S-Nitrosylation in endothelial cells contributes to tumor cell adhesion and extravasation during breast cancer metastasis.

BACKGROUND: Nitric oxide is produced by different nitric oxide synthases isoforms. NO activates two signaling pathways, one dependent on soluble guanylate cyclase and protein kinase G, and other where NO post-translationally modifies proteins through S-nitrosylation, which is the modification induced by NO in free-thiol cysteines in proteins to form S-nitrosothiols. High levels of NO have been detected in blood of breast cancer patients and increased NOS activity has been detected in invasive breast tumors compared to benign or normal breast tissue, suggesting a positive correlation between NO biosynthesis, degree of malignancy and metastasis. During metastasis, the endothelium plays a key role allowing the adhesion of tumor cells, which is the first step in the extravasation process leading to metastasis. This step shares similarities with leukocyte adhesion to the endothelium, and it is plausible that it may also share some regulatory elements. The vascular cell adhesion molecule-1 (VCAM-1) expressed on the endothelial cell surface promotes interactions between the endothelium and tumor cells, as well as leukocytes. Data show that breast tumor cells adhere to areas in the vasculature where NO production is increased, however, the mechanisms involved are unknown. RESULTS: We report that the stimulation of endothelial cells with interleukin-8, and conditioned medium from breast tumor cells activates the S-nitrosylation pathway in the endothelium to induce leukocyte adhesion and tumor cell extravasation by a mechanism that involves an increased VCAM-1 cell surface expression in endothelial cells. We identified VCAM-1 as an S-nitrosylation target during this process. The inhibition of NO signaling and S-nitrosylation blocked the transmigration of tumor cells through endothelial monolayers. Using an in vivo model, the number of lung metastases was inhibited in the presence of the S-nitrosylation inhibitor N-acetylcysteine (NAC), which was correlated with lower levels of S-nitrosylated VCAM-1 in the metastases. CONCLUSIONS: S-Nitrosylation in the endothelium activates pathways that enhance VCAM-1 surface localization to promote binding of leukocytes and extravasation of tumor cells leading to metastasis. NAC is positioned as an important tool that might be tested as a co-therapy against breast cancer metastasis.

Adsorption mechanisms of hexavalent chromium from aqueous solutions on modified activated carbons.

Functional groups of the activated carbon play the major role in metals removal from aqueous solutions and, for this reason, different treatments can be used to modify the adsorbent surface improving the adsorption capacity for a particular pollutant. In this research, oxidation with nitric acid, heating under an inert atmosphere, and ammonia treatment were applied to modify the activated carbon surface. The modified adsorbents were used for the removal of hexavalent chromium (Cr(VI)) from aqueous solutions at different concentrations (10-500 mg L-1), pH 6, and 25 °C. Adsorption mechanisms of Cr(VI) on the activated carbon were proposed based on the surface chemistry, adsorption/reduction, and desorption experiments. Findings demonstrate that acid functional groups of the activated carbon had an important effect on the hexavalent chromium removal. For instance, a high reduction of Cr(VI) to Cr(III) (50%) was obtained by the oxidized adsorbents, whereas the heat treated adsorbents achieved a low reduction (35%), but the ammonia-treated activated carbon achieved the lowest reduction (20%). The heat-treated adsorbent showed the best Cr(VI) adsorption capacity (48 mg g-1), especially at equilibrium Cr(VI) concentration lower than 200 mg L-1, and the fastest adsorption kinetics among the studied adsorbents. Furthermore, the highest Cr(VI) desorption (90%) was achieved with 0.1 N NaOH-NaCl solutions. In summary, an anionic/reduction coupled adsorption mechanism of Cr(VI) seems to be feasible, and the heat-treated activated carbon is an interesting option for sequestering Cr(VI) species from aqueous effluents.

The Impact of Alemtuzumab and Basiliximab Induction on Patient Survival and Time to Bronchiolitis Obliterans Syndrome in Double Lung Transplantation Recipients.

We examined the effect of alemtuzumab and basiliximab induction therapy on patient survival and freedom from bronchiolitis obliterans syndrome (BOS) in double lung transplantation. The United Network for Organ Sharing database was reviewed for adult double lung transplant recipients from 2006 to 2013. The primary outcome was risk-adjusted all-cause mortality. Secondary outcomes included time to BOS. There were 6117 patients were identified, of whom 738 received alemtuzumab, 2804 received basiliximab, and 2575 received no induction. Alemtuzumab recipients had higher lung allocation scores compared with basiliximab and no-induction recipients (41.4 versus 37.9 versus 40.7, p < 0.001) and were more likely to require mechanical ventilation before to transplantation (21.7% versus 6.5% versus 6.2%, p < 0.001). Median survival was longer for alemtuzumab and basiliximab recipients compared with patients who received no induction (2321 versus 2352 versus 1967 days, p = 0.001). Alemtuzumab (hazard ratio 0.80, 95% confidence interval 0.67-0.95, p = 0.009) and basiliximab induction (0.88, 0.80-0.98, p = 0.015) were independently associated with survival on multivariate analysis. At 5 years, alemtuzumab recipients had a lower incidence of BOS (22.7% versus 55.4 versus 55.9%), and its use was independently associated with lower risk of developing BOS on multivariate analysis. While both induction therapies were associated with improved survival, patients who received alemtuzumab had greater median freedom from BOS.

Determining optimal conditions to produce activated carbon from barley husks using single or dual optimization.

When producing activated carbons from agricultural by-products, certain properties, such as yield and specific surface area, are very important for obtaining an economical and promising adsorbent material. Nevertheless, many researchers have not simultaneously optimized these properties and have obtained different optimal conditions for the production of activated carbon that either increases specific surface area but decreases yield or vice versa. In this research, the production of activated carbon from barley husks (BH) by chemical activation with zinc chloride was optimized by using a 2(3) factorial design with replicates at the central point, followed by a central composite design with two responses (the yield and iodine number) and three factors (the activation temperature, activation time, and impregnation ratio). Both responses were simultaneously optimized by using the desirability functions approach to determine the optimal conditions of this process. The findings reveal that after the simultaneous dual optimization, the maximal response values were obtained at an activation temperature of 436 °C, an activation time of 20 min, and an impregnation ratio of 1.1 g ZnCl2/g BH, although the results after the single optimization of each response were quite different. At these conditions, the predicted values for the iodine number and yield were 829.58 ± 78.30 mg/g and 46.82 ± 2.64%, respectively, whereas experimental tests produced values of 901.86 mg/g and 48.48%, respectively. Moreover, activated carbons from BH obtained at the optimal conditions primarily developed a porous structure (mesopores > 71% and micropores > 28%), achieving a high surface area (811.44 m(2)/g) that is similar to commercial activated carbons and lignocellulosic-based activated carbons. These results imply that the pore width and surface area are large enough to allow the diffusion and adsorption of pollutants inside the adsorbent particles. In summary, two responses were optimized to determine the optimal conditions for the production of activated carbons because it is possible to increase both the specific surface area and yield.

Experimental design for the optimization of copper biosorption from aqueous solution by Aspergillus terreus.

An experimental design methodology was applied to study the effects of temperature, pH, biomass dose, and stirring speed on copper removal from aqueous solutions by Aspergillus terreus in a biosorption batch system. To identify the effects of the main factors and their interactions on copper removal efficiency and to optimize the process, a full 2(4) factorial design with central points was performed. Four factors were studied at two levels, including stirring speed (50-150 min(-1)), temperature (30-50°C), pH (4-6) and biosorbent dose (0.01-0.175 g). The main factors observed were pH and biomass dose, along with the interactions between pH and biomass, and stirring speed. The optimal operational conditions were obtained using a response surface methodology. The adequacy of the proposed model at 99% confidence level was confirmed by its high adjusted linear coefficient of determination (R(Adj)(2)=0.9452). The best conditions for copper biosorption in the present study were: pH 6, biosorbent dose of 0.175 g, stirring speed of 50 min(-1) and temperature of 50°C. Under these conditions, the maximum predicted copper removal efficiency was 68.52% (adsorption capacity of 15.24 mg/g). The difference between the experimental and predicted copper removal efficiency at the optimal conditions was 4.8%, which implies that the model represented very well the experimental data.

Artificial Neural Network for predicting biosorption of methylene blue by Spirulina sp.

An artificial neural network (ANN) was used to predict the biosorption of methylene blue on Spirulina sp. biomass. Genetic and anneal algorithms were tested with different quantity of neurons at the hidden layers to determine the optimal neurons in the ANN architecture. In addition, sensitivity analyses were conducted with the optimised ANN architecture for establishing which input variables (temperature, pH, and biomass dose) significantly affect the predicted data (removal efficiency or biosorption capacity). A number of isotherm models were also compared with the optimised ANN architecture. The removal efficiency or the biosorption capacity of MB on Spirulina sp. biomass was adequately predicted with the optimised ANN architecture by using the genetic algorithm with three input neurons, and 20 neurons in each one of the two hidden layers. Sensitivity analyses demonstrated that initial pH and biomass dose show a strong influence on the predicted removal efficiency or biosorption capacity, respectively. When supplying two variables to the genetic algorithm, initial pH and biomass dose improved the prediction of the output neuron (biosorption capacity or removal efficiency). The optimised ANN architecture predicted the equilibrium data 5,000 times better than the best isotherm model. These results demonstrate that ANN can be an effective way of predicting the experimental biosorption data of MB on Spirulina sp. biomass.

Congruence of quality of life among infertile men and women: findings from a couple-based study.

BACKGROUND: It has been consistently demonstrated that infertility is associated with quality of life (QOL) impairments. Research to date has mostly focused on individual's reactions to infertility (mainly women), without an examination of how the partner is reacting to the same condition. The few studies that assessed QOL among couples did not use couple-based analyses, consequently not considering the intra-couple effects. The objectives of this study were to explore the congruence of QOL perception within infertile couples and to estimate the effect of depression levels on the congruence. METHODS: In total, 162 couples were interviewed in an assisted reproduction clinic cross-sectionally. Subjects completed a socio-demographic form, World Health Organization Quality of Life-BREF and the Beck Depression Inventory independently. The statistical strategy was guided to ensure that subjects would be explored within pairs at all times and not as independent groups. Paired t-tests were run, and Cohen's effect was estimated. Depression levels were controlled by linear multiple regressions and repeated-measures ANCOVAs. RESULTS: Out of the five QOL domain scores, only two showed a significant discrepancy between partners (psychological and social relationship domains). Male depression was a significant predictor for all five QOL difference scores, whereas female depression was associated with three (overall, psychological and physical). Moreover, it was demonstrated that, except for the psychological domain and for the female depression on the physical domain, the load of depression as a predictor of the QOL difference scores was markedly low, accounting for not more than 7.5% of the variance of congruence between men's and women's QOL. CONCLUSION: Our findings suggest that QOL scores do not differ markedly between spouses. Since QOL seemed similarly affected in both men and women, consideration might be given to offering interventions to them as a dyad. These results are not in line with the previous non-paired studies, and further investigations are required to address this dissimilarity.

Stability of improvements in exercise performance and quality of life following bilateral lung volume reduction surgery in severe COPD.

STUDY OBJECTIVE: To evaluate the long-term stability of improvements in exercise capacity and quality of life (QOL) after lung volume reduction surgery (LVRS). DESIGN: Case-series analysis. SETTING: University hospital. PATIENTS: Twenty-six patients with severe airflow obstruction (mean FEV1 of 0.67+/-0.18 L) and moderate to severe hyperinflation (mean total lung capacity of 7.30+/-1.90 L). INTERVENTION AND MEASUREMENTS: All patients underwent bilateral LVRS via median sternotomy. Serial measurement of lung function, symptom-limited cardiopulmonary exercise tests, 6-min walk distances (6MWD), and sickness impact profile (SIP) scores were done before, and at 3, 6, 12, and 18 months after surgery. RESULTS: FEV1 (0.93+/-0.29 vs 0.68+/-0.19 L, p<0.001) increased while residual volume (3.47+/-1.2 vs 4.77+/-1.5 L, p<0.001) decreased significantly at 3 months post-LVRS compared to baseline, and these changes were maintained at 12 to 18 months follow-up. Similarly, the increase in 6MWD at 3 months post-LVRS (340+/-84 vs 251+/-114 m, p<0.001) was sustained at all follow-up times. On cardiopulmonary exercise testing, total exercise time (9.0+/-1.8 vs 6.1+/-1.9 min, p<0.001), oxygen uptake at peak exercise (VO2 peak) (14.9+/-4 vs 11.9+/-3 mL/kg/min, p<0.001), maximum oxygen pulse (7.43+/-2.37 vs 5.85+/-1.96 mL/beat, p<0.005), and maximum minute ventilation (VEmax) (30.3+/-10 vs 23.5+/-7.1 L/min, p<0.001) increased significantly at 3 months post-LVRS. On serial study following LVRS, total exercise time remained significantly greater at 6 (8.5+/-1.38 min) and 12 months (8.71+/-2.0 min) post-LVRS compared to baseline (5.81+/-1.9 min, p<0.05). VO2 peak tended to be higher at all follow-up periods (3 months, 16.1+/-4.3; 6 months, 14.5+/-2.6; 12 months, 14.1+/-3.5 mL/kg) compared to baseline (12.6+/-3.9 mL/kg, p=0.08). Similarly, maximum O2 pulse tended to be higher in all follow-up studies (3 months, 8.45+/-2.7; 6 months, 7.6+/-1.7; 12 months, 7.42+/-2.1 mL/beat) compared to baseline (6.39+/-2.5 mL/beat, p=0.06). Higher VEmax continued to be observed at 6 (30+/-10 L/min) and 12 months (28+/-10 L/min) post-LVRS, compared to baseline (23+/-7 L/min, p=0.02). VEmax post-LVRS was significantly higher at 3 and 6 months compared to baseline on post-hoc analysis (p<0.05). Overall SIP scores were lower at 3 months (7 vs 18, p<0.0002) post-LVRS and were sustained in long-term follow-up. CONCLUSION: We conclude that bilateral LVRS via median sternotomy in selected patients with severe, diffuse emphysema improves exercise performance and QOL at 3 months following LVRS and these improvements are maintained for at least 12 to 18 months in follow-up.

Improvements in lung function, exercise, and quality of life in hypercapnic COPD patients after lung volume reduction surgery.

STUDY OBJECTIVE: To determine the impact of preoperative resting hypercapnia on patient outcome after bilateral lung volume reduction surgery (LVRS). METHODS: We prospectively examined morbidity, mortality, quality of life (QOL), and physiologic outcome, including spirometry, gas exchange, and exercise performance in 15 patients with severe emphysema and a resting PaCO2 of > 45 mm Hg (group 1), and compared the results with those from 31 patients with a PaCO2 of < 45 mm Hg (group 2). RESULTS: All preoperative physiologic and QOL indices were more impaired in the hypercapnic patients than in the eucapnic patients. The hypercapnic patients exhibited a lower preoperative FEV1, a lower diffusing capacity of the lung for carbon monoxide, a lower ratio of PaO2 to the fraction of inspired oxygen, a lower 6-min walk distance, and higher oxygen requirements. However, after surgery both groups exhibited improvements in FVC (group 1, p < 0.01; group 2, p < 0.001), FEV1 (group 1, p=0.04; group 2, p < 0.001), total lung capacity (TLC; group 1, p=0.02; group 2, p < 0.001), residual volume (RV; group 1, p=0.002; group 2, p < 0.001), RV/TLC ratio (group 1, p=0.03; group 2, p < 0.001), PaCO2 (group 1, p=0.002; group 2, p=0.02), 6-min walk distance (group 1, p=0.005; group 2, p < 0.001), oxygen consumption at peak exercise (group 1, p=0.02; group 2, p=0.02), total exercise time (group 1, p=0.02; group 2, p=0.02), and the perceived overall QOL scores (group 1, p=0.001; group 2, p < 0.001). However, because the magnitude of improvement was similar in both groups, and the hypercapnic group was more impaired, the spirometry, lung volumes, and 6-min walk distance remained significantly lower post-LVRS in the hypercapnic patients. There was no difference in mortality between the groups (p=0.9). CONCLUSIONS: Patients with moderate to severe resting hypercapnia exhibit significant improvements in spirometry, gas exchange, perceived QOL, and exercise performance after bilateral LVRS. The maximal achievable improvements in postoperative lung function are related to preoperative level of function; however, the magnitude of improvement can be expected to be similar to patients with lower resting PaCO2 levels. Patients should not be excluded from LVRS based solely on the presence of resting hypercapnia. The long-term benefit of LVRS in hypercapnic patient remains to be determined.

Correlation of changes in quality of life after lung volume reduction surgery with changes in lung function, exercise, and gas exchange.

STUDY OBJECTIVES: To evaluate correlations between improvement in quality of life (QOL) in patients with severe COPD before and after they undergo lung volume reduction surgery (LVRS) with changes in pulmonary function tests, gas exchange, exercise performance, and alterations in medical management. DESIGN: Case-series analysis. SETTING: University hospital. PATIENTS: Forty-two patients (mean [+/- SD] age, 56+/-8 years; 53% women) with severe airflow obstruction (FEV(1), 0.62+/-0.2 L), and moderate to severe hyperinflation (total lung capacity [TLC], 6.9+/-1.7 L). INTERVENTION AND MEASUREMENTS: All patients underwent bilateral LVRS via median sternotomy. Measurements of lung function, symptom-limited cardiopulmonary exercise testing, the total distance the patient was able to walk in 6 min in a corridor, and sickness impact profile (SIP) scores were made before and 3 months after LVRS. SIP scores are inversely proportional to the level of function and QOL. RESULTS: Compared to baseline, FEV(1) increased (0.87+/-0.3 vs. 0.62+/-0.2 L, respectively; p<0.01) while residual volume significantly decreased (3.2+/-1.8 vs. 6.3+/-1.2 L, respectively; p<0.004) at 3 months post-LVRS. On cardiopulmonary exercise testing, values increased from baseline to post-LVRS for total exercise time (9.0+/-2.2 vs. 6.0+/-1.5 min, respectively; p = 0.045), maximum oxygen uptake (VO(2)) (16+/-3 vs. 11+/-2 mL/kg/min, respectively; p = 0.01), and maximum minute ventilation (VE) (33+/-9 vs. 28+/-5 L/min, respectively; p = 0.03). The percentage change in the oxygen cost of breathing (VO2/VE ratio) from low to high workloads during exercise was significantly lower after LVRS (p = 0.002). There was no significant change in oxygenation after LVRS (PaO(2)/fraction of inspired oxygen, 331+/-27 vs. 337+/-39, respectively; p = 0.76), but PaCO(2) tended to be lower (41+/-9 vs. 48+/-6 mm Hg, respectively; p = 0.07). Overall SIP scores were significantly lower after LVRS than before (8+/-4 vs. 15+/-2, respectively; p = 0.002). Changes in SIP scores correlated with the change in VO2/VE ratio from low to high workloads, with patients having the smallest changes in VO2/VE ratio having the smallest changes in SIP scores after LVRS (r = 0.6; p = 0.01). Improved or lower SIP scores also tended to correlate with a reduction in residual volume/TLC ratio (r = 0.45; p = 0.09), and there was a linear correlation with a statistically significant Pearson r value with decreased steroid requirements (r = 0.7; p = 0.001). Moreover, changes in psychological SIP subscore tended to correlate with diminished oxygen requirements post-LVRS (r = 0.45; p = 0.09). However, there was no significant correlation between changes in SIP scores and routine measurements of lung function, exercise performance, or gas exchange. CONCLUSION: There is an association between an improvement in QOL and reduced hyperinflation after LVRS. Reduced hyperinflation may lead to more efficient work of breathing during exercise and, therefore, to an increased ability to perform daily activities. Changes in QOL scores correlate best with behaviorally based variables that directly affect the patient's well-being, such as systemic steroid administration.

Treatment of left pneumonectomy syndrome with an expandable endobronchial prosthesis.

Postneumonectomy syndrome has only been described after a right pneumonectomy except in cases of congenital mediastinal anomalies or right-sided aortic arch. Placement of Silastic prostheses into the empty hemithorax is the preferred surgical treatment; however, other nonsurgical options exist. Herein, we report a case of left postpneumonectomy syndrome in an adult who was successfully treated with the placement of an endobronchial stent.

Lung volume reduction surgery in ventilator-dependent COPD patients.

BACKGROUND: Lung volume reduction surgery has been advocated recently as adjunctive surgical therapy to improve lung and chest wall mechanics in selected patients with diffuse emphysema. Although clear-cut guidelines to select candidates have not been fully established, patients decompensated with significant pulmonary artery hypertension and hypercapnic respiratory failure are currently not considered suitable subjects. Accordingly, ventilator-dependent COPD patients are not considered candidates for this procedure. However, because ventilator-dependent COPD patients have an exceptionally poor prognosis, we elected to offer them this promising, but unproved surgical intervention. Herein, we describe the outcome of these three patients. PATIENTS: The 3 patients had recurrent exacerbations of COPD precipitating respiratory failure, and following aggressive medical therapy remained mechanically ventilated for 11 to 16 weeks (1 patient had a brief period of successful weaning before returning to mechanical ventilation). Prior to surgery, the patients had severe hypercapnia and cor pulmonale. Compared with preoperative values, surgery resulted in improvements in PaO2/FIO2, 304 +/- 80 (SD) vs 229 +/- 48 mm Hg, reductions in PaCO2, 44 +/- 3 vs 60 +/- 9 mm Hg, increases in FVC, 1.63 + 0.52 vs 1.09 +/- 0.05 L, and maximum inspiratory pressure, 57 +/- 22 vs 29 +/- 12 cm H2O. Postoperative complications included persistent air leaks and one tension pneumothorax. Patients weaned from mechanical ventilation after 10 to 21 days all were discharged home and they continue to demonstrate improved gas exchange and functional status. CONCLUSIONS: Lung volume reduction surgery in select, ventilator-dependent COPD patients can result in improved gas exchange and respiratory mechanics that enable successful weaning and overall improved functional status.

Discrepancy between severity of lung impairment and seniority on the lung transplantation list.

BACKGROUND: Organ allocation for lung transplantation, based mainly on accrued time on a waiting list, may not be an equitable system of organ allocation. To provide an objective view of the current practice concerning lung allocation, and timing for transplantation, we examined illness severity and list seniority in patients on a lung transplantation waiting list. METHODS: Adult patients awaiting lung transplantation underwent testing for mean pulmonary artery pressure (mPpa), maximum oxygen consumption (VO2 max), 6-minute walk distance (6MWD), forced expiratory volume in 1 second, mean partial pressure of carbon dioxide, partial pressure of oxygen/fractional concentration of inspired oxygen, and diffusing capacity of the lung for carbon monoxide. Relationships between physiological variables and waiting list rankings were then determined. RESULTS: Thirty-four patients were tested and there was no correlation between time spent waiting on the list and mPpa (r=0.01; P=.94), VO2 max percentage predicted (r=0.07; P=.71), or 6MWD (r=0.15; P=.42). Many patients with functional impairments as indicated by low maximum VO2 or by short 6MWD are scheduled to receive their transplant after patients with levels that indicate a lower degree of risk. When compared with a hypothetical reranking based on mean Ppa, 24 of the 34 patients (71%) on our current waiting list were found to be 5 positions higher or lower than this new risk-based ranking. Sixteen patients (47%) were 10 or more positions away from their hypothetical severity-based ranking, and 9 (26%) were at least 15 positions out of place. Sixteen of the 34 patients were ranked lower than they would be based on a severity of illness using the pulmonary artery pressure alone, 17 were ranked higher than "should be" based on pulmonary artery mean, and only 1 patient (ranked in position 15) was appropriately positioned based on seniority and severity of disease based on PA mean. CONCLUSION: Rank order for lung transplantation has no relationship with illness severity, and the discrepancy between disease severity and seniority on the lung waiting list may compromise overall outcomes in the lung transplantation population.

Epilepsy and sport.

Sport and epilepsy are not mutually exclusive, providing the disease has been properly diagnosed and managed and adequate safeguards are taken. The author also outlines specific contraindications for the sports-minded person with epilepsy.

Management of advanced chronic obstructive pulmonary disease.

Successful Management of patients with advanced COPD includes not only a comprehensive therapeutic strategy tailored to the individual patient but also active patient participation. Figures 1 and 2 outline the medical and surgical treatment options for patients with advanced COPD. Patients who are actively smoking should be strongly advised to quit smoking. Bronchodilators and corticosteroids can improve symptoms and may prevent a further decline in lung function in selected COPD patients. The judicious use of antibiotics during an acute exacerbation may be required. O2 therapy improves survival and neuropsychiatric function in COPD patients with hypoxemia. Maintenance of proper nutrition is of utmost importance. A structured outpatient pulmonary rehabilitation is helpful in improving functional capacity and sense of breathlessness. In COPD patients who fail medical therapy, noninvasive positive pressure ventilation and surgical therapy may be considered.

Analyzing and developing effective instructional behaviors for allied health educators.

This article discusses interaction alaysis, a procedure for objectively recording and analyzing the verbal interchange between instructors and students, which can aid instructors in setting goals for improving their instruction. The following questions are addressed: Why should instructors study their own behaviors? What conditions are necessary for studying one's teaching behaviors? What is interaction analysis? How does one implement interaction analysis? How does one interpret the results of interaction analysis? What does research indicate about interaction analysis? The authors mention the well-known Flanders System of Interaction Analysis, and outline the use of a simpler system, the System for Coding Interaction with Multiple Phases (SCIMP), developed by Townsend.

An integrated model of learning.

Worldwide, most educational systems are based on three levels of education that utilize the pedagogical approaches to learning. In the 1960s, scholars formulated another approach to education that has become known as andragogy and has been applied to adult education. Several innovative scholars have seen how andragogy can be applied to teaching children. As a result, both andragogy and pedagogy are viewed as the opposite ends of the educational spectrum. Both of these approaches have a place and function within the modern educational framework. If one assumes that the goal of education is for the acquisition and application of knowledge, then both of these approaches can be used effectively for the attainment of that goal. In order to utilize these approaches effectively, an integrated model of learning has been developed that consists of initial teaching and exploratory learning phases. This model has both the directive and flexible qualities found in the theories of pedagogy and andragogy. With careful consideration and analysis this educational model can be utilized effectively within most educational systems.

Evaluation of muscle tissue and liver glycogen of cattle submitted to transport over long distances and subjected to emergency slaughter / Avaliação do tecido muscular e glicogênio hepático de bovinos transportados por longas distâncias e submetidos ao abate de emergência

The study evaluated the effect of transportation over long distances on cattle muscle tissue of submitted to emergency slaughter in slaughterhouses in northern Tocantins, Brazil. The evaluations consisted in pH, muscle and liver glycogen, muscle histopathology and creatine kinase (CK), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity. Animals were placed into two groups: Experimental Group (EG), consisting of 19 bovines intended for immediate emergency slaughter, and Control Group (CG), composed of 24 bovines slaughtered in accordance with the normal flow. CK and ALT levels were high in EG. AST did not differ between groups. EG showed higher muscle pH and mean of degenerate fibers, mainly on the intercostal. However, muscle and liver glycogen did not differ between groups. In conclusion, cattle transported over long distances and subjected to immediate emergency slaughter showed markedly stress condition, with changes in biochemical parameters in the muscle tissue, determined by cellular degeneration.(AU)

O presente trabalho objetivou avaliar o efeito do transporte em longas distâncias sobre o tecido muscular de bovinos encaminhados ao abate de emergência. Foram avaliados pH, glicogênio muscular e hepático, análise histopatológica muscular, creatina quinase (CK), alanina aminotransferase (ALT) e aspartato aminotransferase (AST). Os animais foram alocados em dois grupos: grupo experimental (GE), constituído por 19 bovinos destinados ao abate de emergência, e grupo controle (GC), composto por 24 bovinos abatidos de acordo com o fluxo normal do frigorífico. A CK e a ALT estavam aumentadas no GE. O AST não diferiu entre os grupos. O GE apresentou maior percentual de fibras degeneradas, e o músculo intercostal teve maior quantidade de degenerações. O pH muscular foi superior no GE. O glicogênio muscular e o hepático não diferiram entre os grupos. Concluiu-se que bovinos encaminhados ao abate de emergência sofrem estresse severo pelo transporte por longas distâncias, com alterações bioquímicas no tecido muscular determinada pela degeneração celular.(AU)

Exercise attenuates levodopa-induced dyskinesia in 6-hydroxydopamine-lesioned mice.

L-DOPA alleviates the motor symptoms of Parkinson's disease, but its long-term use is associated with undesirable dyskinesia. We now tested whether exercise can attenuate this L-DOPA-induced dyskinesia (LID). We tested the effects of exercise on LID in 6-hydroxydopamine hydrochloride-hemiparkinsonian mice. Animals were treated with L-DOPA/benserazide (25/12.5 mg/kg, i.p.) without and with possibility to exercise (running wheel) during 2 weeks. Exercise drastically prevented the development of LID, and its associated aberrant striatal signaling, namely the hyperphosphorylation of dopamine and cAMP-regulated phosphoprotein 32 kDa protein and c-Fos expression. Our results indicate that exercise can partially prevent the development of LID through the normalization of striatopallidal dopaminergic signaling.

Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection.

Background. Bronchus-associated lymphoid tissue (BALT) has been associated with lung allograft rejection in rat transplant models. In human transplant recipients, BALT has not been linked to clinically significant rejection. We hypothesize that the immunohistochemical composition of BALT varies with the presence of acute lung allograft rejection. Methods. We retrospectively examined 40 human lung allograft recipients transplanted from 3/1/1999 to 6/1/2008. Patients were grouped by frequency and severity of acute rejection based on International Society of Heart Lung Transplant (ISHLT) criteria. Transbronchial biopsies were reviewed for BALT by a blinded pathologist. BALT if present was immunohistochemically stained to determine T-and B-cell subpopulations. Results. BALT presence was associated with an increased frequency of acute rejection episodes in the first year after transplantation. Patients with a lower CD4/CD8 ratio had an increased rejection rate; however, BALT size or densities of T-cell and B-cell subpopulations did not correlate with rejection rate. Conclusion. The presence of BALT is associated with an increased frequency of rejection one year after transplant. The lower the CD4/CD8 ratio, the more acute rejection episodes occur in the first year after transplantation. The immunohistochemical composition of BALT may predict patients prone to frequent episodes of acute cellular rejection.