From: kqb@cbnewsl.cb.att.com (kevin.q.brown)
Subject:  Trans Time Newsletter #1
Organization: AT&T Bell Laboratories
Date: Thu, 20 Aug 1992 22:28:04 GMT
X-Crossposted-To: cryonics mailing list

    ------------------------ Forwarded Message ------------------------

> Date: Wed, 19 Aug 92 20:44:23 -0700
> From: quaife@garnet.berkeley.edu
> Message-Subject: Trans Time Newsletter #1

                                        \tt\newsletr\vol1num1.asc
                         THE TRANS TIMES
_________________________________________________________________

                 Newsletter of TRANS TIME, INC.

10208 Pearmain Street, Oakland, CA 94603.            510-639-1955
_________________________________________________________________

Volume 1 Number 1                                     August 1992


                    THE BIRTH OF A NEWSLETTER

                      by Art Quaife, Ph.D.
                   President, TRANS TIME, INC.

TRANS TIME was incorporated on March 13, 1972. In the intervening
twenty years, we have communicated with persons interested in our
services through a variety of means. The media love us, so we have
had a steady stream of coverage on television and radio, and in
newspapers and magazines. We have also published articles in other
cryonics publications such as American Cryonics, ACS Notebook, The
Immortalist, Long Life Magazine, The Cryonicist, and Cryonics.

We will continue to use those channels. But over the years, many
people have become TRANS TIME stockholders, and others have become
customers for our Emergency Responsibility services. We need to
have our own publication, directed to the people with whom we do
business. Here is the first issue of our newsletter, dedicated to
meeting that need.


                              Scope

In this newsletter, we will attempt to cover improvement of our
capabilities, developments related to making suspension arrange-
ments, and equipment acquisitions. We will also cover important re-
search developments and general cryonics news. 


                      TWENTIETH ANNIVERSARY

TRANS TIME was formed twenty years ago by the most active members
of the the American Cryonics Society. We decided that it was time
to go beyond talking about what a great idea cryonics was, and form
a company to provide the service for ourselves and others. We real-
ized that the best way to raise money for equipment and supplies
was through forming a stock corporation. As the only for-profit
cryonics service provider in the world, we continue to offer
cryonicists an opportunity to support the growth of cryonics while
simultaneously earning a return on the growth of their stock
investment.

Eight persons incorporated TRANS TIME. One was Art Quaife, who has
been the President ever since. Another was Jerry White, who has
been on the Board most of the time since, and also served twelve
years as President of ACS. A third was Linda Chamberlain, who with
her husband Fred also formed the Alcor (non-profit) and Manrise
(for-profit) organizations. In 1977, we bought out Manrise and
merged it into TRANS TIME.

All of the original incorporators remain involved in cryonics, to
a greater or lesser extent, except Grace Talbott, who was an M.D in
her seventies when TRANS TIME was formed. She died three years
later, without having made any suspension arrangements, and was not
suspended.

At our Annual Meeting of Shareholders on April 26, we ate birthday
cake reading "Trans 20 years Time, Going on omega" and toasted that
thought liberally with champagne.

                   CRYONIC SUSPENSION PROTOCOL

We are frequently asked just what we do during a cryonic suspen-
sion. In this article we outline the major procedures used to place
a patient into cryonic suspension. There are four main steps:

I)      Stabilize, cool, and transport the patient.

II)     Perfuse the patient with cryoprotective solutions.

III)    Lower the patient's temperature to -79xC.

IV)     Lower the patient's temperature to -196xC.


                             Step I

Follow these guidelines when the patient is pronounced dead:

    *   Maintain blood flow and respiration of the patient (with
        caution). 
    *   Cool the patient by surrounding with ice bags, especially
        the head.
    *   Inject 500 IU/kg of heparin.
    *   Use sterile technique if possible.

This procedure should be performed in conjunction with a physician,
nurse, or paramedic.

1)  At the time of death maintain blood flow (using sternal
compression) and oxygenation (using a bag resuscitator or other
positive pressure device) to limit ischemic injury. Administer the
oxygen through a face mask, or preferably an endotracheal tube.
Avoid mouth-to-mouth resuscitation, because of the danger of
infection. Do cardiopulmonary resuscitation manually until a
mechanical heart-lung resuscitator (with 100% O2) can be employed. 

Note: The chest compression rate affects hemodynamics, and it has
been recommended that one apply 120 compressions/minute and 12
breaths/minute (Circulation 74:63, 1986). CPR (cardiopulmonary
resuscitation) predisposes the patient to gastric insufflation due
to the unprotected airway. Thus while using CPR it is advisable to
intersperse abdominal compressions. It should be noted that chest
compressions may not be efficient enough to maintain adequate blood
flow. A thoracotomy can be performed to expose the heart, which can
be pumped manually.

2)  Establish venous cannulation in the forearm, employ a 3-way
stopcock and tape securely, before the time of death if possible,
for the administration of pharmacological agents. Keep the pathway
open until death using normal saline. Upon death, administer
heparin: 500 IU/kg.

3)  Place the patient on a cooling blanket, if available, and
circulate coolant. Surround the patient with Ziploc ice bags,
paying particular attention to cooling the head. Lower the body
temperature toward 0xC.

4)  Insert thermocouple probes in the esophagus and in the rectum,
and monitor temperature throughout the protocol.

5)  Tape the eyelids closed to prevent dehydration.

6)  Inject 300 mg Tagamet (cimetidine HCl), or administer 20 ml
Maalox through a gastric tube, to prevent HCl production by the
gastro-intestinal tract. 

7)  When suitable, use a Foley catheter to drain the bladder.

8)  While continuing to apply CPR, transport the patient to the
facility where the patient will be prepared for bypass, perfusion,
and extracorporeal oxygenation. The sooner the patient is on bypass
the better, due to superior cooling and oxygenation.


                             Step II

This perfusion step should be performed with the guidance of a
surgeon, perfusionist, and medical technician.

Expose and cannulate the carotid artery and jugular vein. Secure
the cannulas and attach them to the tubing of the bypass circuit. 

Alternatively, one can use the femoral approach. Expose and
cannulate the femoral vein and artery. Secure the cannulas and
attach them to the tubing of the bypass circuit. The cannula in the
femoral vein should be pushed up toward the right atrium of the
heart.

Arterial and venous pressure should be monitored throughout
perfusion to limit edema. Catheters should be inserted into the
radial vein and radial artery or a femoral artery. These catheters
should be coupled to pressure sensors. Monitor pH, O2, CO2, and
cryoprotectant concentration by using a refractometer.

The reservoir should initially contain ice-cold BioTime Dextend~
solution. Begin total body washout and replace the blood with 4 to
6 liters of BioTime Dextend solution (one blood volume or 5 L / 70
kg). Discard the venous effluent into containers holding Clorox
bleach. Add cryoprotective agents to the basic blood substitute as
shown below. About one blood volume of each solution should be
used.

                    Concentration       Amount
    Solution            % (v/v)         perfused

    BioTime Dextend no cryoprotectant   4 to 6 L

    Dextend/Z cryo  1/4 Z cryo          4 to 6 L

    Dextend/Z cryo  1/2 Z cryo          4 to 6 L

    Dextend/Z cryo  3/4 Z cryo          4 to 6 L

    BioTime Z cryo  full strength       4 to 6 L

After perfusion is complete, decannulate and suture the surgical
wounds.


                            Step III

Place thermocouples on the skin surface, and in the esophagus and
rectum (if not already done). Cool the patient in an insulated
chest using dry ice. Monitor the patient's temperature and freeze
gradually. Temperature lowering should ideally be between 0.01 and
0.1 degrees C per minute, with slower preferred especially after
the patient has solidified.
 
                             Step IV

Place the patient in a container, and suspend the container above
the (low) level of liquid nitrogen in a dewar, to begin vapor phase
cooling to -196 degrees C. Cooling should continue slowly at about
0.01xC per minute if possible. Rapid cooling may cause stress
fractures.


                             BIOTIME

TRANS TIME has a close working relationship with BioTime, Inc. Drs.
Paul Segall, Hal Sternberg, and Harold Waitz, BioTime's principal
researchers, have a long history of affiliation with TRANS TIME.
Hal Sternberg is currently our Vice-President, and BioTime
Secretary Judy Segall is also TRANS TIME's Secretary.

BioTime has raised about $5,000,000 to develop further a blood
substitute that may have a variety of surgical applications. We use
their blood substitute in the cryonic suspension of our patients.
We have the right to use any of their products for cryonics
purposes. And we own shares of their stock currently trading on the
NASDAQ for more than $300,000.

All of which leads to the following press release:


                      BRING 'EM BACK ALIVE!

Berkeley, California, May 29 1992. "BioTime Inc. has, for the first
time, successfully revived a baboon following a procedure in which
the animal's deep body temperature was lowered to near-freezing and
its blood was replaced with BioTime's patent-pending blood-
substitute solution.

"The animal was anesthetized, immersed in ice and cooled to below
2 degrees Celsius, using the BioTime solution with cardiopulmonary
bypass procedures. After being bloodless and below 10 degrees
Centigrade for 55 minutes, the animal was rewarmed and revived. The
baboon is presently under study by BioTime scientists to determine
any long-term physical effects.

"The company intends to conduct further experiments on primates,
using its blood-substitute solutions."


The baboon was initially weak in its hindquarters, but has experi-
enced normal recovery. At this writing it is alert and very active,
showing no signs of brain damage.

The BioTime experimenters were ably assisted by the expert staff of
a private research laboratory, whose personnel also assist TRANS
TIME in cryonic suspensions.

The research was broadcast nationwide on CNN News on July 28, 1992.
Over the past five years, we have had a number of similar successes
with dogs, including recovery after four and one half hours of cold
washout. Now we are scaling up one step closer to humans. The
research team is now attempting to extend the bloodless-cold time
to three hours.

The earlier dog research is reported in detail in "Ultraprofound
hypothermia with complete blood substitution in a canine model,"
Julian Bailes et al., Journal of Neurosurgery 74:781-788, 1991.


                         OTHER RESEARCH

Here we include an abstract describing some of their other recent
research. This abstract was published in the Federation of American
Societies for Experimental Biology Journal 6:4, February 26, 1992.

PRESERVING ORGANS USING COLD BLOOD-SUBSTITUTES.   Sternberg H.,
P.E. Segall and H.D. Waitz. BioTime, Inc., Berkeley, CA 94710.

Core-cooling of organ donors can increase the quality of organs for
transplantation. The hamster (Mesocricetus auratus), provides a
convenient and inexpensive model to develop blood-substitutes for
ultraprofound hypothermia. Five hamsters were anesthetized with
ketamine, cooled to 12-14 degrees C, and their right carotid arter-
ies cannulated. They were then chilled to 4 degrees C and their
right jugular veins punctured to allow venous effluent outflow.
Using a modified BioTime Z+ solution (an ice-cold synthetic
buffered aqueous perfusate containing electrolytes, sugars, and
Dextran 40), they were blood-substituted until their hematocrits
were approximately 10%, and cardiac arrest had occurred. The
hamsters were then buried in crushed ice for 3 hours. Afterward,
they were perfused with the BioTime Z+ solution (2 hamsters), or a
second modified Z+ solution (3 hamsters), warmed slightly, and then
perfused with whole hamster blood. All animals revived until they
could respond to stimuli.

In additional studies, a series of 5 chilled hamsters were blood-
substituted with modified Z+ solution, and then perfused with
BioTime Z~ solutions (similar to Z+ solution, but with cryoprotec-
tive agents added). The hamsters were then partially-frozen
overnight (15-18 hours) in a saline slush until their deep body
temperatures reached minimums of -2.7 to -3.5 degrees C, thawed in
a commercial microwave oven, perfused with Z+ solution, and then
warmed and transfused with donor whole blood. In each case
heartbeat was restored. 
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