Dynamic electromyographic analysis of trunk musculature in professional golfers.

Using dynamic surface electrode electromyography, we evaluated muscle activity in 13 male professional golfers during the golf swing. Surface electrodes were used to record the level of muscle activity in the right abdominal oblique, left abdominal oblique, right gluteus maximus, left gluteus maximus, right erector spinae, left erector spinae, upper rectus abdominis, and lower rectus abdominis muscles during the golfer's swing. These signals were synchronized electronically with photographic images of the various phases of the golf swing; the images were recorded in slow motion through motion picture photography. The golf swing was divided into five phases: take away, forward swing, acceleration, early follow-through, and late follow-through. Despite individual differences among the subjects' swings, we observed reproducible patterns of trunk muscle activity throughout all phases of the golf swing. Our findings demonstrate the importance of the trunk muscles in stabilizing and controlling the loading response for maximal power and accuracy in the golfer's swing. This study provides a basis for developing a rehabilitation program for golfers that stresses strengthening of the trunk muscles and coordination exercises.

Glenoid cysts mimicking cervical radiculopathy.

STUDY DESIGN: Patients are often referred for the evaluation of neck or radiating shoulder or arm pain who are suspected of having a possible cervical spine origin of their symptoms. Careful evaluation may show ganglion cysts of the glenohumeral joint mimicking symptoms of cervical radiculopathy. OBJECTIVES: To present a series of patients in whom cysts originating from the glenohumeral joint caused symptoms mimicking cervical radiculopathy. SUMMARY OF BACKGROUND DATA: Suprascapular nerve entrapment in the suprascapular notch by ganglion cysts from the glenohumeral joint has been described as the source of vague radicular symptoms. This paper presents a series of patients referred to a spine practice for the evaluation of cervical radiculopathy who actually had glenoid cysts mimicking cervical radiculopathy. METHODS: Three hundred forty-two patients were evaluated for cervical radiculopathy; of these, eight had glenoid cysts that were the source of the patients' symptoms. RESULTS: All eight patients had a positive shoulder impingement sign, or, in all, symptoms were temporarily relieved with intra-articular lidocaine injection. Four of the eight patients had abnormal electromyelography and nerve conduction velocity for suprascapular nerve compression. Magnetic resonance imaging of the shoulder was diagnostic in all eight patients. CONCLUSION: Proper evaluation of the shoulder must be done because it may mimic symptoms of cervical radiculopathy.

Reversible urinary retention secondary to excessive morphine delivered by an intrathecal morphine pump.

Reversible complication of intrathecal morphine delivered by an implanted pump is described in one patient. The patient was evaluated initially using a contrast CT of the thoracic spine as well as urodynamics studies. After decreasing the intrathecally administered morphine from 2 mg/24 hr to .5 mg/24 hr, the patient's neurogenic bladder reversed within 4 days. Implanted pumps to deliver intrathecal narcotic medications are being used currently to treat intractable pain. This is a case report of reversible urinary retention secondary to the intrathecal narcotic.

Analysis of medications used in the treatment of cervical disk degeneration.

This review focuses on the scientific design and concepts of drug management of cervical disk disorders. Steroids, nonsteroidal anti-inflammatory medicines, narcotics, antidepressants and muscle relaxants are discussed.

Accurate compartment pressure measurement using the Intervenous Alarm Control (IVAC) Pump. Report of a technique.

This study demonstrates the accuracy of a common, readily available pressure transducer system (IVAC pump) for the measurement of compartment syndromes. An in vitro assay was used to compare the accuracy of the IVAC pump manometer with the Hewlett-Packard monometer (HP78532B) and a miniaturized digital fluid pressure manometer (Stryker). The IVAC pump was accurate within 2.4 mm Hg difference of the HP78532B and Stryker manometers. Twenty-five patients suspected of having compartment syndrome posttibial fracture had compartment pressures measured using the IVAC pump. In all the patients, compartment syndrome was accurately assessed (positive in one case and negative in the remainder). The IVAC pump is readily available in most hospitals. It is easy to use and provides accurate measurements of compartment pressures.

Treatment versus non-treatment of hip dislocations in ambulatory patients with myelomeningocele.

Thirty myelomeningocele patients with untreated hip dislocations who had functional quadriceps and good ambulatory capability were evaluated for hip pain, hip motion and sitting ability: they had no pain, good to excellent hip motion and no difficulty in sitting. Three were wheelchair-bound. Nine had a limb-length inequality requiring a shoe lift. They were compared with a similar series of 11 patients who underwent open reduction of a dislocated hip with a two-year follow-up. Two patients in this group had improved and three had worse sitting balance. Serious perioperative complications occurred in six patients. The authors conclude that surgical reduction of paralytic hip dislocations in ambulatory myelomeningocele patients is costly and offers little obvious benefit.

Accurate prediction of experimental cancer chemosensitivity using the subrenal capsule xenograft assay.

The chemosensitivity of a murine lung carcinoma grown as a xenograft under the kidney capsule of a rat was compared to the chemosensitivity of this tumor grown as a spontaneous metastasis in its syngeneic host. The chemosensitivity of the tumor to intravenously or subcutaneously administered drugs determined in the short-term xenograft assay accurately predicted the chemosensitivity of this tumor when it was growing as a spontaneous micrometastasis in its syngeneic host, indicating that in both situations the pharmacological determinants of tumor response to anticancer drugs were similar. These results suggest that tumors growing as xenografts under the kidney capsule accurately reflect the responsiveness of these tumors to chemotherapy and support further investigation of the xenograft subrenal capsule assay as a model that may be useful in predicting effective chemotherapy for human tumors.

Heroin activity in New York City, 1970-1978.

Heroin activity in New York City is traced from 1970 using a variety of indicators. A steady decline in the number of new "intensive" users (those who required treatment) is noted, beginning around 1970. Various possible explanations of this decline are examined. Reductions in the supply of heroin or in the demand for heroin do not appear to be causes of the decline in new users, as these reductions occurred after the decline in new users had already begun. Demographic changes--the passing of the baby boom cohort through the period of highest risk of beginning heroin use--also does not appear to be a viable explanation, as trends in use of other drugs do not show a decline. Changes in attitudes toward heroin as a specific drug are left as the most plausible explanation of the decline in the number of new intensive heroin users.

Assessing age-of-onset data on substance use among New York State public secondary school students.

This study was designed to assess the quality of age-of-onset data obtained in a state-wide secondary school survey on substance use. A representative sample (8,553), consisting of New York State students in public secondary schools (Grades 7-12) responded to a questionnaire during winter 1974/75. For each of eight substances, a parallel comparison was performed. The ages of onset for students of different current ages (12-17) were compared. All substances except alcohol and tobacco displayed similar patterns of age-of-onset response. The apparent discrepancies for alcohol and tobacco may be due to either a real instability in the age-of-onset pattern or to a recall error. The results of the study suggest that retrospective questions may provide useful information, particularly when they relate to memorable events.

A survey of substances use among junior and senior high school students in New York state, Winter 1974-75.

A survey designed to assess drug and alcohol use among the 1,600,000 students in Grades 7 through 12 who attend New York State public schools was administered in 10i schools during the winter of 1974-75. Findings indicate that over 80% of the students have used alcohol and that almost one-third of the students have used marijuana at least once. In addition, 60% of the marijuana users have used no other substance, with the possible exception of alcohol. Also, if a student has used a substance, he is likely to have used it within the last 6 months. Finally, multiple substance use is not predominant among marijuana users, but is predominant among users of other substances.