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Ratio of post-prostatic massage urinary zinc concentration to initial urinary zinc concentration. An improved method of assessing prostatic function.

Various methods have been used clinically to assess prostatic function. We evaluated a number of ways of using zinc in post-prostatic massage urine (VB3) and found that the ratio of VB3 zinc concentration to initial urinary zinc concentration was a good indicator of prostatic secretory activity. This ratio can differentiate hormonally treated patients with carcinoma of the prostate from those untreated and from those with benign prostatic hypertrophy. The specificity is increased for individuals by repeat samples. Comparison of samples before and after resection showed no loss of function and no difference was found between groups treated with orchiectomy or LHRH agonist (Zoladex). The VB3/VB1 zinc concentration could be used in a prospective study of hormonal treatments directed against the prostate, where it could give objective evidence of a fall in secretory function of the gland.

Humans↗

Posture-dependent chronotropic effect of carotid sinus massage.

The hypertensive carotid sinus can be divided into cardioinhibitory (chronotropic) and vasodepressor components; the former can be evaluated by carotid sinus massage performed in the supine position. We present the case of a patient in whom the abnormal cardioinhibitory response could only be demonstrated while in the sitting position.

Carotid Sinus↗

Discordant effects of carotid sinus massage and intravenous adenosine in atypical (fast-slow) atrioventricular nodal reentrant tachycardia.

The precise mechanism underlying supraventricular tachycardia with a long R-P interval is often difficult to assess noninvasively. Carotid sinus massage has been used traditionally to produce transient AV nodal conduction delay at the bedside, and may be of diagnostic or therapeutic benefit. More recently, adenosine has also been shown to be useful in this situation. We report the case of a patient with an incessant long R-P tachycardia in whom the response to CSM was misleading while the response to adenosine was diagnostic. The electrophysiologic responses to both maneuvers are displayed, and a mechanism for the discordant responses is proposed.

Adenosine↗

Carotid sinus massage as a diagnostic and therapeutic tool for atrial flutter-fibrillation.

Alterations in vagal tone can influence the atrial fibrillatory process by changing the atrial refractory period. We observed in a patient with paroxysmal atrial fibrillation (AF) that carotid sinus massage (CSM) changed a "coarse" type of fibrillation into a "fine" type, followed by termination of the arrhythmia. Although coincidental conversion of AF into sinus rhythm could not be excluded, we concluded that it is worth while to try CSM in every patient presenting with AF prior to other interventions to restore sinus rhythm.

Aged↗

Effects of slow stroke back massage on relaxation in hospice clients.

This study was done to investigate a nonpharmacological means of relaxation with 30 hospice clients. The purpose was to examine the effects of slow stroke back massage (SSBM) on systolic and diastolic blood pressure, heart rate and skin temperature. SSBM was associated with decreases in systolic BP, diastolic BP, and heart rate and with an increase in skin temperature. SSBM was shown to produce modest clinical, but statistically significant changes in vital signs which were indicative of relaxation. It is a cost-effective treatment which adds to the comfort of hospice clients.

Adaptation, Physiological↗

Connective tissue massage.

Connective tissue massage (CTM) is a manipulative technique that facilitates the diagnosis and treatment of a wide range of pathologies. Observation and subsequent manipulation of the skin and subcutaneous tissues can have a beneficial effect upon tissues remote from the area of treatment. These effects appear to be mediated by neural reflexes that cause an increase in blood flow to the affected region together with suppression of pain. CTM is becoming accepted more widely as research confirms the claims of an expanding population of practitioners.

Connective Tissue↗

Massage--the scientific basis of an ancient art: Part 1. The techniques.

Manual massage is a long established and effective therapy used for the relief of pain, swelling, muscle spasm and restricted movement. Latterly, various mechanical methods have appeared to complement the traditional manual techniques. Both manual and mechanical techniques are described systematically, together with a review of indications for use in sports medicine.

History, Ancient↗

Right atrial laceration. Complication of external cardiac massage.

Right atrial laceration is described as a complication of external cardiac massage in two patients. In each there was a pre-existent cause of weakness of the atrial wall. There was pronounced right atrial dilation with attenuation of the wall in one case, and in the other there was a granulomatous myocarditis involving the atrial wall. The significance of atrial laceration as a complication of traumatic injuries to the heart is discussed.

Aged↗

His bundle haemorrhage and external cardiac massage: histopathological findings.

Histological examination showed acute haemorrhage of the bifurcating His bundle and of the left bundle branch in a 35 year old man who died after being given external cardiac massage for cardiac arrest. "Hammering" of the ventricular septum crest against the central fibrous skeleton of the heart by compression of the sternum was believed to have caused the haematoma of the junctional tissue.

Adult↗

Immunocytological analysis of leukocyte subpopulations in urine specimens before and after prostatic massage.

OBJECTIVE: To evaluate the presence of leukocyte subpopulations in urine after prostatic massage (VB 3) in symptomatic patients with > or =10 leukocytes/high power field (magnification x1,000) in expressed prostatic secretions, and who were classified as suffering from chronic bacterial prostatitis or inflammatory chronic pelvic pain syndrome. METHODS: 115 consecutive patients were investigated. Granulocytes in centrifuged midstream urine (VB 2) and VB 3 were counted after Papanicolaou stain. Macrophages, B and T lymphocytes were analyzed after immunocytological staining with monoclonal antibodies according to the alkaline phosphatase anti-alkaline phosphatase method. The counts were quantified as the number of cells per view field at a magnification of x400. In all patients, acute or chronic urethritis had been excluded before enrollment in the study. 16 men without signs or symptoms of urogenital inflammation served as controls. RESULTS: Of the 115 patients, 101 men demonstrated > or =10 leukocytes/view field in VB 3. In comparison to VB 2, the leukocyte subpopulations in VB 3 demonstrated an increase in granulocytes (9.2-fold), macrophages (7.6-fold), T lymphocytes (7.6-fold), and B lymphocytes (4-fold). The increase was statistically significant (p<0.001 each). The proportion of these cells in VB 3 was 81.6, 11.1, 5.5, and 1.8%, respectively. As compared to controls, all leukocyte subsets in VB 3 were significantly elevated (p>0.001 each). CONCLUSION: Elevated numbers of leukocytes in VB 3 are indicative of prostatitis provided that urethral inflammation and leukocyturia in VB 2 are excluded. Granulocytes are the predominant cell type of inflammation. The increase in macrophages, T and B lymphocytes in prostatic secretions indicate the participation of both the cellular and humoral immune system in the inflammatory process.

Adult↗

Immediate effects of 'voice massage' treatment on the speaking voice of healthy subjects.

'Voice massage' (VM) treatment includes manipulation of muscles related to speech production and voice and breathing exercises. This study investigated the effects of VM in 10 healthy subjects (5 females, 5 males). They recorded repetitions of the word 'paappa' at normal loudness and as softly as possible and read a text sample before and after 1-hour (1) VM treatment, (2) fast walking, (3) sitting in a library and (4) lying on a bed. Subglottic pressure was estimated from oral pressure during [p]. Transglottal flow and glottal resistance were measured. Voice production was studied with electroglottography. Fundamental frequency, sound pressure level (SPL) and alpha ratio [(SPL of the range 1-5 kHz) - (SPL of the range 50 Hz-1 kHz)] were calculated from text samples, which were also evaluated by 7 voice experts. A questionnaire was used to record subjects' sensations. Changes after lying and sitting suggest lowered effort in phonatory muscles, while after fast walking effort seemed to increase. After VM no significant changes were observed in voice parameters or perceptual quality, but ease of phonation and reduced tension in the neck, shoulders and back were reported. The effects of VM may be partly psychological, partly related to a search of phonatory balance.

Adult↗

Differential diagnosis of testicular mass by cytological examination of seminal fluid collected by ejaculation or prostatic massage.

The cytological examination of the seminal fluid of 3 patients with painless testicular masses was performed using an ordinary conventional technique. Neoplastic cells appeared in the ejaculate or fluid from prostatic massage of all patients. The final pathologies were seminoma, choriocarcinoma and mixed teratocarcinoma. Malignant cells were no longer found in the seminal fluid after orchiectomy. This sample, noninvasive technique plus further flow cytometric study of cellular DNA contents is a great help in the preoperative differential diagnosis of testicular masses.

Adult↗

Early diagnosis of prostatic carcinoma based on in vitro culture of viable tumor cells harvested by prostatic massage.

Prostatic cancer is diagnosed too late in most cases, so that therapy is frequently ineffective or even not undertaken at all because of the already advanced stage of the disease. An early diagnosis technique for prostatic cancer would therefore be highly desirable, also because all other available markers give very unsatisfactory results. Because of our experience in tissue culture of human prostatic specimens, by which we have shown good correlations with patient prognosis, we attempted to grow epithelial cells collected from prostatic fluid after rectal prostatic massage. Samples from prostatic cancer patients, diagnosed by needle biopsy, were grown in culture and were able to survive in vitro for at least 2 weeks, thus providing morphological and biochemical data concerning their neoplastic and differentiation features. The early data on this new approach, which we believe might represent a very useful test for the early diagnosis of the neoplasm, are reported here. The method is noninvasive and suitable for mass screening of the disease. Accuracy and reliability of the technique are currently being tested.

Carcinoma↗

Early diagnosis of prostatic carcinoma may be achieved through in vitro culture of tumor cells harvested by prostatic massage.

As a new method for early diagnosis of prostatic carcinoma we succeeded in growing in vitro the epithelial cells which can be collected from prostatic fluid after rectal prostatic massage. We report here the updated and statistically analyzed series of data (174 patients) on this new approach, which allows all the harvested cells to express their biological features. The method reaches a sensitivity of 72-86% and a specificity of 88-100%. This noninvasive test, which is also suitable for mass screening, may be very useful for an early diagnosis of the neoplasm.

Adult↗

Serotonin reuptake inhibitor (Paxil) does not prevent the vasovagal reaction associated with carotid sinus massage and/or lower body negative pressure in healthy volunteers.

BACKGROUND: The purpose of this study was to assess the effect of the serotonin reuptake inhibitor paroxetine hydrochloride (Paxil, SmithKline Beecham) on cardiovascular reflexes. We hypothesized that Paxil prevents neurally mediated syncope (NMS) by attenuating the sympathoinhibition and vagotonia associated with a vasovagal reaction. METHODS AND RESULTS: In a double-blind randomized study, 25 healthy subjects with a positive response to either carotid sinus massage (CSM) or lower body negative pressure (LBNP) received Paxil (20 mg/d) or placebo for 6 weeks. Arterial baroreflex sensitivity (BRS), muscle sympathetic nerve activity (SNA), baroreflex control of SNA, blood pressure, and heart rate responses to CSM and LBNP were measured at baseline and at 6 weeks. Nineteen subjects completed the study (Paxil, n=9; placebo, n=10). In the Paxil group, BRS decreased significantly compared with baseline (15.8+/-4.0 ms/mm Hg versus 11.0+/-2.6 ms/mm Hg, P=0.05); however, all 9 subjects continued to have a positive response to LBNP with presyncope. Paxil did not attenuate the sympathoinhibition or vagotonia associated with a positive LBNP response and had no significant effect on baroreflex control of SNA. In the control group, no significant change in BRS was noted compared with baseline. Seven out of 9 subjects who had a positive LBNP response at baseline had a repeat positive LBNP response, and the subject with a positive CSM at baseline had a negative response at 6 weeks. CONCLUSIONS: Paxil decreases arterial BRS but does not prevent the presyncope associated with LBNP. The effect of Paxil on the autonomic reflexes in patients with neurally mediated syncope remains unclear.

Animals↗

Clinical conference: Rupture of right ventricle complicating closed chest cardiac massage.

Two cases of rupture of the right ventricle following closed chest cardiac massage are presented. This is believed to result from trapping of blood in the right ventricle at levels of systemic arterial pressure. In one case there was massive pulmonary embolism which interfered with egress of blood from the right ventricle. In the other case, application of pressure during a closed chest resuscitative attempt might have closed the right ventricular outflow tract.

Aged↗

Effect of manual lymphdrainage massage on blood components and urinary neurohormones in chronic lymphedema.

In an earlier paper we have shown that manual lymph drainage massage of edematous limbs can result in the excretion of up to 1 liter urine derived from reabsorption and transport from the interstitial fluid, simultaneously with significant changes in the excretion of urinary neurohormones. These findings indicated that histamine and serotonin were released from the edematous tissue and that circulation improved through increased output of adrenaline and noradrenaline. The results achieved led us to assume that similar changes may have occurred in the blood during treatment, and induced us to study the effect of manual lymphdrainage on various blood constituents and urinary neurohormones.

Adolescent↗