[Exercise Testing in Respiratory Medicine - DGP Recommendations]. / Belastungsuntersuchungen in der Pneumologie ­ Empfehlungen der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e. V.

This document replaces the DGP recommendations published in 1998 and 2013. Based on recent studies and a consensus conference, the indications, choice and performance of the adequate exercise testing method and its necessary technical and staffing setting are discussed. Detailed recommendations are provided: for blood gas analysis and right heart catheterization during exercise, walk tests, spiroergometry, and stress echocardiography. The correct use of different exercise tests is discussed for specific situations in respiratory medicine: exercise induced asthma, obesity, monitoring of rehabilitation or therapeutical interventions, preoperative risk stratification, and evaluation in occupational medicine.

Arabidopsis petiole torsions induced by lateral light or externally supplied auxin require microtubule-associated TORTIFOLIA1/SPIRAL2.

Although rather inconspicuous, movements are an important adaptive trait of plants. Consequently, light- or gravity-induced movements leading to organ bending have been studied intensively. In the field, however, plant movements often result in organ twisting rather than bending. This study investigates the mechanism of light- or gravity-induced twisting movements, coined "helical tropisms." Because certain Arabidopsis cell expansion mutants show organ twisting under standard growth conditions, we here investigated how the right-handed helical growth mutant tortifolia1/spiral2 (tor1) responds when stimulated to perform helical tropisms. When leaves were illuminated from the left, tor1 was capable of producing left-handed petiole torsions, but these occurred at a reduced rate. When light was applied from right, tor1 plants rotated their petioles much faster than the wild-type. Applying auxin to the lateral-distal side of wild-type petioles produced petiole torsions in which the auxinated flank was consistently turned upwards. This kind of movement was not observed in tor1 mutants when auxinated to produce left-handed movements. Investigating auxin transport in twisting petioles based on the DR5-marker suggested that auxin flow was apical-basal rather than helical. While cortical microtubules of excised wild-type petioles oriented transversely when stimulated with auxin, those of tor1 were largely incapable of reorientation. Together, our results show that tor1 is a tropism mutant and suggest a mechanism in which auxin and microtubules both contribute to helical tropisms.

[Exercise testing in respiratory medicine]. / Belastungsuntersuchungen in der Pneumologie.

This document replaces the DGP recommendations published in 1998. Based on recent studies and a consensus conference, the indications, choice and performance of the adequate exercise testing method in its necessary technical and staffing setting are discussed. Detailed recommendations are provided: for arterial blood gas analysis and right heart catherterization during exercise, 6-minute walk test, spiroergometry, and stress echocardiography. The correct use of different exercise tests is discussed for specific situations in respiratory medicine: exercise induced asthma, monitoring of physical training or therapeutical interventions, preoperative risk stratification, and evaluation in occupational medicine.

Cytoskeletal dynamics in interphase, mitosis and cytokinesis analysed through Agrobacterium-mediated transient transformation of tobacco BY-2 cells.

Transient transformation with Agrobacterium is a widespread tool allowing rapid expression analyses in plants. However, the available methods generate expression in interphase and do not allow the routine analysis of dividing cells. Here, we present a transient transformation method (termed 'TAMBY2') to enable cell biological studies in interphase and cell division. Agrobacterium-mediated transient gene expression in tobacco BY-2 was analysed by Western blotting and quantitative fluorescence microscopy. Time-lapse microscopy of cytoskeletal markers was employed to monitor cell division. Double-labelling in interphase and mitosis enabled localization studies. We found that the transient transformation efficiency was highest when BY-2/Agrobacterium co-cultivation was performed on solid medium. Transformants produced in this way divided at high frequency. We demonstrated the utility of the method by defining the behaviour of a previously uncharacterized microtubule motor, KinG, throughout the cell cycle. Our analyses demonstrated that TAMBY2 provides a flexible tool for the transient transformation of BY-2 with Agrobacterium. Fluorescence double-labelling showed that KinG localizes to microtubules and to F-actin. In interphase, KinG accumulates on microtubule lagging ends, suggesting a minus-end-directed function in vivo. Time-lapse studies of cell division showed that GFP-KinG strongly labels preprophase band and phragmoplast, but not the metaphase spindle.

[Acetaminophen - A modern classic under suspicion]. / Paracetamol - ein moderner Klassiker unter falschem Verdacht.

Paracetamol is one of the most popular and widely used drugs for the treatment of pain and fever and provides safe and effective relief of these symptoms since decades. The mechanism of action is very complex and involves the inhibition of the peroxidase portion of the cyclooxygenase enzyme together with the modulation of the serotoninergic and cannabinoid system. Paracetamol is a safe drug, if used in accordance with the regulations and has demonstrated a superior side effect profile to many widely used NSAIDs.

[Doping in trauma surgery: causes, risks and therapy options]. / Doping in der Unfallchirurgie : Ursachen, Risiken und Therapiemöglichkeiten.

Apart from the nearly daily announcements on doping in sport there are ever increasing numbers of professionally employed people in vastly different functions and professions who make use of performance-enhancing substances: a serious social problem. It is not astonishing that even physicians and trauma surgeons who are under constant pressure from costs, time and performance demands also consume performance-enhancing drugs.

[Differential diagnosis of restrictive lung diseases: utility of cardiopulmonary exercise testing]. / Differenzialdiagnostik restriktiver Ventilationsstörungen: Stellenwert der Spiroergometrie.

Exercise dyspnea is a common symptom of restrictive lung diseases. Not only from the clinical perspective but also from the pathophysiological point of view, restrictive lung disorders represent a very heterogeneous group of diseases. Exercise testing is mandatory because pulmonary function tests at rest are not reliable for the diagnostic evaluation and functional characterisation of these patients. Cardiopulmonary exercise testing (CPET) with measurement of gas exchange is the favoured tool. It is an excellent method to investigate exercise dyspnea, describe altered physiological response to exercise and characterise the involved organ systems heart, lung and muscle. This paper addresses the pathophysiology of restrictive lung diseases and the principles of cardiopulmonary exercise testing, discusses case reports and assesses the clinical value of CPET in patients with restrictive lung disease.

Selective 5-HT6 receptor ligands: progress in the development of a novel pharmacological approach to the treatment of obesity and related metabolic disorders.

The increasing global prevalence of obesity unequivocally demonstrates that neither behavioural (diet and exercise) nor pharmacological approaches to this health problem are working. In this area of high unmet clinical need, the 5-HT6 receptor has generated enormous interest amongst academic and pharmaceutical industry scientists as a molecular target for the development of a new generation of safe and more effective anti-obesity drugs. In this review, we have described the major developments that have occurred in the fields of the medicinal chemistry and pharmacology of 5-HT6 ligands, with particular emphasis on their potential application as novel anti-obesity drugs. The last 5 years have witnessed an increasing understanding of the 5-HT6 receptor and its structural requirements that has produced an explosion in the number and diversity of novel, highly selective 5-HT6 receptor agonists, partial agonists and antagonists that have been designed and synthesized. In animal models, 5-HT6 receptor ligands of all functional types have been shown to decrease food intake when given acutely and chronically, to evoke profound and sustained weight-loss in obese animals, and concomitantly to improve a number of cardio-metabolic risk factors. Comparator studies in obese animal models, which are highly predictive of clinical outcomes, indicate that 5-HT6 ligands may have the potential to be more efficacious in the treatment of obesity than the current generation of anti-obesity drugs.

[Guidelines for the sociomedical assessment of performance in patients suffering from coronary heart disease (CHD)]. / Leitlinien zur sozialmedizinischen Leistungsbeurteilung bei koronarer Herzkrankheit (KHK).

The following guidelines were developed for the medical assessment services of the German Federal Insurance Institute for Salaried Employees (BfA). Starting from day-to-day practice criteria and attributes to guide decisions for a systemisation of the sociomedical assessment of performance in coronary heart disease (CHD) were compiled. The guidelines aim at standardising the sociomedical assessment of performance and help to make the decision-making process more transparent - e.g. for the assessment of applications for decreased earning capacity benefits. The guidelines summarise typical manifestations of CHD and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination and for diagnostic tests - especially of myocardial functioning - are illustrated. The assessment of the individual's capacity is outlined, taking occupational factors into account. Following the determination of dysfunctions the remaining abilities and disabilities, respectively, are deduced and compared with occupational demands. Finally inferences are drawn regarding the occupational capacity of the individual.

Benzothiadiazole Activates Resistance in Sunflower (Helianthus annuus) to the Root-Parasitic Weed Orobanche cuman.

ABSTRACT The study was conducted to evaluate the potential of induced resistance to infestation of sunflower (Helianthus annuus L.) by the parasitic weed Orobanche cumana Wallr. Treatment of sunflower seeds with 40 ppm of benzo(1,2,3)thiadiazole-7-carbothioic acid S-methyl ester (BTH) for 36 h completely prevented infection in root chambers. In pot studies using 2.86 x 10(-4) g of Orobanche seeds per gram of soil as inoculum, the total number of O. cumana shoots was reduced by 84 and 95% in the 60-ppm BTH treatment in the first and second trial, respectively. Evaluation of the disease incidences revealed that attachment of O. cumana at the sunflower root and the stage of early penetration was reduced in the BTH-treated plants. Chemical analysis of root extracts revealed synthesis of the phytoalexin scopoletin and of hydrogen peroxide in the BTH-treated sunflower roots, but no increase in lignification. Western blot analysis demonstrated accumulation of the pathogenesis-related protein chitinase in roots and stems of induced resistant plants. These results show that the phenomenon of induced resistance is not restricted to viral, bacterial, and fungal disease and demonstrate the great potential of this protection strategy as an effective component of future plant production systems.

Identification and synthesis of a kairomone mediating host location by two parasitoid species of the cassava mealybug Phenacoccus herreni.

Two encyrtid species, Acerophagus coccois and Aenasius vexans, parasitoids of the cassava mealybug Phenacoccus herreni use a contact kairomone from the body surface of their host as a host-location stimulant. The kairomone was synthesized and identified as O-caffeoylserine based on a combination of chromatographic methods. The synthetic compound was determined to be active.

Hydrogen peroxide and flavan-3-ols in storage roots of cassava (Manihot esculenta crantz) during postharvest deterioration.

Cassava storage roots are an important staple food throughout the lowland humid tropics. However, cassava suffers from a poorly understood storage disorder, known as postharvest physiological deterioration (PPD), which constrains its exploitation. In an attempt to broaden the understanding of PPD, nine different cassava cultivars were analyzed for specific compounds accumulating during the process. The production of hydrogen peroxide (H(2)O(2)) is involved in the early stages of PPD in cassava roots. H(2)O(2) was quantified and localized histochemically at the tissue and cell level in deteriorating roots. This reactive oxygen species accumulated during the first 24 h after harvest, especially in the inner parenchymatic tissue. Three flavan-3-ols, (+)-catechin, (+)-catechin gallate, and (+)-gallocatechin, accumulated during the storage of cassava roots. However, these potential antioxidants cannot be related to early storage disorders or wound responses because they start to accumulate only after 4-6 days.

A new subfamily of sucrose transporters, SUT4, with low affinity/high capacity localized in enucleate sieve elements of plants.

A new subfamily of sucrose transporters from Arabidopsis (AtSUT4), tomato (LeSUT4), and potato (StSUT4) was isolated, demonstrating only 47% similarity to the previously characterized SUT1. SUT4 from two plant species conferred sucrose uptake activity when expressed in yeast. The K(m) for sucrose uptake by AtSUT4 of 11.6 +/- 0.6 mM was approximately 10-fold greater than for all other plant sucrose transporters characterized to date. An ortholog from potato had similar kinetic properties. Thus, SUT4 corresponds to the low-affinity/high-capacity saturable component of sucrose uptake found in leaves. In contrast to SUT1, SUT4 is expressed predominantly in minor veins in source leaves, where high-capacity sucrose transport is needed for phloem loading. In potato and tomato, SUT4 was immunolocalized specifically to enucleate sieve elements, indicating that like SUT1, macromolecular trafficking is required to transport the mRNA or the protein from companion cells through plasmodesmata into the sieve elements.

How Long Have Nonlinear Effects Been Known in the Field of Catalysis?

The similarities and differences between nonlinear effects in asymmetric synthesis (see diagram), predicted 60 years ago by W. Langenbeck, and the long-known amplification phenomenon in stoichiometric reactions with chiral starting materials are discussed.

The determination of complex stabilities with nearly insoluble host molecules. Complexation of barium(II) with substituted diaza-18-crown-6 ligands in aqueous and methanolic solutions.

The complex formation between Ba(2+) and different diaza-18-crown-6 ligands has been studied using a new spectrophotometric method. In the presence of undissolved solid ligand the concentration of the dissolved ligand increases in salt containing solutions due to complex formation. The change in the total concentration of the dissolved ligand can be monitored by UV-VIS spectrometry if the ligand contains absorbing groups. However, any other method to measure the variation of the ligand concentration in solution, e.g. the total organic carbon content, allows the calculation of the stability constants of the complexes formed. It is not essential for the determination of the stability constant to know the absolute concentration of the ligand in solution. The experimental method described offers some advantages compared with other experimental techniques. The main advantage is that only very small amounts of ligands are needed.

Hyperinsulinism and cerebral microangiopathy.

BACKGROUND AND PURPOSE: High insulin levels are a recognized risk factor for atherosclerosis. Microvascular endothelium is more susceptible to metabolic and mitogenic effects of insulin than large-vessel endothelium. Besides their atherogenic effect, high insulin levels impair fibrinolysis by enhancing plasminogen activator inhibitor-1. We undertook this study to evaluate the hypothesis that elevated serum insulin and C-peptide levels are related to cerebral small-vessel disease rather than large-vessel pathology. METHODS: One hundred ninety-four consecutive patients presenting with symptomatic cerebrovascular disease were assigned to three subgroups that were differentiated by clinical presentations, brain imaging studies, and extracranial as well as transcranial vascular ultrasound findings: (1) patients with lacunes (n = 20), (2) patients with subcortical arteriosclerotic encephalopathy (n = 35), and (3) patients with strokes due to large-vessel disease (n = 99). Patients who had suffered a cryptogenic (n = 9) or cardioembolic (n = 16) stroke or who showed characteristics of the microangiopathy and macroangiopathy groups (n = 15) were not further evaluated. Thirty patients without manifestations of cerebrovascular disease were also examined. Fasting blood glucose, insulin, and C-peptide levels were determined in all subjects. RESULTS: There were no significant differences in age or sex among the three groups and control patients. Insulin levels were significantly higher in the lacunar group compared with the subcortical arteriosclerotic encephalopathy group, the macroangiopathy group, and the control patients (median [interquartile range]: 103.8 [198.6], 72.0 [103.2], 66.0 [57.0], and 52.2 [57.0] pmol/L, respectively; all P < .05, Mann-Whitney test). There was a statistically significant difference in insulin concentrations between the microangiopathy group (subcortical arteriosclerotic encephalopathy and lacunes) and the macroangiopathy and control groups (81.0 [110.4], 66.0 [57.0], and 55.2 [57.0] pmol/L, respectively; all P < .05, Mann-Whitney). The same was true for the distribution of C-peptide levels and to a minor extent blood glucose values, but these differences failed to reach statistical significance. CONCLUSIONS: Elevated insulin levels potentially represent a pathogenetic factor in the development of cerebral small-vessel disease, predominantly in patients presenting with lacunes. Whether this is due solely to atherosclerotic changes of the small penetrating arteries or whether changes in hemorheology are operative as well remains to be evaluated.

Responsiveness of basophil granulocytes of horses suffering from chronic obstructive pulmonary disease to various allergens.

As basophils are the major effector cells of allergic reactions, confirmation of the allergic etiology of chronic obstructive pulmonary disease (COPD) was sought by the demonstration of a specific in vitro response of equine basophilic blood cells to some potential allergens (Aspergillus, Cladosporidium, Mucor, Penicillium, extracts of dust particles of hay and straw). The allergen induced degranulation of basophils and the histamine and protease release from basophils during incubation with the allergens were tested. By evaluating the results obtained from 14 COPD horses and eight controls it could be shown that the sensitivity of the basophils of affected horses was increased, particularly against the allergen extract of Mucor mucedo and Mucor spinosus. Further a greater percentage of COPD horses reacted positively with the Mucor allergen extract. The mitogenic stimulation of lymphocytes by PHA and by the allergen extracts used gave comparable results in affected and control horses. Thus the in vitro stimulation of basophils may be an easily to perform testing device for the identification of potential allergens involved in the pathogenesis of equine COPD.

Alterations of cellular immune response during intensive training of event horses.

During strenuous exercise of horses that are prepared for international Three-Day-Events a significant decrease in the in vitro killing rate of phagocytosed yeast cells by the blood granulocytes has been observed. Other immunological parameters, such as the phorbolmyristate dependent chemiluminescence in granulocytes and the mitogenic stimulation of blood lymphocytes, remained unchanged.

Assessment of phagocytic activity of granulocytes using laser flow cytometry.

A laser flow cytometer assay for assessing two functions of polymorphonuclear leucocytes is described. The technique permits the quantitation of phagocytosis and intracellular killing of yeast cells by leucocytes and is illustrated with results obtained using porcine polymorphonuclear leucocytes.