Effectiveness of a childbirth massage programme for labour pain relief in nulliparous pregnant women at term: a randomised controlled trial.

INTRODUCTION: The effect of massage for pain relief during labour has been controversial. This study investigated the efficacy of a programme combining intrapartum massage, controlled breathing, and visualisation for non-pharmacological pain relief during labour. METHODS: This randomised controlled trial was conducted in two public hospitals in Hong Kong. Participants were healthy low-risk nulliparous Chinese women ≥18 years old whose partners were available to learn massage technique. Recruitment was performed at 32 to 36 weeks of gestation; women were randomised to attend a 2-hour childbirth massage class at 36 weeks of gestation or to receive usual care. The primary outcome variable was the intrapartum use of epidural analgesia or intramuscular pethidine injection. RESULTS: In total, 233 and 246 women were randomised to the massage and control groups, respectively. The use of epidural analgesia or pethidine did not differ between the massage and control groups (12.0% vs 15.9%; P=0.226). Linear-by-linear analysis demonstrated a trend whereby fewer women used strong pharmacological pain relief in the massage group, and a greater proportion of women had analgesic-free labour (29.2% vs 21.5%; P=0.041). Cervical dilatation at the time of pethidine/epidural analgesia request was significantly greater in the massage group (3.8 ± 1.7 cm vs 2.3 ± 1.0 cm; P<0.001). CONCLUSION: The use of a massage programme appeared to modulate pain perception in labouring women, such that fewer women requested epidural analgesia and a shift was observed towards the use of weaker pain relief modalities; in particular, more women in the massage group were analgesic-free during labour.

Kinesiology tape does not facilitate muscle performance: A deceptive controlled trial.

Kinesiology tape (KinTape) is a therapeutic tape without much understanding of its mechanism. KinTape claims to increase cutaneous stimulation, which facilitates motor unit firing, and consequently improves functional performance; however these, benefits could be due to placebo effects. This study investigated the true effects of KinTape by a deceptive, randomized, and controlled trial. Thirty healthy participants performed isokinetic testing of three taping conditions: true facilitative KinTape, sham KinTape, and no KinTape. The participants were blindfolded during the evaluation. Under the pretense of applying adhesive muscle sensors, KinTape was applied to their quadriceps in the first two conditions. Normalized peak torque, normalized total work, and time to peak torque were measured at two angular speeds (60°/s and 180°/s) and analyzed with one-way repeated measures ANOVA. Participants were successfully deceived and they were ignorant about KinTape. No significant differences were found between normalized peak torque, normalized total work, and time to peak torque at 60°/s or 180°/s (p = 0.31-0.99) between three taping conditions. The results showed that KinTape did not facilitate muscle performance in generating higher peak torque, yielding a greater total work, or inducing an earlier onset of peak torque. These findings suggest that previously reported muscle facilitatory effects using KinTape may be attributed to placebo effects.

Presence of macrolide resistance in respiratory flora of HIV-Infected patients receiving either clarithromycin or azithromycin for Mycobacterium avium complex prophylaxis.

Clarithromycin 500 mg po bid or azithromycin 1200 mg po weekly is recommended as first line prophylaxis for Mycobacterium avium complex (MAC) in patients with HIV infection whose CD4 counts are <50 cells/microL. HIV-infected patients with CD4+ T-cell counts <200 cells/microL were randomized to receive either clarithromycin 500 mg po bid or azithromycin 1200 mg po weekly for 12 weeks. Nasopharyngeal swabs for Streptococcus pneumoniae and Haemophilus influenzae plus an anterior nare culture for Staphylococcus aureus were obtained at pretreatment, at 6 weeks, and at 12 weeks. A throat culture for oral flora was obtained for susceptibility testing against erythromycin. Minimum inhibitory concentrations (MICs) for clarithromycin and azithromycin were performed on all S. pneumoniae, H. influenzae, and S. aureus isolates. The study was terminated after respiratory flora, from all participants, revealed macrolide resistance. Because results of recent randomized trials indicate minimal efficacy of continuing MAC prophylaxis in patients who respond to potent combination antiretroviral therapy, the observed high incidence of macrolide-resistant bacterial colonization of the respiratory tract in this trial supports the discontinuation of macrolide prophylaxis in all AIDS patients whose CD4 counts have risen above 100 cells/microL.

Tai Chi Chuan training to enhance microcirculatory function in healthy elderly men.

OBJECTIVE: To evaluate cutaneous microcirculatory function in geriatric Tai Chi Chuan (TCC) practitioners. DESIGN: Case-control study. SETTING: Community setting. PARTICIPANTS: Ten elderly male TCC practitioners (mean age, 69.9 +/- 1.5 yr) and 10 sedentary men with matched age and body size (mean age, 67.0 +/- 1.0 yr). INTERVENTION: The TCC group had practiced TCC for 11.2 +/- 3.4 years (mean +/- standard error of the mean), with an exercise frequency of 5.1 +/- 1.8 times weekly. Each session included 20 minutes of warm-up, 24 minutes of TCC practice, and 10 minutes of cool down. MAIN OUTCOME MEASURES: A graded exercise test with gas analysis was conducted on a bicycle ergometer for each subject. Skin blood flow (SkBF), cutaneous vascular conductance, and skin temperature were measured at rest and during exercise testing. Plasma nitric oxide metabolite was analyzed before and immediately after exercise. RESULTS: The TCC group had a 34% higher VO(2)peak than the control group; it also had a higher SkBF, cutaneous vascular conductance, and skin temperature than the control group at rest and during exercise; and it also had a higher level of plasma nitric oxide metabolite than the sedentary group at rest and after exercise. CONCLUSION: Older TCC practitioners had higher cutaneous microcirculatory function during exercise than did their sedentary counterparts. Moreover, this change may be partially mediated by enhancement of nitric oxide release.

Heart rate responses and oxygen consumption during Tai Chi Chuan practice.

Tai Chi Chuan (TCC) is a popular Chinese conditioning exercise, however, its exercise intensity remains controversial. The objective of this study was to determine the exercise intensity of Yang TCC by measuring heart rate (HR) responses and oxygen consumption (VO2) during practice. Fifteen men aged 39.9 +/- 9.5 yrs (range 26-56 yrs) participated in this study. Subjects had practiced classical Yang TCC for 5.8 +/- 2.4 years. HR responses and VO2 were measured during practice of TCC by using a K4 telemetry system. Blood lactate was measured before and immediately after TCC practice. Additionally, breath-by-breath measurement of cardiorespiratory function and sequential determination of blood lactate were performed during the incremental exercise of leg cycling. Measurements obtained during the TCC practice and exercise testing were compared to determine the exercise intensity of TCC. While performing TCC, the mean HR of subjects was 140 +/- 10 bpm, and the mean VO2 was 21.4 +/- 1.5 mL x kg(-1) min(-1). Compared with the data of the exercise test, the HR during practice was 58% of the heart rate range. Meanwhile, the VO2 during TCC practice was 55% of the VO2peak. Additionally, the level of blood lactate immediately after TCC practice was 3.8 mM, which reflected the level of lactate during TCC, approximated the onset of blood lactate accumulation (OBLA). The results demonstrate that TCC is an exercise with moderate intensity, and is aerobic in nature.

Effect of strenuous arm exercise on oxidized-LDL-potentiated platelet activation in individuals with spinal cord injury.

This study investigates how strenuous arm exercise affects oxidized-low density lipoprotein (O(X)-LDL) mediated-platelet activation in patients with SCI. Ten patients with SCI and ten age- and sex-matched healthy subjects exercised strenuously using an arm crank ergometer. The following measurements were taken both when the subjects were at rest, and immediately after exercise: plasma lipid profile, O(X)-LDL mediated platelet aggregability and [Ca(2+)]i, urinary 11-dehydro-thromboxane B2 (11-dehydro-TXB2) and 8-iso-prostaglandin F(2alpha), (8-iso-PG F(2alpha)) contents, and plasma NO metabolite (nitrite plus nitrate) level. Based on these measurements, the major findings of this study can be summarized as follows: 1) the SCI group had higher urinary 8-iso-PGF(2alpha) and 11-dehydro-TXB2 contents, but a lower plasma nitrite plus nitrate level than the control group; 2) at rest, the SCI group had a higher platelet aggregability and [Ca(2+)]i, and O(X)-LDL-potentiated platelet activation than the control group; 3) O(X)-LDL-potentiated platelet aggregation was enhanced by strenuous arm exercise in both groups, but the effect of exercise was more pronounced in the SCI group than in the control group; 4) treating the platelet with L-arginine inhibited O(X)-LDL-potentiated platelet activation in both groups. The study concludes that individuals with SCI had more extensive resting and exercise-enhanced O(X)-LDL-potentiated platelet activation and greater amounts of preformed lipid peroxides than those without SCI. Therefore, supplementation therapy with antioxidants may be needed for patients with SCI, especially in a strenuous arm exercise period.

Resistive inspiratory muscle training: its effectiveness in patients with acute complete cervical cord injury.

OBJECTIVE: To evaluate if resistive inspiratory muscle training (RIMT) can improve lung function in patients with complete tetraplegia within half a year after trauma. DESIGN: A prospective study. The experimental patients received training with a Diemolding Healthcare Division inspiratory muscle trainer for 15 to 20 minutes per session, twice per day, 7 days a week for 6 weeks. SETTING: Hospital-based rehabilitation units. PATIENTS: Twenty patients who were in their first 6 months of complete cervical cord injury were randomly enrolled into RIMT (10 patients) and control (10 patients) groups. MAIN OUTCOME MEASURE: Spirometry, lung volume test, maximal inspiratory pressure, maximal expiratory pressure, and modified Borg scale measurements at rest were performed before training and at the end of 6 weeks of training. RESULTS: Most of the pulmonary parameters showed statistically significant improvements within the RIMT and control groups, but the improvements were greater in the RIMT group. In addition, the improvements in total lung capacity, total lung capacity predicted percentage, vital capacity, minute ventilation, forced expiratory volume in 1 second predicted percentage, and the resting Borg scale in the RIMT group showed significantly greater improvement. CONCLUSION: RIMT can improve ventilatory function, respiratory endurance, and the perceived difficulty of breathing in patients with complete cervical spinal cord injury within half a year after trauma.

Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: a pilot study.

OBJECTIVE: To evaluate the training effect of a Tai Chi Chuan (TCC) program on knee extensor muscular strength and endurance in elderly individuals. DESIGN: Before-after trial. SETTING: Community setting. PARTICIPANTS: Forty-one community dwelling subjects aged 61.1 +/- 9.8 years undertook a TCC program. Nine dropped out during the study. Pretraining and posttraining measurements were obtained from 15 men and 17 women. INTERVENTION: Subjects participated in a 6-month TCC program. Each session consisted of 20 minutes of warm-up, 24 minutes of structured TCC training, and 10 minutes of cool-down exercises. MAIN OUTCOME MEASURES: Peak torque of dominant and nondominant knee extensors was tested at speeds of 60 degrees , 180 degrees , and 240 degrees/sec concentrically and eccentrically. Muscular endurance of the knee extensor was tested at the speed of 180 degrees /sec. RESULTS: In the group of men, concentric knee extensor peak torque increased by 15.1% to 20.0% and eccentric peak torque increased by 15.1% to 23.7%. The group of women also showed increases, ranging from 13.5% to 21.8% in concentric peak torque, and 18.3% to 23.8% in eccentric peak torque. In addition, the knee extensor endurance ratio increased by 9.6% to 18.8% in the men and 10.1% to 14.6% in the women. CONCLUSION: TCC training may enhance muscular strength and endurance of knee extensors in elderly individuals.

The effect of Tai Chi on cardiorespiratory function in patients with coronary artery bypass surgery.

PURPOSE: This study prospectively evaluated the training effect of a 1-yr Tai Chi Chuan (TCC) program for low-risk patients with coronary artery bypass surgery (CABS) after a postoperative outpatient (phase II) cardiac rehabilitation program. METHODS: Twenty patients with mean age of 56.5+/-7.4 yr completed this study. The TCC group included nine men who practiced classical Yang TCC with an exercise intensity of 48-57% heart rate range (HRR). The control group included 11 men whom were recommended to do a home-based self-adjusted exercise program with similar intensity of phase II cardiac rehabilitation. Graded exercise tests were performed before and after 1 yr of training for all subjects. RESULTS: Mean attendance of the TCC group was 3.8+/-1.5 times weekly in contrast to 1.7+/-1.1 times for the control group. During the follow-up examination, the TCC group increased 10.3% in VO2peak (from 26.2+/-4.4 to 28.9+/-5.0 mL x kg(-1) min(-1), P<0.01) and increased 11.9% in peak work rate (from 135+/-26 W to 151+/-28 W, P<0.01). However, the control group showed slight decrease in VO2peak from 26.0+/-3.9 to 25.6+/-4.6 mL x kg(-1) x min(-1) and in peak work rate from 131+/-23 W to 128+/-32 W. At the ventilatory threshold, the TCC group also showed significant increase in VO2 and work rate (P<0.05). The control group did not significantly change in these variables. CONCLUSIONS: The study demonstrated that a 1-yr TCC program for low-risk patients with CABS could favorably enhance cardiorespiratory function.

A therapeutic trial of acupuncture in neurogenic bladder of spinal cord injured patients--a preliminary report.

Eighty patients with spinal cord injury (SCI) and neurogenic bladder were studied. Among them, 28 (70%) cases in the control group and 32 (80%) cases in the electroacupuncture group achieved ultimately balanced voiding and were selected for further analysis. The acupuncture group received electroacupuncture at four acupoints: Chung Chi (Conception Vessel CV3), Kuan Yuan (CV4), and bilateral Tzu Liao (Urinary Bladder UB32), in addition to conventional intermittent catheterization program (ICP). Whereas the control group underwent conventional bladder training program with ICP only. The results revealed that the time of achieving balanced voiding was statistically significantly shorter with electroacupuncture than in the control group: 57.1 +/- 22.6 vs 85.2 +/- 27.4 days (P < 0.005) for upper motor neuron lesions, and 55.4 +/- 22.6 vs 83.4 +/- 26.1 days (P < 0.01) for lower motor neuron lesions. However, there was almost no difference between upper motor neuron lesions and lower motor neuron lesions. When acupuncture commenced was alos a factor to influence the results. Those who received acupuncture within 3 weeks after injury had significantly shortened the total days to achieve a balanced bladder, as compared to those who received acupuncture 3 weeks after injury (46.6 +/- 13.2 vs 65.8 +/- 15.4 days, P < 0.005). Our study implied that acupuncture might be beneficial in the management of neurogenic bladder of SCI, and the earlier the patient received electro-acupuncture therapy, the sooner the bladder balanced. On the other hand, we also found that complete spinal cord injury, either with pronounced detrusor-sphincter dyssynergia in upper motor neuron lesion or with persistent areflexic bladder in lower motor neuron-lesion, was not affected by acupuncture.

12-month Tai Chi training in the elderly: its effect on health fitness.

PURPOSE: The objective of this study was to evaluate the effect of Tai Chi Chuan (TCC) on health fitness in older individuals. METHODS: Thirty-eight community-dwelling persons aged 58 to 70 yr completed this study. The TCC group included 9 men and 11 women; the control group included 9 men and 9 women. The TCC group practiced TCC for 11.2+/-1.4 months, with the attendance of 4.6+/-1.3 times x wk(-1). Each session included 20 min of warm-up, 24 min of TCC practice, and 10 min of cooldown. The exercise intensity was 52-63% of the heart rate range. Cardiorespiratory function, strength, flexibility, and percent of body fat were evaluated before and at the end of this study. RESULTS: The male TCC group showed 16.1% increase in VO2max (P < 0.01), 11 degrees increase in thoracic/lumbar flexibility (P < 0.05), 18.1% increase in muscle strength of knee extensor (P < 0.01), and 15.4% increase of knee flexor (P < 0.05). The female TCC group showed 21.3% increase in VO2max (P < 0.01), 8.8 degrees increase in flexibility (P < 0.05), 20.3% increase in muscle strength of knee extensor (P < 0.05), and 15.9% increase of knee flexor (P < 0.05). The control group showed no significant change in these variables. CONCLUSIONS: The results indicate that a 12-month Tai Chi Chuan program is effective for improving health fitness of the elderly.

Urine levels of aluminum after drinking tea.

A microwave-assisted acid digestion procedure coupled with a graphite furnace atomic absorption method has been applied in the determination of aluminum (Al) in urine to verify the correlation of free forms of Al in tea infusions and urinary excretion of Al. Significant urinary Al excretion has been found in 24-h urine of four volunteers after tea drinking. However, the difference in amount of Al excretion in urine between the consumption of Oolong (black tea) and Long-Jin (green tea), each of them with unique Al contents and species, was not significant. These findings indicated that the high levels of free Al species in tea infusions did not result in significant change in urinary excretion of the metal, possibly owing to the transformation by ligands present in food and the gastrointestinal tract (GIT). However, it could not be assumed that there was no big difference in absorption of the metal in the human body if fractions of consumed Al retained in the body or excreted by bile or feces were considered.

Design and assessment of an adaptive intermittent cervical traction modality with EMG biofeedback.

An intermittent cervical traction modality with closed-loop traction force control based on EMG biofeedback was developed and used for clinical study. This system consists of a EMG scanner, on-line self-adjusted traction force controller, audio/video alarm system, real time therapeutic status display, computer interface hardware, and control software. Twenty-four subjects with diagnosed cervical radiculopathy and muscle spasm symptom who were randomly divided into two groups served as subjects in this study. The control and experimental groups were treated with conventional open loop and new EMG biofeedback closed loop traction control protocols respectively. The results of this study indicate that the average reductions in paraspinal EMG signal during traction after 7 weeks treatment for experimental and control groups were 71 and 50 percent, respectively (p < 0.001). These results not only support the clinical use of intermittent, sitting traction to produce cervical paraspinal muscle relaxation, but also revealed that the average myoelectric activity of cervical paraspinal muscle during traction was reduced as traction force increased over the 7-week duration of traction treatment. Through EMG biofeedback traction force control, muscle injury, neck soreness, or pain after traction may be avoided.

Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners.

OBJECTIVE: To evaluate the health-related fitness of geriatric Tai Chi Chuan (TCC) practitioners. DESIGN: Case-control study of a TCC group and a group of sedentary controls. SETTING: Research project at a hospital-based exercise physiology laboratory. PARTICIPANTS: Seventy-six community-dwelling senior persons (mean age 69.3 +/- 3.9 yr), a TCC group that included 22 men and 19 women and a control group of sedentary subjects that included 18 men and 17 women with matched age and body size. INTERVENTION: The TCC group had practiced TCC regularly for 11.8 +/- 5.6 years, with an exercise frequency of 4.3 +/- 1.3 times per week. Each session included 20 minutes of warm-up, 24 minutes of TCC training, and 10 minutes of cool-down. Exercise intensity was estimated to exceed 70% of maximal heart rate (HRmax). MAIN OUTCOME MEASURE: Breath-by-breath measurement of cardiorespiratory function was obtained during the incremental exercise of leg cycling. Flexibility of thoracic/lumbar spine was measured by an electronic inclinometer. Percentages of body fat was calculated from biceps and subcapsular skinfolds. RESULTS: In the peak exercise, men in the TCC group showed 19% higher peak oxygen uptake (VO2peak) in comparison with their sedentary counterparts (26.9 +/- 4.7 mL/kg/min vs 21.8 +/- 3.1 mL/kg/min). Women in the TCC group also showed 18% higher VO2peak than in the sedentary group (20.1 +/- 2.9 mL/kg/ min vs 16.5 +/- 2.0 mL/kg/min). The TCC group also showed higher oxygen uptake at the ventilatory threshold. In addition, the TCC practitioners were characterized by greater flexibility and lower percentage of body fat in comparison with their sedentary counterparts. CONCLUSION: It is concluded that TCC training has benefits for health-related fitness, and it may be prescribed as a suitable conditioning exercise for the elderly.

Clinical evaluation of a new biofeedback standing balance training device.

For patients with neurological damage of the central nervous system, such as that due to cerebrovascular accident (CVA), standing balance training is a critical therapeutic procedure to be undertaken before walking and self-care training. The identification and characterization of neurological disorder in postural steadiness will enhance our understanding of the postural control system, and help to identify patients at risk of falls in the CVA population. This paper discusses the design and clinical evaluation of a new biofeedback training device for static (postural steadiness) performance of the standing balance system. The device includes a height adjustable standing table, an instrumented force sensing platform, an on-line weight bearing audio/visual biofeedback system, a postural correction mirror, and a belt suspension system for the upper extremities. A quantitative evaluation protocol of bilateral asymmetries in weight distribution and postural sway to characterize standing balance with the force sensing platform is discussed. Finally, the clinical evaluation results of sixty patients with hemiplegia from acute stroke for a period of four weeks are discussed. With this economic standing training device, the static standing steadiness can be trained effectively through weight bearing biofeedback and a postural correction mirror in the clinical and home caring environments.

Two-year trends in cardiorespiratory function among older Tai Chi Chuan practitioners and sedentary subjects.

OBJECTIVE: To evaluate the training effects of Chinese shadow boxing, Tai Chi Chuan (TCC), on the maintenance of cardiorespiratory function in older individuals. DESIGN: Prospective study of a cohort of TCC practitioners and a group of sedentary controls examined 2 years after initial examination. SETTING: Research project at a hospital-based exercise physiology laboratory. PARTICIPANTS: Eighty-four community-dwelling older adults (mean age: 64 +/- 9 years) with no significant cardiovascular, pulmonary, and musculoskeletal disease completed this study. The TCC group, 23 male and 22 female subjects, had been practicing TCC regularly for 6.7 +/- 3.3 years. The control group included 21 male and 18 female sedentary subjects with age and body size matched to the TCC group. INTERVENTION: During the period of the study, the TCC practitioners practiced TCC 5.0 +/- 1.1 times per week. Each session included 20 minutes of warm up, 24 minutes of TCC training, and 10 minutes of cool down. The baseline cardiorespiratory function was recorded in the initial exercise test. The same measurements were repeated 2 years later to determine the rate of decline of cardiorespiratory function. Furthermore, heart rates (HR) were monitored in 18 men and 16 women during the performance of TCC to determine the exercise intensity of TCC. MAIN OUTCOME MEASURE: The study measured 2-year trends of cardiorespiratory function in both groups. RESULTS: In the TCC group, the males showed a 2.8% decrease in maximal oxygen uptake (VO2max) from 31.6 +/- 7.6 mL x kg-1 x min-1 to 30.7 +/- 7.1 mL x kg-1 x min-1; the females showed a 2.9% decrease in VO2 max from 20.7 +/- 2.3 mL x kg-1 x min-1 to 20.1 +/- 2.5 mL x kg-1 x min-1. In contrast, the male control group showed a 6.6% decrease in VO2max from 24.4 +/- 4.4 mL x kg-1 x min-1 to 22.8 +/- 4.4 mL x kg-1 x min-1; the females showed a 7.4% decrease in VO2max from 16.2 +/- 2.3 mL x kg-1 x min-1 to 15.0 +/- 2.7 mL x kg-1 x min-1. At the ventilatory threshold (VeT), the sedentary group also showed a significant decrease in VO2. During the steady-state performance of TCC, subjects' mean HR was approximately the HR at the VeT (53-57% of HRmax reserve). CONCLUSION: The data substantiate that practicing Tai Chi Chuan regularly may delay the decline of cardiorespiratory function in older individuals. In addition, TCC may be prescribed as a suitable aerobic exercise for older adults.

Orthogonal array design as a chemometric method for the optimization of analytical procedures. Part 5. Three-level design and its application in microwave dissolution of biological samples.

The theory and methodology of a three-level orthogonal array design as a chemometric method for the optimization of analytical procedures were developed. In the theoretical section, firstly, the matrix of a three-level orthogonal array design is described and orthogonality is proved by a quadratic regression model. Next, the assignment of experiments in a three-level orthogonal array design and the use of the triangular table associated with the corresponding orthogonal array matrix are illustrated, followed by the data analysis strategy, in which significance of the different factor effects is quantitatively evaluated by the analysis of variance (ANOVA) technique and the percentage contribution method. Then, a quadratic regression equation representing the response surface is established to estimate each factor that has a significant influence. Finally, on the basis of the quadratic regression equation established, the derivative algorithm is used to find the optimum value for each variable considered. In the application section, microwave dissolution for the determination of selenium in biological samples by hydride generation atomic absorption spectrometry is employed, as a practical example, to demonstrate the application of the proposed three-level orthogonal array design in analytical chemistry.

Cardiorespiratory responses of Tai Chi Chuan practitioners and sedentary subjects during cycle ergometry.

Tai Chi Chuan (TCC; shadow boxing) is a traditional Chinese conditioning exercise. To evaluate its beneficial effect on cardiorespiratory function, 21 male and 20 female TCC practitioners, ranging in age from 50 to 64 years, voluntarily participated in this study. The control group comprised 23 male and 26 female sedentary subjects. Breath-by-breath measurement of the cardiorespiratory function was obtained during the incremental exercise of leg cycling. At the maximal exercise level, the oxygen uptake (VO2), O2 pulse and work rate of the TCC group were significantly higher than the respective values of the control group (p < 0.01). At the ventilatory threshold, the TCC group also showed a higher VO2, O2 pulse and work rate (p < 0.05). The results imply that TCC training may be beneficial to the cardiorespiratory function of older individuals. To estimate the exercise intensity of TCC, heart rate (HR) was monitored in 15 men and 15 women while they performed the classical Yang TCC. During the steady-state performance of TCC, the mean HR was 130 +/- 14 bpm for men and 127 +/- 13 bpm for women. The mean HR during TCC exceeded 70% of their HRmax. Our data substantiate that TCC is aerobic exercise of moderate intensity, and it may be prescribed as a suitable conditioning exercise for the elderly.

Heavy metals in some Chinese herbal plants.

The concentrations of nine heavy metals, cadmium, cobalt, copper, iron, manganese, nickel, lead, zinc, and mercury in 42 Chinese herbal medicinal plants were determined. Generally, all the samples studied had, relative to the other trace metals, higher concentrations of iron, manganese, and zinc. The concentration range of the metals determined was comparable to that in many of the East Asian vegetables and fruits. A few samples were found to contain relatively higher concentrations of the toxic metals such as cadmium, lead, and mercury. This was probably caused by contamination during air-drying and preservation.

Reasons for local anesthesia failures.

U.S. dental practitioners administer about 4,000,000 local anesthetic blocks and infiltrations annually. The failure rate to achieve adequate anesthesia for the procedure is estimated to be 5 percent to 15 percent. This article describes five different categories of failures and suggest ways to troubleshoot them.