X-Message-Number: 4750 Date: 09 Aug 95 15:58:25 EDT From: Mike Darwin <> Subject: CRYONICS Fixation & Rewarming Joe Strout posted some suggestions and ideas about fixation and subsequent cryopreservation. There should *definitely* be a part in the FAQ which deals with this issue because it comes up regularly and is tedious to answer over and over again. First, this is not a new idea. It has been around for at least 15 years and was the preferred scenario in Drexler's ENGINES OF CREATIONS. Second, Joe is quite right about fixation making subsequent cryoprotection problematic. In fact, I'll bet Joe might actually have fixed a few brains or animals by now. Aside from protocols based on fixative volumes needed vs. specimin size, a well known way to tell when its time to stop perfusing with fixative is when the vascular resistance begins to climb precipitously. Fixation alters capillary structure and function to essentially bring flow to a halt. Third, any neurophysiologist or electron microscopist worth his/her salt will look at you in horror if you propose fixing an animal via perfusion after say, even 20-30 minutes of normothermic ischemia. There are two reasone for this: a) Many artifacts will appear (such as injured mitochondria and clumped chromatin) which could cloud the issue of where the injury came from (i.e.,the experimental procedure being evaluated, or from ischemia). This is not the major concern for cryonicists. b) Relatively modest period of ischemia result in very poor distribution of the fixative. Red cells become rigid when ATP depleted and stick in capillaries, I-CAM is activated causing leukocyte and RBC plugging, and regional cerebral blood flows go to hell through loss of normal vasomotion. Prolonged, low pressure cryoprotective perfusion seems to open up many capillary beds which would remain closed during fixative perfusion. Of course, it could always be argued that fixation could FOLLOW cryopreservation. We have found this problematic in that the very high viscosity of the perfusate inhibits fixation, as well as probably cryoprotectant induced alteration of proteins in ways that make them less likely to go through the condensation reaction wherein the hydroxyl and amine groups on proteins react (by crosslinking and producing water as a byproduct) and become "fixed." Another point of great importance needs to be made here as well, and Joe alludes to it. Aldehyde fixatives fix proteins. They do not fix carbohydrates or lipids. While carbohydrates may not be very important to memory, identity, and so on from an information-theoretic standpoint, it would be hard to argue that lipids are equally inconsequential since they comprise the major load of the membrane structure which is both the identifying border of cells and the locus for many, many critical biochemical reactions which undoubtedly are important to identity. In order to fix lipids you must generally use a metal like osmium in a reactive form (such as the tetraoxide). Osmium is not, I repeat not, nice stuff. You might be able to substitute mercury compounds or even arsenicals, but the resulting mass of tissue would be not only mildly poisonous, as is the case after aldehyde fixation, but highly poisonous and have a top-drawer haz mat classification. In fact, the use of heavy metals for embalming corpses is specfically forbidden by law in many states (maybe all?) in the US for two reasons: danger to the ground water and environment and, more appropriately, because salts of metals like arsenic and mercury make such good poisons for the purpose of rendering otherwise healthy (or at least not immediately terminal) people dead. This is called homicide. A major reason for the deterioration Joe spoke of in fixed materials is that MOST of the specimin is not fixed. Anyone who has stored a human or animal brain in a jar of aldehyde fixative will observe the progressive leaching of compounds into the bathing media and the progressive deterioration of the tissue macroscopically over a period of several years. Indeed, in specimins where the fixative level was allowed to drop exposing the specimin in a closed jar, I have observed a white, fuzzy mold growing quite nicely on such tissues -- presumably in a formaldehyde saturated atmosphere! Finally, what no one in this discussion has considered is the effect of fixation on cryoinjury. My expectation was that it would reduce it since everything should be turned into a rubbery polymer. Certainly cells in culture which are fixed and repeatedly frozen don't dissolve away like unfixed freeze-cycled controls. However, one nasty consequence of fixation is that it reorganizes membrane structure and opens large pores in the plasmalemma. These pores allow free movement of water, cryoprotectants, salts, and even fairly large molecules like mannitol (MW ca. 190). As a consequence, cells do not dehydrate when freezing occurs and ice propagates right across the cell membrane resulting in intracellular freezing. EM examination of such tissue is a dismal business. The tissue looks WORSE than if it had been straight-frozen without any cryoprotectant or fixative at all. Finally, as alluded to earlier, fixation requires the *diffusion* of chemicals and for diffusion to be effective and rapid enough to inhibit autolysis the maximum distance from fixative to tissue in need of fixation can be no greater than 1 mm and preferably no more than 0.5 mm. In many, maybe even most of today's patients, you are not going to get good distribution of fixative, period. Cooling, on the other hand, while slow in large masses, still will eventually reach ALL of the tissue and in a far more timely manner than fixation. Its effects are thus independent of the condition of the circulatory system or distances between the surface and core of an un- or underperfused area. As to heating, I see no need for little pellets full of nasty, highly reactive compounds. Existing RF technology can rapidly and uniformly rewarm masses the size of human kidneys in excess of 300 to 400xC per minute. Theoretical consideration and some clever design work have demonstrated that the limits of RF heating are not particularly mass dependent -- at least not as far as a human body is concerned. Whole humans can, in theory at least, be rewarmed at comparable rates even with the very limited consideration given to this problem so far. Adequate cryoprotection, present either before or after repair would make this problem much easier by eliminating the presence of ice. Such cryoprotectants would also serve to greatly relax the requirement for very high rates of rewarming to avoid ice formation after repair, from thousands of degreees C per minute to hundres of degrees -- or even lower. I find I must agree with Charles; some of these scenarios, given the technological capabilites they posit, certainly are Rube Goldberg ways of achieving what might simply be done by other means such as using the same end-stage nanotechnology in combination with simple, macro approaches such as RF rewarming. Ralph's scenario and the background which produced it remind me of the old adage: When all you have is a hammer, every problem looks like a nail. Mike Darwin Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=4750