[Different Prevalences of Pneumological Disease Patterns in Outpatient and Inpatient Care]. / Unterschiedliche Häufigkeiten pneumologischer Krankheitsbilder in der ambulanten und stationären Medizin.

BACKGROUND: Evaluating the focus of treatment in pneumological inpatient and outpatient care is of special interest due to its impact on physician, patient and research. This work describes differences and commonalities in the focus of treatment of current pneumological inpatient and outpatient care and discusses their impact on patient, physician and research. METHODS: This study compares the inpatient and outpatient sector based on the prevalence of ICD codes of a pneumological specialist clinic (5.211 cases of 2016) and the most prevalent ICD-10 codes of pneumology practices in the third quarter 2016, published by the Association of Statutory Health Insurance Physicians North Rhine ("Kassenärztliche Vereinigung Nordrhein", 142.431 cases). RESULTS: Whereas the proportion of many pneumological disease patterns treated in physicians' practices and hospitals is similar, the relative frequencies of specific diseases differ considerably between the two. Treatment of allergic conditions such as allergic rhinopathy and bronchial asthma is mostly done on an outpatient basis while respiratory insufficiency and lung carcinoma constitute domains of pneumological inpatient care. CONCLUSION: Despite many commonalities in the focus of treatment in pneumological inpatient and outpatient care, there are also substantial differences between the two. These affect medical training, the conduct of clinical studies, and in particular, patient care. In order to maintain a high level of medical care in all areas of pneumology a close exchange between inpatient and outpatient sector seems crucial. In the end, the availability of medical expertise across both sectors will benefit all: physicians, patients and medical science.

Development of the photosynthetic apparatus during light-dependent greening of a mutant of Chlorella fusca.

The formation of chlorophyll, cytochrome f, P-700, ribulose bisphosphate carboxylase as well as photosynthesis and Hill reaction activities were tested during the light-dependent greening process of the Chlorella fusca mutant G 10. Neither chlorophyll nor protochlorophyllide was detected in the darkgrown cells. When transferred to light the mutant cells developed chlorophyll and established its photosynthetic capacity after a short lag phase. In the in vivo absorption spectra a spectral shift of the red absorption peak position from 674 to 680 nm was indicated during the first 3 h of greening. Cytochrome f was already present in the dark-grown cells, but during the greening phase a threefold increase in the cytochrome f content could be seen. At the early stages of greening a characteristic primary oscillation in the content of cytochrome f was observed. P-700 was lacking in the dark and during the first 30 min of illumination. From the first to the second h of light a forced synthesis of P-700 took place and the time-course curve for the ratios of P-700/chlorophyll rose to a sharp maximum. The synthesis of P-700 started together with photosystem I activity and showed similar kinetics. We found the simultaneous appearance of photosystem II, photosystem I, and photosynthetic activities 30 min after the beginning of the illumination. Based on chlorophyll content they attained maximum activity after 2 h of light, but at this time photosystem I capacity proved to be remarkably higher than photosynthetic and photosystem II activities. Highest carboxylase activity existed in darkgrown cells. During the greening process the activity of the enzyme decreased continuously. After 2 h of illumination chlorophyll synthesis partially served to increase the size of the photosynthetic unit, which consequently led to a decrease in the light energy needed to saturate photosynthesis and also to a decrease of photosynthetic rate based on chlorophyll content.