Scientists use 3-D printing to help grow an ear

WASHINGTON (AP) — Printing out body parts? Cornell University researchers showed it's possible by creating a replacement ear using a 3-D printer and injections of living cells.

The work reported Wednesday is a first step toward one day growing customized new ears for children born with malformed ones, or people who lose one to accident or disease.

It's part of the hot field of tissue regeneration, trying to regrow all kinds of body parts. Scientists hope using 3-D printing technology might offer a speedier method with more lifelike results.

If it pans out, "this enables us to rapidly customize implants for whoever needs them," said Cornell biomedical engineer Lawrence Bonassar, who co-authored the research published online in the journal PLoS One.

This first-step work crafted a human-shaped ear that grew with cartilage from a cow, easier to obtain than human cartilage, especially the uniquely flexible kind that makes up ears. Study co-author Dr. Jason Spector of Weill Cornell Medical Center is working on the next step — how to cultivate enough of a child's remaining ear cartilage in the lab to grow an entirely new ear that could be implanted in the right spot.

Wednesday's report is "a nice advancement," said Dr. Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest Baptist Medical Center, who wasn't involved in the new research.

Three-dimensional printers, which gradually layer materials to form shapes, are widely used in manufacturing. For medicine, Atala said the ear work is part of broader research that shows "the technology now is at the point where we can in fact print these 3-dimensional structures and they do become functional over time."

Today, people who need a new ear often turn to prosthetics that require a rod to fasten to the head. For children, doctors sometimes fashion a new ear from the stiffer cartilage surrounding ribs, but it's a big operation. Spector said the end result seldom looks completely natural. Hence the quest to use a patient's own cells to grow a replacement ear.

The Cornell team started with a 3-D camera that rapidly rotates around a child's head for a picture of the existing ear to match. It beams the ear's geometry into a computer, without the mess of a traditional mold or the radiation if CT scans were used to measure ear anatomy.

"Kids aren't afraid of it," said Bonassar, who used his then-5-year-old twin daughters' healthy ears as models.

From that image, the 3-D printer produced a soft mold of the ear. Bonassar injected it with a special collagen gel that's full of cow cells that produce cartilage — forming a scaffolding. Over the next few weeks, cartilage grew to replace the collagen. At three months, it appeared to be a flexible and workable outer ear, the study concluded.

Now Bonassar's team can do the process even faster by using the living cells in that collagen gel as the printer's "ink." The 3-D technology directly layers the gel into just the right ear shape for cartilage to cover, without having to make a mold first.

The next step is to use a patient's own cells in the 3-D printing process. Spector, a reconstructive surgeon, is focusing on children born without a fully developed external ear, a condition called microtia. They have some ear cartilage-producing cells in that tissue, just not enough. So he's experimenting with ways to boost those cells in the lab, "so we can grow enough of them from that patient to make an ear," he explained.

That hurdle aside, cartilage may be the tissue most amenable to growing with the help of 3-D printing technology, he said. That's because cartilage doesn't need blood vessels growing inside it to survive.

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O.C. killer an obsessive video gamer

Ali Syed was a 20-year-old loner who took occasional computer classes at a community college and spent a lot of time alone in his room playing video games, said an Orange County Sheriff's Department spokesman.

How he crossed paths with 20-year-old Courtney Aoki remains a mystery.

Early Tuesday morning, Aoki was in Syed's bedroom, inside the town house he shared with his parents in the upscale Ladera Ranch development. Gunshots rang out from the bedroom, and Syed ran out of the house and drove away, police said. Aoki was dead from multiple wounds from a shotgun Syed's father had bought him about a year ago.

So began a rampage through Orange County in which Syed killed three people and injured three others before taking his own life, police said.

Authorities on Wednesday released 911 tapes in which Syed's frantic parents reported the shooting.

But officials said they were no closer to knowing a motive for the shooting rampage.

"There's still a lot of work to do in this case," sheriff's spokesman Jim Amormino said.

Syed left "no evidence, no note, no nothing that would explain this very bizarre, violent behavior."

Authorities said they didn't know how Aoki got to the Ladera Ranch home. She was dressed when she was found, and there was no evidence of sexual assault.

Syed's mother called 911 at 4:45 a.m. Tuesday.

"I think somebody's shot ... in my house," she said. "Somebody's shot. I think there's somebody shot."

Hysterical, the woman tried to answer the dispatcher's questions. Her husband eventually took over the phone.

"Can you please send somebody here?" he said. "Our son lives with us and I think they got into a fight or something and we heard a gunshot."

The parents told the 911 operator that they were sleeping when they heard what they thought was a gunshot downstairs. They did not enter their son's room, they told a dispatcher, but said he had left the home in their SUV.

"He's gone out," the father said. "He took the car we have.... Yes, he's not home right now. He drove away."

They told the dispatcher they did not see a victim.

"I have not gone in his room," the father said in answer to a dispatcher's questions. "I don't know what's going on."

Detectives had difficulty identifying Aoki, Amormino said, because she had no identification and no vehicle at the Ladera Ranch residence.

No missing person reports had been filed on her.

Amormino said Aoki was identified Wednesday morning from a second set of fingerprints, but authorities were unable to find her mother until about 2:30 p.m. Although Aoki's mother also lives in Orange County, Aoki did not live with her, Amormino said.

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Oslo Journal: In Norway, TV Program on Firewood Elicits Passions

Kyrre Lien for The New York Times

Lars Mytting at his home in Elverum, Norway. His best-selling book, “Solid Wood: All About Chopping, Drying and Stacking Wood — and the Soul of Wood-Burning” inspired a TV program about cutting, stacking and burning firewood.

OSLO — The TV program, on the topic of firewood, consisted mostly of people in parkas chatting and chopping in the woods and then eight hours of a fire burning in a fireplace. Yet no sooner had it begun, on prime time on Friday night, than the angry responses came pouring in.

“We received about 60 text messages from people complaining about the stacking in the program,” said Lars Mytting, whose best-selling book “Solid Wood: All About Chopping, Drying and Stacking Wood — and the Soul of Wood-Burning” inspired the broadcast. “Fifty percent complained that the bark was facing up, and the rest complained that the bark was facing down.”

He explained, “One thing that really divides Norway is bark.”

One thing that does not divide Norway, apparently, is its love of discussing Norwegian wood. Nearly a million people, or 20 percent of the population, tuned in at some point to the program, which was shown on the state broadcaster, NRK.

In a country where 1.2 million households have fireplaces or wood stoves, said Rune Moeklebust, NRK’s head of programs in the west coast city of Bergen, the subject naturally lends itself to television.

“My first thought was, ‘Well, why not make a TV series about firewood?’” Mr. Moeklebust said in an interview. “And that eventually cut down to a 12-hour show, with four hours of ordinary produced television, and then eight hours of showing a fireplace live.”

There is no question that it is a popular topic. “Solid Wood” spent more than a year on the nonfiction best-seller list in Norway. Sales so far have exceeded 150,000 copies — the equivalent, as a percentage of the population, to 9.5 million in the United States. — not far below the figures for E. L. James’s Norwegian hit “Fifty Shades Fanget,” proof that thrills come in many forms.

“National Firewood Night,” as Friday’s program was called, opened with the host, Rebecca Nedregotten Strand, promising to “try to get to the core of Norwegian firewood culture — because firewood is the foundation of our lives.” Various people discussed its historical and personal significance. “We’ll be sawing, we’ll be splitting, we’ll be stacking and we’ll be burning,” Ms. Nedregotten Strand said.

But the real excitement came when the action moved, four hours later, to a fireplace in a Bergen farmhouse.

Perhaps you have seen a log fire burning on television before. But it would be very foolish to confuse Norway’s eight-hour fireplace extravaganza on Friday with the Yule log broadcast in the United States at Christmastime.

While the Yule log fire plays on a constant repeating loop, the fire on “National Firewood Night” burned all night long, in suspensefully unscripted configurations. Fresh wood was added through the hours by an NRK photographer named Ingrid Tangstad Hatlevoll, aided by viewers who sent advice via Facebook on where exactly to place it.

For most of the time, the only sound came from the fire. Ms. Hatlevoll’s face never appeared on screen, but occasionally her hands could be seen putting logs in the fireplace, or cooking sausages and marshmallows on sticks.

“I couldn’t go to bed because I was so excited,” a viewer called niesa36 said on the Dagbladet newspaper Web site. “When will they add new logs? Just before I managed to tear myself away, they must have opened the flue a little, because just then the flames shot a little higher.

“I’m not being ironic,” the viewer continued. “For some reason, this broadcast was very calming and very exciting at the same time.”

To be fair, the program was not universally acclaimed. On Twitter, a viewer named Andre Ulveseter said: “Went to throw a log on the fire, got mixed up, and smashed it right into the TV.”

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What's Next for Mindy McCready's Two Young Boys?

By Steve Helling

02/19/2013 at 07:00 PM EST

Mindy McCready's apparent suicide on Sunday has left her two young sons in custodial limbo.

The boys – Zander, 6, and Zayne, 10 months – had been in state custody since Feb. 7, when McCready called police to ask for help in making her father and stepmother leave her home. When police arrived, McCready appeared to be intoxicated, according to a Department of Human Services report.

In a subsequent petition, the singer's father, Tim McCready, asked the court to order her to undergo mental health and substance abuse evaluation and treatment, alleging that his daughter, who had recently lost her boyfriend, "hasn't had a bath in a week ... screams about everything ... [is] very verbally abusive to Zander."

After a judge granted the petition, the children were quickly removed and placed into foster care. Although McCready was released from treatment, the boys remained in state custody.

At the time, Zander's father, Billy McKnight, requested custody of his son. "My son needs me," he told PEOPLE on Feb. 8. "I'm married, working and successful. I'm on the right track and proud of it. I've been sober for years. I just want my son."

But McCready's mother and stepfather, Gayle and Michael Inge, also want custody of the children – and authorities seem to agree.

In a proposed order sent to Circuit Judge Lee Harrod, the Department of Human Services proposed that the Inges might be a better fit for the children, claiming that they have "a substantial relationship." The Inges had custody of Zander for much the past few years, during McCready’s rehab and jail stints.

With McCready's death, the judge will have to determine what is in the children's best interest. A custody hearing has been scheduled for April 5.

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Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

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Stobbe reported from Atlanta.

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Online:

JAMA: http://www.jama.ama-assn.org

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com

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Appeals court revives women inmates' bid for Wiccan chaplain

At the Central California Women's Facility in Chowchilla, shown, inmates are contending in a lawsuit that California prison policy favors mainstream religions in violation of the establishment clause of the 1st Amendment. (Los Angeles Times)

By Maura Dolan, Los Angeles Times

February 19, 2013, 3:48 p.m.

A federal appeals court revived a lawsuit Tuesday by female prisoners who contend that the California prison system is violating their rights by refusing to hire a full-time Wiccan chaplain.

A district court rejected the inmates' suit, but a three-judge panel of the U.S. 9th Circuit Court of Appeals ruled that the inmates may have a valid claim.

The California Department of Corrections and Rehabilitation hires chaplains for five faiths: Protestant, Catholic, Jewish, Muslim and Native American. Inmates of other religions are permitted to worship with those chaplains or with volunteer chaplains.

In their lawsuits, inmates at the Central California Women's Facility in Chowchilla contend that the prison policy favors mainstream religions in violation of the establishment clause of the 1st Amendment. The inmates said there were more Wiccans at the women's prison than there were Jewish, Muslim or Catholic prisoners.

Wicca is a pagan religion that involves witchcraft. If the inmates' allegations are true, the appeals court said, "The prison administration has created staff chaplain positions for five conventional faiths, but fails to employ any neutral criteria in evaluating whether a growing membership in minority religions warrants a reallocation of resources."

The court stressed that it was not suggesting the lawsuit should succeed. A lower court must now evaluate the evidence, including a survey of the religious affiliations of inmates at the prison, the panel said.

maura.dolan@latimes.com

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Seeking Direction in Yemen

Yemenis gathered in Change Square in the capital, Sana, this month. Two years after the start of the country’s uprising, the square is almost empty of protesters. 

Yemen, having pulled back from the brink of war in 2011, is slowly embarking on a national dialogue aimed at reconciling its rancorous political factions, under the watchful eyes of Arab and Western monitors.

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Mindy McCready: Under Police Scrutiny at Time of Suicide?

By Steve Helling and Mike Fleeman

02/18/2013 at 06:00 PM EST

Mindy McCready and David Wilson

Courtesy Mindy McCready

When Mindy McCready talked to police in recent weeks, her account of how her boyfriend came to be found with a fatal gunshot wound to the head concerned police, a law enforcement source tells PEOPLE.

"At first, she said she hadn't heard the gunshot because the TV was too loud. Then she said she had heard the gunshot," the source says. "So obviously there were a lot of questions, and the Sheriff was asking for clarification."

But before investigators could re-interview her, the long-troubled country singer also would die under eerily similar circumstances, her body discovered at the same Heber Springs, Ark., house just feet away from where David Wilson died.

McCready's death was blamed on what "appears to be a single self-inflicted gunshot wound," the Cleburne County Sheriff's Office said in a statement.

This differed from how the sheriff characterized Wilson's case. His cause and manner of death still have not been established by the coroner. It was McCready's publicist, and not a law enforcement official, who announced that Wilson had died of a self-inflicted gunshot wound.

After Wilson's death, McCready, 37, spoke to investigators three times, but they didn't feel as if they were through with her.

"At no point did [police] tell her she was a suspect, and she wasn't officially one," says the source. "But she knew that some of her answers didn't stand up to questioning. She was very cooperative, but she just wasn't making a lot of sense."

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Hip implants a bit more likely to fail in women

CHICAGO (AP) — Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.

The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries.

"This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.

Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration.

After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening.

"There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."

Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads — the ball-shaped part of the ball-and-socket joint in an artificial hip — are more likely to dislocate and require a surgical repair.

That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.

The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years.

"Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."

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Online:

Journal: http://www.jamainternalmed.com

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State program to seize illegal guns gaining notice

CE: lraab 76090

lrh—ext 75886 / jlavally slotted

By law, Alexander Hernandez should have surrendered his gun to the state of California three years ago after a judge issued a restraining order against him for alleged domestic violence.

He didn't.

So one night recently , when the 26-year-old was at home in Whittier with his toddler, eight armed agents from the California Department of Justice banged on his door and took it from him.

Agents found the loaded .45-caliber handgun in a safe by his bed. Hernandez, who told the agents he had forgotten that he was supposed to turn in the weapon, was arrested on suspicion of illegally possessing a handgun, records show.

After assuring that the child had a baby-sitter, the agents drove off into the night in search of more illegal guns. Their quest took them across the San Gabriel Valley, from a retirement home to a gated community to a small house with rosebushes in front. In the living room of that house, a mother wept as agents arrested her son. A conviction for misdemeanor battery made it illegal for him to continue possessing his four guns.

California has the nation's only program to confiscate guns from people who bought them legally but later became disqualified. During twice-weekly sweeps over the last five years, agents have collected more than 10,000 guns.

But there are still more than 19,700 people on the state's Armed Prohibited Persons database. Collectively, they own about 39,000 guns. About 3,000 people are added to the list each year.

Clearing the backlog would cost $40 million to $50 million, according to Atty. Gen. Kamala Harris. She estimated that once the backlog is cleared, fielding teams large enough to keep up with people added to the list would cost about $14 million a year.

"This is about prevention," Harris said. "This is about taking guns out of the hands of people who are prohibited from owning them, and are known to be potentially some of the most dangerous people walking around.... It's just common sense."

As gun control has moved to the forefront of national debate, California's program is being studied as a potential model.

The list of prohibited owners is compiled by analysts who track gun sales back to 1996 and match them against databases listing criminal convictions, restraining orders and mental health detentions.

Sometimes the guns are used in killings before the state can retrieve them, according to state Sen. Mark Leno (D-San Francisco), who last month introduced legislation that would provide funding for more agents to conduct sweeps.

For example, Roy Perez had been on the list for three years before he shot and killed his mother, his neighbor and his neighbor's 4-year-old in Baldwin Park in 2008, officials said.

Until recently, the gun apprehension teams had received little attention in the five years they have been sweeping through neighborhoods. But they suddenly have become a topic of intense interest — so much so that when agents rolled through Southern California earlier this month , their big, unmarked trucks were joined by two agents in a rented minivan large enough to carry journalists and camera crews.

The job requires a mixture of force and finesse. The agents show up in heavily armed teams, wearing black jumpsuits bulked up by bulletproof vests. But they don't have warrants and, unless their subject is on probation, they need permission to enter homes to search for guns. Obtaining a search warrant typically requires a reasonable suspicion that the gun would be on the premises, a difficult standard to meet based solely on information from a database, officials said.

Instead, they must talk their way in and coax gun owners into turning over their weapons.

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