Surgical Specialist, Urologists
11 years of experience
Video profile
Accepting new patients
Medical Center
Houston Urologic Assoc
6560 Fannin St
Ste 2030
Houston, TX 77030
713-790-9779
Locations and availability (2)

Education ?

Medical School Score Rankings
Stanford University (1999)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
Patients' Choice 5th Anniversary Award (2012 - 2013)
Patients' Choice Award (2008 - 2013)
Compassionate Doctor Recognition (2010 - 2013)
Appointments
The Methodist Hospital
Associations
American Board of Urology
American Urological Association

Affiliations ?

Dr. Gonzalez is affiliated with 9 hospitals.

Hospital Affilations

Score

Rankings

  • Texas Children's Hospital
    6621 Fannin St, Houston, TX 77030
    • Currently 1 of 4 crosses
  • St Luke's Episcopal Hospital
    Urology
    6720 Bertner Ave, Houston, TX 77030
    • Currently 1 of 4 crosses
  • The Methodist Hospital
    Urology
    6565 Fannin St, Houston, TX 77030
    • Currently 1 of 4 crosses
  • New York Presbyterian HospitalNew York Weill Cornell Center
  • Memorial Hospital For Cancer And Allied Diseases
  • Tx Womans Hosp
  • Cornell Medical Center
  • Nyp-Columbia
  • St. Luke's Episcopal Hospital (Texas Medical Center
  • Publications & Research

    Dr. Gonzalez has contributed to 40 publications.
    Title Uhplc Separation with Ms Analysis for Eight Carbonyl Compounds in Mainstream Tobacco Smoke.
    Date March 2010
    Journal Journal of Chromatographic Science
    Excerpt

    A method to quantify eight carbonyl compounds in mainstream cigarette smoke is presented using ultra-high pressure liquid chromatography (UHPLC). The combination of UHPLC and mass spectrometry (UHPLC-MS) dramatically reduces analysis times as compared to the current in-house high-performance liquid chromatography (HPLC)-UV method. In addition, improved detector selectivity and peak resolution are observed. Sample analysis times are reduced from 47 min with HPLC-UV to less than 5 min using this improved method. Atmospheric pressure chemical ionization, atmospheric pressure photo ionization, and electrospray ionization are directly compared to evaluate ionization potential and linear response range for the carbonyl 2,4-dinitrophenylhydrazine derivatives. Smoke extracts from three standard smoking protocols are analyzed by both UHPLC-MS and HPLC-UV for method comparison purposes.

    Title Leptin Regulation of Proangiogenic Molecules in Benign and Cancerous Endometrial Cells.
    Date January 2009
    Journal International Journal of Cancer. Journal International Du Cancer
    Excerpt

    Several proangiogenic/proinflammatory factors involved in endometrial cancer are regulated by leptin, but the signaling mechanisms responsible for these leptin-induced actions are largely unknown. Here, we report that in benign (primary and HES) and cancerous-endometrial epithelial cells (EEC) (An3Ca, SK-UT2 and Ishikawa), leptin in a dose-dependent manner regulates vascular endothelial growth factor, (VEGF); interleukin-1 beta, (IL-1beta); leukemia inhibitory factor, (LIF) and their respective receptors, VEGFR2, IL-1R tI and LIFR. Remarkably, leptin induces a greater increase in VEGF/VEGFR2 and LIF levels in cancer than in benign cells. However, IL-1beta was only increased by leptin in benign primary-EEC. Cancer-EEC expressed higher levels of leptin receptor (full-length OB-Rb and short isoforms) in contrast to benign primary-EEC. Leptin-mediated activation of JAK2 (janus kinase 2) was upstream to the activation of PI-3K (phosphatidylinositol-3 kinase) and/or MAPK (mitogen-activated protein kinase) signaling pathways. Leptin induction of cytokines/receptors generally involved JAK2 and MAPK activation, but PI-3K phosphorylation was required for leptin increase of LIF, IL-1/IL-1R tI. Leptin-mediated activation of mTOR (mammalian target of Rapamycin), mainly linked to MAPK, played a central role in leptin regulation of all cytokines and receptors. These results suggest that leptin's effects are cell-specific and could confer a proliferative or cell survival advantage or possibly promote endometrial thickness. Leptin's effects on proangiogenic molecules were more evident in malignant versus benign cells and may imply that there is an underlying shift in leptin-induced cell signaling pathways in endometrial cancer cells.

    Title Ablation of Leptin Signaling Disrupts the Establishment, Development, and Maintenance of Endometriosis-like Lesions in a Murine Model.
    Date March 2008
    Journal Endocrinology
    Excerpt

    Leptin, a 16-kDa cytokine, has been implicated in several reproductive processes and disorders. Notably, elevated leptin levels in the peritoneal fluid of women with mild endometriosis has been demonstrated, suggesting a role for this cytokine in the early stages of disease establishment. To gain insight into the functional significance of leptin during the initial requisite proliferative and neovascularization events involved in endometriosis, we investigated the effect of disruption of in vivo leptin signaling on the establishment and/or maintenance of an endometriosis-like lesion in a syngeneic immunocompetent mouse model of endometriosis. Findings of this study show that the disruption of leptin signaling by ip injection of the pegylated leptin peptide receptor antagonist (LPrA) impairs the establishment of endometriosis-like lesions (derived from uteri of C57BL/6 female siblings) and results in a reduction of viable organized glandular epithelium, vascular endothelial growth factor-A expression, and mitotic activity. LPrA treatment resulted in a significant reduction of microvascular density in endometriosis-like lesions after continuous and acute courses. Endometriosis-like lesions (derived from tissue with functional leptin receptor) of Lepr(db) hosts (nonfunctional leptin receptor) were phenotypically similar to those of LPrA-treated mice. Our results confirm that leptin signaling is a necessary component in lesion proliferation, early vascular recruitment, and maintenance of neoangiogenesis in a murine model of endometriosis.

    Title Combination of Alfuzosin and Sildenafil is Superior to Monotherapy in Treating Lower Urinary Tract Symptoms and Erectile Dysfunction.
    Date July 2007
    Journal European Urology
    Excerpt

    OBJECTIVES: This pilot study was undertaken to assess the efficacy and safety of the alpha(1)-blocker alfuzosin 10mg once daily (OD), the PDE-5 inhibitor sildenafil 25mg OD, and the combination of both on lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). MATERIAL AND METHODS: Men aged 50-76 yr with previously untreated LUTS and ED were randomized to receive alfuzosin (n=20), sildenafil (n=21), or the combination of both (n=21) for 12 wk. Changes from baseline in International Prostate Symptom Score (IPSS), voiding diary, maximum urinary flow rate (Qmax), postvoid residual urine (PVRU) volume, and erectile function domain of the International Index of Erectile Function (IIEF) were assessed at week 12. RESULTS: Improvement of IPSS was significant with the three treatments but greatest with the combination (-24.1%) compared with alfuzosin (-15.6%) and sildenafil (-11.8%) [corrected] alone (p<0.03). Frequency, nocturia, PVR, and Qmax were significantly improved with alfuzosin only and the combination. Improvement in IIEF was slight with alfuzosin (16.7%), marked with sildenafil (49.7%), and greatest with the combination (58.6%). Likewise, increases in the frequency of penetration (Q3) and of maintained erection (Q4) were greater with the combination therapy (65.2% and 68.2%, respectively) than with sildenafil (41.7% and 59.1%, respectively) and alfuzosin (27.3% and 33.3%, respectively) alone. All three treatments were well tolerated. CONCLUSIONS: In this pilot study, the combination of alfuzosin 10 mg OD and sildenafil 25 mg OD is safe and more effective than monotherapy with either agent to improve both voiding and sexual dysfunction in men with LUTS suggestive of BPH.

    Title The Evolution of Photoselective Vaporization Prostatectomy (pvp): Advancing the Surgical Treatment of Benign Prostatic Hyperplasia.
    Date January 2007
    Journal World Journal of Urology
    Title First-line Treatment for Symptomatic Benign Prostatic Hyperplasia: is There a Particular Patient Profile for a Particular Treatment?
    Date January 2007
    Journal World Journal of Urology
    Excerpt

    When the range of treatment options for benign prostatic hyperplasia (BPH) is as broad as the BPH spectrum of symptoms, how should urologists and their patients choose the best initial treatment? Treatment goals should include reducing both lower urinary tract symptoms and relieving associated morbidities, such as urinary retention, persistent gross hematuria, recurrent infections, bladder stones, or renal insufficiency-which are all indications for surgery. However, if one views BPH as a chronic and progressive disease, should a primary goal of BPH management be the prevention of the BPH-associated morbidities? The goal of this paper is to provide a literature update regarding various treatment options in the setting of initial treatment for symptomatic BPH. Novel approaches to BPH management are discussed. In all cases, the risks and benefits of each treatment need to be considered and discussed with the patient; the decision is ultimately up to the patient and his urologist.

    Title A Case of Incidental Adrenocortical Oncocytoma.
    Date January 2007
    Journal Nature Clinical Practice. Urology
    Excerpt

    BACKGROUND: A 39-year-old female presented with an incidentally discovered left adrenal mass. She denied any history of hypertension, headaches, palpitations, muscle weakness, bruising easily, or fatigue. Physical examination was unremarkable. INVESTIGATIONS: Physical examination, laboratory analyses, CT scan and MRI. DIAGNOSIS: Oncocytic adrenocortical tumor, or adrenal oncocytoma. MANAGEMENT: Adrenalectomy, gross and histopathologic examination, and follow-up radiologic imaging.

    Title Leptin Signaling Promotes the Growth of Mammary Tumors and Increases the Expression of Vascular Endothelial Growth Factor (vegf) and Its Receptor Type Two (vegf-r2).
    Date December 2006
    Journal The Journal of Biological Chemistry
    Excerpt

    To gain insight into the mechanism(s) by which leptin contributes to mammary tumor (MT) development we investigated the effects of leptin, kinase inhibitors, and/or leptin receptor antagonists (LPrA2) on 4T1 mouse mammary cancer cells in vitro and LPrA2 on 4T1-MT development in vivo. Leptin increases the expression of vascular endothelial growth factor (VEGF), its receptor (VEGF-R2), and cyclin D1 through phosphoinositide 3-kinase, Janus kinase 2/signal transducer and activator of transcription 3, and/or extracellular signal-activated kinase 1/2 signaling pathways. In contrast to leptin-induced levels of cyclin D1 the changes in VEGF or VEGF-R2 were more dependent on specific signaling pathways. Incubation of 4T1 cells with anti-VEGF-R2 antibody increased leptin-mediated VEGF expression suggesting an autocrine/paracrine loop. Pretreatment of syngeneic mice with LPrA2 prior to inoculation with 4T1 cells delayed the development and slowed the growth of MT (up to 90%) compared with controls. Serum VEGF levels and VEGF/VEGF-R2 expression in MT were significantly lower in mice treated with LPrA2. Interestingly, LPrA2-induced effects were more pronounced in vivo than in vitro suggesting paracrine actions in stromal, endothelial, and/or inflammatory cells that may impact the growth of MT. Although all the mechanism(s) by which leptin contributes to tumor development are unknown, it appears leptin stimulates an increase in cell numbers, and the expression of VEGF/VEGF-R2. Together, these results provide further evidence suggesting leptin is a MT growth-promoting factor. The inhibition of leptin signaling could serve as a potential adjuvant therapy for treatment of breast cancer and/or provide a new target for the designing strategies to prevent MT development.

    Title Refractory Overactive Bladder in Men: Update on Novel Therapies.
    Date October 2006
    Journal Current Urology Reports
    Excerpt

    Overactive bladder (OAB) in men is an entity that may be challenging to diagnose and treat, especially in the presence of bladder outlet obstruction. The application of oral medical treatments of lower urinary tract symptoms attributed to benign prostatic hyperplasia has traditionally utilized alpha-adrenergic blockers and 5alpha-reductase inhibitors. After failure of oral medical therapies, surgical options are traditionally offered. Even after surgical options are successful, lower urinary tract symptoms that are secondary to OAB persist. These patients merit a trial of antimuscarinic drugs. Additionally, certain patients with concomitant bladder outlet obstruction who have not been surgically relieved can still merit a trial of antimuscarinic drugs without significant risk of developing urinary retention. When these oral antimuscarinic drugs fail, options still remain for treating men with refractory OAB. Successful application of various diagnostic approaches and the initiation of conservative options as well as other options, such as neuromodulation for refractory urgency and urge incontinence, can help the patient. Finally, emerging data support the use of intradetrusor injections of botulinum toxin for refractory OAB.

    Title Is There a Role for Urodynamics in Chronic Nonbacterial Prostatitis?
    Date September 2006
    Journal Current Urology Reports
    Excerpt

    The etiology of chronic nonbacterial chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is unclear. That may be why treatment with antibiotics and anti-inflammatory drugs often fail. The use of urodynamic testing in evaluating any patient with both pelvic/perineal pain coexistent with voiding symptoms can help identify voiding dysfunction. If identified, urodynamic voiding disorders, such as bladder neck obstruction and pseudodyssynergia, should be specifically treated to ameliorate symptoms. Through more research of nonbacterial CP/CPPS, we will be able to further define the successful role of videourodynamics in men with this disease.

    Title Tadalafil for the Treatment of Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia.
    Date August 2006
    Journal Expert Opinion on Drug Metabolism & Toxicology
    Excerpt

    This article reviews the pharmacological properties of tadalafil and the current evidence supporting its use for treating symptomatic benign prostatic hyperplasia (BPH). The rationale for using tadalafil for BPH stems from the following three observations: first, the prevalence of lower urinary tract symptoms (LUTS), BPH and erectile dysfunction (ED) increases with age; second, phosphodiesterase-5 (PDE5) inhibition mediates smooth muscle relaxation in the lower urinary tract; and third, early clinical evidence demonstrates that PDE5 inhibitors such as tadalafil are successful in treating LUTS and ED. A shared pathophysiology makes PDE5 a promising target to treat both LUTS and ED. A recent randomised, controlled Phase II trial of tadalafil versus placebo for the treatment of symptomatic BPH revealed that tadalafil dosed once daily was well tolerated and demonstrated statistically significant and clinically meaningful efficacy in the treatment of LUTS secondary to BPH and improved erectile function in men with both LUTS and ED. The ability to treat both BPH and ED with one medication is noteworthy given the significant negative impact in quality-of-life measures these disorders have in ageing men. Careful patient selection and further trials are warranted.

    Title Urodynamic Predictors of Outcomes with Photoselective Laser Vaporization Prostatectomy in Patients with Benign Prostatic Hyperplasia and Preoperative Retention.
    Date August 2006
    Journal Urology
    Excerpt

    OBJECTIVES: To determine whether preoperative urodynamic parameters can predict the outcome in men in urinary retention and aid in counseling these men. METHODS: Forty men in urinary retention due to benign prostatic hyperplasia underwent photoselective laser vaporization prostatectomy (PVP). Preoperative urodynamic studies were used to identify the men with detrusor overactivity (DO) and impaired detrusor contractility (IDC). The International Prostate Symptom Score (IPSS), maximal flow rate, and postvoid residual urine volume were collected at 1, 3, 6, and 12 months after PVP. RESULTS: Of the 40 men, 8 (20%) had IDC and 30 had DO (75%) preoperatively. The men without preoperative DO had a significantly lower IPSS than those with preoperative DO at 1 month of follow-up. Men without preoperative IDC had a significantly lower IPSS and postvoid residual urine volume at the same point compared with men with preoperative IDC. The flow rate in men with preoperative IDC 1 and 6 months postoperatively was significantly lower than in men without preoperative IDC. CONCLUSIONS: Preoperative urodynamic parameters predict for outcome in men in urinary retention undergoing PVP. Men in urinary retention benefit from PVP with an improvement in both subjective and objective voiding function, regardless of the presence of DO or IDC. Postoperatively, patients with DO have more voiding symptoms than those without DO, and are almost twice as likely to require anticholinergics. Men without IDC have better IPSS, flow rates, and postvoid residual urine volumes compared with men with IDC. Of the 8 men with IDC, 3 required reoperation within the first year.

    Title Arteriovenous Malformation of Scrotum Causing Virtual Azoospermia.
    Date August 2006
    Journal Urology
    Excerpt

    We report a case of surgical correction of a scrotal arteriovenous malformation (AVM) that reversed severe oligospermia. A 31-year-old man was found to have virtual azoospermia and left scrotal swelling. The left scrotal mass was diagnosed as a varicocele, but the mass did not resolve after bilateral microsurgical varicocelectomies. Postoperative pelvic arteriography revealed a scrotal AVM that was subsequently embolized. With a microsurgical approach, the mass was excised. Surgical correction of the scrotal AVM resulted in marked improvement in his semen parameters. The effect of the AVM on spermatogenesis was most likely mediated by an elevation in scrotal temperature.

    Title Photoselective Laser Vaporization Prostatectomy in Men Receiving Anticoagulants.
    Date March 2006
    Journal Journal of Endourology / Endourological Society
    Excerpt

    BACKGROUND AND PURPOSE: Photoselective laser vaporization prostatectomy (PVP) with a high-power KTP laser is a hemostatic procedure for men with symptomatic benign prostatic hyperplasia (BPH). This study demonstrates the feasibility of PVP in men who are receiving anticoagulants. PATIENTS AND METHODS: Men treated with PVP for symptomatic BPH between July 2002 and September 2003 who were receiving anticoagulants (N=24) were reviewed retrospectively. Their mean age was 75 years, and the mean prostate volume was 82 cc (range 34-164 cc). Nine men (38%) were in retention, eight (33%) had had a myocardial infarction, seven (29%) had had a cerebrovascular accident, and seven had peripheral vascular disease. Of these men, 8 were on warfarin, 2 on clopidogrel, and 14 on aspirin. Men on warfarin discontinued the drug 2 days prior to surgery and restarted it the day after. The other two drugs were not discontinued. The PVP was performed with an 80 W KTP side-firing laser (Laserscope Greenlight PV) through a 23F continuous-flow cystoscope with normal saline as the irrigant. RESULTS: The mean operative time was 101 minutes. No transfusions were required. Most (22; 92%) of the men were discharged without a catheter. The serum hematocrit did not change significantly (40.0% to 38.3%). The International Prostate Symptom Score decreased to 13.6, 10.9, 9.7, and 9.5 at 1, 3, 6, and 12 months from a mean of 18.7 preoperatively. The Qmax increased from 9.0 mL/sec preoperatively to 15.1, 16.3, 20.9, and 20.1 mL/sec at 1, 3, 6, and 12 months. No patients had clinically significant hematuria postoperatively, and none suffered clot retention. CONCLUSIONS: Photoselective laser vaporization prostatectomy is a suitable treatment option in men being treated with anticoagulants, who are at high risk for clinically significant bleeding.

    Title Prostate-specific Antigen Screening in a High-risk Population: Lessons from the Community and How They Relate to Large-scale Population-based Studies.
    Date November 2005
    Journal Urology
    Excerpt

    OBJECTIVES: To estimate the incidence of prostate cancer among African-American men and Caribbean immigrants to the United States, to assess the applicability of large-scale prostate screening trials to a community screening program, and to recruit unscreened men. METHODS: African-American and Caribbean-American men were targeted with a community-based prostate cancer screening program in Jamaica, New York. Serum prostate-specific antigen determination and digital rectal examination were used to determine abnormal findings. The incidence of an abnormal screening examination was used to project the incidence of prostate cancer, which was compared with that in other reported trials. RESULTS: The projected incidence of prostate cancer among African-Americans and Caribbean-Americans older than 50 years was 8% and 7%, respectively, similar to that reported in other trials of African-American men. The projected incidence of prostate cancer in Caribbean-American men aged 40 to 49 years was 1%, the same as the high rate reported among Caribbean men. As in other trials, a family history of prostate cancer and age were strong predictors of abnormal findings. Of the recruited men older than 50 years, 58% had never been screened compared with 42% nationally. CONCLUSIONS: Large population-based screening trials have identified ethnic groups at high risk of prostate cancer. This trial detected high rates of abnormal screening findings by targeting ethnicity. The incidence of an abnormal examination was high in Caribbean-American men younger than 50 years old. Finally, this trial successfully recruited underscreened men.

    Title Chronic Prostatitis and Sensory Urgency: Whose Pain is It?
    Date January 2005
    Journal Current Urology Reports
    Excerpt

    Difficulties encountered in diagnosing and effectively treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is frustrating for clinicians and patients. Scientific evidence cannot establish an exact relationship between the prostate and the symptoms of CP/CPPS, and the prostate continues to be the diagnosis of convenience in this complex syndrome in men. However, if the pain is not the prostate's, whose pain is it? A heterogeneous group of insults can result in a common neurogenic pain response, resulting in recurring pain and voiding or sexual dysfunction. To add to this dilemma, certain life-threatening diagnoses, such as carcinoma-in-situ, is in the differential diagnosis and must be excluded. Urodynamics may be useful in evaluating and treating patients whose voiding symptoms predominate. However, many patients with CP/CPPS will not have measurable abnormalities by conventional methods and likely suffer from a functional somatic syndrome that is best treated with a multimodality approach.

    Title Leptin-induced Increase in Leukemia Inhibitory Factor and Its Receptor by Human Endometrium is Partially Mediated by Interleukin 1 Receptor Signaling.
    Date August 2004
    Journal Endocrinology
    Excerpt

    Leptin and leukemia inhibitory factor (LIF) have been implicated as important mediators of implantation. The present study was designed to investigate whether leptin can directly regulate the expression of LIF and its receptor (LIF-R) in human endometrial cells and/or whether leptin-induced effects are linked to, or regulated in part by IL-1 signaling. Primary endometrial cells and endometrial epithelial cell lines (HES and Ishikawa cells) were cultured for 24-48 h in a medium containing insulin (5 microg/ml) and leptin (3, 10, and 62 nm) or IL-1beta (0.6, 3, and 10 nm) in the presence or absence of cytokines and/or receptor antagonists. The endpoints included phosphorylation of signal transducer and activator of transcription 3 (STAT3) and the relative levels of LIF, LIF-R, IL-1beta, IL-1 receptor antagonist (IL-1Ra) and IL-1 receptor type I (IL-1R tI) as determined by ELISA or Western blotting techniques. Leptin treatment increases the level of phosphorylated STAT3, LIF-R, and LIF. Leptin also increases the levels of IL-1 ligand, receptor, and antagonist as was previously reported. Blockade of OB-R with antibodies or with a specific OB-R inhibitor (leptin peptide antagonist-2) abrogated leptin-induced effects, suggesting that leptin binding to its receptor activates Janus kinase 2/STAT3 signaling. Treatment of endometrial cells with IL-1beta also results in elevated levels of LIF-R. Interestingly, the inhibition of IL-1R tI with a specific antibody or with IL-1Ra negatively affects both leptin-induced and IL-1-induced effects on LIF-R levels. Abnormal endometrial LIF expression has been associated with human infertility and leptin has profound effects on the levels of LIF, IL-1, and their cognate receptors in vitro. Thus, it is tempting to speculate that leptin's role in vivo could include the regulation of other key cytokines to be fundamental to endometrial receptivity during implantation (i.e. LIF and IL-1).

    Title How Do Transurethral Needle Ablation of the Prostate and Transurethral Microwave Thermotherapy Compare with Transurethral Prostatectomy?
    Date November 2003
    Journal Current Urology Reports
    Title Expression of Steroidogenic Acute Regulatory Protein in the Human Corpus Luteum Throughout the Luteal Phase.
    Date December 2001
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    The expression of the steroidogenic acute regulatory protein (StAR) in the human corpus luteum (CL) was examined throughout the luteal phase. The primary 1.6-kb StAR transcript was in greater abundance in early (3.1-fold) and mid (2.2-fold) luteal phase CL compared with late luteal phase CL. The larger StAR transcript (4.4 kb) was found in early and midluteal phase CL, but was not detected in late luteal phase specimens. Mature StAR protein (30 kDa) was present in lower amounts within late CL compared with early and midluteal phase CL. The StAR preprotein (37 kDa) was also detected in greater abundance in early and midluteal CL. Immunohistochemistry revealed that StAR staining was most prominent in thecal-lutein cells throughout the luteal phase. The intensity of the signal for StAR exhibited significant changes throughout the luteal phase, being most intense during the midluteal phase and least during the late luteal phase. Plasma progesterone concentrations were highly correlated (r = 0.73 and r = 0.79) with luteal expression of the preprotein and mature StAR isoforms, respectively, throughout the luteal phase. To examine the LH dependency of StAR expression, the GnRH antagonist, Cetrorelix, was administered during the midluteal phase. Cetrorelix caused a decline in serum LH levels within 2 h, which, in turn, caused a pronounced decline in plasma progesterone within 6 h. The StAR 4.4-kb transcript was not detectable, and the 1.6-kb transcript was reduced by approximately 50% within 24 h of Cetrorelix treatment. The mature 30-kDa StAR protein level declined approximately 30% after Cetrorelix treatment. We conclude that 1) StAR mRNA and protein are highly expressed in early and midluteal phase CL; 2) StAR protein is present in both thecal-lutein and granulosa-lutein cells throughout the luteal phase; 3) StAR protein levels in the CL are highly correlated with plasma progesterone levels; 4) declining StAR mRNA and protein levels are characteristic of late luteal phase CL; and 5) suppression of LH levels during the midluteal phase results in a marked decline in plasma progesterone and a diminished abundance of StAR transcripts in the CL without a corresponding significant decline in StAR protein. Collectively, these data are consistent with the idea that StAR gene expression is a key determinant of luteal progesterone during the normal menstrual cycle. However, the pharmacologically induced withdrawal in the midluteal phase of LH support diminishes luteal progesterone output by mechanisms others than reduced StAR protein levels.

    Title The Effect of Portuguese Man-of-war (physalia Physalis) Venom on Calcium, Sodium and Potassium Fluxes of Cultured Embryonic Chick Heart Cells.
    Date March 2000
    Journal Toxicon : Official Journal of the International Society on Toxinology
    Excerpt

    Portuguese Man-of-war venom markedly increases calcium (45Ca2+) influx into primary, cultured, embryonic chick heart cells. This action is dose-dependent, but is unaffected by organic calcium blockers (diltiazem, verapamil, nifedipine, nimodipine and mibefradil). On the other hand, certain trivalent (La3+, Gd3+) and divalent (Zn2+, Ni2+, Cu2+, Mn2+) metals inhibit venom-induced calcium influx. Sodium (22Na+) influx into chick heart cells is also significantly increased by Man-of-war venom. Flecainide does not block venom-induced sodium influx. The efflux of the potassium analogue, 86Rb+, from heart cells is also significantly increased by the venom. The venom, however, has little or no effect on rubidium (86Rb+) or 2-deoxy-D-[2-3H] glucose influx.

    Title Physiological Problems Associated with Wearing Nbc Protective Clothing During Cold Weather.
    Date March 2000
    Journal Aviation, Space, and Environmental Medicine
    Excerpt

    This report considers how thermal balance of soldiers wearing nuclear, biological and chemical (NBC) protective clothing in combination with the Extreme Cold Weather Clothing System (ECWCS) is affected during work in cold weather. A review of published reports concerning physiological consequences of wearing NBC protective clothing during cold exposure was completed. The findings reported in the experimental literature were too limited to adequately forecast the effects of adding NBC clothing to ECWCS. To remedy the information gap, simulation modeling was employed to predict body temperature changes during alternating bouts of exercise and rest throughout 8 h of exposure to three different severely cold conditions. Published findings indicate that NBC protective clothing may inadequately protect against hand and finger cooling, especially during rest following strenuous activity. No evidence substantiates suggestions that wearing NBC protective masks increases susceptibility to facial frostbite. Collectively, the limited experimental work and the results of simulation modeling argue against any increased risk of hypothermia associated with wearing NBC protective clothing while working in the cold. However, wearing NBC protective clothing during strenuous activity in cold weather may increase the risk of hyperthermia, and cause sweat accumulation in clothing which may compromise insulation and increase the risk of hypothermia during subsequent periods of inactivity.

    Title A Quantitative Evaluation of Alpha1, Alpha4, Alphav and Beta3 Endometrial Integrins of Fertile and Unexplained Infertile Women During the Menstrual Cycle. A Flow Cytometric Appraisal.
    Date November 1999
    Journal Human Reproduction (oxford, England)
    Excerpt

    The expression of integrin molecules alpha1beta1, alpha4beta1 and alphaVbeta3 within endometrial tissue has been proposed as a marker of uterine receptivity during the implantation window. The present investigation examines by flow cytometric analysis the concentrations of alpha1, alpha4, alphaV and beta3 integrin subunits in endometrial stromal (ESC) and epithelial cells (EEC) in two groups of women throughout the menstrual cycle: normal fertile women (n = 27) and women with unexplained infertility (n = 26). Integrin concentrations in endometrial cells were calculated in relative fluorescence units against a negative cellular control. The assessment of integrin subunits detected the protein in ESC and EEC from the late proliferative to the late secretory phase. In both groups of women, the alpha1 was the highest integrin expressed in ESC and EEC throughout the menstrual cycle. All women exhibited low concentrations of alpha4-EEC at the time of the implantation window. Infertile women expressed lower concentrations of the alpha4-ESC during the proliferative and early secretory phase while lower concentrations of the alpha1-ESC were seen during the late secretory phase. Interestingly, the infertile women expressed lower concentrations of beta3-EEC in the early, mid-secretory and late secretory phases (P < 0.05). Infertile women also expressed lower concentrations of alpha1-EEC and alphaV-EEC during the late secretory phase (P < 0.05). It can be concluded that the quantitative determination of beta3-EEC by flow cytometry confirmed its potential feature as a marker of endometrial receptivity at the time of the implantation window. In addition, the defective expression of the alpha1-ESC found in the late secretory phase might be associated with the poor fertility outcome of women with unexplained infertility.

    Title Applications of Predictive Environmental Strain Models.
    Date March 1997
    Journal Military Medicine
    Excerpt

    Researchers at the U.S. Army Research Institute of Environmental Medicine have developed and validated numerical models capable of predicting the extent of physiologic strain and adverse terrain and weather-related medical consequences of military operations in harsh environments. A descriptive historical account is provided that details how physiologic models for hot and cold weather exposure have been integrated into portable field advisory devices, computer-based meteorologic planning software, and combat-oriented simulation systems. It is important that medical officers be aware of the existence of these types of decision support tools so that they can assure that outputs are interpreted in a balanced and medically realistic manner. Additionally, these modeling applications may facilitate timely preventive medicine planning and efficient dissemination of appropriate measures to prevent weather- and altitude-related illnesses and performance decrements. Such environmental response modeling applications may therefore be utilized to support deployment preventive medicine planning by field medical officers.

    Title Metabolic and Thermal Adaptations from Endurance Training in Hot or Cold Water.
    Date July 1995
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    Metabolic and thermal adaptations resulting from endurance training in hot vs. cold water were compared. It was hypothesized that training in hot water would have greater effects on muscle glycogen use and blood lactate accumulation during exercise than training in cold water. Eighteen men exercised at 60% of maximal oxygen uptake while immersed in hot (n = 9) or cold water (n = 9) for 1 h, 5 days/wk, for 8 wk. Training in hot water (35 degrees C) potentiated body temperature increases during exercise, and training in cold water (20 degrees C) blunted body temperature increases during exercise. Before and after training, cardiorespiratory and thermoregulatory responses and muscle glycogen and blood lactate changes were assessed during a 1-h exercise trial in hot water and, on a separate day using the same intensity, in cold water. Oxygen uptake was similar for all trials, averaging 2.0 +/- 0.1 l/min. It was observed that 1) training reduced glycogen use and lactate accumulation during exercise, with no difference between cold and hot water training groups in the magnitude of this effect; 2) lactate accumulation during exercise was the same in hot water as in cold water; and 3) skin temperature decreased more rapidly during cold-water exercise after than before training, with no difference between cold and hot water training groups in the magnitude of this effect. Thus, exercise-induced body temperature increases are not an important stimulus for glycogen-sparing effects and blunted lactate accumulation associated with endurance training.

    Title An Enzyme Immunoassay for Determining Total Thyroxine in Human Serum Using an Ultramicroanalytical System.
    Date July 1991
    Journal Clinica Chimica Acta; International Journal of Clinical Chemistry
    Excerpt

    A simple, rapid competitive ultramicroElisa assay has been developed for the measurement of total thyroxine (T4) using only 10 microliters of serum. Our novel UME is based on fluorescence measurements of the hydrolytic product of 4-methyl-umbelliferyl-beta-D-galactopyranoside. T4-beta-Galactosidase conjugates and monoclonal antibodies were immobilized on polyvinyl plates, with sodium salicylate used as a blocking agent for thyroxine binding protein. The analytical steps were carried out using a semiautomated batch-assay system entitled "SUMA" (system for ultramicroanalysis). The T4 assay was completed in 2 h, with a measuring range of 24-386 nmol/L. The intra-assay coefficient of variation (CV) was 4.6-6.9% and the inter-assay C.V. 9.0-12.4% depending on the T4 concentrations. Percentage recovery ranged from 99.2-111%. Regression analysis showed a good correlation with an established radioimmunoassay (n = 121, r = 0.946, P less than 0.01).

    Title Human Intravascular Immunoglobulin Responses to Exercise-heat and Hypohydration.
    Date September 1989
    Journal Aviation, Space, and Environmental Medicine
    Excerpt

    Several investigators have suggested that prolonged exercise and hypohydration alter the intravascular mass of immunoglobulins. Those studies, however, have methodological concerns which make generalizations from their data very tenuous. This study examined the effects of prolonged moderate intensity exercise in the heat and hypohydration on changes in the intravascular mass of immunoglobulins. Five heat-acclimated males attempted two Heat Stress Tests (HSTs). One HST was completed when subjects were euhydrated and the other HST when subjects were hypohydrated (-5% from base line body weight). The HSTs consisted of 30 min of rest in a 20 degrees C antechamber, followed by a 120-min exposure (2 repeats of 15 min rest and 45 min walking) in a hot (35 degrees C, 45% rh) environment. The following observations were made concerning immunoglobulin responses to hypohydration and exercise-heat stress: a) the changes in concentrations (mg.dl-1) of the measured immunoglobulins were often a reflection of changes in the plasma volume; b) hypohydration increased the intravascular mass (g) of the complement enzyme C3 during resting conditions, but did not alter the intravascular mass of IgG, IgA, and IgM, and c) prolonged treadmill exercise in the heat, when either euhydrated or hypohydrated, did not alter the intravascular mass of IgG, IgA, IgM, and C3. These data indicate that the intravascular mass of immunoglobulins does not change during prolonged moderate intensity exercise in the heat, and that hypohydration results in a translocation of C3 to the intravascular space. In addition, these data indicate that immunoglobulins do not provide a stress index for hypohydration.

    Title Control of Thermoregulatory Sweating During Exercise in the Heat.
    Date September 1989
    Journal The American Journal of Physiology
    Excerpt

    The purposes of this study were the following: 1) to determine whether erythrocyte infusion alters the control of thermoregulatory sweating and 2) to demonstrate how increases and decreases of both plasma tonicity and blood volume influence the thermoregulatory control parameters of threshold temperature and sweating sensitivity. Six non-heat-acclimated and five heat-acclimated males attempted heat stress tests (HSTs) both before and shortly after (48-96 h) autologous erythrocyte infusion. The non-heat-acclimated subjects were euhydrated for both HSTs, whereas the heat-acclimated subjects were studied in a euhydrated and a hypohydrated (-5% body wt) condition both pre- and postinfusion (500 ml of solution containing approximately 60% hematocrit of autologous erythrocytes). The HSTs consisted of treadmill exercise (335 W.m-2) in a hot (35 degrees C, 45% relative humidity) environment, and esophageal temperature and local sweating rate were continuously measured during 25 min of exercise. These experiments resulted in a matrix of conditions where both plasma tonicity and blood volume were increased or decreased relative to control conditions (euhydration, preinfusion). The findings concerning thermoregulatory sweating during exercise in the heat were summarized as follows: 1) acute polycythemia decreases the threshold temperature and increases the sweating sensitivity, 2) both threshold temperature and sweating sensitivity are increased or decreased from control levels dependent on the combined influence of plasma tonicity and blood volume, and 3) equations are presented that describe how plasma tonicity and blood volume alter threshold temperature and sweating sensitivity values.

    Title Polycythemia and Hydration: Effects on Thermoregulation and Blood Volume During Exercise-heat Stress.
    Date October 1988
    Journal The American Journal of Physiology
    Excerpt

    We studied the effects of autologous erythrocyte infusion on thermoregulation and blood volume during exercise in the heat. Specifically, we wanted to determine whether heat-acclimated subjects, as well as hypohydrated subjects, would have a thermoregulatory advantage from acute polycythemia during exercise in the heat. Five heat-acclimated males attempted four heat stress tests (HSTs): two pre- and two postinfusion. Autologous erythrocyte infusion was accomplished with 500 ml of a NaCl-glucose-phosphate solution containing approximately 60% hematocrit. One HST, both pre- and postinfusion, was done while subjects were euhydrated, and one HST was done while subjects were hypohydrated (-5% of body wt). After 30 min of rest in a 20 degrees C antechamber, the HST consisted of a 120-min exposure (2 repeats of 15 min rest and 45 min walking) in a hot (35 degrees C, 45% relative humidity) environment. The findings concerning acute polycythemia in heat-acclimated subjects are summarized: 1) polycythemia increased (P less than 0.05) sweating rate and reduced (P less than 0.01) core temperature during exercise-heat stress for both euhydrated and hypohydrated subjects; 2) the erythrocyte infusion caused an increased (P less than 0.05) plasma volume and increased (P less than 0.01) blood volume; 3) the increased plasma volume was associated with an increased (P less than 0.05) total circulating protein mass; 4) the increased total circulating protein mass tended to better maintain plasma volume when hypohydrated; and 5) heat acclimation may increase extravascular protein mass. Therefore, it is concluded that erythrocyte infusion provides a thermoregulatory advantage during exercise in the heat for heat acclimated subjects when both euhydrated and hypohydrated.

    Title Autologous Red Blood Cell Reinfusion: Effects on Stress and Fluid Regulatory Hormones During Exercise in the Heat.
    Date March 1988
    Journal Aviation, Space, and Environmental Medicine
    Excerpt

    This study assessed the effects of induced erythrocythemia on stress and fluid regulatory hormones during walking exercise in the heat. Six unacclimated male subjects received approximately 600 ml of a sterile saline solution containing 50% volume-to-volume of autologous erythrocytes. Three heat stress tests (HSTs) were attempted: one approximately 2 weeks prior to the reinfusion procedure, a second 48 h after the reinfusion procedure, and a third 1 week later, corresponding to 9 d subsequent to reinfusion. Each HST comprised three consecutive 45-min exercise and 15-min rest intervals (VO2 approximately 2.0 L.min-1, 1.56 m.s-1, 6% incline, 35 degrees C, 45% rh). Blood was withdrawn before the HST and 30 min into each exercise (EX) bout. In all three HST's plasma cortisol (PC) levels were significantly (p less than 0.01) reduced during the first EX bout compared to preexercise levels, and then progressively increased during the second and third EX intervals during HST 1. During HST 2 (48 h postinfusion), however, PC levels were significantly (p less than 0.05) reduced in two blood samples (EX 2, 3) compared to the same blood samples from HST-1 (preinfusion). Plasma renin activity (PRA) and aldosterone (ALD) were significantly (p less than 0.01) increased by the exercise/heat stress, but were unaffected by erythrocythemia either 48 h or 9 d subsequent to reinfusion. PRA and ALD were correlated (r = 0.84, p less than 0.001) under all conditions. We concluded from this study that acutely induced erythrocythemia reduced the stress response to consecutive exercise/heat intervals as manifested in PC responses during HST 2.(ABSTRACT TRUNCATED AT 250 WORDS)

    Title Ct Findings in Gastrointestinal Perforation by Ingested Fish Bones.
    Date February 1988
    Journal Journal of Computer Assisted Tomography
    Excerpt

    Preoperative diagnosis of complications due to foreign bodies in the gastrointestinal tract is uncommon by conventional radiographic methods. We present two cases of gastric and duodenal perforation secondary to fish bone ingestion, diagnosed preoperatively by CT.

    Title Elite Special Forces: Physiological Description and Ergogenic Influence of Blood Reinfusion.
    Date December 1987
    Journal Aviation, Space, and Environmental Medicine
    Excerpt

    We measured the physical exercise capabilities of U.S. Army Special Forces soldiers (male) and determined the subsequent ergogenic influence of autologous blood reinfusion. Twelve subjects (Ss) completed maximal exercise treadmill testing in a comfortable (Ta = 20 degrees C, Tdp = 9 degrees C) environment. Six Ss were later transfused with a 600 ml autologous red blood cell (50% Hct) NaCl glucose-phosphate solution and completed identical maximal exercise tests 3 and 10 d posttransfusion. Pretransfusion, the 12 Ss had a maximal oxygen uptake (VO2max) of 4.36 +/- 0.56 L . min-1 and 55 +/- 4 ml . kg-1 . min-1 with a heart rate of 188 +/- 10 b . min-1 and ventilatory equivalent for oxygen of 37 +/- 3. For the 6 reinfused Ss, hemoglobin and red cell volume (RCV) increased by 10% (p less than 0.05) and 11% (p less than 0.05), respectively, posttransfusion. Reinfusion increased (p less than 0.05) VO2max from 4.28 +/- 0.22 L . min-1 (54 +/- 5 ml . kg-1 . min-1) to 4.75 +/- 0.42 L . min-1 (60 +/- 6 ml . kg-1 . min-1) and 4.63 +/- 0.21 L . min-1 (59 +/- 6 ml . kg-1 . min-1) at 3 and 10 d posttransfusion, respectively. No significant relationship was found between the individual change in RCV and VO2max values pre- to posttransfusion. We conclude that Special Forces soldiers have high levels of aerobic fitness that can be further increased by blood reinfusion for at least 10 d.

    Title Local Sweating and Cutaneous Blood Flow During Exercise in Hypobaric Environments.
    Date August 1987
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    The effect of acute hypobaric hypoxia on local sweating and cutaneous blood flow was studied in four men and four women (follicular phase of menstrual cycle), who exercised at 60% of their altitude-specific peak aerobic power for 35 min at barometric pressures (PB) of 770 Torr (sea level), 552 Torr (2,596 m), and 428 Torr (4,575 m) at an ambient temperature of 30 degrees C. We measured esophageal temperature (Tes), mean skin temperature (Tsk, 8 sites), and local sweating (ms) from dew-point sensors attached to the skin at the chest, arm, and thigh. Skin blood flow (SkBF) of the forearm was measured once each minute by venous occlusion plethysmography. There were no gender differences in the sensitivity (slope) or the threshold of either ms/Tes or SkBF/Tes at any altitude. No change in the Tes for sweating onset occurred with altitude. The mean slopes of the ms/Tes relationships for the three regional sites decreased with increasing altitude, although these differences were not significant between the two lower PBS. The slope of SkBF/Tes was reduced in five of the eight subjects at 428 Torr. Enhanced body cooling as a response to the higher evaporative capacity of the environment is suggested as a component of these peripheral changes occurring in hypobaric hypoxia.

    Title Influence of Polycythemia on Blood Volume and Thermoregulation During Exercise-heat Stress.
    Date June 1987
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    We studied the effects of autologous erythrocyte infusion on blood volume and thermoregulation during exercise in the heat. By use of a double-blind design, nine unacclimated male subjects were infused with either 600 ml of a NaCl-glucose-phosphate solution containing a approximately 50% hematocrit (n = 6, reinfusion) or 600 ml of this solution only (n = 3, saline). A heat stress test (HST) was attempted approximately 2-wk pre- and 48-h postinfusion during the late spring months. After 30 min of rest in a 20 degrees C antechamber, the HST consisted of a 120-min exposure (2 repeats of 15 min rest and 45 min treadmill walking) in a hot (35 degrees C, 45% rh) environment while euhydrated. Erythrocyte volume (RCV, 51Cr) and plasma volume (PV, 125I) were measured 24 h before each HST, and maximal O2 uptake (VO2max) was measured 24 h after each HST. Generally, no significant effects were found for the saline group. For the reinfusion group, RCV (11%, P less than 0.01) and VO2max (11%, P less than 0.05) increased after infusion, and the following observations were made: 1) the increased RCV was associated with a reduction in PV to maintain the same blood volume as during the preinfusion measurements; 2) polycythemia reduced total circulating protein but did not alter F-cell ratio, plasma osmolality, plasma protein content, or plasma lactate at rest or during exercise-heat stress; 3) polycythemia did not change the volume of fluid entering the intravascular space from rest to exercise-heat stress; and 4) polycythemia tended to reduce the rate of heat storage during exercise-heat stress.

    Title Effect of Portuguese Man-of-war Venom on Isolated Vascular Segments.
    Date February 1986
    Journal The Journal of Pharmacology and Experimental Therapeutics
    Excerpt

    The purpose of this study was to characterize the mode of action of nematocyst venom from the Portuguese man-of-war (Physalia physalis) on isolated rabbit arterial ring segments, and to see if these in vitro effects were similar to those observed in the intact skeletal muscle vasculature of the dog (see Loredo et al., J. Pharmacol. Exp. Ther. 232: 301-304, 1985). The venom (0.021-4.28 micrograms/ml) produced dose-dependent relaxations of norepinephrine precontracted arterial segments from various vascular beds. Venom-induced relaxations were blocked by sodium meclofenamate (10-20 micrograms/ml), but not by atropine (6 micrograms/ml), propranolol (4-12 micrograms/ml) or quinacrine (2-4 X 10(-5) M). These results were similar to those observed in the intact skeletal muscle vascular bed of the dog and further implicate the stimulation of endogenous prostaglandin synthesis as the mechanism by which P. physalis venom dilates vasculature.

    Title Vascular Effects of Physalia Physalis Venom in the Skeletal Muscle of the Dog.
    Date March 1985
    Journal The Journal of Pharmacology and Experimental Therapeutics
    Excerpt

    The purpose of this study was to characterize the mode of action of the venom from Portuguese man-of-war (Physalia physalis) on the skeletal muscle vascular bed of dogs anesthetized with sodium pentobarbital (35 mg/kg). Venous outflow and the blood pressure difference across the hind-limb vascular bed were used to calculate changes in resistance due to close arterial injections of the venom (0.001-1 microgram/kg). The venom consistently produced dilations that were blocked by sodium meclofenamate (5 mg/kg). Atropine (1 mg/kg), propranolol, phentolamine, cimetidine (each 2 mg/kg) or tripelennamine (2.5 mg/kg) had no significant blocking effect. The venom also produced transient dilations on vascular beds predilated with histamine or prostaglandin E1, or preconstricted with norepinephrine (each 0.01 microgram/kg) or by sympathetic stimulation (12 V, 20 Hz). These data suggest that Physalia venom dilates skeletal muscle vasculature primarily by stimulation of endogenous prostaglandin synthesis.

    Title Spectral Analysis of Doppler Ultrasonic Flow Signals by a Personal Computer.
    Date March 1984
    Journal Computers in Biology and Medicine
    Excerpt

    This paper describes a method of performing spectral analysis on Doppler acoustical signals from peripheral blood vessels with the use of an Apple II plus personal computer. Digitization is accomplished with a commercially available analog-to-digital converter. The data are transformed with a fast Fourier technique, and the resultant information is plotted by an inexpensive X-Y plotter and/or on a television receiver.

    Title Tissue Pressure and Plasma Oncotic Pressure During Exercise.
    Date March 1984
    Journal Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology
    Excerpt

    Six healthy male subjects exercised on a cycle ergometer for 3 min for assessment of forces involved in transvascular fluid shift during intense exercise. The work load was at 105% of peak O2 uptake of the subjects. This caused a 17.2 +/- 1.2% reduction in plasma volume. The plasma volume loss was associated with an increase in plasma sodium, from 142.6 +/- 0.5 to 148.1 +/- 1.0 meq X 1(-1) (P less than 0.005); chloride, from 101.8 +/- 0.6 to 104.6 +/- 0.9 meq X 1(-1) (P less than 0.005); lactate, from 1.4 +/- 0.2 to 14.0 +/- 1.5 meq X 1(-1) (P less than 0.005); and osmolality, from 283 +/- 2 to 299 +/- 3 mosmol X kg-1 H2O (P less than 0.005) within 2 min after cessation of exercise. Plasma protein increased from 7.0 +/- 0.2 to 8.1 +/- 0.3 g X dl-1 (P less than 0.005), and plasma colloid osmotic pressure from 25.1 +/- 0.6 to 30.6 +/- 1.4 mmHg (P less than 0.005) after exercise. Interstitial fluid pressure in the exercising vastus lateralis muscle increased from a base-line value (SE) of -1.0 +/- 0.9 to + 1.5 +/- 1.1 cmH2O, 14 min after the end of exercise (P less than 0.05). Interstitial fluid pressure of the triceps brachii (inactive) did not change significantly after exercise. Our data suggest that increased transvascular colloid osmotic pressure and elevation of interstitial fluid pressure become increasingly important in preventing loss of plasma volume during maximal exercise.

    Title The Rabbit Ear As a Temperature Sensor.
    Date October 1971
    Journal Life Sciences. Pt. 1: Physiology and Pharmacology
    Title Phosphodiesterase Type 5 Inhibitors for the Treatment of Male Lower Urinary Tract Symptoms.
    Date
    Journal Reviews in Urology
    Excerpt

    Both lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) and erectile dysfunction have a very high prevalence among aging men, and there is some clinical evidence that they may share a common pathophysiology. Consequently, several preliminary studies of phosphodiesterase type 5 inhibitors-sildenafil and tadalafil-have recently been conducted in men with concomitant erectile dysfunction and lower urinary tract symptoms to determine whether these agents are effective for the treatment of symptomatic BPH. These studies have demonstrated efficacy, both alone and in combination with an alpha-blocker, in treating lower urinary tract symptoms along with sexual dysfunction. However, larger-scale randomized studies are necessary to determine long-term safety, efficacy, and cost effectiveness.

    Title Chronic Pelvic Pain Syndrome and the Overactive Bladder: the Inflammatory Link.
    Date
    Journal Current Urology Reports
    Excerpt

    Although the causes of chronic prostatitis/chronic pelvic pain syndrome, painful bladder syndrome/interstitial cystitis, and overactive bladder remain unclear, inflammation may explain some of the causative and propagating features. Cytokines may play a role by recruiting inflammatory cells and ultimately in inducing symptoms. This paper reviews the role of cytokines in the pathophysiology of chronic prostatitis/chronic pelvic pain syndrome, overactive bladder, and painful bladder syndrome/interstitial cystitis.


    Similar doctors nearby

    Dr. Sebastian Ciancio

    Urology
    15 years experience
    Houston, TX

    Dr. Harvey Klein

    General Practice
    42 years experience
    Houston, TX

    Dr. Karen Delhey

    General Practice
    24 years experience
    Houston, TX

    Dr. Timothy Bolton Boone

    General Practice
    25 years experience
    Houston, TX

    Dr. Mark Sutton

    General Practice
    18 years experience
    Houston, TX

    Dr. Michael Coburn

    General Practice
    28 years experience
    Houston, TX
    Search All Similar Doctors