Characterization of Clinostomum sp. (Trematoda: Clinostomidae) infecting cormorants in south-eastern Australia.

Clinostomum Leidy, 1856 (Trematoda: Clinostomidae) is a cosmopolitan, zoonotic genus of fluke that has been poorly studied in an Australian setting. Following previous reports of reservoir fish in Australian fish ponds being heavily infected with Clinostomum metacercaria, the current study was conducted to determine the specific identity of Clinostomum sp. in inland Australia, by examining and characterizing parasites collected from a potential definitive host, cormorants. A total of 33 parasite specimens belonging to the genus Clinostomum were collected from two cormorants (little black cormorants, Phalacrocorax sulcirostris) that were collected from the Narrandera Fisheries Research Centre, New South Wales, at the same locality where metacercaria of Clinostomum sp. have been reported in fish. All specimens in our study were immature adults. Clinostomum specimens with similar morphology have been identified as C. complanatum in the past, based on their morphological characteristics. However, phylogenetic analyses based on the ITS sequence data in the present study suggest they are the same as the Clinostomum sp. previously reported from carp gudgeons (Hypseleotris spp.) from the same farm, and distinct from C. complanatum. The ITS sequences obtained from the specimens in the present study were most similar to those belonging to C. phalacrocoracis (never reported in Australia). Our specimens formed a distinct clade on the phylogenetic tree and their specific identity awaits until fully mature specimens are described in future studies.

Neuromyelitis optica spectrum disorder and active tuberculosis.

Tuberculosis is on the rise again. It brings with it potential for neurological involvement both as a direct infection and as a parainfectious process. Accordingly we report the development of neurological problems affecting a 48-year-old patient's vision and sensation while being treated for active tuberculosis. At its nadir her vision deteriorated to nil perception of light and she had a sensory level to T10. Neuromyelitis optica spectrum disorder was diagnosed. We discuss our management strategy with neuromodulation in the context of active tuberculosis infection.

Comparison of Spatiotemporal Gait Parameters Following Operative Treatment of Trimalleolar Ankle Fractures vs Healthy Controls.

BACKGROUND: Controversy continues regarding appropriate indications for posterior malleolus fracture fixation in unstable rotational trimalleolar ankle injuries, with limited data comparing gait in operatively treated trimalleolar ankle fractures vs control populations. The purpose of this study was to evaluate the effect of trimalleolar ankle fracture fixation on gait parameters in the early postoperative period as compared to a healthy control population. METHODS: Adult patients having undergone operative treatment of isolated trimalleolar ankle fractures were eligible for inclusion. A total of 10 patients met the inclusion criteria and participated in the analysis. Patients were evaluated using standard parameters of human gait 6 months after their index procedures, with gait values compared to a population of 17 non-age-matched healthy control subjects in addition to literature values of healthy populations of younger and older subjects. RESULTS: Significant differences were noted between the spatiotemporal gait parameters of healthy control subjects and patients who had undergone operative treatment of trimalleolar ankle fractures. However, within the fracture group itself, no differences were found between patients with or without posterior malleolar fixation for any of the tested gait parameters. When patients were compared to literature values of younger and older healthy control populations, they were found to have gait patterns more similar to older rather than younger individuals. CONCLUSION: Operative fixation of trimalleolar ankle fracture does not restore normal gait function in the early postoperative period. Fixation of the posterior malleolus in particular also does not appear to improve gait characteristics. Patients who undergo surgery for these injuries demonstrate gait patterns similar to those of healthy older adults. LEVEL OF EVIDENCE: Level II, Therapeutic (prospective cohort study).

The impact of whole-hand vibration exposure on the sense of angular position about the wrist joint.

OBJECTIVES: The purpose of this research is to determine the impact of whole-hand vibration on the capacity of subjects to identify previously presented positions of the hand in both wrist flexion and extension. METHODS: In each movement direction, targets of 15 or 30 degrees were presented with an imposed passive movement from the start position. During the second imposed movement, subjects were required to identify when the target position had been reached. For the vibration condition, 15 s of whole-hand vibration exposure was repeated immediately prior to each target position trial. Proprioceptive capacity was assessed by comparing the identified angular position with the reference position-angular distance expressed in terms of absolute error (AE), constant error (CE), and variable error (VE). RESULTS: For three of the four target positions (15 and 30 degrees flexion and 15 degrees extension), the absolute, constant, and VEs of target identification were insensitive to vibration, whereas for the 30 degrees extension target, both the absolute and CE were significantly different before and after the vibration application, showing the subjects overshooting previously presented target position. All three error measures were larger for the long targets than the short targets. CONCLUSIONS: Short-duration exposure to whole-hand vibration is insufficient to compromise post-vibration position sense in the wrist joint, except near the end range of joint movement in wrist extension. Complement contribution of different proprioceptive receptors (muscle, joint, and skin receptors) seems to be crucial for accuracy to reproduce passive movements, since the capacity of any individual class of receptor to deliver information about movement and position of the limbs is limited.

Synchronous tumors: Hodgkin disease presenting in mesenteric lymph nodes from a right hemicolectomy for colon carcinoma.

The authors report the case of a 56-year-old male diagnosed with Hodgkin disease involving the mesenteric lymph nodes recovered from a right hemicolectomy for colonic adenocarcinoma. The liver and bone marrow were also involved by Hodgkin disease. Synchronous colonic carcinoma and lymphoma in the same patient is a rare occurrence, and Hodgkin disease involving the mesenteric lymph nodes is uncommon as well.

Summation of forces from multiple motor units in the cat soleus muscle.

Nearly all muscle models and most motor control concepts assume that forces from individual muscle fibers and motor units sum in an additive manner once effects of in-series tendon compliance are taken into account. Due to the numerous mechanical linkages between individual fibers, though, it is unclear whether this assumption is warranted. This work examined motor unit force summation over a wide range of muscle forces in the cat soleus. Nonadditive summation implies a nonlinear summation of motor unit forces. Summation nonlinearities were quantified during interactions of 10 individual motor units and 4 motor unit bundles containing approximately 10 units each. These protocols allowed motor unit force summation to be examined from approximately 0 to 25% of tetanic muscle force. Nonlinear summation was assessed by comparing the actual forces to the algebraic sum of individual units and bundles stimulated in isolation. Superadditive summation meant that the actual force exceeded the algebraic sum, whereas subadditive summation meant that the actual force was smaller than the algebraic sum. Experiments tested the hypothesis that superadditive summation occurs at low force levels when few motor units are recruited, whereas subadditive summation prevails above 10% of tetanic force. Results were consistent with this hypothesis. As in previous studies, nonlinear summation in the soleus was modest, but a clear transition from predominately superadditive to predominantly subadditive summation occurred in the range of 6-8% of tetanic force. The largest nonlinearities were transient and appeared at the onset of recruitment and derecruitment of groups of motor units. The results are discussed in terms of the mechanical properties of the connective tissue forming the tendon and linking muscle fibers.