Thursday, November 19, 2009
Two sisters joined at the head have survived 29 hours of surgery to separate them.
Krishna and Trishna, whose mother died giving birth to them in Bangladesh almost three years ago, were operated on in Melbourne by 16 surgeons.
Anaesthetists, nurses and other medics also worked around the clock in a procedure that lasted 16 hours longer than expected.
Leo Donnan, head of surgery at the Royal Children's Hospital, said it was a once-in-a-lifetime operation for the medical team and every minute was tense.
Trishna (L) and Krishna (R), the Bangladeshi set of twins joined at the head before the operation to separate them
The toddlers have a 25 per cent chance of making it through without any harm at all - and there was also the strong possibility that one or both could die.
But after a team of 16 surgeons, assisted by anaesthetists, nurses and other medical staff had worked around the clock in rotation, Mr Donnan stepped from the operating theatre to announce with a smile: 'They have been successfully separated.'
The dangerous operation had taken nearly 13 hours longer than anticipated - including 27 hours to separate the little girls, aged two years and 11 months, and a further two hours of work by plastic surgeons to seal the ensuing holes in their heads.
And although Mr Donnan said there was 'still is a long way to go' with the girls having a 'very difficult time ahead of them,' he said that the way the operation had gone was an historic moment for the hospital and for the twins 'an even more historic moment.'
The Royal Children's Hospital surgical team operate to separate twins Krishna and Trishna
Leo Donnan (C), chief of surgery at Royal Children's Hospital, speaks to the media after Australian doctors successfully separated the twins
The twins had come to the attention of a Melbourne-based organisation, Children First Foundation, which arranged for them to be flown to Australia for an operation that could give them a new start in life - if successful.
After weeks of careful planning, studying X-rays and monitoring the children's daily health and behaviour, the medical teams arranged their working hours, fully aware that the task ahead would not be easy.
On Monday Krishna and Trishna were anaesthetised and placed faced down on two adjoining operating tables. Plastic surgeons stepped forward to open up the skin and then neurosurgeons carefully opened a small area in the skull.
This 'window' allowed surgeons to insert their instruments to separate the brain tissue and blood vessels at the back of the girls' heads.
Krishna and Trishna pictured a year after they were born
Next the twins were carefully lifted and turned over so they were face up, enabling surgeons to complete the separation of the skulls.
Bone had to be severed and connecting tissue separated.
Finally, for the first time, the twins were able to be moved apart and two teams of plastic surgeons set to work sealing the holes in their skulls.
'This is a once-in-a-lifetime operation that teams would do,' said Mr Donnan, adding that the mood inside the operating theatre, where every minute was filled with tension, had changed after the separation.
'It's been a very nice stage to move into,' he said.
And there had been concerns, with problems occurring with Krishna's kidney, but when that crisis eased everyone, according to plastic surgeon Tony Holmes, 'was particularly optimistic and excited.'
He explained there had been a great deal of preparatory work before the operation could even begin.
'There's a lot of mucking around at the beginning of an operation like this,' said Mr Holmes.
'It's mainly for positioning and getting all the tubes right so there's no pressure on the eyes, no kinks in the tubes.'
Mr Holmes and another plastic surgeon, Andrew Greensmith stripped back the skin and that allowed neurosurgeons to create a one inch by seven inch window in the skull so that surgeons Wirginia Maixner and Alison Wray could separate blood vessels and brain matter.
Later the plastic surgeons came back to the girls, closing the brain lining and skulls with artificial caps and closing the skin.
The twins are now in intensive care. It will be weeks before it is known if the operation has been 100 per cent successful - but surgeons said they were remaining optimistic.
- How doctors worked a medical miracle and separated the twins:
Read more: http://www.dailymail.co.uk/news/worldnews/article-1228500/Conjoined-orphaned-twins-Krishna-Trishna-successfully-separated-29-hour-operation.html#ixzz0XKpT3QR2
I didn't know, so I figured I'd give it a shot. I brought an ancient and non-functioning 1987 Macintosh Plus 1MB to the Apple Store in the Meatpacking District in NYC, and this is what happened.
Overall, they were surprisingly unfazed by my request for repairs. They were impressed that I had it, and seemed genuinely interested in helping me get it fixed. They couldn't do anything for me, since Apple only keeps equipment from the last five years on hand, but they pointed me towards Tekserve, another Apple-centric store in NYC.
Thanks to Nick McGlynn and Gawker.tv for shooting the hidden camera footage!
Send an email to Adam Frucci, the author of this post, at firstname.lastname@example.org.
Last week I did a post I had wanted to do for a long time featuring some great slow-motion videos. Today I decided to go the reverse route and look for some great videos using time-lapse photography. I looked at a lot of videos on various topics and as I was perusing I came across an artist named Nico Di Mattia who uses Photoshop to create some of the most amazing works of art you will ever see. Here are the 10 I liked the most...
A hot armed girl
John Locke from Lost
Jennifer Love Hewitt as The Ghost Whisperer
Kiefer Sutherland as Jack Bauer
The Dark Knight
by: Sebastian Blanco
Toyota Hybrid X Concept - click above for high-res image gallery
Exactly how the Prius name navigates the shift from defining the world's most famous hybrid to it's own sub-brand – "Not!" – or moniker for other Toyota hybirds – "Yes!" – has been a source of interest for quite some time. The latest bit of speculative news comes from the Yomiuri newspaper in Japan (via Green Car Advisor) that the automaker is considering building a Prius sport wagon or a Prius SUV about 12 months from now, maybe using lithium-ion batteries (despite Toyota's public pronouncements). Toyota officials would not comment to the Yomiuri about the report.
As we saw with the Hybrid X (above) unveiled at the Geneva Motor Show in 2007, Toyota has been thinking about a Prius wagon for a while. Green Car Advisor speculates that the the Venza could be a good candidate for the production wagon, while any of Toyota's JDM wagons could make the transition to hybrids here. As for a Prius SUV? Tone down the Lexus RX 400h and there you go.
[Source: Yomiuri via Green Car Advisor]
Health, law enforcement officials bemoan greater public tolerance of drug
By Steve Hendrix
Washington Post Staff Writer
Joe Lee, 62, a regular pot smoker, runs a vintage-record shop in Rockville. He says he has noticed more public acceptance of the drug than when he used it while an art student in Baltimore in the 1960s. (Bill O'leary/the Washington Post)
Smoking pot isn't what it used to be for Joe Lee, a 62-year-old vintage-record dealer in Rockville.
Back in the late 1960s, as an art student in Baltimore, he kept his landlord in a constant state of suspicion, with clouds of marijuana smoke poorly masked by clouds of incense.
These days, after four decades of regular use, cannabis is a smaller deal. Lee takes a few hits every other day or so, when he wants to listen to music or laugh with a few friends on the porch. And he's happy to talk about it.
"There's gotten to be greater tolerance, that's for sure," said Lee, the son of one-time acting Maryland governor Blair Lee III. "I know literally hundreds of people my age who smoke. They are upright citizens, good parents who are holding down jobs. You take two or three puffs, and you're good to go. I'm not a Rastafarian; I don't treat this as some holy sacrament. But pot is fun."
A federal survey of Americans' drug use shows that Lee and his friends are not the only baby boomers approaching the age of retirement much as they departed the Age of Aquarius -- with an occasional case of the munchies. The government's most recent survey showed that the share of marijuana users ages 50 to 59 increased from 5.1 percent in 2002 to almost 10 percent in 2007.
Some of those users are empty-nesters, returning to the drug decades after their pot habits gave way to raising children and building careers. Others, like Lee, have kept using pot all along, researchers said.
"We're concerned by the public health impact of this," said Peter Delany, who heads the office in the Substance Abuse and Mental Health Services Administration that conducts the survey. Marijuana could present special problems for older users, he said, including unknown interactions with prescription drugs. "Doctors need to be more sensitive to it," he said. "They may ask older patients about alcohol now but not think to ask about illicit drug use."
But some older marijuana users say they are living evidence that smoking pot does not preclude a normal life, and more older smokers seem more comfortable than at any point since their teen years with going public -- a tribute, they say, to a big boost in public tolerance of marijuana use.Mainstreaming marijuana
In parts of California, licensed medical marijuana dispensaries have become as common as In-N-Out Burger stands. At least 13 other states allow some form of pot use for medicinal purposes, and the Obama administration announced last month that federal prosecutors would no longer go after medical users in those states, a policy shift that activists hailed as a watershed.
Last week, in a reversal, the American Medical Association called for a review of marijuana's status as a Schedule 1 hard drug alongside LSD and PCP and for more study of its medicinal potential.
In May, California's Republican governor, Arnold Schwarzenegger, said it was "time for a debate" on the merits of legalizing and taxing the drug. Nationally, support for legalization has jumped to its highest level in 40 years, up in a Gallup poll from 31 percent in 2000 to 44 percent last month.
In much of American pop culture, the taboo against smoking pot lies largely in ashes -- in ubiquitous references in hip-hop music and in TV programs such as Showtime's "Weeds." Even iconic potheads Cheech Marin and Tommy Chong are in vogue again, back on the road with their 22-city "Light Up America" comedy tour.
All of which adds up to what some commentators see as marijuana's steady march into the mainstream. Conservative pundit George Will recently declared the drug "essentially legalized" in California and predicted that the rest of the nation would follow suit.
That shift in atmosphere has encouraged more older users to take their pot habits public.
"I don't think more people in their 50s are smoking marijuana. I think we are just more comfortable talking about it," said Rick Steves, who writes travel guidebooks and hosts a public TV series on travel. At 54, the clean-cut guru of mass-market European tourism has begun to present himself as the hard-working, successful face of the longtime smoker.
"Even my pastor knows I smoke pot," said Steves, who was recently named Lutheran activist of the year for his work on international poverty relief.
"It's just not that big a deal anymore. It's another recreational drug, like alcohol."
For Steves, the starkest sign of pot's growing acceptance is the annual Hempfest, which draws tens of thousands of marijuana enthusiasts each summer to a park in his home town of Seattle. But he said he has detected a change in more straitlaced cities, including the District, which he visited last week to see his daughter at Georgetown University.
"When I stepped out of my daughter's apartment, a couple of guys were passing a bong on the front stoop," Steves said. "They weren't self-conscious at all."
Although young users generally go to some lengths to keep their pot use under wraps, those of a certain age -- especially those not in danger of being kicked out of school or subjected to workplace drug tests -- seem more likely to talk about their usage.
"It seems the stereotype of the marijuana user as a goofy teenage boy has begun to change," said Shelby Sadler, 48, a freelance editor from Rockville. She described a wide circle of professional friends in the Washington area, many of them women, who use the drug socially. "They are less inclined to hide it now. The kids are gone, and they no longer have to worry about losing their jobs because they're the ones doing the hiring."
Sadler, who was journalist Hunter S. Thompson's longtime editor and works on books with historian Douglas Brinkley, said she smokes a few times a month, usually with friends. The only difference now, compared with when she started at Cornell University, is the clothing.
"Then, it was Crazy Horse crewneck sweaters and oxford shirts," said Sadler, who is editing a history of pot by Keith Stroup, founder of the National Organization for the Reform of Marijuana Laws. "Now I dress like Hillary Clinton."Police, others disagree
Drug counselors bemoan the softening views on marijuana, saying that it complicates their efforts to steer addicts away from illicit substances.
"It's more of a struggle for us when the parents just see heroin or cocaine as the dangerous drugs and sort of turn their heads with marijuana," said Carol Porto, who runs an inpatient drug treatment center in Calvert County.
Most Washington area police departments enforce the laws that make marijuana illegal, officials said. A Montgomery County police spokesman would not comment other than to say that the department has seen no spike in marijuana use by older residents and is not targeting those users.
One older smoker who doesn't mind outing herself is Florence Siegel, an 88-year-old artist from New York who has been smoking regularly since her early 50s. That's when the family's pediatrician suggested they try marijuana together to see "what the kids were so excited about." The pediatrician didn't feel a thing. Siegel said she never stopped.
Now her routine is to sit in her favorite chair each evening, listen to Bach and take a few hits from one of her many pipes. Marijuana boosts her creativity and helps with joint pain that has come with aging, she said.
Siegel smokes occasionally with her daughter Loren Siegel, 64, a recently retired lawyer. But does her 93-year-old husband ever join her?
"Oh, no," she said. "Well, only very rarely."