Doctors Remove Ammunition From Soldier’s Head

The patient arrived in critical condition last month at the Bagram Air Base hospital in Afghanistan, with what American military doctors at first thought was an all too typical war injury: metal shrapnel from an improvised bomb lodged in his head.

A 14.5 millimeter high explosive incendiary round was removed from the scalp of an Afghan National Army soldier.

A CAT scan showed that the piece of metal, about two and a half inches long, was probably a cartridge fragment — again, not at all unusual.

But as the patient, an Afghan soldier in his 20s, was prepared for surgery, the chief radiologist, Lt. Col. Anthony Terreri, took a closer look at the CAT scan. Stunned, he realized the object was an explosive round, primed to go off.

“It looks like we have a problem here,” he announced.

To say the least.

In a joint telephone interview from Bagram on Friday, members of the Air Force medical team recounted the hours that followed Dr. Terreri’s discovery.

Maj. John Bini, a trauma surgeon and a veteran of homemade-bomb injuries from two previous deployments in Iraq, immediately evacuated the operating room. Only the anesthesiologist, Maj. Jeffrey Rengel, who put on body armor, was left to watch the patient.

The surrounding hallways were secured, and a bomb disposal team was urgently summoned. All electrical monitoring devices in the operating room were turned off for fear of detonating the round. To keep track of the patient’s vital signs, doctors turned to manual blood pressure cuffs and a battery-operated heart monitor, and they began counting drips per minute to estimate the amount of the intravenous anesthesia they were giving the patient. “It was taking anesthesia back about 30 years,” Dr. Rengel said.

Within a half-hour, the bomb disposal team arrived and confirmed, based on the CAT scan, that the patient indeed had unexploded ordnance in his head.

“They said, the way these things are set up, this type of round has an impact detonator on the front of the charge,” Dr. Bini said. “They just said, ‘Don’t drop it.’ ”

With that for reassurance Dr. Bini put on body armor as well, and he began the process of surgically removing the round from the patient’s head, joined in the operating room only by Dr. Rengel and a member of the bomb team. He cut through scalp tissue and made a large incision encircling the round, which was lodged under a piece of skull bone and jutted down the right side of the patient’s head. Within 10 minutes, he pulled out the live round. With care, he handed it to the bomb technician, who put it in a bag and left.

Did Dr. Bini breathe a sigh of relief before handing off to a neurosurgeon?

“I didn’t even think about breathing a sigh of relief,” Dr. Bini said. “Technically, it wasn’t a very complicated procedure, and I had the confidence that I wasn’t going to drop it on the floor. This is something we train for — although it’s a very uncommon event.”

In fact, Dr. Bini had taught students how to remove live ordnance from patients in sessions at Wilford Hall Medical Center at Lackland Air Force Base, where he is stationed when not at war. He just had never expected to have to do it in real time.

Dr. Bini said that in the nearly nine years of war in Iraq and Afghanistan, if someone else had removed an unexploded round from a patient, he had not heard of it. He said that a quick review of the medical literature found fewer than 50 cases over the last half-century.

The patient, who was not named by the doctors, has since been discharged from the Craig Joint-Theater Hospital at Bagram and is recovering. Although the patient has brain injuries from bone fragments, Dr. Bini said the Afghan was able to walk, to talk and to eat on his own.

Dr. Bini said he was unaware an unexploded bomb embedded in a patient’s chest had been the plot of a TV show — a two-part episode of “Grey’s Anatomy” in 2006. The character Hawkeye Pierce also pulled an unexploded grenade out of the chest of a wounded soldier in an episode of “MASH” in 1973. “None of that stuff you see on TV approximates reality,” Dr. Bini said.

Glow-in-the-dark cats can help with gene therapy in the future

Last week South Korean scientists reported that they had successfully cloned cats whose genes had been altered so that they 'glow-in-the-dark' under UV light. It is hoped that the ability to alter genes in this way may help scientists discover how to make more complicated gene changes, allowing them to artificially create animals with human genetic diseases for carrying
out research into new treatments or cures. The discovery, made by researchers at Gyeongsang National University, is
significant because - with a duo of glow-in-the-dark cats as living proof - it marks the first time that scientists have successfully altered the genetic code of cloned cats. 'This technology can be applied to cloned animals suffering from the same diseases as humans', Kong Il-keun, who led the research, told AFP. 'It will also help develop stem cell treatments', he said, noting that cats have some 250 kinds of genetic diseases that affect humans, too. The technology can also help clone endangered animals like tigers, leopards and wildcats, Kong said.
The three cats - all Turkish Angoras - were created by taking skin cells from donor female cats and using a harmless virus to insert the gene for 'Red Fluorescent Protein' (RFP) into the nucleus of each cell, thereby altering its genetic code. The nuclei of the donor female's egg cells were then removed and replaced with the gene-altered nuclei of the skin cells, to
create a cloned embryo.
To find out if they had been successful in their attempt at creating gene-altered embryos, the researchers implanted the cloned embryos back into the donor females to show that the cloned kittens did indeed glow-in-the-dark, indicating that they expressed RFP in their skin. The three cats were reportedly born by Caesarian section in January and February of this year. Although one was a stillbirth, the scientists claim that it too had expressed the RFP protein throughout its body, indicating
that their methods had worked in all three cats. The scientists hope that the ability to create animals that mimic human diseases can speed up efforts to find treatment and drugs by allowing scientists to study animals and conduct experiments that are not possible with human patients. With the current price tag of tens of thousands of dollars to clone a single cat,
glow-in-the-dark pets are unlikely to become a commercial venture in the near future.The discovery was announced last week in a press release by the government managed Korea.net news service, however peer reviewed papers and
replications of the same experiment will be eagerly awaited to prove the validity of these results.

Dead Duck

A woman brings a very limp duck into a veterinary surgery. As she lays the duck on the examination table the vet pulls out his stethoscope and listens to the duck's chest for signs of life. After a few moments the vet shakes his head and turns to the woman and says sadly, "I'm sorry but the duck has passed away." The distressed owner wails, "Are you sure?"

"Yes of course I'm sure. The duck is dead," he replies.

"How can you be so sure?" she protests. "I mean you haven't done any testing - he might be in a coma or something." The vet rolls his eyes and leaves the room. He returns with a black Labrador. As the duck's owner looks in amazement, the dog stands on his hind legs, puts his front paws on the examination table and sniffs the duck from top to bottom. He then looks at the vet and with sad eyes shakes his head. The vet pats the dog on the head and takes him out and returns a few moments later with a cat. The cat jumps up on the table and also sniffs the duck from its beak to its tail at the back end and back again. The cat sits and shakes its head and meows softly, jumps down from the examination table and strolls out of the examination room.

The vet looks at the woman and says, "I am sorry, but as I said, this Is most definitely, 100% certifiably, a dead duck."

The vet turns to his computer terminal and after hitting a few keys a bill is printed off, which he hands to the woman. The duck's owner, still in shock, takes the bill. "£450!" she cries. "£450 just to tell me my duck is dead?" The vet shrugs. "If you had accepted my word for it, the bill would have been only £30. But with the LAB report and the CAT scan - it all adds up."