The physiological responses to walking with and without Power Poles on treadmill exercise.

Power Poles are specially constructed, rubber-tipped ski poles designed for use during walking. Using Power Poles simulates the arm motion of cross-country skiing, thus increasing the muscle mass used during walking. This study investigated the potential increases in exercise intensity and energy cost associated with the use of walking poles. Thirty-two apparently healthy volunteers (16 men and 16 women) between the ages of 19 and 33 years participated. Each completed a treadmill maximal oxygen consumption (VO2max) test and two randomly assigned, submaximal walking trials (one with poles and one without poles) on separate days. Each walking trial was conducted on a level treadmill, for 20 minutes, at an identical self-selected pace. Expired gases, heart rate in beats per minute (bpm), and ratings of perceived exertion (RPE) were recorded each minute. Results between trials were compared using repeated measures analysis of variance and Tukey's post hoc tests. It was found that walking with poles resulted in an average of 23% (4.4 ml.kg-1.min-1) higher VO2, 22% higher caloric expenditure (1.5 kcal.min-1), and 16% (18 bpm) higher heart rate responses compared to walking without poles on a treadmill. RPE values averaged 1.5 units higher with the use of the poles, and the pattern of responses between conditions was similar for men and women. It is concluded that the use of Power Poles can increase the intensity of walking at a given speed and, thus, may provide additional training benefits to walkers.

Acute responses to using walking poles in patients with coronary artery disease.

PURPOSE: This study was designed to assess the safety and effectiveness of walking when using 1-lb walking poles in Phase III/IV cardiac rehabilitation patients. METHODS: Following instruction on the proper use of the poles and adequate time to practice, each subject completed two 8-minute walking trials on a level treadmill either with or without walking poles. Each trial was conducted at an identical speed for each subject in a randomized order. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and ratings of perceived exertion (RPE) were recorded every 2 minutes during each trial, while ECG responses (ST segment changes and dysrhythmias) were monitored continuously. RESULTS: Walking with poles significantly (P < .05) increased the energy cost of walking by 21% (3.8 mL/kg/min) compared to walking without poles. There were also significant (P < .05) increases in HR (14 bpm), SBP (16 mm Hg), and DBP (4 mm Hg) when comparing conditions. Calculated oxygen pulse (mL O2.heart beat) values indicated that changes in HR were consistent with the increase in VO2 and were not related to a pressor response mechanism. The only dysrhythmias noted were isolated PVCs, with no differences in the frequency of occurrence between trials. There were no adverse ST segment changes with either trial. CONCLUSIONS: These data demonstrate that at a given speed, the use of 1-lb walking poles can safely increase the intensity of walking exercise in Phase III/IV cardiac rehabilitation patients.

[Adrenocortical tumors. I. Prognostic evaluation of a series of 17 cases using the Weiss criteria]. / Tumeurs de la corticosurrénale. I--Evaluation pronostique d'une série de 17 cas par les critères de Weiss.

Weiss proposed 9 histologic criteria to evaluate the malignancy of adrenal cortical tumors. Each tumor is graded from 0 to 9 according to how many of the criteria are present. Eight of the 17 neoplasms from the present study were graded from 0 to 2; none of these 8 tumors metastasized or recurred. The grade of the nine other neoplasms ranged from 3 to 8; seven lesions metastasized (grade 4 to 8), one recurred (grade 5), and the last one neither metastasized nor recurred (grade 3) although this tumor was considered malignant according to Weiss' system. Even thought the results obtained using Weiss' system are similar to the results that were put forwards initially, and despite prognostic uncertainty with grade 3 tumors, we think that the later system provides a more objective evaluation of the prognosis of adrenal cortical tumors, compared with usual morphologic methods.

[Adrenal cortical tumors. Prognostic evaluation of a series of 12 cases using anti-PCNA antibodies]. / Tumeurs de la corticosurrénale. II--Evaluation pronostique d'une série de 12 cas par l'anticorps anti-PCNA.

Adrenocortical tumors malignancy may be difficult to assess by morphological data. Twelve cases of such tumors were reviewed and classified benign (group I) or malignant (group II) according to follow yp. Using a peroxidase antiperoxidase method, nuclear affinity for anti-PCNA antibody was studied. The percentage of positive nuclei is significantly different in both groups: the mean value is 1.025% in benign tumors (range from 0.40 to 3.02%) and 16.765% (range from 5.62 to 31.40%) in malignant tumors (p < 0.01 according to Mann and Whitney U test). Although our study group is rather small, it suggests that analysis of nuclear affinity for PCNA could be helpful in assessment of adrenocortical tumors malignancy.

Malignant lymphomas in Gabon (equatorial Africa): a morphologic study of 72 cases.

A retrospective morphologic analysis was conducted on 72 malignant lymphomas collected in Gabon, a country of the equatorial area in Africa. Non-Hodgkin's lymphomas (NHLs) were by far the most frequent type of lymphoma, representing 67 cases (93%); only five patients (7%) had Hodgkin's disease. Non-Hodgkin's lymphomas were classified according to two modern systems (Kiel and Working Formulation). The age distribution of NHL patients was bimodal, with the highest peak in the 0 to 14 years age group (these cases were almost exclusively associated with Burkitt's lymphomas), and with the second highest peak in the 55 to 64 years age group. The male to female ratio was 2.5:1, and the overall median age was 44 years. According to the Working Formulation, the NHL cases were composed of one follicular lymphoma (1.5%), 55 diffuse lymphomas (82%), and 11 miscellaneous lymphomas (16.5%). Burkitt's lymphoma was the most frequent NHL (17 cases; 25.4%), followed by diffuse large cell lymphoma (15 cases; 22.4%) and immunoblastic lymphoma (nine cases; 13.4%). Consequently, high-grade NHL formed the largest group (28 cases; 42%), intermediate-grade NHL formed the next largest group (21 cases; 31.3%), and low-grade NHL formed the smallest group (seven cases; 10.4%). These data are compared with series from developed and developing countries, and the observed differences in distribution of the histologic subtypes of malignant lymphoma are discussed.

Kaposi's sarcoma: presence of herpes-type virus particles in a tumor specimen.

Three Kaposi's sarcoma biopsy specimens obtained from three African patients with typical nodular cutaneous tumors were investigated morphologically for cellular modifications suggestive of a viral origin. In one case a Kaposi's sarcoma cell of the endothelial type contained a few intranuclear herpes-type viral inclusions. The present findings complement previous reports of herpes-type viral particles in Kaposi's sarcoma cultured cell lines and suggest that, at least under certain conditions, Kaposi's sarcoma cells enter a virus-producing phase.

Placental pathologic changes in malaria. A histologic and ultrastructural study.

Placenta malarial changes (PMCs) related to maternal plasmodium infection were present in 33% (247 cases) of a series of 741 placentas collected from an unselected population living in an area of high malarial endemicity (Haut-Ogooué, Gabon, Africa). Plasmodia were found on material thick blood films taken at the time of delivery in 42% of the women with and 24% of women without associated PMCs. Plasmodium falciparum was the most frequent infecting organism. PMCs were more frequent and, in general, more marked in primiparas. The primiparas were significantly (P less than 0.001) more numerous in the group with PMCs than in the control group without such changes. The mean weight of term placentas with malarial changes was significantly (46 g; P less than 0.001) less than that of placentas without such changes. The morphologic changes were a combination of the following features: 1) presence of parasites in the intervillous spaces; 2) macrophage concentration in the intervillous spaces; 3) malarial pigment deposits; 4) excess of perivillous fibrinoid deposits; 5) syncytiotrophoblastic damage; and 6) trophoblastic basal lamina thickening. Plasmodia were found in placental intervillous spaces in 42% (105/247). Local parasitemia varied in magnitude; in a few cases, 30% or more of the maternal erythrocytes were infected. Macrophage concentration in the intervillous spaces was present in 29% (72/247) and was always associated with local parasitemia. Macrophages phagocytized red blood cells and malarial pigment, and their number varied inversely with that of the local parasites. It seems, therefore, that macrophages play an important role in local parasite clearance. Malarial brown pigment was observed in all cases from the series. It had characteristic ultrastructural features and occurred in perivillous deposits of fibrinoid, in macrophages, or free in intervillous spaces. Excessive perivillous fibrinoid deposits were a constant histologic finding and were usually associated with syncytiotrophoblastic necrosis or ultrastructural damage such as partial microvilli loss, filamentous material accumulation in intracytoplasmic vacuoles, and "podocytelike" cytoplasmic projections on the basal surface. At these sites the trophoblastic basal lamina was usually thickened. Previously reported morphologic data and our own findings suggest that the peculiar placental changes in malaria, restricted to intervillous spaces and to villous surfaces, may be related to an immunopathologic process.