Cardiorespiratory effects of respiratory protective devices during exercise in well-trained men

The effects of a filtering device, an air-line breathing apparatus and a self-contained breathing apparatus ( SCBA ) on pulmonary ventilation, oxygen consumption and heart rate were studied in 12 well-trained firemen aged 21-35 years. Their average maximal oxygen consumption (VO2 max) was 64.9 ml X min-1 X kg-1. Sequential tests without and with the respirator were performed on a treadmill. The continuous test contained five components, each of which lasted 5 min: sitting at rest, walking at 20%, 40%, and 60% of the individual VO2 max, and recovery sitting. During the higher submaximal work levels and recovery, ventilation, heart rate, and oxygen consumption in particular increased more with respirators than without them. At the highest work level the increments in oxygen consumption caused by the respirators were 13%, (8.7 ml X min-1 X kg-1), 7% (4.4 ml X min-1 X kg-1), and 20% (12.7 ml X min-1 X kg-1) of VO2 max. All three respirators hampered respiration, resulting in hypoventilation. The additional effort of breathing and the weight of the apparatus (15 kg with the SCBA ) increased the subjects' cardiorespiratory strain so clearly that the need for rest periods and the individual's work capacity when the respirators are worn must be carefully considered, particularly with the SCBA .     

Prostate cancer in elderly men

Due to increasing life expectancy and the introduction of prostate-specific antigen (PSA) screening, a rising number of elderly men are diagnosed with prostate cancer. Besides PSA serum levels and Gleason score, age is considered to be a key prognostic factor in terms of treatment decisions. In men older than 70 years, treatment without curative intent may deprive the frail patient of years of life. Modern radical prostatectomy techniques are associated with low perioperative morbidity, excellent clinical outcome, and documented long-term disease control. Thus, radical prostatectomy should be considered because local treatment of organ-confined prostate cancer potentially cures disease. The huge extent of PSA screening programs may lead to overdiagnosis of prostate cancer. Not every man who is diagnosed with prostate cancer will develop clinically significant disease. This has led to the concept of expectant management for screen-detected, small-volume, low-grade disease, with the intention of providing therapy for those men with disease progression.     

Seminiferous tubule involution in elderly men

The observation of different types of seminiferous tubules (from tubules with normal spermatogenesis to sclerosed tubules) in aging human testes points to the progressive stages of tubular involution in elderly men. The tubules with hypospermatogonesis (reduced number of elongated spermatids) show numerous morphological anomalies in the germ cells, including multinucleated cells. Abnormal germ cells degenerate, causing Steroli cell vacuolation. These vacuoles correspond to dilations of the extracellular spaces resulting from the premature exfoliation of germ cells. Degenerating cells that are phagocytized by Sertoli cells lead to an accumulation of lipid droplets in the Sertoli cell cytoplasm. The loss of germ cells begins with spermatids, but progressively affects the preceding germ cell types, and tubules with maturation arrested at the level of spermatocytes or spermatogonia are observed. Simultaneously, an enlargement of the tunica propria occurs. This leads to the formation of sclerosed tubules, some of which display a low seminiferous epithelium consisting of a few cells--including lipid-loaded Sertoli cells and both Ap and Ad spermatogonia--and others, showing complete sclerosis, are devoid of seminiferous epithelium. The development of tubular involution is similar to that reported after experimental ischemia, which also seems to cause nonspecific effects on the testis such as multinucleate cells, vacuoles, and increased lipids in Sertoli cells.     

Characterization of the cortisol response to incremental exercise in physically active young men

This study examined the cortisol response to incremental exercise; specifically to see if there was an increase in blood cortisol levels at low intensity exercise (i.e., < 60% VO2 intensity threshold) and determine whether a linear relationship existed between the blood cortisol responses and exercise of increasing workloads (i.e., intensity). Healthy, physically active young men (n = 11) completed exercise tests involving progressive workload stages (3 min) to determine peak oxygen uptake responses (VO2). Blood specimens were collected at rest and at the end of each stage and analyzed for cortisol. Results showed cortisol was significantly increased from resting levels at the end of the first exercise stage (80 W; 41.9 +/- 5.4% peak VO2) and remained significantly elevated from rest until the exercise ended. Interestingly, however, the cortisol concentrations observed at 80 W through 200 W did not significantly differ from one another. Thereafter, during the final two stages of exercise the cortisol concentrations increased further (p < 0.01). The subjects exceeded their individual lactate thresholds over these last two stages of exercise. Regression modeling to characterize the cortisol response resulted in significant regression coefficients (r = 0.415 [linear] and r = 0.655 [3rd order polynominal], respectively; p < 0.05). Comparative testing (Hotelling test) between the two regression coefficents revealed the polynominal model (sigmoidal curve) was the significantly stronger of the two (p = 0.05). In conclusion, the present findings refute the concept that low intensity exercise will not provoke a significant change in blood cortisol levels and suggest the response to incremental exercise involving increasing exercise workloads (i.e., intensities) are not entirely linear in nature. Specifically, a sigmoid curve more highly accurately characterizes the cortisol response to such exercise.     

Thermogenic shivering in the anesthetized rat

In normal pentobarbital-anaesthetized rats (20 mg/kg, i.p.), Ketanserine (2.5 to 10 mg/kg, i.v.) increases the temperature of the paw skin and decreases the central one. A strong thermogenetic shivering appears when central temperature falls below 35 degrees C. This shivering is a specific characteristics of Ketanserine activity, probably related to its fixation on 5-HT2 central receptors.     

Thermogenic effects of dihydrocodeine in the rat

The object of this study was to assess the effects of dihydrocodeine on thermogenesis and brown adipose tissue activity in the rat from measurements of oxygen consumption and blood flow. Acute injection of dihydrocodeine tartrate (s.c.) stimulated resting oxygen consumption (VO2) in Sprague-Dawley rats in a dose-dependent manner (0.5-50 mg/kg), with a peak response (40-45% increase) occurring at 10-25 mg/kg. This effect was also observed in urethane-anaesthetized rats (although the effect was reduced) and in conscious animals following gastric intubation with the drug. Pretreatment of rats with either a beta-adrenergic antagonist (propranolol, 20 mg/kg), ACTH (4 g/kg), or an opiate antagonist (WIN44441-1, 2 mg/kg) significantly reduced the response to dihydrocodeine, whereas corticosterone injection (5 mg/kg) enhanced the effect. Surgical adrenalectomy or hypophysectomy (HYPX) almost completely abolished the thermogenic effect of dihydrocodeine. Dihydrocodeine also stimulated VO2 in lean (58% increase) and genetically obese Zucker rats (69% increase), and in both Zucker genotypes these responses were only slightly affected by HYPX, but enhanced in HYPX rats treated daily with corticosterone (1 mg/kg). Tissue blood flow, assessed from the distribution of radiolabelled microspheres, was unaffected in white adipose tissue, skeletal muscle, testes, kidney, brain, and liver (arterial supply) after a single injection of dihydrocodeine (25 mg/kg), but flow to interscapular and perirenal brown adipose tissue was increased by 9- to 10-fold. Surgical sympathectomy of brown adipose tissue prevented the increase in blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)     

Determinants of care burden among spouses and children of physically impaired elderly

The study focused on determinants of care burden among spouses and children providing care to older adults. The care recipients in this study are older adults who participated in the Longitudinal Aging Study Amsterdam (LASA) since 1992. A selected subsample of 155 chronically ill respondents with a need for care, 78 of their spouses and 337 of their children participated in a side-study on family care giving. The results show that 32% of the spouses and 40% of the children assists the older adult with personal and/or domestic care. These spouses have provided care for many years with both domestic as well as personal care. The care providing children predominantly assist with household activities and share these tasks with siblings. Children are more likely to provide care when the spouse is not available or not able to provide care. Professional care does not effect children's care behavior. Half of the spouse-carers and one-fifth of the child-carers experienced heavy care burden. A higher care burden is associated with providing personal care, experiencing more negative consequences, and a larger need for assistance. Burdened child-carers also report lower feelings of competence, less consulting with siblings and more disagreement with siblings on caregiving issues. These findings point out that caregiving is not an individual task but a family matter. Support of carers should not only be directed at a decrease of the care load and an strengthening of individual capacities, but also at recruiting other informal (family) caregivers in order to divide the load of care giving more evenly among all those involved.     

Fasting for 72 h increases intramyocellular lipid content in nondiabetic,physically fit men

The purpose of this study was to determine changes in intramyocellular lipid (IMCL) content in the vastus lateralis of nondiabetic, physically fit males over 72 h of fasting. Six men, mean age 35 yr (range 23-55 yr), body mass index 23.7 kg/m2 (21.2-27.4 kg/m2), undertook a water-only fast for 84 h. Vastus lateralis IMCL content was determined using proton magnetic resonance spectroscopy after 12 and 84 h of fasting. Venous blood was sampled at 12-h intervals throughout the fast. IMCL-(CH2)n/water and IMCL-(CH2)n/total creatine ratios increased from 0.00623 +/- 0.00065 to 0.0142 +/- 0.0015 (P = 0.002) and 6.82 +/- 0.87 to 14.96 +/- 1.73 (P = 0.001), respectively. Plasma free fatty acid (FFA), serum triglyceride, and whole blood 3-hydroxybutyrate concentrations increased (P < 0.001, <0.05, <0.03, respectively), whereas plasma glucose and serum insulin concentrations decreased (both P < 0.001) during fasting. In conclusion, 72-h water-only fasting produces a large increase in plasma FFA concentration, a drop in serum insulin concentration, and accumulation of IMCL in the vastus lateralis muscle of nondiabetic, physically fit men.     

Effect of simulated microgravity on endocrine response to insulin-induced hypoglycemia in physically fit men.

Adaptation to microgravity is associated with alteration in some endocrine functions. In the present longitudinal study, the counterregulatory hormonal response to insulin-induced hypoglycemia (ITT, 0.1 IU/kg short acting insulin i. v.) was evaluated under simulated microgravity conditions in 15 physically fit subjects. ITT was performed at the beginning of the investigation, and again after completion of 6 weeks of endurance training and after a subsequent period of 4 days of head-down bed rest at a backward tilt of 6 degrees from the horizontal. Endurance training showed a significant increase in maximal aerobic capacity in previously well-trained subjects (increase by 12 %), as well as on attenuation of counterregulatory response of epinephrine to hypoglycemia. After 4 days of bed rest, basal concentrations of plasma norepinephrine was diminished (p < 0.002) and plasma renin activity was enhanced (p < 0.02). After bed rest, decreased responses of the two catecholamines (norepinephrine, p < 0.001; epinephrine, p < 0.001), growth hormone (p < 0.001), and cortisol (p < 0.05) were observed. Response of plasma renin activity after bed rest was increased (p < 0.01). This longitudinal study indicated that 4 days of bed rest in endurance-trained subjects induced increased response of PRA to hypoglycemia and attenuation of other counterregulatory neuroendocrine responses.     

'Inadequate' dietary habits and mastication in elderly men

Objective: The aim of this study was to re‐evaluate data about oral status, mastication and nutrition in elderly men in Malmö, Sweden, recorded in 1985–1987, to assess associations between inadequate dietary habits, oral conditions and masticatory function. Materials and methods: Four hundred and eighty‐one men, aged 67–68, participated in a comprehensive health examination, including tooth and denture status and masticatory tests. A separate study of dietary habits and nutritional status was made. Ninety‐five men had inadequate dietary habits. The databases of dental/denture status, mastication, nutritional status and social network factors were re‐evaluated for assessment of associations. Results: No significant differences between those with adequate or inadequate nutrition were found with regard to the number of teeth, occlusal contacts or removable dentures. Also self‐assessed chewing did not show any differences. Conclusion: Inadequate dietary habits were independent of teeth and denture status. Some correlations to social network conditions could be identified. Overweight, obesity, low physical activity and high alcohol intake were more common among those with inadequate nutritional intake.     

高龄老年尿钠排泄的特点分析

目的:探讨高龄老年人24 h尿钠排泄特点,为防治老年钠代谢紊乱提供依据.方法:我院老年病房80岁以上老年42例,根据肌酐清除率分为肌酐清除率正常组及异常组.另选中年组24人及老年组31人作为对照.所有患者均检测24 h尿钠、钾、磷、肌酐及肌酐清除率.结果:①高龄组肌酐清除率低于中年组及老年组,24 h尿钠排泄量亦较中年组及老年组减少;高龄组中肌酐清除率异常组的24 h尿钠排泄量较肌酐清除率正常组显著减少.②中年组与老年组尿钠排泄和肌酐清除率无相关关系,高龄组尿钠排泄与肌酐清除有直线相关关系;高龄组肌酐清除率正常组肾脏排钾保钠能力减退、尿钠排泄增加,肌酐清除率异常组钾、钠排泄均减少;③三组的钠摄入量均在6g以上.结论:高龄老年24 h尿钠排泄与肌酐清除率呈直线相关关系.当肾功能处于代偿阶段时,钠排泄增多,但严重肾功能不全时尿钠排泄减少.     

The extrasplanchnic origin of blood dihydrotestosterone in elderly men

The splanchnic extraction and interconversion of testosterone (T) and dihydrotestosterone (DHT) were studied in 5 elderly men undergoing cardiac catheterization using a constant Infusion of [1,2-³H] testosterone and [4-¹⁴C] DHT. Metabolic clearance rate (MCR), splanchnic extraction (SE), splanchnic clearance (SC), extrasplanchnic clearance (ESC), transfer constant In blood ([P]_BB^T-DHT) and transfer constant across the liver ([P]_BB^T-DHT) were calc?ulated. The MCR^T was 675 ± 108 (mean ± SC) L/day and MCR^DHT was 409 ± 68 L/day. SE^T was 45.9 ± 7.0% and SE^DHT was 18.5 ± 5.4%. When these values are compared with those recently reported by us for normal men, there is a $\text{1}\text{3}$ reduction in SE^T and $\text{1}\text{2}$ reduction for SE^DHT in elderly men. The calculated SC^T and ESC^T were 355 ± 72 L/day and 320 ± 86 L/day, respectively. SC^DHT and ESC^DHT were 145 + 48 L/day and 263 ± 77 L/day respectively, suggesting that a major fraction of DHT is metabolized in extrasplanchnic organs. No evidence for a net appearance of DHT by either mass or specific activity analysis in hepatic vein blood was observed indicating that the splanchnic compartment does not contribute DHT into the circulation either by $\text{de novp}$ synthesis or via conversion from testosterone. This work indicates that conversion of testosterone to DHT in elderly men occurs entirely in extrasplanchnic tissue.     

Effect of head-down bed rest on the neuroendocrine response to orthostatic stress in physically fit men

The role of neuroendocrine responsiveness in the development of orthostatic intolerance after bed rest was studied in physically fit subjects. Head-down bed-rest (HDBR, -6 degrees, 4 days) was performed in 15 men after 6 weeks of aerobic training. The standing test was performed before, after training and on day 4 of the HDBR. Orthostatic intolerance was observed in one subject before and after training. The blood pressure response after training was enhanced (mean BP increments 18+/-2 vs. 13+/- 2 mm Hg, p<0.05, means +/- S.E.M.), although noradrenaline response was diminished (1.38+/-0.18 vs. 2.76+/-0.25 mol.l(-1), p<0.01). Orthostatic intolerance after HDBR was observed in 10 subjects, the BP response was blunted, and noradrenaline as well as plasma renin activity (PRA) responses were augmented (NA 3.10+/-0.33 mol.l(-1), p<0.001; PRA 2.98+/-1.12 vs. 0.85+/-0.15 ng.ml(-1), p<0.05). Plasma noradrenaline, adrenaline and aldosterone responses in orthostatic intolerant subjects were similar to the tolerant group. We conclude that six weeks of training attenuated the sympathetic response to standing and had no effect on the orthostatic tolerance. In orthostatic intolerance the BP response induced by subsequent HDBR was absent despite an enhanced sympathetic response.