Indiana Jones

The man who grew a finger

In every town in every part of this sprawling country you can find a faceless sprawling strip mall in which to do the shopping.

Rarely though would you expect to find a medical miracle working behind the counter of the mall's hobby shop.

That however is what Lee Spievak considers himself to be.

"I put my finger in," Mr Spievak says, pointing towards the propeller of a model aeroplane, "and that's when I sliced my finger off."

It took the end right off, down to the bone, about half an inch.

"We don't know where the piece went."

The photos of his severed finger tip are pretty graphic. You can understand why doctors said he'd lost it for good.

Today though, you wouldn't know it. Mr Spievak, who is 69 years old, shows off his finger, and it's all there, tissue, nerves, nail, skin, even his finger print.

'Pixie dust'

How? Well that's the truly remarkable part. It wasn't a transplant. Mr Spievak re-grew his finger tip. He used a powder - or pixie dust as he sometimes refers to it while telling his story.

Mr Speivak's brother Alan - who was working in the field of regenerative medicine - sent him the powder.

For ten days Mr Spievak put a little on his finger.

"The second time I put it on I already could see growth. Each day it was up further. Finally it closed up and was a finger.

"It took about four weeks before it was sealed."

Now he says he has "complete feeling, complete movement."

The "pixie dust" comes from the University of Pittsburgh, though in the lab Dr Stephen Badylak prefers to call it extra cellular matrix.

Pig's bladder

The process he has been pioneering over the last few years involves scraping the cells from the lining of a pig's bladder.

Please turn on JavaScript. Media requires JavaScript to play.

How it works in detail The remaining tissue is then placed into acid, "cleaned" of all cells, and dried out.

It can be turned into sheets, or a powder.

It looks like a simple process, but of course the science is complex.

"There are all sorts of signals in the body," explains Dr Badylak.

"We have got signals that are good for forming scar, and others that are good for regenerating tissues.

"One way to think about these matrices is that we have taken out many of the stimuli for scar tissue formation and left those signals that were always there anyway for constructive remodelling."

In other words when the extra cellular matrix is put on a wound, scientists believe it stimulates cells in the tissue to grow rather than scar.

If they can perfect the technique, it might mean one day they could repair not just a severed finger, but severely burnt skin, or even damaged organs.

Clinical trial

They hope soon to start a clinical trial in Buenos Aires on a woman who has cancer of the oesophagus.

The normal procedure in such cases is often deadly. Doctors remove the cancerous portion and try to stretch the stomach lining up to meet the shortened oesophagus.

In the trial they will place the extra cellular matrix inside the body from where the portion of oesophagus has been removed, and hope to stimulate the cells around it to re-grow the missing portion.

So could limbs be re-grown? Dr Badylak is cautious, but believes the technology is potentially revolutionary.

"I think that within ten years that we will have strategies that will re-grow the bones, and promote the growth of functional tissue around those bones. And that is a major step towards eventually doing the entire limb."

That kind of talk has got the US military interested.

They are just about to start trials to re-grow parts of the fingers of injured soldiers.

Skin burns

They also hope the matrix might help veterans like Robert Henline re-grow burnt skin.

He was almost killed in an explosion while serving in Iraq. His four colleagues travelling with him in the army Humvee were all killed.

He suffered 35% burns to his head and upper body. His ears are almost totally gone, the skin on his head has been burnt to the bone, his face is a swollen raw mess.

So far he has undergone surgery 25 times. He reckons he has got another 30 to go.

Anything that could be done in terms of regeneration would be great he says.

"Life changing! I think I'm more scared of hospitals than I am of going back to Iraq again."

Like any developing technology there are many unknowns. There are worries about encouraging cancerous growths by using the matrix.

Doctors though believe that within the so called pixie dust lies an amazing medical discovery.

To watch related videos, please go to BBC News.

A revised definition of exercising

We're often told that light activities such as walking and housework are enough to keep you fit. Sadly, it's not true


You walked to the station this morning, marched up the escalators and you'll be taking the dog out when you get home tonight. So that's your day's exercise taken care of, right? Well, not necessarily.
In the 1980s, exercise was all about feeling the burn. But in recent years, we've been persuaded that exercise doesn't have to hurt. In fact, it doesn't even need to be exercise, with activities such as housework and walking up stairs counting towards the daily total.

But now the goalposts have been moved again. The American College of Sports Medicine (ACSM), one of the major international organisations responsible for issuing health and fitness guidelines, became so concerned that its advice to "accumulate 30 minutes of moderate activity on most days of the week" was being misinterpreted to mean light activities were sufficient that it went back to the drawing board. The British Association of Sport and Exercise Sciences (Bases), Britain's equivalent body, is doing the same.

"The promotion of `lifestyle activities' since 1995 hasn't increased physical activity levels," says Gary O'Donovan, a lecturer in sport and exercise medicine at the University of Exeter, who is leading the panel writing the new Bases guidelines. "Many people give up on moderate activity because it is too time-consuming and brings little improvement."

A demonstration that lifestyle activity doesn't replace "proper" exercise comes from a study at Bristol University. The research, published in the Journal of Epidemiology and Community Health, found that women who did more than eight hours a week of heavy housework were actually slightly more likely to be overweight than those who did none - and no amount of vacuuming, scrubbing and cleaning lowered their resting heart rates, an indicator of enhanced aerobic fitness.

There are three main changes to the new ACSM guidelines. The "30 minutes of moderate activity" part remains, but "most days" has become a more specific "five days of each week" (presumably to fox those of us who are kidding ourselves that three days count as "most").

More importantly, the paper stipulates that this 30 minutes is in addition to "routine activities". In other words, walking around the office, pulling weeds in the garden and eschewing the lift, while worthwhile, no longer count. The report points out that even those lifestyle activities that are energetic enough to count as moderate exercise aren't performed for long enough to have any meaningful impact.

But perhaps the most significant revision concerns the issue of intensity. For the first time, "vigorous" exercise is offered as an alternative to moderate activity. Instead of labouring through five 30-minute sessions a week, you can zip through three 20-minute high-intensity workouts - or mix and match the two.

At least part of the reason for this amendment is to dispel the myth that moderate-intensity exercise is better than more vigorous activities - the "exercise doesn't have to hurt" message.

A study from Wales recorded the activity levels of 2,000 men aged 40 to 64 over a 10-year period. There was no evidence that either light or moderate physical activity (walking at a leisurely pace, bowling and so on) reduced the risk of dying from heart disease, while more vigorous activity - jogging, swimming, hiking or walking at a brisk pace for one hour at a time - did.

"The simple truth is that the harder you work, the fitter and healthier you'll become," says O'Donovan. In other words, the new guidelines offer not a formula for optimal fitness, but a minimum recommendation for safeguarding your health and your heart.

Assuming you manage to meet the weekly target, you can rest assured that you'll be significantly reducing your risk of cardiovascular disease, diabetes and some cancers. But what constitutes moderate activity?

The issue of how exercise intensity is measured is complex and scientists use a range of different measurements. "How best to describe exercise intensity to the general public so that it gets the right message is difficult," says David Swain, a professor of exercise science at Old Dominion University and a fellow of the ACSM.

"One of the simplest ways to rate intensity is the talk test. If one is exercising hard enough to notice that one is breathing harder, but is still able to speak in complete sentences comfortably, then that is moderate intensity. It should be a level that can be easily maintained for at least 30 minutes. A vigorous intensity is one that makes it difficult to speak in complete sentences, but that can still be maintained continuously for several minutes."

Since we all have different levels of fitness, it's impossible to prescribe any single given activity or target heart rate as suitable for all. And that's why O'Donovan takes issue with the universal promotion of brisk walking.

"There is compelling evidence that brisk walking protects women from diabetes, heart disease and breast cancer, but for most middle-aged men, walking simply isn't challenging enough," he says. "Men who want to reduce their risk of diabetes and heart disease should consider jogging or circuit training, or, better still, running or competitive sports."

But given that it's widely accepted there are proven health benefits from doing five 30-minute sessions of moderate exercise a week, is there really any need to work harder?

Yes, says O'Donovan. "Vigorous exercise offers benefits over and above those gained through moderate-intensity exercise. There's a further reduction in risk of obesity, diabetes and heart disease and a better quality of life. There is also emerging evidence that vigorous activity is essential in the prevention of some cancers, including colorectal cancer. Besides, shorter, sharper sessions are less time-consuming - and lack of time is often cited as a barrier to regular exercise," he says.

Swain says: "If a person does a moderate-intensity workout for a given amount of time or a vigorous-intensity one for a shorter amount of time, and both cases burn the same number of calories, the vigorous exercise will be better."

Which raises the question of why the ACSM didn't simply replace the moderate-exercise message with a vigorous one? Figures from 2005 show that less than half of US adults met even the previous ACSM target, so announcing that the stakes have been raised further may not have been a wise move.

"Many people are too out of condition to attempt high-intensity exercise," says Klaas Westerterp, professor of human energetics at Maastricht University. Westerterp's headline-grabbing research in 2001 revealed that gym-goers burned fewer calories overall than generally active non-gym-goers because they compensated for their efforts by being less active for the rest of the day.

The fact is we need to do both. The new Bases guidelines will recommend that no one goes more than two days without some moderate to vigorous physical activity. "Incorporate more activity into daily routines than you do automatically," Westerterp says.

"And endeavour to include some vigorous activity in your week," adds O'Donovan.

Guardian News & Media

New "Lord of the Rings" series - "The Hobbit"

Sir Ian McKellen back as Gandalf

Sir Ian McKellen has confirmed he will reprise his role as Gandalf in the film remake of JRR Tolkien's The Hobbit.

"Yes, it's true," he told Empire magazine. "It's not a part that you turn down. I loved playing Gandalf."

Two Hobbit films are planned for release in 2010 and 2011. They will be prequels to the Lord of the Rings trilogy, directed by Peter Jackson.

Guillermo del Toro has been named as the director of the movies, to be made back-to-back in New Zealand.

"I spoke to Guillermo in the very room that Peter Jackson offered me the part and he confirmed that I would be reprising the role," Sir Ian said.

He also said del Toro would be starting the script in about six weeks after he has finished filming current project, Hellboy 2.

According to studio New Line, the first film will be an adaptation of The Hobbit and the second will be an original story focusing on the 60 years between the book and the beginning of the Rings trilogy.

"As to how it's going to work over two films and what going to happen on screen, well Guillermo has not got down to working out the major details yet - I can tell you it's going to be amazing though," Sir Ian said.

BBC News.

Do you know who I am?

I hope our students won't do the same.

Cross students give exam authority a ticking-off

The examinations authority has come under fire for "unfair treatment" of candidates in a major English listening exam this month.

Students have complained of unclear instructions in one question in the Hong Kong Advanced level Use of English listening paper on April 5. The paper was worth 18 per cent of total marks for the subject.

In the question, candidates were given a taped conversation between the host of a survivor contest and competitors, and asked to "put ticks or crosses" to identify which of 11 items the competitors were allowed to use in the contest. The Hong Kong Examinations and Assessment Authority said candidates were required to "tick" items allowed and "cross" items not allowed.

But candidates later complained that they did not put crosses for items not allowed because the instruction was unclear, the authority said. After a markers' meeting, the authority agreed there were candidates who had misunderstood the instructions and decided that they be given the benefit of the doubt.

"If candidates used ticks only to indicate items allowed, blank boxes would be treated as indication of items not allowed. If they used both ticks and crosses, then blanks would be treated as omissions and not awarded any marks," a spokeswoman said. "An initial study showed that the majority of candidates used ticks to indicate items allowed and crosses to indicate items not allowed. Only a minority of candidates failed to use crosses to indicate items that were not allowed."

However, the decision to give certain students the benefit of the doubt has angered other candidates.

"Following instructions is a basic thing to do for people sitting exams. It would be unfair to give marks to those who failed to do so," said student Corah Chiu Yuk-yun.

A group named "Against giving benefit of the doubt to people who don't read instructions" has been opened on the social networking website Facebook. It has 348 members and 30 messages criticising the Hong Kong Examinations and Assessment Authority about its marking decision.

A message posted by the group read: "Candidates failed to put crosses probably because they had problems comprehending the question or they did not know the answer. The HKEAA decision allows for the luck factor, a departure from the aim of the listening exam."

The authority spokeswoman said marking of the papers had begun, but she could not say how many complaints about the question had been received.

SCMP. Apr. 29, 2008.

Giant derrick brings wreck of Ukrainian tugboat to surface

The Ukrainian tugboat Neftegaz-67 resurfaced in tatters near Tuen Mun yesterday, 37 days after a deadly collision with a mainland freighter.

There was a gaping 3-metre-by-4-metre hole in the hull's stern. The deputy head of the Guangzhou Salvage Bureau, He Weizhang, said workers might have to cut the tugboat into sections and ship the pieces away instead of plugging it.

"If we can mend the hole, then we'll make it float again. But if not, we'll have to take it apart and ship it," he said.

Neftegaz-67 collided with the mainland cargo ship Yaohai on March 22 and sank in about two minutes, leaving three dead and 15 missing, presumed dead.

Chornomornaftogaz, the Ukrainian oil and gas company that owns the tugboat, contracted the salvage bureau to raise it, thereby recruiting Asia's largest floating derrick, the Hua Tian Long, for the job.

The derrick started lifting the Ukrainian tugboat at around 7am yesterday with eight thick cables, visible from a kilometre away. Neftegaz-67's chimney - yellow and blue, the Ukraine's national colours - appeared above the water in the morning. By 1.30pm, most of its bridge had surfaced, followed by its hull at 7.30pm.

In the afternoon, workers had to detach and test two cables before continuing, Chornomornaftogaz engineer Oksana Mamokha said.

A view of the bridge from the aft showed it was so badly damaged that a cross section of its interior could be seen. One part of the bridge was lifted out separately.

Vessels from the salvage bureau, the Hong Kong police and the marine and fire services departments patrolled a 120-hectare area that was cordoned off around the crash site, on a busy deep-sea channel east of Siu Mo To Island.

They sprayed chemicals into the water to prevent pollution from the tugboat's leaking fuel. Two concentric floating booms surrounded the salvage site, set about 500 metres apart, to prevent fuel from spreading.

The Nan Yang, another derrick from the salvage bureau, floated nose-to-nose to assist the Hua Tian Long as Neftegaz-67 resurfaced.

The lift came four days after it was scheduled, having been delayed three times by Typhoon Neoguri, cable damage and rough weather. No one knew for sure how much longer the operation would take, Ms Mamokha said, and there could be further delays.

Mr He said: "After all, this work is being done on the water. The weather conditions can affect the work at any moment."

Workers would try to plug the hole before looking for other possible collision damage, he said. They would then pump water out and search for bodies.

Chornomornaftogaz estimated the salvage operation would cost US$10 million.

SCMP. Apr. 28, 2008.

[A+] Banning idling engines will make a difference

The government's decision to press ahead with legislation against idling engines is a welcome - although long overdue - step in the battle against air pollution.

Now officials must ensure that the law is introduced in good time and that it contains measures that will prove effective in curbing a practice which wastes energy and is increasingly seen as a form of antisocial behaviour.

Even before the recent public consultation it was clear there was strong public support for a statutory ban on motorists keeping engines running when their vehicles are stationary. Now that the results of the consultation confirm the public backing for the move, the Environmental Protection Department has all the support it needs to go ahead. Officials say the law should be enacted by next year at the latest. It certainly should not take longer than that.

Having taken such a long time to get to this stage, the focus must be on ensuring that the law is not watered down and rendered ineffective by exemptions intended to placate various interest groups - notably the transport sector.

Representatives of truck, taxi and minibus drivers have in the past argued against a ban and succeeded in stalling its introduction. The government went along, arguing that education was more effective than legislation. Now that public momentum is building towards introducing tougher measures, the trade groups are demanding that certain vehicles be exempted. Officials must not give in this time. The law must cover all types of vehicle, with the exception of emergency and special service vehicles such as those for the disabled and elderly. Furthermore, it must be adequately enforced.

It is hard to understand what is so difficult, and harmful to business, about turning a key to cut off an engine. Drivers will save on fuel, and the whole community will benefit from less pollution.

Specious reasons have been advanced, such as discomfort for passengers without constant air-conditioning and the ruinous effects on engines being turned on and off frequently. Drivers should not presume to speak for their passengers, most of whom would support the new law, if the government survey is anything to go by. Indeed, some of the trades' more reasonable concerns have already been dealt with. For example, the first two taxis or minibuses in a queue will, it seems, be allowed to keep their engines running.

Vehicles are the second-largest source of air pollution in Hong Kong. Of all the measures being proposed to fight pollution, banning idling engines is the easiest and cheapest to achieve. It has the added benefit of being likely to change people's behaviour if properly enforced. It can help increase awareness of the need for individuals to play their part in conserving energy and reducing air pollution. With a large public mandate, the new law will make a statement that the city is serious about cleaning up the environment.

Air pollution remains a serious problem in Hong Kong. Roadside monitoring stations recorded very high levels for about 11 per cent of the time in the first quarter of this year, up from 6.48 per cent of the time during the same period last year. General stations also saw higher pollution levels, with readings in the high range 70.5 per cent of the time, up from 51.7 per cent a year earlier. Banning idling engines will help make a difference but it will not solve our city's air pollution problems. A wider range of measures is needed.

SCMP. Apr 27, 2008.