Needs of an uninsured equity-deserving minority patient cohort with physical disabilities during the first wave of the COVID-19 pandemic

Background

Patients with disabilities and those from diverse equity-deserving backgrounds have been disproportionately affected by the SARS COV-2 ("COVID-19") pandemic.

Objective

To describe the significant needs and social determinants of health that affected a group of uninsured patients (from equity-deserving groups) with rehabilitation diagnoses during the early months of the COVID-19 pandemic.

Design

Retrospective cohort study utilizing a telephone-based needs assessment from April to October, 2020.

Setting

Free interdisciplinary rehabilitation clinic serving patients with physical disabilities from equity-deserving minority backgrounds.

Participants

51 uninsured, diverse patients with spinal cord injuries, brain injuries, amputations, strokes, and other diagnoses requiring interdisciplinary rehabilitation care.

Methods

Using a non-structured approach, telephone-based needs assessments were collected monthly. Reported needs were summarized into themes and the frequencies of each theme were recorded.

Results

From the total number of concerns, medical issues were reported with the highest frequency (46%), followed by equipment needs (30%) and mental health concerns (30%). Other frequently mentioned needs centered around themes of rent, employment, and supplies. Rent and employment were more frequently cited in earlier months, and equipment problems were more frequently cited in later months. A minority of patients reported they had no needs, some of whom had acquired insurance.

Conclusions

Our objective was to describe the needs of a racially and ethnically diverse set of uninsured individuals with physical disabilities seen at a specialized interdisciplinary rehabilitation pro bono clinic during the early months of COVID-19. Medical issues, equipment needs, and mental health concerns were the top three needs. To optimally serve them, care providers must be aware of current and future needs for their underserved patients, especially if future lockdowns occur.

Mechanism of plant mediated methane emission in tropical lowland rice

Methane (CH₄) is predominantly produced in lowland rice soil, but its emission from soil to atmosphere primarily depends on passage/conduit or capillary pore spaces present in rice plants. The gas transport mechanism through aerenchyma pore spaces of rice cultivars was studied to explore the plant mediated CH₄ emission. Seven rice cultivars, based on the life cycle duration (LCD), were tested in tropical eastern India. Three LCD groups were, (a) Kalinga 1 and CR Dhan 204 (LCD: 110-120 days); (b) Lalat, Pooja and CR 1014 (LCD: 130-150 days); and (c) Durga and Varshadhan (LCD: 160-170 days). Rate of CH₄emission, root exudates, root oxidase activities and shoot aerenchyma pore spaces were analyzed to study the mechanism of plant mediated emission from rice. Aerenchyma pore space was quantified in the hypothesis that it regulates the CH₄ transportation from soil to atmosphere. The ratio of pore space area to total space was lowest in Kalinga 1 cultivar (0.29) and highest was in Varshadhan (0.43). Significant variations in the methane emission were observed among the cultivars with an average emission rate ranged from 0.86 mg m^-2 h^-1 to 4.96 mg m^-2 h^-1. The CH4 emission rates were lowest in short duration cultivars followed by medium and long duration ones. The greenhouse gas intensity considering average CH₄ emission rate per unit grain yield was also lowest (0.35) in Kalinga 1 and relatively less in short and medium duration cultivars. Root exudation was higher at panicle initiation (PI) than maximum tillering (MT) stage. Lowest exudation was noticed in (197.2 mg C plant^-1 day^-1) Kalinga 1 and highest in Varsadhan (231.7 mg C plant^-1 day^-1). So we can say, the rate of CH₄ emission was controlled by aerenchyma orientation, root exudation and biomass production rate which are the key specific traits of a cultivar. Identified traits were closely associated with duration and adaptability to cultivars grown in specific ecology. Therefore, there is possibility to breed rice cultivars depending on ecology, duration and having less CH₄ emission potential, which could be effectively used in greenhouse gas mitigation strategies.

Effect of Pretilachlor on Soil Enzyme Activities in Tropical Rice Soil

Pretilachlor treatments, namely, recommended dose at 600 g a.i. ha^-1 (RD), double the recommended dose at 1200 g a.i. ha^-1 (2RD), ten times of the recommended dose at 6000 g a.i. ha^-1 (10RD) along with control, were used to study the effects of pretilachlor on soil enzymes in tropical rice soil. Pretilachlor, at recommended dose completely dissipated 30 days after herbicide application. Twenty days after herbicide application, the dehydrogenase activity was inhibited up to 27 %, 28 % and 40 % of initial values of RD, 2RD and 10RD treatments, respectively. Increase in fluorescein diacetate hydrolase activity was observed during the first 25 days post herbicide application up to 29 %, 36 % and 10 % of initial values of RD, 2RD and 10RD treatments, respectively. β-Glucosidase activity in the experiment did not provide a specific trend. In general, urease and acid phosphatase activities were not influenced by pretilachlor application. There were significant differences in alkaline phosphatase activities among the treatments until 25 days after herbicide application. Hence, pretilachlor may cause short term transitory changes in soil enzyme parameters. However, it has negative impact on soil enzymes at very high dose.

Non-target effect of continuous application of chlorpyrifos on soil microbes, nematodes and its persistence under sub-humid tropical rice-rice cropping system

Application of pesticide in agricultural fields is "unnecessary evil" for non-target microflora and fauna. Hence, to identify the safer pesticide molecules against non-target microbes, a long-term pesticide experiment was initiated at National Rice Research Institute, Cuttack, India. In the present study, the effect of continuous application of chlorpyrifos (0.5kgha^-1) in rice fields on non-target groups of soil microbes and nematodes was studied for seven seasons (four wet and three dry seasons) during 2009-2013. Treatments were arranged in a randomized complete block design with four replications of chlorpyrifos-treated (0.5kg a.i. ha^-1) (CT) and untreated control (UT) plots. During seven seasons of experimentation, regular application of chlorpyrifos had no significant effect on population of heterotrophic aerobic, anaerobic, oligotrophic and copiotrophic bacteria in CT compared to UT, whereas, population of asymbiotic aerobic nitrogen fixer, nitrifiers, denitrifiers, gram positive and spore-forming bacteria were significantly reduced by nearly 0.25-2 fold in CT than UT. However, comparatively less deviation in population of actinomycetes, fungi, phosphate solubilizing and sulfur oxidizing bacteria were observed in CT than UT. Significant interactions were found between effects of chlorpyrifos with time in population dynamics of microbes. In plant parasitic nematode species, Meloidogyne graminicola (RRKN) and Hirschmanniella spp. (RRN), were significantly lower (p<0.01) in CT compared to UT after first year onwards. The overall observation of five years data indicated that the RRKN population showed a decreasing trend (R²=0.644) whereas RRN showed increasing trend (R²=0.932) in CT. The drastic chlorpyrifos dissipation was noticed after 15 days of application from the initial residue of 0.25mgkg^-1 soil, which indicated that chlorpyrifos residue in rice field soil was not persistent and its half-life was found to be 4.02 days. Overall, the present findings revealed that non-target effect of repetitive application of chloropyrifos (0.5kgha^-1) on soil microbes and nematodes was found less under rice-rice cropping system.

The Advanced LIGO photon calibrators

The two interferometers of the Laser Interferometry Gravitational-wave Observatory (LIGO) recently detected gravitational waves from the mergers of binary black hole systems. Accurate calibration of the output of these detectors was crucial for the observation of these events and the extraction of parameters of the sources. The principal tools used to calibrate the responses of the second-generation (Advanced) LIGO detectors to gravitational waves are systems based on radiation pressure and referred to as photon calibrators. These systems, which were completely redesigned for Advanced LIGO, include several significant upgrades that enable them to meet the calibration requirements of second-generation gravitational wave detectors in the new era of gravitational-wave astronomy. We report on the design, implementation, and operation of these Advanced LIGO photon calibrators that are currently providing fiducial displacements on the order of 10^-18m/Hz with accuracy and precision of better than 1%.

Non-target effects of pretilachlor on microbial properties in tropical rice soil

The use of herbicides has been questioned in recent past for their non-target effects. Therefore, we planned to study the effect of pretilachlor on growth and activities of microbes in tropical rice soil under controlled condition at National Rice Research Institute, Cuttack, India. Three pretilachlor treatments, namely, recommended dose at 600 g a.i. ha(-1) (RD), double the recommended dose at 1200 g a.i. ha(-1) (2RD), and ten times of the recommended dose at 6000 g a.i. ha(-1) (10RD) along with control, were imposed. The initial residue (after 2 h of spray) deposits in soil were 0.174, 0.968, and 3.35 μg g(-1) for recommended, double the recommended, and ten times of the recommended doses, respectively. No residue in soil was detected in RD treatment on day 45. The half life values were 16.90, 17.76, and 36.47 days for RD, 2RD, and 10RD treatments, respectively. Application of pretilachlor at 10RD, in general, had significantly reduced the number of bacteria, actinomycetes, fungi, nitrogen fixers, and microbial biomass carbon. Pretilachlor at RD did not record any significant changes in microbial properties compared to control. The results of the present study thus indicated that pretilachlor at RD can be safely used for controlling grassy weeds in rice fields.

Effect of elevated CO2 on chlorpyriphos degradation and soil microbial activities in tropical rice soil

Impact of elevated CO2 on chlorpyriphos degradation, microbial biomass carbon, and enzymatic activities in rice soil was investigated. Rice (variety Naveen, Indica type) was grown under four conditions, namely, chambered control, elevated CO2 (550 ppm), elevated CO2 (700 ppm) in open-top chambers and open field. Chlorpyriphos was sprayed at 500 g a.i. ha(-1) at maximum tillering stage. Chlorpyriphos degraded rapidly from rice soils, and 88.4% of initially applied chlorpyriphos was lost from the rice soil maintained under elevated CO2 (700 ppm) by day 5 of spray, whereas the loss was 80.7% from open field rice soil. Half-life values of chlorpyriphos under different conditions ranged from 2.4 to 1.7 days with minimum half-life recorded with two elevated CO2 treatments. Increased CO2 concentration led to increase in temperature (1.2 to 1.8 °C) that played a critical role in chlorpyriphos persistence. Microbial biomass carbon and soil enzymatic activities specifically, dehydrogenase, fluorescien diacetate hydrolase, urease, acid phosphatase, and alkaline phosphatase responded positively to elevated CO2 concentrations. Generally, the enzyme activities were highly correlated with each other. Irrespective of the level of CO2, short-term negative influence of chlorpyriphos was observed on soil enzymes till day 7 of spray. Knowledge obtained from this study highlights that the elevated CO2 may negatively influence persistence of pesticide but will have positive effects on soil enzyme activities.

Updates in adult-onset Still disease: Atypical cutaneous manifestations and associations with delayed malignancy

Adult-onset Still disease (AOSD) is a systemic inflammatory disorder that is clinically characterized by a heterogeneous constellation of symptoms and signs. Though an evanescent eruption is the classic cutaneous finding, recent literature has highlighted atypical rashes associated with Still disease. A second emerging concept in presentations of AOSD is its association with malignancy. This review focuses on these concepts: the clinical spectrum of atypical skin manifestations and AOSD as a paraneoplastic phenomenon. PubMed-MEDLINE was screened for peer-reviewed articles describing atypical presentations of AOSD and cases associated with malignancy. Erythematous, brown or violaceous, persistent papules and plaques were the most common cutaneous finding (28/30 [93%]). Linear configurations were also rarely described. Of these patients, 81% concurrently had the typical evanescent skin eruption. There were 31 patients with associated malignancies, most commonly breast cancer and lymphoma. The diagnosis of malignancy did not precede or immediately follow a clinical presentation otherwise consistent with AOSD in a considerable subset of patients (42%). Understanding the cutaneous spectrum of AOSD and heightened awareness for its delayed association with malignancy may lead to improved recognition of cutaneous variants and reinforce the need for diagnostic evaluation and long-term follow-up for malignancy in patients with this clinical presentation.

Robotic training and clinical assessment of forearm and wrist movements after incomplete spinal cord injury: a case study

The effectiveness of a robotic training device was evaluated in a 24-year-old male, cervical level four, ASIA Impairment Scale D injury. Robotic training of both upper extremities was provided for three hr/day for ten consecutive sessions using the RiceWrist, an electrically-actuated forearm and wrist haptic exoskeleton device that has been designed for rehabilitation applications. Training involved wrist flexion/extension, radial/ulnar deviation and forearm supination/pronation. Therapy sessions were tailored, based on the patient's movement capabilities for the wrist and forearm, progressed gradually by increasing number of repetitions and resistance. Outcome measures included the ASIA upper-extremity motor score, grip and pinch strength, the Jebsen-Taylor Hand Function test and the Functional Independence Measure. After the training, improvements were observed in pinch strength, and functional tasks. The data from one subject provides valuable information on the feasibility and effectiveness of robotic-assisted training of forearm and hand functions after incomplete spinal cord injury.

Pediatric idiopathic transverse myelitis presenting as an anterior cord syndrome: a case report

OBJECTIVES

Describe the case of an Anterior Cord Syndrome secondary to transverse myelitis. ANTERIOR CORD SYNDROME: Anterior Cord syndrome (ACS) is characterized by a lesion that affects the anterior two thirds of the spinal cord while preserving the posterior columns. TRANSVERSE MYELITIS: Transverse myelitis (TM) is an inflammatory disorder with a heterogeneous pathogenesis affecting the spinal cord at one or more segments, resulting in motor, sensory, and autonomic dysfunction in the absence of a preexisting neurological disease or spinal cord compression.

TREATMENT

The patient was treated with methylprednisolone, IV Antibiotics, acyclovir, and inpatient rehabilitation.

REHABILITATION

The patient significantly improved her function throughout inpatient rehabilitation and was discharged after achieving modified independent level with ambulation and all activities of daily living. The patient also gained independence with an intermittent catheterization program and a nightly bowel program, which included suppository and digital stimulation.

CONCLUSIONS

This case illustrates the first documented pediatric patient with a unique case of Anterior Cord Syndrome caused by idiopathic transverse myelitis.

Method for large scale isolation, culture and cryopreservation of human monocytes suitable for chemotaxis, cellular adhesion assays, macrophage and dendritic cell differentiation

This paper presents an improved method of isolating, culturing and cryopreserving human monocytes in large quantity with high purity using standard laboratory centrifuges. Monocytes were isolated from 300 to 360 ml of heparinized human blood using a Double Density technique employing Ficoll Isopaque and 46% iso-osmotic Percoll. Yields of monocytes ranged from 75 to 205 million (from 300 to 360 ml of blood) with an average purity of 90.6%. The ability of fresh or frozen monocytes to adhere to endothelial cells in the presence of oxidized L-alpha-1-palmitoyl-2-arachidonosyl-sn-glycero-3-phosphocholine (oxPAPC) or lipopolysaccharide (LPS) did not differ and no significant difference in response to the chemotactic stimulant N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP) was observed. We define a useful method for the culture and differentiation of fresh or frozen monocytes isolated by this method, into macrophages as judged by morphology, expression of the macrophage marker SRA-1 and induction of inflammatory genes TNF-alpha, IL-6 and COX-2. Also, fresh or frozen Double Density isolated cells can be successfully differentiated into dendritic cells in the presence of GM-CSF and IL-4 as judged by the expression of the hallmark surface proteins CD1a and DC-sign and the absence of CD14. This method also yields a pure population of lymphocytes.

A. Kim, k.f. Anderson, j. Berliner, j. Hassan, j. Jensen, h.j. Mertz, h. Pietsch, a. Rao, R. Scherer, and a. Sutterfield

In this study, three dummies were evaluated on the component level and as a whole. Their responses were compared with available volunteer and embalmed Post Mortem Human Subject (PMHS) data obtained under similar test conditions to evaluate their biofidelity. The volunteer and PMHS data, used as comparators in this study, were used previously to establish some of the biofidelity requirements of the Hybrid III. The BioRID II, the Hybrid III, and the RID2 were all subjected to rear impact HYGE sled tests with deltaVs of 17 and 28 km/hr to determine their biofidelity in these conditions. A static pull test, where a load was manually applied to the head of each dummy, was used to evaluate the static strength of their necks in flexion and extension. Finally, pendulum tests were conducted with the Hybrid III and RID2 to evaluate the dynamic characteristics of their necks in flexion and extension. The sled test results indicate that out of the three dummies, the overall flexibility of the Hybrid III is comparable to that of the volunteer anticipating the impact. The overall flexibilities of the BioRID II and the RID2 are greater than those of all the comparators used in this study (the tensed volunteer and the two embalmed PMHSs). The responses of the Hybrid III are closer to those of the tensed volunteer than those of the PMHSs. The responses of the BioRID II and the RID2 are closer to those of the PMHSs than to the tensed volunteer.

A Comparison of the Hybrid III and BioRID II Dummies in Low-Severity, Rear-Impact Sled Tests

A BioRID II dummy and a Hybrid III dummy, each representative of a midsize adult male, were tested side-by-side in simulated rear-impact sled tests. In all tests the dummies were restrained by 3-point belt systems. The results of 4 test sets conducted at a nominal change in velocity (deltaV) of 16 km/hr are presented and discussed. In three of the test sets, bucket seats were used. The head restraints were placed in the up-position in two of the three test sets and in the down-position in the third set of tests. In the fourth test set, rigid seats without any head restraints were used. While analyzing the BioRID II data, the presence of an axial neck load acting on the head, which bypassed the upper neck load transducer, was discovered in all the reported tests. The implication of this observation is that the axial force and all the moments measured by the BioRID II upper neck load transducer could be erroneous. A second concern with the BioRID II data was the high frequency noise observed, especially on the T1 acceleration response which is used in the NIC calculation. The 18 Hz filter used to process the T1 acceleration data for the NIC calculation attenuated the peak NIC values by 15% as compared to the SAE 180 filtered values. The unmeasured neck loads and high-frequency noise issues need to be resolved before additional BioRID II testing is done. A third concern with the BioRID II is the initial position of its head in the automotive seating posture. It is higher and more forward than that of the 50(th) percentile adult male.

The effect of prenatal cocaine exposure on the stress response of adult mice

The neurotoxic consequences of intrauterine exposure to drugs of abuse, including cocaine, may include compromised fetal brain development with associated lasting behavioral alterations. Some infants exposed to cocaine in utero demonstrate impairments in reactivity and altered behavioral responses to stressful conditions. Alterations in arousal regulation can impact on socialization, adaptation, and educability. Moreover, such alterations may render cocaine-exposed children more vulnerable to the adverse developmental impact of stressful situations, with implications for subsequent behavior and psychopathology. Animal models facilitate the independent analysis and identification of genetic, intrauterine, and postnatal environmental factors in contributing to cocaine-induced alterations in behavioral and neurochemical responses to stressors. Utilizing a prenatal mouse model of gestational cocaine exposure we have identified a behavioral alteration evident as decreased duration of footshock-induced immobility termed "freezing" in cocaine-exposed adults as compared with controls. However, this attenuated behavioral response was not accompanied by demonstrable alterations in corticosterone response, nor was the corticosterone response altered in cocaine-exposed adults following a more protracted restraint-induced stress. The dissociation of these behavioral and neurochemical indices of altered response to stressors may provide insights regarding brain mechanisms underlying alterations in behavioral reactivity to stressful conditions following in utero cocaine exposure. In addition, this preclinical study may have implications for improved diagnostics and therapeutics for infants and children exposed to cocaine in the womb.

Comparative Evaluation of the Q3 and Hybrid III 3-Year-Old Dummies in Biofidelity and Static Out-of-Position Airbag Tests

A comparison of the Q3 and Hybrid III 3-year-old crash test dummies is presented in this paper. The performance of the dummies were compared in sixty biofidelity tests, seventy-seven static out-of-position airbag tests and sixty-three calibration tests. Various time histories and other data pertaining to accelerations, deflections, forces and moments are compared. In addition, the ease of positioning, handling, and the durability of the dummies in various out-of-position test configurations was assessed. Both the Q3 and Hybrid III 3-year-old dummies were calibrated to their respective specifications. The Hybrid III 3-year-old met its calibration requirements, while the Q3 did not always meet its own calibration requirements. The calibration specifications of the Q3 dummy need to be re-examined and possibly refined. The biofidelity of the Q3 and Hybrid III 3-year-old dummies were evaluated in both frontal and lateral test modes. Each dummy was evaluated against its own and the other's specified requirements, when possible. In the frontal test mode, the Hybrid III 3-year-old acceptably met all of its requirements. The Q3 dummy did not meet all of its own frontal biofidelity requirements. Based on these results, the Hybrid III 3-year-old is more biofidelic for primarily frontal loading conditions. With respect to the lateral biofidelity specifications, neither the Hybrid III 3-year-old nor the Q3 dummy met the requirements for the thorax and pelvis tests performed. Both dummies met the head drop requirements. Neither dummy is recommended for lateral loading conditions. For lateral testing where only the head is impacted, the Hybrid III 3-year-old could be used. In general, the responses of both dummies were repeatable in both the frontal and lateral biofidelity tests performed. The Hybrid III 3-year-old and the Q3 dummies were evaluated in static out-of-position airbag tests with three different side airbag systems (two seat-mounted and one door-mounted system), and one frontal passenger airbag system. Throughout this testing, the Q3 resultant head accelerations exhibited an excessive amount of high-frequency noise causing this dummy to be unacceptable for static out-of-position airbag testing. No significant issues were found with the Hybrid III 3-yearold. It was also determined that the Q3 dummy was more difficult to position repeatedly than the Hybrid III 3-yearold. This was due to the dummy's construction and its lack of rigid landmarks.

Early and late chemokine production correlates with cellular recruitment in cardiac allograft vasculopathy

BACKGROUND

Cardiac allograft vasculopathy (CAV) remains the leading cause of late mortality in heart transplant recipients. Activated T lymphocytes and macrophages infiltrate the donor heart before vascular intimal thickening develops, but the specific mediators of mononuclear cell recruitment leading to CAV are unknown. Therefore, we sought to define the relationship between chemokine gene expression and production, T lymphocyte and macrophage recruitment, and intimal thickening in a murine model of CAV.

METHODS

B10.A or B10.BR strain hearts were transplanted heterotopically into B10.BR mice. Recipients were killed at 1, 4, 7, 14, and 30 days. Donor hearts were assayed for chemokine gene expression with ribonuclease protection and for protein with ELISA. Intragraft cellular infiltration was defined immunohistochemically. Intimal thickening was quantitated morphometrically.

RESULTS

Early and late patterns of intragraft chemokine expression associated with distinct cellular infiltration were identified. First, transient MIP-2 and MCP-1/JE production in isografts and allografts correlated with neutrophil and macrophage infiltration. MCP-1/JE production and macrophage infiltration was greater in allografts than isografts. Second, allografts demonstrated sustained lymphotactin, RANTES, and IP-10 expression, beginning at day 4, correlating with persistent macrophage and T lymphocyte infiltration. Intimal thickening became evident at 14 days. Isografts did not display the late pattern of sustained chemokine gene expression, cellular infiltration, or intimal thickening.

CONCLUSIONS

Transient, early MIP-2, and MCP-1/JE production in isografts and allografts correlated with neutrophil and macrophage recruitment, and is likely related to ischemia-reperfusion. In allografts, the delayed induction of chemokines specific for macrophages and T lymphocytes correlated with mononuclear cell infiltration and preceded intimal thickening. This study thus demonstrates a dual pattern of chemokine induction correlating with intragraft mononuclear cell recruitment, associated with ischemia-reperfusion and CAV development. Chemokine-directed interventions may interfere with leukocyte trafficking and inhibit CAV development.

Paraoxonase and coronary heart disease

Paraoxonase (PON1) hydrolyses organophosphate insecticides and nerve gases and is responsible for determining the selective toxicity of these compounds in mammals. Human PON1 has two genetic polymorphisms giving rise to amino-acid substitutions at positions 55 and 192. The 192 polymorphism is the major determinant of the PON1 activity polymorphism towards organophosphates. However, the 55 polymorphism also modulates activity. Ex vivo, the PON1 polymorphisms are important in determining the capacity of HDL to protect LDL against oxidative modification in vitro and this may explain the relationship between the PON1 alleles and coronary heart disease in case-control studies. In recent case-control studies serum PON1 concentration and activity were also found to be decreased in coronary heart disease (CHD) independent of the PON1 polymorphism, and in diabetes serum PON1 specific activity decrease is also independent of the PON1 genetic polymorphism. HDL from transgenic mice lacking PON1 fails to protect LDL against oxidative modification. Thus PON1 may be a determinant of resistance to the development of atherosclerosis by protecting lipoproteins against oxidative modification, perhaps by hydrolysing phospholipid and cholesteryl-ester hydroperoxides.

Expression of mRNA for glial fibrillary acidic protein after experimental cerebral injury

This study was undertaken to determine whether a mRNA for glial fibrillary acidic protein (GFAP) was present in increased amounts as a response to injury and, if so, how was its temporal expression related to the demonstration of GFAP by immunocytochemical techniques. A cerebral freeze-injury was produced in mice and at intervals thereafter the animals were anesthetized, perfused with formalin and histological sections of the brain through the injured area were prepared. A riboprobe for GFAP mRNA labeled with S35 and an immunocytochemical probe for GFAP were utilized to localize mRNA and GFAP immunoreactivity, respectively. For mRNA studies, the histological slide exposed to either sense or antisense probe was overlaid with x-ray film or dipped in photographic emulsion. The developed film was quantitated by digital image analysis. Emulsions were examined by dark-field microscopy. The results indicate that mRNA for GFAP is increased in the cortex in the environs of the injury by 6 hours, becomes maximal at 4-5 days, and is present in increased amounts up to 14 days. The message is enhanced in the adjacent cortex, the subpial region, the adjacent corpus callosum and in the ipsilateral and contralateral callosal radiations. This pattern of enhancement follows the distribution of post-injury edema. Glial fibrillary acidic protein is demonstrable at 24-48 hours after injury. Thus, there is a rapid response of the astrocyte to injury with increased mRNA expression that is followed by expression of GFAP immunoreactivity.

In vitro interaction of astrocytes and pericytes with capillary-like structures of brain microvessel endothelium

A new method to study the interaction of astrocytes and pericytes with cerebral capillary endothelial cells in vitro is described. Endothelial cells derived from bovine brain were cultured on gelatin coated slides and covered with type 1 collagen. Endothelial cells aggregated and formed capillary-like structures (CS) within 3 days. The lining cells of the CS stained immunohistochemically for factor VIII-related antigen. Astrocytes isolated from neonatal mice or pericytes from bovine brain were added to the preparations after the formation of CS. After various periods of co-culture, the slides were fixed with methanol and examined with the immunohistochemical stain for glial fibrillary acidic protein or smooth muscle actin to demonstrate astrocytes or pericytes respectively. Five hours after addition, only 10% of astrocytes were associated with CS. However, by 24 hours, 70% of the astrocytes had assumed a position adjacent to the CS. The astrocytes then developed processes which were intimately apposed to the CS by 3 days, at which time they resembled the in vivo structural relationship between astrocytes and microvessels that occur in areas of central nervous system injury. Progressive elongation of the astrocytes or their processes at the CS was evident at 6 and 9 days of co-culture. The cross-section of CS co-cultured with astrocytes showed continuous cells surrounding a lumen, and the endothelial cells appeared to be connected by tight junctions. When pericytes were added to CS cultures they also preferentially associated with CS, but the contact occurred more rapidly than with astrocytes, 50% being associated with CS by 5 hours. The CS were almost completely covered with elongated pericytes by 24 hours. A chemotactic assay was developed that showed that there was a chemotactic attraction of pericytes to the CS. Thus an in vitro system is now available to study the interrelationships of these cell types and their interaction in development, regeneration and differentiation of the blood-brain barrier.

Uptake, metabolism, and cytotoxicity of isomeric cholesterol-5,6-epoxides in rabbit aortic endothelial cells

The isomeric cholesterol-5,6-epoxides represent two common cholesterol autoxidation products and along with their principal metabolic product, 3 beta,5 alpha,6 beta-cholestane triol, are purportedly angiotoxic. The uptake and cytotoxic action of these compounds was examined in cultured rabbit aortic endothelial cells emphasizing mechanisms of uptake and metabolic fate. The isomeric cholesterol epoxides are incorporated with equal facility and in a dose-dependent manner. The pattern of uptake, which is markedly influenced by media serum concentration and by temperature, suggests that these compounds are partly incorporated through association with serum lipoproteins. After incorporation, both epoxide isomers are rapidly converted to cholestane triol which readily exits the cells. Cholestane triol is further metabolized to an ester-type product representing up to 10% of the added cholesterol epoxides by 24 h of incubation. The order of cytotoxic potency of these cholesterol oxides is: cholestane triol greater than cholesterol-beta-epoxide greater than cholesterol-alpha-epoxide, with LD50 concentrations ranging from 23 to greater than 150 microM in confluent cells. Cholestane triol and cholesterol-beta-epoxide are twice as cytotoxic to subconfluent cells as compared to confluent cells, whereas cholesterol-alpha-epoxide is essentially equitoxic to confluent and subconfluent cells. Cholesterol epoxide cytotoxicity is significantly reduced by treatments in the absence of serum in accord with substantial reduction in uptake when incubations are performed in serum-free media. Our findings show that these cytotoxic cholesterol oxides are incorporated by endothelial cells through a combination of receptor-mediated and nonspecific or passive mechanisms; however, the efficacy of uptake and resulting toxicity is substantially influenced by serum lipoproteins.

Choline uptake by cerebral capillary endothelial cells in culture

A passage of choline from blood to brain and vice versa has been demonstrated in vivo. Because of the presence of the blood-brain barrier, such passage takes place necessarily through endothelial cells. To get a better understanding of this phenomenon, the choline transport properties of cerebral capillary endothelial cells have been studied in vitro. Bovine endothelial cells in culture were able to incorporate [3H]choline by a carrier-mediated mechanism. Nonlinear regression analysis of the uptake curves suggested the presence of two transport components in cells preincubated in the absence of choline. One component showed a Km of 7.59 +/- 0.8 microM and a maximum capacity of 142.7 +/- 9.4 pmol/2 min/mg of protein, and the other one was not saturable within the concentration range used (1-100 microM). When cells were preincubated in the presence of choline, a single saturable component was observed with a Km of 18.5 +/- 0.6 microM and a maximum capacity of 452.4 +/- 42 pmol/2 min/mg of protein. [3H]Choline uptake by endothelial cells was temperature dependent and was inhibited by the choline analogs hemicholinium-3, deanol, and AF64A. The presence of ouabain or 2,4-dinitrophenol did not affect the [3H]choline transport capacity of endothelial cells. Replacement of sodium by lithium and cell depolarization by potassium partially inhibited choline uptake. When cells had been preincubated without choline, recently transported [3H]choline was readily phosphorylated and incorporated into cytidine-5'-diphosphocholine and phospholipids; however, under steady-state conditions most (63%) accumulated [3H]choline was not metabolized within 1 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma beta-thromboglobulin is correlated with platelet adhesiveness to bovine endothelium in patients with diabetes mellitus

We measured simultaneous plasma beta-thromboglobulin (BTG) and adhesion of 51Cr-labelled, washed platelets to confluent, bovine aortic endothelial monolayers in 50 insulin-dependent diabetic patients and 30 normal subjects (respective mean ages (+/- SD) = 45.1 +/- 16.4 and 45.8 +/- 17.2 years). Compared to normal subjects without arteriosclerotic complications, diabetic patients had higher plasma BTG (34.8 +/- 1.8 (SEM) vs. 21.3 +/- 1.8 ng/ml) and platelet adhesiveness to endothelium (PAE) (3240 +/- 170 vs. 2430 +/- 120 X 10(3) platelets per well) (p less than 0.0002, respectively). Results in diabetic patients did not correlate with plasma glucose, hemoglobin AIa-c, known duration of disease, or sex; plasma BTG correlated with age (r = +0.36), and PAE correlated with plasma creatinine (r = +0.39). Those with clinically evident vascular disease, who were also older (47.8 +/- 2.6 (SEM) vs. 37.3 +/- 4.5 years, p less than 0.05), showed trends to higher plasma BTG (36.7 +/- 2.2 (SEM) vs. 28.8 +/- 3.4 ng/ml, p = 0.06) and PAE (3400 +/- 200 vs. 2800 +/- 280 X 10(3) platelets per well, p = 0.09). A strong correlation was found between plasma BTG and PAE in diabetic patients (r = +0.62, p less than 0.0001) either with or without vascular disease, which remained strong after statistical correction (partial Pearson correlation) for age and plasma creatinine, but not in normal subjects (r = +0.08, p greater than 0.1). These studies demonstrate that platelets in some diabetic patients are excessively adhesive to vascular endothelium, and that plasma BTG and platelet adhesiveness are intercorrelated.

Electron microscopic examination of lead treated L6 skeletal muscle line cells in culture

A study has been made of the effects of lead on developing muscle using a cell culture system. When the L6 clonal cell line was treated with lead acetate in culture during the first or second day after plating (but not at later times) fusion of cells to form skeletal muscle straps was inhibited. This inhibition was not due to a general toxic effect of lead on the cells since cell division continued at a normal rate during the first 10 days of culture after lead addition. When cells were examined ultrastructurally using stereology, the only apparent effect of lead was a change in mitochondrial size and configuration. Five times as many partially condensed mitochondria were seen in lead treated cells, and mitochondrial size was also significantly increased. Lead appears to effect a very early event in cell fusion since gap junction formation (a necessary event in fusion) and some synthesis of myofibrils occur even in the presence of lead.

Hormonal regulation of cultured rabbit endometrial cells

A technique for culturing primary explants of rabbit endometrial cells in chemically defined medium has been developed. Diethylstilbestrol and natural estrogens were found to increase the rate of DNA initiation while progesterone had the opposite effect. Ultrastructural studies revealed that with estrogens, the cultures had the appearance of rapidly dividing cells having large euchromatic nuclei and prominent nucleoli, with aboundant free ribosomes in the cytoplasm. On the other hand, progesterone induced the formation of large multinucleated cells and also converted the cells to a more secretory type. When the cultures appear secretory, a protein called blastokinin (uteroglobin) is believed secreted. We have found that cultured cells synthesize blastokinin and progesterone is necessary for its continuous synthesis. The cultures were found to have receptors for the ovarian hormones and these receptors exhibited saturation kinetics. The dissociation constants for the receptors were also determined. A hypothetical model for the hormonal regulation of cell proliferation and differentiation is proposed.

[Introduction to the epidemiological study of five years of extra-hospital psychosocial practice at Ixelles]

This work is aimed at encompassing five years (1969-1973) of extra-hospital psychosocial activity performed by a multidisciplinary team of the sector of the population of Ixelles (85.000 inhabitants). Apart from a population study, we have focused on all consultants (676 patients) in a statistical frame. We have defined three directions: 1. Obtaining a complete picture of the consulting population according to epidemiological and clinical variables. 2. The control in our daily practice of three classical goals which underline the work in sector (permanence -- multidisciplinary team work -- priority to psychotics). 3. The attempt to verify some common assertions in psychiatry, general and social: relationship between season and pathology, between obligation to consults (for the patient) and social class, between type of pathology and social class. Our results for the two last issues differ from those of Hollingshead and Redlich.

Chlamydomonas flagella. I. Isolation and electrophoretic analysis of microtubules, matrix, membranes, and mastigonemes

Methods were developed for the isolation of Chlamydomonas flagella and for their fractionation into membrane, mastigoneme, "matrix," and axoneme components. Each component was studied by electron microscopy and acrylamide gel electrophoresis. Purified membranes retained their tripartite ultrastructure and were shown to contain one high molecular weight protein band on electrophoresis in sodium dodecyl sulfate (SDS)-urea gels. Isolated mastigonemes (hairlike structures which extend laterally from the flagellar membrane in situ) were of uniform size and were constructed of ellipsoidal subunits joined end to end. Electrophoretic analysis of mastigonemes indicated that they contained a single glycoprotein of approximately 170,000 daltons The matrix fraction contained a number of proteins (particularly those of the amorphous material surrounding the microtubules), which became solubilized during membrane removal. Isolated axonemes retained the intact "9 + 2" microtubular structure and could be subfractionated by treatment with heat or detergent. Increasing concentrations of detergent solubilized axonemal microtubules in the following order: one of the two central tubules; the remaining central tubule and the outer wall of the B tubule; the remaining portions of the B tubule; the outer wall of the A tubule; the remainder of the A tubule with the exception of a ribbon of three protofilaments. These three protofilaments appeared to be the "partition" between the lumen of the A and B tubule. Electrophoretic analysis of isolated outer doublets of 9 + 2 flagella of wild-type cells and of "9 + 0" flagella of paralyzed mutants indicated that the outer doublets and central tubules were composed of two microtubule proteins (tubulins 1 and 2) Tubulins 1 and 2 were shown to have apparent molecular weights of 56,000 and 53,000 respectively