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A project by David Colosi, 2004
Photo credits: David Colosi

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C1 L THE NEW TIMES GAZETTE, SCIENCE TIMES, THURSDAY, DECEMBER 2, 2004

Doctors Grow Mini-Satch in Man's Skull

By BLAKE SANDRALEE

minisatch1A man who science scholars believe had the musical center of his brain destroyed in a bizarre roadside accident nine years ago has enjoyed his first live Jazz performance in what experts call an "ambitious'' experiment: surgeons grew a miniature Louis Armstrong from the man's skull.

According to this week's issue of The Lancet medical journal, doctors used a mesh cage, a growth chemical, and the patient's own bone marrow,minisatch3 containing stem cells, and mixed them with the DNA of the deceased Armstrong to create a mini-Satchmo that filled the gap left by the accident.

The patient, a 42-year-old man, lost one eye and suffered a massive puncture to his skull almost a decade ago after an arrow entered his face just below his left eye and exited the top of his skull. Saul Perup pulled off the road to assist a fellow driver whose car had driven over an embankment. When Perup approached the man to offer assistance, the man pointed a loaded crossbow at Perup's face and shot him.

Perup has survived these nine years "unchanged" with the exception of the loss of his left eye and his ability to appreciate the music that had once played a major role in his emotional life. He has been able to merely hear musical sounds and read the sheet music of his favorite Jazz standards through his one remaining eye.

minisatch2Perup's friends have noted that while he has kept his job and continues to perform his duties consistently, and while he relates to his family and friends with the same care, generosity, and self-control as before, since the accident, "Perup is no longer Perup."

His fifteen-year-old daughter Jessica complained, "he used to play a new song for me every night before I went to bed. After the accident he only kissed me goodnight and that was it."

The operation was performed by Dr. Warner Patrinke, a reconstructive cranial surgeon at the University of Kiel in Germany. " He demanded reconstruction,'' Patrinke said.minisatch4 "This patient was really sick of living.''

Patrinke and his group began by creating a virtual Satchmo on a computer, after making a three-dimensional scan of the patient's skull.

The information was used to create a thin titanium micro-mesh cage. Several cow-derived pure bone mineral blocks the size of sugar lumps were then put inside the structure, along with a human growth factor that builds bone and a large squirt of blood extracted from the man's bone marrow, which contains stem cells, and an added squirt of Armstrong's DNA extracted from the mouthpiece of his trumpet, now part of the Louis Armstrong Archives housed in Queens College in New York.

The surgeons then implanted the mesh cage and its contents into the patient's skull. He was given no drugs, other than routine antibiotics to prevent infection from the surgery.

minisatch5The implant was left in for seven weeks, when scans showed new bone and tissue formation. The titanium cage was removed about eight weeks ago. Scans showed new bone, tissue, and DNA continued to form after the removal of the cage.

Four weeks later, Perup heard his first Jazz tune in nine years -Armstrong played his 1926 classic Heebie Jeebies. Perup listens to Armstrong daily now, but complains to his doctor that Satch keeps repeating the same song, and he can't understand the words. Doctors have high hopes that Perup will reach a level that can appreciate scat while Perup is positive that other songs will come back to Satch over time.

Perup has reported no pain or any other difficulties associated with the implant, Patrinke said, adding that he hopes to be able to remove Satchmo from Perup's head about a year from now, so Armstrong can play independently and expand his repertoire.

Continued on Page C14

 

C14 L THE NEW TIMES GAZETTE, SCIENCE TIMES, THURSDAY, DECEMBER 2, 2004

Mini-Satchmo Grown Out of Arrow Wound in Man’s Skull

Continued From Page C1

minisatch_6In the scientific community this operation combined established techniques in a remarkable collage of recent and historical medical cases. Scholars as early as the late 1700's had introduced the possibility of the localization of tasks in the brain. The Perup case is considered by some to be the next major breakthrough in that research.

The most important contribution came in the 1820's when Viennese anatomist Franz Josef Gall designated two areas in the brain: one to Benevolence, which controlled morality and justice, and the other to Veneration, which controlled religious feeling and respect for humanity. But the most famous case, which would leave the door open to localization theory, occurred in 1848.

A Bizarre 19th Century Accident

minisatch_7In an article published in Science in May 1994, a team of doctors led by Hanna Damasio, using the advances in computer technology, reevaluated the facts in the case of Phineas P. Gage. Gage was a railroad worker in Vermont who lived for just under twelve years after an iron tamping rod, three feet seven inches long, one and a quarter inches in diameter tapering over a twelve inch span to a quarter-inch diameter point at one end, weighing thirteen and a quarter pounds, shot through his head in a track-laying explosion. Damasio and her team studied Gage's skull and the rod, archived in the Warren Anatomical Medical Museum at Harvard University, to try to determine the exact trajectory through his head.

The Damasio team determined that the tamping rod pierced what the New York Times called Gage's "moral center." Although Gage lived for eleven and a half years after the accident many thought that his sense of responsibility, sociability, and language changed enough to make Gage no longer Gage.

Oddly enough, Gall's areas of Benevolence and Veneration, Damasio's "moral center," and the "musical center" identified in the Perup case have all been mapped within millimeters of each other making the accuracy of marking boundaries in the brain increasingly difficult.

minisatch_8While the Gage case opened the door to localization theory, and some believe paved the way for the controversial practice of lobotomy and other forms of "testing" sections of the brain, it is too early to tell what door the Perup case will open.

21st Century Radical Experiments

Unquestionably, this ambitious experiment seems to follow a trend of radical experiments in the past decade. In 1995 at the University of Massachusetts, scientists grew a human ear using a mold on the back of a mouse. In 2001, in Portland Oregon, scientists inserted the gene that causes jellyfish to glow under fluorescent light into a monkey egg, fertilized the egg and produced a baby monkey with the added gene in its cells. As recent as August 2004, doctors in Germany assisted a man who had lived nine years without a jaw as a result of cancer surgery by growing a new jawbone in his back muscle and later transplanting it to his mouth.

minisatch_9Even as a clinic in Cleveland Ohio received approval just this month to perform the world's first face transplant, the advance made in the Perup case seems indisputable.

A Medical Controversy

Dr. Berto Umbeco of the University of Bologna, who has no connection to the Perup case, expressed optimism that this breakthrough is the one localization scholars and stem cell researchers have been waiting for.

minisatch_10Stem cells are the master cells of the body that go on to become every tissue. They are a hot area of research with scientists trying to find ways to prompt them to make desired tissues, organs, and, perhaps, human clones.

Grant Stonthos, a stem cell expert at the Institute of Medical and Veterinary Science in Adelaide, Australia expressed that the operation had achieved its purpose and changed a life.

"A patient who had previously lost his ability to appreciate music through the result of a destructive accident can now sit down and tap his foot to his first Jazz tune in nine years ... resulting in an improved quality of life,'' said Stonthos, who also had no connection with the experiment.

Other scientists have not expressed such optimism. Tests have not been done yet to verify whether Mini-Satch was created by the blank-slate stem cells. Rob Paulwn, head of the Center for Tissue Regeneration Science at University College in London, questions whether any major scientific ground has been broken, and suggested that tests may not be able to show whether the new human came from stem cells, rather than from the growth factor alone.

“It sounds like for this patient this has worked.”

"If you put loads of blocks of bone mineral into a hole and you induce cellular activity by putting in growth factors, it's a standard approach that people have used to induce the body's own response,'' said Paulwn, who, also, was not connected with the study. "Clearly some of them are going to work, and it sounds like for this patient, this has worked."

minisatch_11But it is still too early to tell whether Perup or Satch will perform normally in the long term. Biopsies, CT scans, psychological and biographical exams, and performance tests could later provide some answers to the level of Perup's appreciation and the quality of Satch's music, experts said.

"Just making the gross tissue shape right isn't really the problem,'' Paulwn said. "It's what the shape of the tissue is at the microscopic and ultramicroscopic level. It's the architecture and, ultimately, the quality of the music which is so tricky and which is what gives function."

Although questions still remain, everyone seems to agree that Perup's quality of life has improved.

minisatch_12New York University Pre-Med sophomore and saxophone player Peter Fritsch offers more healthy optimism: "Unlike many cases of experimental science where healthy animals are subjected to destructive tests, or healthy people subject themselves to Botox, Liposuction, and 'nip and tucks', scientists in this case took the unfortunate result of a destructive accident and experimented to create a productive result. Not only is Perup optimistic about life again, but so is Satchmo, and so are Jazz lovers around the world.''

 

 

 

INSTALLATION DESCRIPTION: The viewer first encounters the installation through the clouded glass door of room 18.  A faint glow from a lamp distinguishes shadows, and the muted tones of Louis Armstrong rise above the walls.  When the door opens a motion sensor activates lamps, a television, and a scientific electrical device that seemingly powers the room.  Written and erased on the chalkboard-painted walls is a visual palimpsest of citations, diagrams, and bibliographic references.  A wheelchair bound with metal and electrical wire sits in the center of the room.  Miscellaneous items from the immediate vicinity are caught in the web.  The floor is scattered with Satchmo sheet music.  A television in the lap of the chair sputters the current broadcast.  At the top of the chair a skull is bound into the coil.  From the top of the skull a figurine of a trumpet player emerges.  The wires that wind around the chair lead back to a homemade electrical device.  Lights on a laboratory switch box and a stereo receiver indicate a live current.  Wires lead to a brass chandelier that hangs from the ceiling.  Red 'flame' bulbs from the chandelier, two lamps on either side of the chair, and the blue glow from the TV illuminate the room.  A three-dimensional diagrammatic arrow protrudes from the back wall pointing at the figurine rising from the skull.  In another corner of the room a window takes on the illusion of a mirror reflecting back a portion of a face.  A newspaper article pinned to the wall, right of the door, illuminated by a showcase lamp, describes the accident of a man who scientists believe had his musical center destroyed when a hunting arrow shot through his head.  In hopes of helping him appreciate music again, and fully recover, doctors attempted the ambitious experiment of growing a miniature Louis Armstrong in his head.

 

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