'Radical' surgery uses patient's tooth to restore her sight

Friday, September 18, 2009 · 0 comments

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Doctors in Miami announced Wednesday that they had performed a vision-restoring surgery that used the 60-year-old patient's tooth.

The surgery, the first in the USA, was performed Labor Day weekend at the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. Afterward, patient Sharron Thornton was able to see for the first time in nine years. "Sharron was able to see 20/60 this morning. She was seeing only shadows a couple of weeks ago," says ophthalmologist and surgeon Victor Perez.

Thornton was blinded in 2000 by a reaction to a drug she was taking, which damaged her cornea. Perez likened Thornton's cornea to a dirty car windshield. He says her eye surface was too dry for a corneal implant, a standard treatment.

Thornton's eye tooth and part of her jaw bone were removed, then sculpted to create a hole in the tooth through which an optical cylinder lens fit. The tooth acts as a base to hold the lens.

The prosthesis was then placed in a pouch just under the skin of Thornton's cheek, where it would remain for several months to allow for the growth of a living capsule around it.

To surgically implant the tooth-lens prosthesis, a hole was made in the cornea and the capsule embedded over the top of the cornea. The mucous membrane was then pulled back over the eye like a blanket and a hole made for the lens.

"It's a pretty radical operation and can be disfiguring," says James Chodosh, a faculty member at the Massachusetts Eye and Ear Infirmary. But he says the results are worth it to patients.

Thornton says being able to see again is "like Christmas."

Addicts opens another front in Afghan war

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KABUL

As soon as the social worker handed Khord Agha a clean needle, the 28-year-old heroin addict pulled out his packet of tinfoil and began searching for a vein.

After jabbing unsuccessfully several times, he finally found a spot. His shoulders slumped as the drug coursed through his bloodstream, and Agha began talking about how he became one of the surging number of heroin addicts in Afghanistan.

"It started when I was working for a family on their farm in Iran," said Agha, who left Kabul more than eight years ago to find a job. "Everyone was using it to relax. Now, I use it to get through the day, to tolerate the depression of my existence."

Afghanistan, besieged by decades of war, is fighting another battle — a spiraling epidemic of heroin addiction in the country that is the world's largest producer of opium, which is used to make heroin. Some Afghan officials worry these drug addicts could pose a threat to the country's security.

"This is a problem if we don't address it soon can affect all areas of life — even security," said Abdullah Wardak, a physician who heads the Afghan Health Ministry's drug demand reduction department. "If a drug addict is desperate enough for drugs, think what the Taliban could get him to do."

The number of addicts in Afghanistan is far greater than in the USA. A survey by the United Nations Office on Drugs and Crime (UNODC) in 2005 showed Afghanistan had 920,000 heroin addicts, or 3.8% of the population. In the USA, 282,000 people are dependent on heroin, or .2% of the population, according to the 2008 National Survey on Drug Use and Health.

Afghan and U.N. monitors say the problem has grown much worse as the war against Taliban insurgents continues to escalate. There may be more than 1.3 million addicts, says Afghanistan's counternarcotics minister, Col. Gen. Khudaidad, who goes by only one name.

'They all become hooked'

Khudaidad says a big part of the problem are Afghan refugees who picked up the habit while living in Iran or Pakistan and then returned home in recent years.

"They would go work in construction or on a farm, and their bosses would give it to them, so they would sleep well and have energy to work the next day," Khudaidad said. "But they all become hooked."

Jean-Luc Lemahieu of UNODC in Afghanistan said heroin addiction spreads far beyond the population of returning refugees.

Officials closed down a massive drug den in the bombed-out ruins of the old Russian Cultural Center this summer in central Kabul. Lemahieu said up to 1,600 heroin users a day would frequent the den, which he called "the McDonald's of opium addiction." Each day, two to four bodies would be found — victims of overdose, malnutrition or exposure related to drugs.

"We know, of course, what we saw in the Russian Culture Center is only the tip of the iceberg," Lemahieu said.

Before 2001, when U.S. forces toppled the ruling Taliban regime, Afghanistan had one drug treatment center.

Now there are about 45 clinics, and that's still not enough, said the Health Ministry's Wardak.

So six days a week, social workers from the Nejat Rehabilitation Center, fan out around Kabul to offer heroin addicts clean hypodermic needles to prevent the spread of HIV or hepatitis.

Shahzaman Sharifi, a physician and one of the social workers, said addicts' reasons for starting on heroin vary. Some were wounded in Afghanistan's civil war from 1992 to 1996 and turned to opium — then heroin — as a pain reliever. Others used it as an escape from crushing poverty and a sense of hopelessness.

Unending cycle

Sharifi said he sees the same men nearly every day. He always hands the gaunt Mohammed Javed, 37, a package of cookies, along with a clean needle. On a recent visit, Javed's left foot, where he usually injects his heroin, was swollen and oozing.

As Sharifi bandaged the wound, Javed said he had to kick the habit. He told Sharifi he planned to admit himself soon to the rehab center. "My wife told me she will wait for me to get better," said Javed, who hadn't seen his family in years. "I want to stop this, so I can save myself."

The next day, Sharifi checked on Javed. He was slumped in a heroin daze, barely able to speak, a few feet from where Sharifi had left him a day earlier.

Sharifi handed him a clean needle and a package of cookies, then went on with his rounds.

Obama scraps Bush missile-defense plan

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Iran conducted a test-firing of missiles in the desert on July 9, 2008. President Obama said he agreed with his predecessor's assessment that the Iranian missile program poses a threat.
WASHINGTON President Obama's foreign policy has employed a starkly different tone than George W. Bush's, emphasizing engagement and cooperation rather than go-it-alone confrontation. Even so, analysts of various political stripes hadn't seen many big differences on substance.

Until now.

Obama's decision Wednesday to scuttle a costly and technically challenged long-range missile-defense system in Europe marks his most significant reversal of a Bush foreign policy priority. It could change the dynamic of what has been an increasingly tense relationship between the U.S. and Russia, which viewed the Bush plans for missile defenses in Poland and the Czech Republic as a threat.

Bush's proposed missile shield, designed to counter intercontinental missiles from Iran, "was very much a signature initiative of theirs, both with respect to Central Europe and with respect to missile defense," says John Pike, director of GlobalSecurity.org, a defense think tank.

Speaking to reporters at the White House, Obama was careful to portray his decision as a revamping, not an abandonment, of European missile defense. He said he would replace the long-range system Bush envisioned — which had a spotty testing record — with a more reliable defense system aimed at countering what Obama called a more imminent threat from Iran's short-range missiles, which can travel up to 5,000 miles and potentially strike continental Europe.

Defense Secretary Robert Gates said the new plan still places systems in Poland, the Czech Republic and other countries in the region, though the details are still to be ironed out. The plan calls for a ship-based component and some ground-based interceptors designed to target shorter-range missiles that are less difficult to hit.

"Our new missile-defense architecture in Europe will provide stronger, smarter, and swifter defenses of American forces and America's allies," Obama said.

The move wasn't unexpected — Obama had ordered a review of the Bush program shortly after taking office, and outside experts had questioned its feasibility even before then. Even so, Obama's announcement drew heated criticism from Republicans, who accused the president of abandoning central European allies and caving in to Russia in a naive bid for diplomacy.

"Short-sighted and harmful to our long-term security interests," complained Senate Minority Leader Mitch McConnell, R-Ky.

Democrats praised the decision; Senate Armed Services Committee Chairman Carl Levin called it "a sound choice that will improve our security."

Central to the debate over Obama's decision on missile defense is how it will be greeted by Russia, which has been a patron and trading partner of Iran, the Islamic republic that has bedeviled U.S. foreign policy for the last 30 years.

The Iranian regime has an active nuclear energy program, and although U.S. intelligence reports say Iran is not developing an atomic weapon, a new report by the International Atomic Energy Agency concluded Thursday that Tehran has the ability to make a bomb. That news, reported by the Associated Press, also said Iran is on its way to developing a missile system able to carry a nuclear warhead.

Obama is trying to negotiate with Iran. But if those talks fail, his administration will seek to impose "crippling sanctions," in the words of Secretary of State Hillary Rodham Clinton.

Russia, whose president, Dmitry Medvedev, will meet Obama at the United Nations next week, is key to any such effort. So far, it has resisted further sanctions on Iran, which it supplies with weapons and other technology.

If Obama's move was designed to nudge Russia, early signs Thursday weren't encouraging.

Russian Foreign Minister Sergey Lavrov said in a speech before Obama's missile-defense announcement that Moscow will continue to oppose any new sanctions over Iran's nuclear program.

Medvedev, however, said after the announcement that Obama's action was a "responsible move."

Policy reversal

Until now — leaving aside domestic issues with foreign policy implications, such as the treatment of terror detainees — Obama's foreign policy hasn't radically departed from that of his predecessor, though the rhetoric has been much different.

He has talked more about engaging adversaries, though no presidential summits have materialized. He has continued Bush's gradual withdrawal from Iraq and added troops to Afghanistan.

Pushing a so-called "reset" button in the USA's relationship with Russia has yielded little that is tangible. Polls in various countries show that Obama is far more popular abroad than Bush is, but that popularity has yet to translate into visibly better cooperation with U.S. policy goals.

Christian Brose, who was a speechwriter for Bush Secretary of State Condoleezza Rice, wrote recently on foreignpolicy.com: "Our NATO allies have passed on sending more troops to Afghanistan and on lifting restrictions on those already there ... India and China don't share any of Obama's enthusiasm for a climate change deal. ... Pakistan is still dysfunctional and supporting terrorism. Iran and North Korea are all middle fingers and no unclenched fists. ... Rarely has a U.S. administration been so well-liked, so eager to engage with others, and had so little to show for it."

Obama officials disagree, of course, but it's not just former Bush officials who hold that view: In July, Columbia University professor and liberal blogger Lincoln Mitchell wrote a post entitled, "Why Obama's Foreign Policy Looks So Much Like Bush's." He previously was a Democratic consultant.

Republicans, including Obama's 2008 opponent, Sen. John McCain of Arizona, have supported many, though not all, of the new president's foreign policy moves. On Thursday, though, they erupted in a chorus of criticism.

McCain called the decision "seriously misguided," while Florida's Ileana Ros-Lehtinen, ranking Republican on the House Foreign Affairs Committee, dubbed it "a policy of appeasement."

Marc Thiessen, a former Bush speechwriter now at the Hoover Institution, said the "disastrous decision" sends "a signal of weakness to Tehran ... and a terrible signal to Russia, that they can bully us into abandoning our friends in what they consider their sphere of influence."

The partisan uproar came despite the endorsement of the move by Gates, who was Bush's secretary of Defense when the deals with Poland and the Czech Republic were finished last year and who holds the same job for Obama.

"This new approach provides a better missile-defense capability for our forces in Europe, for our European allies and eventually for our homeland than the program I recommended almost three years ago," Gates told reporters at the Pentagon after Obama spoke.

A troubled program

The program Gates once supported has been controversial from the moment Bush proposed it in a speech on May 1, 2001, months before the 9/11 attacks and a year before revelations about Iran's nuclear program.

It called for putting 10 land-based interceptors in Poland and a ground-based radar in the Czech Republic.

The Europe system was never deployed, so it wasn't tested. But similar ground-based interceptors failed to hit targets in five of 13 tests, according to the Pentagon, and they have not demonstrated an ability to detect decoys, the Government Accountability Office says.

The Bush system would have cost $9 billion to $13 billion, according to the Congressional Budget Office, and still would have left parts of Europe unprotected from an Iranian missile. Instead of the long-range interceptors, the United States will put in place more seasoned technology that will focus on medium- and short-range missiles, of which Iran has hundreds, Gates said.

Critics of the Bush approach praised Obama's announcement.

"What the president is proposing here actually produces more defense sooner than the program it replaces," said former Pentagon testing chief Philip Coyle, a longtime skeptic of the Bush program.

"The canceled European deployment would have added only marginally and at high cost to the full coverage of the United States already afforded by the existing ground-based interceptors," physicist Richard Garwin, who helped design the hydrogen bomb and recently was on a commission to assess the ballistic missile threat, said in an e-mail.

In Central Europe, reactions to the news were mixed. Bush's plan had never been popular in the Czech Republic, where polls showed 70% opposed it. In a March, a Czech government fell in part because it supported the missile shield.

Still, it was seen in both countries as a bulwark against an aggressive and expansionist Russia.

"Much of Europe — especially the Central and Eastern regions — will now view the United States as unable to fulfill its promises to its allies in the face of a strengthening Russia," said an analysis by Stratfor, a Texas-based intelligence firm.

Obama's shift on missile defense may embolden the Russians and "encourage them to push other buttons," said Janusz Bugajski, director of the New European Democracies Project at the Center for Strategic and International Studies, a Washington think tank.

Bugajski said it did not go down well in Poland that Obama made the announcement on the 70th anniversary of the Soviet Union's invasion of Poland at the start of World War II.

He said the United States will need to take steps to reassure Central and Eastern European countries that they will be protected against Russia. For example, NATO could devise defense plans for the countries, he said, or station troops on their territories.

Obama and Medvedev plan to meet twice next week, once at the United Nations and again in Pittsburgh for the G-20 economic conference. Those meetings could show what dividends, if any, the president will reap from his first major foreign-policy shift from his predecessor.

Crackdown on artifact crimes gets results

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Jerrica Redd, left, and Jeanne Redd, the first people to be sentenced in an Interior Department investigation into crimes involving Indian artifacts, leave the Federal Courthouse in Salt Lake City on Wednesday.

Jerrica Redd, left, and Jeanne Redd, the first people to be sentenced in an Interior Department investigation into crimes involving Indian artifacts, leave the Federal Courthouse in Salt Lake City on Wednesday.
A federal government crackdown on black-market Indian artifacts and the looting of dozens of sacred objects from Indian ruins in Utah, Arizona, Colorado and New Mexico continued to unfold this week as a mother and daughter were sentenced to three and two years of probation respectively.

Jeanne Redd, 59, and her daughter Jerrica, 37, both of Blanding, Utah, were the first to be sentenced in the Department of the Interior investigation, launched in late 2006. The women pleaded guilty to multiple felonies involving theft and excavation of artifacts and surrendered an antiquities collection of more than 800 objects.

Since the investigation began, 26 people, including several well-known antiquities collectors, have been indicted, according to Melodie Rydalch, a spokeswoman for the U.S. Attorney's Office in Utah.

The investigation has included grave robbers looting Native American burial grounds, two suspects committing suicide and pre-dawn raids by federal agents, Rydalch says.

"It's like a Tony Hillerman book unfolding right before our very eyes," Rydalch noted, referring to popular detective novels based on the Navajo Nation.

Jeanne Redd is the widow of James Redd, a physician and antiquities collector who committed suicide by carbon monoxide poisoning one day after his arrest in June court records show. Steven Shrader, 56, of New Mexico shot and killed himself in Illinois in June, the same day he was scheduled to appear in federal court in Salt Lake City.

Search warrant affidavits filed at the U.S. District Court in Utah say the case began after "a major dealer in archaeological artifacts" agreed to work with federal investigators. The affidavits say investigators were able to penetrate a secretive network of illicit diggers and dealers because the informer, identified only as "the Source," had numerous connections.

In the course of the probe, affidavits say, "the Source" purchased sacred Hopi kachina masks, Navajo pendants, Pueblo pottery and other artifacts from more than two dozen figures.

In Arizona, where no arrests have been made to date, several collectors surrendered artifact collections after federal investigators came with search warrants this summer, said Beth Grindell, director of the Arizona State Museum in Tucson. She described the collections as "quite sizable."

Grindell and Rebecca Tsosie, executive director at Arizona State University's Indian Legal Project, said looters do tremendous scientific damage that also is devastating to Native American tribes.

Brett Tolman, U.S. attorney in Utah, said the probe is far from over. "I hope we've accomplished a deterrent effect that will have an impact on the black market," he said.

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