Physical performance and serum cholesterol fractions in healthy young men.

In 293 healthy, 18--30-year-old male adults (241 well trained athletes with different training types: (A) endurance, (B) mixed, and (C) power training; (D) 52 untrained students), serum total cholesterol and the cholesterol fractions (HDL-, VLDL-, LDL-cholesterol) were investigated. In comparison with the untrained students, lower LDL- and VLDL-cholesterol concentrations were found in group (A) (-0.23 mmol/l, p < 0.01; -0.08 mmol/l, p < 0.001), lower HDL-cholesterol concentrations were found in group (C) (-0.33 mmol/l, p < 0.001). Increased HDL-cholesterol values and decreased VLDL- and LDL-cholesterol values were found in athletes with a rising oxygen-uptake; a significant, age-related increase in HDL-cholesterol occurred only in endurance-trained persons. There was no significant correlation between relative body weight and the HDL-cholesterol in the subjects examined.

Exercise performance of hemodialysis patients during short-term and prolonged exposure to altitude.

The work capacity of patients on maintenance hemodialysis is impaired even at normal inspiratory oxygen pressure. A further restriction can be expected when these patients are exposed to hypoxia at altitude, since most of the usual compensatory mechanisms required to adjust to this environment are impaired or even missing. We tested the tolerance of hemodialysis patients to hypoxia and measured work capacity, hematological, and cardiovascular parameters at rest and during incremental bicycle ergometry during 3-hour exposure to altitudes of 2,000 m and 3,000 m, and during 2 weeks of exposure to an altitude of 2,000 m and compared these data with prealtitude values or with data evaluated in a control group, respectively. In control tests the patients reached work loads at exercise termination of about 66% of age and sex-matched healthy controls, the reduction correlated well with the degree of anemia. During short-term altitude exposure to 2,000 m peak work performance remained unchanged in comparison to prealtitude tests, whereas at 3,000 m it was reduced by about 12%. During the 2-week stay at 2,000 m peak work loads increased significantly by 17% accompanied by an increase in peak oxygen uptake (+15%), blood lactate, heart rates (+10 min-1), and systolic blood pressure (+20 mmHg), whereas the diastolic pressure was comparable to prealtitude values. In another group of hemodialysis patients studied at low altitude under similar experimental conditions none of these parameters was changed. Our data show that during acute exposure to altitudes up to 2,000 m maximal work of hemodialysis patients is not reduced, but is restricted at altitudes higher than that.(ABSTRACT TRUNCATED AT 250 WORDS)

Morphologic development of human shock lung.

In the initial phase of shock, edema spreads throughout the alveolar interstitium even before injury occurs in the alveolar epithelium and endothelium. The endothelium and the epithelium are damaged only subsequently, causing reduction in the average barrier thickness of the epithelium and the endothelium. A point of irreversibility is reached by the end of the first week. While early cell regeneration may be observed within the alveolar endothelium and epithelium, proliferation of fibroblasts and fibrosis of the alveolar wall occur in addition to edema which spreads within the interstitium. This widening of the gas exchange barrier may be considered as the anatomic substrate of respiratory insufficiency induced by shock. This enlargement continues up to the moment when thickening of the alveoli impedes satisfactory functioning of the lung, and, as consequence, threatens the life of the patient.

Standardized fixation of human lung for radiology and morphometry; Description of a "two chamber"-system with formaldehyde vapor inflation.

In order to obtain optimal preservation of lungs for histology, morphometry and radiology a two-chamber system of lung fixation with hot formaldehyde vapor is introduced. Compared with other procedures this system offers small dead space and ensures quick and thorough fixation by imitating "inspiration" and "expiration". Volume- and pressure-regulated "breathing" enables fixation in a stage of the respiration cycle, which can be chosen. This procedure can be used routinely in the autopsy room. The only serious drawback seems to be air pollution, if the chambers are not absolutely insulated.

[Radiologic aspects of lung morphology: lobulus and acinus (author's transl)]. / Die röntgenologische Feinstruktur der Lunge.

Primary lobule, acinus and secondary lobule are the three basic elements of lung tissue. In order to visualize these structures slices of fixed lungs are documented radiologically by plain films, angio-, and bronchograms. Characteristic pathologic alterations of these elements are edema and inflammation. Both lesions present with atypical radiological pattern. In pneumonia it is shown, that differentiation of air conducting structures of the bronchial tree and structures which are involved in gas exchange appears most valuable for interpretation of confluent densities. According to our experience based upon examination of 143 lung specimens separation into lobules is pathophysiological more important than the organisation into the next smaller unit--the acini: patterns of acinar radiodensities are extremely rare and might sometimes be imitated by peribronchial infiltrations.

[Autotransplantation of spleen tissue after traumatic spleen rupture (traumatic splenosis). A report of 4 cases]. / Autotransplantation von Milzgewebe nach traumatischer Milzruptur (traumatische Splenose).

Report on 4 cases of traumatic splenosis (autotransplantation of splenic tissues) which were diagnosed 1 to 15 years after traumatic spleen rupture in childhood or adolescence. In 3 of the 4 cases traumatic splenosis was detected casually, the other case was misinterpreted during laparoscopy as endometriosis. Histologically the autotransplants reveal functional red and white splenic pulp. This may be significant for hematologic diseases. Although clinical signs are often lacking or noncharacteristic, knowledge of traumatic splenosis is important for surgeons, internists (laparoscopy!), gynecologists, and pathologists, because splenic autotransplantants are often misinterpreted as accessory spleens, hemangiomas, endometriosis or peritoneal metastases of melanoma.

[Plasma catecholamines, metabolic substrates, aerobic and anaerobic capacity during graduated treadmill and bicycle ergometer exercise (author's transl)]. / Einfluss einer stufenweisen Laufband- und Fahrradergometrie auf die Plasmacatecholamine, energiereichen Substrate, aerobe und anaerobe Kapazität.

Adrenaline, noradrenaline, glucose, lactate, free fatty acids, and glycerine in blood, as well as heart frequency and oxygen intake were examined in 6 healthy male subjects (28 +/- 2.6 years) before, during and after a graduated treadmill (TME) and bicycle ergometer (BE) test. Adrenaline, noradrenaline, the energy supplying substrates, and the oxygen-intake show no differences during TME and BE at given submaximal levels. Noradrenaline is 27% (0.10 less than p less than 0.05) higher, pulse rate is 6% (p less than 0.05) lower, oxygen intake 4% (greater than 0.05) lower, and the glycerine level 25% (0.10 less than p less than 0.05) lower during maximal BE exercise. The tendency toward a higher noradrenaline release during BE exercise can be influenced by a greater static-pressure stress opposed to a dynamic-circulatory stress during TME testing. An increased alphareceptor stimulation leads to a negative chronotropic effect, whose cause is assumed to be a baroreceptor stimulation. The TME induces a higher circulation and a more economic oxygen supplying of the muscles exercised, as well as a favourable fat oxidation, which is recognizable by a more rapid increase of glycerine (0.10 less than p less than 0.05). When referring to exercise acidification (a tendency toward a lower lactate production during submaximal TME testing shows here), oxygen intake capability, energy supplying substrates, and the catecholamines, both forms of ergometer testing are comparable one to another; a falsification appears only when plasma catecholamines and lactate levels are based on the heart frequency, as it is influenced by the form of exercise.

[Effect of bunitrolol on heart rate, metabolic parameters during physical exercise, and performance]. / Zur Wirkung von Bunitrolol auf Herzfrequenz, metabolische Grössen bei Körperarbeit und Leistungsverhalten.

Plasma catecholamines, glucose, lactate, free fatty acids, and glycerol in the blood, as well as heart rate, oxygen intake, and work capacity have been examined in 9 healthy subjects (28.5 +/- 2 years) at rest, during submaximum and maximum ergometric exercise, after oral administration of a placebo and of 10 mg O-[3-(tert.-butylamino)-2-hydroxypropoxy]-benzonitril (bunitrolol, Stresson), respectively. The results are as follows: 1. As caused by the intrinsic activity of bunitrolol, the heart rate does not show nearly any reduction at rest and during submaximum physical exercise. At maximum exercise level the heart rate is 37 beats/min lower with bunitrolol. The limitation of heart function leads to a work capacity reduction of approx. 14%. 2. After administration of bunitrolol, adrenaline level is significantly lower at rest and during submaximum exercise than with placebo. At a 200 W level, the concentration is higher with bunitrolol, but the maximum results are not attained with placebo. In relation to the percentile of the maximum work capacity, plasma catecholamine level shows no differences with placebo and with bunitrolol, respectively, except that it is lower during maximum exercise and the recovery phase. 3. Glucose, free fatty acids, and glycerol levels show no significant changes with bunitrolol. Lactate decreases significantly after bunitrolol at submaximal exercise levels and during the recovery stage, which can be looked upon as an indication of a glycolysis restriction.

[Catecholamines, Cardiocirculatory, and Metabolic Response During Graduated and Continuously Increasing Exercise]. / Einfluss der annähernd kontinuierlich und stufenweise zunehmenden Körperarbeit auf Plasmakatecholamine, kardiozirkulatorische und metabolische Grössen.

Adrenaline, noradrenaline, glucose, glycerol and the free fatty acids (FFA) in the blood, as well as the heart rate and oxygen intake, were tested in six healthy male volunteers (age: 28 +/- 6 years) during graduated (I) and continuously (II) increasing bicycle ergometric exercise (upright body position). The maximum heart rate, the VO2 max, the maximum lactate and FFA concentration show no significant difference, whereas adrenaline, noradrenaline and the glucose levels are significantly lower, and the glycerol concentration is slightly higher during the maximum test II as compared with test I. At some submaximum exercise levels, the lactate concentration and the heart rate are slightly lower, adrenaline and noradrenaline are significantly lower during test II; the FFA, glycerol and the oxygen intake do not show any significant difference. The duration of exercise was similar in both tests. The total work was about 50% lower in test II, and the maximum performance was slightly higher as compared with test I. These results could have significance for the planning of working conditions, the rehabilitation of patients, and the organisation of training for athletes.

[Effect of selective and non-selective adrenoceptor blockade during physical work on energy metabolism and sympatho-adrenergic system (author's transl)]. / Auswirkung einer selektiven und nichtselektiven Adrenozeptorblockade während Körperarbeit auf den Energiestoffwechsel und das sympathoadrenerge System.

The influence of an acute beta-adrenoceptor blockade on work capacity, oxygen intake, plasma catecholamines, and on energy metabolism was investigated in 9 healthy subjects during graduated ergometric exercise. The examinations were carried out after p.o. administration of 10 mg bunitrolol (BU), methypranol (ME) and placebo in random sequence. The exercise capacity shows a 15% decrease after both beta-blockers; heart rate shows a maximum 20% (BU) and 25% (ME) reduction, respectively. On account of the greater sympathetic intrinsic activity BU does not influence the resting heart rate, in contrast to ME (-8%; p greater than 0.05). BU leads to a decrease of the catecholamine levels (with low sympathetic tone), which is assumed to be caused by an effect on presynaptic receptors. At the same submaximum exercise levels plasma catecholamines are higher after BU and ME than after placebo; however, the maximum levels are not reached with placebo. In relation to the relative oxygen intake, which is inhibited by 4-6% by BU and ME (p greater than 0.05), the differences of the catecholamines decrease in performance caused by beta-blockade. BU does not show an influence on lactate, glucose, free fatty acids, and glycerin and thus represents a more selective blockade. ME inhibits lipolysis (measured by the glycerin level) by a maximum of approx. 50%. Lactate level increase is approx. 30% lower with ME. Glucose level decrease is approx. 20% higher with ME than with placebo.

Comparative echocardiographic examinations in sitting and supine position at rest and during dynamic exercise.

Echocardiograms of 12 healthy male subjects in the supine and sitting positions were obtained. The end-diastolic (EDD) and end-systolic (ESD) diameters of the left ventricle were measured, and the stroke volume was calculated as the cube of the diameter. A significantly (P less than 0.001) smaller stroke volume was found in the sitting rest position (67.1 ml) compared to the supine rest position (92.3 ml). During dynamic exercise, the stroke volume increase in the sitting position (29.7%) was considerably higher than in the supine position (13%). The shortening fraction showed no difference in the sitting and supine positions at rest and during dynamic exercise. The results demonstrate good agreement between the echocardiographic method and other noninvasive procedures.

[Bioequivalence of phenylbutazone preparations following a single intramuscular administration]. / Bioäquivalenz von Phenylbutazon-Präparaten nach einmaliger intramuskulärer Applikation.

Bioequivalence was estimated in 6 resp. 7 male volunteers for two combination drugs of phenylbutazone (Neuro-Elmedal, Sigma Elmedal) after intramuscular administration using a monopreparation as a standard. Plasma levels of phenylbutazone were assayed by high pressure liquid chromatography. With respect to rate and extent both combination drugs were identical to the mono drug.