Name: preparation of gushukang (gsk) granules for in vivo and in vitro experiments
Uploaded: 2019-05-09T12:30:00
Description: Watch this Scientific Journal Video about Preparation Of Gushukang GSK Granules for In Vivo and In Vitro Experiments at JoVE.com

This study was supported by grants from the National Natural Science Foundation of China (81804116, 81673991, 81770107, 81603643, and 81330085), the program for Innovative Team, Ministry of Science and Technology of China (2015RA4002 to WYJ), &#160;the program for Innovative Team, Ministry of Education of China (IRT1270 to WYJ), Shanghai TCM Medical Center of Chronic Disease (2017ZZ01010 to WYJ), Three Years Action to Accelerate the Development of Traditional Chinese Medicine Plan (ZY(2018-2020)-CCCX-3003 to WYJ), and national key research development projects (2018YFC1704302).

All of the experimental procedures were performed with the approval of Institutional Animal Care and Use Committee of the Shanghai University of TCM (SZY201604005).
1. Preparation and administration of GSK working solution
<ol>
	<li>Calculate the equivalent doses of GSK granules for mouse.
	<ol>
		<li>Calculate body surface based on the Meeh-Rubner equation15: body surface = K x (body weight2/3)/1000, where the K values are 10.6 for human and 9.1 for mouse. Assuming a h...

<ol>
	<li>Shu, B., Shi, Q., Wang, Y. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Shen+(Kidney)-tonifying+principle+for+primary+osteoporosis:+to+treat+both+the+disease+and+the+Chinese+medicine+syndrome.">Shen (Kidney)-tonifying principle for primary osteoporosis: to treat both the disease and the Chinese medicine syndrome.</a> Chinese Journal of Integrative Medicine. 21 (9), 656-661 (2015).</li><li>Zhao, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+naturally+derived+small+compound+Osthole+inhibits+osteoclastogenesis+to+prevent+ovariectomy-induced+bone+loss+in+mice.">The naturally derived small compound Osthole inhibits osteoclastogenesis to prevent ovariectomy-induced bone loss in mice.</a> Menopause. 25 (12), 1459-1469 (2018).</li><li>Liu, S. F., Sun, Y. L., Li, J., Dong, J. C., Bian, Q. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preparation+of+Herbal+Medicine:+Er-Xian+Decoction+and+Er-Xian-containing+Serum+for+In+vivo+and+In+vitro+Experiments.">Preparation of Herbal Medicine: Er-Xian Decoction and Er-Xian-containing Serum for In vivo and In vitro Experiments.</a> Journal of Visualized Experiments. (123), e55654 (2017).</li><li>Wang, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+systemic+bone+protective+effects+of+Gushukang+granules+in+ovariectomized+mice+by+inhibiting+osteoclastogenesis+and+stimulating+osteoblastogenesis.">The systemic bone protective effects of Gushukang granules in ovariectomized mice by inhibiting osteoclastogenesis and stimulating osteoblastogenesis.</a> Journal of Pharmacological Sciences. 136 (3), 155-164 (2018).</li><li>Bian, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Oleanolic+acid+exerts+an+osteoprotective+effect+in+ovariectomy-induced+osteoporotic+rats+and+stimulates+the+osteoblastic+differentiation+of+bone+mesenchymal+stem+cells+in+vitro.">Oleanolic acid exerts an osteoprotective effect in ovariectomy-induced osteoporotic rats and stimulates the osteoblastic differentiation of bone mesenchymal stem cells in vitro.</a> Menopause. 19 (2), 225-233 (2012).</li><li>Zhao, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Oleanolic+acid+exerts+bone+protective+effects+in+ovariectomized+mice+by+inhibiting+osteoclastogenesis.">Oleanolic acid exerts bone protective effects in ovariectomized mice by inhibiting osteoclastogenesis.</a> Journal of Pharmacological Sciences. 137 (1), 76-85 (2018).</li><li>Tang, D. Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Osthole+Stimulates+Osteoblast+Differentiation+and+Bone+Formation+by+Activation+of+&#946;-Catenin-BMP+Signaling.">Osthole Stimulates Osteoblast Differentiation and Bone Formation by Activation of &#946;-Catenin-BMP Signaling.</a> Journal of Bone and Mineral Research. 25 (6), 1234-1245 (2010).</li><li>Tashino, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term="Serum+pharmacology"+and+"serum+pharmaceutical+chemistry":+from+pharmacology+of+Chinese+traditional+medicines+to+start+a+new+measurement+of+drug+concentration+in+blood.">"Serum pharmacology" and "serum pharmaceutical chemistry": from pharmacology of Chinese traditional medicines to start a new measurement of drug concentration in blood.</a> Therapeutic Drug Monitoring Research. 5, 54-64 (1988).</li><li>Fu, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ex+vivo+Stromal+Cell-Derived+Factor+1-Mediated+Differentiation+of+Mouse+Bone+Marrow+Mesenchymal+Stem+Cells+into+Hepatocytes+Is+Enhanced+by+Chinese+Medicine+Yiguanjian+Drug-Containing+Serum.">Ex vivo Stromal Cell-Derived Factor 1-Mediated Differentiation of Mouse Bone Marrow Mesenchymal Stem Cells into Hepatocytes Is Enhanced by Chinese Medicine Yiguanjian Drug-Containing Serum.</a> Evidence Based Complement Alternative Medicine. , 7380439 (2016).</li><li>Cao, Y., Liu, F., Huang, Z., Zhang, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Protective+effects+of+Guanxin+Shutong+capsule+drug-containing+serum+on+tumor+necrosis+factor-alpha+induced+endothelial+dysfunction+through+nicotinamide+adenine+dinucleotide+phosphate+oxidase+and+the+nitric+oxide+pathway.">Protective effects of Guanxin Shutong capsule drug-containing serum on tumor necrosis factor-alpha induced endothelial dysfunction through nicotinamide adenine dinucleotide phosphate oxidase and the nitric oxide pathway.</a> Experimental and Therapeutic. 8 (3), 998-1004 (2014).</li><li>Chen, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Application+of+serum+pharmacology+in+evaluating+the+antitumor+effect+of+Fuzheng+Yiliu+Decoction+from+Chinese+Medicine.">Application of serum pharmacology in evaluating the antitumor effect of Fuzheng Yiliu Decoction from Chinese Medicine.</a> Chinese Journal of Integrative Medicine. 20 (6), 450-455 (2014).</li><li>Li, X. L., Wang, L., Bi, X. L., Chen, B. B., Zhang, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gushukang+exerts+osteopreserve+effects+by+regulating+Vitamin+D+and+Calcium+metabolism+in+ovariectomized+mice.">Gushukang exerts osteopreserve effects by regulating Vitamin D and Calcium metabolism in ovariectomized mice.</a> Journal of Bone Mineral Metabolism. , 1-11 (2018).</li><li>Cui, S. Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanistic+study+of+Shen+(Kidney)tonifying+prescription+Gushukang+in+Preventing+and+Treating+Primary+Osteoporosis.">Mechanistic study of Shen (Kidney)tonifying prescription Gushukang in Preventing and Treating Primary Osteoporosis.</a> Journal of Chinese Medical University. 30 (16), 351-354 (2001).</li><li>Wang, Y., Shang, K., Li, Y. K., Tao, X. 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F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cyclophosphamide+causes+osteoporosis+in+C57BL/6+male+mice:+suppressive+effects+of+cyclophosphamide+on+osteoblastogenesis+and+osteoclastogenesis.">Cyclophosphamide causes osteoporosis in C57BL/6 male mice: suppressive effects of cyclophosphamide on osteoblastogenesis and osteoclastogenesis.</a> Oncotarget. 8 (58), 98163-98183 (2017).</li><li>Zhong, L. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+randomized,+double-blind,+controlled+trial+of+a+Chinese+herbal+formula+(Er-Xian+decoction)+for+menopausal+symptoms+in+Hong+Kong+perimenopausal+women.">A randomized, double-blind, controlled trial of a Chinese herbal formula (Er-Xian decoction) for menopausal symptoms in Hong Kong perimenopausal women.</a> Menopause. 20 (7), 767-776 (2013).</li><li>Zhang, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Issues+and+strategies+for+study+of+serum+pharmcology+in+oncology.">Issues and strategies for study of serum pharmcology in oncology.</a> Zhong Yi Yan Jiu. 17 (5), 13-14 (2004).</li><li>Nair, A. B., Jacob, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+simple+practice+guide+for+dose+conversion+between+animals+and+human).">A simple practice guide for dose conversion between animals and human).</a> Journal of Basic and Clinical Pharmacy. 7 (2), 27-31 (2016).</li><li>Xu, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Protective+effect+of+the+traditional+Chinese+medicine+xuesaitong+on+intestinal+ischemia-reperfusion+injury+in+rats.">Protective effect of the traditional Chinese medicine xuesaitong on intestinal ischemia-reperfusion injury in rats.</a> International Journal of Clinical and Experiments Medicine. 8 (2), 1768-1779 (2015).</li><li>Jiang, Y. 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Granules of TCM agents have become one of the common choices for formulations or prescriptions. GSK granules are composed of several herbal medicines based on clinical experiences or the TCM theory, and they exert better curative effects with fewer side effects4. Compared with water decoction, the granules have these advantages: good taste, convenience of delivery, long-term storage, standard protocol and consistent curative effects, as well as higher productivity. Currently, granules are one of t...

Traditional Chinese medicine (TCM) is one of the important complementary and alternative approaches to treat osteoporosis1,2. Water decoction is the basic and most commonly used form of the formula3. However, drawbacks also exist: bad taste, inconvenience for carriage, short shelf life and inconsistent protocols, limiting the uses as well as the curative effects. To avoid the above disadvantages as well as to pursue better effects, granules were developed and have been widely used4. Although many studies have explored the pharmacological mechanisms of one or more effective components from the granules5,6,7, the exact mechanisms and underlying pharmacological processes are still difficult to identify. This is because too many effective components from one granule may simultaneously exert similar or opposed effects4. Therefore, the development of one standard protocol to prepare the granules before delivering to the body not only would have a great impact on the therapeutic outcomes but is also required for both in vivo and in vitro assays.
Moreover, the curative effects of granules in the clinic are difficult to confirm and exactly identify using in vitro or ex vivo studies, which creates a challenge because the pharmacological mechanisms are too complex. To resolve this, the preparation of drug-containing serum was first proposed by Tashino in 1980s8. From then on, numerous researchers applied drug-containing serum to herbal medicine, including granules9,10,11. Currently, the choice of drug-containing serum for in vitro investigations is regarded as one strategy that closely mimics physiological conditions.
Gushukang (GSK) granules were developed to treat postmenopausal osteoporosis (POP) based on clinical practice in light of the theory of TCM. GSK granules prevent bone loss in ovariectomized (OVX) mice in vivo, inhibit osteoclastic bone resorption, and stimulate osteoblastic bone formation4. Consequently, Li et al.12 found that GSK granules have bone protective effects in OVX mice by enhancing the activities of calcium receptor to stimulate bone formation. To confirm the bone-protective effects as well as the pharmacological effects of GSK granules, the authors here provide a detailed procedure for preparation of working solutions and drug (GSK granule)-containing serum. Moreover, this article describes the application of GSK granules in an OVX-induced osteoporotic mouse model and GSK granule-containing serum for in vitro osteoclastogenesis/osteoblastogenesis.
GSK granules are composed of several herbs13,14 and can be completely dissolved in saline easily. Therefore, saline serves as the vehicle. Sham-operated mice (Sham) and OVX mice were administered the same volume of saline as the granule-administered mice. The equivalent doses of GSK granules for the mouse were calculated based on the Meeh-Rubner equation15. This equation not only has the advantage of obtaining safe dosages but also guarantees pharmacological effects15. The three dosages of GSK granules were generated as the follows: (1) GSKL: OVX + low-dose GSK granules, 2 g/kg/day. (2) GSKM: OVX + medium-dose GSK granules, 4 g/kg/day. (3) GSKH: OVX + high-dose GSK granules, 8 g/kg/day. Mice in the GSKL, GSKM and GSKH groups were intragastrically administered GSK granules. Calcium carbonate (600 mg/tablet) with vitamin D3 (125 international unit/tablet), for example, in a mature and marketed product (e.g., Caltrate [CAL]) for treating and preventing osteoporosis, was used as a positive control.

<table>
	<tbody>
		<tr>
			<td>&#945;-MEM</td>
			<td>Hyclone 
			laboratories</td>
			<td>SH30265.018</td>
			<td>For cell culture</td>
		</tr>
		<tr>
			<td>&#946;-Glycerophosphate</td>
			<td>Sigma</td>
			<td>G5422</td>
			<td>Osteoblastogenesis</td>
		</tr>
		<tr>
			<td>Caltrate (CAL)</td>
			<td>Wyeth</td>
			<td>L96625</td>
			<td>Animal interventation</td>
		</tr>
		<tr>
			<td>C57BL/6 mice</td>
			<td>SLAC Laboratory 
			Animal Co. Ltd.</td>
			<td>Random</td>
			<td>Ainimal preparation</td>
		</tr>
		<tr>
			<td>Dexamethsome</td>
			<td>Sigma</td>
			<td>D4902</td>
			<td></td>
		</tr>
		<tr>
			<td>Dimethyl sulfoxide</td>
			<td>Sigma</td>
			<td>D2438</td>
			<td>Cell frozen</td>
		</tr>
		<tr>
			<td>Ethylene Diamine Tetraacetic Acid (EDTA)</td>
			<td>Sangon Biotech</td>
			<td>60-00-4</td>
			<td>Samples treatmnet</td>
		</tr>
		<tr>
			<td>Fetal bovine serum</td>
			<td>Gibco</td>
			<td>FL-24562</td>
			<td>For cell culture</td>
		</tr>
		<tr>
			<td>Gushukang granules</td>
			<td>kangcheng companyin china</td>
			<td>Z20003255</td>
			<td>Herbal prescription</td>
		</tr>
		<tr>
			<td>Light microscope</td>
			<td>Olympus BX50</td>
			<td>Olympus BX50</td>
			<td>Images for osteoclastogenesis</td>
		</tr>
		<tr>
			<td>L-Ascorbic acid 2-phosphate sequinagneium slat hyclrate</td>
			<td>Sigma</td>
			<td>A8960-5G</td>
			<td>Osteoblastogenesis</td>
		</tr>
		<tr>
			<td>Microscope</td>
			<td>Leica</td>
			<td>DMI300B</td>
			<td>Osteocast and osteoblast imagine</td>
		</tr>
		<tr>
			<td>M-CSF</td>
			<td>Peprotech</td>
			<td>AF-300-25-10</td>
			<td>Osteoclastogenesis</td>
		</tr>
		<tr>
			<td>&#924;icro-CT</td>
			<td>Scanco 
			Medical AG</td>
			<td>&#956;CT80 radiograph microtomograph</td>
			<td>Bone Structural analsysis</td>
		</tr>
		<tr>
			<td>RANKL</td>
			<td>Peprotech</td>
			<td>11682-HNCHF</td>
			<td>Osteoclastogenesis</td>
		</tr>
		<tr>
			<td>Sprague Dawley</td>
			<td>SLAC Laboratory 
			Animal Co. Ltd.</td>
			<td>Random</td>
			<td>Blood serum collection</td>
		</tr>
		<tr>
			<td>Tartrate-Resistant Acid Phosphate (TRAP) Kit</td>
			<td>Sigma-Aldrich</td>
			<td>387A-1KT</td>
			<td>TRAP staining</td>
		</tr>
	</tbody>
</table>

preparation of gushukang (gsk) granules for in vivo and in vitro experiments

Traditional Chinese herbal medicine plays a role as an alternative method in treating many diseases, such as postmenopausal osteoporosis (POP). Gushukang (GSK) granules, a marketed prescription in China, have bone-protective effects in treating POP. Before administration to the body, one standard preparation procedure is commonly required, which aims to promote the release of active constituents from raw herbs and enhance the pharmacological effects as well as therapeutic outcomes. This study proposes a detailed protocol for using GSK granules in in vivo and in vitro experimental assays. The authors first provide a detailed protocol to calculate the animal-appropriate dosages of granules for in vivo investigation: weighing, dissolving, storage, and administration. Second, this article describes protocols for micro-CT scanning and the measurement of bone parameters. Sample preparation, protocols for running the micro-CT machine and quantification of bone parameters were evaluated. Third, serum-containing GSK granules are prepared, and drug-containing serum is extracted for in vitro osteoclastogenesis and osteoblastogenesis. GSK granules were intragastrically administered twice per day to rats for three consecutive days. Blood was then collected, centrifuged, inactivated, and filtered. Finally, serum was diluted and used for performing osteoclastogenesis and osteoblastogenesis. The protocol described here can be considered a reference for pharmacological investigations of herbal prescription medicines, such as granules.

Micro-CT scanning results indicated that the OVX mice showed significant bone loss compared to saline control mice (Figure 1A). The intervention (90 days) of GSK granules greatly increased the BMD, particularly in the GSKM group (Figure 1B). The bone structure parameters, such as BMD, BV/TV, Tb.N, and Tb.Th, were quantified. GSK granule treatments led to increased BMD, BV/TV, Tb.N and Tb.Th but decreased Tb.Sp (<strong class="xfi...

Watch this Scientific Journal Video about Preparation Of Gushukang GSK Granules for In Vivo and In Vitro Experiments at JoVE.com

Preparation Of Gushukang GSK Granules for In Vivo and In Vitro Experiments

This article provides a detailed protocol for preparing a working solution of Gushukang granules for animal studies and GSK granule containing serum for in vitro experiments. This protocol can be applied to pharmacological investigations of herbal medicines as well as prescriptions for both in vivo and in vitro experiments.

Preparation Of Gushukang (GSK) Granules for In Vivo and In Vitro Experiments

Traditional Chinese herbal medicine plays a role as an alternative method in treating many diseases, such as postmenopausal osteoporosis (POP). Gushukang ...

This protocol facilities the preparation of a working solution of granules for in vivo studies, as well as the preparation of granule-containing serum for in vitro experiments. One advantage of this technique is that the method can be easily repeated due to the low cost of the materials and the animals you create for the experiments. Begin by adding eight, 16, and 24 grams of Gushukang, or GSK, granules to individual 50-milliliter tubes.Add 48 milliliters of water to each tube, and shake the tubes to completely dissolve the granules. Then, place 1.6 tablets of calcium carbonate supplemented with vitamin D3 into another 50-milliliter tube, and dissolve the tablets in 48 milliliters of saline with shaking. For intragastric administration of the solutions, first gently but firmly manually restrain a one-month-old, female, C57 Black 6 mouse for two to three minutes.When the mouse has calmed, load a 40-millimeter, number 12 gavage needle with 0.24 milliliters of one working solution of GSK granules, and place the gavage needle into the mouse through one side of its mouth until the needle resistance is felt, indicating the needle has reached the stomach. Inject the entire volume of working solution into the animal. Then, retract the gavage needle, and return the mouse to its cage while the other mice are being administered GSK before injecting 0.24 milliliters of calcium carbonate and vitamin D3 solution into each mouse in the same manner.For GSK-containing blood serum collection, after delivering the appropriate concentrations of GSK to a rat by gavage as just demonstrated, confirm a lack of response to toe pinch one hour after the last GSK granule administration. Make an abdominal skin and peritoneal incision, and expose the abdomen to the bottom of the thorax. Use tissue paper to remove the connective tissue of the abdominal aorta to expose the vessel clearly, and use a 10-milliliter syringe equipped with a 22-gauge needle to draw blood from the aorta.Transfer the blood to a sterile 15-milliliter tube, and place the tube upright at room temperature for 30 to 60 minutes. When the blood has clotted, centrifuge the tube to separate out the serum, and transfer all of the serum for up to six rats into a new 50-milliliter tube. Shake the tube to mix the sera before inactivating the serum components in a 56-degree Celsius water bath for 30 minutes.Then, filter the serum through a 0.22-micrometer-pore-size hydrophilic polyethersulfone syringe filter for storage at minus 80 degrees Celsius for up to a year. For in vitro osteoclastogenesis, dilute the three dosages of GSK-containing serum at a one-to-four ratio with minimum Eagle's medium supplemented with L-glutamine, ribonucleosides, and deoxyribonucleosides. Add 200 microliters of each dilution to each well of a bone marrow macrophage culture in a 96-well plate.Then, initiate osteoclast generation by stimulating each well with macrophage colony-stimulating factor and receptor activator for nuclear factor-kappa B ligand. For in vitro osteoblastogenesis, add two milliliters of diluted GSK-containing serum to each well of a 24-well plate bone mesenchymal stem cell culture. Micro-computed tomography scanning results indicate that ovariectomized mice demonstrate significant bone loss compared to saline control mice.Intervention with 90 days of GSK granule treatment greatly increases the bone marrow density, particularly in medium dose GSK-treated animals. GSK granule treatment also leads to an increased trabecular bone number, bone volume over total volume, and trabecular bone thickness, but a decreased bone-trabecular bone separation. Tartrate-resistant acid phosphatase, or TRAP, staining reveals an increase in the number of osteoclasts in ovariectomized mice compared to control animals, while GSK granule treatments decrease TRAP-positive osteoclast differentiation compared to the ovariectomized animals.GSK granule-containing serum also reduces the number of TRAP-positive osteoclasts compared to serum collected from control animals. The successful penetration of the needle into the abdominal aorta is critical to guarantee that a high enough volume blood is harvested from each rat. A successful execution of this method should allot the accumulation of 15 to 20 millimeters of blood, enough material to be used for in vitro experiments.

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