INTRODUÇÃO: O transplante traqueal continua um desafio. Contudo, avanços nas técnicas de revascularização dos enxertos traqueais e no conhecimento da imunobiologia da traquéia, indicam que esta técnica pode ser utilizada com freqüência no futuro próximo. A depuração mucociliar (DM) é o mecanismo de defesa inato mais importante das vias aéreas. A traquéia age como um órgão de defesa devido à DM. A DM ocorre por ação do batimento ciliar do epitélio respiratório que impele o muco que atapeta as vias respiratórias, carreando substâncias nocivas. Idealmente, a DM deve ser preservada em enxertos traqueais passíveis de utilização para transplante traqueal. Nosso intuito foi: 1) avaliar os efeitos da isquemia fria sobre a DM; e 2) avaliar a ação de soluções de preservação administradas por via tópica na manutenção da DM após isquemia fria. MÉTODOS: De 109 ratos Wistar foram obtidos 217 segmentos traqueais. Os segmentos foram distribuídos entre três grupos experimentais e um grupo Controle. Cada segmento foi submergido em LPD-glicose (grupo LPD), histidina-triptofano-cetoglutarato (grupo HTK) ou solução salina (grupo Salina). Avaliou-se a DM após 6,10,16 ou 24 horas de isquemia fria. No grupo Controle os segmentos foram analisados imediatamente após a extração, não havendo isquemia fria, nem submersão em soluções. A velocidade de transporte mucociliar (VTM) foi medida através de microscópio de luz, pela observação do movimento das partículas de muco na superfície dos segmentos traqueais. A freqüência de batimento ciliar (FBC) foi obtida pela sincronização entre o movimento ciliar observado pelo microscópio de luz e um estroboscópio. Em seguida, os segmentos foram corados com hematoxilina-eosina para analisar a integridade epitelial (IE) e a inflamação subepitelial (IS). Foi realizada análise quantitativa do muco intracelular por um programa de computador após coloração com azul de alcião (MI-AA) e PAS (MI-PAS). As amostras mais significativas foram analisadas qualitativamente por microscopia eletrônica de transmissão (ME). Foram realizadas duas análises: 1) grupo Controle e tempos de isquemia; e 2) grupo Controle e soluções de preservação (agrupado pelo tempo de isquemia). RESULTADOS: 1) grupo Controle e tempos de isquemia: O grupo controle foi melhor que os grupos submetidos a isquemia fria quanto à VTM (p=0,0001) e FBC (p=0,012). Contudo, não houve diferença na IE, IS e MI entre o grupo Controle e os demais grupos. 2) grupo Controle e soluções de preservação: O grupo controle apresentou melhor VTM que os grupos LPD, HTK e Salina após isquemia de 6h (p=0,001), 16h (p=0,009) e 24h (p=0,001). O grupo controle apresentou melhor FBC que os grupos LPD, HTK e Salina após isquemia de 24h (p=0,001). Não houve diferença entre os grupos na IE e IS. O grupo Controle apresentou melhor MI-AA que os grupos LPD após 16h (p=0,02) e HTK após 24h de isquemia (p=0,04). Não houve diferença entre os grupos à MI-PAS. À ME, o grupo Salina apresentou maiores alterações secundárias à isquemia do que os demais grupos. CONCLUSÕES: 1) A isquemia fria piora a DM; e 2) O uso de soluções de preservação administradas por via tópica não contribui para manutenção da DM após isquemia fria / INTRODUCTION: Tracheal transplantation is a challenging problem. Recent advances in graft revascularization, and reepithelialization renewed the interest on airway transplantation. Mucociliary clearance (MC) is the most important innate defense mechanism of the respiratory system. MC works by mucous transport carried out by ciliary beating function of the airway epithelium. Trachea acts as a defense organ in the respiratory system through the MC. Ideally, MC should be preserved in tracheal grafts used for transplantation. Preservation solutions improve organ preservation by decreasing ischemic injury. The purpose of the study was: 1) to evaluate the effects of cold ischemia on MC; and 2) to evaluate the impact of topically-applied preservation solutions on MC after cold ischemia. METHODS: From 109 male Wistar rats we obtained 217 tracheal segments. The segments were allocated to one of four groups. Segments were submerged in LPD-glucose (LPD group), histidine-tryptophan-ketoglutarate (HTK group), or saline solution (Saline group), and stored at 4C. MC was analyzed after 6, 10, 16 or 24h of ischemia. Control group have only segments that were analyzed right after extraction, not submitted to cold ischemia or submersion in preservation solutions. The mucociliary transport velocity (MTV) was measured by observation of mucous particle under the surface of the segments, through a light microscope. Ciliary beating frequency (CBF) was achieved by synchronization between cilia movement and a stroboscope flashlight. Tracheas were stained with hematoxylin-eosin in order to analyze the epithelial integrity (EI) and the subepithelial inflammation (SI). A quantitative analysis of the intracellular mucus stained with alcian blue (IM -AB) and PAS (IM-PAS) was achieved by a software. The most significant samples of the tracheal segments were qualitatively analyzed by transmission electronic microscopy (TEM). Two analyses were made: 1) Control group and ischemic time; and 2) Control group and preservation solutions. RESULTS: 1) Control group and ischemic time: Control group had better VTM (p=0,0001) and CBF (p=0,012) than the groups submitted to cold ischemia. However, there was no difference among Control group and the other groups on EI, SI, IM-AB, and IM-PAS. 2) Control group and preservation solutions: Control group showed better MTV than the LPD, HTK, and Saline groups after 6h (p=0,001), 16h (p=0,009) and 24h (p=0,001) of cold ischemia. Control group showed better CBF than the LPD, HTK, and Saline groups after 24h of ischemia (p=0,001). There was no difference among groups on EI and SI. Control group showed better IM-AB than both the LPD group after 16h of cold ischemia (p=0,02), and the HTK group after 24h of cold ischemia (p=0,04). There was no difference among the groups on IM-PAS. TEM showed more findings of ischemic lesion on Saline group. CONCLUSIONS: 1) Cold ischemia impairs MC; and 2) Topically-applied preservation solutions do not ameliorate MC after cold ischemia

Introdução: Em pacientes sob intubação endotraqueal os mecanismos fisiológicos de climatização do ar inspirado são anulados. Durante anestesia geral, quando os gases inspiratórios são ofertados secos e frios, a manutenção da umidade das vias aéreas é condição importante para prevenção de lesões da mucosa respiratória e ressecamento das secreções. Os sistemas de anestesia possuem propriedades de umidicação inerentes, decorrentes do sistema respiratório circular e a presença do absorvedor de CO2. Entretanto, os níveis de umidificação, durante a anestesia, dependem de vários fatores incluindo o tipo de ventilador anestésico, montagem do sistema respiratório e o fluxo de gás fresco utilizado. Porém não há dados na literatura que tenham investigado o efeito nos níveis de umidade do gás inspirado nas propriedades físicas e de transportabilidade do muco respiratório. Objetivo: Avaliar os níveis de Temperatura (T), umidade absoluta (UA) e umidade relativa (UR) do ar inspirado durante anestesia geral oferecidos pelo sistema circular valvular com absorção de CO2 e com a adição do HME em dois tipos de ventiladores (Dräger e Takaoka). Avaliar os efeitos do HME sobre os níveis de Temperatura e Umidade dos gases inspirados ofertados pelos dois equipamentos. Avaliar o impacto da umidade sobre as propriedades físicas e de transportabilidade do muco respiratório. Método: Foram selecionados 44 pacientes da Clínica Cirúrgica II do Departamento de Gastroenterologia do HCFMUSP com indicação de cirurgia abdominal eletiva e anestesia geral com duração superior a 4 horas. Os pacientes foram alocados em 4 grupos conforme o tipo do ventilador utilizado (Dräger ou Takaoka) e a presença ou ausência do HME. O muco respiratório e os dados de temperatura, UR e UA do gás ofertado foram coletados logo após a intubação endotraqueal, e a cada duas horas até o final da cirurgia. A análise do muco respiratório foi realizada através dos seguintes métodos: Transportabilidade mucociliar (MCT), em palato de rã; Transportabilidade pela tosse (TT), através da máquina simuladora da tosse e as propriedades de superfície, através do Ângulo de contato (AC). Resultado: O ventilador Dräger foi significantemente mais efetivo em ofertar níveis mais altos de T, UA e UR comparado ao ventilador Takaoka. A adição do HME aumentou a T e UA nos dois equipamentos. A UR aumentou somente no ventilador Takaoka. Houve um aumento do TMC e da TT no grupo que apresentou níveis mais altos de umidade (i.e. Dräger + HME). O AC não mostrou diferenças entre os quatro grupos. A análise longitudinal mostrou que o TMC foi positivamente afetado com o aumento da UA e UR. A TT foi positivamente afetada com a adição do HME. Conclusão: Nossos resultados mostram que o ventilador Dräger produziu níveis significantemente mais altos de umidade comparados ao ventilador Takaoka e que a adição do HME aumentou os níveis de umidade nos dois equipamentos estudados. Os equipamentos anestésicos e a adição do HME afetaram os níveis de umidade ofertados ao paciente durante a anestesia geral, e essas mudanças influenciaram a transportabilidade do muco respiratório / Background: In patients who are intubated, the natural mechanism of gas climatization by the nose and the upper airway is bypassed. During anesthesia, when the inspiratory gases are cold and dry, humidification of gases is recommended to prevent drying of the mucosal epithelium and respiratory secretions. The anesthesia systems have inherent humidifying properties as a result of the valvular rebreathing of some of the expired humidity and of the production of water in the CO2 absorber. However, the level of moisture in anesthetic ventilation is critically dependent on several factors that include the equipment, the arrangement of the circle breathing system and the fresh gas flow. To date the effect of humidity on respiratory mucus properties and transportability was not investigated. Objectives: The objective of this study was to measure the humidity and temperature of the inspired gas from a circle absorber system in two different ventilators (Dräger and Takaoka) and the effect of a heat and moisture exchanger (HME) on the inspired gas. Furthermore, we also evaluated the impact of humidity on in vitro mucus transportability and physical properties. Methods: We studied 44 patients with no pulmonary disease scheduled for elective surgery that were randomly allocated in four groups according to the anesthetic equipment (Dräger or Takaoka) and the absence or presence of HME. Respiratory mucus was collected and Temperature (T), absolute humidity (AH), relative humidity (RH) of inspired gases were recorded immediately after intubation (T0) and every 2 hours. In vitro respiratory mucus was studied by mucociliary transportability (MCT) by the frog palate method; cough clearance (CC) by the cough equipment, and contact angle (CA) by direct observation. Results: Dräger equipment delivered significantly higher levels of RH and AH when compared to Takaoka. The addition of HME increased AH and T in both equipments. RH was improved only in the Takaoka equipment. MCT, CC showed a non-significant trend to be higher in the group that provided the highest humidity (i.e Dräger + HME). CA did not change among groups. Longitudinal analysis showed that MCT was positively affected by an increase in AH and RH. CC was positively affected by the addition of HME. Conclusion: Our results showed that Dräger equipment was more effective in humidifying anesthetic gas than Takaoka. The performance of both equipments was improved when HME was added. The anesthetic equipment and the addition of HME affect the humidity delivered to the patient that in turn influences in vitro respiratory mucus transportability

No laboratório de investigação médica da disciplina de Cirurgia Torácica do Departamento de Cardio-pneumologia da Faculdade de Medicina da Universidade de São Paulo vem sendo desenvolvida uma linha de pesquisa experimental sobre transplante pulmonar, visando elucidar os efeitos que a cirurgia sobre o brônquio e o uso de drogas imunossupressoras têm sobre o aparelho mucociliar. O presente estudo tem por objetivo avaliar os efeitos da azatioprina e da transecção brônquica sobre o aparelho mucociliar em ratos. Utilizamos 36 ratos machos da raça Wistar, não isogênicos, pesando de 200 a 250g, obtidos no biotério da Faculdade de Medicina da Universidade de São Paulo. Todos os animais foram submetidos à anestesia geral, intubação orotraqueal e ventilação mecânica. Em seguida foi realizada uma toracotomia esquerda com transecção e reanastomose do brônquio principal esquerdo. Por fim síntese do tórax e drenagem fechada, que era retirada quando o animal acordava. Os animais foram divididos em dois grupos: com administração de azatioprina e com administração de solução de salina. Eles foram sacrificados aos 7, 15 e 30 dias para retirada dos pulmões e árvore brônquica. O muco foi coletado do brônquio direito e esquerdo. Foi realizada a medida da velocidade do transporte mucociliar à direita e esquerda dos dois grupos e posterior análise das propriedades dos mucos através da medida da velocidade de transporte relativa no palato de rã e da medida do ângulo de contato. As medidas das variáveis dos brônquios direito e esquerdo com e sem azatioprina nos três tempos de avaliação foram submetidas ao teste de Análise de Variância de Duplo Fator. Nos resultados a velocidade do transporte à esquerda foi significativamente reduzida pela transecção brônquica quando comparada entre os grupos: mostrando-se pior aos 30 dias. A velocidade relativa e o ângulo de contato dos mucos coletados à esquerda mostraram com significado estatístico uma piora nas propriedades do muco pela transecção, pricipalmente aos 30 dias. Com a azatioprina e a transecção observamos piora na velocidade do transporte mucociliar significativa ao longo do tempo, maior aos sete dias e com uma progressiva melhora até os 30 dias. O estudo mostrou que a azatioprina não acarretou piora quando associada à transecção. Na presença de azatioprina houve melhora das propriedades do muco, tendo a velocidade do transporte relativo e o ângulo de contato melhora significativa ao longo do tempo. A azatioprina previne uma piora da qualidade do muco. Concluímos que a transecção brônquica piora o transporte mucociliar; a azatioprina preserva as propriedades do muco; a azatioprina piora o transporte até os sete dias; a azatioprina não interage com a transecção para a redução da velocidade do transporte mucociliar e para a piora do muco / At the Experimental Thoracic Surgery Laboratory, Department of Cardio-Pneumology , Department of Pathology, Experimental Air Pollution Laboratory, in the Medical School, São Paulo University, research in lung transplantation, administration of imunossupression drugs and their effects on the mucociliary system are carried out. We develop models of bronchial transeccion and reanastomosis, unilateral lung transplantation, mucociliary transport velocity and mucus transportability in rats, which allow us to observe the resulting alterations. The mechanisms involved in the impairment of the mucociliary function after lung transplantation and immunosuppression therapy are not yet completely understood. The purpose of the present study was to evaluate the effects of azathioprine on the mucociliary system in a model of bronchial transeccion and reanastomosis in rats. We used 36 rats, submitted to general anesthesia, tracheal tube, mechanical ventilation and left thoracotomy, followed by a left main stem bronchus transeccion and reanastomosis. The animals were separated into 2 groups that received or not azathioprine (AZA), and being sacrificed at 7, 15 and 30 days after the surgical procedure. In situ bronchial mucociliary transport (MCT) was determined distal to the anastomosis of the left main stem transected bronchus (LTB) and in the right intact bronchus (RIB). We also studied the surface properties of mucus by using in vitro mucus transportability with a frog palate preparation and mucus contact angle (mucus adhesively) collecting mucus from LTB and RIB. The measures obtained were submitted to statistical analysis. The results showed that the MCT velocity (mm/min) was significantly lower (p<0.01) in the LTB without the AZA administration compared with the RIB with or without AZA. At the LTB with AZA administration there was significant difference (p<0.05) at 7 days compared with the RIB with and without AZA and no significant difference at 15 and 30 days (p>0.05). Mucus in vitro transportability and adhesiveness showed the worst result at the LTB without AZA (p<0.05). In the group that received AZA on 30 days of LTB there was no significantly difference in mucus properties (p>0.05) compared with the RIB groups (with and without AZA). We concluded that AZA led to a temporary marked impairment of MCT, while this occurrence was maintained up to 30 days in the transected bronchus. In addition, AZA contributes to preventing alterations in the mucus surface properties

Conséquence de l’insuffisance du traitement judiciaire des difficultés des entreprises, le droit de la prévention connaît un attrait de plus en plus important. En droit français et en droit Ohada, la loi du 26 juillet 2005 et l’acte uniforme portant procédure collectives d’apurement du passif ont mis l’accent sur les solutions négociées en vue de redresser la courbe des nombreuses défaillances d’entreprise. Malgré la richesse de l’ensemble des systèmes de prévention au regard du nombre important des mesures incitatives instituées en faveur du débiteur et des créanciers, la confrontation du système français de prévention et du système Ohada de prévention appelle à des résultats mitigés. Même si des deux systèmes le système français de prévention apparaît le plus structuré et le mieux organisé et donc appelé à servir de modèle au droit Ohada, force est de constater que l’objectif de sauvetage poursuivi par les deux législateurs est loin d’être atteint. Dans les faits, le nombre des défaillances d’entreprise augmente de manière considérable, ce qui traduit à l’évidence le caractère inefficace des différents mécanismes juridiques de prévention proposés. Par conséquent, une réforme de l’ensemble des dispositifs de prévention dans les deux ordres juridiques s’impose inéluctablement. Au delà, de l’approche comparative qu’impose ce sujet, il a surtout pour ambition de s’inscrire dans une approche nouvelle du droit des entreprises en difficultés qui prône désormais la contractualisation de la matière afin de la rendre efficace / Due to the inadequate judicial processing of difficulties encountered by enterprises today, the right to prevention is becoming more and more attractive. In France as in Ohada, the law of July 26 2005 and the uniform act concerning collective procedures of passive clearance have stressed the importance of the negociated solutions in order to straighten the curve of the numerous company failures. On account of incitative mesures in favor of debtors and creditors, the confrontation of the French prevention system and the Ohada prevention system have limited results despite the quality of the various prevention systems. Even though the French prevention system, which appears to be better structured and better organized, serves as a model to the juidicial system of Ohada, it must be noted that both legislators are far from achieving their goals. In fact, company failures are increasing rapidly, highlighting the ineffectiveness of the judicial prevention mecanisms that have been proposed until now. Consequently, a reform of all prevention devices in both judicial orders is required. Moreover, the comparative approach set by this matter's principle aim is to develop a new approach in company law which henceforth advocates contractualization of the matter in order to make it more effective.

INTRODUÇÃO: O transplante traqueal continua um desafio. Contudo, avanços nas técnicas de revascularização dos enxertos traqueais e no conhecimento da imunobiologia da traquéia, indicam que esta técnica pode ser utilizada com freqüência no futuro próximo. A depuração mucociliar (DM) é o mecanismo de defesa inato mais importante das vias aéreas. A traquéia age como um órgão de defesa devido à DM. A DM ocorre por ação do batimento ciliar do epitélio respiratório que impele o muco que atapeta as vias respiratórias, carreando substâncias nocivas. Idealmente, a DM deve ser preservada em enxertos traqueais passíveis de utilização para transplante traqueal. Nosso intuito foi: 1) avaliar os efeitos da isquemia fria sobre a DM; e 2) avaliar a ação de soluções de preservação administradas por via tópica na manutenção da DM após isquemia fria. MÉTODOS: De 109 ratos Wistar foram obtidos 217 segmentos traqueais. Os segmentos foram distribuídos entre três grupos experimentais e um grupo Controle. Cada segmento foi submergido em LPD-glicose (grupo LPD), histidina-triptofano-cetoglutarato (grupo HTK) ou solução salina (grupo Salina). Avaliou-se a DM após 6,10,16 ou 24 horas de isquemia fria. No grupo Controle os segmentos foram analisados imediatamente após a extração, não havendo isquemia fria, nem submersão em soluções. A velocidade de transporte mucociliar (VTM) foi medida através de microscópio de luz, pela observação do movimento das partículas de muco na superfície dos segmentos traqueais. A freqüência de batimento ciliar (FBC) foi obtida pela sincronização entre o movimento ciliar observado pelo microscópio de luz e um estroboscópio. Em seguida, os segmentos foram corados com hematoxilina-eosina para analisar a integridade epitelial (IE) e a inflamação subepitelial (IS). Foi realizada análise quantitativa do muco intracelular por um programa de computador após coloração com azul de alcião (MI-AA) e PAS (MI-PAS). As amostras mais significativas foram analisadas qualitativamente por microscopia eletrônica de transmissão (ME). Foram realizadas duas análises: 1) grupo Controle e tempos de isquemia; e 2) grupo Controle e soluções de preservação (agrupado pelo tempo de isquemia). RESULTADOS: 1) grupo Controle e tempos de isquemia: O grupo controle foi melhor que os grupos submetidos a isquemia fria quanto à VTM (p=0,0001) e FBC (p=0,012). Contudo, não houve diferença na IE, IS e MI entre o grupo Controle e os demais grupos. 2) grupo Controle e soluções de preservação: O grupo controle apresentou melhor VTM que os grupos LPD, HTK e Salina após isquemia de 6h (p=0,001), 16h (p=0,009) e 24h (p=0,001). O grupo controle apresentou melhor FBC que os grupos LPD, HTK e Salina após isquemia de 24h (p=0,001). Não houve diferença entre os grupos na IE e IS. O grupo Controle apresentou melhor MI-AA que os grupos LPD após 16h (p=0,02) e HTK após 24h de isquemia (p=0,04). Não houve diferença entre os grupos à MI-PAS. À ME, o grupo Salina apresentou maiores alterações secundárias à isquemia do que os demais grupos. CONCLUSÕES: 1) A isquemia fria piora a DM; e 2) O uso de soluções de preservação administradas por via tópica não contribui para manutenção da DM após isquemia fria / INTRODUCTION: Tracheal transplantation is a challenging problem. Recent advances in graft revascularization, and reepithelialization renewed the interest on airway transplantation. Mucociliary clearance (MC) is the most important innate defense mechanism of the respiratory system. MC works by mucous transport carried out by ciliary beating function of the airway epithelium. Trachea acts as a defense organ in the respiratory system through the MC. Ideally, MC should be preserved in tracheal grafts used for transplantation. Preservation solutions improve organ preservation by decreasing ischemic injury. The purpose of the study was: 1) to evaluate the effects of cold ischemia on MC; and 2) to evaluate the impact of topically-applied preservation solutions on MC after cold ischemia. METHODS: From 109 male Wistar rats we obtained 217 tracheal segments. The segments were allocated to one of four groups. Segments were submerged in LPD-glucose (LPD group), histidine-tryptophan-ketoglutarate (HTK group), or saline solution (Saline group), and stored at 4C. MC was analyzed after 6, 10, 16 or 24h of ischemia. Control group have only segments that were analyzed right after extraction, not submitted to cold ischemia or submersion in preservation solutions. The mucociliary transport velocity (MTV) was measured by observation of mucous particle under the surface of the segments, through a light microscope. Ciliary beating frequency (CBF) was achieved by synchronization between cilia movement and a stroboscope flashlight. Tracheas were stained with hematoxylin-eosin in order to analyze the epithelial integrity (EI) and the subepithelial inflammation (SI). A quantitative analysis of the intracellular mucus stained with alcian blue (IM -AB) and PAS (IM-PAS) was achieved by a software. The most significant samples of the tracheal segments were qualitatively analyzed by transmission electronic microscopy (TEM). Two analyses were made: 1) Control group and ischemic time; and 2) Control group and preservation solutions. RESULTS: 1) Control group and ischemic time: Control group had better VTM (p=0,0001) and CBF (p=0,012) than the groups submitted to cold ischemia. However, there was no difference among Control group and the other groups on EI, SI, IM-AB, and IM-PAS. 2) Control group and preservation solutions: Control group showed better MTV than the LPD, HTK, and Saline groups after 6h (p=0,001), 16h (p=0,009) and 24h (p=0,001) of cold ischemia. Control group showed better CBF than the LPD, HTK, and Saline groups after 24h of ischemia (p=0,001). There was no difference among groups on EI and SI. Control group showed better IM-AB than both the LPD group after 16h of cold ischemia (p=0,02), and the HTK group after 24h of cold ischemia (p=0,04). There was no difference among the groups on IM-PAS. TEM showed more findings of ischemic lesion on Saline group. CONCLUSIONS: 1) Cold ischemia impairs MC; and 2) Topically-applied preservation solutions do not ameliorate MC after cold ischemia

Introdução: Uma imunossupressão eficaz é fundamental para a sobrevivência do paciente após o transplante de pulmão. Estudos prévios demonstraram que drogas imunossupressoras como ciclosporina A, tacrolimo, micofenolato de sódio e prednisona prejudicaram a depuração das vias aéreas de ratos. Para prevenir a rejeição aguda, o basiliximab tem sido utilizado como terapia de indução previamente ao transplante de pulmão em muitos centros ao redor do mundo. Entretanto, existem poucos trabalhos reportando seus efeitos adversos. Objetivo: Avaliar se o basiliximab isolado e em conjunto com a terapia tríplice (tacrolimo, micofenolato de sódio e prednisona) causa efeitos adversos no aparelho mucociliar traqueobrônquico, alterando a depuração mucociliar das vias aéreas de ratos. Método: Oitenta ratos foram distribuídos em quatro grupos conforme o tratamento: Controle, Basiliximab, Tríplice e Basiliximab+Tríplice; e dois subgrupos de acordo com o tempo de tratamento: 7 e 15 dias. Após o período de tratamento, os animais foram eutanasiados e as seguintes análises foram realizadas: análise do lavado broncoalveolar, frequência de batimento ciliar (FBC), velocidade de transporte mucociliar (VTMC), transportabilidade do muco in vitro, histologia, expressão do gene Muc5ac, concentração da proteína mucina do gene Muc5ac e avaliação de apoptose celular no epitélio das vias aéreas. Resultados: Não houve alteração do número de leucócitos no lavado broncoalveolar e da FBC entre os grupos. Já a VTMC foi menor nos grupos Basiliximab e Basiliximab+Tríplice tratados por 7 dias, enquanto nos animais tratados por 15 dias a velocidade foi menor nos grupos Trípice e Basiliximab+Tríplice. O transporte do muco in vitro foi menor no grupo Basiliximab+Tríplice tratado por 15 dias. A porcentagem dos mucos ácido e neutro não foi diferente entre os grupos tratados por 7 e 15 dias, o mesmo ocorreu para a expressão e concentração da proteína mucina do gene Muc5ac. Os grupos Tríplice e Basiliximab+Tríplice tratados por 7 e 15 dias, respectivamente, apresentaram número maior de células apoptóticas no epitélio da via aérea. Conclusão: A droga basiliximab, isolada e em conjunto com a terapia tríplice, prejudicou o aparelho mucociliar traqueobrônquico de ratos, especificamente a depuração mucociliar / Introduction: Optimal immunosuppression is critical to the survival of the patient after lung transplantation. Previous studies showed that immunosuppressive drugs such as cyclosporine, tacrolimus, sodium mycophenolate and prednisone impaired mucociliary clearance of rats. To prevent acute rejection, basiliximab has been used as induction therapy before lung transplantation in many centers around the world. However, there are few studies reporting its side effects. Objective: Evaluate if basiliximab alone and in combination with triple therapy (tacrolimus, sodium mycophenolate and prednisone) causes adverse effects on the tracheobronchial mucociliary apparatus by impairing airways mucociliary clearance of rats. Method: Eighty rats were divided into four groups according to treatment: Control, Basiliximab, Triple and Basiliximab+Triple; and according to the treatment time: 7 and 15 days. After the treatment period, the animals were euthanized and the following analyzes were performed: bronchoalveolar lavage, ciliary beating frequency (CBF), mucociliary transport velocity (MCTV), mucus transportability rate in vitro, hystology, Muc5ac gene expression, concentration of the mucin protein of the Muc5ac gene and evaluation of cellular apoptosis in the airway epithelium. Results: There was no alteration in the number of leukocytes in the bronchoalveolar lavage fluid and the CBF between groups. The MCTV was lower in the Basiliximab and Basiliximab+Triple groups treated for 7 days, while the velocity was lower in the Triple and Basiliximab+Triple groups treated for 15 days. The mucus transportability rate in vitro was lower in the Basiliximab+Triple group treated for 15 days. There was no difference in percentage of both acidic mucus and neutral mucus between groups treated for 7 and 15 days. Also, there was no difference in the expression and concentration of the mucin of the Muc5ac gene. The Triple and Basiliximab+Triple groups treated for 7 and 15 days, respectively, had a higher number of apoptotic cells in the airway epithelium. Conclusion: The basiliximab, alone and in conjunction with triple therapy, impaired the tracheobronchial mucociliary apparatus of rats, specifically the mucociliary clearance

A pressão positiva contínua nas vias aéreas (CPAP) é o tratamento de escolha para pacientes com Apnéia Obstrutiva do Sono, mas muitos sintomas nasais conseqüentes da terapia são relatados. Vazamentos aéreos pela boca e alterações do epitélio respiratório são importantes no desenvolvimento de sintomas nasais e a umidificação aquecida é utilizada no alívio destes sintomas. O objetivo deste trabalho foi o de investigar os efeito agudos do nCPAP e o impacto da umidificação aquecida e vazamento aéreo no transporte mucociliar e inflamação nasal de indivíduos sadios. Para este fim avaliamos o transporte mucociliar nasal in vivo (através do Teste da Sacarina), a transportabilidade in vitro do muco nasal (através do Método Palato de Rã), lavado nasal e sintomas respiratórios (através de uma Escala Visual Analógica) de dezesseis indivíduos sadios antes e após aplicação aguda do CPAP sobre diferentes condições: CPAP com e sem umidificação aquecida e CPAP com e sem vazamento aéreo. O transporte mucociiar nasal in vivo aumentou significativamente após todas as intervenções com CPAP. Não houve diferença significativa da transportabilidade do muco, contagem total e diferencial de células inflamatórias provenientes do lavado nasal após nenhuma das intervenções com o CPAP. Houve um aumento significante da percepção subjetiva dos sintomas respiratórios estudados após o uso do CPAP sem umidificação e com vazamento aéreo. Concluimos que o uso agudo do CPAP independente da umidificação ou vazamento aéreo, aumenta significativamente o transporte mucociliar nasal in vivo, não altera significativamente a transportabilidade do muco nasal nem a composição celular de amostras de lavado nasal. Já o uso do CPAP sem umidificação e com vazamento aéreo causa aumento significativo dos sintomas de ressecamento nasal e de garganta, coriza e obstrução nasal. / Continuous positive airway pressure (CPAP) is the treatment of choice for patients with Obstructive Sleep Apnea but yet nasal symptoms are often reported. Air leaks and changes of the respiratory epithelium are important in the development of nasal symptoms and heated humidification is used to alleviate these symptoms. The aim of this study was to investigate the acute effects of CPAP and the impact of heated humidification and air leak on the nasal mucociliary clearance and nasal inflammation of healthy volunteers. To this end we evaluated nasal mucociliary clearance in vivo (through the Saccharin Test), in vitro nasal mucus transportability (through the Frog Palate Model), nasal lavage and respiratory symptoms (through a Visual Analogue Scale) of sixteen healthy volunteers before and after acute CPAP application under different conditions: CPAP with and without heated humidification and with and without air leak. In vivo nasal mucociliary clearance increased significantly after all CPAP interventions. There was no significant difference in mucus transportability, total or differential inflammatory cell count from the nasal lavage after any CPAP intervention. There was a significant increase in the subjective perception of the respiratory symptoms studied after the use of CPAP without humidification and with air leak. We conclude that the acute use of CPAP independently of humidification or air leak significantly increases in vivo nasal mucociliary clearance, doesn\'t change mucus transportability and total or differential cell count. However, the use o CPAP without humidification and with air leak significantly increased nasal and throat dryness, coryza and nasal obstruction subjective perception.

Transportation agencies are introducing new strategies and techniques that will improve traffic incident management. Apart from other indicators, agencies measure the performance of the strategies by evaluating the incidents timeline. An effective strategy has to reduce the length of the incident timeline. An incident timeline comprises various stages in the incident management procedure, starting when the incident was detected, and ending when there is the recovery of normal traffic conditions. This thesis addresses three issues that are related to the traffic incident timeline and the incident management strategies. First, co-location of responding agencies has not been investigated as other incident management measures. Co-location of incident responders affects the incident timeline, but there is a scarcity of literature on the magnitude of the effects. Evaluation of the co-location strategy is reflected by the response and verification durations because its effectiveness relies on improving communication between agencies. Investigation of the response and verification duration of incidents, before and after operations of a co-located Traffic Management Center (TMC) is done by using hazard-based models. Results indicate that the incident type, percentage of the lane closure, number of responders, incident severity, detection methods, and day-of-the-week influence the verification duration for both the before- and after- period. Similarly, incident type, lane closure, number of responders, incident severity, time-of-the-day, and detection method influence the response duration for both study periods. The before and after comparison shows significant improvements in the response duration due to co-location of incident response agencies. Second, the incident clearance duration may not necessarily reflect how different types of incidents and various factors affect traffic conditions. The duration at which the incident influences traffic conditions could vary – shorter than the incident duration for some incidents and longer for others. This study introduces a performance measure called incident impact duration and demonstrates a method that was used for estimating it. Also, this study investigated the effects of using incident impact duration compared to the traditionally incident clearance duration in incident modeling. Using hazard-based models, the study analyzed factors that affect the estimated incident impact duration and the incident clearance duration. Results indicate that incident detection methods, the number of responders, Traffic Management Center (TMC) operations, traffic conditions, towing and emergency services influence the duration of an incident. Third, elements of the incident timeline before the clearance duration have been overlooked as factors that influence the clearance duration. Incident elements before the clearance duration include verification time, dispatch duration, and the travel time of responders to the incident scene. This study investigated the influence of incident timeline elements before clearance on the extent of the clearance duration. Also, this study analyzed the impact of other spatial and temporal attributes on the clearance duration. The analysis used a Cox regression model that is estimated using the Least Absolute Shrinkage and Selection Operator (LASSO) penalization method. LASSO enables variable selection from incidents data with a high number of covariates by automatically and simultaneously selecting variables and estimating the coefficients. Results suggest that verification duration, response travel duration, the percentage of lane closure, incident type, the severity of an incident, detection method, and crash location influence the clearance duration.

<p>From the pre-Roman and Roman Iron Age, a number of different fossil agrarian landscapes can be found in southern Sweden - clearance cairn areas, celtic fields, stone-wall complexes and geometrically laid-out strip fields. With two different comparative analyses, this paper tries to explain some of the differences between clearance cairn systems and the other fossil field systems</p><p>The shape of the early Iron Age agrarian landscape varies between different provinces of southern Sweden. At Gotland, celtic field systems were laid-out before 500 BC. In Småland at the same time, areas with clearance cairns were created. How can the difference be explained? The different physical appearance of clearance cairn areas and celtic fields can be explained by the different ways to handle the ard in till and in sandy soil. In sandy soils, and other fine soils, the ard will at each turn deposit small amounts of roots, soil and debris at the edge of the field, which over the years will build up the walls of the celtic fields. But in boulder-rich soil the ard will constantly have to be lifted and tilted, which means that the material will be released before the ard reaches the edge of the field. Since crops, vegetation, houses, field system areas, etc. are identical or at least similar in both landscape types, they most likely represent the same farming system with hay-meadow – stabling – manure – intensely cultivated fields</p><p>In most provinces in southern Sweden, the pre-roman celtic fields and clearance cairn areas were replaced by geometrically laid-out strip fields or different kinds of stone-wall complexes enclosing the fields and farms, around AD 200, but not in Småland. There, the clearance cairn areas were used and extended throughout the Iron Age. How can this regional variation be explained? A comparison between the different landscape types reveals no significant differences in tools, crops, houses, etc. that would support that the difference is explained by a shift in farming systems. A more likely hypothesis is that the difference is due to regional pre-state or early-state political structures with an ambition to control land-use. This is based on the observations that 1) within each region the physical appearance of the fossil landscape is very coherent; 2) between the different regions there are significant differences, and; 3) the different systems were introduced approximately simultaneously in the regions Gotland, Öland, Östergötland, Uppland and Västergötland. This hypothesis implies that Småland either had a separate political structure which chose to keep the old clearance cairn land-use system, or lacked a corresponding regional structure.</p>

Vortrag im Rahmen der Open Access Tage 2013, Session "Rechtliche Aspekte des Open Access": Bereits in der „Budapest Open Access Initiative“, dem „Bethesda Statement on Open Access Publishing“ und der „Berliner Erklärung über offenen Zugang zu wissenschaftlichem Wissen“ wird die rechtliche Dimension von Open Access deutlich: Wissenschaftliche Werke sollen nicht nur zugänglich sondern nach nachnutzbar sein. Bei der Umsetzung des Grünen Weges des Open Access kann diese Nachnutzung nur selten umgesetzt werden, da wissenschaftliche AutorInnen im Rahmen von „Copyright Transfer Agreements“ mehrheitlich ausschließliche Nutzungsrechte an Verlage übertragen. Das sich in der politischen Diskussion befindliche Zweitveröffentlichungsrecht würde wissenschaftliche AutorInnen die rechtssichere Zugänglichmachung ihrer Werke auf Repositorien gewähren und damit einen wichtigen Beitrag zur Förderung von Open Access leisten. Vor dem Hintergrund der anhaltenden Diskussion um ein wissenschaftsfreundliches Urheberrecht und der Verankerung eines unabdingbaren Zweitveröffentlichungsrechts widmet sich die Session den rechtlichen Aspekten von Open Access. Referiert und diskutiert werden u.a. die Chancen und Herausforderungen von nicht-exklusiven Verwertungsgesellschaften im Wissenschaftsbereich sowie der Stand und die Perspektive des Zweitveröffentlichungsrechts. Darüber hinaus wird die praktische Umsetzung des Grünen Weges betrachtet: Am Beispiel der SLUB Dresden und dem DINI-Zertifikat 2013 wird der Umgang mit rechtliche Fragestellungen skizziert und mit den TeilnehmerInnen diskutiert. Vortrag 1 C3S: Cultural Commons Collecting Society – auch ein Modell für den Textbereich? Michael Weller (Europäische EDV-Akademie des Rechts, Merzig/Saar) Vortrag 2 Neues gesetzliches Zweitveröffentlichungsrecht – Update zu den Anforderungen an Bibliotheken und Wissenschaftseinrichtungen Thomas Hartmann (Max Planck Digital Library, München) Vortrag 3 Rechteklärung für OA-Zweitveröffentlichungen – das Serviceangebot der SLUB Dresden Elena Di Rosa (Sächsische Landesbibliothek - Staats- und Universitätsbibliothek, Dresden) Vortrag 4 DINI-Zertifikat 2013 – Neuerungen im Abschnitt Rechtliche Aspekte Michaela Voigt (Sächsische Landesbibliothek - Staats- und Universitätsbibliothek, Dresden)