetic information from that virus.

"We can be in manufacturing a lot, lot quicker than people who have to wait for a seed strain," he said.

Protein Sciences' technology is also safer "because these caterpillars don't have any association with man or other animals, so there's no chance for their cells to learn how to propagate human viruses," Adams told AFP.

Under the terms of the grant made to Protein Sciences, if the company's new insect-cell technology proves to be safe and effective, the pharmaceutical minnow, which has just 50 employees, must boost its US manufacturing capability "to provide a finished vaccine within 12 weeks of pandemic onset."

It would also have to produce at least 50 million doses of flu vaccine "within six months of pandemic onset."

That should not be a problem, said Adams, because manufacturing a vaccine using insect cells can be easily and rapidly scaled up because it does not require the same specialized factories required to produce vaccine using egg or mammalian cells.

"We can manufacture our product facilities that make monoclonal antibodies, which is a huge class of products with a huge manufacturing capacity around the world," said Adams.

Protein Sciences' new vaccine against swine flu "could be available right away" if the Food and Drug Administration (FDA) issues an emergency use authorization for it, as it did for the bird flu vaccine developed by Adams's company.

Swiss drugs giant Novartis, which the US government gave $289 million to help develop a vaccine against (A)H1N1 flu, said around two weeks ago that it was poised to begin pre-clinical trials—tests in vitro and on animals—on its first batch of novel swine flu vaccine.

Sanofi-Pasteur of France has said it hopes to have doses of swine flu vaccine ready for clinical trials within weeks, while Taiwan's Adimmune Corporation said it expects to complete clinical trials on its A(H1N1) influenza vaccine around September.

The Woman Behind the "New" Face

This is where you can truly say, WOW!



Nation's first face transplant patient shows face
By MARILYNN MARCHIONE, AP Medical Write




Five years ago, a shotgun blast left a ghastly hole where the middle of her face had been. Five months ago, she received a new face from a dead woman.

Connie Culp stepped forward Tuesday to show off the results of the nation's first face transplant, and her new look was a far cry from the puckered, noseless sight that made children run away in horror.

Culp's expressions are still a bit wooden, but she can talk, smile, smell and taste her food again. Her speech is at times a little tough to understand. Her face is bloated and squarish, and her skin droops in big folds that doctors plan to pare away as her circulation improves and her nerves grow, animating her new muscles.

But Culp had nothing but praise for those who made her new face possible. "I guess I'm the one you came to see today," the 46-year-old Ohio woman said at a news conference at the Cleveland Clinic, where the groundbreaking operation was performed.

But "I think it's more important that you focus on the donor family that made it so I could have this person's face." Up until Tuesday, Culp's identity and how she came to be disfigured were a secret.

Culp's husband, Thomas, shot her in 2004, then turned the gun on himself. He went to prison for seven years. His wife was left clinging to life. The blast shattered her nose, cheeks, the roof of her mouth and an eye. Hundreds of fragments of shotgun pellet and bone splinters were embedded in her face. She needed a tube into her windpipe to breathe. Only her upper eyelids, forehead, lower lip and chin were left.

A plastic surgeon at the Cleveland Clinic, Dr. Risal Djohan, got a look at her injuries two months later. "He told me he didn't think, he wasn't sure, if he could fix me, but he'd try," Culp recalled. She endured 30 operations to try to fix her face. Doctors took parts of her ribs to make cheekbones and fashioned an upper jaw from one of her leg bones. She had countless skin grafts from her thighs. Still, she was left unable to eat solid food, breathe on her own, or smell.

Then, on Dec. 10, in a 22-hour operation, Dr. Maria Siemionow led a team of doctors who replaced 80 percent of Culp's face with bone, muscles, nerves, skin and blood vessels from another woman who had just died.

It was the fourth face transplant in the world, though the others were not as extensive. "Here I am, five years later. He did what he said — I got me my nose," Culp said of Djohan, laughing.

In January, she was able to eat pizza, chicken and hamburgers for the first time in years. She loves to have cookies with a cup of coffee, Siemionow said.

No information has been released about the donor or how she died, but her family members were moved when they saw before-and-after pictures of Culp, Siemionow said.

Culp said she wants to help foster acceptance of those who have suffered burns and other disfiguring injuries.

"When somebody has a disfigurement and don't look as pretty as you do, don't judge them, because you never know what happened to them," she said.

"Don't judge people who don't look the same as you do. Because you never know. One day it might be all taken away." It's a role she has already practiced, said clinic psychiatrist Dr. Kathy Coffman.

Once while shopping, "she heard a little kid say, `You said there were no real monsters mommy, and there's one right there,'" Coffman said. Culp stopped and said, "I'm not a monster. I'm a person who was shot," and pulled out her driver's license to show the child what she used to look like, the psychiatrist said.



Culp, who is from the small town of Unionport, near the Pennsylvania line, told her doctors she just wants to blend back into society. She has a son and a daughter who live near her, and two preschooler grandsons.

Before she was shot, she and her husband ran a painting and contracting business, and she did everything from hanging drywall to a little plumbing, Coffman said. Culp left the hospital Feb. 5 and has returned for periodic follow-up care. She has suffered only one mild rejection episode that was controlled with a single dose of steroid medicines, her doctors said.

She must take immune-suppressing drugs for the rest of her life, but her dosage has been greatly reduced and she needs only a few pills a day.

Also at the Cleveland Clinic is Charla Nash of Stamford, Conn., who was attacked by a friend's chimpanzee in February. She lost her hands, nose, lips and eyelids, and will be blind, doctors said.

Clinic officials said it is premature to discuss the possibility of a face transplant for her. In April, doctors at Harvard-affiliated Brigham and Women's Hospital in Boston performed the nation's second face transplant, on a man disfigured in a freak accident. It was the world's seventh such operation.

The first, in 2005, was performed in France on Isabelle Dinoire, a woman who had been mauled by her dog.

Swine Flu Q & A

By The Associated Press
Fri Apr 24, 6:45 pm ET

Mexico is contending with an outbreak of swine flu, suspected in the deaths of dozens of people and sickening perhaps 1,000. In the United States, at least eight cases have been confirmed with the infection, all of them in California and Texas; only one person was hospitalized. Here are some questions and answers about the illness:


Q. What is swine flu?

A. Swine flu is a respiratory illness in pigs caused by a virus. The swine flu virus routinely causes outbreaks in pigs but doesn't usually kill many of them.

Q. Can people get swine flu?

A. Swine flu viruses don't usually infect humans. There have been occasional cases, usually among people who've had direct contact with infected pigs, such as farm workers. "We've seen swine influenza in humans over the past several years, and in most cases, it's come from direct pig contact. This seems to be different," said Dr. Arnold Monto, a flu expert with the University of Michigan.

Q. Can it spread among humans?

A. There have been cases of the virus spreading from human to human, probably in the same way as seasonal flu, through coughing and sneezing by infected people.

Q. What are the symptoms of swine flu?

A. The symptoms are similar to those of regular flu — fever, cough, fatigue, lack of appetite.

Q. Is the same swine flu virus making people sick in Mexico and the U.S.?

A. The Centers for Disease Control and Prevention said the Mexican virus samples match the U.S. virus. The virus is a mix of human virus, bird virus from North America and pig viruses from North America, Europe and Asia.

Q. Are there drugs to treat swine flu in humans?

A. There are four different drugs approved in the U.S. to treat the flu, but the new virus has shown resistance to the two oldest. The CDC recommends the use of the flu drugs Tamiflu and Relenza.


Q. Does a regular flu shot protect against swine flu?

A. The seasonal flu vaccine used in the U.S. this year won't likely provide protection against the latest swine flu virus. There is a swine flu vaccine for pigs but not for humans.

Q. Should residents of California or Texas do anything special?

A. The CDC recommends routine precautions to prevent the spread of infectious diseases: wash your hands often, cover your nose and mouth when you cough or sneeze, avoid close contact with sick people. If you are sick, stay at home and limit contact with others.

Q. What about traveling to Mexico?

A. The CDC has not warned Americans against traveling to Mexico but advises that they be aware of the illnesses there and take precautions to protect against infections, like washing their hands.

Source: Center for Defense Control and Prevention

I can Pill it, baby!

There’s a new kid trying to make its presence felt on the Diabetic block with a promise that it is free from heart- related side effects (e.g. GlaxoSmithkline’s Avandia) often seen in other treatments.

Onglyza (generic name- Saxagliptin) is Bristol Myers’ answer to Merck’s Januvia, the leading drug in the market and the company is asking the FDA to approve the pill for patients with Type 2 Diabetes.

Let’s hope that Onglyza fulfill its promise and not turn into another bitter pill to swallow in the lucrative Diabetes market, that way we can really proclaim that Life is indeed Sweet!

Please pass the pill, Sugar…

The Heart of the Matter

Teen lives 4 months with no heart, leaves hospital

By RASHA MADKOUR, Associated Press Writer

MIAMI – D'Zhana Simmons says she felt like a "fake person" for 118 days when she had no heart beating in her chest. "But I know that I really was here," the 14-year-old said, "and I did live without a heart."

As she was being released Wednesday from a Miami hospital, the shy teen seemed in awe of what she's endured. Since July, she's had two heart transplants and survived with artificial heart pumps — but no heart — for four months between the transplants.

Last spring D'Zhana and her parents learned she had an enlarged heart that was too weak to sufficiently pump blood. They traveled from their home in Clinton, S.C. to Holtz Children's Hospital in Miami for a heart transplant.

But her new heart didn't work properly and could have ruptured so surgeons removed it two days later.

And they did something unusual, especially for a young patient: They replaced the heart with a pair of artificial pumping devices that kept blood flowing through her body until she could have a second transplant.

Dr. Peter Wearden, a cardiothoracic surgeon at Children's Hospital of Pittsburgh who works with the kind of pumps used in this case, said what the Miami medical team managed to do "is a big deal."

"For (more than) 100 days, there was no heart in this girl's body? That is pretty amazing," Wearden said.

The pumps, ventricular assist devices, are typically used with a heart still in place to help the chambers circulate blood. With D'Zhana's heart removed, doctors at Holtz Children's Hospital crafted substitute heart chambers using a fabric and connected these to the two pumps.

Although artificial hearts have been approved for adults, none has been federally approved for use in children. In general, there are fewer options for pediatric patients. That's because it's rarer for them to have these life-threatening conditions, so companies don't invest as much into technology that could help them, said Dr. Marco Ricci, director of pediatric cardiac surgery at the University of Miami.

He said this case demonstrates that doctors now have one more option.

"In the past, this situation could have been lethal," Ricci said.

And it nearly was. During the almost four months between her two transplants, D'Zhana wasn't able to breathe on her own half the time. She also had kidney and liver failure and gastrointestinal bleeding.

Taking a short stroll — when she felt up for it — required the help of four people, at least one of whom would steer the photocopier-sized machine that was the external part of the pumping devices.

When D'Zhana was stable enough for another operation, doctors did the second transplant on Oct. 29.

"I truly believe it's a miracle," said her mother, Twolla Anderson.

D'Zhana said now she's grateful for small things: She'll see her five siblings soon, and she can spend time outdoors.

"I'm glad I can walk without the machine," she said, her turquoise princess top covering most of the scars on her chest. After thanking the surgeons for helping her, D'Zhana began weeping.

Doctors say she'll be able to do most things that teens do, like attending school and going out with friends. She will be on lifelong medication to keep her body from rejecting the donated heart, and there's a 50-50 chance she'll need another transplant before she turns 30.

For now, though, D'Zhana is looking forward to celebrating another milestone. On Saturday, she turns 15 and plans to spend the day riding in a boat off Miami's coast.

Bone marrow transplant suppresses AIDS in patient

BERLIN (Reuters) - A bone marrow transplant using stem cells from a donor with natural genetic resistance to the AIDS virus has left an HIV patient free of infection for nearly two years, German researchers.

The patient, an American living in Berlin, was infected with the human immunodeficiency virus that causes AIDS and also had leukemia. The best treatment for the leukemia was a bone marrow transplant, which takes the stem cells from a healthy donor's immune system to replace the patient's cancer-ridden cells.

Dr. Gero Hutter and Thomas Schneider of the Clinic for Gastroenterology, Infections and Rheumatology of the Berlin Charite hospital said on Wednesday the team sought a bone marrow donor who had a genetic mutation known to help the body resist AIDS infection.

The mutation affects a receptor, a cellular doorway, called CCR5 that the AIDS virus uses to get into the cells it infects.

When they found a donor with the mutation, they used that bone marrow to treat the patient. Not only did the leukemia disappear, but so did the HIV.

"As of today, more than 20 months after the successful transplant, no HIV can be detected in the patient," the clinic said in a statement.

"We performed all tests, not only with blood but also with other reservoirs," Schneider told a news conference.

"But we cannot exclude the possibility that it's still there."

The researchers stressed that this would never become a standard treatment for HIV. Bone marrow stem cell transplants are rigorous and dangerous and require the patient to first have his or her own bone marrow completely destroyed.

Patients risk death from even the most minor infections because they have no immune system until the stem cells can grow and replace their own.

HIV has no cure and is always fatal. Cocktails of drugs can keep the virus suppressed, sometimes to undetectable levels. But research shows the virus never disappears -- it lurks in so-called reservoirs throughout the body.

Hutter's team said they have been unable to find any trace of the virus in their 42-year-old patient, who remains unnamed, but that does not mean it is not there.

"The virus is tricky. It can always return," Hutter said.

The CCR5 mutation is found in about 3 percent of Europeans, the researchers said. They said the study suggests that gene therapy, a highly experimental technology, might someday be used to help treat patients with HIV.

(Reporting by Oliver Denzer; Writing by Maggie Fox in Washington; Editing by Vicki Allen)

Clinical Eye

Here are some of the latest news that caught my eyes...


General Anesthesia Tied to Developmental Woes in Kids

Youngsters under the age of 3 who had hernia surgery showed almost twice the risk of behavioral or developmental problems later compared to kids who hadn't had surgery, a new study finds.

Researchers suspect that exposure to general anesthesia during these operations might have played a role in the jump in risk, according to lead author Charles DiMaggio, an assistant professor of clinical epidemiology at Columbia University College of Physicians and Surgeons' Mailman School of Public Health in New York City. More...





Dr. Marc Bessler, right, and Dr. Daniel Davis performed a new kind of weight-loss surgery that passes a stapler down the throat to staple the stomach.

Toga (for transoral gastroplasty) is a new weight-loss surgery... click herefor more.




Magnet device aims to treat depression patients...



If it sounds like science-fiction, well, those woodpecker-like pulses trigger small electrical charges that spark brain cells to fire. Yet it doesn't cause the risks of surgically implanted electrodes or the treatment of last resort, shock therapy.

Called transcranial magnetic stimulation or TMS, this gentler approach isn't for everyone. The Food and Drug Administration approved Neuronetics Inc.'s NeuroStar therapy specifically for patients who had no relief from their first antidepressant, offering them a different option than trying pill after pill.

Read the entire article, here.

Face Value

Face transplant patient can smile, blink again



By MARIA CHENG, AP Medical Writer
Fri Aug 22, 7:37 AM ET

LONDON - Transplanting faces may seem like science fiction, but doctors say the experimental surgeries could one day become routine. Two of the world's three teams that have done partial face transplants reported Friday that their techniques were surprisingly effective, though complications exist and more work is still needed.

"There is no reason to think these face transplants would not be as common as kidney or liver transplants one day," said Dr. Laurent Lantieri, one of the French doctors who operated on a man severely disfigured by a genetic disease.

In Friday's issue of the British medical journal Lancet, Lantieri and colleagues reported on their patient's status one year after the transplant. Chinese doctors also reported on their patient, two years after his surgery.

Last year, the French team operated on a 29-year-old man with tumors that blurred his features in a face that looked almost monstrous. They transplanted a new lower face from a donor, giving the patient new cheeks, a nose and mouth. Six months later, he could smile and blink.

The Chinese patient had part of his face ripped off by a bear. Surgeons in Xian gave him a new nose, upper lip and cheek from a donor. After a few months, he could eat, drink and talk normally, and returned home to Yunnan province in southwest China.

The patients were not identified although photos were included in the reports.

As is the case with all transplants, doctors use immune-suppressing drugs to prevent the recipient's body from attacking the donated tissue. In both face transplants, the patients started rejecting the transplanted tissue more than once. Their doctors solved the problem by juggling their medications.

The French patient now takes three pills a day to prevent rejection.

"That's less than most people with diabetes," said Lantieri, a plastic surgeon at the Henri Mondor-Albert Chenevier Hospital in suburban Paris.

Other doctors were reassured by the results.

"To be able to wean down the dosage of the medication in small amounts and relatively quickly, that is encouraging," said Dr. Bohdan Pomahac, a plastic surgeon at the Brigham and Women's Hospital in Boston.

Pomahac has permission to do a face transplant in the U.S., as do doctors at the Cleveland Clinic.

Experts have worried that if patients take lifelong anti-rejection drugs after a transplant, their cancer risk will jump. Some also predicted that rejection would destroy the face within a few years. Those fears seem to have been allayed, Pomahac said.

With three successful partial face transplants so far — including the world's first on a woman whose face was bitten off by a dog in France — doctors say that some of the surgery's initial uncertainties, like how functional the new face would be, are being answered.

For example, Lantieri's patient's face was paralyzed by tumors for more than a decade. The French team wasn't sure if nerves could grow after the transplant. But they discovered later their patient could blink, proving the brain was able to restore long-forgotten facial nerve connections.

Not everyone is convinced that face transplants are so revolutionary.

Dr. Patrick Warnke, a plastic surgeon at the University of Kiel in Germany, calls them a "dead-end road," because he doesn't think the rejection problem can be solved. Instead, he hopes to re-grow tissue from patients' own stem cells.

Still, the biggest obstacle to more face transplants may not be scientific, but social.

"When kidney transplants first began, people were reluctant to donate because there were a lot of cultural, social and religious issues," Pomahac said. "This is exactly the same scenario now."

Doctors plan to do more face transplants, but are having a hard time finding donors.

"Everyone says they would accept a face transplant if they were disfigured," Lantieri said. "The real question is, would you be a donor, or would you allow your family member to donate their face? That is the answer we need to change."

___

On the Net:

http://www.lancet.com