China issues new rules on transplants
Sun, 08 Apr 2007 01:13:59 GMTBy GILLIAN WONG, Associated Press Writer
BEIJING - China published new rules governing human organ transplants in its latest effort to clean up a business critics say has little regard for medical ethics.
But the regulations were packed with shortcomings, a human rights group said Saturday, including a failure to address what it called the "crucial issue" of the procurement of organs from executed prisoners.
The rules issued Friday by China's State Council, or Cabinet, include a ban on the sale of human organs for profit and on donations by people under 18, according to the text of the regulations published by the Communist Party newspaper People's Daily.
The regulations, which take effect May 1, are also meant to standardize transplant procedures at the limited number of hospitals licensed to perform them.
Little information about China's lucrative transplant business is publicly available. Human rights groups have said many organs — including those transplanted into wealthy foreigners — come from executed prisoners who may not have given their permission.
Human Rights Watch urged Beijing for full transparency on the removal of body organs from executed prisoners.
"The regulations show that China is responding to great international concern over organ trade in the country," said Nicholas Bequelin, a Hong Kong-based researcher for Human Rights Watch, in a telephone interview.
"But the regulations are no substitute for an open and transparent system. It leaves vague areas under secrecy, such as the crucial issue of the provenance of the organs, which we know are through judicial executions," Bequelin said.
The rules make it illegal to harvest human organs without permission, but Bequelin said the process of obtaining voluntary consent either from prisoners or their families was "virtually meaningless."
"We're talking about prisoners who are going to be executed. They can be subjected to all sorts of pressure to sign these consents," he said. "It is not an informed consent."
The official Xinhua News Agency said most organs used in transplants come from deceased Chinese citizens who had voluntarily donated. But Bequelin said research showed more than 90 percent of organs used in transplants were obtained from judicial executions.
A senior health official said in November that most organs harvested from cadavers were from executed prisoners, with their prior consent, according to a China Daily newspaper report.
Chinese legislators have been pushing for years for a law to regulate and promote voluntary organ donations. The rules are needed, they say, to prevent unqualified doctors and profit-hungry hospitals from abusing patients.
Health officials say China faces a severe shortage of human organs, estimating that out of 1.5 million people who need transplants in China each year, only about 10,000 operations are carried out.
Voluntary donations remain far below demand in China, partly due to cultural biases against organ removal before burial.
Bacteria in peanut butter linked to leak
Sun, 08 Apr 2007 01:13:59 GMTBy JOSH FUNK, AP Business Writer
OMAHA, Neb. - Moisture from a leaky roof and faulty sprinkler helped salmonella bacteria grow and contaminate peanut butter at its Georgia plant last year, sickening more than 400 people nationwide, ConAgra Foods said.
The Omaha-based company conducted a nearly two-month investigation into the contamination and pledged to ensure that Peter Pan peanut butter is safe when it returns to stores in mid-July.
"Consumer safety and health is our top priority," ConAgra spokeswoman Stephanie Childs said Thursday. "We plan to do our best to regain consumer trust once Peter Pan returns to stores."
Childs said the company traced the salmonella outbreak to three problems at its Sylvester, Ga., plant last August.
The plant's roof leaked during a rainstorm, and the sprinkler system went off twice because of a faulty sprinkler, which was repaired.
The moisture from those three events mixed with dormant salmonella bacteria in the plant that Childs said likely came from raw peanuts and peanut dust.
The plant was cleaned thoroughly after the roof leak and sprinkler problem, but the salmonella remained and somehow came in contact with peanut butter before it was packaged, she said.
ConAgra recalled all its peanut butter in February after federal health officials linked it to cases of salmonella infection. At least 425 people in 44 states were sickened, and lawsuits have been filed against the company.
The recall covered all Peter Pan peanut butter and all Great Value peanut butter made at the Sylvester plant since October 2004. That plant is ConAgra's only peanut butter plant.
Peanuts grow underground and salmonella is present in the dirt, but generally any bacteria are killed when raw peanuts are roasted.
When making peanut butter, the nuts are again heated — above the salmonella-killing temperature of 165 degrees — as they are ground into a paste and mixed with other ingredients before being squirted into jars and quickly sealed.
Experts had speculated that salmonella would be most likely to contaminate peanut butter as it cooled and was placed in jars. At most plants, those steps take just minutes.
The company plans to redesign the plant to provide greater separation between raw peanuts and the finished product, Childs said. The plant will also get a new roof.
ConAgra plans to reopen the plant in early August.
Before this recall, none of ConAgra's recent routine testing had detected salmonella, so the company plans to develop a new procedure.
The http://www.conagrafoods.com
Thai doctors successfully separate twins
Sun, 08 Apr 2007 01:13:59 GMTBy AMBIKA AHUJA, Associated Press Writer
BANGKOK, Thailand - Thai doctors announced Thursday that they successfully performed a rare operation to separate a pair of conjoined female infants, teasing apart their hearts and livers in the delicate procedure.
The girls, Panwad Tiyenjai and Pantawan Tiyenjai, were so-called thoracophagus twins — with their bodies joined from chest to abdomen, said an announcement from Bangkok's Siriraj Hospital.
What made their case unusual was that the upper chambers, or atriums, of their hearts were connected, with one pumping blood to the other, said Dr. Somchai Sriyoschati, a cardiac surgeon who took part in the operation.
The 12-hour operation on Feb. 20, in which 61 doctors and nurses took part, left both girls in good condition, though one has a slight heart defect which can be fixed when she gets older, he said. The girls were eight months old when they were operated on.
The hospital did not say why it delayed in announcing the operation.
Somchai told The Associated Press that a CAT scan and an MRI test before the operation clearly showed the connection between the two hearts, but doctors were unsure if one was dependent on the other.
In some cases where hearts are joined, a diagnosis results in the conclusion that the hearts cannot sustain the patients separately, and that the life of one patient might have to be sacrificed to let the other, stronger one live.
When the operation began and the hearts were exposed, doctors blocked the flow of blood at the joining point to see if each heart could operate independently, Somchai said. Only after finding that stopping the flow caused no apparent problem, did they proceed, he said.
Had stopping the flow between the two hearts caused a problem, further surgery would have been terminated and the twins left in their conjoined state, he said. Conjoined twins who share a heart are often more vulnerable to sickness and have a poor life expectancy compared to separated ones.
The hospital's claims to having performed the first successful operation of its kind — where the hearts were joined at their upper chambers — could not immediately be confirmed.
It was not clear how it differed from an operation performed in the United States in 2002 at the University of Maryland Hospital for Children, where doctors successfully separated two Ugandan girls, Loice and Christine Onziga, who also had connected livers and hearts connected by their upper chambers.
Conjoined twins form when an embryo begins to split into identical twins but stops part way, leaving the partially separated egg to mature. They occur once in every 150,000 to 200,000 live births and are three times as likely to happen to females than males.
The chances of conjoined twins surviving depends on how they are connected. About 40 to 60 percent are stillborn and 35 percent survive 24 hours or less. Those who survive longer are often plagued by medical complications due to shared organs and vital systems.
Disease underlies HatfieldMcCoy feud
Sun, 08 Apr 2007 01:14:02 GMTBy MARILYNN MARCHIONE, AP Medical Writer
The most infamous feud in American folklore, the long-running battle between the Hatfields and McCoys, may be partly explained by a rare, inherited disease that can lead to hair-trigger rage and violent outbursts.
Dozens of McCoy descendants apparently have the disease, which causes high blood pressure, racing hearts, severe headaches and too much adrenaline and other "fight or flight" stress hormones.
No one blames the whole feud on this, but doctors say it could help explain some of the clan's notorious behavior.
"This condition can certainly make anybody short-tempered, and if they are prone because of their personality, it can add fuel to the fire," said Dr. Revi Mathew, a Vanderbilt University endocrinologist treating one of the family members.
The Hatfields and McCoys have a storied and deadly history dating to Civil War times. Their generations of fighting over land, timber rights and even a pig are the subject of dozens of books, songs and countless jokes. Unfortunately for Appalachia, the feud is one of its greatest sources of fame.
Several genetic experts have known about the disease plaguing some of the McCoys for decades, but kept it secret. The Associated Press learned of it after several family members revealed their history to Vanderbilt doctors, who are trying to find more McCoy relatives to warn them of the risk.
One doctor who had researched the family for decades called them the "McC kindred" in a 1998 medical journal article tracing the disease through four generations.
"He said something about us never being able to get insurance" if the full family name was used, said Rita Reynolds, a Bristol, Tenn., woman with the disease. She says she is a McCoy descendant and has documents from the doctor showing his work on her family.
She is speaking up now so distant relatives might realize their risk and get help before the condition proves fatal, as it did to many of her ancestors.
Back then, "we didn't even know this existed," she said. "They just up and died."
Von Hippel-Lindau disease, which afflicts many family members, can cause tumors in the eyes, ears, pancreas, kidney, brain and spine. Roughly three-fourths of the affected McCoys have pheochromocytomas — tumors of the adrenal gland.
The small, bubbly-looking orange adrenal gland sits atop each kidney and makes adrenaline and substances called catecholamines. Too much can cause high blood pressure, pounding headaches, heart palpitations, facial flushing, nausea and vomiting. There is no cure for the disease, but removing the tumors before they turn cancerous can improve survival.
Affected family members have long been known to be combative, even with their kin. Reynolds recalled her grandfather, "Smallwood" McCoy.
"When he would come to visit, everyone would run and hide. They acted like they were scared to death of him. He had a really bad temper," she said.
Her adopted daughter, another McCoy descendant, 11-year-old Winnter Reynolds, just had an adrenal tumor removed at Vanderbilt Children's Hospital. Teachers thought the girl had ADHD — attention deficit hyperactivity disorder. Now, Winnter says, "my parents are thinking it may be the tumor" that caused the behavior. "I've been feeling great since they took it out."
Her adoptive father, James Reynolds, said of the McCoys: "It don't take much to set them off. They've got a pretty good temper.
"Before the surgery, Winnter, when we would discipline her, she'd squeeze her fists together and get real angry and start hollering back at us, screaming and crying," he said.
As for the older McCoys, "they just started dropping dead of the tumors," he said. "They didn't know what it was. A name wasn't really put on the disease until 1968. That's when one of my brothers-in-law had to have surgery, to have some tumors removed in his brain. They started to notice tumors occurring in each of the family members."
Dr. Nuzhet Atuk at the University of Virginia in Charlottesville and geneticists at the University of Pennsylvania studied the family for more than 30 years, Rita Reynolds said.
"They went back on the genealogy and all of that stuff," she said. "They called it madness disease. They said that it had to be coming from the VHL. Our family would just go off, even on the doctors."
Now 85 and retired, Atuk said he could not talk about his work because of medical confidentiality.
Rita Reynolds had two adrenal tumors removed a few years ago. Her mother and three brothers also had them. So do McCoy descendants in Oregon, Michigan and Indiana, she said.
"When you have these tumors, you're easy to get upset," said Rita's mother, Goldie Hankins, 76, of Big Rock, Va., near the Kentucky-West Virginia border. "When people get on your nerves, you just can't take it. You get angry because your blood pressure was so high."
Still, many are dubious that this condition had much of a role in the bitter feud with the Hatfields, which played out in the hill country of eastern Kentucky and West Virginia for decades.
Some say the feud dates to Civil War days, when some members of the families took opposite sides. It grew into disputes over timber rights and land in the 1870s, and gained more notoriety in 1878, when Randolph or "Old Randal" McCoy accused a Hatfield of stealing one of his pigs. The hostilities left at least a dozen dead.
"The McCoy temperament is legendary. Whether or not we can blame it on genes, I don't know," said Ron McCoy, 43, of Durham, N.C., one of the organizers of the annual Hatfield-McCoy reunion. "There are a lot of underpinnings that are probably a more legitimate source of conflict."
"There was a lot of inter-marrying" that could have played havoc with the gene pool, he conceded.
Another relative, Bo McCoy, of Waverly, Ohio, said he had never heard talk of the disease although he has been diagnosed with a different adrenal gland problem — Cushing's syndrome.
Even Reo Hatfield, who drafted the "truce" the two families famously signed in 2003 to officially end hostilities, doubted the role of the McCoys' disease in the feud.
"I would be shocked" if doctors blamed it on illness, he said.
Altina Waller, a professor of history at the University of Connecticut and author of a book about the feud, agreed.
"Medical folks like to find these kinds of explanations. Like the Salem witchcraft thing. That book came out about how that was caused by wheat that was grown that had this parasite or mold or fungus or something that caused everybody in Salem to go nuts," she said.
"How does it explain the other dozen or so feuds that I've looked at in other places?" she asked, citing disputes over coal and other issues. "The rage and violence as such was not confined to McCoys."
She acknowledges that an argument could be made for seeing the McCoys as the more aggressive of the clans.
"One of the reasons the McCoys don't like me as much in the Tug Valley as the Hatfields do is that I seem to suggest that Randal McCoy, the patriarch of the family, was sort of irrational and flamboyant and did jump to, into wanting violence more than, say, Anderson Hatfield," Waller said.
These days, the "feud" has taken a far more civil tone and all but disappeared, members of both families say. The last time it surfaced was in January 2003. McCoy descendants sued Hatfield descendants over visitation rights to a small cemetery on an Appalachian hillside in eastern Kentucky. It holds the remains of six McCoys, some allegedly killed by the Hatfields.
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Associated Press National Writer Allen G. Breed in Raleigh, N.C., contributed to this report.
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On the Net:
VHL Family Alliance: http://www.vhl.org
NIH: http://www.ninds.nih.gov/disorders/von_hippel_lindau/von_hippel_lindau.htm
http://www.nlm.nih.gov/medlineplus/ency/article/000340.htm
