[This tape was duplicated from a 1/2" VHS video master by Colorlab for the National Library of Medicine April 2006 NLM call number HF 5209] [Musical introduction] [United States Navy Presents] [NMRI: Meeting Fleet Needs Through Research] Navy and Marine Corp combat readiness, crucial to our national defense, requires military medical specialists who are prepared to provide health care in support of the operating forces. These specialists must be ready to deal with the medical contingencies associated with war. And with the fleet's worldwide activities during peacetime. Their ability to provide quality medical support is based on the achievements of scientific investigators, whose work influences contingency planning and the ways in which trauma and disease casualties are, and will be, treated. [Signpost: Naval Medical Research Institute] The Navy supports an extensive program of medical research geared towards specific military problems. The hallmark laboratory for these studies is the Naval Medical Research Institute in Bethesda, Maryland. Scientists of NaMRI, as it's commonly called, are providing new and improved approaches to the care and prevention of injury and disease casualties. The benefits of these efforts frequently extend to civilian victims of accidents and disease. One of the most serious complications of combat injuries is septic shock. An overwhelming bacterial infection that accounts for a large number of casualties. Septic shock is caused by toxins from bacteria that invade nearly all traumatic wounds. Through x-ray microanalysis, investigators can examine tissue to determine the presence and extent of septic shock damage. Basic research at NaMRI will lead to a better understanding of the physiological changes that occur when bacterial toxins disturb the body's metabolism. Scientists are examining the effects of therapeutic agents, such as calcium channel agonists for their ability to improve septic shock survival rates. Calcium is essential to maintain blood pressure. In patients with septic shock, the cellular receptors which open channels to allow calcium to enter the cell are not functional. NaMRI scientist are working with a new drug which acts directly to open the channels and allow calcium to enter the cell. In another approach, investigators are doing preliminary work on a vaccine to prevent septic shock. A fluorescence-activated cell sorter is used to detect antibodies to septic shock. Anti-idiotypic antibodies that mimic the bacterial components of septic shock are being prepared and tested for their ability to bind to toxic membrane components produced by the organisms that cause septic shock. NaMRI scientists are also studying the means by which bones grow, in the hope of developing ways to promote proper bone growth when the natural process has been hindered. This technician has isolated the osteoblasts that produce and repair bone, and is attempting to enhance bone growth by subjecting the cells to ultrasound stimulation. Osteoblasts are being grown outside the body in a special medium, and scientists are using them to study the effects of various hormones, experimental drugs, and biophysical stimulation on bone growth. As early as 1949, the Navy recognized the potential for storing and using tissues removed from human cadaver donors as grafts. The NaMRI tissue bank, the world's first tissue bank, has procured and processed: bone, skin, dura, cartilage, tendon, and blood vessels for grafts and transplants and developed a freeze-drying method for long term preservation of non-viable tissue. Recently, NaMRI investigators developed a method to harvest viable bone marrow cells from the vertebral bodies of cadavers or brain-dead organ donors. One donation yields enough cells for at least one marrow transplantation. These living cells can be maintained for long periods of time by freezing them in liquid nitrogen. NaMRI investigators have developed and patented two new systems that can be used to identify the kind and extent of bone marrow damage sustained by a patient. Using digital image analysis, these systems can detect rare cells and determine how they function. The number and type of different bone marrow cells can also be identified. Chemical and biological agents can be added and their effects on individual bone marrow seen and recorded. Immune cells can cause rejection of transplanted tissues. NaMRI scientists have developed a clever technique that uses tiny magnetic beads, smaller than a cell, to remove undesired cells from bone marrow. First, the beads are coated with anti-bodies which cause them to attach to the immune cells. The unwanted cells can then be removed with a simple magnet. This investigator is preparing a gel to analyze a cloned growth factor. The use of growth factors may improve the repair rates of traumatic injuries. A number of these growth factors have now been cloned and their interaction in controlling the proliferation of individual cell types is being studied. Bone marrow stem cells, which produce circulating blood cells and cells that make up the immune system, are placed in an incubator for 14 days. While in this stable environment, the cells are stimulated by growth factors which cause them to mature. Following incubation, the cells are examined to determine how they have matured. The flow cytometer is used to analyze the purity of the bone marrow stem cells. Information is derived from the cells as they pass through the beams of two precisely focused lasers. In addition, a technique was developed by NaMRI investigators using this instrument to analyze the effects of growth factors on the cells. It is hoped that these techniques will allow more effective triage and treatment of combat casualties whose bone marrow cells have been damaged. In combat situations and during peacetime, the impact of heat stress on men is a constant problem for the military. In the rigors of basic training, during combat operations in hot climates, during emergency repair work, and in boiler and engine rooms, galleys and laundries aboard ship. As a needy volunteer performs simulated ship board tasks under carefully controlled environmental extremes, physiologists monitor his cardiovascular and pulmonary functions. Research, such as this, will improve understandings of man's responses to heat stress. Navy and Marine Corps personnel are also required to perform in cold environments, including shipboard activities and land- based assignments. A volunteer, dressed in arctic gear, is housed in a controlled environment which simulates an arctic night. NaMRI scientists are testing his vigilance in this stressful situation. Laboratory hot and cold emersion tanks are used to acclimate subjects to thermal extremes and test thermal tolerances. Here, a subject in a cold immersion tank is monitored for behavioral and physiological changes. Thermal stress can be a serious problem during diving operations. This diver is entering a tank to begin a six hour cold water immersion experiment. Beneath the thermal protective garment, he is wearing a sensor array that records skin and core temperatures, EKG and local heat fluxes. Measurements are taken while the diver is at rest and during exercise. The data gathered in experiments such as this are used to establish safe guidelines for cold water dives and to improve the design of thermal protective garments. This is but one aspect of NaMRI's extensive diving research program. The institute's hyperbaric research facility houses a sophisticated man-rated chamber complex capable of simulating depths to thirty-four hundred feet of seawater. It can house six volunteers for up to three months. And provides a unique environment to conduct hyperbaric investigations under very realistic conditions. A high tech network of atmospheric controls, audio and visual communications, data acquisition and life support systems is constantly monitored during saturation dives to ensure divers' safety and accurate data collection. Decompression sickness: Arguably the most perplexing and life-threatening risk faced by divers is investigated through experimental dives and laboratory studies. Rubbles, caused by too rapid decompression, are clearly visible in these epidural veins carrying blood from the spinal cord. Studies of gas kinetics are done in an effort to unravel the physiological processes which lead to decompression sickness. NaMRI scientists recently developed the statistical technique of maximum likelihood analysis. Combinations of data from thousands of known dives are used to predict the probable incidence of decompression sickness for a diver who follows a new diving schedule. Physiologists are seeking more effective treatments for air embolism. A life-threatening problem which may be encountered by divers during rapid assents. NaMRI scientists are studying the effectiveness of various drugs such as lidocaine to improve recovery from air embolism. Radioisotopes are used to study changes in the brain as a result of air embolism. These images depict the flow of blood to the brain following air embolism. Images such as these help in the development of new therapies for the treatment of air embolism. NaMRI scientists are working in the laboratory to identify sensitive markers for oxygen toxicity which poses a special risk for Navy divers who sometimes must breathe high-oxygen-content gases. This investigator is performing an assay for lipid peroxidation in tissues and plasma from test subjects exposed to hyperbaric oxygen. The indicies developed from tests, such as this, will be used to design safe oxygen exposure levels. Exercise physiologists measure performance under varied diving conditions to determine ways of improving a diver's exercise tolerance. As a diver works out on the treadmill, his oxygen consumption and cardiac rhythm are carefully monitored. Another Navy diver is the subject of a wind gate power test to determine the maximum power generated by his skeletal muscles. Scientists use tests such as these to evaluate physical training programs that may improve performance. The impairment to breathing, imposed by diving rigs, is a factor limiting a diver's performance underwater. While this Navy diver wearing breathing gear is submerged in a tank, scientists are monitoring his tolerance to ventilatory exercise. Research such as this helps define physiological criteria for engineers who fabricate and design diving equipment for the Navy. Today's Navy operates on land as well as on the sea. During land-based operations, exposure to infectious diseases poses a serious threat to personnel, especially in tropical and sub-tropical regions. At the heart of NaMRI's infectious diseases research program is the continuing goal of vaccine development. There are 100 to 300 million new cases of malaria in the tropics each year. NaMRI is working a vaccine that will protect operating forces from becoming infected. This vaccine, presently in the advanced stages of development, is based on the parasite stage inoculated by the mosquito. In addition to the vaccine, NaMRI is developing innovative approaches to diagnosing malaria both in the human host and in the mosquito vector. Diarrheal disease, usually caused by specific bacterial infections, frequently strikes military personnel deployed in endemic regions causing debilitating illness after contact with local food or water. Using a fermenter, organisms which cause infectious diarrheal disease can be grown to permit study of their cellular components, toxins, and ability to cause disease. These studies will provide valuable data to aid in vaccine development. In an attempt to develop a vaccine for typhus, NaMRI investigators are examining the surface components of the organism for clues to how typhus stimulates human and animal immune systems. Investigators use scrub typhus rickettsii to produce experimental human vaccines. A technician inoculates eggs with rickettsial organisms to grow large amounts of the bacteria for use as experimental typhus vaccines. Ten-day old chick embryos are then removed from pathogen- free eggs under rigidly aseptic conditions. The chick embryo cells will be cultured and used to prepare pathogen-free rickettsii. Rapid and accurate diagnosis is crucial to infectious disease control. Several projects at NaMRI are focused on developing field tests for these infections. These techniques include ELIZA tests and DNA probes. This technician is attempting to diagnose infectious disease by using an ELIZA test to measure antibody in a subject's serum. The test can be read visually and color change can be measured using the spectrophotometer coupled with the computer. NaMRI's Lima, Peru detachment also conducts infectious diseases research. Established in January 1983, the detachment operates in collaboration with the Peruvian Navy to conduct research into the epidemiology and arbovirology of febrile and enteric diseases prevalent in the region. Since there are very few roads in the Amazon region, NaMRI investigators have converted a ten-meter boat into a river-going laboratory. Docked at the detachment's field laboratory in Iquitos, the boat can accomodate a research team of six people. They navigate the Amazon River to collect specimens from the natives who live along the riverbanks. Preliminary processing of the specimens is done aboard the boat. The specimens are then taken to the Iquitos laboratory for further study. Today's technology-oriented Navy is a complex industrial system where potentially hazardous materials are used and stored around the clock, each and every day. At NaMRI's toxicology detachment in Dayton, Ohio, researchers develop data on potentially hazardous materials. Detachment personnel have access to the unique Thomas Dome facility where continuous 24 hour a day exposures, which simulate shipboard conditions, can be conducted for periods up to several months. The toxicological data collected here are used to develop hazardous materials guidelines. NaMRI's mission: meeting fleet needs through research brings with it unique challenges and rewards. NaMRI investigators exploring mysterious worlds under the microscope and inside the body are gaining an understanding of the fundamental mechanisms of healing and immunity. Experts in hyperbaric medicine are helping to create new frontiers in the depths of the sea. Scientists are working on vaccine development to allay the ravages of diseases that have long plagued mankind. And researchers, examining physiological responses to stress, are helping man to operate more safely in an increasingly complex environment. Their efforts are serving not only the diverse demands of a globally active fleet, but the needs of all mankind. [United States Navy. The End] [Production by Naval School of Health Sciences. Bethesda, MD. 1987. N1525-85-0081]