Investigations on infection status with H5 and H7 avian influenza virus in short-distance and long-distance migrant birds in 2001.

The role of migrating birds as potential vectors for avian influenza virus (AIV) was investigated. We captured 543 migrating passerines during their stopover on the island of Helgoland (North Sea) in spring and autumn 2001. These birds were sampled for avian influenza A viruses (AIV), specifically the subtypes H5 and H7. For virus detection, samples were taken from 1) short-distance migrants, such as chaffinches (Fringilla coelebs; n = 131) and song thrushes (Turdus philomelos; n = 169); and 2) long-distance migrants, such as garden warblers (Sylvia borin; n = 142) and common redstarts (Phoenicurus phoenicurus; n = 101). Virus isolation assays failed to identify AIV. Therefore, regarding the actual low number of samples, we speculate that the tested four species of passerines were not infected by AIV, indicating that the passerine species examined in this study may play only a minor role as potential vectors of AIV.

No detection of avian influenza A viruses of the subtypes H5 and H7 and isolation of lentogenic avian paramyxovirus serotype 1 in passerine birds during stopover in the year 2001 on the island Helgoland (North Sea).

A total of 543 migrating passerines were captured during their stopover on the island of Helgoland (North Sea) in spring and autumn 2001. They were sampled for the detection of avian influenza A viruses (AIV) subtypes H5 and H7, and for avian paramyxoviruses serotype 1 (APMV-1). The goal of the study was to examine the role of migrating birds as potential vectors for these zoonotic viral diseases. For virus detection samples were taken from a) short-distance migrants such as chaffinches (Fringilla coelebs, n = 131) and song trushes (Turdus philomelos, n = 169), and b) long-distance migrants such as garden warbler (Sylvia borin, n = 142) and common redstarts (Phoenicurus phoenicurus, n = 101). Virus detection was done on conjunctival, choanal cleft and cloacal swabs. Embryonated SPF chicken eggs were used to isolate and propagate virus followed by virus identification in a hemagglutination test, hemagglutination inhibition test and in an agar gel diffusion test. In none of the tested samples AIV was detected. Therefore, we conclude that the tested four species of passerines were infected by these pathogens. Six out of 543 birds (1.1 %) were found to carry non-pathogenic and lentogenic strains of APMV-1. This indicates that the passerine species examined in this study may play only a minor role as potential vectors of APMV-1.

Isolated traumatic avulsion of the flexor digitorum sublimis. A case report.

Like the FDP, the FDS may be avulsed at its insertion. The diagnosis can be made based on a history of resisted extension, palmar pain and tenderness, lack of FDS function, and inability to completely extend the DIP joint secondary to the looping affect of the FDS. In the seven reported cases of FDS rupture no surgical intervention was required. This case represents a case in which surgical intervention was required secondary to an isolated avulsion of the FDS in a football player.

The role of spinal flexion and extension in changing nerve root compression in disc herniations.

Changes in nerve root compression forces with spinal motion were measured on six freshly frozen adult cadaver spine specimens. A model was devised to represent a herniated disc at the L4-5 level. This was done using an anterior approach placing a compression-measuring device through the disc at the L4-5 level and against the L5 root. An accelerometer was used to monitor the range of motion of the spine. Because the compression device was held in a static position, the only variable was the tautness of the nerve root across the tip of the device. By simultaneously monitoring motion and force delivered at the tip of the compression meter placed at the nerve root, we were able to quantitate nerve root tension forces across the tip of the measuring device in relation to spinal motion. The force was measured with controls as well as in flexion and extension. In addition, the force was measured as traction was applied to the L5 root. The amount of compressive force and tension in the nerve root increased with flexion of the spine and decreased with extension of the spine. In conclusion, flexion of the lumbar spine increased the compressive force on the L5 root and extension decreased the compressive force on the L5 root.

Dynamic EMG analysis of torque transfer in professional baseball pitchers.

Fifteen professional baseball pitchers underwent active pitching motion analysis of the abdominal oblique, rectus abdominis, lumbar paraspinous and gluteus maximus muscles bilaterally via surface electrode evaluation. Baseline resting and isometric maximum values were obtained and active data referenced against these for comparison. The muscle activity then was measured during the pitching sequence and analyzed in each of the five pitching phases. The abdominal oblique, lumbar paraspinous and rectus abdominis contralateral to the pitching arm and the ipsilateral gluteus maximus all had increases in activity level of 75 to 100% during the active pitching motion. Using these data indicating specific muscle group patterns with clinical and performance data, we hope to minimize injuries and maximize pitching performance.

Comparison of MRI to contrast CT in the diagnosis of spinal stenosis.

Retrospectively, the MR (magnetic resonance) and contrast CT (computed tomography examinations of 41 patients (123 segments) were objectively scored to evaluate spinal stenosis and disc degeneration. Five categories to evaluate stenosis included the facet joint, foramina, central canal, disc on sagittal section, and disc on axial section. In addition, the ability to demonstrate spondylolysis was compared. The examinations were interpreted by a single observer blinded to the results. Comparisons show 96.6% agreement between MR and contrast CT in the diagnosis of spinal stenosis. Magnetic resonance showed disc degeneration in 74 of 123 segments, while CT showed disc degeneration disease in 27 of 123 segments. Spondylolysis was recognized at three segments on both MR and CT. In conclusion, MR and contrast CT are comparable in their abilities to demonstrate spinal stenosis, and MR is more sensitive in demonstrating disc degeneration.

Severe spondylolisthesis. Reduction and internal fixation.

The authors have developed and algorithm for management of spondylolysis and spondylolisthesis. Since March 1983, 15 patients with an average age of 20 years and with greater than 50% anterior displacement have been treated. The mean follow-up period is 24 months. Before surgery the average anterior displacement was 72%, the average delta angle at L5-S1 representing kyphosis was 73 degrees, and the average lumbar lordosis from L1 to L5 was 64 degrees. An anterior release and fusion was combined with a posterior reduction and instrumentation using the internal fixator. Correction of the anterior displacement averaged 46%, while the kyphosis was corrected a mean of 20 degrees and the lordosis a mean of 12 degrees. The L4 segment was preserved in 13 cases and the L4-L5 angle was improved by a mean of 7 degrees. Postoperative pain and function were improved in all cases. Neurologic complications occurred in four patients, three permanent and one temporary. Hardware failure occurred in two patients, and reoperation has been required in one. Further follow-up evaluation of this technique is required.

A digitizing technique for the study of movement of intradiscal dye in response to flexion and extension of the lumbar spine.

The effects of flexion and extension exercises on lumbar discs and low-back pain are controversial. Our goals were to develop a technique and program for digitizing and analyzing discograms and to study the motion of intradiscal dye in response to flexion and extension. Thirty-five patients following awake discography were evaluated with lateral radiographs obtained in an extension position and a flexion position. Fifty-three segments with normal morphology and 47 segments with abnormal morphology were studied. Discograms with normal morphology showed numerically significant change in position with a more anterior position occurring during extension. Changes in the position of intradiscal dye in discs with abnormal morphology were less predictable. Digitizing was an advantageous technique.

The use of oral colchicine for low-back pain. A double-blind study.

The use of colchicine for the treatment of low-back pain has been controversial; however, recent studies have shown its effectiveness when used intravenously. Studies using oral colchicine alone are lacking. The purpose of this study is to evaluate in a prospective, double-blind fashion the use of oral colchicine in the treatment of low back pain. Group I patients (15) were treated with a placebo capsule, and Group II (12) patients were treated with a colchicine capsule prescribed in a "burst dose" regimen. Patients were evaluated at 1, 2, 4, 6, and 12 weeks with a mean followup of 12 weeks. Parameters studied included patient characteristics, compliance, the McCoy pain drawings, pain analogue scales, the Million scale and objective tests. In terms of therapeutic response, the study shows no statistically significant difference between oral colchicine and placebo. The colchicine group did have an increased number of side effects.