ABSTRACT
BACKGROUND: Ulnar collateral ligament injury (UCLI) has significantly increased in overhead sports during the past 2 decades. Differences in return to sport (RTS) and RTS at previous level (RTSP) after UCLI have not been differentiated. METHODS: A computer-assisted literature search of PubMed, CINAHL, Embase, and SportDiscus databases using keywords related to RTS for UCLI was implemented. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for study methodology. Quality assessment was conducted using a modified Downs and Black scale. RESULTS: A total of 22 retrospective, level 3b or 4, studies (n = 2289) qualified for analysis. Overall RTS proportion was 90% (95% confidence interval [CI], 86%-94%) and overall RTSP proportion was 79% (95% CI, 75%-84%), both with significant heterogeneity (P < .001, I2 = 74%-84%). RTS and RTSP proportions were 89% (95% CI, 83%-94%) and 78% (95% CI, 72%-83%) for Major League Baseball players, 91% (95% CI, 77%-99%) and 67% (95% CI, 52%-81%) for Minor League Baseball players, 95% (95% CI, 75%-100%) and 92% (95% CI, 82%-98%) for collegiate players, and 93% (95% CI, 81%-100%) and 83% (95% CI, 77%-89%) for high school players, respectively. Increased earned run average, walks, and hits per inning pitched, decreased innings pitched, and decreased fastball velocity were found after UCLI. CONCLUSION: Low-level, high-bias evidence demonstrates overall RTS proportion is higher than RTSP, regardless of treatment type for UCLI. Although RTS proportions remained consistent across various levels of play, RTSP proportions were lower in professional players, particularly Minor League Baseball compared with collegiate and high school players. Pitching performance significantly decreased postoperatively in most studies.
Subject(s)
Baseball/injuries , Collateral Ligament, Ulnar , Return to Sport , Ulnar Collateral Ligament Reconstruction/rehabilitation , Collateral Ligament, Ulnar/injuries , Collateral Ligament, Ulnar/physiopathology , Collateral Ligament, Ulnar/surgery , HumansABSTRACT
[reaction: see text] Details of problems and solutions encountered during the development of an enantioselective total synthesis of (+)-cylindricine C are described here. The total synthesis itself was accomplished in 8 steps, featuring an N-acyliminium cyclization strategy, the seldom-used Wharton rearrangement, and a key epimerization at C5.
Subject(s)
Heterocyclic Compounds, 3-Ring/chemical synthesis , Imines/chemistry , Quinolones/chemical synthesis , Acylation , Cyclization , Heterocyclic Compounds, 3-Ring/chemistry , Quinolones/chemistry , StereoisomerismABSTRACT
[reaction: see text] Enantioselective total syntheses of (+)-cylindricines C-E and (-)-lepadiformine through a common tricyclic intermediate are described here. These syntheses are concise and feature an aza-Prins cyclization and a seldom-used Wharton rearrangement en route to the common intermediate.
Subject(s)
Alkaloids/chemical synthesis , Aza Compounds/chemistry , Heterocyclic Compounds, 3-Ring/chemical synthesis , Quinolones/chemical synthesis , Alkaloids/pharmacology , Antifungal Agents/chemical synthesis , Antifungal Agents/pharmacology , Antineoplastic Agents/chemical synthesis , Antineoplastic Agents/pharmacology , Cyclization , Heterocyclic Compounds, 3-Ring/pharmacology , Quinolones/pharmacology , StereoisomerismABSTRACT
The genes decapentaplegic, wingless, and Distalless appear to be instrumental in constructing the anatomy of the adult Drosophila leg. In order to investigate how these genes function and whether they act coordinately, we analyzed the leg phenotypes of the single mutants and their inter se double mutant compounds. In decapentaplegic the tarsi frequently exhibit dorsal deficiencies which suggest that the focus of gene action may reside dorsally rather than distally. In wingless the tarsal hinges are typically duplicated along with other dorsal structures, confirming that the hinges arise dorsally. The plane of symmetry in double-ventral duplications caused by decapentaplegic is virtually the same as the plane in double-dorsal duplications caused by wingless. It divides the fate map into two parts, each bisected by the dorsoventral axis. In the double mutant decapentaplegic wingless the most ventral and dorsal tarsal structures are missing, consistent with the notion that both gene products function as morphogens. In wingless Distal-less compounds the legs are severely truncated, indicating an important interaction between these genes. Distal-less and decapentaplegic manifest a relatively mild synergism when combined.
