Ground Reaction Force and Cadence during Stationary Running Sprint in Water and on Land.

This study was aimed at analyzing the cadence (Cadmax) and the peak vertical ground reaction force (Fymax) during stationary running sprint on dry land and at hip and chest level of water immersion. We hypothesized that both Fymax and Cadmax depend on the level of immersion and that differences in Cadmax between immersions do not affect Fymax during stationary sprint. 32 subjects performed the exercise at maximum cadence at each immersion level and data were collected with force plates. The results show that Cadmax and Fymax decrease 17 and 58% from dry land to chest immersion respectively, with no effect of cadence on Fymax. While previous studies have shown similar neuromuscular responses between aquatic and on land stationary sprint, our results emphasize the differences in Fymax between environments and levels of immersion. Additionally, the characteristics of this exercise permit maximum movement speed in water to be close to the maximum speed on dry land. The valuable combination of reduced risk of orthopedic trauma with similar neuromuscular responses is provided by the stationary sprint exercise in water. The results of this study support the rationale behind the prescription of stationary sprinting in sports training sessions as well as rehabilitation programs.

Marcha en el medio terrestre y en el medio acuático en niños con secuelas de mielomeningocele / Mielomeningocele children gait at over ground and underwater

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Análise das forças de reação do solo na marcha de adultos a 1, 3m de imersão / Analysis of ground reaction forces in underwater gait of adults at 1, 3m of immersion

Este estudo descritivo exploratório objetivou analisar as componentes vertical e ântero-posterior da curva de força de reação do solo na marcha subaquática. Participaram 60 sujeitos, estatura entre 1.60-1,85m e média de idade de 23+-5 anos, divididos em três grupos, conforme o nível de imersão no esterno: grupo 1 - manúbrio, grupo 2 - ponto médio entre xifóide e manúbio e grupo 3 - processo xifóide. Os sujeitos caminharam sobre uma passarela, com duas plataformas de força, profundidade de 1,3m e em quatro situações diferentes: alterando velocidade (lenta/rápida) e posição dos membros superiores (dentro/fora da água). Na análise de dados, utilizou-se a estatística descritiva e inferencial, com p<0,01, na comparação inter e intragrupos. Na componente vertical, as forças variaram de 20 a 40 por cento do peso corporal dos sujeitos dependendo da velocidade e posição dos membros superiores. Na componente ântero-posterior, as forças foram de 5 a 15 por cento do peso corporal também de acordo com a situação. Dessa forma, para um mesmo nível de imersão, as forças podem variar significativamente conforme o modo de realização da marcha subaquática. Um aumento na velocidade da marcha acarreta em aumento da componente ântero-posterior, enquanto que um aumento na massa corporal fora da água acarreta um aumento principalmente da componente vertical. Conhecer alterações é importante para os profissionais que prescrevem atividades em ambiente aquático

Desenvolvimento e teste de suporte de peso corporal instrumentalizado para o treino de marcha em esteira / Development and testing of an instrumented body weight support system for gait training on treadmill

O objetivo deste trabalho foi testar a funcionalidade do sisema de suporte de peso corporal (SPC) instrumentalizado e medir a quantidade de suporte de peso durante o treino demarcha em esteira. Metodo: no SPC instrumentalizado foram inseridas duas celulas de carga, uma tipo anel para meditacao da forca vertical e outra tipo viga retangular para medicao de carga no suporte manual. Somando-se as forcas das celulas tem-se a carga total do SPC durante a marcha. Para testar a funcionalidade do sistema foi realizado ensaio com um paciente com paralisia cerebral dplegica. Resultados: este paciente que possuia autonomia de 33 passos sem apoio conseguiu realizar o ensaio nas velocidades de 1,0 KM/h a 3,5km/h, caminhando por 10 min. Foi conseguida a mensuracao da quantidade de peso suportada pelo instrumental durante todo o ensaio. Com base nas aquisicoes, pode-se ver que o porcentual suportado esta continuamente variando com a locomocao do paciente. A utilizacao do SPC instrumentalizado durante o treino de marcha gerou algumas vantagens: saber o valor e a variacao da porcentagem de peso, gerar retroalimentacao para o paciente e armazenar dados para o acompanhamento do paciente e de sua evolucao ou para compara-lo aos outros pacientes. Conclusao: o equipamento desenvolvido funcionou eficazmente e foi possivel mensurar a forca durante a marcha com SPC na esteira. Ficou caracterizado que esta forca nao e constante e varia tambem com o aumento da velocidade da marcha

Análise comparativa da marcha humana em solo a subaquática em dois níveis de imersão: joelho e quadril / Comparative analysis of the human gait in the terrestrial and aquatic environment in two levels of immersion: hip and knee

Esta pesquisa exploratoria teve por objetivo analisar os parametros da marcha em ambiente aquatico em dois niveis de imersao: quadril e joelho (1,1 e 0,6 m), quando comparada ao ambiente terrestre. Participaram desta pesquisa 11 sujeitos com idade entre 15 e 28 anos, de ambos os generos. Realizaram a marcha em uma passarela de 3,65 metros de comprimento e 0,5 metro de largura. Duas plataformas de forca subaquaticas foram colocadas na passarela de 3,65 metros de comprimento e 0,5 metro de largura. Duas plataformas de forca subaquaticas foram colocadas na passarela para a aquisicao das forcas de reacao do solo e pesagem dos sujeitos. Foram adquiridas no total 220 curvas de forca vertical de reacao do solo por intermedio da plataforma para cada uma das tres situacoes: fora e dentro d`agua nas profundidades que correspondem aproximadamente, aos niveis do quadril e do quadril e do joelho. O valor medio da forca, normalizado pelo corporal (N/PC), do primeiro e segundo picos de forca foi de: 1,03 N/PC fora d`agua, 0,88 N/PC no nivel do joelho e 0,43 N/PC no quadril. No pico minimo os valores foram: 0,87 N/PC fora d`agua, 0,76 N/PC no nivel do joelho e 0,37 N/PC no quadril. Analisando as curvas qualitativamente, foi constatado que conforme aumenta o nivel de imersao vao sendo alteradas as caracteristicas da curva de forca de reacao do solo (primeiro pico, segundo pico e pico minimo), levando a forma da curva a semelhanca da figura de um trapezio. Essas alteracoes no ciclo da marcha sao importantes para a prescricao detratamento para um individuo que nao consiga suportar todo o peso corporal e deva iniciar seu processode recuperacao funcional terapeutica, pois com a reducao das forcas verticais o individuo tera maior seguranca para a fase inicial de treinamento da marcha

Myocardial [18F]FDG tomography using a conventional gamma camera and a seven pinhole collimator.

OBJECTIVE: Seven pinhole tomography (SPHT) is fast, inexpensive, and, because it relies on standard gamma cameras and computers, available everywhere. This article investigates the suitability of SPHT for the detection and localization of 511 keV gammas emitted from 18F without coincidence detection. MATERIALS AND METHODS: A standard SPH collimator and the table were additionally shielded with lead. For comparison, point sources and cardiac phantoms were imaged on SPHT and a triple head gamma camera (THC). The phantom studies were supplemented with patient examinations using a standard clinical protocol. Circumferential profiles allowed a direct comparison of perfusion under different conditions or perfusion plus metabolism. RESULTS: Dedicated for cardiac workup, SPHT has a 5-10 times better sensitivity (dependent on distance) than THC and gives superior resolution for the extension of a lesion perpendicular to the long cardiac axis: The full width at half-maximum for x- and y-directions (FWHMx,y) for a 99mTc-point source was found to be 35 and 22% smaller at 130 and 220 mm distances with SPHT than with THC. The SPHT even surpasses the THC at greater distances. The resolution falls off with 18F: FWHM increases by 70 and 48%, respectively, compared to 99mTc. The in-depth resolution is worse with SPHT: The FWHM (using 99mTc) is 2-3.5 times greater with SPHT than with THC and remains within this range with 18F. CONCLUSION: It is possible to image 18F distributions using SPHT with a very high sensitivity and good detail resolution, even in the presence of 99mTc and 201Tl. The SPHT compares well with THC for 99mTc, except in its in-depth resolution, and is unsurpassed in its sensitivity and ease of performance.

Nonimmunogenic hyperthyroidism: cumulative hypothyroidism incidence after radioiodine and surgical treatment.

During 1977, 246 hyperthyroid patients were seen in our departments, 140 (57%) with nonimmunogenic hyperthyroidism (NIH)--101 with a toxic adenoma (TA) and 39 with multifocal functional autonomy (MFA). All patients but one could be followed over 9 yr, 101 after 131I treatment (RIT), another 29 after surgery (S). Ten patients were left untreated. Thirty-four treated (24%) patients died, none as a result of thyroid or post-treatment complications. There was no hyperthyroidism later than 9 mo after therapy. Only 1% (RIT) and 24% (S) were hypothyroid 1 yr after treatment. But 19% of all treated NIH patients were hypothyroid after 9 yr or at the time of their death, 12% after RIT and 41% after S. The cumulative hypothyroidism incidences 1.4%/yr for RIT and 2.2%/yr for S, were not significantly different. Out of the five survivers without RIT or S, two TA patients were hypothyroid. The effect of RIT on goiter related loco-regional complications was not worse than after S. We conclude that RIT is the treatment for NIH, leaving surgery for exceptional cases.

Ovarian cancer and tumor markers: sialic acid, galactosyltransferase and CA-125.

In an effort to correlate the serum values of potential markers, including CA-125, galactosyltransferase, and total sialic acid, with residual tumor mass after initial surgery, 43 patients with FIGO stage IIb and c, III and IV ovarian cancer were studied. The sensitivity of galactosyltransferase and sialic acid levels was sufficient to correlate their serum values with the corresponding residual tumor mass. Furthermore, 28 patients were histopathologically evaluated for their response to chemotherapy. Determination of these tumor markers did not permit discrimination between small residual disease (less than or equal to 1 cm) and a state of 'no evidence of disease'. Conversely, progression of disease has been associated with a sensitive increase in the level of all three markers. CA-125 has been found to be the most useful of the three for distinguishing between responders and nonresponders.

[Radiometry of epiphyseolysis capitis femoris. A comparison of conventional roentgen study with axial computerized tomography]. / Radiometrie der Epiphyseolysis capitis femoris. Ein Vergleich der konventionellen Röntgenuntersuchung mit der axialen Computertomographie.

CT scans are proposed for the measurement of tibial, femoral and humeral torsion. The value of computerised tomography in the evaluation of slipped capital epiphysis is yet not discussed. Conventional roentgenographic studies have shown that the capital femoral epiphysis slips by rotating backwards. In a study of 5 cases with a right site slip of the capital femoral epiphysis of different extent a comparison of conventional radiography with CT-scan was undertaken. True lateral films of both hips were obtained at the same time when CT scan of the femoral head and the condylar region of the femur were performed. The optimal site of cross-sectioning the femoral head lies in its center. Both measurements of the epiphysial torsion vary more ore less. This is believed to be related to the different plans in which the upper femoral end is projected in conventional radiography and CT-scan. Both angles of epiphysial torsion are geometrically related. A formula is given for mathematical transfer. Only by marked epiphysial displacement both angles vary to a greater extend. CT scan is suggested to be of certain value in the preoperative evaluation in heavy slips.

[Accuracy of length and angle measurements in the roentgen image and sonogram of the pediatric hip joint]. / Die Genauigkeit von Längen- und Winkelmessungen im Röntgenbild und Sonogramm des kindlichen Hüftgelenkes.

The results of measurement of length and angles in the x-ray and ultrasound image of the infantile hip joint are dependent on the different shape of the joint but also on different x-ray projections, on a limited accuracy and incorrect technique in measurement. From our investigations on the accuracy of measurement a differentiation between normal and pathological infantile hip joints is not possible by measuring geometrical data in the x-ray resp. ultrasound image. In the x-ray the greatest possible error of the acetabular angle is +/- 3 degrees, that of the so-called "AMC-angle" +/- 5 degrees and of the Alpha- and Beta-angle in the ultrasound image +/- 10 degrees. Thus the collection of geometrical data in the x-ray and ultrasound image of the infantile hip joint is not more reliable than a qualitative assessment orientated on the osseous resp. cartilaginous corner of the acetabulum.

Surgical repair of the kidney after blunt lesions of intermediate degree using a Vicryl mesh: an experimental study.

Twelve experimentally induced blunt renal lesions in pigs were treated either with an alloplastic renal capsule made of semi-elastic Vicryl mesh or with homologous pig fibrin adhesive or with through-and-through chromic catgut sutures as controls. The Vicryl mesh capsule was made by the Ethnor Company (Paris, France) to our specifications. The postoperative isotope nephrograms, which were repeated until the Vicryl had been fully resorbed, showed good renal function in every case. However, when compared to the controls, the kidneys which had been repaired with Vicryl mesh contained considerably less scar tissue at the site of parenchymal rupture and showed neither perirenal fibrosis nor atrophy of the parenchyma in the vicinity of the capsule. Our preliminary results seem to confirm that simple and rapid surgical treatment of moderately severe blunt renal lesions is possible using the alloplastic Vicryl mesh capsule. The method may also be suitable for reconstruction of the parenchyma following multiple nephrotomies, such as for removal of staghorn calculus, and experimental investigations are under way to clarify this point.

Obstructive uropathy: frusemide test and analysis of renographic curve patterns.

49 patients with clinically proven uropathy and 14 others suffering from nephropathy underwent quantitative 131I-OIHA renography, combined with a frusemide provocation test. In significant obstruction, diuresis reaction was typically less than 5% (predictive value of a positive test 76%). The renographic curves, derived from the renal cortex and from the pyelon were diverging, with the pelvic curve showing a continuous rise (predictive value of a positive test for the curve pattern analysis 92%). Non-obstructive dilatation of the urinary system was characterized by a high diuresis index (greater than 15%) (predictive value 82%). The curve pattern was plateau-like before and showed a converging course of cortical and pelvic activity spontaneously, at least after diuresis provocation (predictive value 75%). Nephropathy alone could exceptionally mimick both significant obstruction and non-obstructive dilatation. Qualitative renographic curve analysis combined with diuresis provocation renders a higher diagnostic yield regarding the dynamic state of questionable uropathy than either test alone.

Renal artery stenosis and evaluation of the effect of endoluminal dilatation. Comparison of dynamic CT scanning and I-131-OIHA renogram.

Percutaneous transluminal dilatation was performed in 16 patients with hypertension and renal artery stenoses. Dynamic CT scanning and an I-131-OIHA renogram was performed before and after dilatation. After the procedure (follow-up greater than or equal to 3 months) the hypertension was assessed clinically as normalized in six, improved in five, and unimproved in five patients. The attenuation difference at dynamic CT scanning between both kidneys at the time of peak enhancement following intravenous bolus injection of contrast material diminished significantly from 16 +/- 4 HU before to 7 +/- 6 HU (P = 0.015) after dilatation in the patient group with cured hypertension, whereas the relative opacification of the poststenotic kidneys increased from 43.6 +/- 2.4% to 47.4 +/- 1.7% (P = 0.014). The results of the Isotope renogram showed a similar increase of the relative function of the poststenotic kidneys from 33 +/- 5% to 38 +/- 7% (P = 0.227) and significant improvement of the clearance from 112 +/- 34 to 175 +/- 48 ml/min/1.73m2 (P = 0.040). The results of both techniques did not significantly change in the group of patients with only moderate improvement of hypertension. Deterioration of the results occurred in those patients in which the hypertension remained unchanged.

Tomoscintigraphic assessment of myocardial metabolic heterogenity.

I-123-omega-heptadecanoic acid (HDA) was evaluated for myocardial scanning in 59 healthy volunteers and 133 patients, using a 7-pinhole collimator. Early (uptake) and late (retention) images were compared visually. Regional HDA elimination was also followed semiquantitatively based on the calculation of a retention-over-uptake ratio, R(phi), derived from the maximal counts/pixel in 60 midventricular slice sectors. The healthy heart concentrated HDA homogeneously in all segments with no difference between early and late images. The minimal R(phi), taken as representative of that myocardium with the best function, was unchanged after maximal ergometer stress and with dipyramidole-induced hyperperfusion. A circumscribed decreased HDA uptake is the clear-cut criterion for an abnormal finding. HDA tomography of the myocardium had an 86% sensitivity for myocardial infarcts (MIs) up to 4 wk old, and 83% for myocardial scars (MSs). Comparing early and late tomograms, we find a cool-warm sequence more often with acute and subacute MIs. A cool-cool or a cold-cold sequence dominated with MSs. HDA tomoscintigraphy cannot replace TI-201 for the evaluation of regional coronary reserve in coronary heart disease.

Comparison of gastrointestinal loss of alpha-1-antitrypsin and chromium-51-albumin in Ménétrier's disease and the influence of ranitidine.

In a 37-year-old patient with Ménétrier's disease, 51Cr-albumin and alpha 1-antitrypsin (alpha 1-AT) output was measured simultaneously in gastric juice and feces. While the 51Cr-albumin studies demonstrated a threefold increase in gastrointestinal protein loss, alpha 1-AT was found in normal quantities in gastric juice and feces. The histamine H2 antagonist, ranitidine, led to a marked reduction in gastric protein loss, as evidenced by decreased 51Cr activity in the stomach. Studies of protein loss in the gastric juice during pentagastrin stimulation (6 micrograms/kg/h) showed that the 51Cr-albumin output paralleled the volume secreted, whereas alpha 1-AT decreased with lower pH values, not being detectable below pH 3. This probably results from peptic degradation of alpha 1-AT at low pH. We conclude that fecal alpha 1-AT determination cannot be used for the assessment of protein-losing gastropathy in patients who are not achlorhydric.

Experiments with the double isotope single-injection method for determining glomerular filtration rate and effective renal plasma flow in veal calves.

Single injections of the radiochemicals Cr51-EDTA and I125-ortho-iodohippurate (I125-OH) were used simultaneously to measure the glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), respectively, in 26 calves weighing between 37 kg and 90 kg. The mean GFR was 2.31 ml per minute per kg and the mean ERPF was 9.62 ml per minute per kg. These values are very similar to the GFR and ERPF measured in young calves and adult cattle by using constant infusions of inulin and para-aminohippurate as marker substances. Correlation coefficients of the order of 0.70 were found between clearance values and body-weights. The method described is rapid and reliable.