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World's First Quadruple Limb Transplant Fails

samzenpus posted more than 2 years ago | from the not-this-time dept.

Medicine 124

New submitter smoothjazz writes "The world's first quadruple limb transplant failed, according to Hacettepe University. Doctors had to remove the arms and legs that had been transplanted last Friday onto Sevket Çavdar, 27, because of tissue incompatibility. From the article: 'Doctors had first removed one leg from the patient after his heart and vascular system failed to sustain the limb and then the other leg and two arms. "The science council (of the hospital) decided to remove the organs one by one due to additional metabolic complications in the following process," the hospital said in a statement. "Our patient is now in the intensive care unit. The critical process is still continuing," it added.'"

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124 comments

Well, now he's worse off than before... (0)

Anonymous Coward | more than 2 years ago | (#39174379)

Those were evil limbs anyway!

Re:Well, now he's worse off than before... (0)

Anonymous Coward | more than 2 years ago | (#39174491)

Angel reference?

EVIL HAND!

Re:Well, now he's worse off than before... (5, Funny)

Hatta (162192) | more than 2 years ago | (#39174769)

I hear they're charging him an arm and a leg for the procedure.

Re:Well, now he's worse off than before... (4, Funny)

fahrbot-bot (874524) | more than 2 years ago | (#39175001)

Coincidentally, patient's name is Bob.

Re:Well, now he's worse off than before... (1)

sycodon (149926) | more than 2 years ago | (#39175857)

The Dyslexic are wondering why they are transplanting limbs onto a Cadavar, why they named it Evket, and why Samzenpus can't spell cadaver.

Re:Well, now he's worse off than before... (0)

Anonymous Coward | more than 2 years ago | (#39175275)

I hear they're charging him an arm and a leg for the procedure.

Comedy aside, it does present a good point: in the future they might think about attaching 1, maybe 2 limbs at a time so the support systems can catch up.

Re:Well, now he's worse off than before... (1)

K. S. Kyosuke (729550) | more than 2 years ago | (#39175301)

I hear they're charging him an arm and a leg for the procedure.

That's quite common in modern world, but in his place, I'd be really pissed off for being billed twice.

What's in a name (3, Funny)

Dan East (318230) | more than 2 years ago | (#39174411)

Anyone else notice the similarity between "Çavdar" an "cadaver", in a story that already parallel's a certain work by Mary Shelley in a number of ways.

A foreign character, that's what (2)

tepples (727027) | more than 2 years ago | (#39174447)

I also noticed that the summary has "evket" while the article has "Sevket". Is it yet another character that Slashdot's administrators refuse to allow in Slashdot's character set?

Re:A foreign character, that's what (0)

Anonymous Coward | more than 2 years ago | (#39174495)

> Is it yet another character that Slashdot's administrators refuse to allow in Slashdot's character set?

What? The letter S?

Re:A foreign character, that's what (1)

tepples (727027) | more than 2 years ago | (#39174915)

Probably an S with some sort of diacritic on it. The summary has Çavdar while the article has Cavdar, indicating that the name in the summary may have been copied from a source other than the article, such as the Today's Zaman article [todayszaman.com].

Re:What's in a name (1)

Amouth (879122) | more than 2 years ago | (#39174569)

yea it got me at first - i was trying to figure out how they failed to transfer limbs to a "cadaver" and then couldn't figure out why the hell you would do that.. then i realized it was the guys name "Çavdar"

Re:What's in a name (1)

ColdWetDog (752185) | more than 2 years ago | (#39174705)

Maybe it's has a different meaning in Turkish, but I, for one, would not like to run around with that name.

Especially with this Zombie thing that's taking over. Just a bad idea all around.

Re:What's in a name (0)

Anonymous Coward | more than 2 years ago | (#39175735)

Çavdar means rye in Turkish. Like "catcher in the rye".

Re:What's in a name (0)

Anonymous Coward | more than 2 years ago | (#39174631)

Unless evket was going to be cast out of society upon successful surgery and the doctors were all driven mad and were unable to prevent every person they love from being violently murdered, this really has very little to do with Shelley's Frankenstein. That was mostly a warning about pushing the boundaries of science, with the intended audience being the scientists. In this particular situation, it's mostly just a shitty outcome for the patient. (My empathy for their disappointment is why I wrote this. I don't think I'd be fond of having myself compared with Frankenstein's monster.)

Re:What's in a name (3, Informative)

Anonymous Coward | more than 2 years ago | (#39174633)

That character is equivalent to the "ch" sound in English. His name would be pronounced as Shevket Chavdar.

Re:What's in a name (1)

MisterSquid (231834) | more than 2 years ago | (#39177407)

That character is equivalent to the "ch" sound in English. His name would be pronounced as Shevket Chavdar.

Nice try but it needs further clarification. "Ch" as in "school" or ch "branch">?

Re:What's in a name (1)

Nicknamename (2572429) | more than 2 years ago | (#39177483)

Why didn't they just do it one limb at a time. Sounds like showing off and malpractice to me. Too many Dr. Frankensteins, too few people who understand the spirit of the Hippocratic oath.

Would the limbs have ever worked? (1)

Dinghy (2233934) | more than 2 years ago | (#39174461)

I'll admit I'm no doctor, but I don't think I'm that out of touch to have missed an announcement like being able to splice/repair nerves. *starts timer to see how quickly I'm proven to be out of touch*

Re:Would the limbs have ever worked? (0)

Anonymous Coward | more than 2 years ago | (#39174527)

I have to agree, I was a bit confused by the headline. I was unaware that modern medicine could transplant one limb, much less four. Has there ever been a successful limb transplant? Did they just say "fuck it, lets do all four on our first try"?

Re:Would the limbs have ever worked? (0)

Anonymous Coward | more than 2 years ago | (#39174737)

Wow, when you woke up this morning, how did you remove 40 year's worth of eye cheese?

Re:Would the limbs have ever worked? (4, Informative)

Scootin159 (557129) | more than 2 years ago | (#39174563)

Limb transplants are nothing new: http://en.wikipedia.org/wiki/Hand_transplantation [wikipedia.org]

Re:Would the limbs have ever worked? (1)

sconeu (64226) | more than 2 years ago | (#39174645)

And they've been reattaching severed limbs since the '70s. My friend's dad had his arm reattached after a boating accident circa '76. He was one of the first.

Re:Would the limbs have ever worked? (4, Interesting)

x0 (32926) | more than 2 years ago | (#39175289)

And they've been reattaching severed limbs since the '70s. My friend's dad had his arm reattached after a boating accident circa '76. He was one of the first.

Re-attaching someone's own tissue, I think, doesn't have anywhere near the challenges of a limb transplant. I have a BK leg amputation, and have been wearing a prosthetic sine 1995. I asked the ortho surgeon at the time whether or not a transplant was viable, and back then the answer was 'no'.

Having read this article, I have started to reach out once again to see what the possibilities are.

m

Re:Would the limbs have ever worked? (2)

sconeu (64226) | more than 2 years ago | (#39175587)

The OP's question was about nerve reattachment, which is the same whether it's your own or someone else's.

Re:Would the limbs have ever worked? (1)

x0 (32926) | more than 2 years ago | (#39176533)

The OP's question was about nerve reattachment, which is the same whether it's your own or someone else's.

If it were that simple (relatively speaking), you would think that limb replacements would be relatively common. That they are not informs me there are challenges above and beyond mere nerve and tendon re-attachment.

m

Re:Would the limbs have ever worked? (1)

Bios_Hakr (68586) | more than 2 years ago | (#39174689)

That's mostly controlled by muscles/tendons in the forearm. They mention some nerve repair, but I doubt they really mean it in the way we think they mean it.

If this had worked, he'd have been exactly as bad off as before. He would have just looked *slightly* more normal and been a *much* greater burden on his caregivers.

Re:Would the limbs have ever worked? (5, Interesting)

canajin56 (660655) | more than 2 years ago | (#39175307)

I doubt they really mean it in the way we think they mean it.

What do you think nerve repair means? If you think it means using very tiny thread to suture the nerve sheath, while being careful not to suture the inner portion, then that's exactly what it means. The nerve itself will knit on its own. It's been done for a long time. You can find surgical manuals from the 30s that document proper nerve suture techniques. The first documented nerve suture was performed in 600 AD (though I can't find reference to the effectiveness of it). Microsurgery techniques have made great strides since then. And I believe that the major nerves will be in a larger bundle for an above-elbow arm transplant compared with a hand transplant, so this situation is actually easier than the hand transplant cases (though peripheral nerves are another story altogether). At any rate, nerves also regrow all on their own, though for an arm it can take 2-3 years of slow progress. There have been several above-elbow arm transplants that resulted (after 2 years recovery) in full elbow mobility, limited but useful sensation, and extension and flexing of fingers and thumb. (Citation for one such transplant [wiley.com], full article may be behind paywall).

The problem with nerve regrowth in transplants is that sometimes they just don't, though in 2009 French doctors discovered that they can trigger regrowth by manual stimulation of the motor cortex using magnetic impulses. The theory being that nerves that aren't being used by the brain anymore won't regrow, so if the amputation was not recent, the nerves won't grow without a jump start straight to the brain.

Above elbow/knee transplants can also have the problem that that much vascular bone marrow greatly increases the chance of graft-versus-host. Though apparently it can also lead to the opposite result, with the host accepting the graft tissue more readily.

Re:Would the limbs have ever worked? (0)

Anonymous Coward | more than 2 years ago | (#39174647)

They did a hand/ fore arm transplant a few years back that worked out OK and full responsiveness was restored to it. They've also done a full trachea as well more recently, including voicebox if I remember correctly.

They've also been doing a lot of work on splicing nerves with the prosthetics group, with the most promising I've seen (and I am out of touch on this) re-routing the nerves to muscles no longer being used to amplify the signal for the prosthetic to pick up.

Re:Would the limbs have ever worked? (4, Insightful)

Mabhatter (126906) | more than 2 years ago | (#39174721)

They can repair the gross nerves now... Of course in limbs they are fairly spread out.... At least enough to gain some mobility.

You're not going to play piano, bit at least you can feed youself and wipe your own ass again!

I'm curious how they thought the heart was going to support the limbs... That's like 80% increase in body mass when the body had adjusted to not havin any limbs. Would you even have enough blood in your body to pump??? Had they done one it probably woul have worked... The problem is how to keep te others alive until they can be attached... Otherwise 4different doners would be even worse.

The future is in the big black robot suit....

Re:Would the limbs have ever worked? (3, Insightful)

mikael (484) | more than 2 years ago | (#39175021)

They were advertising for volunteers to donate enough blood for that guy. What are the psychological effects of having more "body" that is not you, than is you? There was even an organ transplant of the more private parts, but the man's wife has psychological objections after the transplant.

Re:Would the limbs have ever worked? (1)

mitzoe (2531020) | more than 2 years ago | (#39176923)

The future is in the big black robot suit....

NOOOOOOOOOOOOOO!

Re:Would the limbs have ever worked? (1)

jellomizer (103300) | more than 2 years ago | (#39177493)

How many of you who actually watched the movie tried to keep yourself from laughing at the scene, in fear that there may be some unstable guy behind you who actually thought they just watched a good movie.

Re:Would the limbs have ever worked? (1)

afidel (530433) | more than 2 years ago | (#39177647)

Sure, my dad sliced right through a nerve bundle while slicing the turkey on Thanksgiving a few years ago. The ER doc did a passable enough job of stitching him up but he noticed severe sensory problems with the thumb along with some movement problems when he took off the splint a day or two later. He went to a specialist and the guy ended up doing microsurgery to repair the nerve bundle as well as to do a better job of re-attaching the tendon.

They removed WHAT? (3, Insightful)

freeze128 (544774) | more than 2 years ago | (#39174471)

Since when is an arm or a leg considered an ORGAN?

Re:They removed WHAT? (1)

Anonymous Coward | more than 2 years ago | (#39174497)

Since always...

Re:They removed WHAT? (2)

Anrego (830717) | more than 2 years ago | (#39174537)

I’m no doctorb, but I believe the most technical medical explanation for an “organ” is: a bunch of stuff joined together which does something.

Re:They removed WHAT? (1)

ColdWetDog (752185) | more than 2 years ago | (#39174727)

Since when is an arm or a leg considered an ORGAN?

Typical guy thinking.

Re:They removed WHAT? (0)

Anonymous Coward | more than 2 years ago | (#39174859)

Typical guy critisism.

Re:They removed WHAT? (1)

Baloroth (2370816) | more than 2 years ago | (#39174827)

Since the term "organ" means "tool". Literally. Also, since Wikipedia defines it as "a collection of tissues joined in structural unit to serve a common function." So, yes, an arm or a leg is an organ, most definitely, just not the kind of organ most people think of as "organs."

Re:They removed WHAT? (1)

jklovanc (1603149) | more than 2 years ago | (#39175111)

Yet again Wikipedia is not the final word on the world's knowledge. There is one main issue with calling a limb an "organ" is that it contains only part of another well difined "organ"; skin. Skin the the biggest organ in the human body and one can not have part of one organ be part of another organ. If you want to bring up the veins and arteries; ther are not organs but a system.

Another point is that the fact that there are bones in a limb breaks the "structural unit" clause. The arm bones are only part of the structural unit of the skeletal system.

Is the digestive system an organ even though it matches the broades interpretation of the definition? No, it is made up of several organs, esophagous, stomach, large intestines, small intestines, bowel.

Here is a better definition from a medical site;
"Organ: A relatively independent part of the body that carries out one or more special functions. The organs of the human body include the eye, ear, heart, lungs, and liver."
Sorry but movement is not a "special function".

Re:They removed WHAT? (1)

Baloroth (2370816) | more than 2 years ago | (#39175599)

Skin the the biggest organ in the human body and one can not have part of one organ be part of another organ.

Why not? The penis is an organ by every definition (common and medical) I can find, and it most certainly includes another organ (the skin, unless you want to try arguing the skin isn't part of the penis, which would be an odd argument). Also, the ear (absolutely an organ) includes skin as well. The arm is more usually considered an "appendage" and medically speaking it might be more precisely called an "organ system" or part of a system. And the arms certainly perform special functions (grasping objects). Organ is a fairly general term. IMO it can certainly be applied to the arm, although you may want to use another term so as to avoid any confusion.

Modern medicine (-1)

Anonymous Coward | more than 2 years ago | (#39174515)

What's the deal with quadruple limb transplants? Is it good or is it whack?

too bad (0, Funny)

Anonymous Coward | more than 2 years ago | (#39174573)

I feel bad for this person. These type of surgeries don't have a leg to stand on.

The world's first... Voltron. (1)

NumenMaster (618275) | more than 2 years ago | (#39174587)

Well, they were trying to make the first voltron. Perhaps they didn't go through the checklist... Activate interlocks! check. Dyna-therms connected. check. Infra-cells up; check. Woops, forgot the megathrusters. ABORT

What in hell could have prompted them to do all 4 (1)

spads (1095039) | more than 2 years ago | (#39174609)

at the same time in the first place? Sounds like a bit of shameless headline grabbing to me.

Re:What in hell could have prompted them to do all (1)

DougBTX (1260312) | more than 2 years ago | (#39174683)

I was thinking that too, but then, what about the donor? Presumably doing them all at once would have given they guy a matching "set".

Re:What in hell could have prompted them to do all (1)

spads (1095039) | more than 2 years ago | (#39174807)

Yes, that bares consideration. Hopefully they had a good reason for it, though that business about them being an up and coming transplant center (eg. "first face") does make one wonder.

Re:What in hell could have prompted them to do all (1)

berashith (222128) | more than 2 years ago | (#39174739)

could be that they got all 4 at the same time, from the same place. Recovery would be difficult enough without having different strengths and dimensions to the added parts, and I dont know how long these would keep without being attached to a living something.

Re:What in hell could have prompted them to do all (0)

Anonymous Coward | more than 2 years ago | (#39174741)

I wonder if it was the case of finding a compatible donor and a sort of now or never scenario where if the did not try the transplant the limbs would have not been preservable. My first reaction was similar to yours though, I must admit.

Re:What in hell could have prompted them to do all (1)

mikael (484) | more than 2 years ago | (#39175053)

China is pleased to announced the first successful head, torso, legs and arms transplant completed without any loss of blood or complications. The entire operation was completed in record time and avoided the use of any invasive surgery. Within hours of completing the procedure, the patient was able to stand up and walk around.

Re:What in hell could have prompted them to do all (0)

Anonymous Coward | more than 2 years ago | (#39175261)

Also all the parts had Apple iphone logos on them.

I think I would have started with arms. (3, Insightful)

pecosdave (536896) | more than 2 years ago | (#39174613)

Even as a non-doctor I realize that adding that much body mass to Bob or Art or whatever his name was would stress his system that wasn't used to it.

After doing some arm cardio for a while with a stable patient probably a year or more later, then maybe legs. It would probably take at least that long to find the next donor anyway.

Re:I think I would have started with arms. (1)

Hentes (2461350) | more than 2 years ago | (#39174953)

It would probably take at least that long to find the next donor anyway.

When there is a donor they usually have four limbs, my guess is that the doctors didn't want the rest of it go to waste.

Re:I think I would have started with arms. (0)

Anonymous Coward | more than 2 years ago | (#39175199)

They could have found another recipient.

Re:I think I would have started with arms. (0)

Anonymous Coward | more than 2 years ago | (#39175399)

Sounds like they need to institute rigorous exercise regime for potential transplant recipients, in order to prepare their cardiovascular system for the extra body mass.

Re:I think I would have started with arms. (1)

Anonymous Coward | more than 2 years ago | (#39175411)

Even as a non-doctor, I realize that fiddling with the internals of a human body would stress the system that isn't used to it. Obviously surgery is too dangerous and harmful! We should stick to proven treatments such as tiger testicles and baby livers.

strain on vascular system (2)

schlachter (862210) | more than 2 years ago | (#39174617)

I wonder if it would have had a higher chance of success if they had only transplanted one or two limbs? Seems like it would have been less strain on his vascular system. Anyways...very sad.

Re:strain on vascular system (1)

Mithent (2515236) | more than 2 years ago | (#39174787)

Sounds like it would have been a better idea. It must be difficult enough to for the body to adapt to one newly-attached limb, let alone 4 at once.

Re:strain on vascular system (3, Interesting)

ColdWetDog (752185) | more than 2 years ago | (#39174821)

The whole thing sounds terribly weird. Where do you find a person who, acutely, loses all four limbs? If it's traumatic, then the chances of them surviving the accident or whatever are pretty slim, much less four limb reattachments. If it's congenital then why do all four at once? Maybe you think you have a good donor (although it seems like that is wrong, FTFA)?

Searching the Internet and avoiding Fox News and the Daily Mail, I found this link [todayszaman.com] which shows a picture of the patient - he's in a wheelchair and he clearly has some deformity in his hands, so this may well have been congenital. The donor (a motorcycle accident victim, remember that fellas, in the industry we do call you all 'organ donors' for a reason) also donated his face to another transplant.

Just hope to hell he had a clear understanding of what he was getting into.

Re:strain on vascular system (0)

Anonymous Coward | more than 2 years ago | (#39175153)

Somebody who fell into a combine harvester. I remember reading Readers Digest while in the hospital waiting room as a kid.

Karl Merk [dailymail.co.uk]

Matus Hrdy [youtube.com]

Corporal Andy Reid [youtube.com]

Oscar the cat [smartplanet.com]

I do wonder whether it wouldn't be possible to reconstruct hands using a titanium skeleton (like they do for jawbone replacement) and use airbags to stretch the skin so that it would cover that skeleton.

Re:strain on vascular system (1)

nbauman (624611) | more than 2 years ago | (#39176045)

Where do you find a person who, acutely, loses all four limbs? If it's traumatic, then the chances of them surviving the accident or whatever are pretty slim, much less four limb reattachments.

It happens occasionally. One way is massive soft tissue infection, to which the arms and legs are particularly sensitive. One woman had that happen to her after childbirth. Another way is blood clots throughout the body, that particularly affect the arms and legs.

One of the body's survival mechanisms in extreme cases is to withdraw blood circulation to the arms and legs, so the limbs are particularly vulnerable.

These are terrible diseases in which most people die, so the doctors thought it was an accomplishment to have them survive at all. You might think that they would be better off dead, but the people who survive are almost always glad to be alive and almost never want to die.

Re:strain on vascular system (0)

Anonymous Coward | more than 2 years ago | (#39176753)

"Where do you find a person who, acutely, loses all four limbs?"

http://en.wikipedia.org/wiki/Boxing_Helena

Re:strain on vascular system (0)

Anonymous Coward | more than 2 years ago | (#39176777)

The whole thing sounds terribly weird. Where do you find a person who, acutely, loses all four limbs?

There are seven billion people on this planet. It would be weird if you couldn't find one.

he clearly has some deformity in his hands, so this may well have been congenital.

Those are prostheses!

Re:strain on vascular system (0)

Anonymous Coward | more than 2 years ago | (#39175007)

Seems they bit-off more than they could chew.

Just maybe.. (0)

Anonymous Coward | more than 2 years ago | (#39174629)

We should have started with one limb, and worked up to all four. Give the guy a hand, see if it takes.

If all goes well, and the arm works as intended, rinse/repeat x3 and you're all good.

If not, well you can save the time and effort of attaching 3 extra limbs.

Augmentations (1)

Anonymous Coward | more than 2 years ago | (#39174637)

He never asked for this.

The doctors are puzzled... (5, Funny)

Anonymous Coward | more than 2 years ago | (#39174697)

...but the patient is completely stumped.

Re:The doctors are puzzled... (0)

Anonymous Coward | more than 2 years ago | (#39175335)

Who cares about the latter?

All at once is a little extreme (1)

AdrianKemp (1988748) | more than 2 years ago | (#39174831)

However most here don't seem to grasp that having (seriously) unmatched legs would be a nightmare for a normal person, let alone one that is trying to rehab from complete amputation.

It's one thing for the leg to be slightly different length, but different muscle tone, length, bone structure (obviously not gross structure) would make rehab all but impossible.

I do however find it a little odd that they felt the need to do all four at the same time... surely the odds of success would have higher doing the legs and then the arms at a later date (with a different donor)

Re:All at once is a little extreme (2)

Daetrin (576516) | more than 2 years ago | (#39175429)

I agree, the proposal to do it one limb at a time, presumably from four different donors due to the amount of time between operations, isn't very feasible.

However it seems like starting with two arms would be the way to go. First because they draw less blood than the legs, so there would be less for the vascular system to adapt to. Second because if i was a quadriplegic and had the choice of getting just my arms back or just my legs back, i'd definitely opt for the arms. If you've just got arms you can always use a wheelchair to get yourself around. If you've just got legs... well i guess you could do a few "manual" tasks using your toes, but it doesn't seem like the optimum way to do things.

Feel sorry for him (1)

kooky45 (785515) | more than 2 years ago | (#39174833)

Such a shame, probably has the highest hopes for a better life and may not survive now.

Tissue Incompatibility (2)

StikyPad (445176) | more than 2 years ago | (#39175005)

Doctors had to remove the arms and legs that had been transplanted last Friday onto evket Ãavdar, 27, because of tissue incompatibility.

I look forward to the day where limbs and organs can be lab-grown from a patient's own cells and we won't have to worry about tissue rejection. While sad, I hope these sort of stories can at least help to inform the public of the promise that tissue engineering holds. The overwhelming majority of deaths in the US are a result of organ failure, whether due to cancer, heart disease, or other chronic illness. The ability to replace organs and tissue with their lab-grown counterparts would be a huge boost to both life expectancy and quality of life for a significant portion of the population.

Re:Tissue Incompatibility (1)

wbr1 (2538558) | more than 2 years ago | (#39176029)

If there is a genetic congenital defect, regrowth would just regrow a deformed limb, unless we knew how to correct the genetics as well.

Anyone know this hospital? (1)

MMC Monster (602931) | more than 2 years ago | (#39175105)

I'm wondering what sort of hospital this was.

Is it the local equivalent of the best in breed hospital, or it just some local hospital where the surgeon ran amok and no protocols were followed?

Re:Anyone know this hospital? (0)

Anonymous Coward | more than 2 years ago | (#39175859)

It is one of the good hospitals in Turkey. It is located in Ankara, capital of Turkey. Btw it is the doctor that matters nowadays, not the place.

Bummer, I first read the headline... (1)

PapaBoojum (232247) | more than 2 years ago | (#39175117)

...as "World's First Quadruple Limb Transplant FLAILS", which would have been a positive sign.

What Did They Keep? (2)

InsertCleverUsername (950130) | more than 2 years ago | (#39175245)

removed one leg from the patient after his heart and vascular system failed to sustain the limb and then the other leg and two arms. "The science council (of the hospital) decided to remove the organs one by one

Wow. From a quick scan of the summary, it sounds like they took out everything but the guy's chassis. Leg, leg, arm, arm, and then the next sentence about removing organs one by one? Can his family visit him in the head museum?

R.I.P. (3, Informative)

Anonymous Coward | more than 2 years ago | (#39176169)

It is reported by Turkish news that the guy just passed away.

mofd uP (-1)

Anonymous Coward | more than 2 years ago | (#39176369)

that have raged distended. All I minutes now while expulsion of IPF
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