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The German National Cohort (NAKO) is a multidisciplinary, population-based prospective cohort study that aims to investigate the causes of widespread diseases, identify risk factors and improve early detection and prevention of disease. Specifically, NAKO is designed to identify novel and better characterize established risk and protection factors for the development of cardiovascular diseases, cancer, diabetes, neurodegenerative and psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases in a random sample of the general population. Between 2014 and 2019, a total of 205,415 men and women aged 19–74 years were recruited and examined in 18 study centres in Germany. The baseline assessment included a face-to-face interview, self-administered questionnaires and a wide range of biomedical examinations. Biomaterials were collected from all participants including serum, EDTA plasma, buffy coats, RNA and erythrocytes, urine, saliva, nasal swabs and stool. In 56,971 participants, an intensified examination programme was implemented. Whole-body 3T magnetic resonance imaging was performed in 30,861 participants on dedicated scanners. NAKO collects follow-up information on incident diseases through a combination of active follow-up using self-report via written questionnaires at 2–3 year intervals and passive follow-up via record linkages. All study participants are invited for re-examinations at the study centres in 4–5 year intervals. Thereby, longitudinal information on changes in risk factor profiles and in vascular, cardiac, metabolic, neurocognitive, pulmonary and sensory function is collected. NAKO is a major resource for population-based epidemiology to identify new and tailored strategies for early detection, prediction, prevention and treatment of major diseases for the next 30 years.

IntroductionPoor sleep is a risk factor for adverse health events. For health prevention, it may be helpful to know whether poor sleep or sleep disorders in individuals are associated with sleep problems in their partners or children.MethodsIn the MultiGeneration Study (MGS, conducted from 2013 to 2016), 1237 partners (aged 27 to 90 years) and 1660 adult children (aged 18 to 66 years) of index persons were recruited. Index persons are participants of the Heinz Nixdorf Recall Study, a population-based cohort study in the Ruhr area (study start 1999-2001, 4841 participants aged 45-75 years). We used two analysis populations: one with 1181 index persons whose partners were in MGS, and one with 1083 index persons with at least one adult child in MGS. Sleep characteristics were assessed using questionnaires (including the Pittsburgh Sleep Quality Index). The exposure was the presence of a sleep characteristic of the index subject.ResultsChildren showed the investigated sleep characteristics more often if these were also present in their parent (e.g., RR (relative risk) = 1.28 (95% CI: 1.06-1.55) for poor sleep quality). In partners, strong associations were observed for rising times and napping, but only weak associations for snoring, poor sleep quality and sleep disorders. Snoring of the bed partner is a risk factor for poor sleep (e.g., RR = 1.67 (0.91-3.07) for difficulties falling asleep).ConclusionAggregation is observed for many sleep characteristics in people living in partnerships as well as in parents and their adult children.

Breathing changes induced by repeated short olfactory stimuli are used as an objective indicator of the integrity of the olfactory system. Until now, it has not been investigated whether chemosensorically induced changes in inspiratory and expiratory time parameters can be suppressed intentionally. The same applies to breathing changes due to weak CO34 healthy adult normosmics were stimulated during relaxed regular nasal breathing using a flow olfactometer with nine differently concentrated HDespite high motivation, the chemosensorically induced breathing changes could not be suppressed intentionally. Rest breathing reacted to both stimulants by changes in both the inspiratory and the expiratory time parameters. However, it outweighed the expiratory reactions. COChemosensorically triggered breathing changes cannot be suppressed intentionally. They therefore provide an additional objective tool to check the functionality of nasal chemosensory afferents.Atemänderungen auf wiederholte kurze olfaktorische Reize werden als objektiver Indikator für die Intaktheit des Riechsystems eingesetzt. Bislang war nicht untersucht, ob sich olfaktorisch-induzierte Änderungen inspiratorischer und exspiratorischer Zeitparameter willentlich unterdrücken lassen. Das Gleiche gilt auch für Atemänderungen infolge schwacher CO34 gesunde erwachsene Normosmiker wurden während entspannter regelmäßiger Nasenatmung über ein Fluss-Olfaktometer mit 9 unterschiedlich konzentrierten HTrotz hoher Motivation ließen sich die induzierten Atemänderungen nicht absichtlich unterdrücken. Die Ruheatmung reagierte auf beide Stimulanzien sowohl mit Änderungen der inspiratorischen als auch der exspiratorischen Zeitparameter. Es überwogen jedoch die exspiratorischen Reaktionen. COChemosensorisch ausgelöste Atemänderungen lassen sich nicht absichtlich unterdrücken. Sie bieten daher ein zusätzliches Werkzeug, um die Funktionstüchtigkeit der nasalen chemosensorischen Afferenzen zu überprüfen.

In the attentive waking state, pleasant odours often prolong inhalation while unpleasant odours often shorten the exhalation. It should be checked whether this induced breathing pattern is maintained even during sleep.23 healthy normosmic adults were examined by polysomnography for one night and randomized pulsed either with HReaction indices with reductions of DEX were larger than spontaneous RI and RI for PEA and HWhen stimulated with an unpleasant smell in sleep, the respiratory reaction pattern from the awake state is preserved. RI with shortened DEX can be considered as an imperfect arousal.Im aufmerksamen Wachzustand verlängern angenehme Gerüche häufig die Einatmung, während unangenehme Gerüche häufig die Ausatmung verkürzen. Es soll überprüft werden, ob dieses induzierte Atemmuster auch im Schlaf erhalten bleibt.23 gesunde normosmische Erwachsene wurden für 1 Nacht polysomnografisch untersucht und dabei entweder mit HReaktionsindizes mit Verkürzungen von DEX waren bei einer HBei Reizung mit einem unangenehmen Geruch im Schlaf bleibt das respiratorische Reaktionsmuster aus dem Wachzustand erhalten. RI mit verkürzten DEX können als unvollkommene Arousals angesehen werden.

Data on self-reported cardiovascular and metabolic diseases are available for the first 100,000 participants of the population-based German National Cohort (GNC, NAKO Gesundheitsstudie).To describe assessment methods and the frequency of self-reported cardiovascular and metabolic diseases in the German National Cohort.Using a computer-based, standardized personal interview, 101,806 participants (20-75 years, 46% men) from 18 nationwide study centres were asked to use a predefined list to report medical conditions ever diagnosed by a physician, including cardiovascular or metabolic diseases. For the latter, we calculated sex-stratified relative frequencies and compared these with reference data.With regard to cardiovascular diseases, 3.5% of men and 0.8% of women reported to have ever been diagnosed with a myocardial infarction, 4.8% and 1.5% with angina pectoris, 3.5% and 2.5% with heart failure, 10.1% and 10.4% with cardiac arrhythmia, 2.7% and 1.8% with claudicatio intermittens, and 34.6% and 27.0% with arterial hypertension. The frequencies of self-reported diagnosed metabolic diseases were 8.1% and 5.8% for diabetes mellitus, 28.6% and 24.5% for hyperlipidaemia, 7.9% and 2.4% for gout, and 10.1% and 34.3% for thyroid diseases. Observed disease frequencies were lower than reference data for Germany.In the German National Cohort, self-reported cardiovascular and metabolic diseases diagnosed by a physician are assessed from all participants, therefore representing a data source for future cardio-metabolic research in this cohort.HINTERGRUND: Aus der NAKO Gesundheitsstudie, der größten deutschen bevölkerungsbasierten Studie zur Gesundheit, liegen die Daten zu selbst berichteten kardiovaskulären und metabolischen Erkrankungen der ersten ca. 100.000 Teilnehmenden vor. ZIEL: Beschreibung der Methoden zur Erhebung sowie Berechnung der Häufigkeit kardiovaskulärer und metabolischer Erkrankungen in der NAKO.101.806 Teilnehmende (20–75 Jahre, 46 % Männer) aus 18 bundesweiten Studienzentren wurden in einem computergestützten, standardisierten persönlichen Interview gebeten, anhand einer vorgegebenen Liste anzugeben, welche Erkrankungen bei ihnen jemals ärztlich diagnostiziert wurden, darunter auch kardiovaskuläre und metabolische Erkrankungen. Für Letztere wurden deren geschlechtsspezifische relative Häufigkeiten berechnet und diese mit Referenzzahlen verglichen.Bezogen auf die kardiovaskulären Erkrankungen berichteten 3,5 % der Männer und 0,8 % der Frauen, jemals einen Herzinfarkt diagnostiziert bekommen zu haben, 4,8 % bzw. 1,5 % eine Angina pectoris, 3,5 % bzw. 2,5 % eine Herzinsuffizienz, 10,1 % bzw. 10,4 % Herzrhythmusstörungen, 2,7 % bzw. 1,8 % eine Claudicatio intermittens und 34,6 % bzw. 27,0 % eine arterielle Hypertonie. Die Häufigkeit berichteter diagnostizierter metabolischer Erkrankungen lag bei 8,1 % bzw. 5,8 % für Diabetes mellitus, bei 28,6 % bzw. 24,5 % für Hyperlipidämie, bei 7,9 % bzw. 2,4 % für Gicht und bei 10,1 % bzw. 34,3 % für Schilddrüsenerkrankungen. Die beobachteten Häufigkeiten lagen insgesamt etwas niedriger als Vergleichsdaten für Deutschland.Die NAKO erhebt von allen Teilnehmenden selbst berichtete, ärztlich diagnostizierte kardiovaskuläre und metabolische Erkrankungen und stellt damit eine Datenressource für weitergehende kardiometabolische Forschungsfragestellungen dar.

Computed tomography (CT) examinations are frequent in follow-up care of testicular cancer (TC) but may increase the risk for other cancers. We wanted to assess the actual number of CT and X-ray examinations within the first 5 years after a diagnosis of TC in Israel during 2003–2007. The database of Maccabi Healthcare Services, Israel, was searched for TC patients diagnosed in 2003 to 2007 by direct linkage with the Israel National Cancer Registry. Data on diagnostic imaging examinations (CT of chest, abdomen, or pelvis, unspecified sites; X-ray of chest) were extracted during a 5-year follow-up for 226 incident patients. The actual number of CT and X-ray examinations was compared to the National Comprehensive Cancer Network (NCCN) guideline. We tabulated the median with 10th and 90th percentiles (P10, P90) for the number of CTs and X-rays considering histology, stage, and adjuvant strategy. The number of abdomen or pelvis CTs for TC patients receiving chemo- or radiotherapy was in accordance with the NCCN guideline. The median of abdomen or pelvis CTs for surveillance patients was 8.5 (P10, P90: 3; 13) for nonseminoma and 5.0 (P10, P90: 5; 13) for seminoma patients compared to 14 to 17 CTs recommended. The number of chest X-rays was lower than recommended in the guideline for all adjuvant strategies. The NCCN guidelines regarding CTs were met for TC patients treated with chemo- or radiotherapy but fell below recommendations for surveillance. Guidelines from 2011 and 2012 were updated in favor of fewer CTs during surveillance. • The number of CTs followed the NCCN guidelines in patients treated with chemo- or radiotherapy. • Surveillance patients received fewer CTs and X-rays than recommended in the NCCN guidelines from 2005. • The number of applied CT examinations corresponded to a radiation dose that did not substantially raise the lifetime risk for cancer.

Objective Poor sleep quality as well as short and long sleep duration has been linked to type 2 diabetes. In addition to confirmational analyses, we examined the impact of daytime napping on incident diabetes, and we assessed associations between sleep characteristics and incident prediabetes. Methods In a subgroup of the Heinz Nixdorf Recall Study, a population-based cohort study in Germany (N = 2962; age 45–75 years, without history of cancer, stroke, or cardiovascular diseases), diabetes at baseline and at 5-year follow-up was assessed by self-report and measurement of serum glucose levels. Prediabetes was defined as impaired fasting glucose (6.1–6.9 mmol/L). A sleep questionnaire was used to assess difficulties falling asleep, difficulties maintaining sleep, early morning arousal, and duration of nocturnal and daytime sleep. Results In adjusted regression models, short (≤5 hours) and long (≥7.5 hours) sleepers were at greater risk for diabetes (relative risk [RR] = 1.56, 95% confidence interval [CI] = 1.02–2.39, and 1.40, 95% CI = 1.01–1.96, respectively [reference: 7 hours]). Moreover, the prevalence of any regular sleep disorder was associated with incident diabetes (RR = 1.30, 95% CI = 1.01–1.68), and with incident prediabetes (RR = 1.31, 95% CI = 1.00–1.72). Regular daytime nappers had no increased risk of incident diabetes (RR = 1.00, 95% CI = 0.70–1.41). Conclusion This study shows that people with regular sleep disorders, people with short and long sleep duration, but not regular daytime nappers are at increased risk of diabetes. Furthermore, regular sleep disorders are associated with an increased risk of prediabetes.

In a previous study, the detection threshold for H2S during aerobic exercise worsened with forced nasal breathing. The cause remained unclear. It is to be examined how the detection threshold changes with exclusive mouth breathing.During a resting phase, an aerobic physical load and subsequent recovery phase, different H2S concentrations were applied inspiratory-synchronously intranasal using a flow-olfactometer in a staircase procedure. The missing nasal breathing was objectified online and offline. The reaction times were determined. In parallel, various vital parameters have been measured.The passive detection thresholds for H2S between the load and recovery phases did not differ. In the resting phase, the threshold was highest. The reaction times were not different in the three experimental phases.An increased sympathetic tone, resulting from an approximately half-hour aerobic exercise, did not change the passive olfactory threshold for H2S during oral respiration compared to the subsequent recovery period. The high olfactory threshold in the resting phase might be explained by initial adaptation difficulties to the experimental conditions.Während aerober körperlicher Belastung verschlechterte sich in einer früheren Studie bei Nasenatmung die Wahrnehmungsschwelle für H2S. Die Ursache blieb offen. Es soll in dieser Studie geprüft werden, wie sich die Wahrnehmungsschwelle bei alleiniger Mundatmung verändert.Während einer Ruhephase einer aeroben Belastung und nachfolgender Erholungsphase wurden unterschiedliche H2S-Konzentrationen mittels eines Fluss-Olfaktometers im staircase Verfahren inspirationssynchron intranasal appliziert. Die fehlende Nasenatmung wurde online und offline objektiviert. Es wurden die Reaktionszeiten bestimmt. Parallel sind verschiedene Vitalparameter gemessen worden.Die passiven Wahrnehmungsschwellen zwischen den Belastungs- und der Erholungsphasen differierten nicht. In der Ruhephase war die H2S Schwelle am höchsten. Die Reaktionszeiten waren in den drei Versuchsphasen nicht different.Eine etwa halbstündige aerobe Belastung veränderte die passive Riechschwelle für H2S bei Mundatmung im Vergleich zur nachfolgenden Erholungsphase nicht. Die hohe Riechschwelle in der Ruhephase wird mit anfänglichen Anpassungsschwierigkeiten an die Versuchsbedingungen erklärt.

Whether smelling is reduced during aerobic exercise is described contradictorily in the sparse literature.To clarify this question, in healthy subjects the passive detection thresholds for short HThe participants achieved the highest values for the detection threshold in the load phase. By means of rm-ANOVA and post-hoc tests, a significant difference in the mean values of detection thresholds between the measurements at rest and during cycling as well as between the recovery and load phases was observed. However, the mean values of the detection thresholds between the resting and recovery phases did not differ.The worsening of olfactory detection thresholds during acute aerobic physical exercise and their immediate improvement during recovery phase to rest values suggests that the detection threshold is influenced by exercise. The most probable cause for this is a dilution effect caused by additional inflowing neutral ambient air in the case of forced nasal breathing.Ob sich bei akuter aerober körperlicher Belastung das Riechvermögen verschlechtert, wird in der Literatur widersprüchlich beschrieben.Zur Klärung dieser Fragestellung wurden die passiven Wahrnehmungsschwellen für kurze HDie Versuchsteilnehmer hatten ihre höchsten Werte für die Wahrnehmungsschwelle in der Belastungsphase. Mittels rm-ANOVA und post-hoc-Tests war ein signifikanter Unterschied der Mittelwerte der Wahrnehmungsschwellen zwischen den Messungen in Ruhe und während körperlicher Belastung sowie zwischen der Erholungs- und Belastungsphase zu verzeichnen. Die Mittelwerte der Wahrnehmungsschwellen zwischen der Ruhe- und Erholungsphase differierten hingegen nicht.Die Verschlechterung der olfaktorischen Wahrnehmungsschwellen während einer akuten aeroben körperlichen Belastung und deren unverzügliche Verbesserung während der Erholungsphase auf Ruhewerte lassen auf eine Beeinflussung der Riechschwelle durch die körperliche Anstrengung schließen. Als wahrscheinlichste Ursache hierfür kommt ein bei forcierter Nasenatmung ausgelöster Verdünnungseffekt durch zusätzlich einströmende geruchsneutrale Umgebungsluft in Betracht.

Sleep characteristics are associated with incident cardiovascular diseases (CVD), but there is a lack of studies on the association between sleep characteristics and incidence/progression of coronary artery calcification (CAC).In the Heinz Nixdorf Recall Study, a population-based cohort study in Germany, CAC was assessed by electron-beam tomography at baseline and at 5-year follow-up. In an analysis set of 3043 subjects (age at baseline 45-74 years; 47% men), we fitted logistic and linear regression models to assess associations between self-rated sleep characteristics (nocturnal and total sleep duration; napping; various sleep disorders) and CAC incidence/CAC progression. Progression was measured as 5-year progression factor, as categories of absolute CAC change, and additionally characterized as rapid or slow compared to an extrapolation of baseline CAC values.We observed barely any association between sleep characteristics and CAC progression regardless of the chosen statistical approach; associations between sleep and CAC incidence were slightly larger, e.g., the geometric mean of the 5-year CAC progression factor was 6.8% (95% confidence interval: -9.5; 25.9) larger for ≤5 h, 2.9% (-7.3; 14.3) larger for 5.1-6.9 h and 7.1% (-2.4; 15.7) smaller for ≥7.5 h total sleep compared to 7-7.5 h total sleep. For subjects with any regular sleep disorder, the geometric mean of the 5-year CAC progression was 3.5% (-4.7; 11.2) smaller compared to subjects without any regular sleep disorder.In this German cohort study, sleep characteristics were barely associated with CAC progression.

Alterations of breathing pattern evoked by odors are used to proof the integrity of the olfactory system in the sense of respiratory olfactometry. Spontaneous breathing changes normally cannot be distinguished from evoked changes. It is therefore necessary to repeatedly apply stimuli with a pure odorant during tidal breathing, randomized with neutral air, to detect a majority of olfactory-evoked respiratory changes.In 26 adult normosmics, 15 HHOnly the randomized nasal stimulation with an odor and a blank makes the respiration-olfactometry meaningful.Durch Gerüche evozierte Atemänderungen werden zum objektivierenden Nachweis der Intaktheit des Riechsystems im Sinne einer Respirations-Olfaktometrie genutzt. Spontane Atemänderungen lassen sich in der Regel nicht von evozierten unterscheiden. Es müssen deshalb wiederholt Reize mit reinen Riechstoffen randomisiert mit Leerreizen in die Ruheatmung appliziert werden, um mehrheitliche Atemänderungen bei olfaktorischer Reizung darzustellen.Bei 26 erwachsenen Normosmikern wurden mit Hilfe eines Fluss-Olfaktometers 15 überschwellige HHNur die randomisierte nasale Reizung mit einem Riechstoff und einem Leerreiz machen die Respirations-Olfaktometrie aussagefähig.

Introduction: There is only limited quantitative information on the association between intake of sleep disturbing drugs and nocturnal sleep disturbances. Information on sleep disturbing effects of drugs mostly derives from clinical trials with highly selected patient collectives. As these patient collectives[for full text, please go to the a.m. URL], GMDS 2015; 60. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS)

Background/Objectives: Sleep duration influences weight change in children and young adults, but there is less evidence in middle-aged, and, in particular, older adults. We assessed associations between sleep duration, daytime napping and sleep disturbances, respectively, with change of weight and waist circumference in older subjects. Contrary to previous studies, we also used two points in time to assess sleep characteristics. Methods: We used data from the population-based Heinz Nixdorf Recall study, a cohort study in Germany with a baseline and two follow-up visits (age 45–74 years, median follow-up 5.1 years for first, 5.2 years for second follow-up visit). In adjusted linear regression models (N=3751), we estimated weight change between baseline and first follow-up visit in relation to various self-reported sleep characteristics measured at baseline. Furthermore, we estimated change of weight and waist circumference, respectively, between first and second follow-up visit in relation to patterns of sleep characteristics measured at baseline and at the first follow-up visit (N=2837). Results: In all analyses, short and long sleep duration, sleep disturbances, and regular daytime napping were associated with Conclusions: Our study gave no evidence that sleep characteristics were associated with clinically relevant weight gain in the older population.

The affective valence of an olfactory stimulus will be encoded in its respiratory response. Unpleasant odors shorten the inhalation of the first stimulated breaths in wakefulness and sleep. The aim of the present study was to assess the effekt of intravenous anesthetic propofol on the chemosensory evoked changes of breathing pattern.13 ASA 1/2 patients got intranasal chemosensory stimuli (H2S and CO2) by flow-olfactometer during "deep" (EEG-based bispectral analysis, BIS:≤60) and "moderate" (BIS60) propofol-induced sedation with preserved spontaneous breathing. The duration of the in- and exhalation was analyzed for 5 breaths before and for 2 breaths after the onset of stimulation.During deep sedation respiratory reactions were observed only by CO2 irritation. During moderate sedation respiratory responses were evoked by H2S stimuli, too. In moderate sedation extensions of the inhalations of the first breath after both the unpleasant pure olfactory H2S stimuli and the trigeminal stimuli were more frequent than reductions.Olfactory stimuli change the breathing only during moderate sedation, trigeminal stimuli during deep and moderate propofol-induced sedation. In opposite to both wakefulness and sleep the duration of inhalation is often extended by H2S-stimuli during moderate sedation.

The nonischemic forearm exercise test (NIFET) has been shown to be as effective as the classic ischemic forearm exercise test (IFET) in the diagnosis of patients with McArdle disease. Recently, the lactate increase normalized to the mechanical energy production in NIFET was suggested to have a intermediate sensitivity and satisfactory specifity for the screening of mitochondrial disorders.NIFET at 80% maximal contraction force (MCF) was performed in normal controls (n = 41), patients with mitochondrial disorders (n = 15) and other myopathies (diseased controls, n = 20). 26 healthy volunteers also underwent IFET at 80% MCF. The ratio of lactate increase and workload was defined as specific lactate production (mmol x s/N x l).In normal controls there was no significant different lactate increase during NIFET and IFET. The workload performed showed only a weak significant positive correlation with the lactate increase in the NIFET in normal controls (r(2) = 0.20) but not in IFET and NIFET with patients. A moderate negative correlation of specific lactate production and the absolute workload was found in all groups and in both protocols (r(2) = 0.22-0.34). The specific lactate production was highest in patients with other myopathies, intermediate in patients with mitochondrial disorders and lowest in normal controls. NIFET showed a sensitivity of only 20 % and a specifity of 95% for normal controls, but only 75 % for diseased controls.The specific lactate production during NIFET is neither sufficiently specific nor sensitive for the diagnosis of mitochondrial disorders. Increased specific lactate production during rest-to-work transition period might be caused by increased acetyl group deficits.

A prestimulatory regular breathing is required for the respiration-olfactometry. In a sitting position, just about every second prestimulatory breathing sequence fulfilled this requirement checking off -line. It should be examined whether breathing in reclining position is more regular.The coefficients of variation of the time parameters of breathing in reclining and sitting position during 30 min were determined and compared.Breathing regularity did not increase in reclining position with 48 healthy persons (age group 1: 18 to 30 years, n = 24, 18 women; age group 2:55 years, n = 24, 13 women). The age and gender had no eff ect on the proportion of regular breathing. With 7 persons, the yield of 5 on each other following regular breaths was inadequate. Additionally one person excluded from our study was not able to breathe regularly without interruptions.The respiration-olfactometry cannot be performed in each person. It is not more successful in reclining than in sitting position.

Background/Aims: Mechanical strain of the lung tissue is a physiological process that affects the behavior of lung cells. Since recent evidence also suggests alterations in the expression of certain genes as a consequence of mechanotransduction, our study aimed at the analysis of the gene expression profile in lung epithelial cells subjected to chronic cyclic strain. Methods: Various human lung epithelial cell lines (A549 as principal adherent cell line and four others) were subjected to cyclic strain (16 % surface distension, 12 min-1) in a Strain Cell Culture Device for 24 h. In comparison to static controls, expression analyses were performed by gene microarray and qPCR. Results: Microarray analysis revealed many differences in the gene expression but at moderate levels. Altogether 25 genes were moderately down-regulated (0.86-fold ± 0.06) and 26 genes were up-regulated (1.18-fold ± 0.10) in A549 and the others. Strain-regulated genes often code for transcription factors, such as E2F4 and SRF. qPCR analyses confirmed the up-regulation of both transcription factors and further genes, such as PLAU (urokinase-type plasminogen activator) and S100A4 (S100 protein A4). Moreover, we showed the down-regulations of AGR2 (anterior gradient 2) and LCN2 (lipocalin 2). Conclusions: We identified many genes of which the expression was moderately altered in lung epithelial cells subjected to chronic cyclic strain. Although many moderate changes in the gene expression profile might affect cellular behavior, it also suggests an effective adaptation of cells to mechanical forces in long-term conditions.

Respiratory orienting reactions after olfactory stimulation can be seen as an indicator of an intact olfactory processing. Olfactory stimuli have to be recognized and they have to be important for a subject in order to generate a respiratory orienting reaction.Hyposmic patients were stimulated pre-nasally with one sub-threshold and two supra-threshold concentrations of hydrogen sulfide (H(2)S) using a flow olfactometer. Nasal respiration was measured unilaterally using a differential pressure transducer. The data were processed after digitalization with the LabView software package. Duration of inspiration (DIN) and duration of expiration (DEX) were used as test variables for the evaluation of a regular resting respiration or a poststimulation respiration complex (PRC), respectively.The rate of poststimulatory respiration alterations (47%) in hyposmic subjects was significantly higher than the rate of spontaneous changes after resting respiration (31%). The reaction rate was not stimulus concentration-dependent. In spite of the stimulus recognition poststimulatory respiration alterations were less often in hyposmic subjects compared to normosmic subjects.Maybe this is due to the reduced significance of perceptible odors for hyposmic persons.

Until now there has been no standardized and internationally accepted method available to objectify taste perception. Such a method would be useful for expert opinions in the assessment of gustatory disorders. The aim of our study was to develop and evaluate an analogous method for the gustatory sense.Nonrandomized, controlled clinical trial.A continuous flow of water was presented to the tongues of 34 healthy adult subjects (15 men, 19 women). In this stream, suprathreshold gustatory stimuli were applied during regular resting respiration. Nasal respiration was measured unilaterally with a differential pressure transducer.No significant differences were measured between the different tastants but were between tastants and blanks. Gustatory-evoked changes in the breathing pattern resulted frequently in a prolongation of the first poststimulatory breath. The second and third breath became frequently shorter.The observed gustatory-evoked respiratory responses are probably orienting reflex (OR) reactions. The deceleration of the first breath could be related to attention toward any chemosensory input. The acceleration of the second and third breath could reflect the subject's intention to recognize the four taste qualities. The measurement of respiratory OR evoked by gustatory stimuli can be used as a simple, inexpensive, and reliable objectifying clinical tool to prove intact central gustatory processing.

There is currently no commercial tool available to examine gustatory perception objectively. We investigated whether early changes of breathing patterns can be evoked by gustatory stimulation, and whether there are differences between sweet, sour, salty and bitter stimulation.Using a randomised design, 34 young adult subjects (15 male, 19 female; average age: 24.6 years, median: 23, minimum: 22, maximum: 33) with normal sense of taste were stimulated by supra-threshold taste solutions for approximately 6 s. A pressure sensor recorded nasal respiratory changes using LabView software. The interstimulus-interval was longer than 1 min depending on regular status of unstimulated breath. Durations of inspiration (DIN) and expiration (DEX) were analysed. Values outside the 95%-confidence intervals were defined as gustatory evoked changes.The rates of alteration differed significantly in the first, second and third post stimulatory breath. The rates were regarding to DIN between 25.87% and 36.49%, and regarding to DEX between 35.31% und 43.13%. Blank stimuli showed a rate between 5.97% and 8.96% in DIN and in DEX between 10.66% and 11.48%. There were no differences in reaction frequency between the four taste solutions. Every subject reacted to gustatory stimulation more frequently than to blanks.Like other sensory modalities, gustatory input is able to evoke early respiratory orienting responses. The reaction rate is not dependent on the hedonic component of the gustatory input, as has already been shown for respiration-olfactometry.