SURGERY
Face transplant may be only way to restore speech THE race to conduct the first face transplant, albeit only partial, has been won by a French team, ahead of rivals in the US and the UK. But were the surgeons right to give 38-year-old Isabelle Dinoire a triangular flap of facial tissue containing the nose, lips and chin of a dead woman? Dinoire, who had been savaged by her dog, thanked the surgeons after waking from the 4-hour operation at a hospital in Amiens on 27 November. But some doctors and medical ethicists have questioned whether the team, led by Bernard Devauchelle and JeanMichel Dubernard, should have delayed the procedure until they had first tried repairing the wounds using conventional surgery. The French team has the support of its rivals, however. The key justification, they say, is that the transplant offered the only hope of giving the woman a functioning – and cosmetically normal – pair of lips. “If there is total amputation of both lips, I would dispute that there’s any conventional surgery that could correct that,” says Gordon Tobin of the
MICHAEL HUGHES/CORBIS
By Andy Coghlan
Isabelle Dinoire’s dog had savaged parts of her face
University of Louisville in Kentucky, whose team also plans to perform face transplants. “So I would agree with the French team doing the procedure.” Peter Barker, who heads another rival team at London’s Royal Free Hospital, echoed this view. The dog had bitten off Dinoire’s lips, chin and the tip of her nose after she had taken sleeping pills following a family argument. Since then, she had been unable to speak or eat properly. The difficulty with lips is that they are virtually useless unless they move. “You could have rebuilt a nice nose,” says Tobin. “But with the lips, the only option would have been to put up flaps of tissue from the chest. She would have had a poor cosmetic result, and virtually no functional capabilities.”
Dubernard and Devauchelle tackled this problem using a triangular graft taken from a brain-dead donor in Lille who was still on a life-support machine. As well as skin and fat, the graft contained a multitude of nerves, muscles, arteries and veins. During the operation, the surgeons stitched the arteries and veins to the corresponding vessels in the patient’s face, restoring blood flow to the graft. They then joined the networks of facial nerves and muscles needed to restore lip movement. Dinoire will now be given rehabilitation therapy to relearn how to speak and eat – she has reportedly already eaten strawberries and chocolate – but she will have to wait to see if full movement returns. 10 DECEMBER 2005
SUPERCONDUCTIVITY
HOT CONTENDER OUSTS CURRENT CHAMP By Melanie Cooper IN THE 1980s, “high-temperature superconductors” promised everything from magnetically levitating trains to resistance-free power lines and cheap MRI scanners. They have failed to deliver largely because they could not carry enough current. Now a material will not only conduct with zero resistance but has overtaken its rivals on the current it can carry. The material, magnesium diboride (MgB2), sparked a huge research effort after it was shown to superconduct earlier this year. The “off-the-shelf” chemical loses all electrical resistance below 39 kelvin. This is cold when www.newscientist.com
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compared with working temperatures of more than 100 kelvin reached by many chemically complex high-temperature superconductors. But it is almost double the temperature of any other simple metallic compounds. A key test for the material, however, is how much current it can carry. Three papers in this week’s Nature answer that question (vol 411, p 558, p 561 and p 563). One team, led by Chang-Beom Eom at the University of Wisconsin at Madison, persuaded MgB2 to carry higher currents when thin films of the material became contaminated with oxygen. David Caplin and colleagues at Imperial College London blasted the compound with
protons. At around 20 kelvin with a strong magnetic field, the material carried a current to compete with the best high-temperature superconductors. “What is needed now is a way, presumably chemical, of junking it up inexpensively,” says Caplin. A third group, led by Sungho Jin at Lucent Technologies’ Bell Labs in New Jersey, has made dense, iron-clad superconducting MgB2 wires. Paul Grant of the Electric Power Research Institute in Palo Alto, California, says these finds “make substantial progress towards improving the properties vital to high electric current and magnetic field applications”. 3 JUNE 2001 Fifty years of New Scientist | 31
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