by Martin Li. / Year shown on spine: 1997. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references (leaves 150-157). / DECLARATION --- p.II / ABSTRACT --- p.III / ACKNOWLEDGEMENTS --- p.VII / CONTENTS --- p.VIII / LIST OF ABBREVIATIONS --- p.XIV / LIST OF TABLES --- p.XVI / LIST OF CHART --- p.XXIII / LIST OF FIGURES --- p.XXIV / Chapter CHAPTER 1 --- OBSTRUCTIVE AIRWAY DISEASE: PUBLIC HEALTH AND CLINICAL ASPECTS --- p.1 / Chapter 1.1. --- Background --- p.1 / Chapter 1.2. --- Magnitude of the problem --- p.2 / Chapter 1.2.1. --- Asthma --- p.2 / Chapter 1.2.2. --- Chronic obstructive pulmonary disease --- p.3 / Chapter 1.2.3. --- Prevalence of osteoporosis in Hong Kong --- p.4 / Chapter 1.2.4. --- History of asthma care --- p.5 / Chapter 1.2.5. --- Treatment of OAD --- p.5 / Chapter 1.3. --- Side effects of Glucocorticoid in OAD patients --- p.6 / Chapter 1.4. --- Side effccts of inhaled corticosteroids in OAD patients --- p.7 / Chapter 1.5. --- Trend of asthma therapy in Hong Kong --- p.8 / Chapter CHAPTER 2: --- OSTEOPOROSIS: PUBLIC HEALTH AND CLINICAL ASPECTS --- p.11 / Chapter 2.1. --- Bone Biology --- p.11 / Chapter 2.2. --- Skeletal Organisation --- p.11 / Chapter 2.3. --- Bone remodelling --- p.12 / Chapter 2.4. --- Effect of corticosteroids on bone remodelling --- p.13 / Chapter 2.5. --- Corticosteroids induccs osteoporosis --- p.13 / Chapter 2.6. --- Factors affecting BMD --- p.14 / Chapter 2.6.1. --- Peak bone mass --- p.14 / Chapter 2.6.2. --- Ethnic factors --- p.14 / Chapter 2.6.3. --- Aging --- p.15 / Chapter 2.6.4. --- Calcium intake --- p.15 / Chapter 2.6.5. --- Oestrogen --- p.16 / Chapter 2.6.6. --- Alcohol consumption --- p.17 / Chapter 2.6.7. --- Cigarette smoking --- p.17 / Chapter 2.7. --- Physical activity and BMD --- p.17 / Chapter 2.8. --- Body composition in Chinese subjects --- p.18 / Chapter CHAPTER 3 --- "PHASE I: BODY COMPOSITION AND BONE MINERAL DENSITY IN OBSTRUCTIVE AIRWAY DISEASE PATIENT AND NORMAL CONTROL SUBJECTS: OBJECTIVES, SUBJECTS AND METHODS" --- p.20 / Chapter 3.1. --- Objectives --- p.20 / Chapter 3.2. --- Subjects and methods --- p.21 / Chapter 3.2.1 --- OAD patients --- p.21 / Chapter 3.2.1.1 --- Disease definition and selection criteria --- p.21 / Chapter 3.2.1.2. --- Normal Control subjects --- p.21 / Chapter 3.3. --- Power of estimation --- p.22 / Chapter 3.4. --- Survey methods --- p.22 / Chapter 3.5. --- Questionnaire --- p.23 / Chapter 3.6. --- Body composition and bone mineral density measurement --- p.23 / Chapter 3.6.1. --- Body composition analysis --- p.24 / Chapter 3.6.2. --- Lumbar spine and proximal hip bone mineral density analysis --- p.24 / Chapter 3.6.3. --- Routine quality control of measurements --- p.24 / Chapter 3.6.4. --- Precision on patient repositioning --- p.25 / Chapter 3.7. --- Statistical methods --- p.25 / Chapter 3.8. --- Bone mineral density of normal control subjects --- p.25 / Chapter CHAPTER 4 --- PHASE II: FLUORIDE IN THE TREATMENT OF OSTEOPOROSIS --- p.27 / Chapter 4.1. --- Introduction --- p.27 / Chapter 4.2. --- Mechanisms of action --- p.28 / Chapter 4.2.1. --- Antiresorptive effect of fluoride --- p.28 / Chapter 4.2.2. --- Force-oriented osteogenic effect of fluoride --- p.28 / Chapter 4.2.3. --- Biochemical osteogenic effect --- p.29 / Chapter 4.3. --- Effect of fluoride salts on BMD: results of clinical trials --- p.29 / Chapter 4.4. --- Effcct of fluoride on bone histomorphology --- p.30 / Chapter 4.5. --- Compliance with sodium fluoride therapy --- p.31 / Chapter 4.6. --- Contradiction of fluoride treatment --- p.31 / Chapter 4.7. --- Sodium monofluorophosphate preparation --- p.32 / Chapter CHAPTER 5 --- PHASE II: THE EFFECTS OF FLUORIDE ON BONE MINERAL DENSITY OF OAD PATIENTS ON STEROID TREATMENT --- p.37 / Chapter 5.1. --- Objectives --- p.37 / Chapter 5.2. --- Subjects and methods --- p.37 / Chapter 5.2.1. --- Power of the study --- p.37 / Chapter 5.2.2. --- Subjects --- p.37 / Chapter 5.2.3. --- Method of randomisation --- p.38 / Chapter 5.2.4. --- Treatment modalities --- p.39 / Chapter 5.2.4.1. --- Treatment group --- p.39 / Chapter 5.2.4.2. --- Control group --- p.39 / Chapter 5.2.5. --- Bone mineral density measurements --- p.39 / Chapter 5.2.6. --- Routine quality control of measurement and precision on patient repositioning --- p.40 / Chapter 5.2.7. --- Methods of monitoring drug compliance --- p.40 / Chapter 5.2.8 --- Statistical methods --- p.40 / Chapter CHAPTER 6 --- RESULTS FOR PHASE I --- p.42 / Chapter 6.1. --- Statistical power of this phase of the study --- p.42 / Chapter 6.2. --- Clinical features of OAD subjects on inhaled steroid --- p.42 / Chapter 6.3. --- Anthropometric measurements and bone mineral density --- p.45 / Chapter 6.4. --- Analysis of covariance for BMDs differences --- p.48 / Chapter 6.5. --- Multiple regression --- p.50 / Chapter 6.6 --- Correlation --- p.51 / Chapter CHAPTER 7 --- RESULTS FOR PHASE II: FLUORIDE AND CALCIUM TRIAL --- p.81 / Chapter 7.1. --- Factors affects the power of studies --- p.81 / Chapter 7.2. --- Clinical findings --- p.82 / Chapter 7.3. --- Body measurements and bone mineral densitometry --- p.85 / Chapter CHAPTER 8: --- DISCUSSION FOR PHASE I --- p.117 / Chapter CHAPTER 9: --- DISCUSSION FOR PHASE II: TRIDIN AND CALCIUM TRIAL --- p.124 / APPENDIX 1: QUESTIONNAIRE FOR OAD BONE MINERAL DENSITY STUDY --- p.132 / APPENDIX 2: BONE SCANS FROM HOLOGIC QDR2000 --- p.137 / APPENDIX 3. TABLES AND REFERENCE CURVES FOR NORMAL HONG KONG CHINESE FEMALE OR MALE BMD --- p.142 / REFERENCE --- p.150

Os efeitos da obstrução uretral parcial na musculatura da bexiga urinária de coelhos foram investigadas usando as ferramentas estereológicas. Foram utilizadas 12 fêmeas de coelhos da raça Norfolk, com três meses de idade e peso corporal variando de 2,5-3,0 kg. O procedimento cirúrgico consistiu de celiotomia mediana retro-umbilical para exposição da bexiga urinária. A parede dorsal da uretra foi divulsionada de sua íntima associação com o útero e vagina, o suficiente para a passagem de fio nylon 2-0. Um pino de Steinmann (3 mm de diâmetro) foi interposto temporariamente entre a uretra e o fio para determinar indiretamente o grau de obstrução uretral. Após três, sete e doze semanas os animais foram ortotanasiados e comparados com o grupo de animais controle (não obstruídos). Os fragmentos da bexiga foram preparados para microscopia de luz. Cortes seriados foram realizados para o estudo morfométrico e estereológico. Os três eixos: crânio-caudal (CC), dorso-ventral (DV) e latero-lateral (LL) aumentaram em todos os grupos analisados: controle, 3, 7 e 12 semanas. Os valores para CC foram estatisticamente similares para 3, 7 e 12 semanas. O mesmo foi observado no eixo DV. Os valores para o eixo LL foram similares para os grupos de 7 e 12 semanas. O estudo morfométrico baseou-se em determinar o tamanho da fibra (área seccional) e comprimento da fibra muscular. Nos animais do grupo de 3, 7 e 12 semanas foi observado um aumento de 4,63x, 4,32x e 7,10x no tamanho celular e um decréscimo de 2,55x, 1,94x e 4,04x no comprimento da fibra muscular quando comparados ao grupo controle. O estudo estereológico baseou-se em estimar o volume referência (Vref), a densidade numérica (Nv), o número total de fibras musculares (N), a densidade de volume (Vv) e o volume da fibra muscular (Vn). O Vref apresentou um aumento de 11,07x, 7,98x e 31,7x quando comparado com o grupo controle. A densidade numérica (Nv) aumentou 0,06x e 0,05x para os grupos de 3 e 7 semanas, respectivamente, em relação ao grupo controle. O grupo de 12 semanas, no entanto, apresentou um decréscimo de 0,01x em comparação com o grupo controle. Os grupos de 3, 7 e 12 semanas apresentaram, respectivamente, um aumento de 0,81x, 12,56x e 38,43x em número total de células. A densidade de volume (Vv) para os grupos de 3, 7 e 12 semanas apresentou um aumento de 0,97x, 0,56x e 0,86x em relação ao grupo controle. E finalmente, o volume médio da fibra muscular apresentou um aumento de 0,62x, 0,81x e 0,82x, respectivamente para os animais de 3, 7 e 12 semanas. Os dois mecanismos: hipertrofia e hiperplasia ocorrem na bexiga urinária de coelhos, porém não sabemos a seqüência exata em que aparecem. / The effects of partial urethral obstruction on rabbit´s urinary bladder musculature were investigated using stereological designed methods. A total of 12 female Norfolk rabbits weighing from 2.5 to 3 kg were used. A retro-umbilical celiotomy was made to expose the urinary bladder. The urethra´s dorsal wall was isolated from its association with the uterus. A 3mm-Steinmann-pin was positioned on the urethra to produce a standard degree of obstruction and a ligature was tied up around it, using a 2-0 nylon silk. Three, seven and twelve weeks after the surgery procedures the rabbits were euthanised. Bladder fragments were prepared for light microscopy. Serial sections were performed to morphometric and stereological study. In relation to the bladder axis: cranio-caudal (CC), dorso-ventral (DV) and latero-lateral (LL) increased in all groups analysed: control, 3, 7 and 12 week-obstructed animals. Values for CC were statistically similar for 3, 7 and 12-week-obstructed groups. The same was observed for DV axis. The LL axis showed values statistically similar for 7 and 12-week-obstructed groups. The morphometric study was based on the muscle fibre size (sectional area) and the muscle fibre length. In 3, 7 and 12-week-obstructed animals, it was observed a 4.63, 4.32 and 7.10-fold cell size increase and a 2.55, 1.94 and 4.04-fold decrease in length, respectively, when compared to control group. As for the stereological study. Vref presented a 11.07, 7.98 and 31.7-fold increase when compared to control subjects. Numerical density (Nv) increased by 0.06 and 0.05 in 3 and 7-week-obstructed groups, respectively, in relation to control group. Twelve week-obstructed group. Presented however a 0.01x-decrease compared to control animals. Three, seven and twelve-week-obstructed groups presented, respectively, 0.81, 12.56 and 38.43-fold increase in total number of cells (N). Volume density presented a 0.97, 0.56 and 0.86-fold increase in 3, 7 and 12-week-obstructed groups, respectively. And finally, mean muscle cell volume (Vn) presented a 0.62, 0.81 and 0.82-fold in 3, 7 and 12-week obstructed groups, respectively. Both mechanisms: hypertrophy and hyperplasia happened to occur on rabbit´s urinary bladder, thought we do not know the exact sequence in which they appear altogether.

Made available in DSpace on 2016-04-28T20:18:27Z (GMT). No. of bitstreams: 1 2006-Katia Barao Corgozinho.pdf: 1754960 bytes, checksum: e41b81ec345f919ab44aeb86dc073f65 (MD5) Previous issue date: 2006-01-17 / Perineal urethrostomy is a surgical procedure used in male cats to create a new opening between the pelvic urethra and skin in the perineal region. Indications for it include recorrent urethral obstruction and urethral obstruction that cannot be relieved by catheterization and reverse flushing. Perineal urethrostomy, when indicated and propely perfomed, is benefical to the patient and plagued with few complications. The purpose of this study was perform clinical evaluation of seventeen cats submitted to the perineal urethrostomy and evaluate the surgical complications in six months. This report evaluated the cats in the first day and up to six months after the surgery which were followed with biochemical, radiological analysis and urinalysis in this period, using questionnaires for better organization of the data. Sixteen cats had penile urethral trauma by catheterization and one cat had recurrent urethral obstruction. Complications observed after this procedure included hemorrhage, wound dehiscence, heamaturia or/and straining and urinary bacterial infection. None had urine burns or irritation or was incontinent or died. The most serious complication, urethral stricture, didn`t occur. The penile trauma was the major cause to indicate the urethrostomy. This study concluded that perineal urethrostomy predispose the urinary tract to increased bacterial contamination and subsequent infection. But many cats enjoy a long-term disease-free outcome and the clients consider their cats to have a good quality of life following surgery. / A uretrostomia perineal ? um procedimento cir?rgico realizado em gatos machos com o intuito de criar um novo orif?cio entre a uretra p?lvica e a pele na regi?o perineal. As indica??es dessa t?cnica incluem a obstru??o uretral recorrente e a obstru??o que n?o pode ser aliviada por cateteriza??o e lavagem reversa. A uretrostomia perineal quando indicada e realizada adequadamente, ? ben?fica para o paciente e gera poucas complica??es. O objetivo desse trabalho foi avaliar clinicamente 17 gatos submetidos ? uretrostomia perineal e as complica??es p?s-cir?rgicas no per?odo de seis meses. A an?lise foi efetuada no primeiro dia de atendimento at? o sexto m?s p?s-cir?rgico e os animais foram acompanhados com an?lises bioqu?micas, radiografias e com urin?lise, usando question?rios para melhor organiza??o dos dados. Dezesseis gatos tinham traumatismo na uretra peniana em conseq??ncia da cateteriza??o uretral e um gato apresentou obstru??o uretral recorrente. As complica??es p?s-operat?rias observadas foram hemorragia, deisc?ncia de sutura, hemat?ria/dis?ria e infec??o bacteriana urin?ria. Nenhum paciente teve irrita??o da ferida, queimadura por urina, incontin?ncia ou veio a ?bito. A complica??o mais s?ria, a estenose uretral, n?o aconteceu. A iatrogenia foi a maior causa para a indica??o da uretrostomia perineal nesses animais. Esse estudo indicou que a uretrostomia perineal predisp?e ao aumento da contamina??o bacteriana e infec??o urin?ria. Por?m muitos gatos ficam longos per?odos sem apresentar sinais cl?nicos de doen?a do trato urin?rio inferior e os propriet?rios consideram que seus gatos t?m boa qualidade de vida ap?s a cirurgia.

Objetivos: Determinar o percentual de asmáticos com má percepção da dispnéia e sua correlação com a intensidade da broncoconstrição aguda, hiper-responsividade brônquica, uso de medicação de manutenção e controle da asma. Métodos: Ensaio clínico não controlado com pacientes asmáticos do ambulatório de asma do Hospital São Lucas da PUCRS. Foram realizados testes de broncoprovocação com metacolina com protocolo dosimetrado e avaliada a percepção da dispnéia após cada dose administrada, utilizando a escala de Borg. Foram coletados dados demográficos e questionado quanto ao controle da asma, medicação em uso e necessidade de broncodilatador de curta ação. Para análise estatística foram utilizados teste de Chi-Quadrado e Teste t de Student e correlação de Spearman. Resultados: Foram estudados 65 pacientes com asma, dos quais 53 tiveram sua avaliação completa. Trinta e dois pacientes apresentaram percepção da dispnéia (60,5%) quando ocorreu broncoconstrição induzida pela metacolina. Entretanto, 21 pacientes (39,5%) não apresentaram alteração em relação aos sintomas de dispnéia, mesmo com queda de 20% do VEF1. Os grupos dos percebedores e não percebedores não apresentavam diferenças quanto ao VEF1 basal, percentagem de queda do VEF1 e dose de metacolina necessária para broncoprovocação. Não houve correlação significativa entre percepção da dispnéia com idade (p=0,247), sexo (p=0,329), uso de medicação de manutenção (p=0,152), controle da asma (p=0,562), hiper-responsividade brônquica (p=0,082) e gravidade da broncoconstrição aguda (p=0,749). Conclusões: Percentagem significativa dos asmáticos apresenta baixo grau de percepção da broncoconstrição. Os fatores relacionados com a incapacidade de identificação da modificação da função pulmonar não estão bem definidos. Diagnóstico e orientação dos maus percebedores é fundamental para redução de morbidade e mortalidade por asma. / Objective: To assess the percentage of poor perception of dyspnea in asthmatics and its correlation with acute bronchoconstriction severity, airway hyperresponsiveness, medication use and asthma control. Methods: Uncontrolled clinical trial of asthmatics from outpatient department HSL-PUCRS. Methacholine challenge testing was performed with five-breath dosimeter protocol. The perception of airway narrowing after 20% fall in FEV1 was evaluated using the Borg scale. Data concerning demographic information, asthma control, long-term management medication and rescue medication consumption were recorded. Chi-square test and Student´s T test and Spearman’s correlation were applied for the statistical analysis. Results: 65 patients were included and 53 completed the evaluation. 32 patients presented dyspnea (60,5%) when methacholine induced bronchoconstriction occurred but 21 patients (39,5%) did not show any difference related to dyspnea symptoms, even with 20% fall in FEV1. There were no differences between the two groups in terms of the baseline FEV1, % of fall FEV1, and methacoline dose that promoted a positive test. There was no significant association between airway obstruction and age (p= 0.247), sex (p=0.329), long term management medication use (p=0.152), asthma control (p=0.562), airway hyperresponsiveness (p=0.082), and acute bronchoconstriction severity (p=0.749). Conclusion: Significant percentage of astmatics presents poor perception of bronchoconstriction. The identification and orientation of this group of patients is essential to make plans of interventions and eventually reduce asthma morbidity and mortality.

The overall purpose of the study was to examine the aesthetic impacts of wind farm obstruction lighting. The research problems investigated in this study were; aviation safety regulations for wind farm obstruction lighting in different countries, obstruction lighting technology, and the public attitudes towards wind farming. The research was designed taking into account the research problems, questions, and the researcher experience. Hence, mixed method approach was employed to collect as much, and as diverse data as possible. The sample was drawn focusing wind energy project developers, operators, and the owners. Seeking to build a detailed narrative, a web-based survey was conducted to gather the thoughts, and opinions of the sample population, in addition, to a thorough literature review conducted earlier. The key findings of this study are that the lighting system should be efficient to operate in terms of technology with least aesthetic impacts. Out-dated wind farm obstruction lighting systems are annoying, and contributes to overall aesthetic impacts that triggers nagetive attitudes towards wind farming. In addition, for wind farms near any aerodrome, infrared integrated into light emitting diodes obstruction lighting have minimal aesthetic impacts. Whereas, the radar-activated obstruction lighting is a better choice for wind farms further away from aerodromes. The study argued that understanding the affecting components of attitudes would give various stakeholders a realistic understanding about attitudes towards wind farming. This study concludes that the optimization of lighting angle, intensity, color, and luminance will help reducing the aesthetic impacts under the prevailing regulations, and mapping affective components of attitudes will help in better understanding the public support towards wind farming.

Soient $k$ un corps de caractéristique nulle et $G$ un $k$-groupe algébrique linéaire. Il est bien connu que si $G$ est abélien, les torseurs sous $G_(X)$ sur un $k$-schéma $\pi:X\rightarrow \textup(Spec)\;k$ fournissent une obstruction à l'existence de points $k$-rationnels sur $X$, puisque la suite spectrale de Leray donne dans les bons cas (\textit(e.g.) $X$ propre) une suite exacte de groupes sur laquelle on peut directement lire l'obstruction à ce qu'un $\bar(G)_(X)$-torseur $\bar(P)\rightarrow\bar(X)$ de corps des modules $k$ soit défini sur $k$, \textit(i.e.) qu'il provienne par extension des scalaires à la cl(ô)ture algébrique $\bar(k)$ de $k$ d'un $G_(X)$-torseur $P\rightarrow X$. Le point crucial est que cette obstruction est mesurée par une gerbe, qui est neutre lorsque $X$ possède un point $k$-rationnel. On essaye ici d'étendre ce résultat au cas non-commutatif, et on en déduit (sous certaines conditions) des obstructions cohomologiques non-abéliennes à l'existence de points $k$-rationnels sur $X$, et des résultats sur la descente des torseurs.

Exterior tensor products of elliptic operators on smooth manifolds and manifolds with conical singularities are used to obtain examples of elliptic operators on manifolds with edges that do not admit well-posed edge boundary and coboundary conditions.

ABSTRACT Heaves is triggered by exposure to dust and its components, such as endotoxin, and is characterized by clinical signs such as coughing, decreased exercise tolerance, difficulty breathing and abnormal lung sounds which are due to bronchoconstriction and accumulation of neutrophils in the airways. Pulmonary intravascular macrophages (PIMs) are believed to increase horses sensitivity to endotoxemia-induced lung inflammation. The first objective of this study was to investigate a hitherto unknown role of PIMs in equine heaves. I used mouldy hay (MH) to induce heaves and gadolinium chloride (GC) to deplete PIMs in order to compare responses between non-treated and GC-treated heaves horses. A modified randomized crossover study (2X2 factorial) was conducted in which mares (N=9) were exposed to 4 different treatments: alfalfa cubes (Cb), alfalfa cubes + GC (Cb-GC), mouldy hay (MH) and MH + GC (MH-GC). Each treatment was followed by broncholaveolar lavage (BAL). MH was fed for 7 days to induce heaves followed by Cb for 21 days to achieve remission, whereas the treatments in which heaves was not induced (Cb; Cb-GC), the cubes were fed prior to the BAL and for 14 days after the BAL to allow recovery from the BAL procedure. BAL fluids were processed to investigate total cell, neutrophil and alveolar macrophage concentrations. In addition, TNFá protein levels as well as TNFá, IL-8, and TLR4 mRNA expression in BAL cells were assessed in order to infer on their activation state.<p> Data showed higher concentration of dust (3X), endotoxin (20X), and endotoxin per milligram of dust (7X) in MH compared to the Cb environment. Clinical scores and neutrophil concentrations in BAL were higher when mares received MH compared to MH and GC (MH-GC). Real time reverse transcriptase PCR revealed a significant lower expression of IL-8 and TLR4 mRNA in BAL cells from MH-GC mares compared to MH. TNFá mRNA expression as well as protein concentration were not affected by the different treatments. In vitro secondary LPS challenge significantly increased IL-8 mRNA expression in cells from MH treatment compared to without LPS, but not in the MH-GC treatment. TLR4 expression was not affected by the secondary challenge. Although secondary LPS challenge increased expression of TNFá mRNA and protein, the differences among treatment groups were not meaningful. In conclusion, PIM depletion attenuates clinical scores, migration of inflammatory cells into the alveolar space and expression of pro-inflammatory molecules in BAL cells of heaves horses.<p> The observations on the role of PIMs in heaves in horses prompted me to examine the occurrence of PIMs in human lungs. I found a trend for higher numbers of septal macrophages in autopsied lungs from human patients who died of non-pulmonary pathologies compared to those having either COPD or asthma. If these septal macrophages indeed represent the PIMs, this finding is contrary to existing belief that humans, unlike horses, do not have PIMs.

ABSTRACT Heaves is triggered by exposure to dust and its components, such as endotoxin, and is characterized by clinical signs such as coughing, decreased exercise tolerance, difficulty breathing and abnormal lung sounds which are due to bronchoconstriction and accumulation of neutrophils in the airways. Pulmonary intravascular macrophages (PIMs) are believed to increase horses sensitivity to endotoxemia-induced lung inflammation. The first objective of this study was to investigate a hitherto unknown role of PIMs in equine heaves. I used mouldy hay (MH) to induce heaves and gadolinium chloride (GC) to deplete PIMs in order to compare responses between non-treated and GC-treated heaves horses. A modified randomized crossover study (2X2 factorial) was conducted in which mares (N=9) were exposed to 4 different treatments: alfalfa cubes (Cb), alfalfa cubes + GC (Cb-GC), mouldy hay (MH) and MH + GC (MH-GC). Each treatment was followed by broncholaveolar lavage (BAL). MH was fed for 7 days to induce heaves followed by Cb for 21 days to achieve remission, whereas the treatments in which heaves was not induced (Cb; Cb-GC), the cubes were fed prior to the BAL and for 14 days after the BAL to allow recovery from the BAL procedure. BAL fluids were processed to investigate total cell, neutrophil and alveolar macrophage concentrations. In addition, TNFá protein levels as well as TNFá, IL-8, and TLR4 mRNA expression in BAL cells were assessed in order to infer on their activation state.<p> Data showed higher concentration of dust (3X), endotoxin (20X), and endotoxin per milligram of dust (7X) in MH compared to the Cb environment. Clinical scores and neutrophil concentrations in BAL were higher when mares received MH compared to MH and GC (MH-GC). Real time reverse transcriptase PCR revealed a significant lower expression of IL-8 and TLR4 mRNA in BAL cells from MH-GC mares compared to MH. TNFá mRNA expression as well as protein concentration were not affected by the different treatments. In vitro secondary LPS challenge significantly increased IL-8 mRNA expression in cells from MH treatment compared to without LPS, but not in the MH-GC treatment. TLR4 expression was not affected by the secondary challenge. Although secondary LPS challenge increased expression of TNFá mRNA and protein, the differences among treatment groups were not meaningful. In conclusion, PIM depletion attenuates clinical scores, migration of inflammatory cells into the alveolar space and expression of pro-inflammatory molecules in BAL cells of heaves horses.<p> The observations on the role of PIMs in heaves in horses prompted me to examine the occurrence of PIMs in human lungs. I found a trend for higher numbers of septal macrophages in autopsied lungs from human patients who died of non-pulmonary pathologies compared to those having either COPD or asthma. If these septal macrophages indeed represent the PIMs, this finding is contrary to existing belief that humans, unlike horses, do not have PIMs.

With the advent of the Age of Knowledge Economy, most businesses are gradually realizing that only knowledge can guarantee the long-term competition advantage for any individual business. To strengthen its competitive edge, China Steel Corporation (also known as CSC) has been actively investing in knowledge management in recent years. The purpose of this study, then, is an attempt to find out the factors that may be hindering CSC¡¦s knowledge management and innovation and possible solutions to these issues. This study will first construct a relevant theory to knowledge management and innovation obstruction, followed by a discussion regarding the current situation of CSC¡¦s knowledge innovation and management. Through in-depth interview and questionnaire survey with CSC¡¦s individual departments, the present research is going to try to ascertain the factors in CSC¡¦s knowledge obstruction, to devise a plausible solution relevant to the company¡¦s problems, and to serve as an example for other businesses who may also be mapping their own knowledge management. The primary research subject of this study includes current CSC staff with a rank of certified engineer or above. All subjects are arranged into five main groups according to their departments. A total of 410 questionnaires are issued, but only 244 responses are deemed valid and are included in the research. Through various statistical analyses, like Reliability analysis, descriptive statistical analysis, ANOVA, etc., the present study concludes with the following findings: I.Through literature and interview, the cause and factors of knowledge management and innovation obstruction are discovered to be: A.System: 1. A lack of knowledge inheritance, 2. Insufficient trigger, 3. No professional staff, 4. No operational standard. B.Personnel: 1. Unwilling to share, 2. Insufficient training, 3. Insufficient time, 4. A lack of teamwork, 5. Insufficient understanding. C.Platform: 1. Insufficient data, 2. Insufficient hardware, 3. Time inefficiency, 4. Operation difficulty, 5. Insufficient safety. D.Management: 1. Insufficient understanding, 2. Insufficient willpower, 3. Insufficient support, 4.Insufficient communication. II.This study, through questionnaire survey, has confirmed that the degree in which each factor magnifies the obstruction depends on: A.In structural surface, platform is the most severe component, and personnel is considered to be a less severe component. The time inefficiency, insufficient safety and insufficient data are the three leading factors in the platform component, followed by personnel¡¦s insufficient time and insufficient hardware. B.Unwilling to share, a lack of teamwork, and insufficient understanding are the mildest obstruction factors. III.Most subjects of the survey consider the current progress satisfactory, and they also believe that the personnel component has the most progress among many other factors, followed by the work done in knowledge innovation. The platform receives the lowest progress rating. IV.The relationship between individual difference, progress, and innovation obstruction: A.Staff from different work units experiences significant difference in terms of ¡§innovation progress¡¨, ¡§system obstruction¡¨, ¡§personnel obstruction¡¨, ¡§platform obstruction¡¨, and ¡§management obstruction¡¨, etc. Sales unit people face more hindrance in system, personnel, and management than other units. Operation unit people experience the least obstruction, and they also acquire more ¡§innovation progress¡¨ than the sales unit. B.Staff with different work positions experiences significant difference in terms of ¡§system obstruction¡¨, ¡§personnel obstruction¡¨, and ¡§management obstruction¡¨, etc. Engineers in general face more hindrance than other staff in terms of the three main categories ¡V¡§system obstruction¡¨, ¡§personnel obstruction¡¨, and ¡§management obstruction¡¨. On the other hand, technicians evidently experience less obstruction than other kinds of staff. C.Staff with different educational backgrounds experiences significant difference in terms of ¡§system obstruction¡¨, ¡§personnel obstruction¡¨, ¡§platform obstruction¡¨, and ¡§management obstruction¡¨, etc. As a whole, staff with higher education will experience more obstruction and its accompanying factors. D.Staff with different seniority levels experiences significant difference only in terms of ¡§personnel obstruction¡¨. The result of post-occupational multi-comparison analysis shows that this obstruction does not reach a significant standard.