Sprint performance and propulsion asymmetries on an ergometer in trained high- and low-point wheelchair rugby players.

The purpose of this study was to examine the propulsion asymmetries of wheelchair athletes while sprinting on an instrumented, dual-roller ergometer system. Eighteen experienced wheelchair rugby players (8 low point (LP) (class ≤1.5) and 10 high point (HP) (class ≥2.0)) performed a 15-second sprint in their sports wheelchair on the instrumented ergometer. Asymmetry was defined as the difference in distance and power output (PO) between left and right sides when the best side reached 28 m. Propulsion techniques were quantified based on torque and velocity data. HP players covered an average 3 m further than the LP players (P = .002) and achieved faster sprint times than LP players (6.95 ± 0.89 vs 8.03 ± 0.68 seconds, P = .005) and at the time the best player finished (5.96 seconds). Higher peak POs (667 ± 108 vs 357 ± 78 W, P = .0001) and greater peak speeds that were also evident were for HP players (4.80 ± 0.71 vs 4.09 ± 0.45 m/s, P = .011). Greater asymmetries were found in HP players for distance (1.86 ± 1.43 vs 0.70 ± 0.65 m, P = .016), absolute peak PO (P = .049), and speed (0.35 ± 0.25 vs 0.11 ± 0.10 m/s, P = .009). Although HP players had faster sprint times over 28 m (achieved by a higher PO), high standard deviations show the heterogeneity within the two groups (eg, some LP players were better than HP players). Quantification of asymmetries is important not only for classifiers but also for sports practitioners wishing to improve performance as they could be addressed through training and/or wheelchair configuration.

Radioulnar laxity and clinical outcome do not correlate after a distal radius fracture.

Injury to the triangular fibrocartilage complex associated with distal radius fracture may cause symptoms of ulnar instability. Assessed by a radioulnar stress test, increased laxity of the distal radioulnar joint has in two previous studies been depicted to be associated with poorer outcome. This prospective study of 40 adults investigates the correlation of this test with functional outcome as measured by DASH. No clinically significant difference was found in relation to this test at two and five years after injury. Therefore using this test alone to decide whether or not to perform an acute repair of the TFCC cannot be recommended.

Radioulnar ratio in detection of distal radioulnar joint instability associated with acute distal radius fractures.

Lesions of the triangular fibrocartilage complex (TFCC) are commonly associated with distal radius fractures and may adversely affect the functional outcome. This prospective study evaluated computed tomography, using the radioulnar ratio (RUR), to detect laxity of the distal radioulnar joint in 48 consecutive patients with acute distal radius fractures and compared the results with a radioulnar stress test. We found the clinical stress test to be reliable in chronic cases, but the RUR method of questionable value in both acute and chronic cases.

Width and variation of the ENA flux ribbon observed by the Interstellar Boundary Explorer.

The dominant feature in Interstellar Boundary Explorer (IBEX) sky maps of heliospheric energetic neutral atom (ENA) flux is a ribbon of enhanced flux that extends over a broad range of ecliptic latitudes and longitudes. It is narrow (approximately 20 degrees average width) but long (extending over 300 degrees in the sky) and is observed at energies from 0.2 to 6 kilo-electron volts. We demonstrate that the flux in the ribbon is a factor of 2 to 3 times higher than that of the more diffuse, globally distributed heliospheric ENA flux. The ribbon is most pronounced at approximately 1 kilo-electron volt. The average width of the ribbon is nearly constant, independent of energy. The ribbon is likely the result of an enhancement in the combined solar wind and pickup ion populations in the heliosheath.

Direct observations of interstellar H, He, and O by the Interstellar Boundary Explorer.

Neutral gas of the local interstellar medium flows through the inner solar system while being deflected by solar gravity and depleted by ionization. The dominating feature in the energetic neutral atom Interstellar Boundary Explorer (IBEX) all-sky maps at low energies is the hydrogen, helium, and oxygen interstellar gas flow. The He and O flow peaked around 8 February 2009 in accordance with gravitational deflection, whereas H dominated after 26 March 2009, consistent with approximate balance of gravitational attraction by solar radiation pressure. The flow distributions arrive from a few degrees above the ecliptic plane and show the same temperature for He and O. An asymmetric O distribution in ecliptic latitude points to a secondary component from the outer heliosheath.

An improved assay for enumeration of circulating endothelial cells.

Circulating endothelial cells have been established as markers of vascular disease, such as small vessel vasculitis, acute vascular rejection in renal transplant recipients, and cyclosporine-induced endothelial damage. Enumeration of these cells by immunomagnetic isolation and acridine staining remains the gold standard but necessitates considerable experience and expenditure. A simpler test would therefore be of great utility. Hence, our aim was to develop an improved simple assay to enumerate endothelial cells in peripheral blood. We had already used various surface markers to corroborate the endothelial origin of cells. Here, we studied the enumeration of cell numbers with immunomagnetic isolation and a variety of subsequent stains, such as CD31, von Willebrand's factor (vWF) immunocytochemistry, and Ulex europaeus lectin-1 (UEA-1). Eventually, we devised a simple protocol for enumeration using immunomagnetic isolation and a subsequent UEA-1 lectin stain. We evaluated the use of this protocol in parallel to immunomagnetic isolation and acridine counting alone in 92 renal transplant recipients who underwent renal biopsy. Recovery of various concentrations of human umbilical vein endothelial cells from blood was also studied. Immunomagnetic isolation and subsequent UEA-1 staining permits easier enumeration of circulating endothelial cells in peripheral blood. The assay is simple and easy to use, thus allowing for a more widespread use of circulating endothelial cells as a marker of vascular damage.

Suramin inhibits initiation of defense signaling by systemin, chitosan, and a beta-glucan elicitor in suspension-cultured Lycopersicon peruvianum cells.

Systemin-mediated defense signaling in tomato (Lycopersicon esculentum) plants is analogous to the cytokine-mediated inflammatory response in animals. Herein, we report that the initiation of defense signaling in suspension-cultured cells of Lycopersicon peruvianum by the peptide systemin, as well as by chitosan and beta-glucan elicitor from Phytophtora megasperma, is inhibited by the polysulfonated naphtylurea compound suramin, a known inhibitor of cytokine and growth factor receptor interactions in animal cells. Using a radioreceptor assay, we show that suramin interfered with the binding of the systemin analog (125)I-Tyr-2, Ala-15-systemin to the systemin receptor with an IC(50) of 160 microM. Additionally, labeling of the systemin receptor with a photoaffinity analog of systemin was inhibited in the presence of suramin. Receptor-mediated tyrosine phosphorylation of a 48-kDa mitogen-activated protein kinase and alkalinization of the medium of suspension-cultured cells in response to systemin and carbohydrate elicitors were also inhibited by suramin. The inhibition of medium alkalinization by suramin was reversible in the presence of high concentrations of systemin and carbohydrate elicitors. Calyculin A and erythrosin B, intracellular inhibitors of phosphatases and plasma membrane proton ATPases, respectively, both induce medium alkalinization, but neither response was inhibited by suramin. The polysulfonated compound heparin did not inhibit systemin-induced medium alkalinization. NF 007, a suramin derivative, induced medium alkalinization, indicating that neither NF 007 nor heparin interact with elicitor receptors like suramin. The data indicate that cell-surface receptors in plants show some common structural features with animal cytokine and growth factor receptors that can interact with suramin to interfere with ligand binding.

Langer-Giedion syndrome associated with scimitar syndrome.

We describe an infant with Langer-Giedion syndrome combined with scimitar syndrome.

Positioning of nuclei in the secondary Mycelium of Schizophyllum commune in relation to differential gene expression.

In this paper we propose a novel type of gene regulation in the MATA|l4 MATB|l4 heterokaryon of Schizophyllum commune by means of differential positioning of the nuclei. It was found that binucleate hyphae with juxtaposed nuclei secrete SC4 hydrophobin (abundant during fruit-body formation), while SC3 (abundant during aerial hyphae formation in both mono- and dikaryons) appeared to be absent. Certain growth conditions disrupted the binucleate state in that the compatible nuclei became separated at a considerable distance. Under these conditions SC4 was not secreted while SC3 was secreted to a high degree. Disruption of the binucleate state was earlier observed in developing aerial hyphae which secrete SC3. Apparently, when the nuclei are in close proximity the dikaryon-expressed genes are switched on by interaction of the products of the MATA and MATB mating-type genes, while SC3 is suppressed by interacting products of the MATB genes, as occurs in the common MATA heterokaryon (MATA= MATB|l4). Growth conditions that lead to disruption of the binucleate state apparently result in abolishment of interaction between the MATB mating-type genes. Under these conditions, dikaryon-specific mRNAs do not accumulate in the MATA|l4 MATB|l4 heterokaryon, while SC3 mRNA becomes highly abundant.

Changes in exercise capacity following cardiac rehabilitation in patients stratified according to age and gender. Results of the Massachusetts Association of Cardiovascular and Pulmonary Rehabilitation Multicenter Database.

BACKGROUND: Using information collected prospectively from a multicenter cardiac rehabilitation database, this study was designed to evaluate baseline exercise tolerance and subsequent change in functional capacity among consecutive patients enrolled in supervised cardiac rehabilitation stratified according to age and gender. In addition, the study evaluated change in functional capacity among those with the lowest initial exercise tolerance (<5 METS) and assessed patient factors that correlate to the highest relative improvements in functional capacity after training. METHODS: A total of 778 patients performed an initial exercise test upon entry into cardiac rehabilitation, during which peak heart rate, blood pressure, and estimated peak MET levels were derived, and ischemic responses were evaluated. After 10 +/- 2 weeks of supervised prescribed exercise, 500 patients who completed the program performed follow-up exercise testing. RESULTS: The subjects included 558 men (72%) and 220 women (28%) of whom 492 (63%) were <65 years, 241 (31%) were 65 to 75 years, and 45 (6%) were >75 years. At baseline, the peak initial MET level for men was 8.6 +/- 3.4 METS and for women was 6.0 +/- 2.6 METs. The peak initial MET level declined with age: age <65 = 8.9 +/- 3.4 METS; age 65 to 75 = 6.6 +/- 2.6 METS; and age >75 = 5.7 +/- 2.9 METS. When stratified according to age and gender, the baseline exercise tolerance for men significantly (P <.0001) declined with age and was higher than that of women <65 and 65 to 75 years of age. After training, the relative improvement in exercise tolerance for each age and/or gender subgroup was: age <65: men 36%, women 41%; age 65 to 75: men 36%, women 50%; and age >75: men 36%, women 32%. Among 163 patients with an initial peak MET level <5, exercise tolerance rose from 4.1 +/- 0.7 to 8.3 +/- 3.5 METS (P <.0001). Multivariate analysis demonstrated that the greatest change in exercise tolerance with training was associated with those compliant patients with initial peak METS <5. No significant net change in the occurrence of exercise-induced ischemia was observed. CONCLUSIONS: Among consecutive patients enrolled in cardiac rehabilitation, baseline exercise tolerance differs relative to age and gender, with male gender and younger age demonstrating the highest functional capacity. Exercise training yielded significant improvements in exercise tolerance among men and women of every age group including those older than 75 years, and particularly among those with an initial peak MET level <5. Thus, referral to cardiac rehabilitation programs should be advocated for both men and women, and should not be limited by age.

[Changes in the internal object world in an obsessive-compulsive patient during 3 years ambulatory psychotherapy. A study with the Repertory Grid Technique]. / Veränderung der inneren Objektwelt bei einer zwangskranken Patientin während einer 3jährigen ambulanten Psychotherapie. Eine Untersuchung mit der Repertory-grid-Technik.

The significance of the repertory-grid technique, which is based on Kelly's theory of personal constructs for the analysis of course and change of behavioral abnormalities, is assessed in a case report on the psychotherapy of an obsessive compulsive patient. The method delineates judgements regarding herself, significant other persons, and disease conceptualizations. This idiographic method, situated between empirical and hermeneutic techniques, is particularly valuable for the detection of psychotherapeutic changes. Traditional procedures that aim at invariance of values can be lacking in sensitivity. The repertory grid follows the individual's own constructs and idiosyncratic views. This obviates doubts on the relevance of terms and factorial dimensions for the proband. In this case, study of the combination of the idiographic grid technique and nomothetic questionnaires was useful for validation and interpretation of findings. The dimensions of the individual grid test are not covered by questionnaires and belong to a different level of cognitive processes.

Murphy's contributions to disability studies: an inquiry into ourselves.

Robert Murphy's career, culminating in the study of disability, gives evidence of deep commitment to understanding the human condition in adversity. His life-long interest in the psychological, sociological and cultural significance of behavior; his work on alienation, developed through fieldwork in small scale societies in South America and Africa; his fascination with the estrangement that arises from the conflict between our need to integrate and to be autonomous; and his own experience of a progressive debilitating disease provided him with rich insights for his interpretation of disability. This paper examines Murphy's contributions to our understanding of the meanings and implications of disability, for those who personally experience it, and for the 'others' in their lives.

Do fish oils prevent restenosis after coronary angioplasty?

BACKGROUND: The omega-3 polyunsaturated fatty acids derived from fish oils have been shown to modulate many factors believed to affect the pathogenesis of atherosclerosis. Because certain features of restenosis following angioplasty mimic some of the early changes of atherogenesis, some researchers have suggested that fish oil might prevent restenosis following angioplasty. We report the effects of omega-3 fatty acids on the rate of restenosis following percutaneous intraluminal coronary angioplasty (PTCA). METHODS AND RESULTS: From August 1989 through September 1992, 551 patients were randomized to start receiving a daily dietary supplement of ten 1.0-g capsules containing 80.6% ethyl esters of omega-3 fatty acids providing 4.1 g eicosapentaenoic acid (EPA) and 2.8 g docosahexaenoic acid (DHA) for 6 months or an equal amount of an ethyl ester of corn oil. Four hundred seventy subjects who were well matched for risk factors completed successful angioplasty of one or multiple lesions in native coronary vessels and constituted the study cohort, of whom 447 were evaluable at 6 months after PTCA. The criteria for restenosis were that the quantitative coronary angiography at 6 months show a > 30% increase in narrowing at the stenosis site or loss of at least half of the gain achieved at the time of PTCA and final restenosis with < 50% luminal diameter remaining. In 93% of the patients, the end point was determined by angiography and in all except 1% of these by quantitative coronary angiography. Compliance with the fish oil supplement was good as judged by incorporation of EPA and DHA in plasma and red blood cell phospholipids. The restenosis rate among analyzable patients was 46% for corn oil and 52% for fish oil (P = .37). The addition of 200 mg alpha-tocopherol for all subjects during the study had no effect on restenosis rates. CONCLUSIONS: This was the largest of such trials to date, and a supplement of 8 g/d of omega-3 fatty acids failed to prevent the usual high rate of restenosis after PTCA. No adverse effects were attributable to this large daily supplement of omega-3 fatty acids.

[Psychopathology, coping and defence in intensive-care patients]. / Psychopathologie, Coping und Abwehr bei intensivmedizinisch behandelten Patienten.

We performed a follow-up study of psychosocial aspects of intensive care during 3 months on 122 consecutive patients admitted to a medical intensive care unit for at least 8 hours. 54 patients were interviewed in the intensive care unit. These data were evaluated using 2 rating scales for the course of the interview and the psychopathological findings (AMDP-system). Coping patterns based on both rating scales were intra- and interindividually highly variable and did not show systematic trends in time. High variability was interpreted as showing an effort towards more efficient individual coping strategies. The reaction to ICU admission remembered later on general ward was almost uniform: threat to life was minimized and personal capabilities enhanced. Systematically coloured recollections are seen as a part of further coping strategies restoring the individual competence of coping and minimizing the narcissistic offence of illness.

Nerve, plexus and spinal cord: possible targets for non-invasive neuromagnetic measurements in man.

Somatosensory evoked neuromagnetic fields are recorded from peripheral nerves in the upper arm, from plexus brachialis at the ventral and dorsal thorax and from the dorsal horn of the cervical spinal cord ('P13m') at the upper lateral neck. Some perspectives for clinical applications are suggested.

The Sc7/Sc14 gene family of Schizophyllum commune codes for extracellular proteins specifically expressed during fruit-body formation.

The Sc7 and Sc14 genes are specifically expressed in the dikaryon of the basidiomycete fungus Schizophyllum commune during fruiting. These genes are closely linked (within 6 kb) and highly similar in gene structure and nucleotide sequence (70% identical nucleotides in their coding regions). The encoded proteins (204 and 214 amino acids, respectively) have 87% similarity in amino acids (56% of the amino acids are identical). They contain putative signal sequences for secretion, are rich in aromatic amino acids which are generally located at similar positions, and they are generally hydrophilic. Inspection of databanks showed similarities with pathogenesis-related proteins (PR1) from plants, testis-specific proteins from mammals and venom allergen proteins from insects. An antibody raised against a Sc7 fusion protein showed the presence of the Sc7 protein in the culture medium and in the fruit bodies where it is apparently loosely associated with hyphal walls.

The effect of cholesterol screening on college students.

This study was designed to determine the effect of cholesterol screening on college students' knowledge retention and self-reported behavior change. Students (N = 180, age M = 21.4 +/- 4.1 years) enrolled in a self-paced personal fitness course participated in a screening accompanied by two educational handouts and oral information from the technician. Six weeks later, subjects completed a questionnaire that revealed that 76% remembered their exact cholesterol level. Only 36%, however, remembered specifically why their cholesterol level was important, 22% remembered the three National Cholesterol Education Program (NCEP) categories and values, and only 36% could fully identify their correct NCEP follow-up. Chi-square analyses revealed no significant differences between expected and observed frequencies for gender or cholesterol category by cognitive information retention. Analyses did reveal more self-reported dietary and exercise changes for those testing above 200 mg/dL than for those below 200. Although college students may remember their cholesterol level after 6 weeks and may take some action if they are above the desirable level, the knowledge base established in a typical screening situation appears inadequate. Educational efforts accompanying most screenings should be improved, and some attention should be given to young adults who test at the high end of the desirable category.