En bloc resection, is this the future of non-muscle invasive bladder cancer management? Presentation of our technique and brief review of the literature.

INTRODUCTION: The quality of the initial transurethral resection of bladder tumors (TURBT) plays a key role in accurate local staging thus affecting treatment decision-making and disease prognosis. TURBT is still the gold standard for non-muscle invasive bladder cancer (NMIBC). However, en bloc resection of bladder tumors (ERBT) gradually expanded as a promising alternative to TURBT, aiming to overcome certain inherent limitations of conventional resection. We hereby describe a step-by-step bipolar ERBT technique and briefly review the current trends surrounding the role of various en bloc techniques in the field. CASE PRESENTATION: We present the case of a 65-year old patient undergoing bipolar ERBT for a single, approximately 2 cm, papillary bladder mass. An experienced urologist completed the procedure within 17 min and without any intra- or postoperative complications. No conversion to TURBT was needed, and an adequate specimen for histological assessment was obtained. The patient made an uneventful recovery, and no recurrence was noted at 12-months. CONCLUSION: Our initial experience demonstrates that ERBT via bipolar current is relatively quick, safe, and reliable. Prospective comparative clinical trials will examine its efficacy, and long-term oncological superiority in managing NMIBC.

Jackstone: A Calculus "Toy" in the Bladder. A Case Report of Rare Entity and Comprehensive Review of the Literature.

Background: An uncommon type of urinary calculus, Jackstone was named after its distinct resemblance to the children's game "Jacks." It typically involves the bladder and, to a lesser extent, the upper urinary tract. Case Presentation: Herein, we report a case of Jackstone vesical calculus in a 75-year-old male undergoing elective open prostate surgery for benign prostate hyperplasia refractory to medical treatment. Preoperative clinical examination revealed intermittent gross hematuria and symptoms suggestive of bladder outlet obstruction, while radiological investigation confirmed the presence of a solitary star-shaped spike-like bladder stone along with an overly enlarged prostate. Following open simple prostatectomy and concomitant intact stone removal, our patient made an uneventful postoperative recovery. Conclusion: This case highlights an infrequent subtype of bladder lithiasis and further expands upon the importance of promptly treating the underlying cause once this rare entity is detected. A comprehensive review of the literature on Jackstone calculi is further presented.

Incidental discovery of endourethral clip migration 10 years after radical prostatectomy: A case report and review of the literature.

INTRODUCTION: Surgical clips (SCs) have been widely used for a variety of surgical procedures over the years. Despite their advantages and proven effectiveness, several clip-related complications have been reported, creating dilemmas as to their optimal use. CASE DESCRIPTION: Herein, we present a rare delayed and incidental discovery of two endourethral metallic SCs in a 77-year-old male seeking treatment for acute renal colic. The patient had undergone open radical retropubic prostatectomy 10 years ago, and had an uneventful postoperative recovery. Computed tomography scan revealed left-sided hydronephrosis secondary to proximal ureteral calculus, as well as SCs at the level of vesico-urethral (VUR) anastomosis. Flexible cystoscopy confirmed the imaging findings, showing two endourethral clips, partly obstructing the VUR. Firstly, a serial wire-guided dilation took place, followed by left ureteral double-J stent placement. Unfortunately, the clips could not be concurrently removed due to their firm attachment to the bladder neck. Hence, our patient was scheduled for transurethral resection of the bladder neck and simultaneous endoscopic clip removal. CONCLUSIONS: To the best of our knowledge, this is the first report to highlight such a delayed incidental finding, 10 years after open retropubic radical prostatectomy (RRP), during a JJ stent insertion for obstructive uropathy without previous clip-induced lower urinary tract symptoms. Although rare, physicians should be aware of the potential clip-related complications arising either in the short- or long-term postprostatectomy setting.

Fitness effects of one-year soccer training of 8-10 and 10-12-year-old school children.

BACKGROUND: The purpose of the study was to investigate the effect of one-year soccer training on physical fitness performance, of under ten (U10) and under twelve (U12) youth levels. METHODS: The study included 28, 10-year-old children, and 28, 12-year-old children. In the U12 group, 19 children participated only in the physical fitness sessions at school (control group) and 9 children in four extra soccer trainings (soccer group). In the U10 group, 11 children participated only in the physical fitness sessions at school (control group) and 17 children in four extra soccer trainings (soccer group). Height, body weight, body fat, standing long jump, 30 m sprint, sit and reach test, abdominal test and Yo-Yo IE1 tests were performed at the beginning and at the end of the season. RESULTS: School physical education programs and soccer training cannot affect anthropometric characteristics like body fat and Body Mass Index. Soccer groups improve their performances at all fitness tests (P<0.05). The U10 control group did not increase its performance in abdominal test and the U12 level control group did not improve in the abdominal test nor Yo-Yo IE1 Test. Soccer groups in all ages indicated greater improvements than control groups (P<0.05). CONCLUSIONS: In conclusion soccer training four times per week can improve the physical fitness of U10 and U12 children.

The effect of beach volleyball training on muscle performance of indoor volleyball players.

BACKGROUND: Beach volleyball is frequently used as a conditioning activity for indoor volleyball players, but little information exists regarding any performance benefits when transitioning from sand to hard court. The present study examined the effect of 12 weeks beach volleyball training on muscle performance of indoor volleyball players. METHODS: Eleven athletes who completed an indoor volleyball season and were willing to train and compete at beach volleyball, participated in the study. Muscle endurance of knee extensors and plantar flexors (torque at 120°·s-1 following 40 contractions), muscle strength of knee extensors/ flexors (60, 180, 300°·s-1), dorsi/plantar flexors (torque at 60, 120, 180°·s-1) trunk flexors (60, 90, 180°·s-1) and power (squat [SJ] and countermovement [CMJ] jumps performed on sand and hard court surfaces) were assessed pre- and post-12 weeks of beach volleyball training. RESULTS: Knee extensors and plantar flexors endurance was higher post-12 weeks, as less torque decrease was found after 40 contractions for both muscle groups at post-12-week-time points. Knee extensors strength was higher post-12-weeks for 60 and 300°·s-1, while dorsi flexors strength was higher post-12 weeks for all speeds. SJ and CMJ vertical jump height was improved when measured on sand and on hard court. CONCLUSIONS: Twelve weeks of systematic training and competition at beach volleyball can improve muscular endurance of lower limbs and jumping height in indoor volleyball players. More importantly, these improvements are transferrable to hard court, making beach volleyball a very attractive alternative for conditioning indoor volleyball players during the off-indoor volleyball season.

Cardiorespiratory and metabolic alterations during exercise and passive recovery after three modes of exercise.

The objective of this study was to investigate the potential variations in cardiorespiratory and metabolic parameters and running performance among 3 modes of exercise of the same duration, namely, intermittent running with active recovery (AR) or passive recovery (PR) and continuous running (CR) and whether these variations could affect passive recovery time (PRT). Fifteen male physical education students with a subspecialty in soccer were studied (mean age 22.3 ± 2.5 years, training experience 12.3 ± 2.5 years) in the middle of the playing season. The results showed that during exercise, the highest heart rate (HR) and VO2 values were observed in CR, whereas the lowest values in PR followed by AR. Blood lactate (BLa) concentration was higher in PR by 38% compared to that in AR (p < 0.05). The exercise duration was similar between PR and AR tests and longer than in CR. With regard to PRT, the highest HR (186 ± 9 b · min(-1)), VO2 (55.5 ± 5.2 ml · kg(-1) · min(-1)), and BLa (5.1 ± 1.7 mmol · L(-1)) values were found in CR. No differences in HR and VO2 between PR and AR were detected. However, despite the differences in BLa concentration between AR and PR during exercise, the PRT BLa values between these 2 exercise modes were not different. Among the 3 running protocols, only CR appeared to have fully challenged the cardiorespiratory system inducing maximal HR and VO2 responses during exercise and high BLa values in PRT, yet these responses were not associated with better exercise performance compared to intermittent running. Therefore, intermittent exercise, regardless of implementing passive or active interval, might be the preferable exercise mode particularly in activities extended over 30 minutes.

The effect of different exercise-testing protocols on atrial natriuretic peptide.

The aim of this study was to examine and to compare alterations in the secretion of atrial natriuretic peptide (ANP) during different exercise-testing protocols in moderately trained men. Fifteen healthy male physical education students were studied (mean age 22·3 ± 2·5 years, training experience 12·3 ± 2·5 years, height 1·80 ± 0·06 m, weight 77·4 ± 8·2 kg). Participants performed an initial graded maximal exercise testing on a treadmill for the determination of VO(2max) (duration 7·45-9·3 min and VO(2max) 55·05 ± 3·13 ml kg(-1) min(-1) ) and were examined with active recovery (AR), passive recovery (PR) and continuous running (CR) in random order. Blood samples for plasma ANP concentration were taken at rest (baseline measurement), immediately after the end of exercise as well as after 30 min in passive recovery time (PRT). The plasma ANP concentration was determined by radioimmunoassay (RIA). The results showed that ANP plasma values increased significantly from the rest period to maximal values. In the short-term graded maximal exercise testing the ANP plasma values increased by 56·2% (44·8 ± 10·4 pg ml(-1) versus 102·3 ± 31·3 pg ml(-1) , P<0.001) and in the CR testing the ANP levels increased by 29·2% (44·8 ± 10·4 pg ml(-1) versus 63·3 ± 19·8 pg ml(-1) , P<0.001) compared to the baseline measurement. Moreover, the values of ANP decreased significantly (range 46·4-51·2%, P<0.001) in PRT after the end of the four different exercise modes. However, no significant difference was evident when ANP values at rest and after AR and PR were compared. It is concluded that the exercise testing protocol may affect the plasma ANP concentrations. Particularly, short-term maximal exercise significantly increases ANP values, while the intermittent exercise form of active and passive recovery decreases ANP concentrations.

Myosin heavy chain isoform distribution in single fibres of bodybuilders.

The purpose of this study was to investigate the long-term effects of high intensity resistance training on myosin heavy chain (MHC) isoform composition of single fibres. Muscle biopsies were obtained from the right vastus lateralis of eight bodybuilders (BB) and seven physical education students (PES). Histochemical analyses were used to determine the fibre type distribution and the fibre cross-sectional area. MHC isoform composition of single fibres was determined with protein electrophoresis. The percentage of fibres expressing MHC IIA and MHC I/IIA was larger in BB (P < 0.05), while MHC IIX was completely absent (P < 0.05). In contrast, myofibrilar ATPase histochemistry only revealed a significantly lower percentage of type IIX fibres in BB (P < 0.05). The muscle fibre profile in the vastus lateralis muscle of BB may represent an adaptation based on the mechanical and biochemical demands of the long-term resistance training.

Morphology of the deltoid muscles in elite tennis players.

The aim of this study was to examine the deltoid muscle properties of the dominant and non-dominant arm of Greek professional male tennis players. Eight male tennis players (mean age 22.0 years, s = 3.2) were subjected to biopsy of the deltoid muscle of both arms. Adenosine triphosphate (ATPase) histochemistry and myosin heavy chain (MHC) composition were performed on the samples with homogenate electrophoresis. No significant differences were observed in the percentage of types I, IIa, IIab, and IIb muscle fibres between the deltoid muscles of the two arms. Types I, IIa, and IIx muscle fibres of the dominant and non-dominant deltoid muscles did not differ significantly for MHC isoform composition. Type IIab muscle fibres showed a similar cross-sectional area (CSA) percentage distribution between the two arms. The CSA percentage for types I, IIa, and IIb muscle fibers did not differ significantly between the dominant and the non-dominant arm. We conclude therefore that regular tennis training probably does not lead to any significant changes in the muscle fibre types of the dominant and non-dominant arms of elite tennis players.

Effects of basketball training on maximal oxygen uptake, muscle strength, and joint mobility in young basketball players.

The purpose of this study was to examine the effects of prolonged basketball skills training on maximal aerobic power, isokinetic strength, joint mobility, and body fat percentage, in young basketball players, and controls of the same age. Twenty basketball players and 18 control boys participated in the study. Basketball players participated both in their school's physical education program and in a children's basketball team training program. Controls participated only in their school's physical education program. All subjects were tested every 6 months (18 months total, 11(1/2), 12, 12(1/2), 13 years old) for VO(2)max, peak torque values of the quadriceps and hamstrings at 180 and 300 degrees x s(-1) and range of motion of the knee and hip joints. Body fat percentage was assessed at the beginning and the end of the experimental period. Results showed that the basketball group had lower heart rate values in all ages and higher VO(2) values in the initial test compared with the control in submaximal intensity. The VO(2)max was altered in both groups on the final test, when compared to the initial test. However, the basketball group had a higher VO(2)max on each of the 6-month follow-up measurements, compared to the control group (p < 0.001). At the end of the 18-month follow-up period no significant differences were observed in isokinetic strength and joint mobility of the lower limbs between the 2 groups. On the contrary, the boys of the trained group had significantly lower percentage body fat values, compared to controls. In conclusion, regular basketball training increased aerobic power and decreased body fat percentage of prepubescent boys, while it did not affect muscle strength and joint mobility of the lower limbs. The major implication suggested by the findings of the present study is that, in order to improve the basic physical components, specific training procedures should be incorporated during the basketball training sessions. It is recommended that all children should be involved in some type of cardiovascular and resistance training program.