The role of α-adrenergic receptors in exercise-induced bronchoconstriction (EIB) was studied. 9 asthmatic patients with a marked degree of EIB (group I) and 6 asthmatic patients with no or a less severe EIB (group II) were investigated and compared with 8 healthy control persons. Pulse rate, airway resistance and end-expiratory thoracic gas volume were measured at rest and immediately and 15 min after exercise. Group I subjects showed a significant inhibition of EIB after α-adrenergic blockade with phentolamine (10 mg as aerosol) and after cholinergic blockade with an atropine-ester (60 mg as aerosol). In 7 of 9 patients who had received phentolamine, and in 3 of 6 patients who had received atropine-ester, the EIB was completely suppressed. In group II the administration of propranolol (40 mg orally) produced a significant increase in EIB. The effect of propranolol could be inhibited by the addition of α-adrenergic blockade with phentolamine (10 mg as aerosol). The control subjects had no measurable EIB, even after the administration of propranolol (40 mg orally). It is concluded that, in addition to the vagal system, an activated α-adrenergic system is involved in the phenomenon of EIB.

No abstract

Plasma nor-epinephrine (NE) and epinephrine (E) levels at rest and immediately after exercise were estimated in 8 patients with asymptomatic extrinsic allergic bronchial asthma. The patients had a normal airway resistance at rest and developed a marked bronchoconstriction (EIB) during exercise, which could be prevented by previous alpha-adrenergic blockade with phentolamine. In 7 control persons NE and E levels were measured also after beta-adrenergic blockade with propranolol. The following results were obtained: 1. At rest NE levels showed no significant differences between the groups. After exercise an increase of NE was observed in all groups, but in patients, even after phentolamine, and in normals after propranolol the increase was significantly higher than in the normal group within the control test. 2. No significant differences between the groups were found in E levels at rest and after exercise. Exercise caused no significant increase of E levels, except in the normals after propranolol application. 3. No significant correlation existed between NE levels and the increase of airway resistance after exercise. It is concluded that during exercise in asthmatics the sympathetic activity is enhanced, but the provocation of an EIB does not seem to be mediated by enhanced plasma NE levels.

Wisconsin, always one of the pioneers in public sector bargaining, has contributed here a move from traditional to cooperative bargaining. As in many jurisdictions, bargaining had developed in a way that produced a great deal of conflict, characterized by frequent and lengthy impasses, a grievance backlog that reached 1,400 arbitration cases and a public and political leadership that was losing patience. This jointly written article illustrates how change can begin, the role of statewide leadership, the resulting work behind the scenes and the possibilities. Since 1992, the Wisconsin Department of Employment Relations and the state's largest labor union, the 27,000-member Wisconsin State Employees Union (WSEU), have successfully used “consensus bargaining.” This cooperative, problem-solving approach contrasts sharply with the traditional adversarial and confrontational approach to bargaining. Consensus bargaining focuses on identifying and meeting bargainers' interests and creating a positive and constructive basis for discussions. This problem-solving approach has created more cooperative labor-management relations in Wisconsin State Government, reduced bargaining time, stimulated creative new contract provisions and helped develop a more positive and closer labor-management relationship. There are several keys to successful consensus negotiation: management and union leaders must be committed to the process; leaders must model cooperative behavior; bargainers should receive formal training in the process; negotiators must be candid throughout bargaining; and management and labor have to realize that reaching agreement on a contract is the beginning, not the end of creating a cooperative relationship. Wisconsin State Government, the WSEU, and other state employee unions have successfully used the consensus process and are committed to this cooperative approach.