The Convective Transport of Active Species in the Tropics (CONTRAST) Experiment.

The Convective Transport of Active Species in the Tropics (CONTRAST) experiment was conducted from Guam (13.5° N, 144.8° E) during January-February 2014. Using the NSF/NCAR Gulfstream V research aircraft, the experiment investigated the photochemical environment over the tropical western Pacific (TWP) warm pool, a region of massive deep convection and the major pathway for air to enter the stratosphere during Northern Hemisphere (NH) winter. The new observations provide a wealth of information for quantifying the influence of convection on the vertical distributions of active species. The airborne in situ measurements up to 15 km altitude fill a significant gap by characterizing the abundance and altitude variation of a wide suite of trace gases. These measurements, together with observations of dynamical and microphysical parameters, provide significant new data for constraining and evaluating global chemistry climate models. Measurements include precursor and product gas species of reactive halogen compounds that impact ozone in the upper troposphere/lower stratosphere. High accuracy, in-situ measurements of ozone obtained during CONTRAST quantify ozone concentration profiles in the UT, where previous observations from balloon-borne ozonesondes were often near or below the limit of detection. CONTRAST was one of the three coordinated experiments to observe the TWP during January-February 2014. Together, CONTRAST, ATTREX and CAST, using complementary capabilities of the three aircraft platforms as well as ground-based instrumentation, provide a comprehensive quantification of the regional distribution and vertical structure of natural and pollutant trace gases in the TWP during NH winter, from the oceanic boundary to the lower stratosphere.

Atmospheric benzenoid emissions from plants rival those from fossil fuels.

Despite the known biochemical production of a range of aromatic compounds by plants and the presence of benzenoids in floral scents, the emissions of only a few benzenoid compounds have been reported from the biosphere to the atmosphere. Here, using evidence from measurements at aircraft, ecosystem, tree, branch and leaf scales, with complementary isotopic labeling experiments, we show that vegetation (leaves, flowers, and phytoplankton) emits a wide variety of benzenoid compounds to the atmosphere at substantial rates. Controlled environment experiments show that plants are able to alter their metabolism to produce and release many benzenoids under stress conditions. The functions of these compounds remain unclear but may be related to chemical communication and protection against stress. We estimate the total global secondary organic aerosol potential from biogenic benzenoids to be similar to that from anthropogenic benzenoids (~10 Tg y(-1)), pointing to the importance of these natural emissions in atmospheric physics and chemistry.

Experimental changes to limb muscles elicit contralateral reactions: the problem of controls

The extensor digitorum longus muscle (EDL) or soleus muscle (SOL) in rats was mechanically overloaded on one side. The muscles were (i) untreated (normal) or (ii) self- or foreign-reinnervated (leading to persisting muscle fibres) or transplanted (leading to regenerating muscle fibres). The effects of the different procedures were studied in the treated and untreated muscles on the operated side and in the untreated muscles on the contralateral side. Overloading led to an absolute increase in mass (versus control values) in the normal muscles and to a relative increase in mass (versus the lower mass after reinnervation) in the treated muscles. The mechanism underlying this gain in mass was usually a compensatory hypertrophy. Overloading was followed by transformation of fibres from fast to slow in normal muscles. In the reinnervated muscles, the fibre distribution changed in response to the new nervous input and then remained constant. The majority of the experimental procedures elicited significant muscular changes in the contralateral muscles, including hyperplasia, fibre transformation and fibre hypertrophy or atrophy. The changes are interpreted as the consequence of a general compensatory neuromuscular activity designed to maintain a symmetrical posture during walking and running. These frequent and substantial muscular changes in the unoperated muscles clearly show that the muscles of the contralateral side cannot be used as normal controls.

Active therapy for chronic low back pain: part 2. Effects on paraspinal muscle cross-sectional area, fiber type size, and distribution.

DESIGN: Randomized prospective study to compare the effects of three types of active therapy on the back muscle structure of chronic low back pain patients. OBJECTIVES: To analyze the effects of 3 months active therapy on gross back muscle size and muscle fiber type characteristics and their relationship to changes in muscle function. SUMMARY OF BACKGROUND DATA: Many studies have documented a diminished muscular performance capacity in cLBP patients, but few have supported this with evidence of alterations in either the macro- or microscopic structure of the paraspinal muscles. Investigations of the changes in muscle structure following active rehabilitation are even rarer. METHODS: Assessments of trunk muscle cross-sectional area (using MRI), erector spinae fiber size/type distribution and pathology (percutaneous biopsy), and muscle function (see Part 1) were made in a group of 59 individuals with cLBP, who were participating in a randomized trial of active therapies for cLBP (physiotherapy, muscle training on devices, aerobics). RESULTS: Fifty-three out of 59 patients (90%) completed the therapy. At baseline, significant correlations were observed between the size of the paraspinal muscles and isometric back extension strength (P=0.0001), and between the proportional area of the muscle occupied by each fiber type and the fatigability of the muscle (P=0.012). Following therapy, there were small (few percent) increases in trunk muscle size in the aerobics and physiotherapy groups and a similarly slight decrease in the devices group. Changes in erector spine size correlated only weakly and nonsignificantly with changes in back extension strength. There were no major changes in fiber type proportion or fiber size in any group following therapy. CONCLUSION: Three months active therapy is not sufficient to reverse the typical "glycolytic" profile of the muscles of cLBP patients or to effect major changes in backmuscle size. The alterations in muscle performance observed (increased strength and endurance; Part 1) werenot explainable on the basis of structural changes within the muscle.

First eddy covariance flux measurements by PTR-TOF.

The recently developed PTR-TOF instrument was evaluated to measure methanol fluxes emitted from grass land using the eddy covariance method. The high time resolution of the PTR-TOF allowed storing full mass spectra up to m/z 315 with a frequency of 10 Hz. Three isobaric ions were found at a nominal mass of m/z 33 due to the high mass resolving power of the PTR-TOF. Only one of the three peaks contributed to eddy covariance fluxes. The exact mass of this peak agrees well with the exact mass of protonated methanol (m/z 33.0335). The eddy covariance methanol fluxes measured with PTR-TOF were compared to virtual disjunct eddy covariance methanol fluxes simultaneously measured with a conventional PTR-MS. The methanol fluxes from both instruments show excellent agreement.

[Medical check-ups on the <>. Benefit for population at risk or self-selection of healthy and health-conscious patients?]. / Medizinische Check-ups auf dem Gesundheitsschiff. Nutzen für Risikogruppen oder Selbstelektion gesunder und gesundheitsbewusster Patienten?

The aim of the present study was to assess health related characteristics and reasons for participation on the <>, second, to compare these variables with a representative Swiss Health Survey (SHS). Characteristics of the participants were collected cross-sectionally and afterwards compared with results of the SHS. Response rate was 74.6% (n = 206). Compared to the SHS population smoking rate and alcohol consumption were significantly lower and a doctor's visit within the last 12 months more frequent. Considerable differences in health related characteristics exist between our study and the SHS suggesting a self-selection of healthy people. Thus a potential health gain by this kind of medical prevention program is at least questionable.

Delayed muscle fiber transformation after foreign-reinnervation of excessive muscle tissue.

Following partial denervation motor units can increase (by self-reinnervation) as much as four to five times their normal size. To investigate the still unknown quantitative reinnervation capacity of a motor nerve in the case of foreign-reinnervation, in adult male rats the denervated sternomastoid muscle was either self-reinnervated by its original nerve or foreign-reinnervation by the omohyoid nerve, which had to reinnervate the three times the amount of muscle fibers and six times the amount of muscle mass. After survival times of 7, 8, 9, or 10 months, nerves and muscles were investigated histochemically and immunohistochemically. The omohyoid nerve could fully reinnervate the sternomastoid muscle, but at 7 and 8 months this muscle still revealed nearly the same proportions of IIA and IIB fibers as were seen in the self-reinnervated sternomastoid at all stages. However, in the following 2 months a shift of the fiber pattern toward that of the normal omohyoid was observed, as evidenced by a strong increase in type IIB fibers (from 24% to 62%), at the expense of type IIA fibers. These findings are in contrast to those after foreign (cross) reinnervation of leg muscles where the fiber transformation (according to the foreign motor input) occurs in parallel with the reinnervation process during the first 2-3 months. The delayed fiber transformation observed could be the consequence of the highly enlarged peripheral field of the omohyoid motoneuron pool or could merely reflect a general difference between limb and neck muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

[Refractory hypertension: evaluation and treatment]. / Therapieresistente Hypertonie: Abklärung und Behandlung.

Refractory hypertension is common in patients non-compliant with antihypertensive therapy, in obese and stroke patients, and due to drug interactions with nonsteroidal anti-inflammatory drugs or excessive alcohol intake. The evaluation and management of these pitfalls as well as the causes of secondary hypertension are discussed.

[Does a reduction of drugs yield a higher quality of life in geriatric patients?]. / Bessere Lebensqualität geriatrischer Patienten durch weniger Medikamente?

Considering the constant increase of medication costs in medical institutions we analysed in a Swiss municipal nursing home whether medication in geriatric long term patients can be reduced without compromising quality of life. To document these effects we applied two established questionnaires on different issues of quality of life; the interviews with the patients and with the nursing staff were performed as a pre-post-comparison of the 3-month intervention. The new geriatric medication concept allowed a decreased daily medication as well as a 23% reduction of the medication costs at an average. In comparison to a previous group of control this study showed no reduction in quality of life for nursing home residents but even a stabilisation yielding to an actual improvement of quality of life.

[Can falls in nursing homes be avoided?]. / Sind Stürze in Langzeitpflegeeinrichtungen vermeidbar?

Fall-related injuries in nursing homes for the aged are frequent and cost-intensive. Their iatrogenic causes are well known and avoided in modern geriatric institutions. We examined all falls in an institution during the period of 19 months. Patients who carry out daily tasks on a semi-independent level were most at risk. The main risk-factor was dementia. Medication did not prove a major risk-factor. At 37% p. a. the risk of falling was lower than in previous studies. This was due to a restriction on benzodiazepines with short term effects, minimising of neuroleptics, diuretics and other types of antihypertensives as well as avoidance of polypharmacy. Unavoidable risks need to be identified and should result in use of a hip protector.

[Drug therapy knowledge in ambulatory cardiovascular patients]. / Was wissen Herzkreislaufpatienten über ihre Medikamente?

To analyse drug therapy knowledge of prescribed drugs and self-administered medicinal products we interviewed 222 ambulatory cardiovascular patients. Spontaneous mentions of drugs (at least 3 preparations on average) were completed later on specific questioning. 40% of patients once interrupted their therapy due to adverse drug reactions. Most patients knew the labels of their medicaments but the effects and indications only in 50%. Nevertheless 70% were satisfied with the informations of the physician. Drugs available over the counter were consumed in many of the respondents: 50% consumed analgetics, and--mainly female patients--25% sedatives and 15% laxatives or diuretics. We conclude that specific questioning on self-administation of OTC preparations or formerly prescribed drugs results in an improved overview of medication and a better handling of polymedication and drug compliance.

[Cost analysis for ambulatory patients in internal medicine]. / Kostenanalyse ambulanter Patienten einer medizinischen Poliklinik.

We analyzed the diagnostical and therapeutical costs of 300 ambulatory patients over a two year period in a Swiss university policlinic of internal medicine. The calculations were based on the catalogue of hospital services (Spitalleistungskatalog) and the drugstore prices for pharmaceuticals (Apothekenpreise). The overall costs for the 300 patients were about 238,400 CHF. The refund by the health insurances represented 56% (excluding specific services such as radiological examinations). The main costs concerned analytical laboratory services (32%), physicians services (27%), technical services (26%), and pharmaceuticals (15%). Some analytical and technical services were prescribed unexpectedly frequently. Prevalent among the emitted pharmaceuticals were protone pump inhibitors, modern cardiovascular drugs and statins. Presumed reasons may be a minor cost awareness of the physicians and a trend towards modern but expensive therapies. An adequate cost awareness can only emerge from precise data of effective costs.

Increase of skeletal muscle relaxation speed by direct injection of parvalbumin cDNA.

Parvalbumin (PV) is a high affinity Ca(2+)-binding protein found at high concentration in fast-contracting/relaxing skeletal muscle fibers of vertebrates. It has been proposed that PV acts in the process of muscle relaxation by facilitating Ca2+ transport from the myofibrils to the sarcoplasmic reticulum. However, on the basis of metal-binding kinetics of PV in vitro, this hypothesis has been challenged. To investigate the function of PV in skeletal muscle fibers, direct gene transfer was applied in normal and regenerating rat soleus muscles which do not synthesize detectable amounts of PV. Two weeks after in vivo transfection with PV cDNA, considerable levels of PV mRNA and protein were detected in normal muscle, and even higher amounts were detected in regenerating muscle. Twitch half-relaxation time was significantly shortened in a dose-dependent way in transfected muscles, while contraction time remained unaltered. The observed shortening of half-relaxation time is due to PV and its ability to bind Ca2+, because a mutant protein lacking Ca(2+)-binding capacity did not promote any change in physiology. These results directly demonstrate the physiological function of PV as a relaxing factor in mammalian skeletal muscle.

Influence of age and duration of symptoms on fibre type distribution and size of the back muscles in chronic low back pain patients.

Many studies have documented an association between chronic low back pain (LBP) and deficits in back muscle strength and endurance. The sub-optimal performance is believed to be the result of alterations in the size and structure of the muscle, although the long-standing issue of whether the observed changes precede or are a consequence of the pain remains unresolved. If consequent to the problem, and predominantly related to disuse of the muscles, then it may be expected that a relationship between muscle structure and symptom duration would exist. Lumbar paraspinal muscle samples were obtained from 59 chronic LBP patients using the percutaneous biopsy technique. The samples were subject to routine histochemical analysis for the examination of muscle fibre type characteristics and cytochemical architectural changes. In 55 of the patients, the gross cross-sectional areas of magnetic resonance images of the trunk muscles were also measured. Multivariate analysis showed that symptom duration was the strongest predictor of the individual proportions of the fast-fatigable type IIX fibres; with age and gender included in the model, nearly 30% of the variance in fibre type distribution could be accounted for. Duration of pain had no influence on fibre size. Gross muscle cross-sectional area correlated directly with lean body mass and inversely with age, but showed no relationship with symptom duration. Pathological changes in the internal fibre structure were more frequently encountered in older patients, and were independent of symptom duration. The results suggest that, over the long term, fibre type transformations rather than alterations in fibre size are the predominant changes to be found in the muscles of chronic LBP patients. The direction of change supports the results of many previous studies that have demonstrated corresponding differences in the fatigability of the muscles. There is a strong case for the early implementation of active measures to attempt to offset the development of these changes in back pain patients.

[Subacute thoracic pain]. / Subakuter Thoraxschmerz.

A 75-year old woman with essential hypertension presented two days after the onset of a sudden and strong thoracic pain. The pain did neither increase during breathing nor decrease after the ingestion of nitroglycerine, and could not be triggered by physical manipulation of the thoracic wall. Electrocardiogram showed a left bundle branch block, chest X-ray showed a widened upper mediastinum. Rupture/dissection of an aberrant right subclavian artery (a. lusoria) could be diagnosed by computed tomography. Successful implantation of an endovascular stent-graft was carried out. Evaluation of (sub)acute thoracic pain should include two-plane chest X-ray and, in case of a widened mediastinum, further investigation by computed tomography. In case of highly suspected rupture/dissection of an intrathoracic artery, a specific imaging procedure such as computed tomography is crucial.