Latest Face Transplant Surgeries Restore Form and Function

By Jeffrey Soares, USAMRMC Public Affairs

At the 2012 Medical Health System Research Symposium in Fort Lauderdale, Fla., high-tech programs and products are being discussed by researchers focused on translating futuristic technology into modern-day practice.

In the 1990 sci-fi film “Total Recall,” Arnold Schwarzenegger’s character receives a new face via high-tech methods, so that he can elude pursuers.  The image causes viewers to imagine a world where this is not only possible, but typical.  Today, providing a new face to someone in need is on its way to becoming typical thanks to the work of researchers such as Dr. Eduardo Rodriquez, who is the chief plastic surgeon at the R Adams Cowley Shock Trauma Center at the University of Maryland.

In his Aug. 14 presentation, “Comprehensive Facial Transplantation,” Rodriquez conveyed how he and his surgical team at Maryland used every resource available during a 36-hour surgery to attach a healthy donor face to a 37-year-old gunshot victim whose own face was disfigured.  The procedure is considered to be the most extensive operation of its kind ever performed.

Although the patient, Richard Lee Norris, is a civilian from rural Virginia, Rodriquez described the implications for warfighters.

“The ultimate goal of this project was to treat the wounded warrior,” Rodriquez said.  “We wanted to develop a strategy that would essentially reconstruct the massive disfigurement of the face of soldiers [wounded in battle].”  He added that beyond appearance the goal is to restore function.

“As injuries between the lower face and upper face are considered very difficult injuries to treat, the operation to repair these injuries must be proportionate to the problem in order to take these patients to the next level,” Rodriquez explained.

Rodriquez and his team -- specialists in craniofacial surgery and microsurgery -- spent hundreds of hours in rigorous training and rehearsal before the patient ever entered the operating room.  In a procedure of this magnitude, no margin of error could be tolerated by the surgical team.  They studied the underlying relevant clinical anatomy to ensure proper transplantation, and they also considered the procedure from an aesthetic perspective, to see where incisions could be placed in order to go undetected.

The team used computerized surgical planning to ensure the exact transfer of the donor face to the patient, and they were extremely thorough in aligning the oral/dental/tongue configuration during the transfer to ensure that the patient could chew and speak correctly.

Considering the magnitude of this procedure, it is nothing short of amazing that the patient is recovering on schedule at this time.  Upon showing a comparison photo of Norris prior to and following the extensive surgery, Rodriquez himself appeared a bit surprised -- and pleased -- about the recovery.

“You can appreciate the dramatic change in this individual’s not only appearance but also function,” Rodriquez said.  “This would not have been possible with conventional measures.”

The doctor and his team plan to continue performing state-of-the-art craniofacial reconstructions, with a goal of 3-5 facial transplantation surgeries per year.

NASA, State Department and Veteran Affairs Innovation Initiative Host Open Source Summit

Sonja Alexander

Headquarters, Washington     

202-358-1761

sonja.r.alexander@nasa.gov

WASHINGTON -- Registration for the second Open Source Summit, hosted by NASA, the U.S. State Department and the Veteran Affairs Innovation Initiative to advance the use of open source software in government, is under way. The event will be held June 20-21 at the Robert H. Smith School of Business at the University of Maryland in College Park, Md.

The summit will convene leaders from government and industry as well as software practitioners to discuss the development, release and use of open source software, which is characterized by a collaborative development process and free user access.

Discussion topics will include the current and future state of the government open source community, how-to insights for open source projects in government, real-world projects and their successes and challenges, and government procurement of open source software.

As the role of open source in government expands and matures, the relationship between technology, policy and culture will be increasingly important. Open source brings numerous benefits to government software projects, including increased software quality, reduced development costs, faster development cycles and reduced barriers to public-private collaboration through new opportunities to commercialize technology. This inherently transparent, participatory, and collaborative approach is revolutionizing the way software is created, improved and used.

For more information and to register, visit http://open.nasa.gov/summit.

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Where Have All the Hummingbirds Gone?

Glacier lilies and broad-tailed hummingbirds out of sync

The glacier lily as it's called, is a tall, willowy plant that graces mountain meadows throughout western North America. It flowers early in spring, when the first bumblebees and hummingbirds appear.

Or did.

The lily, a plant that grows best on subalpine slopes, is fast becoming a hothouse flower. In Earth's warming temperatures, its first blooms appear some 17 days earlier than they did in the 1970s, scientists David Inouye and Amy McKinney of the University of Maryland and colleagues have found.

The problem, say the biologists, with the earlier timing of these first blooms is that the glacier lily is no longer synchronized with the arrival of broad-tailed hummingbirds, which depend on glacier lilies for nectar.

By the time the hummingbirds fly in, many of the flowers have withered away, their nectar-laden blooms going with them.

Broad-tailed hummingbirds migrate north from Central America every spring to high-mountain breeding sites in the western United States. The birds have only a short mountain summer to raise their young. Male hummingbirds scout for territories before the first flowers bloom.

But the time between the first hummingbird and the first bloom has collapsed by 13 days over the past four decades, say Inouye and McKinney. "In some years," says McKinney, "the lilies have already bloomed by the time the first hummingbird lands."

The biologists calculate that if current trends continue, in two decades the hummingbirds will miss the first flowers entirely.

The results are reported in a paper in the current issue of the journal Ecology. In addition to McKinney and Inouye, co-authors of the paper are Paul CaraDonna of the University of Arizona; Billy Barr of the Rocky Mountain Biological Laboratory in Crested Butte, Colo.; David Bertelsen of the University of Arizona; and Nickolas Waser, affiliated with all three institutions.

"Northern species, such as the broad-tailed hummingbird, are most at risk of arriving at their breeding sites after their key food resources are no longer available, yet ecologists predict that species will move northward as climate warms," says Saran Twombly, program director in the National Science Foundation's Division of Environmental Biology, which funded the research.

"These conflicting pressures challenge society to ensure that species don't soon find themselves without a suitable place to live."

Broad-tailed hummingbirds that breed farther south have fewer challenges.

"In Arizona, for example," says Inouye, "there's no obvious narrowing of the timing between the first arriving males and the first blooms of, in this case, the nectar-containing Indian paintbrush."

Higher latitudes may be more likely to get out of sync ecologically because global warming is happening fastest there.

As the snow continues to melt earlier in the spring, bringing earlier flowering, says Inouye, the mountains may come alive with glacier lilies long before hummingbirds can complete their journey north.

"Where have all the flowers gone?" then will be "where have all the hummingbirds gone?"

 -NSF-

NASA Administrator to Deliver Commencement Address at University of Maryland Eastern Shore

Lauren Worley

Headquarters, Washington                          

202-358-1288

lauren.b.worley@nasa.gov

 

Bill Robinson

University of Maryland Eastern Shore

410-621-2355

wrobinson3@umes.edu

WASHINGTON -- NASA Administrator Charles Bolden will provide the commencement address to the 2012 graduating class of the University of Maryland Eastern Shore in Princess Anne, Md., on Friday, May 18, at 10 a.m. EDT. The address will take place in the William P. Hytche Center.

Bolden also will be awarded the university's Presidential Medal for his service as a U.S. Marine and as an astronaut.

Media representatives who want to attend the event should contact Bill Robinson, director of the UMES Office of Public Relations at 410-621-2355 or wrobinson3@umes.edu.

UMES is a land-grant, historically black college founded in 1886. For more information about University of Maryland Eastern Shore, visit http://www.umes.edu.

For more information about Administrator Bolden, visit http://www.nasa.gov/about/highlights/bolden_bio.html.

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NASA'S Swift Narrows Down Origin of Important Supernova Class

J. D. Harrington

Headquarters, Washington

WASHINGTON -- Studies using X-ray and ultraviolet observations from NASA's Swift satellite provide new insights into the elusive origins of an important class of exploding star called Type Ia supernovae.

These explosions, which can outshine their galaxy for weeks, release large and consistent amounts of energy at visible wavelengths. These qualities make them among the most valuable tools for measuring distance in the universe. Because astronomers know the intrinsic brightness of Type Ia supernovae, how bright they appear directly reveals how far away they are.

"For all their importance, it's a bit embarrassing for astronomers that we don't know fundamental facts about the environs of these supernovae," said Stefan Immler, an astrophysicist at NASA's Goddard Space Flight Center in Greenbelt, Md. "Now, thanks to unprecedented X-ray and ultraviolet data from Swift, we have a clearer picture of what's required to blow up these stars."

Astronomers have known for decades that Type Ia supernovae originate with a remnant star called a white dwarf, which detonates when pushed to a critical mass. The environment that sets the stage for the explosion, however, has been harder to pin down.

According to the most popular scenario, a white dwarf orbits a normal star and pulls a stream of matter from it. This gas flows onto the white dwarf, which gains mass until it reaches a critical threshold and undergoes a catastrophic explosion.

"A missing detail is what types of stars reside in these systems. They may be a mix of stars like the sun or much more massive red- and blue-supergiant stars," said Brock Russell, a physics graduate student at the University of Maryland, College Park, and lead author of the X-ray study.

In a competing model, the supernova arises when two white dwarfs in a binary system eventually spiral inward and collide. Observations suggest both scenarios occur in nature, but no one knows which version happens more often.

Swift's primary mission is to locate gamma-ray bursts, which are more distant and energetic explosions associated with the birth of black holes. Between these bursts, astronomers can use Swift's unique capabilities to study other objects, including newly discovered supernovae. The satellite's X-ray Telescope (XRT) has studied more than 200 supernovae to date, with about 30 percent being Type Ia.

Russell and Immler combined X-ray data for 53 of the nearest known Type Ia supernovae but could not detect an X-ray point source. Stars shed gas and dust throughout their lives. When a supernova shock wave plows into this material, it becomes heated and emits X-rays. The lack of X-rays from the combined supernovae shows that supergiant stars, and even sun-like stars in a later red giant phase, likely aren't present in the host binaries.

In a companion study, a team led by Peter Brown at the University of Utah in Salt Lake City looked at 12 Type Ia events observed by Swift's Ultraviolet/Optical Telescope (UVOT) less than 10 days after the explosion. A supernova shock wave should produce enhanced ultraviolet light as it interacts with its companion, with larger stars producing brighter, longer enhancements. Swift's UVOT detected no such emission, leading the researchers to exclude large, red giant stars from Type Ia binaries.

Taken together, the studies suggest the companion to the white dwarf is either a smaller, younger star similar to our sun or another white dwarf. The X-ray findings will appear in the April 1 issue of The Astrophysical Journal Letters; the ultraviolet results appear in the April 10 edition of The Astrophysical Journal.

The ultraviolet studies rely on early, sensitive observations. As Brown's study was being written, nature provided a great case study in SN 2011fe, the closest Type Ia supernova since 1986. Early Swift UVOT observations show no ultraviolet enhancement. According to the findings in an unpublished study led also by Brown, this means any companion must be smaller than the sun.

Swift data on SN 2011fe also figure prominently in unpublished studies led by Alicia Soderberg at the Harvard-Smithsonian Center for Astrophysics in Cambridge, Mass. Preliminary results suggest that the explosion was caused by merging white dwarfs.

Swift launched in November 2004 and is managed by Goddard. It is operated in collaboration with Pennsylvania State University and other national and international partners.

For images related to this story, visit http://www.nasa.gov/swift.

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