Graduated compression stockings: physiological and perceptual responses during and after exercise.

The aim of this study was to examine the effect of wearing graduated compression stockings on physiological and perceptual variables during and after intermittent (Experiment 1) and continuous (Experiment 2) running exercise. Fourteen recreational runners performed two multi-stage intermittent shuttle running tests with 1 h recovery between tests (Experiment 1). A further 14 participants performed a fast-paced continuous 10-km road run (Experiment 2). Participants wore commercially available knee-length graduated compression stockings (pressure at ankle 18 - 22 mmHg) beneath ankle-length sports socks (experimental trials) or just the latter (control trials) in a randomized counterbalanced design (for both experiments). No performance or physiological differences were observed between conditions during intermittent shuttle running. During the 10-km trials, there was a reduction in delayed-onset muscle soreness 24 h after exercise when wearing graduated compression stockings (P < 0.05). There was a marked difference in the frequency and location of soreness: two participants in the stockings trial but 13 participants in the control trial indicated soreness in the lower legs. Wearing graduated compression stockings during a 10-km road run appears to reduce delayed-onset muscle soreness after exercise in recreationally active men.

Creating IPR and design value.

How a start-up company is overcoming competitive pressures by securing worldwide intellectual property rights and delivering customer delight.

Inspiratory muscle fatigue following running to volitional fatigue: the influence of baseline strength.

Respiratory muscle fatigue has been demonstrated following short-term exercise to volitional fatigue, as well as following prolonged submaximal exercise. There is some suggestion that the respiratory muscles of 'athletic' individuals have superior strength and greater fatigue resistance but it is not known whether inspiratory muscle strength influences fatigueability of the inspiratory muscles. The present study examined this question in 24 moderately trained young men. Inspiratory muscle strength was measured at residual volume using a hand held Mouth Pressure Meter before and after an incremental, multistage shuttle run to volitional fatigue. Following the run, there was a significant fall in inspiratory mouth pressures (-10.5 +/- SD 8.2%; p < 0.001 Pre- vs Post Pipeak). The subjects with the weakest inspiratory muscles exhibited significantly greater fatigue than those with the strongest (-17.0 +/- SD 7.8% c.f. 6.8 +/- SD 4.4% for the 25th and 75th percentiles respectively p < 0.01). These data support existing evidence that the respiratory muscles fatigue following high intensity exercise. In addition, they provide new evidence that this phenomenon occurs in moderately trained young men and that the severity of the fatigue is related to the baseline strength of the inspiratory muscles.

Functional antagonistic activity of Rec 15/2739, a novel alpha-1 antagonist selective for the lower urinary tract, on noradrenaline-induced contraction of human prostate and mesenteric artery.

The aim of this study was to compare with known reference standards the functional in vitro alpha-1 antagonistic activity of Rec 15/2739 on noradrenaline-induced contractions of human prostate and mesenteric artery. We also characterized these tissues with regard to the alpha-1 adrenoceptor subtypes present. Comparing the apparent pKB values revealed Rec 15/2739 to be one of the most potent compounds action on the prostate. Its potency was slightly lower than that of tamsulosin and was higher than the potencies of prazosin, terazosin and 5-methylurapidil. On the mesenteric artery, tamsulosin was the most potent compound. Comparing the results from the functional studies with those obtained from radioreceptor binding studies, we found that the potency (pKB value) in inhibiting the contraction of prostatic tissue showed a close and significant correlation with the affinity for native and recombinant alpha-1A adrenoceptors. No significant correlation was found with affinity for either the native or the recombinant alpha-1B adrenoceptor subtype, or for recombinant alpha-1d receptors. Similar results were obtained for mesenteric artery. In order to characterize further the alpha-1 adrenoceptor subtypes present in the examined tissues, we investigated the functional effects of chloroethylclonidine, an alpha-1B-D subtypes selective alpha-1 adrenoceptor irreversible antagonist, and those of nifedipine, which antagonizes the extracellular calcium influx primarily mediated by alpha-1A adrenoceptor stimulation. The results indicate the presence of both chloroethylclonidine-sensitive and -insensitive alpha-1 adrenoceptor subtypes in the human prostate, whereas in mesenteric artery the alpha-1A subtype seems to be present exclusively. The possibility that the functionally relevant alpha-1 adrenoceptor subtype could be classified as alpha-1L in both tissues shoul also be considered.

[Terazosine in the treatment of benign prostatic hypertrophy]. / La térazosine dans le traitement de l'hypertrophie bénigne de la prostate.

A review is presented of the current status of terazosin in the treatment of BPH. The results of many clinical trials indicate a definite and significant improvement in both subjective and objective parameters. Attention is drawn to certain possible problems and limitations of placebo controlled trials with alpha-adrenergic blockers for BPH. Parameter improvements appear to be dose-related, and the importance of dose titration is stressed. The pharmacokinetic properties of the drug enables a once daily administration. Long term treatment for more than two years indicates that efficacy is maintained.

Antispasmodic effects of flavoxate, MFCA, and REC 15/2053 on smooth muscle of human prostate and urinary bladder.

The antispasmodic effects of the flavone compounds flavoxate hydrochloride, 3-methylflavone carboxylic acid (MFCA), and REC 15/2053 (and in the case of the detrusor, oxybutynin), on the human detrusor, prostatic adenoma, prostatic capsule, and bladder neck, were studied by the in vitro isometric method. All the compounds inhibited, in different orders of potency, potassium-induced contractions of the tissues. Flavoxate showed a slightly greater activity than the other two compounds in the prostatic and bladder neck tissues. However, REC 15/2053 displayed greater activity in the detrusor than in the other tissues. The relaxant effect on the prostatic tissues suggests a potential use for these compounds in benign prostatic obstruction.

Triorchidism--a reconstructive approach.

Testicular duplication is a relatively rare condition. A case is described in which conservative surgery was performed with reconstruction to produce a single testis.

Alpha-adrenergic blockers for the treatment of benign prostatic hyperplasia.

There seems little doubt that alpha-adrenergic blockers can afford a measure of relief to many sufferers from BPH. The exact role this treatment has to play in the overall management of these patients has yet to be clearly defined. A continuing search is being made for more effective drugs, with the hope of finding one that will be more specific in its action on the prostate and produce fewer generalized effects. Whether this will prove possible may depend on whether any further subgroup of alpha receptors more specific to the prostate can be found or whether some method of targeting the drugs to the required region can be devised. If a drug treatment that reduces the size of the prostate can be found, perhaps a combination of the two forms of medical treatment will have a place. At present, it seems reasonable to conclude that there is good justification for using the alpha-blocking drugs available when employed in the manner and for the indications outlined herein.

Place of extracorporeal shock-wave lithotripsy (ESWL) in management of cystine calculi.

We treated 12 patients with sixteen renal and one ureteral cystine stones primarily with extracorporeal shock-wave lithotripsy (ESWL). Among the stones thirteen were greater than 25 mm. In four stones less than 25 mm, three stones completely disappeared and 1 was reduced to small fragments, following ESWL. In thirteen stones greater than 25 mm, twelve were treated by ESWL initially, and one by surgery. Of the 12 cases treated initially by ESWL, 4 became stone-free, 4 remained with small fragments, and 1 remained with large fragments. Two patients were operated on because of poor response to ESWL and 1 patient lost kidney function because of prolonged obstruction. Disintegration of cystine stones greater than 25 mm required an average of 8,522 shock-waves in 4.33 sessions. The problems associated with application of ESWL monotherapy to cystine stones are presented.

Hypoglycemic coma in anorexia nervosa. Case report and review of the literature.

Clinically significant hypoglycemia is an unusual complication of anorexia nervosa. We describe a 44-year-old woman with a 5-year history of anorexia nervosa who presented with hypoglycemic coma and eventually experienced sudden death. Biochemical studies showed suppressed levels of insulin, C peptide, and proinsulin during hypoglycemia; appropriate elevations of growth hormone and cortisol levels were observed, suggesting that the hypoglycemia was related to severe malnutrition. Nine previously reported cases of severe hypoglycemia in anorexia nervosa are reviewed (six of the patients involved also died). The presence of severe hypoglycemia in anorexia nervosa implies a grave prognosis and mandates aggressive medical and nutritional therapy to improve the chance of survival.

Alpha-adrenergic mechanisms in dynamics of benign prostatic hypertrophy.

Smooth muscle tone in the enlarged prostate is directly related to stimulation of the alpha-adrenergic receptors present in prostatic tissue. Variations in tone produce corresponding alterations in the degree of prostatic obstruction. Such variations can explain the spontaneous symptomatic variations seen clinically in benign prostatic hypertrophy (BPH), and represent a "dynamic component" in obstruction which is superimposed on the underlying basic "mechanical component." The obstructive symptoms posed by the dynamic component can be reduced to a minimum by pharmacologic blockade of the alpha-adrenergic receptors. Alpha-blockade can also reduce irritative symptoms. Acute obstruction due to overstimulation of alpha-receptors can be relieved or prevented by alpha-blockade.

Treatment of complete staghorn calculi by extracorporeal shock wave lithotripsy monotherapy with special reference to internal stenting.

Extracorporeal shock wave lithotripsy monotherapy was used to treat 41 patients with complete staghorn calculi. In 20 patients polyethylene angiographic pigtail catheters were inserted prophylactically as ureteral stents and the other 21 patients did not receive stents. Prophylactic stenting reduced the incidence of complications and the need for percutaneous nephrostomy tubes to relieve subsequent ureteral obstruction. Internal stenting maintained the sterility of the urinary tract and reduced the average hospital stay by a third. Residual stone fragments representing less than 5 per cent of the original stone mass remained in 56 per cent of the patients, particularly in those with hydronephrotic kidneys. We suggest that extracorporeal shock wave lithotripsy monotherapy with prophylactic stenting is the preferred treatment for noninfected complete staghorn calculi.

Vesicouterine fistula: a rare complication of cesarean section.

Vesicouterine fistula is a rare complication of cesarean section. Most patients present early postoperatively, while others are seen months later with urinary incontinence. Recurrent urinary infections, menstruation through the bladder (menouria), secondary infertility and amenorrhea are less common reasons for consultation. Although more than 100 such cases have been described, there have been few reports on fertility after surgical cure of the fistula. We report 4 cases of a vesicouterine fistula after cesarean section. The first patient was treated nonoperatively and the other 3 patients were treated surgically. Three patients had normal pregnancies after resolution of the problem. The clinical features, etiological factors and treatment modalities are discussed.