Physiological effects of shift work on hospital nurses

OBJECTIVE: The purpose of this study was to assess the physiological effects of shift work on the urinary excretion rates of norepinephrine, 6-sulfatoxymelatonin and estriol in hospital nurses. METHOD: Twenty-four hour urine specimens were examined on a daytime/nighttime basis for each work shift of pregnant and non-pregnant subjects. The urinary norepinephrine and 6-sulfatoxymelatonin were measured by enzyme-linked immunosorbent assay and estriol by radio-immunoassay. RESULTS: Urinary norepinephrine level during the night work was higher than the night levels of the days off and the day shift. Urinary 6-sulfatoxymelatonin level during the night work was lower than the night levels of the days off and the day shift. Urinary estriol level of pregnant subjects showed no differences among work shift and also between daytime and nighttime. CONCLUSIONS: Urinary excretion rates of norepinephrine and 6-sulfatoxymelatonin were affected by shift work both for non-pregnant and pregnant subjects. It was unlikely that urinary estriol levels in the pregnant subjects were significantly affected by shift work.     

Cardiorenal-endocrine responses to head-out immersion at night

Cardiorenal-endocrine responses to 3-h head-out immersion (HOI) (water temperature = 34.5 +/- 0.5 degrees C) were studied during day (0900-1400 h) and night (2300-0400 h) in six hydropenic male human subjects. Although HOI induced a reversible increase in urine flow in all subjects, the response was faster and greater in magnitude during the day compared with night (P less than 0.05). Na excretion and osmolal clearance (Cosm) also followed the identical response pattern as urine flow, and in fact, the HOI-induced diuresis was entirely accounted for by the increased Cosm. Endogenous creatinine clearance was not different between the day and the night and remained unchanged during HOI. Both plasma renin activity and aldosterone concentration and urinary aldosterone excretion were nearly twofold greater during the day compared with night before HOI but decreased to the same level during HOI in both daytime and the nighttime series (P less than 0.05). There was no correlation between the Na excretion rate and renin-aldosterone levels either before or during HOI. Plasma antidiuretic hormone (ADH) level was comparable between day and night before HOI and decreased to a similar level during HOI in both daytime and nighttime series (P less than 0.05 for nighttime HOI). Cardiac output increased from 3.3 1/min before HOI to 5-6 1/min during HOI without showing any significant circadian difference. Hematocrit, hemoglobin, and plasma concentrations remained unchanged under all conditions. It is concluded that the renal response to HOI is subject to nocturnal inhibition, which cannot be attributed to circadian differences in the degree of HOI-induced central blood pooling, renin-aldosterone, or ADH responses.     

Post-traumatic Stress Disorder in children and adolescents: from Sigmund Freud's "trauma" to psychopathology and the (Dys)metabolic syndrome.

Post-traumatic Stress Disorder (PTSD) is an anxiety syndrome that develops after exposure to traumatic life events. Symptoms include re-experience of the initial trauma, avoidance of stimuli associated with the trauma and symptoms of excessive arousal. Neuroendocrine studies in adults with PTSD have demonstrated that basal cerebrospinal fluid (CSF) CRH levels are elevated and urinary cortisol levels are variable--low in the majority of cases--whereas other studies demonstrate no differences in urinary and plasma cortisol concentrations. Urinary catecholamine excretion is higher in PTSD patients than those of control subjects and other psychiatric disorders. Children may differ from adults in their psychologic and physiologic responses to severe stressors. Also, exposure to stress during critical periods of development may have irreversible effects on behavioral maturation and may affect specific vulnerable brain areas, altering CNS development. Similar to findings in adult studies, PTSD in children is characterized by increased sympathetic nervous system (SNS) activity, as indicated by elevated norepinephrine levels in the periphery. High cortisol levels in urine or saliva have been reported in most studies of childhood PTSD, while prospective longitudinal studies concerning the natural history of neuroendocrine changes in pediatric PTSD after an acute stressor are limited. The identification of neurobiologic changes in response to early adverse experiences is of major importance for the prognosis, prevention, management, and treatment of children and adolescents at risk for or suffering from PTSD.     

Day-night differences in the response of the pineal gland to swimming stress

The effect of swimming stress on pineal N-acetyltransferase activity, hydroxyindole-O-methyltransferase (HIOMT) activity, and melatonin content was studied during the day and night in adult male rats. At night, elevated pineal activity was suppressed by light exposure before the animals swam. During the day, swimming for 2 hr did not stimulate NAT activity unless the animals were pretreated with desmethylimipramine (DMI), a norepinephrine uptake blocker. Pineal melatonin content after daytime swimming exhibited a weak rise, unless DMI was injected, in which case melatonin levels showed a highly significant increase. Swimming at night caused a greater (compared to daytime levels) increase in NAT activity in both noninjected and DMI-injected rats. Melatonin levels at night were highly significantly stimulated (compared to daytime values) even without pretreatment of the rats with DMI. The greater response of the rat pineal to swimming stress at night may relate either to an increase in the number of beta-adrenergic receptors in the pinealocyte membrane at night or to a reduced capacity of the sympathetic neurons in the pineal to take up excess circulating catecholamines. Pineal HIOMT activity was not influenced by swimming (with or without DMI) either during the day or at night.     

Some determinants of population variation in cortisol levels in a British urban community.

Urinary cortisol excretion rates were determined from three urine samples given over 2 days, a rest day and a working day, by 51 men and 50 women. Each subject also completed a questionnaire relating to life style factors and to perceived levels of stress, busyness and happiness on each day. In men, an association between raised cortisol and high levels of stress was found. In women, high levels of busyness were associated with low cortisol excretion rates. The subjective experiences measured accounted for around 10-20% of cortisol variation in this naturalistic setting.     

Diurnal and annual variation of adrenocortical activity in the squirrel monkey

Diurnal changes in basal cortisol levels and stress reactivity were assessed in male and female squirrel monkeys. Blood samples were collected at four-hour intervals throughout the day and night in the mating and nonmating seasons. Basal cortisol levels in females were similar in both seasons, but males tended to have higher cortisol levels during the mating season, especially at night. For both sexes, cortisol secretion was highest between 0400 and 0800 preceding the onset of the diurnal activity period. Assessment of cortisol responses following brief handling and anesthesia indicated that stress responses were relatively stable across the year, but cortisol increments were slightly higher in the nonmating season. Cortisol levels post-stress were generally related to prior baseline values. Thus, a knowledge of biorhythmic changes in basal hormone levels was important for predicting hormone levels after acute stressors. Males also underwent marked seasonal variation in their basal testosterone levels, which markedly altered the nature of their testosterone responses 30-minutes poststress. © 1995 Wiley-Liss, Inc.     

Influence of age on orthostatic changes in plasma renin activity and urinary catecholamines in man.

The authors studied plasma renin activity (PRA), urinary epinephrine, norepinephrine and dopamine excretion and their mutual relationships in 54 healthy subjects under basal (recumbent) conditions and age-related orthostatic changes in these parameters. The test subjects were divided into six 10-years groups, according to their year of birth (1901-1910 to 1951-1960). In the oldest groups (1901-1910 and 1911-1920), both basal PRA values and norephrine and epinephrine excretion and their postural increase were smaller than in younger subjects. Conversely, urinary dopamine excretion and the dopamine/norepinephrine and epinephrine ratio rose with advancing age. There were no significant differences between the plasma sodium and potassium concentrations in the various groups. Urinary aldosterone excretion was slightly higher in the oldest group than in the others, but was still within the control value limits. The intravenous administration of Inderal reduced both resting PRA values and the orthostatic increase in the youngest age groups, so that their PRA approached the values in older subjects. Higher norepinephrine and epinephrine excretion and the lower dopamine/norepinephrine and epinephrine in young subjects may play a role in their higher PRA, especially in the orthostatic reaction. Diminution of sympathetic activity, with lower norepinephrine and epinephrine excretion and relatively high dopamine excretion, may have a direct bearing on the lower PRA values in older subjects. The diminished capacity of older subjects for catecholamine mobilization and raised renin secretion during an orthostatis stress may be related to the higher incidence of orthostatic forms of hypotension in old age.     

Urinary corticosteroid excretion patterns in the okapi (Okapia johnstoni)

Stress is known to alter a variety of biological processes, including behavior and reproduction. It is therefore important to understand the stress levels of animals in captivity, especially those for whom captive breeding is a priority, such as the okapi. Levels of stress hormones can be measured from samples collected noninvasively, such as urine or feces, which are preferable with nondomestic species for whom drawing blood might in itself be a considerable stressor. To understand the excretion of cortisol in urine in the okapi, four (1.3) animals were subject to three injections: saline, 200 IU of an adrenocorticotropic hormone (ACTH) analogue, and 300 IU of the analogue. Their 24‐hr urinary corticosteroid levels were compared with 4 baseline days. Injection with the ACTH analogue significantly increased the urinary corticosteroid levels compared with saline injections and baseline. Eight (3.5) okapi were then observed for 24 hr per day for 5 days to determine their normal patterns of corticosteroid production. The mean corticosteroid levels varied significantly by individual. A significant circadian pattern in urinary corticosteroid was apparent independent of individual or gender, with cortisol rising during the daylight hours and decreasing again at night. Zoo Biol 27:381–393, 2008. © 2008 Wiley‐Liss, Inc.     

Plasma catecholamines and pituitary adrenal hormones in response to noise exposure

To evaluate the immediate effect of exposure to a high level of noise on the sympatho-adrenal and pituitary-adrenal systems, measurements were made of circulating catecholamines, growth hormone, ACTH, and cortisol in seven normal male subjects. They were studied on two random experimental days: a control day and a noise-exposure day with an intermittent noise alternating between 99 dB (A) and 45 dB (A) for 2 h. Analysis did not reveal any variation in the plasma levels of norepinephrine (NE), epinephrine (E) or dopamine (D), measured every 20 min, which might have been related to noise exposure. Similarly, analysis of the 2-h urine samples collected from 8 a.m. to 2 p.m. revealed no significant changes in urinary catecholamine excretion. Plasma levels of GH and ACTH did not differ significantly from those for control days, but cortisol showed a brief, significant levelling-off in its pattern during the exposure period. The data demonstrate that exposure to a high level of noise, although considered as "unpleasant", does not induce any important endocrinological changes in man. These conclusions differ from those for studies on animals where reactions to noise may be related to a more general stressing situation.     

Sleep impairments in healthy seniors: roles of stress, cortisol, and interleukin-1 beta

Study Objectives: Increased stress responsivity and a longer-lasting glucocorticoid increase are common findings in aging studies. Increased cortisol levels at the circadian nadir also accompany aging. We used 24h free urine cortisol to assess these age changes in healthy seniors. We hypothesized that free cortisol levels would explain individual differences in age-related sleep impairments. Design: The study compared sleep, cortisol, and sleep-cortisol correlations under baseline and “stress” conditions in men and women. Setting: Subjects were studied in the General Clinical Research Center under baseline conditions and a mildly stressful procedure (24h indwelling intravenous catheter placement). Participants: Eighty-eight healthy, nonobese subjects (60 women and 28 men) from a large study of successful aging participated in the study. Mean ages were 70.6 (±6.2) and 72.3 (±5.7) years for women and men, respectively. Measurements: The 24h urines were collected for cortisol assay (radioimmunoassay [RIA]); blood was sampled at three diurnal time points for assay (enzyme-linked immunosorbent assay [ELISA]) of interleukin-1 (IL-1) beta; sleep architecture and sleep electroencephalograms (EEGs) were analyzed (after an adaptation and screening night) on baseline and stress nights via polysomnography and EEG power spectral analysis. Results: Healthy older women and men with higher levels of free cortisol (24h urine level) under a mild stress condition had impaired sleep (lower sleep efficiency; fewer minutes of stages 2, 3, and 4 sleep; more EEG beta activity during non-rapid eye movement sleep [NREM] sleep). Similar results were obtained when stress reactivity measures were used (cortisol and sleep values adjusted for baseline values), but not when baseline values alone were used. Gender differences were apparent: Men had higher levels of free urine cortisol in both baseline and mild stress conditions. Cortisol and sleep correlated most strongly in men; cortisol stress response levels explained 36% of the variance in NREM sleep stress responses. In women, but not men, higher cortisol was also associated with earlier time of arising and less REM sleep. Higher cortisol response to stress was associated with increased circulating levels of IL-1β, explaining 24% of the variance in a subset of women. Conclusion: These results indicate that free cortisol (as indexed by 24h urine values) can index responses to mild stress in healthy senior adults, revealing functional correlations (impaired sleep, earlier times of arising, more EEG beta activity during sleep, more IL-1β) and gender differences. (Chronobiology International, 17(3), 391-404, 2000)     

Diel patterns of nitrogen excretion, plasma constituents, and behavior in the gulf toadfish (Opsanus beta) in laboratory versus outdoor mesocosm settings

Nitrogen excretion by the gulf toadfish (Opsanus beta) is of interest because of its high proportion of urea excretion compared with that of other teleosts. To better understand the factors influencing the timing of nitrogen excretion, the ratio of excreted urea∶ammonia, and the effector molecules regulating these processes, gulf toadfish were subjected to a series of experiments that moved them progressively from internal laboratory to outdoor mesocosm settings while assessing their behavior, nitrogen excretion patterns, levels of plasma hormones/effectors, and other parameters. In confined flux chambers in both laboratory and outdoor settings, toadfish nitrogen excretion was largely observed as urea pulses, with no apparent diel patterns to the pulses. Unrestrained toadfish in mesocosms exhibited distinctly nocturnal behavior, remaining exclusively in shelters during the day but taking several forays out into the mesocosm at night. In contrast to nitrogen excretion patterns in chambers, urea and ammonia were coexcreted in mesocosms and ratios for urea∶ammonia were very close to 1∶1 for both fed and fasted toadfish. The majority of measured excretion (and corresponding declines in plasma urea levels) occurred during two distinct periods of pulsing during daylight hours (0600-1000 and 1600-1800 hours). The declines in plasma urea associated with excretion were preceded by/coincided with declines in plasma cortisol. No day/night or hourly patterns in plasma serotonin (5-hydroxytryptamine [5-HT]) were observed, but there was a strong positive correlation among all samples between plasma urea and 5-HT. There was also a negative correlation between plasma cortisol and 5-HT. As expected for a nocturnally active species, plasma melatonin was significantly lower in daylight hours. A variety of enzyme activities (glutamine synthetase, glutaminase) and mRNA levels (glutamine synthetase, urea transporter, and Rhesus proteins) showed no significant variation over a diel cycle. Unlike prior laboratory studies, our results show that gulf toadfish in a natural setting have a distinctly diurnal pattern of nitrogen excretion and that ammonia and urea are coexcreted. The decline in plasma cortisol associated with urea pulses noted in prior laboratory studies was not as evident in the natural setting.     

Reciprocity between endocrine state and contest behavior in the killifish, Kryptolebias marmoratus

Given the dramatic behavioral effects of winning and losing contests, and pronounced changes in stress and sex steroid hormones post-fight, it is reasonable to suppose that these hormones also dictate future behavior. We sampled water-borne cortisol, testosterone (T), and 11-ketotestosterone (KT) before and after contests in the mangrove killifish, Kryptolebias marmoratus, to determine how endogenous steroid hormone levels might predict and respond to contest dynamics or success. Pre-fight cortisol related negatively, and pre-fight T related positively to contest initiation and winning, particularly in the smaller opponent. In the pairs where a larger fish won the contest, winners with higher pre-fight T and lower pre-fight cortisol delivered more attacks to the losers. Contest duration and escalation influenced post-fight hormone concentrations primarily in losers. Escalation significantly increased post-fight cortisol, T, and KT for losers but not for winners. However, winners that attacked losers at higher rates had higher levels of post-fight cortisol. Losers also demonstrate the most consistent post-fight hormone responses, particularly to contest escalation and duration. Despite the bidirectional relationship between hormones and contest behavior, we found no overall mean differences in pre- or post-fight cortisol, T, or KT between eventual winners and losers. Thus, it is evident that the categorical states of winner and loser cannot alone reveal the complex, reciprocal associations between endocrine systems and social behavior.     

SLEEP IMPAIRMENTS IN HEALTHY SENIORS: ROLES OF STRESS,CORTISOL, AND INTERLEUKIN-1 BETA

Study Objectives: Increased stress responsivity and a longer-lasting glucocorticoid increase are common findings in aging studies. Increased cortisol levels at the circadian nadir also accompany aging. We used 24h free urine cortisol to assess these age changes in healthy seniors. We hypothesized that free cortisol levels would explain individual differences in age-related sleep impairments. Design: The study compared sleep, cortisol, and sleep-cortisol correlations under baseline and “stress” conditions in men and women. Setting: Subjects were studied in the General Clinical Research Center under baseline conditions and a mildly stressful procedure (24h indwelling intravenous catheter placement). Participants: Eighty-eight healthy, nonobese subjects (60 women and 28 men) from a large study of successful aging participated in the study. Mean ages were 70.6 (±6.2) and 72.3 (±5.7) years for women and men, respectively. Measurements: The 24h urines were collected for cortisol assay (radioimmunoassay [RIA]); blood was sampled at three diurnal time points for assay (enzyme-linked immunosorbent assay [ELISA]) of interleukin-1 (IL-1) beta; sleep architecture and sleep electroencephalograms (EEGs) were analyzed (after an adaptation and screening night) on baseline and stress nights via polysomnography and EEG power spectral analysis. Results: Healthy older women and men with higher levels of free cortisol (24h urine level) under a mild stress condition had impaired sleep (lower sleep efficiency; fewer minutes of stages 2, 3, and 4 sleep; more EEG beta activity during non–rapid eye movement sleep [NREM] sleep). Similar results were obtained when stress reactivity measures were used (cortisol and sleep values adjusted for baseline values), but not when baseline values alone were used. Gender differences were apparent: Men had higher levels of free urine cortisol in both baseline and mild stress conditions. Cortisol and sleep correlated most strongly in men; cortisol stress response levels explained 36% of the variance in NREM sleep stress responses. In women, but not men, higher cortisol was also associated with earlier time of arising and less REM sleep. Higher cortisol response to stress was associated with increased circulating levels of IL-1β, explaining 24% of the variance in a subset of women. Conclusion: These results indicate that free cortisol (as indexed by 24h urine values) can index responses to mild stress in healthy senior adults, revealing functional correlations (impaired sleep, earlier times of arising, more EEG beta activity during sleep, more IL-1β) and gender differences. (Chronobiology International, 17(3), 391–404, 2000)     

Effects of nighttime low frequency noise on the cortisol response to awakening and subjective sleep quality

The effects of night-time exposure to traffic noise (TN) or low frequency noise (LFN) on the cortisol awakening response and subjective sleep quality were determined. Twelve male subjects slept for five consecutive nights in a noise-sleep laboratory. After one night of acclimatisation and one reference night, subjects were exposed to either TN (35dB L(Aeq), 50dB L(Amax)) or LFN (40dB L(Aeq)) on alternating nights (with an additional reference night in between). Salivary free cortisol concentration was determined in saliva samples taken immediately at awakening and at three 15-minute intervals after awakening. The subjects completed questionnaires on mood and sleep quality. The awakening cortisol response on the reference nights showed a normal cortisol pattern. A significant interaction between night time exposure and time was found for the cortisol response upon awakening. The awakening cortisol response following exposure to LFN was attenuated at 30 minutes after awakening. Subjects took longer to fall asleep during exposure to LFN. Exposure to TN induced greater irritation. Cortisol levels at 30 minutes after awakening were related to "activity" and "pleasantness" in the morning after exposure to LFN. Cortisol levels 30 minutes after awakening were related to sleep quality after exposure to TN. This study thus showed that night time exposure to LFN may affect the cortisol response upon wake up and that lower cortisol levels after awakening were associated with subjective reports of lower sleep quality and mood.     

Simulated microgravity, psychic stress, and immune cells in men: observations during 120-day 6 degrees HDT.

Because 6 degrees head-down tilt (HDT) is an established method to mimic low gravity on earth, the aim of the present study was to determine the effects of 120-day HDT on psychic stress and peripheral blood immune cells in six healthy male volunteers. Psychological state was assessed by a current stress test, and cortisol was measured in saliva. During HDT, all volunteers developed psychic stress, and the diurnal rhythm of cortisol secretion was significantly altered. In addition, urine excretion of dopamine and norepinephrine increased. The innate part of the immune response was activated, as evidenced by the increase in the expression of beta(2)-integrins on polymorphonuclear leukocytes and a rise in the number of circulating natural killer (NK) cell lymphocytes. The ratio of T-helper to T-cytotoxic and T-suppressor cells decreased, whereas no changes in T and B lymphocytes were observed. Plasma levels of interleukin-6 increased significantly and returned to basal levels after the end of the HDT period. Thus 6 degrees HDT appears to be a valid model to induce psychic stress and neuroendocrine-related changes in the immune system, changes that might also be encountered by astronauts and cosmonauts during long-duration spaceflights.     

Diurnal variation of salivary cortisol in captive African elephants (Loxodonta africana) under routine management conditions and in relation to a translocation event

The present study assessed the diurnal variation in salivary cortisol in captive African elephants during routine management (baseline) and in relation to a potential stressor (translocation) to evaluate to what extent acute stress may affect diurnal cortisol patterns. Under baseline conditions, we collected morning and afternoon saliva samples of 10 animals (three zoos) on different days in two study periods (n = 3–10 per animal, daytime and period). Under stress conditions, we sampled the transported cow (newcomer) and the two cows of the destination zoo before and after the transport in the morning and afternoon (n = 3–9 per animal, daytime and transport phase), as well as after the first introduction of the newcomer to the bull (n = 1 per animal). Cortisol was measured in unextracted samples by enzyme immunoassay. Under baseline conditions, we observed the expected diurnal variation with higher cortisol levels in the morning than in the afternoon. Under stress conditions, neither a significant difference between pre- and posttransport, nor between morning and afternoon levels was found. The percentage difference between morning and afternoon cortisol after the transport, however, was remarkably lower than before the transport in the newcomer potentially indicating a stress response to familiarization. Saliva samples taken immediately after the introduction of the newcomer to the bull revealed a marked cortisol increase. Our findings indicate that stressors may disturb the diurnal cortisol rhythm. Furthermore, provided that samples can be collected promptly, salivary cortisol is a useful minimally invasive measure of physiological stress in the African elephant.     

Urinary cortisol responses of longtailed macaques to five cage sizes,tethering, sedation,and room change

Urinary free cortisol responses to five cage sizes, cage level, room change, tethering adaptation, chronic catheterization, and ketamine sedation were measured in 14 female and 14 male wild-born adult Macaca fascicularis. Urinary free cortisol, a physiological measure of psychological well-being that can be collected unobtrusively, provided a measure of the animals' general adrenocortical response to various conditions over a time course of hours. Urinary free cortisol values in response to stimulation with adrenocorticotropic hormone (ACTH) validated the measure as a reflection of blood values. Cortisol values were expressed as a ratio to creatinine, which normalized for differences in urinary output and body weight (muscle mass). Cage size (20–140% of regulation floor area) and housing level (upper vs. lower cage) had no effect on stress, as measured by cortisol excretion. Room change elicited a slight increase in cortisol excretion for the first day, but not to a level suggesting stress. Sedation, surgery, some aspects of tethering adaptation, and chronic catheterization produced urinary cortisol evidence of stress. Even so, animals varied in their responses and all showed adaptation. Males and females did not differ in normal mean values but females tended to have higher cortisol levels in response to potential stressors investigated in this study. Cortisol levels continued to decline gradually throughout the study. © 1993 Wiley-Liss, Inc.     

The driving license examination as a stress model: effects on blood picture, serum cortisol and the production of interleukins in man

We have studied the following stress model: the tension caused by sitting for the theoretical part of the driving license examination. Volunteers were investigated twice, after their driving license examination and after a (stress-free) control session. The effects of the stress were investigated by studying the blood picture (differential counts), serum concentration of cortisol, and cytokine production in stimulated blood cells. Relationships between the subjective perception of stress and the physiological reaction were also investigated. This stress induced significant increase in the concentrations of cortisol and hemoglobin, and in the values of hematocrit and MCV, and in the lipopolysaccharide-induced release of IL-1beta and -6. The subjective feelings of irritability and wakefulness were also significantly higher after the exam. A significant relationship was found between the changes in the stimulated production of IL-1beta and irritability. The responsiveness to psychological stress might be influenced by the temporary mood of the subjects.     

Effects of pressure on the skin exerted by clothing on responses of urinary catecholamines and cortisol,heart rate and nocturnal urinary melatonin in humans

The study investigated how the pressure exerted on the skin by clothing worn while working in the daytime affected the urinary excretion of adrenaline, noradrenaline and cortisol, heart rate, and also melatonin secretion at night. Nine young women (experiment I) and seven young women (experiment II) participated. Participants wore either a 100% cotton jacket (tight clothes, TC) or a 100% cotton T-shirt (loose clothes, LC). Loose-fitting, 100% cotton tank tops and panties were worn as underwear in both the TC and the LC groups. The main results can be summarized as follows: (1) urinary excretion of adrenaline, noradrenaline and cortisol was facilitated, and the amounts of urinary excretion were significantly higher when TC were worn. Heart rate was significantly higher in the TC group; (2) nocturnal urinary melatonin excretion was significantly greater in the TC group. These results are discussed in terms of an enhancement of diurnal sympathetic nervous system activity caused by pressure on the skin produced by tight clothing.     

Health patterns associated with type A behavior: a managerial population.

Type A Behavior is a behavioral syndrome found to be related to coronary heart disease and characterized by excessive drive, ambition, and competitiveness. Managers from 12 different companies were examined for this syndrome and for a number of the known risk factors in coronary heart disease (blood pressure, cholesterol, triglycerides, uric acid, smoking, and fitness). Those individuals exhibiting extreme Type A Behavior (Type A) showed significantly higher blood pressure (systolic and diastolic) and higher cholesterol and triglyceride levels. A greater percentage of these individuals were cigarette smokers. On serum uric acid there were no differences. In each age group, Type A's were less interested in exercise, although differences in cardio-respiratory fitness were found only in the oldest age group. Type A Behavior also was related to age, education, company growth rates, and stress symptoms. Overall, the Type A1's were found to be higher on a number of risk factors known to be associated with coronary heart disease. With regard to the Type A2's (individuals with less developed Type A Behavior), the findings were not conclusive.