Marathon performance in relation to maximal aerobic power and training indices in female distance runners.

The purpose of this study was to examine the relationships of marathon performance time (MPT) to maximal aerobic power (VO2 max), physical characteristics, and training indices recorded for 12 weeks prior to a race in 35 female distance runners. The marathon experience of the subjects ranged from two to fifteen races. Physical and aerobic power characteristics (mean +/- S.D.) were: age, 35.7 +/- 8.5 yr; height, 166.4 +/- 5.7 cm; weight, 55.1 +/- 5.7 kg; body fat, 15.7 +/- 5.0%; VO2 max, 56.5 +/- 6.2 ml . kg-1 . min-1. Marathon time for this race averaged 227.0 +/- 31.6 min. Records from individual training diaries indicated the runners averaged 71.0 +/- 10.0 workout days, 10.0 +/- 10.0 two X day-1 workouts, 81.0 +/- 8.0 total workouts, 12.3 +/- 1.8 mean km . workout-1, 5402.8 +/- 1302.6 total training min, 187.0 +/- 18.0 m . min-1 training pace, 112.2 +/- 32.1 max km . wk-1, 83.1 +/- 23.4 mean km . wk-1, 998.8 +/- 282.6 km . 12 wk-1 and 13.8 +/- 2.4 mean km . day-1. MPT was positively correlated to body mass index (r = 0.52), and body fat (r = 0.52) but negatively related to VO2 max (r = -0.65). MPT was also negatively related to previous marathons completed (r = -0.47), workout days (r = -0.47), two X day-1 workouts (r = -0.52), total workouts (r = -0.56), mean km . workout-1 (r = -0.58), total training min (r = -0.56), m . min-1, training pace (r = -0.66), max km . wk-1 (r = -0.70), mean km . wk-1 (r = -0.74), km . 12 wk-1 (r = -0.74), and mean km . day-1 (r = -0.77). MPT for our population of runners may be predicted (r = 0.82, R2 = 0.68) by the following equation: MPT, (min) = 449.88 - 7.61 (-/x km.day-1 run) - 0.63 (m.min-1, training pace); SEE = +/- 18.4 min.     

Postoperative radiation therapy in the management of lung cancer

Postoperative radiation therapy for lung cancer is still controversial. In a 9-year period, 69 patients with non-oat-cell carcinoma of the lung (16% stage I, 26% stage II, and 58% stage III) received such therapy. The radiation dose was less than 5,000 cGy in 42 patients, 5,000-5,900 cGy in 16, and 6,000 cGy or more in 11; follow-up ranged from 24 to 64 months. Actuarial survival at 2 and 4 years was 50% and 16%, respectively, for squamous cell carcinoma, and 40% and 26% for adenocarcinoma. The 5-year survival for stages I, II, and III cancer was 29%, 17%, and 19%, respectively. Histologic findings and type of surgery did not affect survival, but the radiation dose apparently did. The 3-year survival for patients who received less than 6,000 cGy was 35%, compared with 73% for patients who received higher doses. In eight patients, treatment failed within the irradiated volume: all had received doses of less than 6,000 cGy, and the volume in three was judged to be inadequate.     

Making a home in the community for the academic medical center.

Academic medical centers (AMCs) have traditionally provided primary care for low-income and other underserved populations. However, they have had difficulty developing lasting partnerships with other organizations serving the same populations. This article describes an exception to the rule, in which an academic division was created at Duke University Medical Center to develop effective collaborations with health care and social service providers in Durham, North Carolina, including both public agencies and private organizations. Together, the division and its partners have created and operate programs that improve health outcomes and access to care for those at risk. These programs share a number of characteristics: they are designed to meet the needs of the patient, not the provider; they are based in the community, not in the AMC; they bring services to people's homes, schools, and neighborhoods; they are multidisciplinary, combining health, social, and even mental health services; and, once established, they are revenue-generating and can be made self-supporting when grant funding ends. These programs are also innovative. They are designed to model and test new ways of organizing and delivering care. Preliminary indications suggest that they also strengthen the AMC's relationships with the surrounding community.     

Evaluation of maternal plasma creatine kinase activity as a marker of abnormal early pregnancy

We have tested the value of maternal plasma creatine kinase activity for diagnosing ectopic pregnancies obtained after in-vitro fertilization and embryo transfer. Plasma creatine kinase was assayed in 57 patients: 20 normal, 23 miscarriages and 14 ectopic pregnancies, for a total of 240 samples. All values were in the lower part of the normal range except only one in a miscarrying patient. A statistically significant difference was observed for a cut-off value of 45 IU/l between normal and ectopic pregnancies. However, for this cut-off point, the measurement of plasma creatine kinase activity had a sensitivity of 0.50 and a specificity of 0.76 for the diagnosis of ectopic pregnancy. The positive predictive value was 0.69. Creatine kinase activity measurements are thus of no practical value in this particular population, in which an early and specific marker of ectopic implantation would be of paramount interest. The association of human chorionic gonadotrophin (HCG) determinations and ultrasound scanning of the pelvis still remain the best paraclinical support for an early diagnosis of ectopic implantation.      

Urinary cytokines following photodynamic therapy for bladder cancer. A preliminary report

This preliminary study was undertaken to test for the presence of urinary cytokines whose detection would provide evidence in support of the theory that photodynamic therapy (PDT) produces an immunologic response in patients treated for bladder cancer. Gamma interferon, interleukin 1-beta, interleukin 2, and tumor necrosis factor-alpha were assayed for in the urine of 4 patients treated with photodynamic therapy for bladder cancer, in 7 control patients undergoing transurethral surgical procedures, and in 5 healthy control subjects. Quantifiable concentrations of all cytokines, except gamma interferon, were measured in urine samples from the PDT patients with the highest light energies, while no urinary cytokines were found in the PDT patient who received the lowest light energy nor in any of the control subjects. These findings suggest that a local immunologic response may occur following PDT for bladder cancer.     

Legionella in cooling towers.

Legionellosis (Legionnaires' disease and Pontiac fever) outbreaks have been associated with aerosols ejected from contaminated cooling towers--wet-type heat rejection units (WTHRUs) used to dissipate unwanted heat into the atmosphere. The Vermont Department of Health undertook a program to inventory, inspect, and sample all WTHRUs in Vermont from April 1981 to April 1982. All WTHRUs were sampled for Legionella pneumophila and data were obtained for location, design, construction, and operating characteristics. Of the 184 WTHRUs operating, statistical analyses were performed on those 130 which were sampled for L. pneumophila only once during the study period. Of these, 11 (8.5%) were positive for L. pneumophila. Sources of makeup water and period of operation had significant association with the recovery of L. pneumophila. Five out of 92 towers (5.4%) utilizing surface water sources for cooling were positive for L. pneumophila, in contrast to 6 positive towers of the 38 units (15.8%) which obtained makeup water from ground water sources (p = .054 by chi-square test). Nearly 15% of the 54 units which operated throughout the year were positive, compared to less than 4% of the 76 towers operating seasonally (p = .03 by chi-square test). The mean pH of the cooling water in units where L. pneumophila was recovered (8.3) was significantly higher than the mean pH of 7.9 in units testing negative (p less than .05 by t-test). In addition, the mean log-transformed turbidity of positive towers, 0.03 nephelometric units (ntu), was significantly lower than the mean of log turbidity of negative towers, 0.69 ntu (p less than .02 by t-test).