bluuebunny/crossref_metadata_2025 huggingface dataset:
Psicologia na Atenção Básica à Saúde: demanda, território e integralidade
Authors: Jimenez Luciene
Published: March 2012

O início do exercício da psicologia nos serviços brasileiros de Atenção Básica à Saúde (UBS) aconteceu na década de 1980. Na década seguinte, sob inúmeras críticas a uma prática individualizante, deu-se sua exclusão formal da Estratégia Saúde da Família, o que não impediu a realização de trabalhos. Neste artigo, o relato de uma análise da demanda no ano de 1996, realizada a partir de anamneses em grupos e do referencial da psicologia/análise institucional, revelou a importância das disputas sobre o território e do histórico das instituições na constituição da demanda de crianças e adolescentes para a saúde mental em uma UBS da periferia da grande São Paulo. O relato apresentado e a retomada formal da psicologia na Atenção Básica por meio dos Núcleos de Apoio à Saúde da Família (2008) apontam para o desafio de revitalizar os tradicionais instrumentos agregando-os à complexidade dos territórios e à busca pela integralidade.
"Cada Caps é um Caps": uma coanálise dos recursos, meios e normas presentes nas atividades dos trabalhadores de saúde mental
Authors: Ramminger Tatiana , Brito Jussara Cruz de
Published: March 2012

Este artigo propõe uma ampliação de diálogo em um duplo sentido. Diálogo entre os campos da Saúde Mental e da Saúde do Trabalhador e diálogo entre os pesquisadores e os trabalhadores. Valendo-se do dispositivo metodológico da Comunidade Ampliada de Pesquisa, colocamos em diálogo os saberes acadêmicos e os saberes da experiência cotidiana dos trabalhadores dos Centros de Atenção Psicossocial (Caps), visando compreender quais são os recursos, meios e normas disponíveis para o desenvolvimento do trabalho em saúde mental. Percebemos o quanto os trabalhadores de saúde mental têm que ser engenhosos em suas atividades, fazendo a gestão de inúmeras normas conflitantes (burocracia administrativa X plasticidade, oferta do serviço X demanda dos usuários, demanda dos gestores municipais X demanda do gestor estadual, Caps X ambulatório, etc.), muitas vezes sem os recursos e meios fundamentais para a realização de suas atividades, fragilizando e exaurindo o trabalhador em um "uso exarcebado de si".
Micropolítica em saúde mental: um processo histórico em uma instituição de saúde
Authors: Garcia Jr. Carlos Alberto Severo , Furlan Filipe Caldeira , Borges Vivian Roxo , Pasini Vera Lucia
Published: March 2012

Este artigo apresenta uma reflexão dentro do campo da saúde mental, considerada aqui enquanto produção histórica correlata a uma instituição de atenção e ensino em saúde no município de Porto Alegre-RS. O caminho percorrido remonta a construção das bases da atenção à saúde mental através de uma aproximação de uma abordagem metodológica cartográfica. Analisamos as relações de forças que perpassam os acontecimentos históricos. Identificamos, ainda, os cruzamentos e distanciamentos em interface ao cenário nacional. Para tanto nos utilizamos de um arcabouço teórico situado em Mario Testa. Nessa construção histórica, procuramos colocar em análise os poderes técnico, político e administrativo que constituem as produções em saúde mental. Neste percurso, concluímos com alguns encontros que nos mostram uma imagem do grupo hospitalar atravessado por diversas instituições: o modelo privado, o modelo público, a saúde mental e a psiquiatria tradicional.
Characterization of non-calcareous "thin" red clay from south-eastern Brazil: applicability in wall tile manufacture
Authors: Sousa S. J. G. , Holanda J. N. F.
Published: March 2012

In this work the use of "thin" red clay from south-eastern Brazil (Campos dos Goytacazes, RJ) as raw material for the manufacture of wall tile was investigated. A wide range of characterization techniques was employed, including X-ray diffraction (XRD), X-ray fluorescence (XRF), scanning electron microscopy (SEM), grain-size analysis, and thermogravimetric analysis. The wall tile body was prepared by the dry process. The tile pieces were uniaxially pressed and fired between 1080 - 1180 ºC using a fast-firing cycle. The following technological properties were determined: linear shrinkage, water absorption, apparent density, and flexural strength. The development of the microstructure was followed by SEM and XRD analyses. It was found that the "thin" red clay is kaolinitic type containing a substantial amount of quartz. The results also showed that the "thin" red clay could be used in the manufacture of wall tiles, as they present properties compatible with those specified for class BIII of ISO 13006 standard.
Caracterização dos resíduos cauliníticos das indústrias de mineração de caulim da amazônia como matéria-prima para produção de pozolanas de alta reatividade
Authors: Barata M. S. , Angélica R. S.
Published: March 2012

As regiões do Rio Capim e do Rio Jari são os principais distritos caulinitícos da Região Amazônica, detentores das maiores reservas brasileiras de caulim de alta qualidade para aplicações como cobertura de papel. O caulim é lavrado e beneficiado por três grandes companhias que são responsáveis pela geração de aproximadamente 500 mil de toneladas anuais de um resíduo decorrente da etapa de centrifugação. Esse resíduo, na forma de polpa, é depositado em lagoas de sedimentação que ocupam grandes extensões de áreas. O objetivo da pesquisa foi investigar as características físicas, químicas e mineralógicas dos resíduos processados da Região do Jari e do Capim, de modo a avaliar se atendem aos requisitos como matéria-prima para a produção de uma pozolana de alta reatividade, o metacaulim, adição mineral que incorporada ao cimento Portland proporciona alto desempenho às misturas de concreto e argamassas. Os resíduos foram caracterizados por difração de raios X, análise térmica, espectroscopia de infravermelho, microscopia eletrônica de varredura, fluorescência de raios X e difração a laser. Ambos os resíduos são constituídos por no mínimo 92% de caulinita de baixa granulometria, cujas áreas superficiais específicas são superiores a 8 m²/g e os diâmetros médios de partículas inferiores a 1 µm. Os teores de sílica livre (quartzo) não foram superiores a 3%. O alto grau de concentração de caulinita destes resíduos dispensa os rígidos parâmetros de controle de remoção de impurezas, normalmente empregados na produção deste tipo de pozolana. O caulim do Rio Jari, com quantidade de defeitos na estrutura cristalina superior ao da caulinita do Rio Capim, proporcinou maior grau de desidroxilação a uma temperatura mais baixa quando calcinado, indicando a possibilidade de redução de gastos com energia para a produção da adição mineral. Os resultados das análises foram convergentes e apontam ambos os caulins estudados como excelentes matérias-primas para a produção do metacaulim de alta reatividade.
Modificação da estabilidade dos polimorfos de TiO2 nanométrico pelo excesso de superfície de SnO2
Authors: Matioli A. , Miagava J. , Gouvêa D.
Published: March 2012

Vários óxidos de uso cerâmico têm fases cristalinas estáveis somente quando suas partículas são nanométricas. O TiO2 em sua forma anatase é estável para partículas nanométricas enquanto que a fase rutilo é estável para partículas maiores. Isto ocorre devido às energias de superfície que modificam a energia total do sistema e a estabilidade das fases. A energia de superfície por sua vez pode ser alterada devido à distribuição não uniforme de aditivos, como nos efeitos de segregação. Neste trabalho foi estudado a ação do SnO2 na estabilidade das fases do TiO2 nanométrico preparado pelo método dos precursores poliméricos derivado do método Pechini. Verifica-se que existe um forte efeito na estabilidade das fases anatase e rutilo com relação à concentração de SnO2 ao mesmo tempo que várias propriedades de superfície são alteradas bem como uma forte alteração dos tamanhos de partículas indicando que mesmo não existindo grandes diferenças de carga e tamanho entre os dois cátions, um fenômeno de superfície pode estar por trás da estabilidade das fases cristalinas.
Caracterização tecnológica da argila plástica de Pântano Grande, RS
Authors: Cruz R. T. da , Bergmann C. P. , Bragança S. R.
Published: March 2012

A região de Pântano Grande, RS, é conhecida pela qualidade de seus caulins. Nesta região, incluindo-se as cercanias das cidades de Gravataí e Viamão, encontra-se uma argila plástica de cor de queima clara, mas com característica refratária. Ressalva-se a importância desta argila, pela dificuldade de se obter argilas plásticas a distâncias convenientes para indústria cerâmica. Neste trabalho, foi realizada a caracterização tecnológica desta argila. As propriedades de queima foram avaliadas para a faixa de temperatura de 1200 ºC a 1400 ºC, incluindo-se uma mistura com uma argila refratária e queima a 1300 ºC. Após, investigou-se o comportamento de gresificação por meio de misturas com fundentes sódicos, potássicos e cálcicos, analisando-se também a resistência mecânica à flexão. Deste modo, obteve-se a completa caracterização da referida argila, destacando-se o potencial de aplicação da mesma.
Comparação entre os métodos de aplicação de fluido de corte convencional e otimizado na retificação plana de cerâmicas
Authors: Iceri D. M. , Sousa R. M. e , Destro R. S. , Oikawa M. H. , Bianchi E. C. , Aguiar P. R. de , Fortulan C. A.
Published: March 2012

Com o grande crescimento tecnológico e a necessidade de melhoria, um dos materiais que ganhou uma grande gama na área da engenharia mecânica é a cerâmica, pois possui vantagens físico-químicas e propriedades mecânicas significativas sobre o aço. Entretanto, sua usinagem é um processo difícil e delicado, que requer ainda uma grande atenção em relação ao seu estudo. Assim, o processo de retificação é um dos métodos que tem apresentado bons resultados, porém um grande problema acerca de tal processo é o uso excessivo de fluidos de corte, o que se tornou uma preocupação mundial, já que os fluidos apresentam graves problemas socioambientais, além disso, o fluido de corte é responsável por uma grande parte do custo final do processo, provocando, desse modo, um grande interesse em pesquisas referentes a métodos alternativos de forma a reduzir o consumo e melhorar as características do fluido de corte utilizado. Este trabalho visa comparar duas técnicas de lubri-refrigeração, o método convencional e a Lubrificação Otimizada. O uso do método otimizado é uma alternativa à diminuição do volume de fluido utilizado, já que este tem como princípio a aplicação de uma menor quantidade de fluido de corte com uma alta velocidade, localmente aplicada, ou seja, com essa redução benefícios ambientais e socioeconômicas são obtidos. A análise do trabalho será feita a partir da avaliação das variáveis de saída do processo de retificação plana tais como o comportamento rugosidade e desgaste do rebolo, já que por elas é possível avaliar o processo em relação a qualidade da peça versus custo. Com essas analises, pretende-se avaliar se a técnica otimizada é viável a substituição da refrigeração convencional na retificação plana de cerâmicas.
Estudo das reações alcalis-sílica associadas ao uso da lama vermelha em argamassas colantes e de revestimento
Authors: Ribeiro D. V. , Silva A. M. S. , Labrincha J. A. , Morelli M. R.
Published: March 2012

A incorporação de resíduos industriais em matrizes cimentícias, com o objetivo de inertização, é uma alternativa de reutilização que tem sido bastante estudada nos últimos anos. No presente trabalho, estudou-se a lama vermelha, resíduo sólido gerado no processo de beneficiamento da bauxita e que, devido a seu elevado pH, é considerado "perigoso". Apesar do uso deste resíduo ter sido reportada em trabalhos anteriores, algumas patologias podem estar associadas à sua utilização, devido à elevada concentração de íons alcalinos (principalmente o sódio), favorecendo as reações álcalis-sílica (RAS) e às dificuldades de moldagem (reologia) devido à elevada finura deste resíduo. Apesar destes prováveis problemas provenientes do uso indiscriminado da lama vermelha como adição às argamassas e concretos, ainda são poucas as pesquisas que os contemplam, sendo este o foco do presente trabalho. Foram verificadas as propriedades reológicas das argamassas, utilizando um reômetro e a avaliação da RAS, de acordo com as normas ASTM C 1260-07 e NBR 11582. Os resultados obtidos foram bastante satisfatórios quanto ao comportamento das argamassas frente à RAS, apesar da elevada concentração de álcalis na lama vermelha, com grande influência reológica.
Efeito das propriedades dos esmaltes e engobes sobre a curvatura de revestimentos cerâmicos
Authors: Dal Bó M. , Melchiades F. G. , Boschi A. O. , Hotza D.
Published: March 2012

As interações entre suporte-esmalte e suporte-engobe foram estudadas separadamente frente à curvatura central de revestimentos cerâmicos. Formularam-se duas amostras de esmaltes e quatro amostras de engobes cerâmicos, as quais foram aplicadas sobre um determinado tipo de suporte cerâmico com classificação dentro do grupo B-IIb, pela norma ABNT NBR 13.818/1997 - ISO 13006. Foram mensuradas características como "coeficiente de expansão térmica linear" e "diferença de retração entre suporte-engobe".Foi proposto um método para a avaliação da interação entre o suporte-esmalte e suporte-engobe. Os resultados evidenciaram que, para a interação suporte-esmalte o método de sobreposição de curvas dilatométricas foi aplicado; para a interação suporte-engobe, realizando um teste estatístico com planejamento fatorial 2², evidenciou-se que a variável "diferença de retração linear" entre o suporte e o engobe é a variável significativa para descrever a curvatura central de revestimentos cerâmicos.
Distintos enfoques sobre esteroides anabolizantes: riscos à saúde e hipermasculinidade
Authors: Cecchetto Fátima , Moraes Danielle Ribeiro de , Farias Patrícia Silveira de
Published: March 2012

Abordam-se dois enfoques sobre o uso de esteroides anabólicos androgênicos (EAA): o primeiro encontra-se na literatura biomédica, centrada em seus efeitos na saúde de homens jovens; o segundo refere-se aos próprios usuários, focalizando os aspectos socioculturais do consumo. Foi utilizada metodologia qualitativa a partir da análise de dois tipos de material: (i) artigos da área biomédica; (ii) material de pesquisas realizadas entre 2001 e 2004, incluindo etnografia e entrevistas semiestruturadas com 19 homens praticantes de jiu-jítsu no Rio de Janeiro. Os resultados indicam um descompasso entre o enfoque biomédico, que condena o uso considerado não terapêutico de EAA e as representações e práticas dos usuários que recorrem a essas substâncias com o objetivo de aprimoramento da força e da musculosidade. Conclui-se que a relação entre o consumo de substâncias anabolizantes e a construção social da masculinidade precisa ser mais estudada no âmbito da saúde pública.
Phase II Study of Bevacizumab in Combination with Trastuzumab and Capecitabine as First-Line Treatment for HER-2-positive Locally Recurrent or Metastatic Breast Cancer
Authors: Martín Miguel , Makhson Anatoly , Gligorov Joseph , Lichinitser Mikhail , Lluch Ana , Semiglazov Vladimir , Scotto Nana , Mitchell Lada , Tjulandin Sergei
Published: March 2012

We report the first results from a phase II, open-label study designed to evaluate the efficacy and safety of bevacizumab in combination with trastuzumab and capecitabine as first-line therapy for human epidermal growth factor receptor (HER)-2-positive locally recurrent (LR) or metastatic breast cancer (MBC). Patients were aged ≥18 years with confirmed breast adenocarcinoma, measurable LR/MBC and documented HER-2-positive disease. Patients received bevacizumab (15 mg/kg on day 1) plus trastuzumab (8 mg/kg on day 1 of cycle 1, 6 mg/kg on day 1 of each subsequent cycle) plus capecitabine (1,000 mg/m2 twice daily, days 1–14) every 3 weeks until disease progression, unacceptable toxicity, or consent withdrawal. Eighty-eight patients were enrolled; 40 (46%) are still on study treatment. The median follow-up was 8.8 months (range, 0.9–17.1 months). The overall response rate, the primary endpoint, was 73% (95% confidence interval [CI], 62%–82%), comprising 7% complete and 66% partial responses. The median progression-free survival interval was 14.4 months (95% CI, 10.4 months to not reached [NR]), with 35 events. The median time to progression was 14.5 months (95% CI, 10.5 months to NR), with 33 events. Treatment was well tolerated; main side effects were grade 3 hand–foot syndrome (22%), grade ≥3 diarrhea (9%), and grade ≥3 hypertension (7%). Overall, 44% of patients experienced grade ≥3 treatment-related adverse events and 13 patients discontinued capecitabine because of toxicity, but continued with bevacizumab and trastuzumab. Heart failure was seen in two patients. The combination of bevacizumab, trastuzumab, and capecitabine was clinically active as first-line therapy for patients with HER-2-positive MBC, with an acceptable safety profile and no unexpected toxicities.
Insects, Insecticides and Hormesis: Evidence and Considerations for Study
Authors: Cutler G. Christopher
Published: March 2012

Insects are ubiquitous, crucial components of almost all terrestrial and fresh water ecosystems. In agricultural settings they are subjected to, intentionally or unintentionally, an array of synthetic pesticides and other chemical stressors. These ecological underpinnings, the amenability of insects to laboratory and field experiments, and our strong knowledgebase in insecticide toxicology, make the insect-insecticide model an excellent one to study many questions surrounding hormesis. Moreover, there is practical importance for agriculture with evidence of pest population growth being accelerated by insecticide hormesis. Nevertheless, insects have been underutilized in studies of hormesis. Where hormesis hypotheses have been tested, results clearly demonstrate stimulatory effects on multiple taxa as measured through several biological endpoints, both at individual and population levels. However, many basic questions are outstanding given the myriad of chemicals, responses, and ecological interactions that are likely to occur.
Should Repurchase Transactions be Accounted for as Sales or Loans?
Authors: Chircop Justin , Kiosse Paraskevi Vicky , Peasnell Ken
Published: March 2012

SYNOPSIS:

In this paper, we discuss the accounting for repurchase transactions, drawing on how repurchase agreements are characterized under U.S. bankruptcy law, and in light of the recent developments in the U.S. repo market. We conclude that the current accounting rules, which require the recording of most such transactions as collateralized loans, can give rise to opaqueness in a firm's financial statements because they incorrectly characterize the economic substance of repurchase agreements. Accounting for repurchase transactions as sales and the concurrent recognition of a forward, as “Repo 105” transactions were accounted for by Lehman Brothers, has furthermore overlooked merits. In particular, such a method provides a more comprehensive and transparent picture of the economic substance of such transactions.

JEL Classifications: M41; G21; G38.

Data Availability: Data are available from the public sources identified in the paper.
Effects of Transcutaneous Electrical Nerve Stimulation on Pain, Pain Sensitivity, and Function in People With Knee Osteoarthritis: A Randomized Controlled Trial
Authors: Vance Carol Grace T. , Rakel Barbara A. , Blodgett Nicole P. , DeSantana Josimari Melo , Amendola Annunziato , Zimmerman Miriam Bridget , Walsh Deirdre M. , Sluka Kathleen A.
Published: March 2012

Background

Transcutaneous electrical nerve stimulation (TENS) is commonly used for the management of pain; however, its effects on several pain and function measures are unclear.

Objective

The purpose of this study was to determine the effects of high-frequency TENS (HF-TENS) and low-frequency TENS (LF-TENS) on several outcome measures (pain at rest, movement-evoked pain, and pain sensitivity) in people with knee osteoarthritis.

Design

The study was a double-blind, randomized clinical trial.

Setting

The setting was a tertiary care center.

Participants

Seventy-five participants with knee osteoarthritis (29 men and 46 women; 31–94 years of age) were assessed.

Intervention

Participants were randomly assigned to receive HF-TENS (100 Hz) (n=25), LF-TENS (4 Hz) (n=25), or placebo TENS (n=25) (pulse duration=100 microseconds; intensity=10% below motor threshold).

Measurements

The following measures were assessed before and after a single TENS treatment: cutaneous mechanical pain threshold, pressure pain threshold (PPT), heat pain threshold, heat temporal summation, Timed “Up & Go” Test (TUG), and pain intensity at rest and during the TUG. A linear mixed-model analysis of variance was used to compare differences before and after TENS and among groups (HF-TENS, LF-TENS, and placebo TENS).

Results

Compared with placebo TENS, HF-TENS and LF-TENS increased PPT at the knee; HF-TENS also increased PPT over the tibialis anterior muscle. There was no effect on the cutaneous mechanical pain threshold, heat pain threshold, or heat temporal summation. Pain at rest and during the TUG was significantly reduced by HF-TENS, LF-TENS, and placebo TENS.

Limitations

This study tested only a single TENS treatment.

Conclusions

Both HF-TENS and LF-TENS increased PPT in people with knee osteoarthritis; placebo TENS had no significant effect on PPT. Cutaneous pain measures were unaffected by TENS. Subjective pain ratings at rest and during movement were similarly reduced by active TENS and placebo TENS, suggesting a strong placebo component of the effect of TENS.
Difficile égalité des chances : l'enseignement de la philosophie entre aristocratisme républicain et démocratisation improbable.
Authors: David Rémy
Published: March 2012

Résumé Ce texte est issu d’une intervention proposée lors de la seconde édition du colloque international de l’UNESCO « Enseignement de la philosophie – Philosophie de l’enseignement », consacré à : « L’égalité des chances à l’école : quelle égalité ? quelles chances ? ».
Du marché unique à la monnaie unique LEA : une formation pratique
Authors: Clauzure Émilie
Published: March 2012

L’auteur se propose, à travers l’étude des mémoires et des stages de maîtrise, obligatoires pour l’obtention du diplôme, de tester la visibilité de la formation pratique, appliquée, proposée par LEA. L’étude sera menée à partir des travaux des vingt dernières années, de 1978, première promotion de maîtrise, jusqu’à 1997, dernière année en date. Elle visera à mettre en évidence la ventilation selon les champs culturel, social, économique, politique... des différents sujets ; le poids des différentes langues ; l’incidence des liens avec les établissements universitaires étrangers. Les éléments ainsi réunis seront contrastés avec l’objectif déclaré de la filière LEA, dans son habilitation puis dans les modifications qu’elle y a apportées au fil de deux décennies.
Colonic Epithelial Cells Express Specific Ligands for Mucosal Macrophage Immunosuppressive Receptors Siglec-7 and -9
Authors: Miyazaki Keiko , Sakuma Keiichiro , Kawamura Yuki I. , Izawa Mineko , Ohmori Katsuyuki , Mitsuki Motoaki , Yamaji Toshiyuki , Hashimoto Yasuhiro , Suzuki Akemi , Saito Yukio , Dohi Taeko , Kannagi Reiji
Published: March 2012

Immune cells are known to express specific recognition molecules for cell surface glycans. However, mechanisms involved in glycan-mediated cell–cell interactions in mucosal immunity have largely been left unaccounted for. We found that several glycans preferentially expressed in nonmalignant colonic epithelial cells serve as ligands for sialic acid-binding Ig-like lectins (siglecs), the immunosuppressive carbohydrate-recognition receptors carried by immune cells. The siglec ligand glycans in normal colonic epithelial cells included disialyl Lewisa, which was found to have binding activity to both siglec-7 and -9, and sialyl 6-sulfo Lewisx, which exhibited significant binding to siglec-7. Expression of these siglec-7/-9 ligands was impaired upon carcinogenesis, and they were replaced by cancer-associated glycans sialyl Lewisa and sialyl Lewisx, which have no siglec ligand activity. When we characterized immune cells expressing siglecs in colonic lamina propriae by flow cytometry and confocal microscopy, the majority of colonic stromal immune cells expressing siglec-7/-9 turned out to be resident macrophages characterized by low expression of CD14/CD89 and high expression of CD68/CD163. A minor subpopulation of CD8+ T lymphocytes also expressed siglec-7/-9. Siglec-7/-9 ligation suppressed LPS-induced cyclooxygenase-2 expression and PGE2 production by macrophages. These results suggest that normal glycans of epithelial cells exert a suppressive effect on cyclooxygenase-2 expression by resident macrophages, thus maintaining immunological homeostasis in colonic mucosal membranes. Our results also imply that loss of immunosuppressive glycans by impaired glycosylation during colonic carcinogenesis enhances inflammatory mediator production.
Cutting Edge: Inhibition of IL-6 Trans-Signaling Protects from Malaria-Induced Lethality in Mice
Authors: Wunderlich Claudia M. , Delić Denis , Behnke Kristina , Meryk Andreas , Ströhle Peter , Chaurasia Bhagirath , Al-Quraishy Saleh , Wunderlich Frank , Brüning Jens C. , Wunderlich F. Thomas
Published: March 2012

Circulating IL-6 levels correlate with the severity of blood-stage malaria in humans and mouse models, but the impact of IL-6 classic signaling through membrane IL-6Rα, as well as IL-6 trans-signaling through soluble IL-6Rα, on the outcome of malaria has remained unknown. In this study, we created IL-6Rα–deficient mice that exhibit a 50% survival of otherwise lethal blood-stage malaria of the genus Plasmodium chabaudi. Inducing IL-6 trans-signaling by injection of mouse recombinant soluble IL-6Rα in IL-6Rα–deficient mice restores the lethal outcome to malaria infection. In contrast, inhibition of IL-6 trans-signaling via injection of recombinant sGP130Fc protein in control mice results in a 40% survival rate. Our data demonstrate that IL-6 trans-signaling, rather than classic IL-6 signaling, contributes to malaria-induced lethality in mice, preceded by an increased inflammatory response. Therefore, inhibition of IL-6 trans-signaling may serve as a novel promising therapeutic basis to combat malaria.
Depletion of Invariant NKT Cells Reduces Inflammation-Induced Preterm Delivery in Mice
Authors: Li Li-Ping , Fang Yi-Chuan , Dong Guo-Fa , Lin Yi , Saito Shigeru
Published: March 2012

This study sought to determine whether invariant NKT (iNKT) cells play an essential role in inflammation-induced preterm delivery. Preterm delivery and fetal death rates were determined in wild-type (WT) C57BL/6 mice and iNKT cell-deficient Jα18−/− mice injected i.p. with LPS. The percentages of decidual immune cells, including activated subsets, and costimulatory molecule expression were analyzed by flow cytometry. Th1 and Th2 cytokine production in the culture supernatants of decidual mononuclear cells was measured by ELISA. To some extent, Jα18−/− mice were resistant to LPS-induced preterm delivery. The proportions of decidual CD3+ and CD49b+ cells were slightly lower in Jα18−/− mice than in WT Jα18+/+ mice, whereas almost no CD3+CD49b+ cells could be found in Jα18-null mice. The percentages of activated decidual DCs, T cells, and NK cells were significantly lower in LPS-treated Jα18−/− mice than in WT mice. The CD40, CD80, and CD86 expression levels on decidual CD11c+ cells from Jα18−/− mice were also significantly lower than in WT mice. Mean concentrations of Th1 cytokines IFN-γ and IL-12p70 in the culture supernatants of decidual mononuclear cells from LPS-treated Jα18−/− mice were apparently lower than those of LPS-induced WT mice. Additionally, the proportions of activated CD11c+ cells, CD3+ cells, and CD49b+ cells in LPS-induced preterm delivery mice were strikingly higher in both WT and null mice when compared with the control PBS group and LPS-injected but normally delivered mice. Our results suggest that iNKT cells may play an essential role in inflammation-induced preterm birth.
NKG2D Mediates NK Cell Hyperresponsiveness and Influenza-Induced Pathologies in a Mouse Model of Chronic Obstructive Pulmonary Disease
Authors: Wortham Brian W. , Eppert Bryan L. , Motz Greg T. , Flury Jennifer L. , Orozco-Levi Mauricio , Hoebe Kasper , Panos Ralph J. , Maxfield Melissa , Glasser Stephan W. , Senft Albert P. , Raulet David H. , Borchers Michael T.
Published: March 2012

Chronic obstructive pulmonary disease (COPD) is characterized by peribronchial and perivascular inflammation and largely irreversible airflow obstruction. Acute disease exacerbations, due frequently to viral infections, lead to enhanced disease symptoms and contribute to long-term progression of COPD pathology. Previously, we demonstrated that NK cells from cigarette smoke (CS)-exposed mice exhibit enhanced effector functions in response to stimulating cytokines or TLR ligands. In this article, we show that the activating receptor NKG2D is a key mediator for CS-stimulated NK cell hyperresponsiveness, because CS-exposed NKG2D-deficient mice (Klrk1−/−) did not exhibit enhanced effector functions as assessed by cytokine responsiveness. NK cell cytotoxicity against MHC class I-deficient targets was not affected in a COPD model. However, NK cells from CS-exposed mice exhibit greater cytotoxic activity toward cells that express the NKG2D ligand RAET1ε. We also demonstrate that NKG2D-deficient mice exhibit diminished airway damage and reduced inflammation in a model of viral COPD exacerbation, which do not affect viral clearance. Furthermore, adoptive transfer of NKG2D+ NK cells into CS-exposed, influenza-infected NKG2D-deficient mice recapitulated the phenotypes observed in CS-exposed, influenza-infected wild-type mice. Our findings indicate that NKG2D stimulation during long-term CS exposure is a central pathway in the development of NK cell hyperresponsiveness and influenza-mediated exacerbations of COPD.
Galectin-1 Reduces the Severity of Herpes Simplex Virus-Induced Ocular Immunopathological Lesions
Authors: Rajasagi Naveen K. , Suryawanshi Amol , Sehrawat Sharvan , Reddy Pradeep B. J. , Mulik Sachin , Hirashima Mitsuomi , Rouse Barry T.
Published: March 2012

Stromal keratitis is a chronic immunopathological lesion of the eye caused by HSV-1 infection that can result in blindness. Because the inflammatory lesions are primarily orchestrated by Th1 cells, and to a lesser extent by Th17 cells, inhibiting their activity represents a useful form of therapy. In this study we evaluated the therapeutic potential of galectin-1 (gal-1), an endogenous lectin that in some autoimmune diseases was shown to suppress the functions of Th1 and Th17 cells. Treatment was begun at different times after ocular infection with HSV and the outcome was assessed clinically as well as for effects on various immune parameters. Treatment with recombinant gal-1 significantly diminished stromal keratitis lesion severity and the extent of corneal neovascularization. Treated mice had reduced numbers of IFN-γ– and IL-17–producing CD4+ T cells, as well as neutrophil infiltration in the cornea. Furthermore, disease severity was greater in gal-1 knockout mice compared with their wild-type counterparts. The many effects of gal-1 treatment include reduction in the production of proinflammatory cytokines and chemokines, increased production of IL-10, and inhibitory effects on molecules involved in neovascularization. To our knowledge, our findings are the first to show that gal-1 treatment represents a useful approach to control lesion severity in a virally induced immunopathological disease.
Functional Recruitment of the Human Complement Inhibitor C4BP to Yersinia pseudotuberculosis Outer Membrane Protein Ail
Authors: Ho Derek K. , Riva Rauna , Kirjavainen Vesa , Jarva Hanna , Ginström Erica , Blom Anna M. , Skurnik Mikael , Meri Seppo
Published: March 2012

Ail is a 17-kDa chromosomally encoded outer membrane protein that mediates serum resistance (complement resistance) in the pathogenic Yersiniae (Yersinia pestis, Y. enterocolitica, and Y. pseudotuberculosis). In this article, we demonstrate that Y. pseudotuberculosis Ail from strains PB1, 2812/79, and YPIII/pIB1 (serotypes O:1a, O:1b, and O:3, respectively) can bind the inhibitor of the classical and lectin pathways of complement, C4b-binding protein (C4BP). Binding was observed irrespective of serotype tested and independently of YadA, which is the primary C4BP receptor of Y. enterocolitica. Disruption of the ail gene in Y. pseudotuberculosis resulted in loss of C4BP binding. Cofactor assays revealed that bound C4BP is functional, because bound C4BP in the presence of factor I cleaved C4b. In the absence of YadA, Ail conferred serum resistance to strains PB1 and YPIII, whereas serum resistance was observed in strain 2812/79 in the absence of both YadA and Ail, suggesting additional serum resistance factors. Ail from strain YPIII/pIB1 alone can mediate serum resistance and C4BP binding, because its expression in a serum-sensitive laboratory strain of Escherichia coli conferred both of these phenotypes. Using a panel of C4BP mutants, each deficient in a single complement control protein domain, we observed that complement control protein domains 6–8 are important for binding to Ail. Binding of C4BP was unaffected by increasing heparin or salt concentrations, suggesting primarily nonionic interactions. These results indicate that Y. pseudotuberculosis Ail recruits C4BP in a functional manner, facilitating resistance to attack from complement.
The Utility and Limitations of Current Web-Available Algorithms To Predict Peptides Recognized by CD4 T Cells in Response to Pathogen Infection
Authors: Chaves Francisco A. , Lee Alvin H. , Nayak Jennifer L. , Richards Katherine A. , Sant Andrea J.
Published: March 2012

The ability to track CD4 T cells elicited in response to pathogen infection or vaccination is critical because of the role these cells play in protective immunity. Coupled with advances in genome sequencing of pathogenic organisms, there is considerable appeal for implementation of computer-based algorithms to predict peptides that bind to the class II molecules, forming the complex recognized by CD4 T cells. Despite recent progress in this area, there is a paucity of data regarding the success of these algorithms in identifying actual pathogen-derived epitopes. In this study, we sought to rigorously evaluate the performance of multiple Web-available algorithms by comparing their predictions with our results—obtained by purely empirical methods for epitope discovery in influenza that used overlapping peptides and cytokine ELISPOTs—for three independent class II molecules. We analyzed the data in different ways, trying to anticipate how an investigator might use these computational tools for epitope discovery. We come to the conclusion that currently available algorithms can indeed facilitate epitope discovery, but all shared a high degree of false-positive and false-negative predictions. Therefore, efficiencies were low. We also found dramatic disparities among algorithms and between predicted IC50 values and true dissociation rates of peptide–MHC class II complexes. We suggest that improved success of predictive algorithms will depend less on changes in computational methods or increased data sets and more on changes in parameters used to “train” the algorithms that factor in elements of T cell repertoire and peptide acquisition by class II molecules.
Cutting Edge: Asymmetric Memory T Cell Division in Response to Rechallenge
Authors: Ciocca Maria L. , Barnett Burton E. , Burkhardt Janis K. , Chang John T. , Reiner Steven L.
Published: March 2012

Clonal selection of a T cell for use in the immune response appears to necessitate proliferative expansion and terminal effector differentiation of some cellular progeny, while reserving other progeny as less-differentiated memory cells. It has been suggested that asymmetric cell division may promote initial cell diversification. Stem cell-like models of adaptive immunity might predict that subsequent encounters with a pathogen would evoke reiterative, self-renewing, asymmetric division by memory T cells. In this study, we show that murine memory CD8+ T cells can divide asymmetrically in response to secondary encounter with pathogen. Critical regulators of signaling and transcription are partitioned to one side of the mitotic spindle in rechallenged memory T cells, and two phenotypically distinct populations of daughter cells are evident from the earliest divisions. Memory T cells may thus use asymmetric cell division to generate cellular heterogeneity when faced with pathogen rechallenge.
Cytological diagnosis of metastatic alveolar rhabdomyosarcoma in the ascitic fluid: Report of a case highlighting the diagnostic difficulties
Authors: Nelson Andrew C. , Singh Charanjeet , Pambuccian Stefan E.
Published: March 2012

Alveolar rhabdomyosarcoma is an uncommon tumor affecting adolescents and young adults that is only rarely encountered in body fluid cytology. We report the cytological features of metastatic alveolar rhabdomyosarcoma in the ascitic fluid of a 17-year-old female patient, who had presented with abdominal distention, 21 months after being diagnosed with perirectal alveolar rhabdomyosarcoma. The rare single neoplastic cells that were admixed with abundant reactive mesothelial cells were initially misinterpreted as reactive mesothelial cells. However, their neoplastic nature was established after a careful review of their cytological features and the performance of immunoperoxidase stains. Compared to the reactive mesothelial cells that were present in the sample, the malignant cells were smaller, with less ample and more homogenous cytoplasm. They had slightly larger, more hyperchromatic, and more frequently eccentric nuclei, with larger nucleoli. This case highlights the potential pitfall of the misinterpretation of metastatic alveolar rhabdomyosarcoma cells for reactive mesothelial cells. Awareness of this potential diagnostic problem and recognition of the cytomorphological features of this neoplasm in the body fluids allows the identification of malignant cells, even when they are rare and intimately associated with mesothelial cells.
Surgically repaired posttraumatic CSF rhinorrhea: An institutional experience and review of literature
Authors: Kumar Brijesh , Sahu Rabinarayan , Srivastava A.K. , Nair Anup , Mehrotra Anant ,   Rajkumar
Published: March 2012

Posttraumatic cerebrospinal fluid (CSF) rhinorrhea frequently complicates anterior skull base fracture. Although skull base fracture is present in only about 7% cases of head injury, CSF rhinorrhea develops in 30% of cases with basal fracture.

A total of 43 cases admitted in our Institute (SGPGI Lucknow) from January 2000 to June 2011with history of head trauma followed by CSF rhinorrhea. Forty one cases were included in this study as two patients refused surgery.

Out of forty one cases, 26 cases (63%) were admitted with history of recurrent meningitis, 21 cases (51%) with loss of smell, 26 cases (63%) with delayed onset CSF rhinorrhea, 3 cases (7%) with early onset rhinorrhea which did not improve after trauma, 12 cases (30%) with early onset rhinorrhea which improved but reappeared after some time. Twenty cases (48.8%) were repaired by extradural approach, 10 cases (24.4%) were repaired by intradural approach and 11 cases (26.8%) were repaired by endoscopic approach. 12 cases (29.0%) required re-surgery for persistent or recurrence of CSF rhinorrhea.

Although posttraumatic CSF rhinorrhea usually resolves with conservative management, its persistence makes an individual prone for further complications like meningitis, brain abscess and septicaemia. Timely surgical intervention usually gives promising results. Endoscopic repair was better than transcranial repair.
Surgery for encephalomalacias presenting with intractable epilepsy
Authors: Sarat Chandra P. , Ansari Abuzer , Chauhan Avnish , Kumar Amandeep , Garg Ajay , Sarkar Chitra , Bal C.S. , Tripathi Manjari
Published: March 2012

Surgery for intractable epilepsy caused by encephalomalacia (especially post-traumatic) has been reported very scarcely in the literature.

21 cases are presented who underwent resections for encephalomalacias for medically intractable epilepsy are presented from a series of 632 cases.

Seizure duration pre-surgery ranged from 3 to 29 years (mean 7.8 years, median of 7 years). Seizure frequency ranged from 2 seizures/month to 7/day, with a median of 10 seizures/month. Causes included head trauma (9), encephalitis (2), peri natal ischemia (3) post abscess (3) and idiopathic (4). The postoperative follow-up was 21 months (ranging from 12 to 63 months). 17 had Engel’s Class I seizure outcome. Four patients had poor seizure outcome (two Class IV and two Class III). All post traumatic encephalomalacias had excellent outcome, and post encephalitis the worst.

Encephalomalacia with intractable epilepsy have a varied outcome and depends on the pathology.
Intra-arterial thrombolysis for acute ischemic stroke: Our institutional experience
Authors: Narayana R.V. , Pati Rajesh , Dalai Sibasankar
Published: March 2012

The standard treatment for acute ischemic stroke is intravenous (IV) rtPA for patients who can reach the hospital within 3 to 4.5 h. There are case reports, where IA thrombolysis has helped patients in case an IV thrombolysis has failed. We report 14 cases of acute ischemic stroke treated by intra-arterial (IA) thrombolysis.

We have retrospectively analyzed 14 cases of acute ischemic stroke treated at our department between December 2008 and October 2011 by intra-arterial thrombolysis. The patients with suspected large vessel occlusion (11 patients) and patients not responding to IV rtPA (3 patients) were considered for the IA thrombolysis.

We achieved complete recanalization (TIMI 3) in 11 patients. One patient had a bleed following the procedure but recovered well during the hospital stay. All the patients were followed up to 90 days. Majority of them have good functional outcome.

Our study suggests that intra-arterial thrombolysis is a feasible option in the subgroup of patients with large vessel occlusion. However, there is a need for a randomized multicentric study to support our results.
Novel therapies for high-grade gliomas: A vision for future
Authors: Tandon Vivek , Mahapatra Subhashree , Mahapatra Ashok
Published: March 2012

The treatment for high-grade glioma remains an enigma. The standard treatment using surgery, radiation therapy and chemotherapy for such highly malignant lesions has only yielded modest results, in terms of survival and improving the quality of life of patients. Less than 10% of such patients survive beyond two years. All conventional therapies have failed to increase the survival beyond this extent. There has been a growing interest in the molecular approaches for the treatment of high-grade gliomas which include gene therapy, oncolytic virotherapy, and immunotherapy. These new therapies are in preclinical and investigational stages. They may not substitute the conventional therapies; they may not be the ultimate elixir for this deadly disease. However, in the coming years, they are likely to have synergistic and complimentary roles alongside conventional therapies. Through this paper, we have attempted to highlight the rationale behind gene therapy which can be used for cytotoxic approaches, immunomodulation strategy, and targeted toxin delivery in the tumor cell. We have reviewed current available literature and through this paper focus on reporting such therapeutic options, their potential usage, benefits and limitations.
Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization
Authors: Sin Anthony , Cuellar Hugo , Brown Benjamin
Published: March 2012

We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA) laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.
Low dose ionizing radiation induced acoustic neuroma: A putative link?
Authors: Borkar Sachin , Agrawal Deepak
Published: March 2012

Although exposure to high dose ionizing radiation (following therapeutic radiotherapy) has been incriminated in the pathogenesis of many brain tumors, exposure to chronic low dose ionizing radiation has not yet been shown to be associated with tumorigenesis. The authors report a case of a 50-year-old atomic reactor scientist who received a cumulative dose of 78.9 mSv over a 10-year period and was detected to have an acoustic neuroma another 15 years later. Although there is no proof that exposure to ionizing radiation was the cause for the development of the acoustic neuroma, this case highlights the need for extended follow-up periods following exposure to low dose ionizing radiation.
Central liponeurocytoma: Case report and review of literature
Authors: Ailawadhi Pankaj , Sharma M.C. , Mahapatra A.K. , Sarat Chandra P.
Published: March 2012

Cerebellar liponeurocytoma consists of well-differentiated neurons with the cytology of neurocytes in addition to a population of lipidized cells. Hence it is biphasic in appearance and has been included in the category of glioneuronal tumors of the central nervous system by the WHO working group on the Classification of Tumors of the Nervous System. However, liponeurocytoma is not exclusive to the cerebellar or fourth ventricular location. Since its inclusion in the central nervous system tumor classification, nine cases with similar histological and immunohistochemical features have also been described in the lateral ventricles. We describe here such a lateral ventricular tumour in a 30-year-old woman, characteristically showing divergent glio-neuronal differentiation and lipidized neoplastic cells. Therefore, we suggest that future WHO tumor classification should consider that liponeurocytomas are not entirely restricted to the cerebellum and henceforth change of nomenclature might be considered, as also pointed out by other authors.