Validation of the BIOPAC indirect calorimeter for determining resting energy expenditure in healthy free-living older people

The BIOPAC indirect calorimeter for measuring resting energy expenditure (REE) is less cumbersome than many other calorimeters. We tested the hypothesis that the BIOPAC calorimeter is as well suited for determining REE in older people as traditional calorimeters. In 50 healthy persons (24 men and 26 women; age range, 61-83 years), REE by BIOPAC was validated against Vmax Spectra indirect calorimeter as a criterion method. Resting energy expenditure by BIOPAC was recorded at 2 different time intervals to find optimal conditions for older persons. Also, REE by 7 published equations was validated. The Bland-Altman procedure was used to test agreement between methods. Multiple regression analysis was applied to develop a new equation for predicting REE from BIOPAC. The BIOPAC calorimeter and most empirical equations significantly overpredicted mean REE in both sexes. Mifflin's equation best-predicted mean REE. Limits of agreement were wide for BIOPAC and narrow for most empirical equations. The Lührmann and Müller equations had smallest limits of agreement in men (±950 kJ/24 h) and the Harris-Benedict and Müller equations in women (±672 kJ/24 h). A new equation was developed for the BIOPAC device improving both predictions of mean and individual REE (R² = 0.671, standard error of the estimate = 136 kJ/24 h). Using this equation, 72.9% of subjects were lying within 10% of measured REE, compared with only 12.5% when using the manufacturer's algorithm. In conclusion, the BIOPAC calorimeter is suitable for measuring REE in healthy older adults when the new prediction equation is applied. This calorimeter is not applicable to frail older persons.     

Effects of low, subinhibitory concentrations of antibiotics on expression of a virulence gene cluster of pathogenic Escherichia coli by using a wild-type gene fusion

S fimbrial adhesins (Sfa) represent virulence factors of E. coli wild-type strains causing urinary tract infections and meningitis of the new born. In order to determine the influence of subinhibitory concentration of antibiotics on the expression of the sfa gene cluster, a wild-type strain carrying the lacZ gene, coding for the enzyme β-galactosidase fused to the sfa determinant was used. The expression of lacZ which was under the control of the sfa wild-type promoters, was now equivalent to the sfa gene expression of wild-type strain 536. With this strain the influence of subinhibitory concentrations of 28 antibiotics on the expression of the sfa determinant was studied. The expression was strongly suppressed by a treatment of the wild-type fusion strain by aztreonam, gentamicin, clindamycin and trimethoprim; the latter had a dramatic effect on sfa expression. It was further shown for clindamycin and trimethoprim that the reduction of sfa gene expression was dependent on the concentration of the antibiotics. In contrast imipinem, amphotericin B and rifampicin weakly stimulated sfa expression. We conclude that gene fusions between virulence-associated loci and indicator genes in wild-type pathogens are useful to study virulence modulation due to subinhibitory concentration of antibiotics on the genetic level.     

Polymers with carbazolyl groups, 3 Fluorescence properties of some polysiloxanes with pendant carbazolyl groups

The polarized fluorescence spectra and the time-resolved fluorescence decay of some novel carbazole-containing polysiloxanes were measured in solution and in the solid state. The fluorescence data show that these polymers, due to the conformational freedom of the carbazole group, are free of excimer-forming sites. As indicated by the extensive fluorescence depolarization in solid solution, the migration of excitation energy along the chain is fast with respect to the fluorescence lifetime, and the number of migrational steps comes up to the number of chromophores per chain. If the polymers were prepared starting from commercial carbazole (which contained small amounts of aromatic impurities), the occurrence of sensibilized benzocarbazole-like fluorescence in the solid state and in concentrated solution demonstrates the high efficiency of transferring the excitation energy to a suitable acceptor.     

Die Gesundheitsreform 2004 im vorparlamentarischen Beratungsverfahren zwischen Bund und Ländern*

Ohne Zusammenfassung*) Vortrag vor der Deutschen Gesellschaft für Kassenarztrecht e. V. in Berlin am 13. 11. 2003.     

Relations between axon length and axon caliber: Is maximum conduction velocity the factor controlling the evolution of nerve structure?

A search was made for any existent relationship between the length of a nerve fiber and the caliber of its axon. This was done in the hope of defining morphological parameters useful for assessing conduction time.Four fiber populations were examined: (1) phrenic fibers in rat and rabbit during different phases of body growth; (2) phrenic fibers of mature animals of greatly different body size including mouse and cow; (3) rat intercostal nerves which vary in length by a factor exceeding 5 due to the funnel-shape of the thorax; and (4) ventral root fibers of the cow.In all of these fiber populations, there was no evidence for a direct relationship between the length of a fiber and its caliber. Rather, a tendency was noted for fiber caliber to approach certain ceilings independent of length.These data, seen in conjunction with other information on fiber structure, cast serious doubt on the widely accepted concept that maximum conduction velocity is the factor controlling nerve structure. A much more likely factor controlling the structure of myelinated nerve fibers is the capacity to modulate information by frequency coding of impulses.     

Microbiological investigations on cryopreserved human semen

Primary mycological contamination was studied in 565 random human ejaculates. After sperm preservation at low temperature, secondary mycological contamination of 55 of the ejaculates was investigated. 25 ejaculates were cryopreserved with and without antibiotics and examined bacteriologically before and after different phases of cryopreservation. Furthermore, semen samples of several donors were inoculated with suspensions of different concentrations of yeasts and with the test bacteria Escherichia coli K 12 and Staphylococcus aureus SG 511. Microbiological results were then compared before and after cryopreservation. The following results were obtained: 1.9.8% of samples showed primary mycological contamination (1.9% with Candida albicans). 2. Cryopreservation reduced the concentration of fungi by more than 90% on average. 3. Only one semen sample was contaminated with bacteria (Staphylococcus aureus haemolyticus and Streptococcus nonhaemolyticus). Non-pathogenic bacteria were found in 11 ejaculates (Micrococcus luteus in 5 samples and Staphylococcus epidermidis in 6 samples), and contamination was largely unaffected by cryopreservation, even in the presence of antibiotics. 4. Test bacteria inoculated into semen were not influenced by the addition of antibiotics to the cryoprotective medium.     

Urge incontinence in the elderly – supraspinal reflex incontinence

World Journal of Urology -     

Laser-assisted removal of a foreign body in the bronchial system of an infant

Background and Objective: Foreign body aspiration is an important cause of acute respiratory distress in children. Removal by use of rigid tracheo-bronchoscopy under general anesthesia is usually the treatment of choice, but this technique is sometimes unsuccessful. Thoracotomy in these instances often cannot be avoided. Study Design/Patients and Methods: Case report with review of the literature. The patient was 19 months old with an aspirated foreign body. A Neodym:YAG laser with a special small-size delivery system was inserted into the rigid “baby” bronchoscope. The NeodymiumrYAG laser with a wavelength of 1,064 nm and a Helium-Neon 630 nm light guide provided an aiming beam to weaken and cut the aspirated chicken bone. Results: The foreign body could be easily removed with a regular biopsy forceps. Conclusion: We discuss a patient in whom laser-assisted rigid tracheobronchoscopy obviated the need for thoracotomy. © 1995 Wiley-Liss, Inc.     

Selection of Filters and Evaluation In Vitro of the Selective Dual Filtration Artificial Kidney, SEDUFARK

Transport properties of different artificial kidney membranes have been studied employing substances with molecular weights ranging from 60 daltons (urea) to 62,000 daltons (dextran). The results from these studies were used to select filters for the SElective DUal Filtration ARtificial Kidney, SEDUFARK.
Selection criteria for filters to be used in long-term clinical trials with SEDUFARK were based on biological tests showing toxicity of large molecular weight substances in uremic blood plasma and clinical advantages of returning middle molecular weight substances to the patient. The filters selected were used for evaluation in vitro of the complete SEDUFARK system. The results confirmed a theoretical analysis of this system, demonstrating that selective removal of substances within given molecular weight ranges from uremic blood plasma is feasible with a combination of commercial filters. The efficiency of the system, however, is limited due to the "cut-off' characteristics and hydraulic permeabilities of membrane types currently available.     

Diprafenone for treatment of Wolff-Parkinson-White syndrome

Summary The effect of intravenous (1.5 to 2.0 mg/kg body weight) and oral (300 to 375 mg/d) diprafenone was studied in 15 patients with the Wolff-Parkinson-White syndrome and symptomatic supraventricular tachycardia. Intravenous application of diprafenone significantly increased atrioventricular nodal conduction time as well as the effective refractory periods of the right ventricle and the accessory pathway in both the antegrade and retrograde directions. Antegrade conduction block in the accessory pathway occurred in two patients after the dose was increased to 2.0 mg/kg body weight. Intravenous diprafenone suppressed the inducibility of supraventricular tachycardia in two patients, but the tachycardia cycle length was significantly increased in all other patients. Fourteen patients were treated with oral diprafenone, and 11 were asymptomatic during a 17-month follow-up, two of these after the dose had been increased to 375 mg/d. Oral therapy had to be withdrawn in two patients because of adverse gastrointestinal side effects and in one because of recurring bronchospasm.