Forced shoulder abduction and elbow flexion test: a new simple clinical test to detect superior labral injury in the throwing shoulder.

PURPOSE: Although several clinical tests for detecting superior labral injury of the shoulder have been reported, some of the maneuvers involved are complicated and diagnosis is still inaccurate. The purpose of this report is to introduce our forced shoulder abduction and elbow flexion test (forced abduction test) along with an assessment of its efficacy in the throwing shoulder in comparison with other clinical tests. TYPE OF STUDY: Prospective nonrandomized clinical trial. METHODS: Fifty-four throwing athletes who underwent arthroscopic surgery were prospectively studied. Superior labral injury was present in 24 cases (Snyder's classification was type 2 in 22, and type 3 in 2). Several clinical tests were performed preoperatively and the results were recorded on our original chart. The condition of the superior labrum was then examined during arthroscopic surgery. The results of these tests were compared with the arthroscopic findings as a standard. The forced abduction test was defined as positive when pain at the posterosuperior aspect of the shoulder on forced maximal abduction was relieved or diminished by elbow flexion. RESULTS: The sensitivity, specificity, and accuracy of the forced abduction test were 67%, 67%, and 67%, respectively. It was one of the most useful tests, along with the crank test and O'Brien's test (crank test, 58%, 72%, 66%; O'Brien's test, 54%, 60%, 57%; respectively). Furthermore, the results of the forced abduction test showed a significant correlation with the presence of superior labral injury (P = .0275, chi-square test). CONCLUSIONS: The forced abduction test was technically simple and its usefulness was comparable to the O'Brien's and crank tests for diagnosing superior labral injury in throwing shoulders. LEVEL OF EVIDENCE: Level II.

Structure and photochemistry of nitrocobalt(III) tetraphenylporphyrin with axial triphenylphosphine in toluene solutions.

Thermal and photochemical reactions of nitroaquacobalt(III) tetraphenylporphyrin, (NO(2))(H(2)O)Co(III)TPP, have been investigated in toluene solutions containing triphenylphosphine, P phi(3). It is found that Pphi(3) thermally abstracts an oxygen atom from the NO(2) moiety of (NO(2))(H(2)O)Co(III)TPP with a rate constant 0.52 M(-1) s(-1), resulting in the formation of nitrosylcobalt porphyrin, (NO)CoTPP. The 355-nm laser photolysis of (NO(2))(H(2)O)Co(III)TPP at low concentrations of P phi(3) (<1.0 x 10(-4) M) gives Co(II)TPP and NO(2) as intermediates. The recombination reaction of Co(II)TPP and NO(2) initially forms the coordinately unsaturated nitritocobalt(III) tetraphenylporphyrin, (ON-O)Co(III)TPP, which reacts with P phi(3) to yield nitro(triphenylphosphine)cobalt(III) tetraphenylporphyrin, (NO(2))(P phi(3))Co(III)TPP. Subsequently, the substitution reaction of the axial P phi(3) with H(2)O leads to the regeneration of (NO(2))(H(2)O)Co(III)TPP. From the kinetic studies, the substitution reaction is concluded to occur via a coordinately unsaturated nitrocobalt(III) porphyrin, (NO(2))Co(III)TPP. At higher concentrations of P phi(3) (>4 x 10(-3) M), (NO(2))(H(2)O)Co(III)TPP reacts with P phi(3) to form (NO(2))(P phi(3))Co(III)TPP: the equilibrium constant is obtained as K = 4.3. The X-ray structure analysis of (NO(2))(P phi(3))Co(III)TPP reveals that the P-Co-NO(2) bond angle is 175.0(2) degrees and the bond length Co-NO(2) is 2.000(7) A. In toluene solutions of (NO(2))(H(2)O)Co(III)TPP containing P phi(3) (>4 x 10(-3) M), the major light-absorbing species is (NO(2))(P phi(3))Co(III)TPP, which yields (NO)CoTPP by continuous photolysis. The laser photolysis of (NO(2))(P phi(3))Co(III)TPP gives Co(II)TPP, NO(2), and P phi(3) as initial products. The NO(2) molecule is suggested to be reduced by P phi(3) to yield NO, and the reaction between NO and Co(II)TPP gives (NO)CoTPP. The quantum yield for the photodecomposition of (NO(2))(P phi(3))Co(III)TPP is determined as 0.56.

Detection and identification of the Candida species by 25S ribosomal DNA analysis in the urine of candidal cystitis.

Candida species in clinical urine samples were identified directly by the newly developed method of PCR analysis on 25S ribosomal DNA (rDNA). Two dogs were referred to the Animal Medical Center, Nihon University School of Veterinary Medicine, Fujisawa, Kanagawa, Japan for the examination of chronic cystitis. Microscopic examination of urine samples from these dogs revealed yeast cells. Urine culture on Sabouraud's dextrose agar at 27 degrees C for 5 days produced white to cream colored colonies. The isolates were identifical to Candida albicans and C. parapsilosis by mycological examination, respectively. The nucleotide sequences of 25S ribosomal DNA from these urine isolates showed 99% similarity to those of a reference strain of Candida albicans or C. parapsilosis. The nucleotide sequences of 25S rDNA obtained directly from urine samples were also identical to C. albicans and C. parapsilosis, respectively. Confirming the results on the isolates cultured from the same urine samples. This PCR analysis method could be available for the direct identification of Candida species in urine samples within 2 days.