Doctors transplant windpipe with stem cells

Breakthrough windpipe transplant uses stem cells Play Video AP  – Breakthrough windpipe transplant uses stem cells
In this image released by the Hospital Clinic of Barcelona on Tuesday, Nov. 18, AP – In this image released by the Hospital Clinic of Barcelona on Tuesday, Nov. 18, 2008, a procedure used …

LONDON – Doctors have given a woman a new windpipe with tissue grown from her own stem cells, eliminating the need for anti-rejection drugs.

"This technique has great promise," said Dr. Eric Genden, who did a similar transplant in 2005 at Mount Sinai Hospital in New York. That operation used both donor and recipient tissue. Only a handful of windpipe, or trachea, transplants have ever been done.

If successful, the procedure could become a new standard of treatment, said Genden, who was not involved in the research.

The results were published online Wednesday in the medical journal, The Lancet.

The transplant was given to Claudia Castillo, a 30-year-old Colombian mother of two living in Barcelona, suffered from tuberculosis for years. After a severe collapse of her left lung in March, Castillo needed regular hospital visits to clear her airways and was unable to take care of her children.

Doctors initially thought the only solution was to remove the entire left lung. But Dr. Paolo Macchiarini, head of thoracic surgery at Barcelona's Hospital Clinic, proposed a windpipe transplant instead.

Once doctors had a donor windpipe, scientists at Italy's University of Padua stripped off all its cells, leaving only a tube of connective tissue.

Meanwhile, doctors at the University of Bristol took a sample of Castillo's bone marrow from her hip. They used the bone marrow's stem cells to create millions of cartilage and tissue cells to cover and line the windpipe.

Experts at the University of Milan then used a device to put the new cartilage and tissue onto the windpipe. The new windpipe was transplanted into Castillo in June.

"They have created a functional, biological structure that can't be rejected," said Dr. Allan Kirk of the American Society of Transplantation. "It's an important advance, but constructing an entire organ is still a long way off."

So far, Castillo has shown no signs of rejection and is not taking any immune-suppressing drugs, which can cause side effects like high blood pressure, kidney failure and cancer.

"I was scared at the beginning," Castillo said in a press statement. "I am now enjoying life and am very happy that my illness has been cured."

Her doctors say she is now able to take care of her children, and can walk reasonable distances without becoming out of breath. Castillo even reported dancing all night at a club in Barcelona recently.

Genden said that Castillo's progress needed to be closely monitored. "Time will tell if this lasts," he said. Genden added that it can take up to three years to know if the windpipe's cartilage structure is solid and won't fall apart.

People who might benefit include children born with defective airways, people with scars or tumours in their windpipes, and those with collapsed windpipes.

Martin Birchall, who grew Castillo's cells at the University of Bristol, said that the technique might even be adapted to other organs.

"Patients engineering their own tissues is the key way forward," said Dr. Patrick Warnke, a surgeon at the University of Kiel in Germany. Warnke is also growing patients' tissues from stem cells for transplants.

Warnke predicted that doctors might one day be able to produce organs in the laboratory from patients' own stem cells. "That is still years away, but we need pioneering approaches like this to solve the problem," he said.

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The Male DR Nurse

by phatreecio

Being an intern is a challenging experience. We have to rotate unto several wards and sections in order to be able to fully appreciate all the fields of the Nursing profession. And what really was very upsetting on my end was being assigned at the delivery room. Well, I'm a male and sometimes, pregnant women feel awkward when the "xy" chromosomed human being joins this special section. And the dreadful day came, I can still imagine that very moment when our instructor announced my name being listed as one of those who will have their duty inside the delivery room. "Mr. Stuart, you'll be reporting this Thursday at the delivery room. Ms. Smith, Ms. Jones and Ms. Roberts will join you as well!"

In order to save myself from being nervous on my first day, I went to the place ahead of time. I was wearing my scrubs but still, my hands were cold and my heart is pounding like crazy. I just can't seem to relax. My instructor called our names. "Stuart, Patrick?!". Silence. "Again?! Stuart, Patrick?!" "Oh my! Ma'am, I am very sorry, Present!" My thoughts were flying. I keep on telling myself that this feeling shall pass soon. The instructor introduced herself. “I am Ms. Cindy Periwinkle, and I will be assisting you here in the delivery room. You will be graded according to your skills, knowledge, and the application of your related learning experience. “

We were distributed all throughout the section to maximize our workforce. I was assigned at the pre-natal area. As I walked along the aisle of the reception area, I noticed a woman around her late 30’s. She was brown-skinned, with thin hair, dry lips, and bulging eyes. I looked at her tummy and I roughly estimated that she’s on her due date. She looked at me with a curious look and I sat down in front of my assigned seat. I looked at her chart. It says G4P3 and I was not wrong, she’s approaching her due date. My instructor brought here inside the examination area. While I was writing down something on the logbook, I heard my instructor calling my name. “Patrick! Wear your mask, cap, and sterile gloves!” My heart started to throb. Lub-dub. Lub-dub. I started to become nervous again. I entered the room and voila. I saw the woman on the examination table with legs spread apart revealing her privates. She looked at me again with this curious stare. My instructor called my attention and said, “I’m going to teach you how to do the internal exam to assess how many cm the cervix had dilated. You first need to spread the labia with your thumb and little finger and then slowly insert your index and middle finger.”

It felt so uncomfortable and due to my overwhelming anxiety at that moment, what I did was to immediately insert my index and middle finger and it did enter the vagina without that much trouble. My instructor told me that it was wrong and I have to do it again. So, I removed my gloves and put on a new set of sterile gloves. I slowly spread the labia but it kept on going back to its previous position. I can’t seem to perfect it. Next thing I knew was I am slowly forcing my fingers deep into the vagina to feel the cervix. My instructor told me, “You will feel something hard. It feels like touching your ears. Pretending that I felt it to end this misery as soon as possible, I said, “Yeah! It’s there. Wow. Amazing!” She then asked me, “How many cm?” And because I was upset, I shouted, “Umm. 20 cm” I can see my instructor was about to burst in laughter but she didn’t to be professional. “No, she has a 6 cm dilatation and she will be giving birth for the next 24-48 hours. I felt that I turned red that moment and said “Oh! I’m, I’m sssorry Ma’am, T-TTThanks for the information!”

I went out and rested for a while outside to relax. I saw the full-term pregnant woman and she was smiling and her eyes looked funny. I returned a smile and I believe I blushed at that moment.

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New marrow transplant has success against sickle cell

Doctors at UPMC Children's Hospital of Pittsburgh and two other centers have completely cured sickle cell anemia in six out of seven patients using a new, less toxic approach to bone marrow transplantation.

The patients, five of whom were treated at Children's by Dr. Lakshmanan Krishnamurti, got bone marrow from siblings after a reduced-intensity preparation of their bodies for the transplants, according to a study being published in the journal Biology of Blood and Marrow Transplantation.

The less intensive use of chemotherapy and radiation before the transplants cut the risks that come from completely wiping out a patient's bone marrow before the procedure.

Sickle cell anemia is an inherited disease that damages red blood cells and is particularly prevalent among African-Americans. It causes pain, breathing problems, strokes and organ damage and can shorten lifespans by 25 to 30 years. Bone marrow transplants, which create the ability to make healthy red blood cells from the donor, are the only known cure.

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Hope College estimates 400 students, staff struck by norovirus-like illness

HOLLAND -- Hope College looked like a ghost town on Sunday -- day four of a contagious noroviris-like outbreak which caused Ottawa County Health Department officials to order the campus to close Friday.

Hope College officials say since Friday, more than 400 staff and students have come down with symptoms of the nasty flu that has been knocking down people like bowling pins.

The small liberal arts college is now unlikely to open before Wednesday, according to the college.

Earlier Sunday, the college said the number of reported cases of the flu-like illness causing vomiting and diarrhea for 24 to 48 hours climbed to 180, but many students felt those numbers self-reported to the health department are low.

"About half my friends have gotten sick and several didn't go to a clinic because it's a viral illness and doctors can't really do anything for you, anyway," said Katie Opatik-Duff, a freshman.

She created a Facebook page for the campus community called "Hope College: The Great Plague of 2008," because she wanted to find out how many people the brief but miserable illness laid low.

About one third of the 3,200 campus community had registered at the site Sunday, 14 percent of whom said they are sick or had been.

"It's a pretty good representative sample, and based on it my estimate is that 400 people got sick," said Duff, who returned home to Middleville on Friday to try to avoid getting sick. She lives in Dykstra Hall, which was hard-hit by the virus.

By Sunday evening, the college had updated its sickness numbers.

"Many of the reports are coming from students who chose to leave campus when the order was issued on Friday and are now ill," reads a statement from the college issued around 5:30 p.m.

Health officials strongly urged students to remain on campus, but not congregate, to help stop the spread of the infection. Many students able to travel decided to go home, anyway. People typically remain contagious three days after recovering, health officials said.

Students are trying to keep a sense of humor about the mystery bug. The Facebook page offers T-shirts for sale that say "Norovirus '08" on the front and "Victim -- The college is not being quarantined ... students are encouraged to remain calm" on the back.

Campus cleaning crews were busy last weekend inside all campus buildings, sanitizing common surfaces. Phelps Dining Hall, the main cafeteria on campus, has re-opened for take-out orders served in disposable containers.

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