Posts for November 30th, 2005

Facial Transplant

November 30, 2005

Doctors in France Perform First Partial Face Transplant

By THE ASSOCIATED PRESS

Filed at 7:30 p.m. ET

LYON, France (AP) — Doctors in France said they had performed the world’s first partial face transplant, forging into a risky medical frontier with their operation on a woman disfigured by a dog bite.

The 38-year-old woman, who wants to remain anonymous, had a nose, lips and chin grafted onto her face from a brain-dead donor whose family gave consent. The operation, performed Sunday, included a surgeon already famous for transplant breakthroughs, Dr. Jean-Michel Dubernard.

”The patient’s general condition is excellent and the transplant looks normal,” said a statement issued Wednesday from the hospital in the northern city of Amiens where the operation took place. Dubernard would not discuss the surgery, but confirmed that it involved the nose, lips and chin.

”We still don’t know when the patient will get out,” he said. A news conference is planned for Friday.

Scientists in China have performed scalp and ear transplants, but experts say the mouth and nose are the most difficult parts of the face to transplant. In 2000, Dubernard did the world’s first double forearm transplant.

The surgery drew both praise and sobering warnings over its potential risks and ethical and psychological ramifications. If successful — something that may not be known for months or even years — the procedure offers hope to people horribly disfigured by burns, accidents or other tragedies.

The woman was ”severely disfigured” by a dog bite in May that made it difficult for her to speak and chew, according to a joint statement from the hospital in Amiens and another in the southern city of Lyon where Dubernard works.

Such injuries are ”extremely difficult, if not impossible” to repair using normal surgical techniques, the statement said.

”For pushing the bounds of science, they are to be applauded, as long as they have got full informed consent from the patient and the donor’s family,” added Dr. Iain Hutchison, chief executive of the London-based Facial Surgery Research Foundation.

Scientists around the world are working to perfect techniques involved in transplanting faces. Today’s best treatments leave many people with facial disfigurement and scar tissue that doesn’t look or move like natural skin.

A complete face transplant, which involves applying a sheet of skin in one operation, has never been done before. The procedure is complex, but uses standard surgical techniques.

Critics say the surgery is too risky for something that is not a matter of life or death, as regular organ transplants are.

The main worry for both a full face transplant and a partial effort is organ rejection, causing the skin to slough off.

”It is not clear whether an individual could be left worse off in the event that a face transplant failed,” said Dr. Stephen Wigmore, chair of the ethics committee of the British Transplantation Society.

Complications also include infections that turn the new face black and require a second transplant or reconstruction with skin grafts, perhaps even one or two years later. Drugs to prevent rejection are needed for life and raise the risk of kidney damage and cancer.

Such concerns have delayed British plans to attempt the operation. In France, ethics authorities rejected an application to try a full face transplant last year, but left the door open for a partial procedure involving the mouth and nose.

In the United States, the Cleveland Clinic is among those planning to attempt a face transplant.

The French surgery ”doesn’t change our plans,” said Cleveland surgeon Dr. Maria Siemionow. ”We are really looking for the right candidate,” which she described as ”severely disfigured patients which have already had the conventional treatment” and for whom a transplant is the last chance.

Dubernard, who is also a lawmaker in France’s lower house of parliament, collaborated in the operation with the Amiens hospital’s Dr. Bernard Devauchelle. Weekly news magazine Le Point reported that the recipient lives in Valenciennes, in northeast France, and that the donor’s facial organs were removed in a hospital in Lille, about 60 miles from where the transplant was performed.

In 1976, Dubernard performed Europe’s first pancreas transplant. He also led teams that performed a hand transplant in September 1998 and the world’s first double forearm transplant in January 2000.

The hand transplant recipient, New Zealander Clint Hallam, later had it amputated. Doctors said he failed to take the required drugs and his body rejected the limb.

The double-forearm recipient, Denis Chatelier from France, said in 2003 that he had regained ”normal usage” of his hands and was even able to shave himself. His forearms were severed in a model rocket accident.

Doctors from Jinling Hospital in Nanjing, China, reported that in September 2003, they transplanted two ears, part of the scalp and other facial skin from a brain-dead young man to a 72-year-old woman with advanced skin cancer.

Four months later, there were no signs of rejection or tumor recurrence, but it is not known how the patient fared after that.

Doctors around the world have performed partial face transplants using the patients’ own skin, but these don’t require anti-rejection drugs.

——

Associated Press writers Emma Ross in London, Marilynn Marchione in Milwaukee, Wisconsin, and John Leicester in Paris contributed to this report.

 

The Economy

November 30, 2005
Economic Memo

Upbeat Signs Hold Cautions for the Future

By VIKAS BAJAJ

Gasoline is cheaper than it was before Hurricane Katrina slammed into New Orleans. Consumer confidence jumped last month and new- home sales hit a record. The stock market has been rising. Even the nation’s beleaguered factories seem headed for a happy holiday season.

By most measures, the economy appears to be doing fine. No, scratch that, it appears to be booming.

But as always with the United States economy, it is not quite that simple.

For every encouraging sign, there is an explanation. Consumer confidence is bouncing back from what were arguably some of its worst readings in years. Gasoline prices – the national average is now $2.15, according to the Energy Information Administration – have fallen because higher prices held down demand and Gulf Coast supplies have been slowly restored.

The latest reading on home sales, released yesterday, contradicts most recent measures of housing activity, which generally indicate a slowdown. And, yes, manufacturers’ fortunes are on the mend, but few besides airplane makers are celebrating.

It all means the economy is likely to end the year with a splash. But before you splurge on a new car, consider this: Many economists do not expect the party to continue, especially if the Federal Reserve continues taking the punchbowl away and raises interest rates. That could further slow the housing market, damp consumer spending and crimp corporate profits.

Indeed, the Organization for Economic Cooperation and Development said yesterday that 2005 growth would most likely settle at 3.6 percent, down from 4.2 percent in 2004. The organization also forecast 2006 growth at 3.5 percent, but other economists think that may be too optimistic.

"The two major concerns are the extent of slowdown in housing and how it can feed into growth and consumer spending," said Joshua Shapiro, chief United States economist at Maria Fiorini Ramirez Inc., a research firm in New York.

Many analysts, including Mr. Shapiro, say a housing slowdown is already under way. Along with rising interest rates and anemic job growth, any such drop-off could sap the economy next year – by just how much is still subject to debate.

Americans have taken advantage of historically low mortgage rates to buy homes, refinance existing loans and borrow money for renovations or other household needs, all of them important and substantial spurs to spending, Mr. Shapiro said. 00

While neither he nor others expect that activity to dry up, even a modest tapering off could knock growth down a peg or two. Mr. Shapiro, for one, says growth could drop from 3.5 percent in 2005 to 3.2 percent in 2006.

The average interest rate on a 30-year, fixed-rate mortgage was 6.28 percent last week, up from a low of 5.53 percent in June, according to Freddie Mac, the housing-finance company.

The Commerce Department said yesterday that new-home sales jumped 13 percent in October, to an annual pace of 1.42 million, a record. But that contradicted earlier data showing sales of existing homes slowing, construction activity easing, mortgage applications falling and confidence declining among home builders.

Two possible explanations for the record pace of new-home sales are that buyers see a final opportunity to purchase a new house before interest rates go up again, and they are taking advantage of sales incentives that some home builders are now offering. But not everyone agrees.

"I basically have a wait-and-see attitude with some healthy suspicion about this report," said David F. Seiders, chief economist at the National Association of Home Builders. "Either there is something that all of those other reports are not telling us, or this will get revised."

In another seemingly upbeat report, the Conference Board, a research group supported by business, said consumer confidence jumped 16 percent. Still, it is below the pre-Katrina level. And the Commerce Department said orders for durable goods – big-ticket items that last more than three years – jumped 3.4 percent, but most of that increase was concentrated in military and commercial planes.

In addition to housing, the Federal Reserve and businesses will have a big part in setting the economy’s pace next year – the Fed through interest rates and companies by their hiring decisions.

There is great speculation about how much more the Fed, where Ben S. Bernanke is expected to succeed Alan Greenspan as chairman in February, will raise its benchmark short-term rate, now at 4 percent, before Mr. Greenspan leaves.

There is also the question of whether Mr. Bernanke will feel compelled to prove his inflation-fighting mettle by nudging them higher still. The question may seem like splitting hairs, especially when the debate is whether the rate will be 4.5 percent or 4.75 percent, but it certainly has investors’ attention.

The recent rally in the bond market, which is considered a haven in periods of economic stress, indicates that many investors are betting that the Fed "is likely to overshoot in its tightening," Ethan S. Harris, chief United States economist at Lehman Brothers, wrote in a note to clients.

A harder question, and one that could greatly influence policy makers, is whether business will pick up any of the slack if consumers are no longer spending as much.

So far the evidence is inconclusive.

After adding an average of 202,000 jobs a month for the first seven months of the year, companies hit a slow patch late in the summer. In August, businesses created just 148,000 jobs; that was followed by a decline of 8,000 in September after Katrina. And just when economists expected a big bounce back in October, the Labor Department reported a net increase of just 56,000 jobs.

Analysts are eagerly awaiting the Labor Department’s next jobs report, out Friday, and hoping the recent weakness will prove temporary. But they worry that job creation may turn out to be disappointing because of deep-rooted concerns about thinning profit margins, caused by, among other things, high energy costs.

"This is only a fear that has sprung up recently," said Mr. Shapiro of Maria Fiorini Ramirez.

Economists expect 220,000 new jobs will be created, according to a survey by Bloomberg News.

Another hard-to-measure factor that could have a positive bearing on both businesses and consumers is rebuilding activity in the Gulf Coast and parts of Florida. The reconstruction that accompanies major disasters has been known to have a greater economic impact than the initial series of shocks.

Many analysts say a housing-led slowdown is likely to be delayed until the second half of 2006 because billions of dollars that the federal government and insurance companies are starting to pump into hurricane-affected regions will make up for softer consumer spending.

"That is going to push up production activity into the first half of the year," said Michael C. Fratantoni, an economist at the Mortgage Bankers Association, which expects 3.7 percent economic growth in 2006, up from 3.6 percent in 2005. "The second half of the year, we see somewhat of a drop-off."

Grateful Dead Backlash

Kristy McDonald/Associated Press

Grateful Dead’s former lead singer, the late Jerry Garcia, in Oakland, Calif., in 1992.

November 30, 2005

Deadheads Outraged Over Web Crackdown

The Grateful Dead, the business, is testing the loyalty of longtime fans of the Grateful Dead, the pioneering jam band, by cracking down on an independently run Web site that made thousands of recordings of its live concerts available for free downloading.

The band recently asked the operators of the popular Live Music Archive (archive.org) to make the concert recordings – a staple of Grateful Dead fandom – available only for listening online, the band’s spokesman, Dennis McNally, said yesterday. In the meantime, the files that previously had been freely downloaded were taken down from the site last week.

Dissent has been building rapidly, however, as the band’s fans – known as Deadheads – have discovered the recordings are, at least for the time being, not available. Already, fans have started an online petition, at www.petitiononline.com/gdm/petition.html, threatening to boycott the band’s recordings and merchandise if the decision is not reversed. In particular, fans have expressed outrage that the shift covers not only the semiofficial "soundboard" recordings made by technicians at the band’s performances, but also recordings made by audience members.

To the fans, the move signals a profound philosophical shift for a band that had been famous for encouraging fans to record and trade live-concert tapes. The band even cordoned off a special area at its shows, usually near the sound board, for "tapers" – a practice now followed by many younger jam bands.

But more broadly, it suggests that a touchstone of baby-boomer counterculture – the recording made by and shared, sometimes via mail, among hard-core fans – may be subverted in a digital era when music files can be instantly transmitted worldwide.

The move comes as the group, which disbanded after the 1995 death of its leader and ringmaster, Jerry Garcia, has begun selling downloads of its live concerts through its own official Web site. The band (whose surviving members – the guitarist Bob Weir, the bassist Phil Lesh and the drummers Mickey Hart and Bill Kreutzmann – have since played together under the more compact name the Dead) sells album-length recordings of the shows at prices that can run from about $8 to roughly $16 a copy.

Unlike the digital files sold at popular music services like Apple Computer’s iTunes or Real Networks’ Rhapsody, the band sells its music as files that can be copied and transferred without restriction.

The independently operated Live Music Archive evidently posed unwelcome competition.

"These folks assembled a Deadhead’s dream collection and made it available," Mr. McNally said. "When we discovered it, we decided to take a wait-and-see approach. Eventually, it was the band’s conclusion, after a long discussion with them, to request that they change their policies" and make the live recordings available only as streams.

The contretemps makes clear that the band’s decades-long support of fan recordings and trading did not anticipate the popularity of music online.

"One-to-one community building, tape trading, is something we’ve always been about," Mr. McNally said. "The idea of a massive one-stop Web site that does not build community is not what we had in mind. Our conclusion has been that it doesn’t represent Grateful Dead values."

Most fans, he continued, "understand they were being granted an extraordinary privilege, and they responded by taking it very seriously" by respecting the band’s wishes not to sell their live recordings. "This is not the same situation," he added.

David Gans, who is the host of a syndicated radio program, "The Grateful Dead Hour," said in an interview yesterday that the battle is rooted in the band’s "historically lackadaisical attitude toward their intellectual property." He added: "When they were making $50 million a year on the road, there wasn’t a lot of pressure to monetize their archives." Now, however, it may be difficult to put the genie back in the bottle. While the move to revise the Live Music Archive may deal a blow to what many fans considered an organized library of material, "the idea that they could stop people from trading these files is absurd," Mr. Gans said, adding: "It’s no longer under anyone’s control. People have gigabytes of this stuff."

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