[Rehabilitation for patients with obesity]. / Rehabilitation bei Adipositas.

Inpatient rehab for people with obesity is much more than exercise therapy and nutritive education. It depends on many requirements such as adjusted rooms, special furniture and systems for determining the resting metabolic rate. An interdisciplinary treatment concept is needed to come up to the individual internal, orthopedic and psychological requirements of this complex syndrome. Growing up in an obese promotional environment many patients are suffering from depression, anxiety and eating disorders. Without focussing on these comorbidities it seems not promising to come to a permanent change of motivation. In this article we disbribe the surrounding conditions of an residential therapy in which the patient feels understood and can gain a new self-conception for a long-lasting weight loss.

Predictive Validity of a Screening Instrument for the Risk of Non-Return to Work in Patients With Internal Diseases.

OBJECTIVE: To test the predictive validity of the SIMBO (Screening-Instrument zur Feststellung des Bedarfs an medizinisch-beruflich orientierten Maßnahmen in der medizinischen Rehabilitation [Screening Instrument for the Access to Work-Related Multimodal Rehabilitation]; total score ranges from 0 to 100 points) in patients with internal diseases in a rehabilitation setting. DESIGN: Prospective multicenter study. SETTING: Inpatient rehabilitation centers. PARTICIPANTS: Patients (N=1366) aged 18 to 65 years with internal diseases. INTERVENTIONS: Multimodal rehabilitation programs. MAIN OUTCOME MEASURES: The primary outcome was occurrence of a critical return-to-work (RTW) event during the follow-up period. Receiver operating characteristic analyses were performed. Sensitivity, specificity, and positive predictive values were calculated for each disease group using the cutoff score of 27 points. RESULTS: A total of 1366 patients with neoplasms (n=203); endocrine, nutritional, and metabolic diseases (n=355); and diseases of the circulatory (n=470), respiratory (n=255), and digestive (n=83) systems were included. Between 9.9% and 40.6% of the patients reported critical RTW events during the 3-month follow-up period. The area under the curve was between .849 (.754-.923) and .903 (.846-.959). Sensitivity and specificity ranged from 65.6% to 92.9% and from 80.4% to 89.9%, respectively. The positive predictive values were between 40.4% and 77.8%. CONCLUSIONS: The risk score SIMBO predicts short-term RTW problems after rehabilitation in patients with internal diseases. The cutoff of 27 points was confirmed as a reasonable threshold.

Compartments in Scyphozoa.

Polyps of Scyphozoa have a cup-shaped body. At one end is the mouth opening surrounded by tentacles, at the other end is an attachment disc. The body wall consists of two tissue layers, the ectoderm and the endoderm, which are separated by an extracellular matrix, the mesoglea. The polyp's gastric cavity is subdivided by septa running from the apical end to the basal body end. The septa consist of two layers of endoderm and according to biology textbooks the number of septa is four. However, in rare circumstances Aurelia produces polyps with zero, two, six, or eight septa. We found that the number was always even. Therefore we propose that two types of endoderm exist, forming alternating stripes running from the oral body end to the aboral end. The stripes have some properties of developmental compartments. Where cells of different compartments meet, they form a septum. We also propose that the ectoderm is subdivided into compartments. The borders of the ectodermal and endodermal compartments are perpendicular to each other. Tentacles of the polyp and rhopalia (sense organs) of the ephyra (young medusa), respectively, develop at the border between two ectodermal compartments. The number can be even or odd. Rhopalia formation is particularly favored where two ectodermal and two endodermal compartments meet.

A newly discovered oxidant defence system and its involvement in the development of Aurelia aurita (Scyphozoa, Cnidaria): reactive oxygen species and elemental iodine control medusa formation.

In Aurelia aurita, applied iodine induces medusa formation (strobilation). This process also occurs when the temperature is lowered. This was found to increase oxidative stress resulting in an increased production of iodine from iodide. One polyp produces several medusae (initially termed ephyrae) starting at the polyp's oral end. The spreading of strobilation down the body column is controlled by a feedback loop: ephyra anlagen decrease the tyrosine content in adjacent polyp tissue by producing melanin from tyrosine. Endogenous tyrosine is able to remove iodine by forming iodiferous tyrosine compounds. The reduced level of tyrosine causes the ephyra-polyp-border to move towards the basal end of the former polyp. We argue that an oxidant defence system may exist which makes use of iodide and tyrosine. Like other marine invertebrates, polyps of Aurelia contain iodide ions. Inevitably produced peroxides oxidise iodide into iodine. The danger to be harmed by iodine is strongly decreased by endogenous tyrosine which reacts with iodine to form iodiferous tyrosine compounds including thyroxin. Both substances together, iodide and tyrosine, form an efficient oxidant defence system which shields the tissue against damage by reactive oxygen species. In the course of evolution (from a species at the basis of the animal kingdom like Aurelia to a highly evolved species like man) the waste product thyroxin (indicating a high metabolic rate) has developed into a hormone which controls the metabolic rate.

Sterile polystyrene culture dishes induce transformation of polyps into medusae in Aurelia aurita (Scyphozoa, Cnidaria).

Polyps of Aurelia aurita produce medusae once a year. Under laboratory conditions this process, termed strobilation, can be induced by lowering the incubation temperature for about two weeks. Here we report a fast induction of strobilation by sterile polystyrene culture dishes. The effect is abolished when the culture dishes are washed twice with hot water prior to the experiment. We recommend that polystyrene cultureware should be pre-washed whenever there is an indication of unusual effects.

Translocation of 3-deoxy-D-arabino-heptulosonate 7-phosphate synthase precursor into isolated chloroplasts.

A cDNA encoding 3-deoxy-D-arabino-heptulosonate 7-phosphate (DAHP) synthase (EC 4.1.2.15) from potato (Solanum tuberosum L.) presumably specifies a chloroplast transit sequence near its 5'-end. In order to show the function of this transit sequence, we constructed a plasmid that contains the entire coding region of the cDNA downstream from a T7 promoter. Using this plasmid as template, DAHP synthase mRNA was synthesized in vitro with T7 RNA polymerase. The resulting mRNA served as template for the in vitro synthesis of a 59-kDa polypeptide. This translation product was identified as the DAHP synthase precursor by immunoprecipitation with a monospecific polyclonal antibody raised against pure tuber DAHP synthase and by radiosequencing of the [(3)H]leucine-labeled translation product. Incubation of the 59-kDa polypeptide with isolated spinach (Spinacia oleracea L.) chloroplasts resulted in a 53-kDa polypeptide that was resistant to protease treatment. Fractionation of chloroplasts, reisolated after import, showed the mature DAHP synthase in the stroma fraction. Incubation of the 59-kDa polypeptide with a chloroplast precursor-processing enzyme cleaved the precursor between Ser49 and Ala50, generating a mature DAHP synthase of 489 residues. The uptake of the DAHP synthase precursor into isolated chloroplasts was inhibited by anti-DAHP synthase, and the precursor was not processed cotranslationally by canine microsomal membranes. We conclude that the transit sequence is able to direct DAHP synthase into chloroplasts.

Redox regulation of Arabidopsis 3-deoxy-D-arabino-heptulosonate 7-phosphate synthase.

The cDNA for 3-deoxy-D-arabino-heptulosonate 7-phosphate synthase of Arabidopsis encodes a polypeptide with an amino-terminal signal sequence for plastid import. A cDNA fragment encoding the processed form of the enzyme was expressed in Escherichia coli. The resulting protein was purified to electrophoretic homogeneity. The enzyme requires Mn(2+) and reduced thioredoxin (TRX) for activity. Spinach (Spinacia oleracea) TRX f has an apparent dissociation constant for the enzyme of about 0.2 microM. The corresponding constant for TRX m is orders of magnitude higher. In the absence of TRX, dithiothreitol partially activates the enzyme. Upon alkylation of the enzyme with iodoacetamide, the dependence on a reducing agent is lost. These results indicate that the first enzyme in the shikimate pathway of Arabidopsis appears to be regulated by the ferredoxin/TRX redox control of the chloroplast.

A shoot meristem-like organ in animals; monopodial and sympodial growth in Hydrozoa.

Thecate Hydrozoa produce stems from which polyps branch off. Similar to plants these stems form in two ways, either in a sympodial or in a monopodial type of growth. In the latter group a terminal organ develops which has similarities to a shoot apical meristem of higher plants: it elongates without a further differentiation. Similar to leaf formation in plants, thecate Hydrozoa produce polyps in a repetitive manner. This process continues during the whole life of the animal and has not yet been found to be limited by internal mechanisms. We studied the monopodially growing thecate Hydrozoon Dynamena pumila and suggest that the stem tip, the apical shoot meristem-like organ, is a polyp primordium hindered to develop into a polyp by the laterally developing polyps.

THE SHIKIMATE PATHWAY.

The shikimate pathway links metabolism of carbohydrates to biosynthesis of aromatic compounds. In a sequence of seven metabolic steps, phosphoenolpyruvate and erythrose 4-phosphate are converted to chorismate, the precursor of the aromatic amino acids and many aromatic secondary metabolites. All pathway intermediates can also be considered branch point compounds that may serve as substrates for other metabolic pathways. The shikimate pathway is found only in microorganisms and plants, never in animals. All enzymes of this pathway have been obtained in pure form from prokaryotic and eukaryotic sources and their respective DNAs have been characterized from several organisms. The cDNAs of higher plants encode proteins with amino terminal signal sequences for plastid import, suggesting that plastids are the exclusive locale for chorismate biosynthesis. In microorganisms, the shikimate pathway is regulated by feedback inhibition and by repression of the first enzyme. In higher plants, no physiological feedback inhibitor has been identified, suggesting that pathway regulation may occur exclusively at the genetic level. This difference between microorganisms and plants is reflected in the unusually large variation in the primary structures of the respective first enzymes. Several of the pathway enzymes occur in isoenzymic forms whose expression varies with changing environmental conditions and, within the plant, from organ to organ. The penultimate enzyme of the pathway is the sole target for the herbicide glyphosate. Glyphosate-tolerant transgenic plants are at the core of novel weed control systems for several crop plants.

The orientation of the dorsal/ventral axis of zebrafish is influenced by gravitation.

Following fertilization of eggs of Brachydanio rerio a blastodisc is formed which, by cleavage divisions and epibolic movements, gives rise to a cell cap covering the yolk. When about half of the yolk is covered by the cells, a thickening appears at the progressing margin, the embryonic shield, which gives rise to the axial organs of the future embryo. Thereby, the dorsal/ventral axis can be recognized. Our experiments show that the blastodisc is formed at the position of the micropyle, the only site where the sperm can enter the egg and oocyte. Later the head appears at this position. We show that the position of the embryonic shield on the circumference of the cell cap is influenced by gravitation. We also demonstrate that there is no correlation between the orientation of the first or second cleavage plane and the position of the embryonic shield.

Dicapryloylglycerol and ammonium ions induce metamorphosis of ascidian larvae.

Larvae of the tunicate Ciona start metamorphosis between some hours and a few days after hatching. Several substances were found to reduce this time span, such as vital dyes [Cloney (1961) Am Zool 1:67-87; Hirani (1961) Bull Mar Biol Stn Asamushi 11:121-125], heavy-metal ions including copper [see review by Lynch (1961) Am Zool 1:59-66] and the hormone thyroxine [Patricolo et al. (1981) Cell Tissue Res 214:289-301]. This study shows that low concentrations of ammonium ions as well as the second messenger dicapryloylglycerol induce metamorphosis immediately after hatching. On the other hand, when the follicle cells are removed newly hatched Ciona remain larvae for days. Follicle cells are possibly degraded by bacteria, which thereby produce ammonia.