From: sbharris@ix.netcom.com(Steven B. Harris)
Subject: Re: Lysosomes, Autolysis & Brain Cell "Suicide"
Date: Sat, 01 Nov 1997
Newsgroups: sci.cryonics,sci.med

In <345b40a1.28769605@news.uh.edu> rsmith@bayou.uh.edu (Randy) writes:

>Been doing some basic biology reading (_Instant Biology_  by
>Rensberger), and here's a morbid little passage from that book (for a
>seemingly moribund forum):
>
>"Lysosome -- the Cell's Stomach...filled with powerful digestive
>enzymes.. send the broken-down food out to be used elsewhere in the
>cell [and here's the interesting part].... Lysosomes are sometimes
>called "suicide bags" because the enzymes they contain could digest
>the whole cell if they got out, which they do when the body is
>severely deprived of oxygen. During suffocation or drowning, cells
>become more acidic inside, which makes lysosome membranesbreak down
>and release their caustic jiuces. Brain cells are the first to undergo
>this reaction, often destroying themselves in four or five minutes
>after breathing stops."
>
>I believe this process is known as autolysis.
>Randy
>Cryonics: Gateway to the Future?
>http://members.wbs.net/homepages/c/r/y/cryofan1.html
>***********************************



The passage is incorrect, however.  The idea that brain cells digest
themselves and go balloey in 4-5 minutes is an urban myth.   Cells in
brains look reasonably intact (though there are reversible interior
changes like chromosome clumping) for at least half an hour after
clinical death.  All the unquestionable "cell death" (autolysis)
happens MUCH later, on reperfusion.  And most importantly, it's
preventable!

Some species like monkeys can go 20 minutes with total ischemia at
normal body temperature, and sometimes survive intact.  This is a
important clue that the mechanisms responsible for brain cell
preservation to 20 minutes, at least, are quite *simple,* and probably
rely on only a few simple changes in chemistry (since there isn't a lot
of genetic difference between monkeys and humans).  Bolstering this
assumption is the fact that dogs, which are about as susceptable to
hypoxia as humans, can be revived with little injury and with proper
brain chemistry management, after 15 minutes of complete brain ischemia
(clinical death) at normal body temperature.  We've done this
repeatedly at 21st Century medicine, as reported in a recent newspaper
article (no secrets being told here).

                                           Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.life-extension,sci.cryonics
Subject: When DO Neurons Die Without Oxygen?  Not When You Thought.
Date: 19 Feb 1998 04:54:24 GMT

    For a long time there has been the idea that neurons "die" in 4 to
6 minutes without oxygen.  Just what exactly "death" means on a cell
level, however, has been a bit of a sticky thing to define.  It's not
as though a little ghost, shaped like a semi-formed neuron but with
blank holes for eyes, comes out of each cell at the moment it crumps.

    So what does happen?  The cells of the brain, even the neurons,
look much the same for some hours after death.  But how are they
functionally?  We now know that resuscitation can be acomplished as
long as 20 minutes after cardiac arrest, even at normal temperatures.
But what are the ultimate limits?

   A short research letter published just this week in Lancet gives
some clues.  Some of the letter follows:


LANCET 351, Feb 14, 1998    pp. 499-500

Recovery of axonal transport in "dead neurons"
Jipei Dei, et al.

It is generally believed that a neuron is highly sensitive to hypoxia
or glucose deprivation and that cerebral ischaemia of more than several
minutes results in irrevelersible brain neuron damage.  This view has
been challenged [1], and we now present evidence for survival of human
brain neurons up to 8 hours after death such that they still have the
potential for recover their functions of energy metabolism and axonal
transport.

The evidence was obtained from our study of more than 30 postmortem
human brains.  Postmortem delay is usually 3-6 hours.  Brain tissues,
ranging from a slice of 400 um to a block of 3 x 2 x 2 cm, from
different areas (cortex, hypothalamus, and brainstem) were preincubated
in modified artificial cerebrospinal fluid at 0-4 C. for 2-3 hours.
[Two tracers were added which can be taken up and transported only
along living neurons.  After incubation, tissues are fixed, cut, and
viewed. Transport of tracer was seen only in the presense of oxygen and
glucose, demonstrating active process]

"Our findings indicate that with suitable in-vitro treatment so-called
dead neurons recover oxidative metabolism, energy production, and
axonal transport.  There appear to be some mechanisms that protect
neurons from death and, to some extent, their function may recover. ...
New strategies for treating human brain injury induced by transient
cardiac arrest or stroke may be developed." (!)

[1] See reference to 1985 volume on resuscitation and brain research in
original article


                                     Steven B. Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.life-extension,sci.cryonics
Subject: Re: When DO Neurons Die Without Oxygen?  Not When You Thought.
Date: 19 Feb 1998 18:35:18 GMT

In <34ec621f.1144133@news.erols.com>
delaneyp(NoSpam!)@medlib.georgetown.edu (Paul A. Delaney) writes:

>In a sense this is not a new discovery.  Guyton, in his book "Textbook
>of Medical Physiology" described an experiment in which researchers
>working on dogs removed the blood from their brains (the dogs') for up
>to 30 min, and when reperfused the dogs saw no ill effects.  His
>theory is that blood clots are more responsible for brain damage that
>just lack of oxygen.
>----------------------------------------
>Paul A. Delaney
>Georgetown University School of Medicine


    But having read that experiment (from the 1960's) one finds that
the dogs' brains were cooled at the same time (the blood dilution was
done with cold fluid).  So it's really hard to evaluate.  We knew from
icewater drowing that you got a lot more than 10 minutes with cooling.
The point here is that you get hours even without cooling.  Most
cadavers are not gotten to the morgue before an hour or two, and even
then air cooling (even in a morgue refrigerator is VERY slow (a few
degrees an hour).
                                    Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.life-extension,sci.cryonics
Subject: Re: When DO Neurons Die Without Oxygen?  Not When You Thought.
Date: 28 Feb 1998 00:04:39 GMT

In <Pine.SOL.3.94.980227154428.13716C-100000@sunburst> Steen Goddik
<sgoddik@usd.edu> writes:

>One description I have heard is, that when the RER degranulate, the
>cell is not actually dead yet, but it is very close to it, and thaat
>that point it is pretty much irreversible.


RER = ribosomes on endoplasmic reticulum?  These fall appart after less
than an hour in the brain.  But as we see, neuronal function is very
much recoverable after many hours.

It's much the same in the heart-- changes like mitochondrial swelling
and nuclear chromatin clumping which were thought to signify cell
death, all turned out to be reversible.  And in cold brains something
really remarkable happens:  the entire axonal transport system
disappears.  De-polymerizes!  Warm the animal up, though, and it
assembles itself again, and functions fine.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Vertebrate with No Red Blood Cells!
Date: 9 May 1998 05:57:24 GMT

In <1998May8.225917.28631@jarvis.cs.toronto.edu> bae@cs.toronto.edu
(Beverly Erlebacher) writes:

>In article <6ivtcq$p1l@dfw-ixnews10.ix.netcom.com>,
>Steven B. Harris <sbharris@ix.netcom.com> wrote:
>>In <35530fbb.67617349@news.mcgill.ca> asheft@po-box.mcgill.ca (Alex
>>Sheftel) writes:
>>
>>>I have heard from somewhere that there exists a vertebrate that has no
>>>red blood cells. Does anyone know what this animal is and how it can
>>>survive? I think it's a reptile or amphibian (just a hunch). I would
>>>really appreciate any help on this or how I can find information about
>>>this.
>>
>>
>>I think you heard wrong. There are invertebrate *chordates* without red
>>cells, which use a protein carrying vanadium (not iron) as the oxygen
>>carrying pigment. These are the tunicates. All chordates have at least a
>>stiff notochord, but some have no true spine, and tunicates are
>>examples. (Thus, all vertebrates are chordates, but not the reverse.)
>
>I answered this guy in another group. There's a fish that lives at the
>coast of Antarctica with no erythrocytes. It lives in water below 0C,
>which is well oxygenated. It's an ambush predator - it mostly stays still
>except for occasional lunges at prey. There was an article about it in
>Scientific American 20 or 30 years ago. Surprisingly, it's a fair sized
>fish.


Comment:

   Oh, I see.  Not "no red cells" as in erythrocytes that aren't red.
But no cells at all for carrying oxygen!  Interesting.

   In suspended animation research at the lab I work at, we cool dogs
to about 1-2 C (ice temp) for many hours, and below temps of 15-20 C we
wash them out with a saline/starch solution and run them completely
bloodless on the heart/lung machine.  The combination of lower
metabolic rate and increased solubility of O2 at those temps does the
same thing as in your fish. Of course, these animals are anaesthetized
and unconscious.  After as long as 5.5 hours, however, you can warm
them up, run the blood back in, restart the heart, and they're
ultimately fine.  So even mammals can go the no-RBC route for a little
while, in the cold.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: soc.history.what-if,sci.physics,
	misc.education.home-school.christian,sci.life-extension,sci.med
Subject: Re: PROOF OF LIFE AFTER DEATH (minus the holy water)
Date: 26 Aug 1998 10:13:18 GMT

In <6rtjrv$mjm@josie.abo.fi> dagren@news.abo.fi (Dag ]gren FYSI)
writes:
>
>john@petcom.com wrote:
>> NDEs indicate that thought continues
>> on operating tables and in body bags
>> when one might 'think' that the brain
>> could not be getting enough blood to
>> achieve neural activity.
>> So if thought continues after neural
>> activity quits, so must the individual.


Comment:

    The problem is: when does neural activity quit?  When the heart
stops, or you're exposed to vacuum, or your brain vessels are clamped
or cut (beheading, hanging, etc), neurons run out of oxygen in about 15
seconds, and that's when you check out, active- consciousness wise.
Whether some residual or diminished consciousness continues for a time
after that, as in sleep, is a question yet to be resolved. It's not
unlikely.   Neurons don't run totally out of anaerobically generated
ATP until about 2 minutes into ischemia, but it's impossible there are
any electrical impulses after THAT of any kind (EEG goes totally flat
long before, but considerably after 15 seconds-- usually between 1 and
2 minutes).

   Thinking after no electrical activity seems unlikely, unless you
postulate metaphysical processes for thinking.  If these are possible,
tho, how come you can't think or dream under hypothermic anaesthesia,
which also stops your EEG totally?

   I really doubt if NDEs occur in body bags, unless somebody didn't
check to see that the BP really was "zero" (it's actually about 10 mm
at clinical death, going from there to zero over the few minutes, again
as ATP runs out and fluid is sucked out of the vascular system by leak
from capillaries, due to ATP pumps quitting.  But there is no
circulation, because the same pressure is on the venous side also).

   The idea that the person does not continue if thought does not
continue, is wrong.  The person is software.  Reboot from hardware, and
the person still exists.  That happens long after 2 minutes of death.
Conventional wisdom says 6 minutes, but I've seen dogs recover after
almost 17.  And you can culture live neurons out of the brain after 12
hours of normothermic death.  Who knows what future resuscitation
technology holds?

                                Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: soc.history.what-if,sci.physics,
	misc.education.home-school.christian,sci.life-extension,sci.med
Subject: Re: NO PROOF OF LIFE AFTER DEATH
Date: 26 Aug 1998 19:05:12 GMT

In <35E46832.56ED@livingston.net> jwwright <jwwright@livingston.net>
writes:
>
>>    I really doubt if NDEs occur in body bags, unless somebody didn't
>> check to see that the BP really was "zero" (it's actually about 10 mm
>> at clinical death, going from there to zero over the few minutes, again
>> as ATP runs out and fluid is sucked out of the vascular system by leak
>> from capillaries, due to ATP pumps quitting.  But there is no
>> circulation, because the same pressure is on the venous side also).
>>
>>    The idea that the person does not continue if thought does not
>> continue, is wrong.  The person is software.  Reboot from hardware, and
>> the person still exists.  That happens long after 2 minutes of death.
>> Conventional wisdom says 6 minutes, but I've seen dogs recover after
>> almost 17.  And you can culture live neurons out of the brain after 12
>> hours of normothermic death.  Who knows what future resuscitation
>> technology holds?
>>
>>                                 Steve Harris, M.D.
>
>sometimes i get near death reading this crap.
>i wonder HOW the human software gets rebooted in the brain. obviously
>you mean just powering up the memory which has not been erased because
>the lack of nutrients was not gone long enough to totally wipe out
>sections of the memory. remember, there is no harddrive storage to
>"reboot" the application from.

   Who said that?  The hard drive is your neurons and their synaptic
connections.  All that happens when you lose EEG is your active
application in RAM (the electrical "you") goes away.  But that's just
thinking and short term memory.  It's not your long term memories and
personaility and all the circuits that make you YOU-- these are all
hard-encoded in synapse changes.  People recover fine after totally
flat EEG (More than 3 but less than 4 monutes of circulatory arrest, or
anaesthesia plus hypothermia, etc), and lose only a little short term
memory.


>since we know that some people experience
>brain damage from lack of oxygen (that loss of memory or capability),
>it's easy to assume there is no backup storage.

   No.  It can equally be due to physical brain damage, which certainly
happens after oxygen is gone long enough.  But it doesn't happen at 5
minutes.  Rather, it's a result of reperfusion injury: free radical
damage, continued ischemia due to blood sludging, exitotoxicity from a
whole cascade of toxic neurotransmitters, and apoptosis from an
activated inflamatory cascade. It happens long after the blood pressure
is back up, and can continue for days.  The future of resuscitation is
learning how to stop it.  As I said, I've seen dogs back in apparently
perfect condition (have old long term memories, and able to learn and
move normally) after more than 16 mintues of total lack of blood
pressure at 37.5 C (close to their normal body temp, and the standard
for these experiments).  Dogs are about as sensity to ischemia as
humans, so this should be possible in people, too (the treatment to get
these results in dogs is horrendously complex-- with no treatment they
are end up brain-dead after 17 minutes of clinical death, even though
their hearts can be restarted fine).


>and it's easy to assume
>that it isn't replaced by the omnipotent whatever when you physically
>recover from such an event.
>so you would go into the after life with no recollection of what
>happened in your lifetime.
>regards.


   I don't know what to make of this statement.  It appears to be
speculative nonsense.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: soc.history.what-if,sci.physics,sci.life-extension,sci.med
Subject: Re: PROOF OF LIFE AFTER DEATH (minus the holy water)
Date: 27 Aug 1998 09:33:06 GMT

In <6s169v$qmo$1@ostrich.cybercomm.net> "Jennifer Ann Petersen"
<jennifer@jenniferpetersen.com> writes:

>Steven B. Harris wrote in message
<6s0n3u$bj7@dfw-ixnews4.ix.netcom.com>...
>>   The idea that the person does not continue if thought does not
>>continue, is wrong. The person is software. Reboot from hardware, and
>>the person still exists. That happens long after 2 minutes of death.
>>Conventional wisdom says 6 minutes, but I've seen dogs recover after
>>almost 17. And you can culture live neurons out of the brain after 12
>>hours of normothermic death. Who knows what future resuscitation
>>technology holds?
>
>
>A person forgetting how to construct sentences, forgetting where they
>went to school, forgetting how to tie shoe laces, forgetting what their
>mother looked like or loosing a sense of humor and a dog being revived
>and being able to eat and bark are two different things. Not that I
>disagree with you but I don't think rebooting a dog and rebooting a
>person can really be equated when looking at these time limits.



Of course, there's no way to know but to do the experiment.  However,
it's to be noted that dogs are also about as sensitive to the movement
disorder effects of hypoxia as humans-- the ataxia, apraxis, and tremor
which is the halmark of ischemic brain damage.  And we don't see this
either, after the recovery period.

One of our dogs, after resuscitation, learned to nose up the latch on
his kennel gate, to get to a bitch in heat on the other side.  We
changed the dog on the other side to a rather nasty male alpha, and the
latch stayed closed.  I would regard that as reasonably high on the dog
IQ scale.  If brain damage has been done, it's of a very subtle order.

                                        Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.aids,misc.health.alternative
Subject: Re: Vitamin Vultures (was Re: Life Extension HIV protocol)
Date: 2 Dec 1998 23:26:53 GMT

In <eeeF3D11L.AJH@netcom.com> eee@netcom.com (Mark Thorson) writes:

>In article <742hog$k7r@sjx-ixn9.ix.netcom.com>,
>Steven B. Harris <sbharris@ix.netcom.com> wrote:
>>
>>    George didn't write that protocol, nor did I.  The LEF employs me
>>part time to do resuscitation research for them, not do advertizing.
>
>Uh, would that be for the treatment of "chronic, full-body
>frostbite"?
>
>(Not that I have anything against that sort of thing :-)


    Treatment of chronic full-body frostbite is WAY beyond our
technology.  But some of our research is in preserving organs at liquid
nitrogen temps with no ice formation and no frostbite, as it were.  So
one day, perhaps we'll be able to vitrify whole humans with little or
no damage.

   Resuscitation I work on now is all stictly from temps above
freezing.  We can keep dogs at 40 F for 5 hours or so, without damage.
We can resuscitate from 17 minutes of clinical death at normal body
temperatures also, with little or no brain damage.  The brain does NOT
die after 5 or 10 minutes at normal temps, without oxygen-- that's a
great myth.  Nobody knows what the limits are.  My guess is at least 30
minutes, even without hypothermia, but it might be in the range of The
Day The Earth Stood Still--- hours.  With hypothermia we know it's at
least an hour, and probably many hours.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: misc.health.aids,misc.health.alternative
Subject: Re: Vitamin Vultures (was Re: Life Extension HIV protocol)
Date: 3 Dec 1998 08:05:29 GMT

In <745fjg$rb2$1@supernews.com> "Kathy" <kreneeSPAMMUSTDIE@loop.com>
writes:

>Steven B. Harris wrote
>>   Resuscitation I work on now is all stictly from temps above
>>freezing. We can keep dogs at 40 F for 5 hours or so, without damage. We
>>can resuscitate from 17 minutes of clinical death at normal body
>>temperatures also, with little or no brain damage. The brain does NOT
>>die after 5 or 10 minutes at normal temps, without oxygen-- that's a
>>great myth.
>
>Geezzz!  I just threw up.  I was not prepared to read about
>animal abuse--would have skipped your post.  Would you please
>amend the subject line next time.
>
>Thank you.
>Kathy



   It's animal abuse or kid abuse.  Any rehab hospital is full of
people brain-damaged permanently from lack of oxygen for 10 minutes or
less.  Chonic vegetative state, they call it.  They sit and drool,
mostly.  Drowned kids resuscitated too late.  Heart attack victims who
the paramedics didn't quite defibrillate in time.  The lucky ones just
have cerebral palsy.  Most of these people now alive, if they could be
treated with a human adapted version of what we've discovered already
from animal research, would be perfectly normal, and could go back to
normal lives.

    So. It's the dogs or (ultimately) your kids or your parents or your
spouse.  Or somebody else's.  You don't get to choose NONE.  That's not
an option.  All you get to do is close your eyes and pretend really
hard.  But that doesn't make the problem go away.  Anymore than the
fact that you haven't visited your local pound lately and watched them
kill strays, makes THAT problem disappear.  Or visited a slaughterhouse
to them hang the bleeding steers up by the heels to let you see where
that hamburger you eat and that leather you wear comes from.

                                      Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med.cardiology,alt.health.policy.drug-approval,alt.activism,
	talk.politics.medicine,sci.med
Subject: Re: Doctor-bashing
Date: 11 Mar 1999 06:40:44 GMT

In <36E69063.C9B121CC@emory.edu> Andrew Chung <achung@emory.edu>
writes:

>This brings up an important point. IMO, one reason (among many) doctors
>are paid the big bucks is because they are able to *resurrect* people. I
>can imagine the expression of George's face when he reads this. Hopefully
>someone will be around to check his blood pressure and administer ACLS if
>needed.
>
>--
>Andrew Chung



   And ACLS is really horribly primitive.  All those heart drugs and
not a single agent to protect the brain, which is (after all) far more
sensitive to ischemic damage during shock.

    We're getting normal non-brain-damaged dogs back after 17 mintues
of warm cardiac arrest, without prior intervention.  That's a LONG time
to be (warm and) dead.  Dogs are about as sensitive to brain damage as
people are.  So that at least should be possible for young healthy
humans as well (drownings, asphixia, electrocutions, exsanguination,
etc).  It takes a dozen brain protective drugs and some fancy other
stuff, alas.  None of which work very well alone (ischemic damage is a
web of interlocked stuff-- block one path and the rest nail you.  As
well lock ONE car door to guard against thieves).  But the FDA requires
drugs to be tested one by one, and about 5 resuscitation brain drugs
have failed this in human trials, at a cost of millions each.  They'll
just keep doing that.  And that's if they can get around the issue of
informed consent for resuscitation research.  You should live so long
as to see a cocktail used for this, and a cocktail is all that is going
to work.

   We could solve this problem.  At this point the difficulties are
entirely political, and very few are physiological.  A bitch, huh?

   Did you ever see The Day The Earth Stood Still?  Well, even THAT is
possible.  You can get live neurons out of cadavers for 24 hours at
least.  The brain does NOT die at 10 minutes.  Or 20.  Or 30.  The
limits have yet to be defined, but we know that what we are doing now
in resuscitation with people, is witchdoctory.  The only thing to be
said about it is that it's very impressive compared with doing nothing
at all.

                                      Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med.cardiology,alt.health.policy.drug-approval,alt.activism,
	talk.politics.medicine,sci.med
Subject: Re: Doctor-bashing
Date: 11 Mar 1999 12:10:17 GMT

In <36E7A3A9.B2CDE89@gw-tech.com> Carey Gregory <cgregory@gw-tech.com>
writes:
>
>Steven B. Harris wrote:
>>
>>     We're getting normal non-brain-damaged dogs back after 17 mintues
>> of warm cardiac arrest, without prior intervention.  That's a LONG time
>> to be (warm and) dead.
>
>Long enough for me to say don't even try, please.  I wouldn't want to be the
>thing that gets resuscitated.


    No reason to think you'd be any different, if the job was done
right (of course, we won't know until it's tried on people-- don't hold
your breath.  It won't be in the US).  Of course, at present
standard-of-care now in any place "you" wouldn't get resuscitated, in
the sense of coming back as a live person.  Rather your brain wouldn't
make it, and your body would be the standard brain-dead beating heart
organ donor candidate.



>
>>    We could solve this problem.  At this point the difficulties are
>> entirely political, and very few are physiological.  A bitch, huh?
>
>Hey, the FDA has an obligation to protect dead people from dangerous drugs....


   That's just about it.  The Frankenstein syndrome strikes again.  I
really think to make any progress we're going to have to create a new
box on your driver's license, wherein you check off whether or not you
want to be a candidate for new resuscitation technology experiments, if
you ever find yourself in need of resuscitation.  Keeping in mind that
this may make the difference between you being brain dead vs being
vegetative.  Or between being vegetative and being functional but
spastic and impaired/disabled.  Or between being permanently impaired,
and being completely normal.  The odd and slightly disturbing thing
about resuscitation technology is that the total number of alive but
permanently brain-damaged people stays the same, no matter how much it
improves.  They just aren't the same people.  For each improvement
people move from one category to another, and there end up more fully
recovered people at one end, and fewer people who are dead/brain-dead
at the other.  So you can think of it as moving people from dead to
fully fine.  And so it does, as a social policy-- but that's a NET
effect.  In any given case, it happens far less often.  It's good for
society, no question, but whether it's good for you the individual
patient, is a matter of some luck.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Heart Attack and effects on Brain
Date: 27 Mar 1999 15:38:12 GMT

In <3704ed6a.4799124@nntp.ix.netcom.com> hhomler@ix.netcom.com (Howard
Homler) writes:

>On Sat, 27 Mar 1999 17:35:53 +0800, Robert Mascaro
><rmascaro@scnet.com.au> wrote:
>
>>I'm interested in information from anyone who has had experience, or who
>>may be reseaching the effects of a patient who has had an arrested heart
>>for 20 minutes and has had CPR invoked for this period. . This
>>particular patient is now in a coma with suspected global brain damage.
>>Is there any reseach on whether the brain may be able to regenerate
>>damaged tissue etc.
>>Thankyou.
>Yes, plenty of research. The condition is called anoxic brain damage,
>and the liklihood of recovery is predicted by the presence or absence
>of certain reflexes.  The situation in post-traumatic brain injury is
>usually better than with anoxic injury, with some people showing
>improvement over months, but anoxia is much more serious... H2


   Yes, and darnit, a lot of it is preventable!  My lab has dogs, whose
brains are just as sensitive to lack of oxygen as those of people,
walking and running and playing and learning new things after 17
minutes of NO blood pressure.  NO CPR.  No pre-medication other than a
light dose of barbiturate (not enough to make much difference, as is
known from many, many other experiments).  Nada.  17 minutes of being
warm (37.5 C) and dead (from fibrillation from 1 second of AC current).
That's a long time.  The procedure to resuscitate from that state is
long and complex, and it involves dozens of chemicals, hypothemia
(induced AFTER the resuscitation begins), and a lot of other stuff.
The chance of anything like this making it though the FDA on some
protocol is zip.  The FDA wants you to test interventions individually,
and with anoxic brain damage that's a lot like locking one car door to
prevent burglary (as I've said before).  Some procedures, like heart
transplants, are just not amenable to testing out all of the individual
maneuvers on groups of people before you put them all together <g>.
The FDA understands this regarding surgery (sort of-- they aren't
complete morons) but cannot comprehend that the same is true of
complicated chemical repair (ie., they are just dull-normal government
workers).  Worse still, the FDA still wants informed consent in
resuscitation trials.  Now think about the logistics of that.

  Indeed, we not only have the FDA, we have also the USDA.  The animal
rights people are steadily making it more and more impossible to work
on dogs.  So the human vegetables at these ischemic times (10-20
minutes at normal body temps) will continue.  You can write congress,
or learn to live with it.  As for us, when it comes time, we'll market
in Japan.  Sayonara.

                                   Steve Harris. M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: medicine and morality
Date: 26 Jan 2000 08:59:19 GMT

>In article <86gsj3$rbl$1@bob.news.rcn.net>, Wayne <wlogsdon@erols.com>
>wrote:
>
>>3. Arrogant physicians deciding when we are dead, often so they can
>>steal fresh organs. A heinous example is withdrawing life support from
>>microencephalic children for the purpose of getting fresh organs. I
>>believe that people are dead when their heart has stopped beating (or
>>the mechanical equivalent if on life support) AND their brains shows no
>>activity AND at least 1 additional hour has passed to allow for cellular
>>death.



   I'm afraid you're being naive if you think there's such an easily
defined thing as a moment of "cellular death." If you think it's hard
to tell when a person on "life support" (ie, a ventolator) has died,
try it for a cell.  There isn't any little heart what quits beating
when a brain cell dies, and no little neuron-shaped ghost with little
blank eye-holes that rises up out of the cell at the critical moment,
saying "booooo0000!"  Neurons have no pulse. And some of the little
buggers last a disgustingly long time before they disolve.  It doesn't
happen in 5 minutes.  Or even an hour, as recent stroke treatment
results illustrate. While structure remains, repair is in theory
possible.  Sometimes, it's even simpler than we imagined.  For example,
it was recently proven that live neurons can be recovered from cadavers
up to 24 hours after death, with no special treatment of the corpse
beyond what is normally done (ie, the body is taken to the hospital
morgue and put in the refrigerator, where it cools as fast as any large
piece of meat, which is to say, slowly.)  By "live," we mean neurons
that have normal membrane potential, working axonal transport, etc.
That hadn't been proven before, only because nobody thought to try it.
If you wait until that is no longer possible, you're going to be
waiting around with bodies at room temperature quite a long time.  And
even then, what have you proven?  Without a ghost-detector, you've only
proven that you've gone beyond the limits of your repair systems, not
that repair is forever impossible.

From: Steven B. Harris <sbharris@ix.netcom.com@ix.netcom.com>
Newsgroups: sci.med
Subject: Re: Baby dead for over 2 hours brought back to life .
Date: Sat, 03 Mar 2001 20:02:21 GMT

In article <3a9db8f3.330827454@news.nwlink.com>,
	pfriley@watt-not.com (PF Riley) wrote:

>On Wed, 28 Feb 2001 08:29:19 -0500, "Jeffrey Peter, M.D."
><kidsdoc2000@hotmail.com> wrote:
>
>>Big deal. This happens all the time.
>
>Huh? Maybe so, but they usually end up with a baclofen pump, G-tube, a
>nice comfy wheelchair, and drool bib. The remarkable part of this
>story is that there appears to be no major brain damage.


Kids cool their brains in these situations partly by conduction. They
have big heads, thin skulls. The record icewater drowning in a kid
who recovered well without major brain damage, is over an hour.
Estimates for full cardiac arrest time for this Canadian kid are just
that-- estimates.

You get a factor of at least 3 for every -10 C drop in temp in anoxic
time for the brain. At 15.5 C that exponential decrease gives you an
anoxic factor of about exp[ln3*(-21.5/10]= 1/5.5. Every minute of
arrest at 27 C is worth 5.5 minutes at 15.5 C. So you get 45 min
instead of 8 minutes for the same amount of brain damage. In animal
models, also post resuscitation cooling of even -2 to -6 C greatly
retards anoxic damage, probably for the same reason that putting your
hand in cold water after a burn, or putting ice on a sprained ankle,
does.  This kid certainly had that.

Challenges for the future are in post anoxic cooling for adults
who've suffered cardiac arrest. That's a hard problem, but we're
working on it.  Doing it slowly (> 4 hours) doesn't help for head
injury (this just out in the New England Journal of Medicine). But
the effect in dogs goes away after only 15 minutes, just as it does
with your burned finger. The challenge is cooling the injured brain
that fast.

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: alt.support.cancer,misc.health.alternative,sci.med.diseases.cancer,
	sci.med
Subject: Re: Cancer alternatives
Date: Mon, 15 Apr 2002 19:57:35 -0600
Message-ID: <a9g0h9$qs8$1@slb6.atl.mindspring.net>

"Steph" <steph@vancouver.island> wrote in message
news:3rKu8.40678$Kq4.1599279@news2.calgary.shaw.ca...

> Steve I wouldn't argue that there may be a 1% residual bit of truth.
> Howevere don't get paranoid. There is no no FDA regulatory bar to the
> development of new cancer drugs. They are being developed all the time, both
> in the US, and also in those fortunate parts of the world not under the
> control of the FDA

COMMENT

There's no absolute regulatory bar. Anybody with a couple of hundred million
$ can play. It's very democratic.

Your problem is you see the things that get developed, but you don't see the
things that don't get developed.  Sometimes you can't even imagine them.

Example: in experimental animals, if you cool the brain by just -4 C within
the first 15 minutes after resuscitation, then the effect of 10 minutes
without oxygen and blood flow looks like only 5 minutes.  That's the
difference between being fine and recovering completely after a cardiac
arrest or a drowning, and being brain-dead or permanently institutionalized.

And we know the effect works in people, because a modest effect is seen in
air-cooling after cardiac arrest (although this takes 6 to 8  hours-- funded
by a company which makes air beds, in Germany and Australia, reported this
Feb 21 in the NEJM). But we expect that it's nothing compared to what you
could get at 15 minutes, because if you wait 6 hours in animals you get
essentially nothing. I'm amazed they got any effect in people at all (it was
small-- but the first treatment for resuscitation encephalopathy ever
demonstrated).

Now, how can you cool the brain in 15 min?  One way only I know: dump
ice-cold fluorocarbon down the lungs.  Effect demonstrated by myself and
colleagues last year in living anaesthetized dogs (who survived it fine).

Problem: No fluorocarbon has been approved by the FDA for liquid breathing.
FDA just kicked Alliance (the only contender) out of this market after
millions and millions were spent by Alliance Pharmaceutical trying to show
efficacy for newborn lung disease, and only managing to show safety, since
the FDA stacked the books against them. Alliance's chemical won't work for
cooling anyway.

Now, that's a 100 million dollar hurdle. How do you suppose it affects me in
my trying to raise investment capital for my technique?  You got it.  I
can't get any. Investors wish me well personally, but when it comes to
writing checks, they laugh.

All this has effects which filter down through the industry. You don't see
liquid breathing as in the movie The Abyss. You should live so long. Once
upon a time, companies like Allied Chemical (no relation to Alliance) made
fluorocarbons liquids as candidates for medical research. There's no money
in that now, because it's clear that there isn't going to be any medical
research, because (particularly after the Alliance fiasco) there isn't any
investment. So even that's gone. An entire infrastructure simply doesn't
exist, because at the of the regulatory tunnel, investors see the FDA.

One day you or somebody you know, is going to be without oxygen or blood
pressure for 10 minutes, and is going to need this technique badly. Guess
what? It won't be there. It's just the same for many a cancer drug you'll
never know about. And many a drug which won't be developed for 20 years,
when you need it yesterday.

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: alt.support.cancer,misc.health.alternative,sci.med.diseases.cancer,
	sci.med
Subject: Re: Cancer alternatives
Date: Tue, 16 Apr 2002 13:44:37 -0600
Message-ID: <a9huva$lf6$1@slb0.atl.mindspring.net>

"Steph" <steph@vancouver.island> wrote in message
news:ToMu8.42196$Kq4.1654234@news2.calgary.shaw.ca...

> Steve,
> you are arguing from the specific to the general.
> Your objectivity seems to have suffered with your presumably shabby
> treatment by the people who control the funds. I sympathise, but I don't buy
> your general argument


Well, arguing from the specific to the general always presents problems, but
it (induction) is where the major progress in knowledge occurs, don't you
know.  In science there's progress in understanding, and there's progress in
classifying, and I'd rather do the physics than the stamp-collecting.

My own treatment is how I know the stories of how rotten the research
biomedical establishment is, are not just stories. I'm there. I go to the
meetings, publish in the peer reviewed journals. The people who do the
work in establishment science are good people, with high integrity-- and
the work is real. But biomedical research funding is rotten to the core,
and is not based on any kind of realistic assessment of risk-vs-clinical
benefit of the research. If you had some way to give the people who do
the research and who control the funding, the very disease they're trying
to look at, it might "concentrate the mind" in the needed way.  As it is,
I see no evidence that any of them have enough imagination to do more
than blunder about and generate data to get the next grant with. The
sense of urgency just isn't there.

One of the giants in the field of resuscitation had a daughter who died of
post resuscitation encephalopathy.  He discovered the technique of
post-resuscitation cooling almost 20 years ago. But with a multi-million
dollar center in Pittsburgh attacking this problem on all fronts, he hasn't
made any more progress against the FDA than I have.  And he's retiring.  So
sorry.

His work is being carried on in Austria and some other places, with a mix of
government and private funding. Slowly, it will get here. In a decade, many
of these ideas will be in clinical trials (in some other country not the
US).  But every paramedic should have been carrying a device for lung lavage
since 1990. The FDA is the reason they aren't.

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: alt.support.cancer,misc.health.alternative,sci.med.diseases.cancer,
	sci.med
Subject: Re: Cancer alternatives
Date: Tue, 16 Apr 2002 13:25:21 -0600
Message-ID: <a9htr7$b5$1@slb3.atl.mindspring.net>

"P Moran" <pjmoran@gil.com.au> wrote in message
news:1JPu8.2495$c_3.310905@ozemail.com.au...
> And it so happens that even in these times of widespread sympathy for
> alternative methods, those claiming to have useful treatments are not
> coming forward with evidence that might provoke mainstream interest.
> The NCCAM has now has 70 million dollars available yearly for
> investigation of alternatives.

Which is really very little money.  Most of NCCAM's money has gone for
administration surprise, surprise.  It goes to people who can tell you how
to pick alternative medicine claims-- sort of like those guys who can tell
you how to pick stocks (which is how they make their money, rather than by
buying stock themselves, strange to tell).

> Are those offering alternative cancer treatments cueing up
> to have their method tested first?  Not on your life.

A few experiences with the NIH will cure you of cueing, I assure you.
You've written how many NIH, SBIR and military grant proposals, Peter?


> Are all those who claim to have a patented alternative methods raising
> venture capital to get their methods properly researched, the way earnest
> researchers do?   No.

Venture capital, in general, will not give you money if your stuff is 10
years and 200 million dollars away from FDA approval. Even if it works on
animals right now. You've written how many business plans, Peter?  You have
to have an angel who is committed to your work all out of proportion to
rational expectation of return on investment.  These are very rare.

My own field, resuscitation research, presents something of the Arkansas
traveler problem-- there's no point fixing the leaky roof when it's not
raining, and you certainly can't fix it while it IS raining. Medical
research runs on people who have problems, and the longer they have them
before they die, the better funded it is. AIDS has better funding than
anybody else because the people who turned up HIV+ had many years of health
ahead before they were going to get ill.  They were young, often had lots of
disposable income, and they were articulate and pissed.  The perfect
activist group (85 yo incontinent dementia patients aren't nearly so good at
closing down bridges in San Francisco). In the case of resuscitation, the
people who need it usually don't know they need it until they do, and then
they need it for 10 minutes only. And during that time they're unconscious.
Also not your best activist group. But several hundred THOUSAND people every
year die of, or with, post-resuscitation encephalopathy in the US.

>  It is so convenient to claim FDA obsructionism and
> medical oppression if you are a quack.

Yep. But don't invert the logic, since that's not logical.  It does not
follow that all those who claim FDA obstructionism and medical oppression
are quacks. Stopped clocks are still right twice a day.


> Steve Harris may be right that it costs 100 million to get FDA approval
> for yet another antidepressant, or antihistamine, for all I know.  But
> cancer is a special case.  It is much easier and cheaper to show
> objective benefit from any truly effective anticancer agent.

Actually it isn't. And the FDA generally won't let you try. Until you've
been through animal research and phase I and II trials which cost an amazing
amount of money. They make an exception for a few alternative people just so
that people like you will think the basic problem has been fixed. And you
see-- it works. They give money to one guy and they have you completely
fooled. Here we go:


> Gonzales was able to obtain 1.2
> million for a controlled trial of his alternative treatment with a case
> series of ELEVEN patients.


Gonzales, the poster-child for defenders of the current establishment,
hit the jackpot, not unlike people who win the California lottery. He's a
Mexican doctor with US credentials-- nice and politically correct in
today's environment-- and he's got some money from the alternative office
to give some terminal patients the veg diet and Tijuana coffee enema
blah-blah treatment (which you can get in Tijuana a lot cheaper than a
hundred thousand a pop-- the extra money is to actually get the data
scientifically).  That's fine-- I'm glad we'll finally put that dog to
rest. But it's not typical in any way.

> And there are millions of cancer- affected
> families ready to help finance anything alternative that can distinguish
> itself from the pack with a bit of solid data.

Yes, but the problem is getting to there, isn't it? Getting to there is the
research, and when it comes to research, cancer patients have a strange
paraneoplastic syndrome which affects the muscles of the right hand which
are involved in signing checks-- I commend it to the neurologists to come up
with the mechanism. People will cough up 10 grand for something if they're
promised a cure and have no orthodox alternative (which is how Tijuana does
it), but that's not "research."  Generating the money to SHOW that something
works is the problem. The FDA didn't treat Gonzales as it does most people,
and neither did the NIH. And Gonzales didn't find 11 cancer patients to pay
him $100,000 each, to give them coffee enemas they could get cheaper down
South.


SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med
Subject: Re: Decapitation
Date: Mon, 19 Aug 2002 13:58:04 -0700
Message-ID: <ajrm5u$4tp$1@nntp9.atl.mindspring.net>

PF Riley wrote in message <3d6065c3.314318420@news.nwlink.com>...
>On Sun, 18 Aug 2002 20:06:55 GMT, "Ryan" <ryan@ryan.ryan> wrote:
>>
>>So i've heard, of this special. I haven't seen it and didn't notice it
>>broadcast here on Australian Discovery.. sounds interesting. As a
>>neurosurgeoun, you would know the answer to this (one of my many many..)
>>question: Why is it relevant to medicine to know how long my brain will work
>>after my head has been removed? I ask not sarcastically, but pure curiosity.
>
>I know you're not asking me, but I think it's because some day, when
>we're doing head transplants, we'll need to know the maximum allowable
>cold ischemic time just as we do kidney transplants today.
>
>PF


We pretty much know it. Dogs have been kept in circ arrest as long as 3
hours at 1 C and revived without problems, and their brains are about as
sensitive to anoxia as humans. But that's about the limit without fancy
drugs, and without . Currently neuro procedures in circ arrest humans are
limited to 45 min at 15 C. All this is pretty consistent with a "Q10"
metabolic slowing of a factor of 2.2 for every -10 C, which means that at
ice temp you get a factor of 2.2^3.7 = 18.5 in "time stretch" for anoxia at
the ice point. So that 3 hours is about like 9.7 min of anoxia at normal
body temps, and 45 min at 15 C is about like 8 min at 37 C. Which sounds
like a lot, but 8-10 min of total anoxia is survivable with *post*
resuscitation cooling, which of course all these experiments include also.

Note also that how long you can survive total anoxia has nothing to do with
how long you can stay conscious, of course.

SBH



--
I welcome email from any being clever enough to fix my address. It's open
book.  A prize to the first spambot that passes my Turing test.

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med
Subject: Re: of plague dogs and cryonics
Date: 26 Jun 2005 16:46:09 -0700
Message-ID: <1119829569.731997.325400@o13g2000cwo.googlegroups.com>

"Topics are resuscitation, liquid ventilation, pharamaceutical drug
delivery and microemulsions."

>>Cryonics? (You didn't think I'd get that did you.)
I think you'd have to do a lot of cat karma to make up for killing dogs
so wealthy wackos could be frozen until some time in the future when
they're rescusitated with just, er...slight brain and other organ
damage. <<

COMMENT:

Hypothermia's a hot topic these days. Hypothermia induction for
purposes of minimizing brain damage after resuscitation isn't cryonics.


Circulation. 2005 Jun 21;111(24):3195-201. Epub 2005 Jun 13.

Hypothermia improves defibrillation success and resuscitation outcomes
from ventricular fibrillation.

Boddicker KA, Zhang Y, Zimmerman MB, Davies LR, Kerber RE.

Cardiovascular Center, College of Medicine, University of Iowa, Iowa
City, USA.

BACKGROUND: Induced hypothermia is recommended to improve neurological
outcomes in unconscious survivors of out-of-hospital ventricular
fibrillation (VF) cardiac arrest. Patients resuscitated from a VF arrest
are at risk of refibrillation, but there are few data on the effects of
already existing hypothermia on defibrillation and resuscitation. METHODS
AND RESULTS:  Thirty-two swine (mean+/-SE weight, 23.0+/-0.6 kg) were
divided into 4 groups: normothermia (n=8), mild hypothermia (35 degrees
C) (n=8), moderate hypothermia (33 degrees C) (n=8), and severe
hypothermia (30 degrees C) (n=8). Hypothermia was induced by surrounding
the animal with ice, and VF was electrically induced. After 8 minutes of
unsupported VF (no CPR), the swine were defibrillated (biphasic waveform)
with successive shocks as needed and underwent CPR until resumption of
spontaneous circulation or no response (> or =10 minutes). First-shock
defibrillation success was higher in the moderate hypothermia group (6 of
8 hypothermia versus 1 of 8 normothermia; P=0.04). The number of shocks
needed for late defibrillation (> or =1 minute after initial shock) was
less in all 3 hypothermia groups compared with normothermia (all P<0.05).
None of the 8 animals in the normothermia group achieved resumption of
spontaneous circulation compared with 3 of 8 mild hypothermia (P=NS), 7
of 8 moderate hypothermia (P=0.001), and 5 of 8 severe hypothermia
(P=0.03) animals. Coronary perfusion pressure during CPR was not
different between the groups. CONCLUSIONS: When VF was induced in the
setting of moderate or severe hypothermia, resuscitative measures were
facilitated with significantly improved defibrillation success and
resuscitation outcome. The beneficial effect of hypothermia was not due
to alteration of coronary perfusion pressure, which suggests that changes
in the mechanical, metabolic, or electrophysiological properties of the
myocardium may be responsible.

PMID: 15956132 [PubMed - in process]

===================================
Crit Care Med. 2005 Feb;33(2):414-8.

Hypothermia for neuroprotection after cardiac arrest: systematic review
and individual patient data meta-analysis.

Holzer M, Bernard SA, Hachimi-Idrissi S, Roine RO, Sterz F, Mullner M;
on behalf of the Collaborative Group on Induced Hypothermia for
Neuroprotection After Cardiac Arrest.

Department of Emergency Medicine, General Hospital Vienna, Medical
University of Vienna, Vienna, Austria.

OBJECTIVE: Only a few patients survive cardiac arrest with favorable
neurologic recovery. Our objective was to assess whether induced
hypothermia improves neurologic recovery in survivors of primary cardiac
arrest. DATA SOURCE: Studies were identified by a computerized search of
MEDLINE, EMBASE, CINAHL, PASCAL, the Cochrane Controlled Trial Register,
and BIOSIS. STUDY SELECTION: We included randomized and quasi-randomized,
controlled trials of adults who were successfully resuscitated, where
therapeutic hypothermia was applied within 6 hrs after arrival at the
emergency department and where the neurologic outcome was compared. We
excluded studies without a control group and studies with historical
controls. DATA EXTRACTION: All authors of the identified trials supplied
individual patient data with a predefined set of variables. DATA
SYNTHESIS: We identified three randomized trials. The analyses were
conducted according to the intention-to-treat principle. Summary odds
ratios were calculated using a random effects model and translated into
risk ratios. More patients in the hypothermia group were discharged with
favorable neurologic recovery (risk ratio, 1.68; 95% confidence interval,
1.29-2.07). The 95% confidence interval of the number-needed-to-treat to
allow one additional patient to leave the hospital with favorable
neurologic recovery was 4-13. One study followed patients to 6 months or
death. Being alive at 6 months with favorable functional neurologic
recovery was more likely in the hypothermia group (risk ratio, 1.44; 95%
confidence interval, 1.11-1.76).  CONCLUSIONS: Mild therapeutic
hypothermia improves short-term neurologic recovery and survival in
patients resuscitated from cardiac arrest of presumed cardiac origin. Its
long-term effectiveness and feasibility at an organizational level need
further research.

Publication Types:
    Meta-Analysis
    Review

PMID: 15699847 [PubMed - indexed for MEDLINE]

========================================


Resuscitation. 2001 Aug;50(2):189-204.

Rapid (0.5 degrees C/min) minimally invasive induction of hypothermia
using cold perfluorochemical lung lavage in dogs.

Harris SB, Darwin MG, Russell SR, O'Farrell JM, Fletcher M, Wowk B.

Critical Care Research, Inc. Rancho Cucamonga, CA,  USA.
sbharris@ix.netcom.com

OBJECTIVE: Demonstrate minimally invasive rapid body core and brain
cooling in a large animal model. DESIGN: Prospective controlled animal
trial. SETTING: Private research laboratory. SUBJECTS: Adult dogs,
anesthetized, mechanically ventilated. INTERVENTIONS: Cyclic lung lavage
with FC-75 perfluorochemical (PFC) was administered through a dual-lumen
endotracheal system in the new technique of 'gas/liquid ventilation'
(GLV). In Trial-I, lavage volume (V-lav) was 19 ml/kg, infused and
withdrawn over a cycle period (tc) of 37 s. (effective lavage rate
V'-lav=31 ml/kg/min.) Five dogs received cold (approximately 4 degrees C)
PFC; two controls received isothermic PFC.  In Trial-II, five dogs
received GLV at V-lav=8.8 ml/kg, tc=16 s, V'-lav=36 ml/kg/min.
MEASUREMENTS AND MAIN RESULTS:  Trial-I tympanic temperature change was
-3.7+/-0.6 degrees C (SD) at 7.5 min, reaching -7.3+/-0.6 degrees C at 18
min. Heat transfer efficiency was 60%. In Trial-II, efficiency fell to
40%, but heat-exchange dead space (VDtherm) remained constant. Lung/blood
thermal equilibration half-time was <8 s. Isothermic GLV caused
hypercapnia unless gas ventilation was increased. At necropsy after
euthanasia (24 h), modest lung injury was seen. CONCLUSIONS: GLV cooling
times are comparable to those for cardiopulmonary bypass. Heat and CO(2)
removal can be independently controlled by changing the mix of lavage and
gas ventilation. Due to VDtherm of approximately 6 ml/kg in dogs,
efficient V-lav is >18 ml/kg. GLV cooling power appears more limited by
PFC flows than lavage residence times. Concurrent gas ventilation may
mitigate heat-diffusion limitations in liquid breathing, perhaps via
bubble-induced turbulence.

PMID: 11719148 [PubMed - indexed for MEDLINE]

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med
Subject: Re: of plague dogs and cryonics
Date: 26 Jun 2005 18:33:00 -0700
Message-ID: <1119835980.062802.184610@z14g2000cwz.googlegroups.com>

>>The first one and the third one are not really of much clinical
significance *except* insofar as they suggest that cooling *before*
cardiac arrest/VF occurs protects the brain. <<

COMMENT:

The third trial was merely an animal model showing it's possible to
produce hypothermia very rapidly. That can be done also AFTER a cardiac
arrest, provided that a perfusing rhythm has been established.

Yes, the first abstract is looking at hypothermia induced before
arrest.

The second is a metaanalysis of three trials of INDUCED post
resuscitation hypothermia in humans. In all of these hypothermia was
INDUCED after the resuscitationed patient arrived at the hospital. If
you read the individual studies, you will see that patient admission
temp is a controlled variable. It doesn't differ between treatment and
control groups PRIOR to randomization to post resuscitation
hypothermia. So temperature during arrest is not a factor. Nor is
hypothermia a cause of arrest in any of these cases--- those were
excluded. These are primary cardiac arrest cases. Many from heart
attack and surely most from primary cardiac diseases. The point of the
study is that humans benefit from post arrest cooling just as animals
do (and there are many animal trials of POST resuscitation induced
hypothermia if you'd like me to post some).

>>Have you given up on your cryonics work? Is the real end goal of your
research no longer resusuitation after years/decades/centuries of
suspended animation through freezing? <<

COMMENT:

Well, that's one of my really LONG TERM goals :).  But most of those
advances will be made by the organ preservation people, at temperatures
far below those at which I work. I'm interested in taking off 5 degrees
C, really, really fast.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med
Subject: Re: missing head
Date: 29 Jun 2005 15:00:46 -0700
Message-ID: <1120082446.129412.283530@o13g2000cwo.googlegroups.com>

>Setting aside moral issues, I have a few logistical questions regarding
>the utility of this process in the populations identified as potential
>beneficiaries. How is the field medic on the battlefield going to
>actually carry the required solutions and keep them at the correct
>temperature?

COMMENT:
Well, obviously not on a medic's back, though some people who know
little about what medics actually carry first thought so.  Safar's
group did some DOD work with a couple of liters of chilled saline. It
wasn't that impressive.

It's obviously a difficult problem to carry "cold". You need insulation
and heat-exchange material and fluid. Just which ones is a technical
problem into which quite a lot of thought has gone. Suffice to say it's
possible, but it requires at least half the body weight of the wounded
soldier. And this requires a powered vehicle with electrical power, for
transport.  Still, such things do inhabit many modern battlefields.

>>Even more worrisome, given that these are patients who have
exsanguinated, how will the field medic or the paramedic in civilian
life prevent the fluid from pouring out of the same holes that the
patient's blood poured out of? The medic can apply pressure to the
wound/wounds/ but that will only keep the blood from pouring out to the
outside. It won't do a damn thing to stop the internal bleeding of the
solution. I suppose when the body cavity or cavities are full the fluid
might remain in the blood vessels but now you have a different and very
serious problem. How many medics will you need on the battlefield to
make sure that all the mortally wounded who are bleeding to death are
given this potentially life saving 'treatment." <<

COMMENT:
That's the rub indeed. All this technology makes more sense for heart
attack victims than soldiers. However, the DOD has more money than the
NIH right now, and you dance with the fella what brung ya.

Combat use isn't COMPLETELY crazy. It seems possible that there is a
class of internal slow-leakers or peripheral gushers who could be
patched up enough to use this technique, but not enough to save
otherwise. For hypothermia you don't need large amounts of cold blood,
just large amounts of cold fluid, which may be available. Part of the
charm of hypothermia is that once you get to near-ice temp (as we know
from dog experiments), you can go several hours without blood pressure
at ALL, which means you don't have to patch up remaining leaks after
that, until you get to a terminal treatment surgical center, perhaps
far away from the battle-site. Most shock/trauma battle victims die in
the first hour, and that's about how long it takes to get to them with
a helicopter. If you could do 3 hours, it would make a major
difference. So the bottom line is that if you can put in ice cold fluid
as fast as it leaks out for an hour, after that you can just "box and
go" and you would need no more personnel for transport of such a
"suspended" casualty, than you would any transplant organ "on ice." As
to how many medic vehicles "in the field"  it would take to have this
kind of thing available, nobody knows. I'm not defending the military
shock-trauma program, please remember. A civilian hypothermia
shock-trauma one with nobody shooting at you, would be hard enough.

The easiest target for hypothermia is extending non-braindamage arrest
time in heart attack or drowning from 5 to 15 minutes, which would make
a big difference in how many people could be rescued by paramedics in
big cities. This could also be done by post-resuscitation cooling, but
some of it might need to be done in the field.

>> Quote from article: 'As potentially crazy as this might sound, you're
comparing it against essentially certain death, so it's hard to see how
we can do any worse," said Scalea, who attended the symposium at Pitt.
"All of us are incredibly energized by the thought of being able to do
better.'"  This is the kind of thing that terrifies me, this belief in
the medical profession that dead is the worst thing that can happen to a
patient....it isn't. Sometimes living is. <<

COMMENT:
Indeed, but you haven't thought it out.  Without good resuscitation
we've already seen examples of what such living is like, in Terry
Schiavo and before her, Karen Ann Quinlan. They didn't get that way
because somebody put them into hypothermia. They got that way because
somebody DIDN'T.  The most horrible thing that can happen to you,
already happens to many people NOW.

Will hypothermia cut the number of Schiavos?  Frankly, no, probably
not. But it won't increase it either. It will stay just the same. The
people who would have been Schiavos at 10 minutes will instead be fine,
and the Schiavos will come from the group at 20 or 25 mintues, who
would otherwise have been brain-dead, and thus quickly pronounced.  The
total effect, however, will be to move some people from the class of
"dead" to the class of "Resuscitated and well."  Without changing much
the number of people in the gray zone between that is so horrifying to
most. The way to get out of that class is to have a good living will.
Technology won't change the fact of it much, or the number of people in
it much. What it will do, is give more people back their full and
complete lives, and that's worth doing.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med
Subject: Re: of plague dogs and cryonics
Date: 29 Jun 2005 14:22:59 -0700
Message-ID: <1120080179.575681.147760@g14g2000cwa.googlegroups.com>

>>Nor am I repulsed by death - if you're alive it comes with the
territory. Like you, I'm revolted by someone who ignores social norms
and then claims himself to be superior because he isn't held back by
silly things like normal human morals. Where I come from we call such
people sociopaths... <<

COMMENT:

People at the forefront of research have been called worse. Few
advances in bioscience have come without somebody screaming and yelling
about Frankenstein. That's almost the way you know you're onto
something worth doing and truely new.

I just read an autobiographical book by Edwards and Steptoe, who took
the heat about "test tube babies" 35 years ago. People wailed and
yelled about ethics. They talked about Brave New World. They warned
about safety and malformed babies. The Roman Catholic church opined
that the marriage contact didn't include the right to reproduce, but
was only a  license for lawful sexual intercouse from which children
MIGHT result. And so on. Leon Kass of the National Academy of sciences
(yeah, the same one who's still here giving grief to cloners) was there
to oppose it, and to say that the procedure didn't really *cure*
anything, and the couples were still infertile, so it wasn't really
*therapeutic*. Yawn. Edwards merely pointed out that Kass should be
just as much against eyeglasses and dentures. We've had similar debates
right here on sci.med.

Today we know the Test Tube Baby procedure by a different name (IVF),
and in my state MediCal pays for it if you're too poor to afford it.
Even if you have 12 kids, and they're all on public assistance, as
would be the new ones.. It would be politically incorrect NOT to pay
for it. Reproductive assistance is a new human right, apparently, like
money for Viagra. That is how humans "progress."  Although, strangely,
the people initially against most forms of progress in medicine call
themselves "progressives."

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med
Subject: Mild Whole Body hypothermia (92 F) as Brain Ischemia Treatment in 
	Newborns
Date: 12 Oct 2005 18:31:51 -0700
Message-ID: <1129167111.371198.262470@f14g2000cwb.googlegroups.com>

Induced 3-day mild whole body hypothermia treatment of hypoxic infants
reduces death rate by 13%, cerebral palsy by 11%.

http://www.healthscout.com/template.asp?page=newsDetail&ap=1&id=528505