bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarcoplasmic reticulum–mitochondrial through-space coupling in skeletal muscleThis paper is one of a selection of papers published in this Special Issue, entitled 14th International Biochemistry of Exercise Conference – Muscles as Molecular and Metabolic Machines, and has undergone the Journal’s usual peer review process.
Authors: Dirksen Robert T.
Published: May 2009

The skeletal muscle contractile machine is fueled by both calcium and ATP. Calcium ions activate the contractile machinery by binding to troponin C and relieving troponin-tropomyosin inhibition of actinomyosin interaction. ATP binding to myosin during the contractile cycle results in myosin detachment from actin, and energy liberated from subsequent ATP hydrolysis is then used to drive the next contractile cycle. ATP is also used to lower myoplasmic calcium levels during muscle relaxation. Thus, muscle contractility is intimately linked to the proper control of sarcomeric Ca2+ delivery and (or) removal and ATP generation and (or) utilization. In skeletal muscle, the sarcoplasmic reticulum (SR) is the primary regulator of calcium storage, release, and reuptake, while glycolysis and the mitochondria are responsible for cellular ATP production. However, the SR and mitochondrial function in muscle are not independent, as calcium uptake into the mitochondria increases ATP production by stimulating oxidative phosphorylation and mitochondrial ATP production, and production and (or) detoxification of reactive oxygen and nitrogen species (ROS/RNS), in turn, modulates SR calcium release and reuptake. Close spatial Ca2+/ATP/ROS/RNS communication between the SR and mitochondria is facilitated by the structural attachment of mitochondria to the calcium release unit (CRU) by 10 nm of electron-dense tethers. The resultant anchoring of mitochondria to the CRU provides a structural basis for maintaining bidirectional SR–mitochondrial through-space communication during vigorous contraction. This review will consider the degree to which this structural link enables privileged or microdomain communication between the SR and mitochondria in skeletal muscle.
Molecular responses to high-intensity interval exerciseThis paper is one of a selection of papers published in this Special Issue, entitled 14th International Biochemistry of Exercise Conference – Muscles as Molecular and Metabolic Machines, and has undergone the Journal’s usual peer review process.
Authors: Gibala Martin
Published: May 2009

From a cell-signaling perspective, short-duration intense muscular work is typically associated with resistance training and linked to pathways that stimulate growth. However, brief repeated sessions of high-intensity interval exercise training (HIT) induce rapid phenotypic changes that resemble traditional endurance training. Given the oxidative phenotype that is rapidly upregulated by HIT, it is plausible that metabolic adaptations to this type of exercise could be mediated in part through signaling pathways normally associated with endurance training. A key controller of oxidative enzyme expression in skeletal muscle is peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), a transcriptional coactivator that serves to coordinate mitochondrial biogenesis. Most studies of acute PGC-1α regulation in humans have used very prolonged exercise interventions; however, it was recently shown that a surprisingly small dose of very intense interval exercise, equivalent to only 2 min of all-out cycling, was sufficient to increase PGC-1α mRNA during recovery. Intense interval exercise has also been shown to acutely increase the activity of signaling pathways linked to PGC-1α and mitochondrial biogenesis, including AMP-activated protein kinase (α1 and α2 subunits) and the p38 mitogen-activated protein kinase. In contrast, signaling pathways linked to muscle growth, including protein kinase B/Akt and downstream targets p70 ribosomal S6 kinase and 4E binding protein 1, are generally unchanged after acute interval exercise. Signaling through AMP-activated protein kinase and p38 mitogen-activated protein kinase to PGC-1α may therefore explain, in part, the metabolic remodeling induced by HIT, including mitochondrial biogenesis and an increased capacity for glucose and fatty acid oxidation.
The many ways to regulate glucose transporter 4This paper is one of a selection of papers published in this Special Issue, entitled 14th International Biochemistry of Exercise Conference – Muscles as Molecular and Metabolic Machines, and has undergone the Journal’s usual peer review process.
Authors: Klip Amira
Published: May 2009

Glucose uptake into skeletal muscle is primarily mediated by glucose transporter 4 (GLUT4). The number of GLUT4 polypeptides at the surface of muscle cells rises rapidly in response to insulin, contraction, depolarization, or energy deprivation. However, distinct mechanisms underlie the gain in surface GLUT4 in each case. Insulin promotes its exocytosis to the membrane, regulating vesicle movement, tethering, docking, and fusion. In contrast, muscle contraction, depolarization, and energy demand reduce GLUT4 endocytosis. The signals involved in each case also differ. Insulin utilizes Akt, Rabs, and selective actin remodelling, whereas depolarization and energy deprivation engage AMP-activated protein kinase and Ca2+-dependent signals. GLUT4 internalizes via 2 major routes that involve dynamin, but only one requires clathrin. The clathrin-independent route is slowed down by energy deprivation, and is regulated by AMP-activated protein kinase. In addition to regulation of the exocytic and endocytic movement of GLUT4, glucose uptake is also modulated through changes in the transporter’s intrinsic activity. The glycolytic enzymes glyceraldehyde-3-dehydrogenase and hexokinase II contribute to such regulation, through differential binding to GLUT4.
Overexpression of the CXCL3 gene in response to oxidized low-density lipoprotein is associated with the presence of tendon xanthomas in familial hypercholesterolemia
Authors: Martín-Fuentes Paula , Civeira Fernando , Solanas-Barca María , García-Otín Angel Luis , Jarauta Estíbaliz , Cenarro Ana
Published: May 2009

To examine if overexpression of certain chemokines and proinflammatory cytokines in response to oxidized low-density lipoprotein could be involved in the onset and development of tendon xanthomas (TX), we quantified IL-1β, TNF-α, and IL-8 and compared gene expression of PPAR-γ, NF-κBIA, IL-8, IL-1β, CXCL3, tryptase, and TNF-α in macrophages of familial hypercholesterolemia subjects with and without TX stimulated with oxidized low-density lipoprotein at 1, 3, 6, and 18 h of incubation. We propose that chemokines belonging to the CXC family could play an important role in the etiology of TX, with CXCL3 being a possible biological marker of onset and development of TX.
Effect of alteration of translation error rate on enzyme microheterogeneity as assessed by variation in single molecule electrophoretic mobility and catalytic activity
Authors: Nichols Ellert R. , Shadabi Elnaz , Craig Douglas B.
Published: May 2009

The role of translation error for Escherichia coli individual β-galactosidase molecule catalytic and electrophoretic heterogeneity was investigated using CE-LIF. An E. coli rpsL mutant with a hyperaccurate translation phenotype produced enzyme molecules that exhibited significantly less catalytic heterogeneity but no reduction of electrophoretic heterogeneity. Enzyme expressed with streptomycin-induced translation error had increased thermolability, lower activity, and no significant change to catalytic or electrophoretic heterogeneity. Modeling of the electrophoretic behaviour of β-galactosidase suggested that variation of the hydrodynamic radius may be the most significant contributor to electrophoretic heterogeneity.
Volume regulation in the human airway epithelial cell line Calu-3
Authors: Harron Scott A. , Clarke Christina M. , Jones Christina L. , Babin-Muise Dominique , Cowley Elizabeth A.
Published: May 2009

Cells regulate their volume in response to changes in the osmolarity of both their extracellular and their intracellular environments. We investigated the ability of the human airway epithelial cell line Calu-3 to respond to changes in extracellular osmolarity. Although switching Calu-3 cells from an isosmotic to a hyperosmotic environment resulted in cell shrinkage, there was no compensatory mechanism for the cells to return to their original volume. In contrast, switching to a hyposmotic environment resulted in an initial cell swelling response, followed by a regulatory volume decrease (RVD). Pharmacologic studies demonstrate that the voltage-activated K+channels Kv4.1 and (or) Kv4.3 play a crucial role in mediating this RVD response, and we demonstrated expression of these channel types at the mRNA and protein levels. Furthermore, inhibition of the large- and intermediate-conductance Ca2+-activated K+channels KCa1.1 (maxi-K) and KCa3.1 (hIK) also implicated these channels as playing a role in volume recovery in Calu-3 cells. This report describes the nature of volume regulation in the widely used model cell line Calu-3.
Amelioration of hypoperfusion after traumatic brain injury by in vivo endothelin-1 knockout
Authors: Petrov Theodor
Published: May 2009

Endothelin 1 (ET-1) is one of the most powerful vasoconstrictors in the brain. Its expression is upregulated after traumatic brain injury (TBI) and is a major factor in the ensuing hypoperfusion. Attenuation of ET-1 effects has been mainly achieved by blockade of its receptors. The result of a direct blockade of ET-1 mRNA synthesis is not known. We used the Marmarou’s model to inflict injury to male Sprague–Dawley rats injected with antisense ET-1 oligodeoxynucleotides (ODNs) before injury. Laser Doppler flowmetry in noninjured rats (2 groups, i.e., untreated and animals that received cODNs) revealed a constant cerebral blood flow of approximately 14 mL·min–1·100 g–1, whereas the values from injured animals pretreated with control ODNs (cODNs) or from animals subjected to TBI alone were approximately 8.0 mL·min–1·100 g–1 during the 18–48 h time period post-TBI. After antisense ET-1 ODNs pretreatment, however, cerebral blood flow in injured animals was approximately 17 mL·min–1·100 g–1 during the 6–48 h time period. Antisense ET-1 ODNs-treated animals also had 19%–29% larger microvessel cross-sectional area and approximately one-third less ET-1 immunoreactivity in the 50–75% range after injury than did cODNs-treated animals after TBI. The results indicate that this direct in vivo approach is an effective therapeutic intervention for the restoration of cerebral blood flow after TBI.
Evidence that extracellular anions interact with a site outside the CFTR chloride channel pore to modify channel properties
Authors: Zhou Jing-Jun , Linsdell Paul
Published: May 2009

Extracellular anions enter into the pore of the cystic fibrosis transmembrane conductance regulator (CFTR) Cl– channel, interacting with binding sites on the pore walls and with other anions inside the pore. There is increasing evidence that extracellular anions may also interact with sites away from the channel pore to influence channel properties. We have used site-directed mutagenesis and patch-clamp recording to identify residues that influence interactions with external anions. Anion interactions were assessed by the ability of extracellular Pt(NO2)42– ions to weaken the pore-blocking effect of intracellular Pt(NO2)42– ions, a long-range ion–ion interaction that does not appear to reflect ion interactions inside the pore. We found that mutations that remove positive charges in the 4th extracellular loop of CFTR (K892Q and R899Q) significantly alter the interaction between extracellular and intracellular Pt(NO2)42– ions. These mutations do not affect unitary Cl– conductance or block of single-channel currents by extracellular Pt(NO2)42– ions, however, suggesting that the mutated residues are not in the channel pore region. These results suggest that extracellular anions can regulate CFTR pore properties by binding to a site outside the pore region, probably by a long-range conformational change. Our findings also point to a novel function of the long 4th extracellular loop of the CFTR protein in sensing and (or) responding to anions in the extracellular solution.
Effects of nest substrate on egg deposition and incubation conditions in a natural population of fathead minnows (Pimephales promelas)
Authors: Wisenden Brian , Alemadi Shireen , Dye Thomas P. , Geray Katie , Hendrickson Jodi , Rud Courtney , Jensen Michael , Sonstegard Goodwin , Malott Michelle
Published: May 2009

Fathead minnows ( Pimephales promelas Rafinesque, 1820) occur commonly in small lakes across the prairie region of North America. Males establish nests, court females, and tend the eggs. In our study population in Minnesota, males choose between two distinct nest substrates that differ in exposure to abiotic conditions affecting egg development: the underside of pond-lily (genus Nuphar Sm.) pads or the underside of submerged sticks. We found that lily pad nests contained more eggs, more clutches of different ages, and eggs distributed over a larger area than nests under submerged sticks. The difference in egg incubation temperatures between lily pad nests and stick nests varied diurnally with air–water temperature gradients. Proximity to the surface allowed lily pad nests to be significantly warmer during the day but only slightly cooler at night than nests under submerged sticks, resulting in about 10 h shorter time to hatch. The availability of lily pads for nests may greatly alter selection on sexual behaviour by males in competing for limiting nest sites of high quality, and female opportunity to exercise choice of mate. Moreover, availability of lily pads changes the role of abiotic conditions. In warm weather, males that nest under lily pads may achieve greater reproductive success than males that nest under sticks.
Morphine uptake, disposition, and analgesic efficacy in the common goldfish (Carassius auratus)
Authors: Newby N. C. , Wilkie M. P. , Stevens E. D.
Published: May 2009

The purposes of the present study were to examine the rate of morphine uptake in goldfish ( Carassius auratus (L., 1758)) when administered via the water, to calculate the pharmacokinetics of morphine when administered intraperitoneally, and to determine whether morphine could act as an analgesic. When administered via the water, morphine uptake was very slow, and the concentration accumulated in the plasma was <1% of that in water after 2 h. Furthermore, changing water pH or hardness caused small changes in morphine uptake from the water, but plasma levels remained <1% of water concentrations after 2 h exposure. The pharmacokinetics of morphine administered intraperitoneally (40 mg/kg) revealed a half-time for elimination of 37 h and a mean residence time of 56 h. Finally, morphine acted as an analgesic when administered via the water as demonstrated by significantly decreased rubbing behaviour in response to the presence of a noxious stimulus (subcutaneous injection of 0.7% acetic acid). Although morphine appeared to have analgesic properties in goldfish, morphine administered via ambient water is not recommended because of its slow rate of uptake.
Costs and economy of autotomy for tail movement and running speed in the skink Trachylepis maculilabris
Authors: Cooper, Jr. William E. , Smith Chad S.
Published: May 2009

Economy of autotomy (shedding less than complete tails) is advantageous via retention of ability to autotomize and reduction of costs, including lipid loss, regeneration, and decreased social status. We studied its effects on predator-distracting tail movements and running speed in the speckle-lipped mabuya ( Trachylepis maculilabris (Boettger, 1913)) by removing fractions of the autotomizable portion. Distance moved was shorter for autotomized tail segments one third of the total tail length than for longer segments. Movement duration did not vary with proportion removed. Longer movement suggests that shedding longer segments improves ability to distract predators, enhances difficulty of capturing a tail, and may require longer handling time. Tails were difficult to break in regenerated sections and did not move when broken. The lack of movement of regenerated portions after separation suggests permanent loss of capacity to distract predators. Decreased speed was confirmed as a cost of autotomy in lizards that lost at least two thirds of their tail. In lizards that lost one third of tails speed was intermediate to that of intact lizards and those that lost more. Graded decrease in speed as proportional loss increases is consistent with progressive loss of a counterweight that reduces lateral motion while running. Economy of autotomy entails trade-offs between immediate and long-term escape ability.
Novel β-substituted calix[4]pyrroles
Authors: Sessler Jonathan L. , Roznyatovskiy Vladimir V. , Lynch Vincent M.
Published: May 2009

Calix[4]pyrroles have attracted considerable attention within the macrocyclic, supramolecular, and porphyrin analog communities due to their ability to act as simple-to-synthesize receptors for common anions, such as chloride and fluoride. Reported here is what we believe is a new, potentially generalizable route to fully β-alkyl substituted calixpyrroles. These products are accessible from the starting pyrrolic esters, and are obtained via simple reaction with CH3Li , followed by subsequent quenching with HCl in ether. A representative system has been characterized by X-ray diffraction analysis. The present route allows access to calix[4]pyrroles bearing functionality, such as double bonds, off the so-called C-rim; such systems are of interest because they could allow for further synthetic elaborations and permit incorporation of calix[4]pyrroles into more complex structures.
Synthesis and spectroscopic properties of 1-(acridin-9-yl)-dipyrranes and 1-(acridin-9-yl)-dipyrrins
Authors: Gryko Daniel T. , Voloshchuk Roman
Published: May 2009

A new process leading to 1-(acridin-9-yl)dipyrranes has been elaborated. The titled skeleton is assembled in a convergent fashion from 5-aryl substituted dipyrranes and acridine via a nucleophilic addition, followed by the oxidation of adducts, which are formed in situ. These products were transformed into respective 1-(acridin-9-yl)dipyrrins via 2,3-dichloro-4,5-dicyano-1,4-benzoquinone mediated oxidation. Spectroscopic studies were conducted which revealed large Stokes shifts in 1-(acridin-9-yl)dipyrranes and led to the conclusion that there is a significant conjugation between both moieties in molecules of 1-(acridin-9-yl)dipyrrins.
Activation of PPARγ by rosiglitazone attenuates intestinal Cl−secretion
Authors: Bajwa Poonam J. , Lee Jimmy W. , Straus Daniel S. , Lytle Christian
Published: May 2009

The thiazolidinedione (TZD) drugs rosiglitazone (Ro) and pioglitazone (Po) are PPARγ agonists in widespread clinical use as insulin-sensitizing agents in Type 2 diabetes. On the basis of recent evidence implicating PPARγ as a positive modulator of intestinal epithelial differentiation, we hypothesized that TZD drugs might attenuate intestinal secretory function. To evaluate this possibility, we examined the effects of Ro and Po on electrogenic Cl−secretion [short-circuit current ( Isc)] in mouse intestinal segments and in cultured human intestinal epithelial cells (HT29-Cl.19A). As hypothesized, oral administration of Ro (20 mg·kg−1·day−1) to mice for 8 days markedly reduced intestinal Iscresponses to cAMP (forskolin)- and Ca2+(carbachol)-dependent stimuli. In these Ro-treated mice, cholera toxin-induced intestinal fluid accumulation was reduced 65%. With continued Ro treatment, the Iscresponse to carbachol recovered significantly, whereas that to forskolin remained attenuated. Treatment of HT29 cells for 5 days with 10 μM Ro or Po in vitro brought about a similar hyposecretory state. In HT29 cells, the loss of cAMP-dependent Cl−secretion was attributable to a reduced expression of CFTR Cl−channel, KCNQ1 K+channel, and Na-K-2Cl cotransporter-1 proteins. The transient loss of Ca2+-dependent Cl−secretion involved an impairment of basolateral Ca2+-stimulated K+channel activity without a detectable loss of KCa3.1 channel protein. Our results establish TZD drugs as important modulators of intestinal Cl−secretory function.
Hindlimb unweighting induces changes in the p38MAPKcontractile pathway of the rat abdominal aorta
Authors: Summers Scott Matthew , Hayashi Yuichiro , Nguyen Steven Vu , Nguyen Thu Minh , Purdy Ralph Earl
Published: May 2009

Hindlimb unweighting (HLU) of rats is a model used to mimic the cephalic fluid shift potentially involved in the orthostatic intolerance experienced by astronauts. Certain arteries in these rats exhibit a decreased contractile response to adrenergic agonists. It was shown previously that this may be caused by changes in thick filament regulation (Summers et al., Vascul Pharmacol 48: 208–214, 2008). In the present study, it was hypothesized that HLU also modifies thin filament regulation by effects on p38MAPKand ERK. Abdominal aorta rings from 20-day HLU rats and untreated controls were subjected to phenylephrine and phorbol 12,13-dibutyrate (PDBU) concentration response curves in the presence and absence of two inhibitors: the p38MAPKinhibitor SB-203580 and the MEK inhibitor U-0126. SB-203580 decreased control sensitivity to both agonists, but HLU sensitivity was not significantly affected. U-0126, which blocks enzymes immediately upstream of ERK, affected sensitivity to both agonists equally between control and HLU. Western blot analysis revealed no change in total levels of p38MAPKand its downstream target heat shock protein 27 but did reveal a decrease in phosphorylated levels of both after stimulation with PDBU and phenylephrine after HLU treatment. Neither total ERK nor phosphorylated levels after stimulation were affected by HLU. Total levels of caldesmon, a molecule downstream of both pathways, were decreased, but phosphorylated levels after stimulation were decreased by roughly twice as much. The results of this study demonstrate that HLU downregulates p38MAPK, but not ERK, signaling. In turn, this may decrease actin availability for contraction.
Elevated Antithyroid Peroxidase and Antinuclear Autoantibody Titers in Ménière’s Disease Patients: More than a Chance Association?
Authors: Nacci Andrea , Dallan Iacopo , Monzani Fabio , Dardano Angela , Migliorini Paola , Riente Lucrezia , Ursino Francesco , Fattori Bruno
Published: May 2009

Objective/Hypothesis: The aim of this prospective study is to evaluate the possible association between Ménière’s disease (MD) and autoantibodies. Methods: Fifty-five patients with definite MD (51 unilateral and 4 bilateral) were matched with 55 patients with unilateral vestibular paresis without cochlear involvement and 55 healthy subjects. Blood samples were collected from all study subjects for the determination of serum TSH, free triiodothyronine, free thyroxine, anti-TSH receptor antibody, antithyroperoxidase antibody, antithyroglobulin antibody and of antibodies to non-organ-specific antigens, namely antinuclear antibodies, antibodies to extractable nuclear antigens and antineutrophilic cytoplasmic antibodies. Results: Thirty-three subjects (60%) of the MD group had 1 or more elevated serum autoantibody levels, both organ and non-organ specific; 16 patients (29.1%) with unilateral vestibular paresis had 1 or more elevated serum autoantibody levels, while 13 healthy subjects (23.6%) had 1 or more elevated serum autoantibody levels. Conclusions: Based on our data we speculate that there is a more than a chance association between MD and ‘autoimmunity’, thus suggesting a hypothetical role of the immune system in MD pathogenesis. In other words, a pathogenetic role of an ‘immune dysregulation’ in MD patients can be hypothesized.
Earlier Intervention Leads to Better Sound Localization in Children with Bilateral Cochlear Implants
Authors: Van Deun Lieselot , van Wieringen Astrid , Scherf Fanny , Deggouj Naïma , Desloovere Christian , Offeciers F. Erwin , Van de Heyning Paul H. , Dhooge Ingeborg J. , Wouters Jan
Published: May 2009

We present sound localization results from 30 children with bilateral cochlear implants. All children received their implants sequentially, at ages from 6 months to 9 years for the first implant and 1.5–12 years for the second implant, with delays of 10 months to 9 years. Localization was measured in the sound field, with a broadband bell-ring presented from 1 of 9 loudspeakers positioned in the frontal horizontal plane. The majority of the children (63%) were able to localize this signal significantly better than chance level. Mean absolute error scores varied from 9 to 51° (root mean square error scores from 13 to 63°). The best scores were obtained by children who received their first implant before the age of 2 years and by children who used hearing aids prior to implantation for a period of 18 months or longer. Age at second implantation was important in the group of children who did not use a contralateral hearing aid during the unilateral implant period. Additionally, children who attended a mainstream school had significantly better localization scores than children who attended a school for the deaf. No other child or implantation variables were related to localization performance. Data of parent questionnaires derived from the Speech, Spatial and Qualities of Hearing Scale were significantly correlated with localization performance. This study shows that the sound localization ability of children with bilateral cochlear implants varies across subjects, from near-normal to chance performance, and that stimulation early in life, acoustically or electrically, is important for the development of this capacity.
Color Discrimination Performance in Patients with Alzheimer’s Disease
Authors: Salamone Giovanna , Di Lorenzo Concetta , Mosti Serena , Lupo Federica , Cravello Luca , Palmer Katie , Musicco Massimo , Caltagirone Carlo
Published: May 2009

Background/Aims: Visual deficits are frequent in Alzheimer’s disease (AD), yet little is known about the nature of these disturbances. The aim of the present study was to investigate color discrimination in patients with AD to determine whether impairment of this visual function is a cognitive or perceptive/sensory disturbance. Methods: A cross-sectional clinical study was conducted in a specialized dementia unit on 20 patients with mild/moderate AD and 21 age-matched normal controls. Color discrimination was measured by the Farnsworth-Munsell 100 hue test. Cognitive functioning was measured with the Mini-Mental State Examination (MMSE) and a comprehensive battery of neuropsychological tests. The scores obtained on the color discrimination test were compared between AD patients and controls adjusting for global and domain-specific cognitive performance. Results: Color discrimination performance was inversely related to MMSE score. AD patients had a higher number of errors in color discrimination than controls (mean ± SD total error score: 442.4 ± 84.5 vs. 304.1 ± 45.9). This trend persisted even after adjustment for MMSE score and cognitive performance on specific cognitive domains. Conclusions: A specific reduction of color discrimination capacity is present in AD patients. This deficit does not solely depend upon cognitive impairment, and involvement of the primary visual cortex and/or retinal ganglionar cells may be contributory.
Concept of Representation and Mental Symptoms
Authors: Rejón Altable Carlos , Vidal Castro Carol , López Santín J.M.
Published: May 2009

Background: Most current theories explaining theory of mind (ToM) rely on the concept of ‘representation’, as it is usually employed in cognitive science, and is thus affected by its epistemic shortcoming, namely its incapacity to use ‘sub-signifier’ level information. This shortcoming is responsible for the lack of specificity of ToM deficits, which are now found in very different syndromes, from schizophrenia to bipolar disorder or borderline personality disorder, in spite of its original formulation being restricted to childhood autism. Method: Representation, its shortcomings and the way they may affect clinical/research programs undergo a conceptual analysis, which shows how representational-founded semiology leave out information that is essential for symptom specificity and correct symptom assessment. Schizophrenic autism, delusional perception and axial syndromes are studied as examples of both the difficulties that have arisen and possible ways of dealing with them. Results: Transfers of properties between different meanings of ‘representation’ together with a systematic ambiguity in the use of ‘representation’ are proposed as the main ways for representational approaches to assure stability to their proposals in spite of the violence exerted on clinical phenomena. Conclusions: It is exposed how systematic ambiguity and epistemic shortcomings both affect Leslie’s formulation of ToM and, further, the importance of these characteristics of the concept of ‘representation’ for general issues in psychiatric semiology.
Die InfusInsbehandlung der schweren Dehydratation (Säuglingstoxikose)
Authors: Egli F. , Wyss P. , Stalder G.
Published: May 2009

Die schwere Dehydratation (Säuglingstoxikose) ist eine häufige le-bensbedrohliche Krankheit. Die Infusionsbehandlung der verschiedenen Dehydratationsformen wird ausführlich besprochen. Den Behandlungsschemata werden zudem eine Reihe wichtiger Rat-schläge für die Diagnose vorausgeschickt. Es wird zudem auf klinische und pathophysiologische Besonderheiten, die bei der Infusionsbehandlung der schweren Dehydratation zu beachten sind, hin-gewiesen.
Total Parenteral Alimentation in Childhood General Considerations
Authors: Shmerling D.H.
Published: May 2009

The paper presents a discussion of the definition, the indications and some of the difficulties and complications of total long-term parenteral alimentation in infants and children. The problems of protein quality, the inadequacy of the E/T ratio, the quantities and quality of carbohydrates and the metabolic complications due to inappropriate electrolyte and mineral salts composition are reviewed. It is pointed out that the optimal amounts of some of the components used are still under investigation, that there seems to be no imperative reason not to use glucose as the sole carbohydrate in this age group and that most of the possible long-term sequelae and complications of total long-term parenteral alimentation will have to be looked for by prospective studies of the children treated.
Paraplazentare Ernährung des Fetus
Authors: Heller L. , Fahnenstich E. , Gerner R. , Halberstadt E. , Römer E.
Published: May 2009

Intraamnial applizierte Aminosäuren verschwinden unerwartet rasch und relativ gleichmäβig aus der Amnionflüssigkeit. Bei Plazentainsuffizienz und damit gleichzeitig bestehendem intrauterinem Ei-weiβmangel nimmt der Aminosäurenspiegel im Fruchtwasser beson-ders rasch ab, während er bei intrauterinem Fruchttod über Stunden praktisch unverändert bleibt. Diese Beobachtung läβt darauf schlie-βen, daβ die infundierten Aminosäuren vom lebenden Fetus verwer-tet werden. Dafür spricht auch ein Absinken der Glukosekonzen-tration und ein Anstieg des Pyruvats im Fruchtwasser. Nach den bisherigen Erfahrungen erscheint es durchaus möglich, den Fetus auf paraplazentarem Wege mit lebenswichtigen Substraten zu versorgen.
Systematische und zufällige Fehler bei der Bestimmung von Parametern des Säure-Basen-Haushalts
Authors: Liss E.
Published: May 2009

Es wird ein Überblick über die häufigsten Fehlerursachen bei der Bestimmung der Parameter des Säure-Basen-Haushalts gegeben. Von besonderem Einfluβ sind die systematischen Fehler, die u. a. durch unsachgemäβe Lagerung der Blutproben, durch Verwendung unge- eigneter Eichlösungen oder mangelhafte Temperaturkonstanz bei der pH-Messung auftreten können. Die Erzielung einer guten Präzision ist beim derzeitigen Stand der Apparatetechnik unproblematisch.
Bilanzierte künstliche Ernährung nach totaler Pankreatektomie (Stoffwechseldaten)
Authors: Reissigl H. , Bodner E. , Falser N.
Published: May 2009

Der Epsatz von operativ verlorengegangenen Bestandteilen des normalen Stoffwechsels stellt ein bedeutsames Problem für den Kliniker dar. Anhand eines Falles von totaler Pankreatektomie wegen Pan-kreaskarzinom wird dieses für die klinische Nachbehandlung essen-tielle Problem aufgezeigt. Es ist Sinn dieser Veröffentlichung, durch den direkten Vergleich der Aussagekraftverschiedener labordiagnostischer Methoden die ideale Palette von reproduzierbaren Laborunter-suchungen aufzuzeigen, welche nach einer so einschneidenden Operation eine genaue Kontrolle des Stoffwechsels des Patienten im Sinne therapeutischer Maβnahmen garantieren. Es werden die als Verlaufskontrolle erhobenen Laborwerte tabel-larisch aufgeführt und Schluβfolgerungen für therapeutische Maβnahmen, wie z. B. die laufende Gerinnungskontrolle, gezogen.
Über die Komplikationen des Vena-subclavia-Katheters und deren Verhütung
Authors: Bauer H.
Published: May 2009

Der Vena-subclavia-Katheter (VSK) hat sich heute in Notfallmedizin und Intensivtherapie als Vena-cava-Zugang bestens bewährt. Er ist jedoch mit einer Reihe teils schwerwiegender Komplikationen be-lastet. Die wesentlichsten sind solche durch Fehlpunktion wie Pleura-und Arterienverletzung, embolische Komplikationen wie Katheter-embolie, Luftembolie oder Thrombembolie sowie die Infektion. Ur-sache und Häufigkeit dieser Komplikationen sowie ihre Verhütung werden dargestellt. Abschlieβend wird ein Kathetermodell (Cava-fix®) vorgestellt, das in seiner Konzeption die Gefahrenquellen des VSK weitestgehend berücksichtigt. Die Vorteile des VSK gegenüber anderen Methoden des Katheterismus der Vena cava dürfen als ge-sichert gelten. Die Indikation ist wegen der genannten Komplikationen jedoch eng zu stellen.
Experience with Essential Amino Acids in the Treatment of Patients with Chronic Uremia
Authors: Ahlberg M. , Bergström J. , Fürst P. , Josephson B. , Norée L.-O. , Vinnars E.
Published: May 2009

Nitrogen balance studies in chronic severe uremia have shown that it is possible to convert the negative nitrogen balance on a protein-poor diet to a positive one when the diet is supplemented with the essential amino acids intravenously or orally. It has been possible to make the diet variable and good tasting. This is a great advance as the patients can remain on the diet for a long time. 15N-studies have shown that this nitrogen balance represents true protein synthesis. These studies have also shown that histidine may be an essential amino acid in chronic severe uremia and further improves the nitrogen balance. During long-term treatment with the diet supplemented with the essential amino acids including histidine, no signs of progressive neuropathy, bleeding or muscle wasting have been observed. We think that this diet and amino acid regimen is a feasible way to keep chronic severe uremic patients in fairly good general condition and nutritive state until they can have a renal transplantation or a place in a home-dialysis program.
Infusionstherapie bei der Harnleiterdarmimplantation
Authors: Stark R. , Harler B.
Published: May 2009

Es wird auf die speziellen Probleme der Harnleiterdarmimplantation eingegangen, in deren Gefolge es häufig zu Elektrolyt-stoffwechselstörungen wie Hyperchlorämie, metabolischer Azi-dose und Hypokaliämie mit alien Komplikationen kommt. Die präoperative Vorbereitung des Patienten sowie die postoperative Infusionsbehandlung werden ausführlich dargelegt, wobei An-haltspunkte für die zuzuführende Infusions-, Elektrolyt- und Ka-lorienmenge gegeben werden. Auf postoperative Komplikationen wird anhand eines speziellen Falls hingewiesen, auch die Theo-rien zu den Ursachen der Elektrolytentgleisungen werden kurz erwähnt.
Chemisch definierte Diät (CDD) als eine diagnostische und therapeutische Hilfe bei Nahrungsmittelallergie
Authors: Berggren E.
Published: May 2009

Vivasorb® bewährte sich als Diagnostikum und Therapeutikum bei einer 78jährigen Patientin, die drei Jahre lang an einer Nahrungsmittelallergie gelitten hatte. Die Ernährung rait Vivasorb® machte die Patientin nicht nur völlig beschwerdefrei, sondern ermöglichte auch eine Austestung der verantwortlichen ingestiven Allergene trotz kompletter oraler Ernährung.
Langzeitverträglichkeit hochdosierter Infusionen von Hydroxyäthylstärke und Dextran 60 bei normovolämischen Kaninchen
Authors: Hölscher B.
Published: May 2009

Normovolämischen Kaninchen wurden 6% Hydroxyäthylstärke in 0,9% NaCl, 6% Dextran 60 in 0,9% NaCl oder 0,9% NaCl in einer Dosierung von 50 ml täglich 5mal wöchentlich bis zu einer beabsichtigten Versuchsdauer von 3 Wochen i.v. verabreicht. In der Hydroxyäthylstärke- und Dextran-Serie überlebten nur je 2, in der NaCl-Serie 4 Versuchstiere bis zum Versuchsende. In alien 3 Serien fanden sich erhebliche Flüssigkeitsansammlungen in den groβen Körperhöhlen und ödematöse Lungenveränderungen als Folgen der Kreislaufüberbelastung. In Leber und Niere waren schwere hydropische Zellveränderungen bei den mit Hydroxyäthylstärke oder Dextran behandelten Versuchstieren nachzuweisen, dage-gen nicht, wenn nur NaCl infundiert worden war. Nach den mitgeteilten Befunden besteht kein Unterschied zwischen den Effekten extrem hoher, über einen Zeiraum von 3 Wochen verabreichter Dosen von Hydroxyäthylstärke und Dextran 60.
Heparintherapie bei postoperativer Verbrauchskoagulopathie im Kindesalter
Authors: Fischer M. , Wurnig P.
Published: May 2009

Bei acht Kindern wurde aufgrund klinischer und blutgerinnungs-analytischer Befunde in der postoperativen Phase eine Gerinnungs-störung im Sinne einer Verbrauchskoagulopathie festgestellt. Eine »niederdosierte Heparintherapie«, ergänzend zur postoperativen Basistherapie, wurde durchgeführt, wobei die Dosis bei 3–5 E/kg Körpergewicht/h lag und als Dauerinfusion verabreicht wurde. Die günstigen Behandlungsergebnisse wurden besprochen.
Plasma Exchange with Plasma Protein Fraction and Lactated Ringer’s Solution Using the Continuous Flow Cell Separator
Authors: Farrales F.B. , Summers T. , Belcher C. , Bayer W.L.
Published: May 2009

Ten patients underwent 50–70 percent plasma exchanges using the continuous flow cell separator. The exchange material consisted of Plasma Protein Fraction (PPF) and Lactated Ringer’s Solution (LRS) instead of fresh frozen, modified or lyophilized plasma. No bleeding or other complications were encountered. The coagulation factor activity after exchange was above that required for hemostasis. The procedure is safe, expeditious and efficient.
Serologischer Nachweis karzinomspezifischer Antigene (und deren Bedeutung als Spenderscreening bzw. für bestimmte Krankheitsgruppen)
Authors: Reissigl H. , Falser N.
Published: May 2009

In den letzten Jahren sind in umfassendem Maβe Methoden zur labor -diagnostischen Entdeckung karzinomspezifischer Proteinfraktionen im Serum entwickelt worden. Am Beispiel des Alpha-1-Fetoproteins wird versucht, die Brauchbarkeit und die diagnostische Aussagekraft dieser Untersuchungen an einem groβen Potential klinisch »gesun-der« Patienten zu überprüfen. Anhand eines Falls von primärem Leberkarzinom, der durch Routinekontrolle des Alpha-1-Fetoproteins am Blutspender diagnostiziert werden konnte, wird die Möglichkeit breitschichtiger Untersuchungen zur Früherfassung des Malignomwachstums diskutiert.
Stoffwechselverhalten bei totaler parenteraler Ernährung in der postoperativen Phase
Authors: Peter K. , Dutz R. , Greiner E. , Kersting K.-H. , Martin E. , Mast D. , Schaub P. , Schmidt R. , Schmitz E.R.
Published: May 2009

Bei magenoperierten Patienten wurde eine postoperative totale parenterale Ernährung mit einer Kombination zweier sich in ihrer Zusammensetzung ergänzender Infusionslösungen durchgeführt. Täglich wurden 80 g L-Aminosäuren, zirka 2500 kcal in Form eines Glukose-Lävulose-Xylit-Gemisches sowie Elektrolyte und Spurenelemente infundiert. Stoffwechselparameter, Serumspiegel und Urinausscheidung der wichtigsten zugeführten Substanzen wurden täglich zum gleichen Zeitpunkt bestimmt. Die Relation der Kalorienträger Glukose: Lävulose: Xylit = 1:1:1 erwies sich dabei als günstige Kombination in bezug auf Stoffwechselverhalten sowie notwendige tägliche Kalorienzufuhr. Der Basisbedarf der Patienten an Elektrolyten wurde durch die in den Lösungen enthaltene Menge weitgehend gedeckt.
Bedeutung der postoperativen parenteralen Ernährung – gemessen an nieder- und hochmolekularen Plasmaproteinen
Authors: Kult J. , Treutlein E. , Dragoun G.-P. , Heidland A.
Published: May 2009

Durch kontinuierliche parenterale Zufuhr von Kohlenhydraten, verbunden mit essentiellen Aminosäuren und L-Histidin, konnte bei 24 Patienten nach abdominellen chirurgischen Eingriffen während des postoperativen Verlaufs eine signifikante Verbesserung des Harnstoffstickstoffs im Serum und des Plasmaproteinstoffwechsels erreicht werden. Eine vergleichbare Kontrollgruppe von 15 Patienten zeigte unter alleiniger bilanzierter Wasser-, Elektrolyt- und Vitamin-zufuhr in der postoperativen Phase signifikant schlechtere Ergebnisse. Von besonderem klinischem Interesse scheinen die Beobachtungen zu sein, daβ sich unter dem Einfluβ der parenteralen Ernährung die beginnende Azotämie und das Defizit der Immunglobuline (IgG) insbesondere der Komplementkomponenten (C1q, C3-Aktivator) schneller nach dem operativen Streß bessern. Gleichzeitig zeigte sich, daß eine adäquate parenterale Ernährung auch die postoperative Verhaltensweise einiger Plasmaproteine (des retinolbindenden Proteins, des Albumins, Transferrins und Präalbumins) signifikant beeinflussen kann.
Zur Bedeutung des Kohlenhydratanteils in einer synthetischen Diät
Authors: Förster H. , Heller G. , Fortmeyer H.P.
Published: May 2009

Bei Ernährungsversuchen mit freiwilligen Versuchspersonen wurde der Einfluβ einer praktisch fettfreien kohlenhydratreichen Diät auf verschiedene Parameter untersucht. In Ergänzung wurde in tier-experimentellen Fütterungsversuchen der Einfluβ unterschiedlicher Kohlenhydratzusätze auf Parameter des Fettstoffwechsels bestimmt. Bei den freiwilligen Versuchspersonen führte die fettfreie, kohlen-hydratreiche Ernährung rasch zu einer Verminderung der Serumcholesterinkonzentration. Dieser Effekt war besonders ausgeprägt bei primär erhöhten Serumcholesterinwerten. Austausch der Glukosekohlenhydrate (sie bestanden vorwiegend aus Oligosacchariden) durch Fruktose oder durch Saccharose hatte keine weiteren Veränderungen der Serumkonzentrationen von Cholesterin oder von Triglyzeriden zur Folge (z. B. im Sinne einer Hyperlipämie). Bei freiwilligen Versuchspersonen konnten somit keine Anzeichen für eine kohlenhydratinduzierte Hyperlipämie gefunden werden. lm Tierversuch konnte nur unter extremen Bedingungen (60% Fruktose in der Nahrung) ein mäβiger Anstieg der Serumtriglyzeridkonzentration durch Verfüttern von Fruktose hervorgerufen werden. Die Cholesterinkonzentration im Serum blieb jedoch auch unter diesen Bedingungen völlig unverändert. Auch ein wesentlicher Einfluβ auf die Fettkonzentration der Leber (Triglyzeride oder Cholesterin) konnte nicht festgestellt werden. Erst bei vollständig unausgewogener Diät (80% Glukose oder 80% Fruktose) kam es zu einer leichten Leberverfettung und zu einer mäβigen Hypertriglyzeridämie. Die Cholesterinkonzentration im Serum blieb jedoch weitgehend gleich, diejenige in der Leber verminderte sich sogar. Aus diesen Ergebnissen wird die Schluβfolgerung gezogen, daβ eine kohlenhydratinduzierte Hypertriglyzeridämie nur unter den extremen Bedingungen einer Nährstoffimbalanz oder einer Überernährung hervorgerufen werden kann.
Die Wirksamkeit verschiedener Elektrolytlösungen auf den Wasser- und Elektrolythaushalt in der postoperativen Phase
Authors: Martin E. , Peter K. , Glocke M. , Hilgenfeldt F. , Kersting K.-H. , Müller H.P. , Riegelsberger B. , Schaub P.
Published: May 2009

Drei quantitativ und qualitativ unterschiedlich zusammengesetzte Elektrolytlösungen wurden in ihren Auswirkungen auf die Homöostase in der pr-ä, intra- und postoperativen Phase bei Patienten, die sich mittelschweren operativen Eingriffen unterziehen muβten, unter-sucht. Anhand von Elektrolyt- und Osmolaritätsbestimmungen in Serum und 24-Stunden-Urin, Blutgasanalysen, Bestimmungen von Hämoglobin und Hämatokrit sowie des 24-Stunden-Volumens und spezifischen Gewichtes des Urins konnte eine für die pr-ä, intra-und postoperative Situation des Patienten »bedarfsadaptierte« Elektrolytzufuhr ermittelt werden. Die gemessenen Parameter konnten durch die Zufuhr einer Infusionslösung mit diesem Elektrolytgehalt im Meβzeitraum vor, während und nach der Operation lückenlos im Normbereich gehalten werden.
Dauerregistrierung des Leistungsumsatzes bei Patienten mit Schädel-Hirn-Trauma und Hirntumoren
Authors: Wesemann W.
Published: May 2009

Mit Hilfe einer Meβkette, der das Prinzip der indirekten Kalorimetrie zugrunde liegt, wird bei Patienten mit Hirntumoren und Hirntraumen der Energieumsatz langzeitregistriert. Entgegen den Vorstellungen, daβ die katabole Stoffwechselsituation in der postoperativen/ posttraumatischen Phase einer Minusbilanz zwischen Bedarf und enteralem/parenteralem Angebot entspricht, zeigt sich, daβ im Regel-fall der Energiebedarf nur um das 1- bis 11/2fache gegenüber der Norm gesteigert ist. Klinische Verläufe, die durch gesteigerte muskuläre Aktivität gekennzeichnet sind (Anfallsgeschehen, Streckauto-matismen, hochgradige psychomotorische Unruhezustände), weisen bei Langzeitmessung einen maximalen Tagesbedarf von 3500 Kalorien auf. Die Änderung der katabolen Stoffwechselsituation durch ein hoch-kalorisches Angebot (5000 und 6000 Kalorien/Tag) kann bei dem deutlich geringeren Verbrauch nur auf einer Beeinflussung der Stoff-wechselregulation beruhen.
Der vertragliche Auskunftsanspruch des Patienten gegen den transfundierenden Arzt
Authors: Uhlenbruck W.
Published: May 2009

Nach herrschender Meinung in Literatur und Rechtsprechung besteht kein Anspruch des Patienten auf Herausgabe von Krankenunterlagen wie z. B. Röntgenaufnahmen, EKG, Blutbild, EEG usw. gegen den behandelnden Arzt. Eine gesetzliche Ausnahme findet sich neuerdings aber in § 29 Abs. 3 RöntgenVO. Das Oberlandesgericht Köln hat in einer Entscheidung vom 15. Juni 1974 den Rechts-anspruch eines Privatpatienten gegen einen Krankenhausarzt auf Herausgabe der Krankenunterlagen bejaht. Obgleich sich zur Herausgabepflicht von ärztlichen Unterlagen eine Änderung der Rechtsprechung abzuzeichnen beginnt, hat sich die rechtliche Situation des Arztes im Haftpflichtprozeβ kaum verschlechtert, denn in fast alien Fallen einer berechtigten Herausgabeverweigerung des Arztes
Grundsätzliches zur Applikationstechnik von Infusionen
Authors: Esser H.
Published: May 2009

Zur Applikation von Infusionslösungen eignet sich am besten der Vena-subclavia-Katheter; die damit verbundenen teilweise schwer-wiegenden Komplikationen lassen sich nur durch eine saubere Einführungstechnik und bei Beachtung der Kontraindikationen weit-gehend vermeiden. In seltenen Fallen dient der Cava-inferior-Katheter als Alternativzugang. Bei kurzdauernden Infusionen und nicht bestehender Kreislaufzentralisation kommen Arm- und Beinvenenpunktionen in Betracht. Wegen häufiger Komplikationen und Schwierigkeiten beim Einführen wird vom Armvenenkatheter abgeraten.
Infusionstherapie bei Störungen des Natrium- und Wasserhaushalts
Authors: Kolloch R. , Stumpe K.O.
Published: May 2009

Wassermangel, Wasserüberschuβ sowie Natriummangel stellen die wichtigsten Störungen des Natrium- und Wasserhaushalts dar. Dabei müssen die drei Gröβen Wasser, Elektrolyte und Säure- Basen- leichgewicht wegen vielfältiger Interdependenzen stets in ihrem komplexen Zusammenhang betrachtet werden. Die Wiederherstellung einer ausgeglichenen Bilanz zwischen Ein- und Ausfuhr bildet die Grundlage der Infusionstherapie.
Infusionstherapie bei gastroenterologischen Erkrankungen
Authors: Miederer S.E.
Published: May 2009

ln einer knappen Übersicht werden die Indikationen und Anwendungen der Infusionstherapie im gastroenterologischen Bereich (Erbrechen, Fisteln, Durchfälle, Ileus, Peritonitis) besprochen. Dabei wird darauf hingewiesen, daβ bei Wasser- und Elektrolytverlusten starre Therapieschemata nicht sinnvoll sind, sondern daβ immer, sofern dies möglich ist, eine Bilanzierung zu erfolgen hat. Die parenterale Ernährung findet ihre Anwendung bei Obstruktionen des oberen Gastrointestinaltrakts, bei Maldigestion und Malabsorption. Auf die Problematik der Infusionstherapie beim Leberkoma und bei der akuten Pankreatitis wird hingewiesen.