Search

ZusammenfassungDie Deutsche Gesellschaft für Pneumologie hat die AWMFS1-Leitlinie Post-COVID/Long-COVID initiiert. In einem breiten interdisziplinären Ansatz wurde diese S1-Leitlinie basierend auf dem aktuellen Wissensstand gestaltet.Die klinische Empfehlung beschreibt die aktuellen Post-COVID/Long-COVID-Symptome, diagnostische Ansätze und Therapien.Neben der allgemeinen und konsentierten Einführung wurde ein fachspezifischer Zugang gewählt, der den aktuellen Wissensstand zusammenfasst.Die Leitlinie hat einen expilzit praktischen Anspruch und wird basierend auf dem aktuellen Wissenszugewinn vom Autorenteam stetig weiterentwickelt und adaptiert.

ZusammenfassungAsthma und COPD sind die häufigsten obstruktiven Atemwegserkrankungen. Die chronische Inflammation bedingt eine Induktion von proinflammatorischen Zytokinkaskaden. Neben der systemischen Inflammation tragen Hypoxämie, Hyperkapnie, eine katabole Stoffwechsellage, eine gonadale oder eine Schilddrüsendysfunktion, eine muskuloskelettale Dysfunktion und Inaktivität sowie Vitamin D‑Mangel zu einem erhöhten Knochenbruchrisiko bei. Iatrogene Ursachen der Osteoporose sind die zum Teil langjährigen Anwendungen von inhalativen oder systemischen Glukokortikoiden (GC). Die inhalative GC Applikation bei Asthma ist oft schon im Kindes- und Jugendalter indiziert, aber auch interstitielle Lungenerkrankungen wie die chronisch organisierende Pneumonie, die Sarkoidose oder rheumatische Erkrankungen mit Lungenbeteiligung werden mit inhalativen oder oralen GC behandelt. Bei PatientInnen mit zystischer Fibrose kommt es durch die Malabsorption im Rahmen der Pankreasinsuffizienz, durch Hypogonadismus und chronische Inflammation mit erhöhter Knochenresorption zu einer Abnahme der Knochenstruktur. Nach Lungentransplantation ist die Immunsuppression mit GC ein Risikofaktor.Die pneumologischen Grunderkrankungen führen zu einer Veränderung der trabekulären und kortikalen Mikroarchitektur des Knochens und zu einer Verminderung von osteologischen Formations- und Resorptionsmarkern. Hyperkapnie, Azidose und Vitamin D‑Mangel können diesen Prozess beschleunigen und somit das individuelle Risiko für osteoporotische Fragilitätsfrakturen erhöhen.Eine Knochendichtemessung mit einem T‑Score −2,5 auf. Eine niedrig-traumatische Fraktur in der Anamnese indiziert eine osteologische Therapie.Neben der Optimierung des Vitamin D‑Spiegels sind sämtliche in Österreich zur Behandlung der Osteoporose zugelassenen antiresorptiv oder anabol wirksamen Medikamente auch bei pneumologischen PatientInnen mit einem erhöhten Knochenbruchrisiko entsprechend der nationalen Erstattungskriterien indiziert.

ZusammenfassungDie COVID-19-Pandemie stellt derzeit weltweit eine Herausforderung dar. In Österreich konnte eine Krise innerhalb des medizinischen Versorgungssystems bisher verhindert werden. Die Behandlung von Patienten mit ambulant erworbener Pneumonie („community acquired pneumonia“, CAP), inklusive durch SARS-CoV-2-Infektionen, sollte sich auch während der Pandemie weiterhin an evidenzbasierten CAP-Leitlinien orientieren. COVID-19-spezifische Anpassungen sind jedoch sinnvoll. Die Behandlung von Patienten mit chronischen Lungenerkrankungen muss während der Pandemie angepasst werden, ist aber weiterhin zu gewährleisten.

Background Many animal models have been used to study the pathophysiology of hydrocephalus; most of these have been rodent models whose lissencephalic cerebral cortex may not respond to ventriculomegaly in the same way as gyrencephalic species and whose size is not amenable to evaluation of clinically relevant neurosurgical treatments. Fewer models of hydrocephalus in gyrencephalic species have been used; thus, we have expanded upon a porcine model of hydrocephalus in juvenile pigs and used it to explore surgical treatment methods. Methods Acquired hydrocephalus was induced in 33–41-day old pigs by percutaneous intracisternal injections of kaolin (n = 17). Controls consisted of sham saline-injected (n = 6) and intact (n = 4) animals. Magnetic resonance imaging (MRI) was employed to evaluate ventriculomegaly at 11–42 days post-kaolin and to plan the surgical implantation of ventriculoperitoneal shunts at 14–38-days post-kaolin. Behavioral and neurological status were assessed. Results Bilateral ventriculomegaly occurred post-induction in all regions of the cerebral ventricles, with prominent CSF flow voids in the third ventricle, foramina of Monro, and cerebral aqueduct. Kaolin deposits formed a solid cast in the basal cisterns but the cisterna magna was patent. In 17 untreated hydrocephalic animals. Mean total ventricular volume was 8898 ± 5917 SD mm3 at 11–43 days of age, which was significantly larger than the baseline values of 2251 ± 194 SD mm3 for 6 sham controls aged 45–55 days, (p Conclusions Kaolin induction of acquired hydrocephalus in juvenile pigs produced an in vivo model that is highly translational, allowing systematic studies of the pathophysiology and clinical treatment of hydrocephalus.

Background Training intensities in pulmonary rehabilitation are commonly based on fixed percentages of peak heart rate (HRpeak), heart rate reserve (HRR), or peak work load (Wpeak). For patients suffering from interstitial lung disease (ILD) it is unknown, whether those intensities are appropriate when compared to individual ventilatory thresholds (VT1 and VT2) derived from cardiopulmonary exercise testing (CPET). The aim of this study was to compare fixed HR percentages with HRs at VT1 and VT2. Study Design and Methods A total of 120 subjects, 80 ILD patients and 40 healthy controls, underwent a symptom-limited CPET. From the ILD patient, 32 suffered from idiopathic pulmonary fibrosis (IPF), 37 from connective tissue disease (CTD) and 11 from sarcoidosis. Results HRs at fixed percentages, i.e., at 70%HRpeak, at 70%Wpeak and at 60%HRR were significantly lower in the ILD patients compared to the control group. Large percentages of HR values at 70%Wpeak and 60%HRR ranged between the HRs at VT1 and VT2 in ILD subgroups and controls as well. HRs at 70%HRpeak were lower than HRs at VT1 in 66% of the IPF patients, 54% of the CTD patients and 55% of patients with sarcoidosis compared to 18% in the control group. Discussion Our findings demonstrate a considerable scattering of fixed HR percentages compared to HRs at the individual VTs derived from CPET in ILD patients. Thus, the use of HRs at the individual VTs is recommended for appropriate prescription of exercise intensity in pulmonary rehabilitation of ILD patients.

Die COVID-19-Pandemie stellt derzeit weltweit eine Herausforderung dar. In Österreich konnte eine Krise innerhalb des medizinischen Versorgungssystems bisher verhindert werden. Die Behandlung von Patienten mit ambulant erworbener Pneumonie („community acquired pneumonia“, CAP), inklusive durch SARS-CoV-2-Infektionen, sollte sich auch während der Pandemie weiterhin an evidenzbasierten CAP-Leitlinien orientieren. COVID-19-spezifische Anpassungen sind jedoch sinnvoll. Die Behandlung von Patienten mit chronischen Lungenerkrankungen muss während der Pandemie angepasst werden, ist aber weiterhin zu gewährleisten.

Spezifisches Atemmuskeltraining (IMT) ist in der Lage, die Funktion der Atemmuskulatur zu verbessern. Anhand der Studienlage und klinischen Praxis haben sich 3 Methoden etabliert: 1.) kontrollierte Stenoseatmung („resisitive load“), 2.) „threshold load“ und 3.) normokapnische Hyperpnoe. Die jeweiligen Methoden und zugehorigen Trainingsgerate weisen spezifische Charakteristika auf. Die Einleitung eines IMT erfordert eine vorausgehende Diagnostik der Atemmuskelfunktion und eine detaillierte individualisierte Trainingseinweisung und -anleitung. Ziel dieser Ubersichtsarbeit ist es, anhand der aktuell verfugbaren Literatur die unterschiedlichen IMT-Methoden bei den wichtigsten Indikationsgebieten zu beleuchten und kritisch zu diskutieren. Bei den neuromuskularen Erkrankungen werden Muskeldystrophien, spinale Muskelatrophien, amyotrophe Lateralsklerose, Phrenicusparese und Verletzungen des Ruckenmarks dargestellt. Zudem werden die Bereiche interstitielle Lungenerkrankungen, Sarkoidose, Linksherzinsuffizienz, pulmonal-arterielle Hypertonie, Kyphoskoliose und Adipositas beleuchtet. Bei den obstruktiven Atemwegs- und Lungenerkrankungen werden COPD, Asthma, Mukoviszidose und „Non-CF-Bronchiektasen“ aufgearbeitet. Abschliesend finden sich Ausarbeitungen fur den Bereich Weaning vom Respirator und im Zusammenhang mit korperlicher Aktivitat.

Pulmonary rehabilitation is a complex intervention with growing evidence, effective and without side effects, which led to a wide acceptance in the last years. Its history is young, in the 1960s and 1970s clinicians started to establish a comprehensive program for pulmonary patients. This article is a very subjective and brief description of the history of pulmonary rehabilitation and an attempt to picture the status quo 2015 in Austria.

Die pneumologische Rehabilitation ist ein wesentlicher Bestandteil der Therapie bei Patienten mit chronischen Lungenerkrankungen. Sie fuhrt zu einer Verbesserung der Leistungsfahigkeit und der Lebensqualitat, sowie zu einer Abnahme der Anzahl und Dauer der Spitalsaufenthalte bei Patienten mit COPD und Reduktion der Gesundheitskosten.

Chronic obstructive pulmonary disease (COPD) represents a major global health problem; however, there are no data regarding clinical phenotypes of these patients in Austria. This was an analysis from the Austrian cohort of the cross-sectional Phenotypes of COPD in Central and Eastern Europe (POPE) study, which was offered to patients with stable COPD in a real-life setting. Patients were recruited at 5 different outpatient facilities in 3 different provinces in Austria. All consecutive patients aged ≥40 years with a diagnosis of COPD confirmed by a post-bronchodilator forced expired volume in 1 s/forced vital capacity (FEV1/FVC) ratio

First finding of Simulium sublacustre Davies 1966 in Central Europe. A contribution to the Simuliid fauna in the Aller-Leine-area. Simulium reptans, S. argyreatum, and S. sublacustre have been identified for the first time in the Aller-Leine-area. It is the first finding of S. sublacustre in Central Europe. The habitats are briefly described. The taxonomy of S. sublacruste is discussed, and the main taxonomic characteristics of the female are described. Zusammenfassung Simulium reptans, S. argyreatum und S. sublacustre werden erstmals fur das Aller-Leine-Gebiet nachgewiesen. Fur S. sublacustre ist es der Erstnachweis in Mitteleuropa. Die Fundorte werden kurz beschrieben. Auf die Taxonomie von S. sublacustre wird hingewiesen. Die wichtigsten taxonomischen Merkmale des Weibchens werden beschrieben.

HINTERGRUND: Ziel unserer Studie war es, den Effekt von einem Jahr ambulanter wohnortnaher Rehabilitation auf funktionelle Parameter sowie auf die Lebensqualitat und Exazerbationsrate bei Patienten mit COPD zu untersuchen. METHODIK: Wir inkludierten 100 Patienten in ein multidisziplinares Rehabilitationsprogramm, welches sowohl Ausdauer-, Kraft- und inspiratorisches Atemmuskeltraining beinhaltet. Wir fuhrten folgende Messungen vor der Rehabilitation sowie nach sechs und 12 Monaten durch: Spiroergometrie, modifizierter Bruce Test, Kraft der Arme und Beine sowie inspiratorische Atemmuskelkraft. Zusatzlich wurde der Saint Georges Respiratory Questionnaire und die Exazerbationstage ein Jahr vor sowie wahrend der Rehabilitation erhoben. ERGEBNISSE: 100 Patienten (42 f/58 m) mit COPD (COPD IV – N = 36, COPD III – N = 42, COPD II – N = 22), einem mittleren Alter von 60,5 ± 9,6 Jahren, einem BMI von 25,8 ± 6,0 begannen ein pneumologisches Rehabilitationsprogramm uber einen Zeitraum von einem Jahr. Die Spiroergometrie (VO2max von 1,1 auf 1,3 l/Min, P < 0.05), der modifizierte Bruce Test (von 13 ± 7 Min auf 18 ± 9 Min; P < 0.001), die Kraft der Arme (von 39,9 ± 3 auf 52,9 ± 8 kg; P < 0.001) und Beine verbesserten sich (von 85,3 ± 45 auf 131,5 ± 57 kg; P < 0.001). Der Maximal inspiratorische Druck stieg von 81,1 auf 108,8 mbar (P < 0.0001). Es kam zu keinen Veranderungen in der FEV1 oder FEV1/FVC, jedoch der Saint Georges Respiratory Questionnaire (Gesamtscore) verbesserte sich von 37,2 ± 3,6 auf 26,5 ± 2,8; P < 0.001. Auch kam es zu einer Reduktion der Exazerbationsraten von 2,8 im Jahr vor der Rehabilitation auf 0,8; P = 0.006) sowie der Hospitalisationstage (von 27,3 auf 3,3, P < 0.001). FOLGERUNGEN: Ein Jahr ambulanter pneumologischer Rehabilitation fuhrt zu einer deutlichen Verbesserung der korperlichen Leistungsfahigkeit und der gesundheitsbezogenen Lebensqualitat, weiters konnen die Anzahl der Exazerbationen sowie die Hospitalisationstage reduziert werden.

Objectives: There is still little information about the cardiorespiratory effects of cardiac resynchronization therapy (CRT) in patients undergoing all-day physical activity. This study aimed to assess the effects of CRT on ventilatory perfusion coupling during submaximal exercise. Methods: Metabolic and hemodynamic parameters were obtained during treadmill exercise testing as well as during rest for each single-right (RV), -left (LV) and biventricular (BiV) pacing mode as well as during intrinsic conduction (VVI 30) in 37 patients. Only responders to CRT (>10% increase in cardiac output (CO) during BiV pacing; n = 27) were included into the evaluation. Results: LV and BiV pacing increased systolic (144 ± 25 and 142 ± 28 vs. 118 ± 29 mm Hg, p < 0.05) and mean blood pressure (108 ± 19 and 109 ± 19 vs. 94 ± 25 mm Hg, p < 0.05) as well as CO (7.0 ± 0.6 and 7.2 ± 0.8 vs. 6.0 ± 0.6 l/min, p < 0.05 and p < 0.01) during exercise as compared to VVI 30. Simultaneously, LV and BiV pacing decreased dead space ventilation (18 ± 3 and 17 ± 3 vs. 20 ± 4, p < 0.01) and the ventilatory equivalent for oxygen (31 ± 4 and 31 ± 5 vs. 36 ± 6; p < 0.05) compared to intrinsic conduction. Conclusion: The improvement in ventilatory efficacy during CRT, which is demonstrated by the decrease in the ventilatory equivalent for oxygen, results from an increase in CO and thus from a reduction in the ventilatory perfusion mismatch.

Specific respiratory muscle training (IMT) improves the function of the inspiratory muscles. According to literature and clinical experience, there are 3 established methods: 1.) resistive load 2.) threshold load and 3.) normocapnic hyperpnea. Each training method and the associated devices have specific characteristics. Setting up an IMT should start with specific diagnostics of respiratory muscle function and be followed by detailed individual introduction to training. The aim of this review is to take a closer look at the different training methods for the most relevant indications and to discuss these results in the context of current literature. The group of neuromuscular diseases includes muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, paralysis of the phrenic nerve, and injuries to the spinal cord. Furthermore, interstitial lung diseases, sarcoidosis, left ventricular heart failure, pulmonary arterial hypertension (PAH), kyphoscoliosis and obesity are also discussed in this context. COPD, asthma, cystic fibrosis (CF) and non-CF-bronchiectasis are among the group of obstructive lung diseases. Last but not least, we summarize current knowledge on weaning from respirator in the context of physical activity.

The Frequent Image Frames Enhanced Digital Orthorectified Mapping (FIFEDOM) camera was designed to provide a cost-effective remote-sensing method for accurate acquisition of forest information, such as spatial distributions of individual tree species and tree structures for forest monitoring and management. Compared with existing regular digital cameras, the FIFEDOM camera has several unique features as follows: (1) it can collect data not only in the visible bands (550 and 670 nm) but also in the near-infrared band (800 nm); (2) it has a frame rate of up to 3 frames/s with a frame size of 3500 times 2300; and (3) it has a wide angular field view with 150deg along track and 78.8deg across track. Its high frame rate and wide angular field view allow it to obtain a sequence of images that oversample ground target areas. The multiangle database and bidirectional reflectance signatures of forest canopies can be generated from the oversampled image data, which can be used to identify forest species and estimate tree structures. In addition, the multiframe highly overlapped FIFEDOM data can also be used to generate a very dense, high-quality, and reliable digital surface model. Effective methods for radiometric and geometric calibration of the FIFEDOM camera were developed in this paper. A data-acquisition campaign was carried out in 2004 over the Algoma boreal forest, Ontario, Canada. The FIFEDOM data were validated using the data acquired by the Compact Airborne Spectrographic Imager instrument, which was flown together with the FIFEDOM camera.

31-Phosphorous magnetic resonance spectroscopy (31P MRS) is a unique tool to investigate IN VIVO high-energy phosphates (HEP) in the human heart. We hypothesized that physical capacity may be associated with myocardial HEP status. Healthy, male volunteers (n = 105, mean age 51 +/- 7 years) underwent bicycle ergometry with a stepwise increasing workload to determine maximal working capacity (MWC). Heart rate (HR) and blood pressure (BP) were measured continuously during exercise and 4 minutes of recovery. Further 31-Phosphorous 2-dimensional chemical shift imaging (31P 2D CSI) MRS was performed to assess myocardial HEP metabolism by determining phosphocreatinine to beta-ATP ratios (PCr/b-ATP) using a 1.5 tesla scanner. Volunteers with MWC230 Watt had significantly higher PCr/b-ATP ratios than those with MWC200 Watt (1.93 +/- 0.36 vs. 1.59 +/- 0.35; p0.001). Additionally, those with a recovery systolic (S)BP195 mmHg had significantly higher ratios than those with a recovery SBP195 mmHg (1.74 +/- 0.3 vs. 1.51 +/- 0.2; p0.05). We observed a linear correlation between the PCr/b-ATP ratio and MWC (r = 0.411; p0.001) and recovery SBP (r = - 0.290; p0.01). After statistical correction for age, these correlations remained significant. In this study, we observed a correlation of parameters of physical fitness determined by bicycle exercise testing and cardiac PCr/b-ATP ratios.

Pulmonary rehabilitation is a complex intervention with growing evidence, effective and without side effects, which led to a wide acceptance in the last years. Its history is young, in the 1960s and 1970s clinicians started to establish a comprehensive program for pulmonary patients. This article is a very subjective and brief description of the history of pulmonary rehabilitation and an attempt to picture the status quo 2015 in Austria.

Adjustable maintenance dosing with either budesonide/formoterol or budesonide was compared in asthma patients. This double-blind trial randomized 133 patients (mean forced expiratory volume in 1s 66% predicted) to receive 2 inhalations twice daily of budesonide/formoterol 160/4.5 microg (640/18 microg/day) or budesonide 320 microg (1280 microg/day) for 4 weeks. The study drug was adjusted in both groups according to symptoms to 2-4 inhalations daily during Weeks 5-8 and 1-4 inhalations daily during Weeks 9-20. Asthma was well controlled in both groups, with minimal levels of treatment failure (5 budesonide/formoterol vs. 2 budesonide patients; P=NS) and minimal use of reliever therapy. Clinically important improvements in health-related quality of life (HRQL) occurred in the physical functioning and emotional role functioning domains (both P

To deal with the extremely high data rate and huge data volume generated on‐board a hyperspectral satellite, the Canadian Space Agency (CSA) has developed two fast on‐board data compression techniques for hyperspectral imagery. The CSA is planning to place a data compressor on‐board a proposed Canadian hyperspectral satellite using these techniques to reduce the requirement for on‐board storage and provide a better match to available downlink capacity. Since the compression techniques are lossy, it is essential to assess the usability of the compressed data and the impact on remote sensing applications. In this paper, 11 hyperspectral data users covering a wide range of application areas and a variety of hyperspectral sensors assessed the usability of the compressed data using their well understood datasets and predefined evaluation criteria. Double blind testing was adopted to eliminate bias in the evaluation. Four users had ground truth available. They qualitatively and quantitatively compared the produ...

Analysis of shape began to emerge as a useful method in medical image computing with the potential to improve the accuracy of medical diagnosis as well as the understanding of processes behind growth and disease. Our work aims at investigating the suitability of the medial representation method (m-reps) to model and analyze shape and shape differences between healthy and diseased hearts. For this experimental study we used MRI short axis scans of 16 male subjects, 11 healthy volunteers (age: 50 ± 10) and 5 patients (age: 57 ± 11) with dilatative cardiomyopathy (CMP, EF: 22 ± 10%). Controlled semi-automated segmentation using the level set method provided labels, which were used for the modeling process. To evaluate the model to image quality the similarity index (SI) was calculated. The SI for the left ventricle was 0.93, and for the right ventricle SI = 0.9. Applying extended Principal Component Analysis (PCA) on all 16 subjects revealed the distribution of the individual shapes, showing discrimination between healthy and diseased ventricles. The first two main components of the PCA, mainly responsible for discrimination, cover more than 40% of the whole shape space. Applying the medial based approach and using shape statistics using component analysis for the left and right ventricle is feasible. This preliminary work promises to discriminate at least globally based on shape differences between healthy and diseased hearts. The resulting question however is, if this approach is good enough to detect early structural changes leading to diseased hearts.

Acute myocarditis may result in severe hemodynamic compromise with fatal outcome. Furthermore, recent studies suggest myocarditis as a major cause of sudden unexpected death. A variety of cardiotropic viral, rickettsial, and bacterial infectious agents have been identified to date. Parvovirus B19 (PVB19) is usually benign in childhood, but it may also cause death due to myocarditis. We present here the case of an adult female who presented with fatigue, dyspnea on exertion, and orthostatic dizziness 8 months after successful liver transplantation. Cardiologic work-up, including left ventricular endomyocardial biopsy, revealed acute myocarditis secondary to PVB19. Since no specific therapy for this virus is available, the patient was treated symptomatically with an angiotensin-converting enzyme inhibitor plus beta-blocker and diuretics. After a period of stabilization, new-onset rapid atrial fibrillation caused acute low-output syndrome within 14 days after hospital admission. The patient eventually died because of refractory cardiogenic shock. In conclusion, to our knowledge this is the first report of PVB19-induced myocarditis confirmed by detection of viral genome in myocardium in a liver transplant recipient.

To investigate the presence of diarrheagenic Escherichia coli in Lambaréné, Gabon, 150 children with diarrhea were screened for enteroaggregative E. coli (EAEC), enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enterohemorrhagic E. coli (EHEC), and enteroinvasive E. coli (EIEC) using polymerase chain reaction and an HEp-2 cell culture techniques. Isolates of EAEC were detected in 57 children, two thirds of them between six months and two years of age, and isolates of ETEC were detected in seven patients. Isolates of EPEC, EHEC, and EIEC were not present in this population. Among the EAEC, the pCVD432 plasmid, a heat stable (ST)-like (ST-like) enterotoxin (EAST), and a plasmid-encoded heat-labile toxin (PET) were detected in 19, 34, and 42 cases, respectively. Detection of pCVD432, EAST, and PET were significantly associated with EAEC identified by the HEp-2 cell assay. Although detected only in 16 patients, the presence of the fimbriae AAF I (aagA) and AAF II (aafA) were more likely to occur in EAEC than in non-EAEC (odds ratio [OR] = 4.1, 95% confidence interval [CI] = 0.5-38.6, and OR = 2.3, 95% CI = 1.0-5.3, respectively). The EAEC isolates exhibited decreased susceptibility for ampicillin, tetracycline, and trimethoprim.

death plays a pathogenic role in a rat model of heart failure. Int J Cardiol 2009;134:82–90. [6] Matsui Y, Takagi H, Qu X, et al. Distinct roles of autophagy in the heart during ischemia and reperfusion: roles of AMP-activated protein kinase and Beclin 1 in mediating autophagy. Circ Res 2007;100:914–22. [7] Asanuma K, Tanida I, Shirato I, et al. MAP-LC3, a promising autophagosomal marker, is processed during the differentiation and recovery of podocytes from PAN nephrosis. FASEB J 2003;17:1165–7. [8] Shewan LG, Coats AJ. Ethics in the authorship and publishing of scientific articles. Int J Cardiol 2010;144:1–2.

This paper evaluates lossy vector quantization-based hyperspectral data compression algorithms, using red-edge indices as end-products. Three compact airborne spectrographic imager (CASI) data sets and one airborne visible/infrared imaging spectrometer (AVIRIS) data set from vegetated areas were tested. A basic compression system for hyperspectral data called the "reference" system, and three-speed improved compression systems called systems 1, 2, and 3, respectively, were examined. Five red-edge products representing the near infrared (NIR) reflectance shoulder (Vog 1), the NIR reflectance maximum (Red rs), the difference between the reflectance maximum and the minimum (Red rd), the wavelength of the reflectance maximum (Red lo), and the wavelength of the point of inflection of the NIR vegetation reflectance curve (Red lp) were retrieved from each original data set and from their decompressed data sets. The experiments show that the reference system induces the smallest product errors of the four compression systems. System 1 and 2 perform fairly closely to the reference system. They are the recommended compression systems since they compress a data set hundreds of times faster than the reference system. System 3 performs similarly to the reference system at high compression ratios. Product errors increase with the increase of compression ratio. The overall product errors are dominated by Vog 1, Red rs, and Red rd, since the amplitude of product error for these products is over one order of magnitude greater than those for the Red-lo and Red lp products. The difference between the overall error from the reference and that from system 1 or 2 is below 0.5% at all compression ratios. The overall product error induced by system 1 or 2 is below 3.0% and 2.0% for CASI and AVIRIS data sets, respectively, when the compression ratio is 100 and below. Spatial patterns of the product errors were examined for tha AVRIS data set. For all products, the errors are uniformly distributed in vegetated areas. Errors are relatively high in nonvegeted and mixed-pixel areas.

In this work the operation of an industrial semi-batch reactor is optimized. In the reactor a strongly exothermic polymerization reaction takes place and the objective is to minimize the duration of the batch time. Various operational as well as quality and safety related constraints have to be met during the batch and at its final time. In particular, a cooling system failure is taken into account explicitly since the temperature rise in this case must not exceed a corresponding limit. The optimization is based on a detailed process model derived from first principles. A reduced model is developed for optimization and trajectories for the operational variables feed flowrate and reactor temperature are calculated. The results show that significant reductions of the batch time are possible and that their extent depend on the formulated safety constraints. For a selected case the obtained optimal trajectories are verified experimentally in laboratory and production scale.

Hintergrund und Methode. Wir fuhrten 1996 und 1997 bei insgesamt 13.414 Eltern von 5- bis 7-jahrigen Schulanfangern in Wien auf der Basis des international standardisierten ISAAC-Fragebogens (ISAAC: international study of asthma and allergies in children) eine epidemiologische Querschnittsuntersuchung durch. Ergebnisse. Trotz asthmatischer Symptome [1996: 8,2% (n=385) – 1997: 6,9% (n=603)] wurde nur bei 1/3 der Kinder (1996: 29,9% – 1997: 32,6%) eine Asthmadiagnose gestellt, mehr als die Halfte (n=349) der symptomatischen Kinder erhielt keinerlei antiasthmatische Therapie. Im Spatsommer geborene Kinder hatten im Vergleich zu im Februar geborenen Kindern signifikant haufiger asthmatische Symptome. Schlussfolgerungen. Ziel der Arbeit war es, einen Uberblick uber Symptompravalenz, Asthmadiagnose, Medikation und Betreuungssituation zu erhalten. Es lassen sich Unterdiagnostik und Unterversorgung annehmen. Des weiteren konnten wir die Einsatzmoglichkeiten des schularzlichen Diensts aufzeigen. Einschrankend muss darauf hingewiesen werden, dass die Beteiligungsraten in kunftigen Erhebung angehoben werden mussen. Mit gut validierten Instrumenten ergeben sich hier neue Einsatzmoglichkeiten.

The goal of this study was to show whether a correlation exists between the intensity of specific respiratory muscle training and the improvement of strength and endurance in inspiratory musculature in patients with neuromuscular disorders (NMD). Sixteen patients with NMD (13 with Duchenne muscular dystrophy and 3 with spinal muscular atrophy) performed inspiratory muscle training (IMT) at home with a special training apparatus for 9 months. Maximal inspiratory mouth pressure (PI(MAX)) and 12s-maximum voluntary ventilation (12s-MVV) test served as parameters for inspiratory muscle strength and endurance, respectively. In patients whose inspiratory vital capacity (VC(in)) declined by less than 10% during the year before training began (n = 10), a significant positive correlation was found between the number of successfully completed strength and endurance exercises and the improvement of PI(MAX) (P < 0.05) and 12s-MVV (P < 0.05). In patients whose VC(in)-decline exceeded 10% (n = 6), indicating more progressive respiratory system involvement of the disease, no significant correlation between the improvement of PI(MAX) and 12s-MVV and the intensity of training was found. In patients with NMD, the effects of IMT-runs are dose-dependent, provided that the respiratory system involvement of the disease is only slowly progressive.

Several studies note that bronchial hyperresponsiveness has increased in the past years. There is a connection between allergen exposition during childhood and the development of asthma bronchiale. 1988 a questionnaire was sent to the parents of 281 Viennese school children. The children were tested for bronchial hyperresponsiveness as well as for sensitization to airborne allergens like Alternaria alternata (A. alternat) and Dermatophagoides pteronyssinus (D. pter.). The same test with the same methodology was repeated in 390 children at the same school in 1997. In the period from 1988 to 1997 the number of children with bronchial hyperresponsiveness increased significantly from 20 to 27 percent. The prevalence of sensitization increased from 24 to 34 percent. The report of asthmatic symptoms and allergic reactions is increasing as well.

The purpose of the present study was to investigate the factors that may contribute to the sensitization to flour in baker's apprentices, and to predict this type of sensitization with a stepwise logistic regression model. Of the total of 258 baker's apprentices, 54 (20.9%) exhibited specific IgE development against flour allergens (wheat, rye, and/or barley). Allergologic variables, such as the total IgE level and IgE specific to grass pollen, tree pollen, weed pollen, molds, and animal dander, were found to correlate strongly with the sensitization to flour. However, the correlation between the presence of other manifest allergies and the sensitization to flour was weak. The presence of shadowing of the paranasal sinuses on the radiograph (mucosal thickening, opacity, air/fluid levels, and/or polypous shadowing) correlated with flour sensitization as well as with the leukocyte and lymphocyte counts in peripheral blood. Of the lung function data, only total lung capacity (in percentage of the predicted values) weakly correlated with the sensitization to flour. We were able to predict flour sensitization with a sensitivity of 63%, a specificity of 90%, and an efficiency of 84% by using the parameters that allow for the presence or absence of IgE specific to grass pollen and tree pollen, the presence or absence of radiographic shadowing, and total lung capacity in percentage of the predicted values.

BACKGROUND--To date there are no data on the effects of lung transplantation on diaphragmatic function in patients with end stage chronic obstructive pulmonary disease (COPD). It is not known whether the relation between the transdiaphragmatic pressure (PDI) and lung volume is altered in recipients after transplantation as a result of changes in diaphragmatic structure caused by chronic hyperinflation. The effect of lung transplantation on diaphragmatic strength was determined in patients with COPD and the relation between postoperative PDI and lung volume analysed. METHODS--Diaphragmatic strength was assessed in eight double lung transplant recipients, six single lung transplant recipients, and in 14 patients with COPD whose lung function was similar to those of the transplant recipients preoperatively. PDI obtained during unilateral and bilateral phrenic nerve stimulation at 1 Hz (twitch PDI) at functional residual capacity (FRC) and during maximal sniff manoeuvres (sniff PDI) at various levels of inspiratory vital capacity (VCin) served as parameters for diaphragmatic strength. Sniff PDI assessed at the various VCin levels were used to analyse the PDI/lung volume relation. RESULTS--Lung transplantation caused a reduction in lung volume, especially in the double lung transplant recipients. As a consequence sniff PDI was higher in the double lung transplant recipients than in the patients with COPD at all levels of VCin analysed. However, sniff PDI values analysed at comparable intrathoracic gas volumes were not reduced in the patients with COPD when compared with those who underwent lung transplantation. Bilateral twitch PDI values were similar in the patients with COPD and in the lung transplant recipients. In the single lung transplant recipients unilateral twitch PDI values were similar on the transplanted and the non-transplanted side. The relation between PDI and lung volume was similar in the patients with COPD and in the lung transplant recipients. CONCLUSIONS--In patients with COPD lung transplantation leads to an increase the maximal sniff induced PDI values by placing the diaphragm in a more favourable position for pressure generation. Since patients with COPD and postoperative lung transplant recipients showed similar PDI/lung volume relations, this suggests that chronic pulmonary hyperinflation does not cause major functional alterations of the diaphragm.

Rehabilitation programmes in chronic obstructive pulmonary disease (COPD) require exercise training above the anaerobic threshold. However, not all COPD patients develop metabolic acidosis during exercise. The hypothesis of this study was that non-exercise variables, characterizing the mechanical load on the inspiratory muscles during breathing at rest, can be used to reliably predict which patients with COPD are not able to develop metabolic acidosis during exercise. Thirty participants with COPD performed a symptom-limited cycle ergometer test. The oesophageal pressure/time index (PTIoes: the product of pressure magnitude and duration), the mean rate of pressure development during inspiration (Poes/TI), and the mean airway resistance (Raw)/maximal oesophageal pressure (Poesmax) ratio served as indices for the mechanical load on the inspiratory muscles. The oxygen uptake (VO2) at which plasma standard bicarbonate was seen to decrease from its baseline value was taken as the anaerboic threshold (AT). Mean Raw was significantly higher in those patients in whom the AT could not be detected. No other lung function parameters measured at rest allowed the accurate selection of those patients who did or did not develop exercise metabolic acidosis. On the other hand, Raw/Poesmax, PTIoes and Poes/TI were significantly different in the two patient groups. Additionally, whereas in the patient group with identifiable AT exercise hyperpnoea produced a non-linear increase of Poes/TI with respect to PTIoes above the AT, in the patient group without identifiable AT there was a linear relationship between Poes/TI and PTIoes throughout exercise. We conclude that the determination of inspiratory muscle load indices at rest may be useful in pulmonary rehabilitation programmes, for identifying those patients with COPD who do not develop exercise induced metabolic acidosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchoalveolar lavage (BAL) was performed on 70 RA patients, 28 without extra-articular manifestations, nine with pulmonary involvement, 13 with sicca-syndrome, 20 with other extra-articular manifestations such as renal involvement, cutaneous vasculitis and rheumatoid nodules. Fifteen patients without rheumatic or pulmonary disease served as the control group. Compared with the control group RA patients showed a statistically significant increase of lymphocytes, especially of activated (DR+)T(CD3+)-helper (CD4+) cells, resulting in a significantly diminished percentage of alveolar macrophages, B(CD21+)-lymphocytes, T-suppressor (CD8+) cells and an increased CD4/CD8 ratio. This cell distribution pattern was more pronounced in RA patients with lung involvement with significant differences to the other RA patients with regard to lymphocytes, DR positive cells and CD4 positive/DR positive cells. It is concluded that these results indicate an altered balance of immunocompetent cells not only in the joints but also in the lung. The changes are more distinct if local manifestations can be diagnosed clinically.

Cardiac resynchronization therapy (CRT) is limited by the high numbers of nonresponders. This study analyzed the impact of the cardiorespiratory functional reserve to predict the response to CRT.Twenty-eight patients (age 67 ± 9 years, LVEF35%, NYHA class III, QRS 158 ± 25 ms) underwent submaximal cardiopulmonary treadmill exercise testing prior and 6 months after implantation of a CRT device. Breath-to-breath gas analysis was used for calculation of the oxygen uptake efficiency slope (OUES = non-effort-dependent index of cardiorespiratory functional reserve) in the responder and nonresponder group. Responders to CRT [defined by a decrease in left ventricular end-systolic volume (LVESV)15%] showed a significant lower cardiorespiratory reserve at baseline (prior CRT) as compared to the nonresponders (OUES 1,235 ± 651 vs. 2,480 ± 590; p0.01). Responders showed an increase in OUES during CRT at the 6 months follow-up (1,879 ± 663; p0.05) whereas nonresponders showed no significant changes from baseline (2,194 ± 422; ns). Both responders and nonresponders showed an improvement in LVEF at the 6 months follow-up (23 ± 5 vs. 31 ± 9% and 26 ± 7 vs. 32 ± 3%; p0.05). Responders to CRT showed a decrease in NYHA classification (3.0 vs. 2.6 ± 0.5; p0.05) and a decrease in LVESV (175 ± 58 vs. 128 ± 40 ml; p0.05).Nonresponders to CRT showed a more preserved cardiorespiratory functional reserve as compared to responders despite similar NYHA classification. Evaluation of the OUES by submaximal exercise testing improves identification of responders to CRT.

We investigated the incidence of allergic sensitization and the risk factors underlying sensitization in 214 urban children exposed to horse chestnut pollen. By means of the Phadezym RAST, we found IgE specific to horse chestnut pollen in 12.6% of the urban children, whereas it occurred in only 1.9% of control subjects recruited from a rural area. Reports of allergic symptoms in spring during the horse chestnut pollen load coincided with the presence of specific IgE in 5.1% of the urban group as against 1.4% of the recruited from the rural area. Environmental factors other than those related to urban living and higher horse chestnut pollen counts had no significant impact on allergic sensitization. Increased total IgE levels (greater than 100 kU/l), however, and the sensitization to pollen of other species significantly raised the odds for sensitization to chestnut pollen. They were highest in highly atopic children with sensitization to pollen, especially to that of plane trees (OR = 73.9). These results suggest the relevance of horse chestnut pollen because of the high allergic sensitization rate among urban children, and they should also be borne in mind when it comes to the planting of trees in urban areas.

Bronchoalveolar lavage lymphocytes from 15 patients with pulmonary sarcoidosis and 8 healthy controls were investigated for nucleolar silver staining patterns and lymphocyte subpopulations. Patients with sarcoidosis had increased numbers of silver stained dots versus controls (2.20 +/- 0.24 versus 1.78 +/- 0.07; p less than 0.001). The number of silver stained dots showed the strongest positive correlation to helper cells (OKT 4+) (r = 0.781; p less than 0.0001). These results may be interpreted as further evidence of lymphocytic activation, especially of helper cells (OKT 4+) in pulmonary sarcoidosis.

Intermittent snoring and cyclic oscillations of heart rate and oxyhaemoglobin saturation (Sao2) are characteristic features of the obstructive sleep apnoea syndrome (OSAS). Thus, overnight recordings of laryngeal sounds and heart rate by a portable device (MESAM) and of Sao2 by oximetry are applicable to screen outpatients for the presence of OSAS. Computerized analysis for time intervals of constant heart rate and intervals between snoring sounds is used by MESAM to quantify respiratory disturbances during sleep. Rapid increases in Sao2 during the postapnoeic hyperventilation period together with the number of desaturations are used by a new software for quantitative analysis of oximetry. To elucidate reliability of results from automatically scored MESAM and oximetry recordings, we compared the four computer calculated respiratory disturbance indices from heart rate (RDIH), snoring (RDIS), resaturations (RDIR) and desaturations (RDID) with the apnoea plus hypopnoea index (AHI) from simultaneously performed polysomnography. The study population consisted of 53 snorers with an AHI of 19.0 +/- 2.6 (median +/- SEM; range 0.7-87.8). Whereas both RDI's from MESAM correlated rather weakly with the AHI from polysomnography (RDIH: r = 0.32, p less than 0.05; RDIS: r = 0.33, p less than 0.05), this correlation was much better for the RDI's from oximetry (RDIR: r = 0.951, RDID: r = 0.93; p much less than 0.0001). Accepting a plus/minus 30 percent difference from the AHI, the RDIR classified 77% of patients correctly, the RDID 62%, the RDIS 32% and the RDIH 23%. In conclusion, results from computerized analysis of oximetry for desaturations and rapid resaturations correlate more closely with polysomnography than those from automatic scoring of MESAM recordings.

Sensitization to mould spores was investigated in six patients with hypersensitivity pneumonitis, eight patients with idiopathic lung fibrosis, and six healthy controls by immunodiffusion and immunofluorescent testing of personal spore samples. The new technique of personal spore sampling with the Burkard personal volumetric air sampler and indirect immunofluorescent test for detection of spore-specific IgG and IgM confirmed that five patients with hypersensitivity pneumonitis and four with lung fibrosis were actually exposed and sensitized to moulds. Personal spore sampling and subsequent immunofluorescent tests represent sensitive tools for detection of individual mould sensitization and air quality control.

An incremental cycle ergometer test performed with a total of 40 healthy subjects (25 male, 15 female) was used to study the mechanical load on the ventilatory muscles. The parameters for the mechanical load on the ventilatory muscles are the time integral of the oesophageal pressure and the mean oesophageal pressure change per time unit (dPoe/dTI) of each breathing manoeuvre. The pressure-time integral is the area delimited by the oesophageal pressure trace and the inspiratory time axis. It is expressed as a fraction of the product of the subject's maximum oesophageal pressure (Poe(max)) and total breath cycle duration (TTOT). This parameter is called oesophageal tension time index (TTIoe). The relationship between minute ventilation and these two parameters during ergometer test showed gender-specific variations because of the differences between men and women as to anthropometric data, lung function parameters and maximum ventilatory muscle strength. Moreover, the dPoe/dTI values significantly depend on the breathing frequency. The present study has provided evidence that, in general, the TTIoe and dPoe/dTI values in terms of a specific minute ventilation (VE) are higher in women than in men. Parameters for the mechanical load on the ventilatory muscles regarding the level of pressure to be generated as well as the duration and velocity of muscle contraction should therefore also allow for the gender of the patients.

The simulation of powder compaction for Nd–Fe–B, Sm–Co, and barium ferrite shows the influence of different static field strengths and different mold filling on particle misalignment. The final magnetization differs up to 20%. The processing determines the pressure activated processes in which the particle overcomes a volume barrier, characterized by elastic energy fluctuations. Isostatic compaction shows less pressure activated processes as compared to uniaxial mold pressing. However, an improved magnetization of about 10% owing to isostatic pressing was observed only for spherical particles. The pressure activated processes determine particle density defects such as cracks and pores, misalignment of c axes at the punch side, at corners and at particle density defects, and internal stress areas with cold plastic flow.

The maximal sniff generated mouth and transdiaphragmatic pressures of six healthy volunteers (three women and three men) were measured at various lung volumes between residual volume and 95% of total lung capacity. At residual volume the mean (SD) maximum transdiaphragmatic pressure was 163 (18) cm H2O (1 cm H2O = 0.0981 kPa). With increasing lung volume the maximum pressures generated declined, so that at 95% of total lung capacity the mean pressure was 68 (15) cm H2O. Mouth pressures showed a similar relation to lung volume. At residual volume the mean maximum mouth pressure was 74 (8) cm H2O, compared with 38 (6) cm H2O at 95% of total lung capacity. The relation between pressure and lung volume was linear for measurements at lung volume levels between residual volume and 85% of total lung capacity; values at 95% of total lung capacity, however, were lower than predicted from the linear regression of the other points. The use of a second order polynomial regression showed a higher coefficient of determination in all cases (0.72 and 0.69 for transdiaphragmatic and mouth pressures on the basis of all pressure values for all subjects). Sniff generated mouth and transdiaphragmatic pressures show a predictable dependence on lung volume, supporting their use as measures of global inspiratory muscle power and diaphragm strength respectively.

The risk factors for sensitization to pets was investigated in 169 male pupils. A recent or former contact with cats, dogs, and guinea pigs in own home was reported in 52 (30.8%), 42 (24.9%), and 20 (11.8%) study subjects, respectively. Clinically manifested allergy was found in two probands to cats and in two others to guinea pigs, three of them had formerly had pets and one proband with allergic rhinitis to cats had never had any pet. Sensitization to animals and aeroallergens was investigated with Phadezym-RAST. Only owners of cats had a higher incidence of cat sensitization than probands without direct contact (26.9% versus 10.3%, P less than 0.01). No statistically significant difference in sensitization to dogs and guinea pigs was found in groups with and without these pets. A strong correlation existed between sensitization to pets and other aeroallergens (house dust mite: P less than 0.025, birch pollen: P less than 0.0001, mugwort: P less than 0.0001, and grass pollens: P less than 0.0001). No association was found between sensitization to pets and smoking history, bronchial hyperreactivity to methacholine or radiological findings of the paranasal sinus.