How does the cam morphology develop in athletes? A systematic review and meta-analysis.

OBJECTIVE: A higher prevalence of cam morphology has been reported in the athletic population but the development of the cam morphology is not fully understood. The purpose of this systematic review is to establish the timing of development of the cam morphology in athletes, the proximal femoral morphologies associated with its development, and other associated factors. DESIGN: Embase, MEDLINE and the Cochrane Library were searched for articles related to development of the cam morphology, and PRISMA guidelines were followed. Data was pooled using random effects meta-analysis. Study quality was assessed using the Downs and Black criteria and evidence quality using the GRADE framework. RESULTS: This search identified 16 articles involving 2,028 participants. In males, alpha angle was higher in athletes with closed physes than open physes (SMD 0.71; 95% CI 0.23, 1.19). Prevalence of cam morphology was associated with age during adolescence when measured per hip (ß 0.055; 95% CI 0.020, 0.091) and per individual (ß 0.049; 95% CI 0.034, 0.064). Lateral extension of the epiphysis was associated with an increased alpha angle (r 0.68; 95% CI 0.63, 0.73). A dose-response relationship was frequently reported between sporting frequency and cam morphology. There was a paucity of data regarding the development of cam morphology in females. CONCLUSIONS: Very low and low quality evidence suggests that in the majority of adolescent male athletes, osseous cam morphology developed during skeletal immaturity, and that prevalence increases with age. Very low quality evidence suggests that osseous cam morphology development was related to lateral extension of the proximal femoral epiphysis.

Controlling the adhesion of the diatom Navicula perminuta using poly(N-isopropylacrylamide-co-N-(1-phenylethyl) acrylamide) films.

Poly(N-isopropylacrylamide)-co-N-(1-phenylethyl) acrylamide [P(NIPAAm-co-PEAAm)] thermo-responsive thin films with a lower critical solution temperature (LCST) adjusted to fit marine applications were used to investigate the effect of changes in the wetting properties of a surface on the adhesion of the diatom Navicula perminuta, an organism which forms slime films on surfaces immersed in an aquatic environment. Although the strength of attachment of cells was affected by whether the film was collapsed or expanded, no significant decrease in adhesion strength occurred upon temperature decrease. The effects were attributed to possible strong interactions between the hydrophobic segments of the responsive film when collapsed with components in the adhesive complex.

Directional freezing of equine semen in large volumes.

Despite its potential impact on the horse industry, sperm cryopreservation is not an established technology throughout the industry, for a number of reasons that include a reduction in pregnancy rate and increased cost per pregnancy. We have evaluated a novel directional freezing technique, based on a multi-thermal gradient (MTG), by comparing it with the conventional, controlled-rate cryopreservation method (CRCM). Ninety-seven ejaculates with > or =50% motility, collected from 31 stallions were each divided into two parts and subsequently frozen by either MTG or CRCM. Frozen samples were then stored in liquid nitrogen until thawing. The two treatments were evaluated by three methods: progressive linear motility (PLM), viability stain and hypoosmotic swelling (HOS) test. High correlation was found between the three evaluation methods for all post-thaw samples. Eighty-eight per cent of the ejaculates frozen by MTG had post-thaw PLM > or =35%, whereas only 59% of the ejaculates frozen by CRCM had such motility. Post-thaw evaluations of samples frozen by MTG and CRCM were: PLM - 50.2 +/- 1.5% and 37.4 +/- 1.5%, respectively; viability - 53.6 +/- 1.5% and 39.5 +/- 1.4%, respectively; membrane integrity, as evaluated by HOS - 36.2 +/- 1.3% and 26.5 +/- 1.1%, respectively. The differences according to all the evaluation methods were highly significant (p < 0.001), and the results indicate that freezing stallion semen by MTG is superior to CRCM.

Phytomenadione or menadiol in the management of an elevated international normalized ratio (prothrombin time).

AIM: To evaluate the efficacy of oral menadiol compared to intravenous phytomenadione when correcting coagulopathies associated with cholestasis. METHODS: A total of 26 patients with cholestasis and an international normalized ratio (prothrombin time) greater than 1.2, were randomized to receive either 20 mg o.d. for 3 days of oral menadiol (n=12), or 10 mg o.d. of intravenous phytomenadione (n=14) prior to endoscopic retrograde cholangeopancreatography. Liver function tests and international normalized ratio were measured daily for 3 days. RESULTS: Liver function tests and international normalized ratio were comparable between groups at entry into the study (P > 0.05), but serum albumin was significantly lower in the intravenous phytomenadione group following treatment (P < 0.05). A decrease in international normalized ratio occurred in both groups following administration of vitamin K (P < 0.05). Two patients in the intravenous group required fresh frozen plasma, as failure to normalize international normalized ratio was observed. No adverse drug reactions were observed in either group, and no patient required re-admission for bleeding during a 4-week follow-up period after cholangeopancreatography. CONCLUSION: Oral menadiol appears to be an effective alternative to intravenous phytomenadione in the correction of coagulopathies associated with obstructive liver disease. This simplifies the care of patients with deranged clotting times requiring cholangeopancreatography, particularly those to be managed as out-patients.

The fission yeast git5 gene encodes a Gbeta subunit required for glucose-triggered adenylate cyclase activation.

Fission yeast adenylate cyclase is activated by the gpa2 Galpha subunit of a heterotrimeric guanine-nucleotide binding protein (G protein). We show that the git5 gene, also required for this activation, encodes a Gbeta subunit. In contrast to another study, we show that git5 is not a negative regulator of the gpa1 Galpha involved in the pheromone response pathway. While 43% identical to mammalian Gbeta's, the git5 protein lacks the amino-terminal coiled-coil found in other Gbeta subunits, yet the gene possesses some of the coding capacity for this structure 5' to its ORF. Although both gpa2 (Galpha) and git5 (Gbeta) are required for adenylate cyclase activation, only gpa2 is needed to maintain basal cAMP levels. Strains bearing a git5 disruption are derepressed for fbp1 transcription and sexual development even while growing in a glucose-rich environment, although fbp1 derepression is half that observed in gpa2 deletion strains. Multicopy gpa2 partially suppresses the loss of git5, while the converse is not true. These data suggest that Gbeta is required for activation of adenylate cyclase either by promoting the activation of Galpha or by independently activating adenylate cyclase subsequent to Galpha stimulation as seen in type II mammalian adenylate cyclase activation.

Overexpression, purification, and characterization of the cloned metallo-beta-lactamase L1 from Stenotrophomonas maltophilia.

The metallo-beta-lactamase L1 from Stenotrophomonas maltophilia was cloned, overexpressed, and characterized by spectrometric and biochemical techniques. Results of metal analyses were consistent with the cloned enzyme having 2 mol of tightly bound Zn(II) per monomer. Gel filtration chromatography demonstrated that the cloned enzyme exists as a tightly held tetramer with a molecular mass of ca. 115 kDa, and matrix-assisted laser desorption ionization and time-of-flight mass spectrometry indicated a monomeric molecular mass of 28.8 kDa. Steady-state kinetic studies with a number of diverse penicillin and cephalosporin antibiotics demonstrated that L1 effectively hydrolyzes all tested compounds, with k(cat)/Km values ranging between 0.002 and 5.5 microM(-1) s(-1). These characteristics of the recombinant enzyme are contrasted to those previously reported for metallo-beta-lactamases isolated directly from S. maltophilia.

Frostbite arthropathy.

Frostbite injuries are typically associated with soft tissue damage, but deeper structures such as bones, joints, and cartilage may eventually be affected in more than half of all patients. We report a case of a 29-year-old man who presented with bilateral distal and proximal interphalangeal joint pain, decreased range of motion, and an examination and radiographs consistent with osteoarthritis (OA). The symptoms began two decades previously after a frostbite injury sustained to both hands at age 9. This case illustrates some important clinical sequelae resulting from frostbite injury, such as premature OA, Additionally, because the injury occurred before epiphyseal growth plate closure, he also developed brachydactyly. The thumbs were spared, as has also been reported by others, because the thumb is often protected in the palm.

Jump distance of dance landings influencing internal joint forces: II. Shear forces.

Little is known about shear loading patterns during dance movements. The purpose of the study was to investigate the effect of jumping distance (JD) on contributors of ankle and knee shear forces (SF) generated during the landing phase of traveling jumps. Six female dancers performed 10 trials each at 30, 60, and 90% maximum jump distance (JD) and 15 jumps ranging from 35 to 100% JD. A sagittal view of the right leg landing onto a force platform was filmed using a high-speed cine camera. Greater ankle and knee joint reaction shear forces (JRSF) and quadriceps SF (QuadSF) were observed (P < 0.05) at increased JD. Although the triceps surae SF (TriSurSF) also increased at greater JD for all but one participant, the effect on minimizing the increase in the ankle SF was minor. The peak QuadSF magnitude and rate of loading were always greater than the corresponding knee JRSF variables. However, the increased QuadSF that occurred at longer jumps led to increased knee SF for only half of the participants.

Maturation alters the pulmonary arterial response to hypoxia and inhaled nitric oxide in the presence of endothelial dysfunction.

Surgical intervention in ever younger patients has led to a new appreciation of the unique physiology of the neonate. Specifically, newborn patients may respond very differently to hypoxic episodes and subsequent treatment with inhaled nitric oxide than older infants. In the current study, we examined differences in the pulmonary arterial response to hypoxia and inhaled nitric oxide in 48-hour-old (n = 8) and 14-day-old (n = 8) Yorkshire pigs in a model of nitric oxide synthase inhibition, as might be seen with endothelial dysfunction. Data were acquired after treatment with the nitric oxide synthase inhibitor N omega-nitro-L-arginine during hypoxia (inspired oxygen fraction = 0.10) and during inhalation of nitric oxide (100 ppm). Input mean impedance, reflecting distal arteriolar vasoconstriction, and characteristic impedance, reflecting proximal arterial geometry and distensibility, were calculated. The modulus of elasticity, a measure of the "stiffness" of the proximal vessels, was also calculated. Hypoxia caused a large increase in input mean impedance in both 48-hour-old and 14-day-old pigs (4826 +/- 272 versus 8744 +/- 488 dyne.cm.sec-5 and 3129 +/- 73 versus 6000 +/- 134 dyne.cm.sec-5, respectively; p = 0.0078). Characteristic impedance was not altered in the younger animals (1171 +/- 76 dyne.cm.sec-5) but increased in the older animals (419 +/- 15 versus 797 +/- 20 dyne.cm.sec-5. p = 0.0078). Older animals also experienced an increase in the modulus elasticity (1.92E06 +/- 3.2E05 versus 1.05E07 +/- 3.9E05 dyne/cm2, p = 0.0078). These data show that inhibited nitric oxide production, as might be seen in endothelial dysfunction, potentiates the profound hypoxic vasoconstriction observed at the level of the distal pulmonary arterioles in both neonatal and infant animals. In contrast, only older animals had a stiffening of the larger, more proximal vessels with hypoxia. In both age groups, inhaled nitric oxide effectively reduced the increases in impedance.

Pulmonary arterial endothelial dysfunction potentiates hypercapnic vasoconstriction and alters the response to inhaled nitric oxide.

BACKGROUND: Pulmonary hypertensive crisis can be initiated by episodes of hypercapnic acidosis. Hypercapnic vasoconstriction in the newborn pulmonary arterial circulation may be modulated by endogenous production of nitric oxide (NO) by the endothelial cell and effectively treated with inhalation of NO. METHODS: Sixteen 48-hour-old piglets were randomized to receive a hypercapnic challenge after administration of either saline vehicle or the NO synthase inhibitor N-omega-nitro-L-arginine (L-NA). Pulmonary arterial pressure, flow, and radius measurements were taken at baseline, after infusion of vehicle or L-NA, during hypercapnia (inspired fraction of carbon dioxide, 0.15), and during inhalation of NO (100 ppm). Fourier analysis was used to calculate input mean impedance, reflecting distal arteriolar vasoconstriction, and characteristic impedance, reflecting proximal arterial geometry and distensibility. RESULTS: Input mean impedance was increased with L-NA administration. Animals pretreated with L-NA also underwent a much larger increase in input mean impedance with exposure to hypercapnia than untreated animals. Characteristic impedance increased in the treated animals, but not in the controls. CONCLUSIONS: In the newborn pulmonary arterial circulation, endogenous NO production by the endothelial cell modulates resting tone distally, but not proximally. In addition, lack of a functional endothelium markedly potentiates the distal vasoconstrictor response to hypercapnia and produces proximal vasoconstriction. Despite impaired endothelial function, inhaled NO remains an effective vasodilator in hypercapnic pulmonary vasoconstriction.

Capsaicin-induced rapid receptive field reorganization in cuneate neurons.

1. To determine whether activity in unmyelinated or thinly myelinated primary afferents affects the organization of cutaneous receptive fields (RFs) in the cuneate nucleus, subcutaneous injections of capsaicin were made into the RFs of cuneate neurons in anesthetized cats. The effects of capsaicin injection on RF size and position, response properties, and spontaneous firing rates were determined during single-unit recordings. 2. Subcutaneous injection of capsaicin (10% dissolved in 70% ethanol) into peripheral RFs produced rapid RF reorganization in all neurons tested (n = 20), even when the original RF remained responsive to tactile stimulation. RF reorganization was marked by the appearance of newly responsive RFs. These RFs appeared as either contiguous expansions of the original RF or as new, noncontiguous fields. Control injections of the vehicle alone never produced RF reorganization (n = 9). RF reorganization was not related to changes in spontaneous activity. 3. Following capsaicin-induced RF reorganization, subcutaneous injections of lidocaine were made into the original RFs (n = 8). These injections produced no additional RF reorganization in seven of the eight neurons, even though in each case the lidocaine injections produced at least partial blocks of responsiveness from within the original RF. 4. In approximately one-half of the neurons (9 of 20), the reorganized RFs had response properties that were different from those of the original RF. This result suggests that, for neurons in the dorsal column nuclei (DCN), physiological mechanisms that normally mask inputs and restrict RF size can give rise to response specificity. 5. The results of these experiments demonstrate that capsaicin-induced RF reorganization, which has been reported previously in ventrobasal thalamus and primary somatosensory cortex, can arise within the dorsal column-medial lemniscal system, at the level of the DCN. The present results also provide evidence that rapid RF reorganization in cuneate neurons can be produced by blockade of a subset of peripheral afferents that are sensitive to capsaicin.

Health care reform: motivation for discrimination?

One of the major issues in the health care reform debate is the requirement that employers pay a portion of their employees' health insurance premiums. This paper examines the method for calculating the employer share of the health care premiums, as specified in the President's health care reform proposal. The calculation of the firm's cost of providing employee health care benefits is a function of marital status as well as the incidence of two-income earner households. This paper demonstrates that this method provides for lower than average premiums for married employees with no dependents in communities in which there is at least one married couple where both individuals participate in the labor market. This raises the non-wage labor costs of employing single individuals relative to individuals which are identical in every respect except their marital status. This paper explores the economic implications for hiring, as well as profits, for firms located in a perfectly-competitive industry. The results of the theoretical model presented here are clear. Under this proposed version of health care reform, ceteris paribus, firms have a clear preference for two-earner households. This paper also demonstrates that the incentive to discriminate is related to the size of the firm and to the size of the average wage of full-time employees for firms which employ fewer than fifty individuals. While this paper examines the specifics of President Clinton's original proposal, the conclusions reached here would apply to any form of employer-mandated coverage in which the premiums are a function of family status and the incidence of two-earner households.

Receptive field reorganization in dorsal column nuclei during temporary denervation.

Altered sensory input can result in the reorganization of somatosensory maps in the cerebral cortex and thalamus, but the extent to which reorganization occurs at lower levels of the somatosensory system is unknown. In cat dorsal column nuclei (DCN), the injection of local anesthetic into the receptive fields of DCN neurons resulted in the emergence of a new receptive field in all 13 neurons studied. New receptive fields emerged rapidly (within minutes), sometimes accompanied by changes in adaptation rates and stimulus selectivity, suggesting that the new fields arose from the unmasking of previously ineffective inputs. Receptive field reorganization was not imposed by descending cortical inputs to the DCN, because comparable results were obtained in 10 additional cells when the somatosensory and motor cortex were removed before recording. These results suggest that mechanisms underlying somatotopic reorganization exist at the earliest stages of somatosensory processing. Such mechanisms may participate in adaptive responses of the nervous system to injury or continuously changing sensory stimulation.

Measurement of hyphema: a clinical method.

The purpose of this study was to devise a simple and reliable method of accurately measuring hyphema in the anterior chamber. Simple measurements of specific ocular characteristics, namely the corneal diameter and the vertical height of the blood column, are all that is required. Reference tables were generated to determine the amount of blood in the anterior chamber, and the percentage of volume occupied by blood.

The polyspecific immunoglobulin response to HSV-1 viral proteins: determination of immunogenic proteins and relative antibody titres to individual polypeptides by immunoblotting.

We developed an immunoblotting procedure to characterise the polyspecific immunoglobulin response to the proteins of herpes simplex virus (HSV)-1. We found that 8-20% gradient polyacrylamide gels provided no advantage over fixed 8.5% gels for preparing Western blots for use in immunoblotting. The amount of protein loaded on the gels markedly influenced which proteins were detected by immune serum. The presence of Triton-X-100 0.5% in washes and buffers improved band clarity on immunoblots. In optimal conditions, immune mouse serum reacted with up to 33 HSV-1 lysate proteins. Six bands or regions appeared to be of major immunogenic reactivity, including the (122-130) x 10(3)-mol. wt region, a 75 x 10(3)-mol. wt protein, the gD region of approximately (56-64) x 10(3)-mol. wt and two non-glycosylated bands at mol. wts(10(3)) 42 and 44. Minor proteins, more weakly reactive, were detected at 27 other areas. The relative antibody titres in immune mouse serum to the different major regions showed antibody titre to gD greater than gB/gC greater than (42/44) x 10(3) much greater than P75 much greater than VP154. Most human sera reacted with all of the major and many of the minor immunogenic proteins but individual sera varied markedly in the proteins recognised. We conclude that immunoblotting is valuable for evaluating immunoglobulin responses to major and minor immunogenic proteins of HSV-1.

The immunoglobulin response to individual HSV-1 viral polypeptides: kinetics of the response during primary and secondary experimental infection with herpes simplex virus.

We studied the immunoglobulin response to individual viral polypeptides in experimental primary and secondary infection with herpes simplex virus (HSV)-1 in mice. After a single footpad inoculation with 10(5.6) pfu of HSV-1, immunoglobulin to proteins mol. wts (10(3)) 44 and 75 appeared on day 7. Antibodies to gB, gC, gD, 42 x 10(3)- and (48-52) x 10(3)-mol. wt proteins appeared on day 11 and antibody to the major capsid protein, VP154, appeared on day 15 after infection. The secondary immune response was characterised by early production of antibody to gD on day 3 followed by antibodies against the 42 x 10(3)- and 44 x 10(3)-mol. wt proteins on days 4 and 5 respectively. Antibodies to glycoprotein gC and gB were delayed until day 7 of the secondary immune response. In both primary and secondary immune responses the responses against proteins of mol. wts (10(3)) 42 and 44 were particularly intense and of high titre. We conclude that the kinetics of anti-polypeptide antibody appearance is markedly asynchronous; and that the anti-glycoprotein responses occur too late in primary infection to contribute to viral clearance.

Oxygen transfer characteristics of the blood of reedfish, Erpetoichthys calabaricus.

Oxygen transport characteristics and phosphate compounds were measured in the blood of reedfish, Erpetoichthys calabaricus, a bimodal breather. Blood from reedfish possessed the following values (mean +/- SD): hematocrit (21.7 +/- 0.4%), hemoglobin concentration (7.53 +/- 1.75 g%), red blood cell count (0.45 +/- 0.10 X 10(6)/mm3) and oxygen capacity (10.1 +/- 2.3 vol%). Although hematocrit, hemoglobin concentration, red blood cell count and oxygen capacity were all highly intercorrelated (P less than 0.01 in all cases), none of these parameters were significantly correlated with sex, weight or length in our sixteen fish sample. Erythrocyte volumes equalled 480 micrometers3, showed less variation (CV = 10.4%) and did not correlate with any other measured variable. Blood oxygen dissociation curves were sigmoidal and the P50's equalled 17.34 +/- 3.04 at 1% CO2 and 25 degrees C. Mean Bohr shift (delta log P50/delta pH) was -0.274 +/- 0.087. Temperature strongly influenced blood oxygen affinity. At 1% CO2, delta log P50/delta T equalled 0.026 +/- 0.006 (mean +/- SD). These hematological properties indicate that the blood of reedfish is similar to those of other tropical air-breathering species. Concentrations of total phosphate in the erythrocytes and percentage of total phosphate bound as nucleotide triphosphates were high. Surprisingly, 2,3diphosphoglycerate was found which has been reported in the erythrocytes of only two other fish species. Blood characteristics of reedfish exposed to air for 4 hr with one exception (Hill numbers) were not significantly different from water exposed controls. This suggests that the reedfish does not possess blood respiratory mechanisms to facilitate respiration solely by air-breathing.