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Cholinergic polymodal chemosensory cells in the mammalian urethra (urethral brush cells = UBC) functionally express the canonical bitter and umami taste transduction signaling cascade. Here, we aimed to determine whether UBC are functionally equipped for the perception of salt through ENaC (epithelial sodium channel). Cholinergic UBC were isolated from ChAT-eGFP reporter mice (ChAT = choline acetyltransferase). RT-PCR showed mRNA expression of ENaC subunits Scnn1a, Scnn1b, and Scnn1g in urethral epithelium and isolated UBC. Scnn1a could also be detected by next generation sequencing in 4/6 (66%) single UBC, two of them also expressed the bitter receptor Tas2R108. Strong expression of Scnn1a was seen in some urothelial umbrella cells and in 65% of UBC (30/46 cells) in a Scnn1a reporter mouse strain. Intracellular [Ca2+] was recorded in isolated UBC stimulated with the bitter substance denatonium benzoate (25 mM), ATP (0.5 mM) and NaCl (50 mM, on top of 145 mM Na+ and 153 mM Cl- baseline in buffer); mannitol (150 mM) served as osmolarity control. NaCl, but not mannitol, evoked an increase in intracellular [Ca2+] in 70% of the tested UBC. The NaCl-induced effect was blocked by the ENaC inhibitor amiloride (IC50 = 0.471 mu M). When responses to both NaCl and denatonium were tested, all three possible positive response patterns occurred in a balanced distribution: 42% NaCl only, 33% denatonium only, 25% to both stimuli. A similar reaction pattern was observed with ATP and NaCl as test stimuli. About 22% of the UBC reacted to all three stimuli. Thus, NaCl evokes calcium responses in several UBC, likely involving an amiloride-sensitive channel containing alpha-ENaC. This feature does not define a new subpopulation of UBC, but rather emphasizes their polymodal character. The actual function of alpha-ENaC in cholinergic UBC-salt perception, homeostatic ion transport, mechanoreception-remains to be determined.
Wird eine Klage auf Feststellung von Unfallfolgen rechtskräftig abgewiesen, steht diese Rechtskraft einem Anspruch auf Rücknahme des früheren, bestandskräftigen, Unfallfolgen verneinenden Bescheides nach § 44 SGB X entgegen. Denn es steht aufgrund der Rechtskraft der gerichtlichen Entscheidung fest, dass Unfallfolgen nicht vorliegen, der frühere Bescheid also rechtmäßig ist.
Mit dem Anspruch, die Qualität in der medizinischen Rehabilitation weiterzuentwickeln, haben sich im Jahr 2007 13 Kliniken von acht Trägern zusammengeschlossen. Heute, ein gutes Jahrzehnt später, vereint der Qualitätsverbund Gesundheit rund 30 Reha-Kliniken von elf Trägern, darunter kommunale und kirchliche Institutionen, Privatunternehmen und die Rehazentren der Deutschen Rentenversicherung Baden-Württemberg.
Erst mal abwarten…
(2018)
Qualität und Wirksamkeit – Gedanken zur qualitätsorientierten Steuerung in der Rehabilitation
(2018)
Further development on globally convergent algorithms for solution of stationary network problems is presented. The algorithms make use of global non-degeneracy of Jacobi matrix of the system, composed of Kirchhoff's flow conservation conditions and transport element equations. This property is achieved under certain monotonicity conditions on element equations and guarantees an existence of a unique solution of the problem as well as convergence to this solution from an arbitrary starting point. In application to gas transport networks, these algorithms are supported by a proper modeling of gas compressors, based on individually calibrated physical characteristics. This paper extends the modeling of compressors by hierarchical methods of topological reduction, combining the working diagrams for parallel and sequential connections of compressors. Estimations are also made for application of topological reduction methods beyond the compressor stations in generic network problems. Efficiency of the methods is tested by numerical experiments on realistic networks.