Assessment and management of psychosocial stress in lung transplant candidates. Toronto Lung Transplant Group.

Candidates for lung transplants have had their lives significantly disrupted, both by life-threatening lung disease and by involvement with a transplant program. The assessment and management of psychosocial distress as it has occurred in lung transplant candidates is described. Experience suggests that an informal social support network has been invaluable but is best complemented by formal interventions. Involvement with these candidates requires that the social worker be attuned to the unique circumstances and experiences of lung transplantation.

Expression of neuron-specific enolase in cultured neurons from the fetal rat.

A specific antiserum to neuron-specific enolase (NSE), an isoenzyme of the glycolytic enzyme enolase, has been used to immunocytochemically study the differentiation of dissociated embryonic brain cells grown in serum-supplemented or serum-free (defined) medium for 4-28 days. The number of positively stained neurons increased with time up to 21 days in culture, irrespective of the medium composition. By day 14, the majority of neurons contained immunoreactive NSE in their cell bodies and fiber profiles. These data indicate that cultured embryonic neurons undergo differentiation in their serum-supplemented or serum-free medium, and that dissociated brain cell cultures may provide a model system for investigating cellular and molecular aspects of neuronal differentiation.

Scanning electron microscopy of Mycoplasma pneumoniae on the membrane of individual ciliated tracheal cells.

Cell monolayer cultures were prepared from hamster tracheal explants by a collagenase exposure and subsequent incubation in Waymouth's MAB 87/3 medium. The epithelial outgrowth occurred on glass cover slips. Cilia on the monolayers continued to beat normally after the "parent" explant was removed. Monolayer cultures infected with Mycoplasma pneumoniae had significant amounts of attachment. A morphological analysis of the attachment was conducted with scanning electron microscopy. Clusters, cocci, and filaments of M. pneumoniae all attached to the epithelial cells, but the filaments were especially common. Mycoplasmas were seen in association with both ciliated and nonciliated cell membranes. On ciliated cells, mycoplasmas were on the ciliary strands and on the cell membrane. When located immediately adjacent to or in between cilia, mycoplasmas were oriented vertically with the constricted attachment tip oriented down toward the host cell membrane. When located more than a micron away from the ciliary fibers, mycoplasmas lay horizontally along the epithelial cell membrane. The photographic data suggest that clusters or "sperules" of mycoplasmas may liberate individual mycoplasmas that attach to the cell membrane. It appears that the receptor sites for M. pneumoniae are rather uniformly distributed along the ciliated cell membrane, and are not restricted to the interciliary areas.

Development of an improved tracheal explant bioassay for the detection of the ciliary dyskinesia factor in cystic fibrosis serum.

A tracheal ring explant system, when used with 25% cystic fibrosis (CF) serum, displayed obvious ciliostasis. Hamster, rabbit, and guinea pig explants all had measurable decreases in ciliary activity after 24 hr of incubation in the serum. The differential response to CF serum (relative to normal serum) was greatly increased by using explants which were maintained 24-72 hr in minimal essential medium (MEM) with 10% horse serum and which were selected on the basis of optimal ciliary activity and vigor. With such a bioassay system of guinea pig tracheal explants, incubation with 25% normal serum would produce essentially no change in relative ciliary activity (score of 242 of a possible 300), whereas CF serum resulted in an 86% decrease (score of 33). Scanning electron microscopic observation indicated that the explants displaying the CF-ciliostatic effect had significant accumulations of mucous over the ciliated epithelial surface. A biochemical viability assay (dehydrogenase activity) showed no cytonecrosis when CF serum-treated tissues were compared to standard explants (10% horse serum in MEM) or control explants (25% normal human serum).