Forearm elevation impairs local static handgrip endurance likely through reduction in vascular conductance and perfusion pressure: revisiting Rohmert's curve.

Maximal isometric contraction time (MICT) is critical for most motor tasks and depends on skeletal muscle blood flow at < 40% of maximal voluntary strength (MVC). Whether limb work positions associated with reduced perfusion pressure and facilitated vessel compression affect MICT is largely unknown. In 14 healthy young men we therefore assessed bilateral handgrip MICT at 15, 20, 30, 40, and 70% of MVC in horizontal forearm positions of 0.

[From vibration trauma to pharyngeal muscle instability: A self-sustaining pathophysiological process (circulus vitiosus) in obstructive sleep apnea].

Pharyngeal stability is ensured by both anatomical and non-anatomical factors. In addition to the anatomical width, functional factors are also significant in determining the degree of obstruction of the upper airway. The functionality of the pharyngeal muscles depends on an undisturbed sensorimotor system.

[Critical Closing Pressure (Pcrit) and Negative (Subatmospheric) Expiratory Pressure (NEP) for Diagnosis of Pharyngeal Collapsibility in Patients With Obstructive Sleep Apnea (OSA)].

The determination of critical closing pressure (Pcrit) is the diagnostic gold standard for assessing the severity of pharyngeal instability. Pcrit measurements are typically performed during natural nocturnal sleep (NREM Stage 2) in combination with polysomnography. However, determining Pcrit during sleep is time-consuming and impractical for routine use.

[Valsalva and Müller maneuvers: who is who and what is what?].

The original Valsalva manoeuvre (VM) was described in detail by the Italian anatomist, physician and surgeon Antonio Maria Valsalva (1666-1723). The VM consists of a voluntary forced expiratory effort against a closed upper airway. It was used tradionally in otolaryngology for testing the openess of the eustachian tubes and expelling pus/fluid from the middle to the external ear.

[The search for the "node of life": breathing regulation].

The article provides a historical overview of developments in the understanding of respiratory rhythm and its control mechanisms over the last two centuries. In the 19 century, a structure in the medulla oblongata was first described as the "node of life". In 1743, Taube discovered the carotid body, and in 1927 the Spaniard de Castro described its morphology and innervation.

[From "processing" and "fermentation" to oxidative metabolism].

The theory of the four humors or humorism (Hippocrates of Kos) viewed disease as an imbalance of the humors. Galen of Pergamon further developed the theory by describing digestion as a sequence of chemical reduction processes that convert into the various humours. Theophrastus von Hohenheim attempted to overcome humorism in the 16th century and establish medicine on a natural-philosophical-alchemical basis.

[The upper airway in obstructive sleep apnea patients is pathological even when awake].

Obstructive sleep apnea (OSA) is characterized by partial or complete obstruction of the pharyngeal airway. Anatomical factors can be distinguished from non-anatomical factors. Age and obesity are the main risk factors for OSA; however, approximately 50% of patients are not obese.

[Sleep disorders in patients with chronic tinnitus].

Tinnitus has a lifetime prevalence of 25% in Germany. A common comorbidity in chronic cases are sleep disorders. The aims of this study were to detect sleep disorders and to identify possible associations with tinnitus parameters.

Chronic cough in postmenopausal women and its associations to climacteric symptoms.

Background: Postmenopausal women often have chronic cough. Hormonal changes might be affecting lung function and the mucous membrane of the airways, causing hypersensitivity of the cough reflex. Therefore, postmenopausal hormonal changes could play a key role in the association between increased cough and menopause.

[In commemoration of Adolf Kussmaul's 200th birthday: Describer of the Kussmaul Breathing and pioneer of endoscopy].

Adolf Kussmaul (1822-1902) studied medicine in Heidelberg. The name Kussmaul is known worldwide for the panarteritis nodosa, the pulsus paradoxus and the venous pulse in callous mediastinopericarditis as well as the high-frequency and deep breathing in diabetic ketoacidosis. Kussmaul was also a pioneer in the endoscopic diagnosis and treatment of diseases of the oesophagus and stomach.

[Why you should know the "nose cycle" as a pneumologist and sleep medicine specialist].

The nasal cycle refers to the anticyclic swelling and decongestion of the two nasal cavities that occur during the day and during sleep, while the overall nasal flow remains constant. The nasal cycle was first described by R. Kayser in 1895.

[Analysis of Snoring in Patients with Obstructive Sleep Apnea (OSA) by Polysomnography and LEOSound].

Introduction: Snoring was monitored in patients with obstructive sleep apnea (OSA) using the LEOSound-Monitor and simultaneously polysomnographic (PSG) recording. In obstructive apneas snoring is normally apparent after apnea termination and the beginning of ventilation. We wanted to know how often obstructive apneas are terminated by ventilation in combination with snoring.

[Adherence to CPAP Three Months after Starting Therapy in 1078 Patients with Obstructive Sleep Apnea (OSA)].

Introduction: Nocturnal Continuous Positive Airway Pressure (CPAP) is considered the gold standard treatment for obstructive sleep apnoea (OSA). The CPAP therapy is a long-term treatment but does come with few possible side effects. The adherence to the therapy is frequently suboptimal.

Acoustic Monitoring of Night-Time Respiratory Symptoms in 14 Patients with Exacerbated COPD Over a 3- Week Period.

Introduction: In clinical practice, wheezing and coughing represent a worsening of the respiratory situation of COPD patients and should be monitored long-term during and after an Acute Exacerbation of COPD (AECOPD) to observe the therapy. We investigated if overnight monitoring of wheezing and coughing is feasible during AECOPD and whether automatic long - term monitoring enables an objective assessment during and after an AECOPD.

Methods: In 14 patients (age: 56-80 years) with pre-existing COPD (stages B-D) nighttime wheezing and coughing events were monitored for a period of three weeks.

[Negative-pressure pulmonary edema and alveolar hemorrhage are potentially life-threatening complications of upper airway obstruction].

Negative pressure pulmonary edema and alveolar hemorrhage are potentially life-threatening complications after relief of upper airway obstruction. The laryngeal-pharyngeal obstruction results in high negative intrapleural pressures. The increased intrapleural pressures affect the integrity of the alveolo-capillary membrane due to various factors.

[The bronchial arteries: a small but vital contribution to lung perfusion after lung transplantation].

Blood supply to the lungs is carried out by the pulmonary and bronchial-arterial system. The bronchial-arterial vessels are involved in supplying the small airways all the way up to the terminal bronchioles. The bronchial-arterial system is also necessary for the regulation of airway temperature, humidity and mucociliary clearance.

[Recurrent Pulmonary Hemorrhages with Hemoptysis as a Result of Vocal Cord Dysfunction (VCD) - An Attempt to Explain].

We present the case of an otherwise healthy 19-year-old student who has been affected by vocal cord dysfuntion (VCD) since she is fourteen. 3 years after that diagnosis she has also been coughing blood at an increasing rate (1-3 times per week). We postulate that the haemoptoe is the result of breathing against a closed airway which can lead to excessively high negative intrathoracic pressures.

Pilot study on nocturnal monitoring of crackles in children with pneumonia.

Background: The clinical diagnosis of pneumonia is usually based on crackles at auscultation, but it is not yet clear what kind of crackles are the characteristic features of pneumonia in children. Lung sound monitoring can be used as a "longtime stethoscope". Therefore, it was the aim of this pilot study to use a lung sound monitor system to detect crackles and to differentiate between fine and coarse crackles in children with acute pneumonia.

[Adherence to CPAP Three Months after Starting Therapy in 1078 Patients with Obstructive Sleep Apnea (OSA)].

Introduction:  Nocturnal Continuous Positive Airway Pressure (CPAP) is considered the gold standard treatment for obstructive sleep apnoea (OSA). The CPAP therapy is a long-term treatment but does come with few possible side effects. The adherence to the therapy is frequently suboptimal.

[The Road to Discovery of the Pulmonary Gas Exchange - From the "Phlogiston-" to the "Oxygen Theory"].

The discovery of oxygen and pulmonary gas exchange was a major advancement in our understanding of breathing. For centuries it was believed that the lungs were primarily necessary to cool the heart or to "refine" the blood. Richard Lower (1631-1691) observed that the blood had a different colour before and after passage through the lung.

Predisposing factors of daytime sleepiness in obese OSA patients.

Excessive daytime sleepiness is a common symptom in obese patients with obstructive sleep apnea. We investigated predisposing factors of excessive daytime sleepiness by comparing obese non-sleepy with sleepy patients with obstructive sleep apnea. Excessive daytime sleepiness was determined by the Epworth Sleepiness Scale in 43 patients (34 men and 9 women) with obstructive sleep apnea (apnea-hypopnea index ≥ 15 events per hr) and obesity (body mass index ≥ 30 kg m ).

[From the anatomical teaching dissection to tuition at the bedside-A historical appraisal].

At all times anatomists endeavored to procure scientific foundations for medicine. The anatomist dissected corpses in order to serve the living. The knowledge of anatomy is a prerequisite for the understanding of physiological and pathophysiological processes.

High Plasma Cystine Levels Are Associated with Blood Pressure and Reversed by CPAP in Patients with Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) independent of obesity (OBS) imposes severe cardiovascular risk. To what extent plasma cystine concentration (CySS), a novel pro-oxidative vascular risk factor, is increased in OSA with or without OBS is presently unknown. We therefore studied CySS together with the redox state and precursor amino acids of glutathione (GSH) in peripheral blood mononuclear cells (PBMC) in untreated male patients with OSA (apnea-hypopnea-index (AHI) > 15 h, = 28) compared to healthy male controls ( = 25) stratifying for BMI ≥ or < 30 kg m.