Relationships between muscle strength and muscle cross-sectional area in male sprinters and endurance runners.
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Biomedical subjects
Publications and source records attributed to J Weir.
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One hundred ambulant outpatients with active, endoscopically proven peptic ulceration entered a double-blind trial of either tripotassium-dicitratobismuthate or placebo. Thirty-four patients had gastric ulceration, 56 had duodenal ulceration, three had both gastric and duodenal ulcers, and two had stomal ulceration. Five patients with gastric ulceration were withdrawn from the trial. Three patients with both gastric and duodenal ulceration and two patients with stomal ulceration were excluded from statistical analysis. After 28 days of tripotassium-dicitratobismuthate 94% of gastric ulcer patients had significant endoscopic healing (P less than 0.01). Although 75% of duodenal ulcers healed after 28 days of tripotassium-dicitratobismuthate, this was not statistically significant because of a 60% rate of healing with placebo. Tripotassium-dicitratobismuthate produced a significantly quicker symptomatic response in duodenal ulcer patients (P less than 0.01). No serious side effects were recorded, and patient acceptability was high. It is concluded that tripotassium-dicitratobismuthate is an effective agent for promoting gastric ulcer healing and for symptomatic relief in duodenal ulceration.
Computer analysis of M-mode echocardiograms has been used for evaluation of left ventricular function. Ventricular dimensions and velocities of heart wall movement have been measured. In addition, a non-invasive estimate of ventricular wall stress has been obtained using the systolic cuff blood pressure combined with echocardiogram data, and simultaneous apex cardiography has been employed to look for any disruption in the timing of changes in ventricular dimension and wall stress. Various parameters have been calculated from the data to provide a quantitative indication of changes in the ventricle. A study has been carried out of 117 patients divided into four groups; one of normal subjects and the others containing patients with ischaemic heart disease, hypertrophic cardiomyopathy and dilated cardiomyopathy. Abnormal features of the echocardiograms have been evaluated from comparisons with data for normal subjects. Relationships between the quantities measured have been studied to give a fuller understanding of changes taking place in the ventricle, so that the data can be employed as the basis for a non-invasive assessment of ventricular function.
The maximum voluntary force (strength) which could be produced by the knee-extensor muscles, with the knee held at a right angle, was measured in a group of healthy young subjects comprising twenty-five males and twenty-five females. Both legs were tested: data from the stronger leg only for each subject were used in the present study. Computed tomography was used to obtain a cross-sectional image of the subjects' legs at mid-thigh level, measured as the mid-point between the greater trochanter and upper border of the patella. The cross-sectional area of the knee-extensor muscles was determined from the image obtained by computer-based planimetry. The subjects' height and weight were measured. An estimate of body fat content was obtained from measurements of skinfold thicknesses and used to calculate lean body mass. Male subjects were taller (P less than 0.001), heavier (P less than 0.001), leaner (P less than 0.001) and stronger (P less than 0.001) than the female subjects. No significant correlation was found to exist between strength of the knee-extensor muscles and body weight in the male or in the female subjects. In the male subjects, but not in the female group, there was a positive correlation (r = 0.50; P less than 0.01) between strength and lean body mass. Muscle cross-sectional area of the male subjects was greater than that of the female subjects (P less than 0.001). The ratio of strength to cross-sectional area for the male was 9.49 +/- 1.34 (mean +/- S.D.). This is greater but not significantly so, than that for females (8.92 +/- 1.11). In both male and female groups, there was a significant (P less than 0.01) positive correlation between muscle strength and cross-sectional area. A wide variation in the ratio of strength to muscle cross-sectional area was observed. This variability may be a result of anatomical differences between subjects or may result from differences in the proportions of different fibre types in the muscles. The variation between subjects is such that strength is not a useful predictive index of muscle cross-sectional area.
Two consecutive series of patients with a T wave asymmetry ratio of 2.0 or greater have been studied. Patients with bundle-branch block or who were on digoxin or a similar drug were excluded. In 50 of the 69 patients, the heart was examined either by echocardiography or by direct inspection. Sixty-one of the 69 patients had diseases commonly associated with left (or right) ventricular hypertrophy and/or dilatation. The remaining eight patients had clinically pure ischaemic heart disease. Of the 50 hearts examined by echocardiography or direct inspection (including six with pure ischaemic heart disease), 49 were found to have abnormal thickness of the left (or right) ventricle, or increased end-diastolic left ventricular diameter, or a combination of hypertrophy and dilatation. In 12 of the 47 patients with left ventricular hypertrophy or dilatation, the electrocardiogram did not satisfy the Sokolow and Lyon voltage criterion of left ventricular hypertrophy.
We describe a patient with chyluria due to abdominal Bancroftian filariasis. The patient showed two unusual complications, an immune complex glomerulonephritis and a chronic urinary infection. We also discuss the use of the CT whole body scanner in the diagnosis and delineation of the extent of the disease.
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The relationship between left ventricular dimension measured using M-mode echocardiography and simultaneous apex cardiography has been studied in 69 normal subjects (2 groups) and 159 patients with heart disease (6 groups). A loop was formed by plotting the apex cardiogram, which is related to ventricular wall stress, against ventricular dimension. Abnormalities in ventricular function due to shape or volume changes in the isovolumic phases of the cardiac cycle produced characteristic alterations in the loop pattern. These changes were measured and the results for different groups compared. Normal subjects were divided into two age groups (13-38, 40-78) and no significant differences were found between them. In the heart-disease, patients, 25% had an abnormal decrease in dimension during isovolumic contraction and 25% had an abnormal increase during isovolumic relaxation. When the downstroke of the apex cardiogram was differentially analysed, it was possible to show that 60% of heart-disease patients lay outside the normal range. By using these techniques it is possible (a) to show abnormal ventricular response to pressure changes during the isovolumic periods, (b) to quantify the abnormality and, (c) to detect early abnormal muscle behaviour before it becomes visible on conventional ultrasound recordings.
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169 female patients with outlet obstruction have been studied urodynamically. The results of treatment of the outlet obstruction in 102 patients have been analysed and the reason for the failures discussed. Patients with stable detrusors and those with symptoms of recurrent urinary tract infection responded well to treatment, provided this relieved the obstruction adequately; symptomatic relief was less common in patients with unstable detrusors, despite adequate outflow readjustment.
Echocardiography was performed on 9 patients being treated for cardiogenic shock with an intra-aortic balloon. The value of simultaneous recording of the electrocardiogram, cardiac movements, and arterial pressure, with the echocardiogram of the intra-aortic balloon is discussed. The results indicate that echocardiography provides a method of studying intra-aortic balloon function.
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