bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a 2‐week treatment with pulsed monochromatic light in healthy pigs: a clinical and morphological study
Authors: Jensen‐Waern M. , Ekman S.
Published: March 2003

Background: Pulsed monochromatic light (PML) is now used clinically for pain relief and wound healing in both human and veterinary practice. The purpose of this study was to evaluated the clinical and pathological effects of PML irradiation in an animal model, using healthy specific pathogen‐free pigs.

Methods: After 2 weeks of habituation, one group of animals (n=9) underwent treatment with pulsating monochromatic infrared and red light while the control group (n=9) was left untreated. PML was given five times a week during a 2‐week period, and at each treatment the total radiant exposure was 6.3 J/cm2. At the completion of the study, all pigs were subjected to complete necropsy.

Results: None of the animals showed any clinical signs of disease during the study period. The measured hematological and clinico‐chemical variables all showed values within the reference range and the daily weight gain was high in both the treatment and control groups (825 and 923 g/day, respectively). The pathological examination revealed no morphological differences between treated and non‐treated animals.

Conclusion: In healthy pigs, no adverse effects of low‐energy photon therapy on the clinical state of health or on the morphology of different tissues were observed.
The effects of EGb 761 on lipid peroxide levels and superoxide dismutase activity in sunburn
Authors: Ozkur Mehtap Kilinc , Bozkurt Meral Sasoglu , Balabanli Barbaros , Aricioglu Aysel , Ilter Nilsel , Gürer Mehmet Ali , Inalöz H. Serhat
Published: March 2003

Background/Purpose: Free oxygen radicals are involved in inflammatory skin reactions induced by ultraviolet B (UVB). In this study, the effect of a herbal antioxidant Ginkgo biloba extract (EGb 761) was investigated in UVB irradiated mice skin.

Methods: The study was carried out on four groups of mice (n = 6 in each group). The first group was a control group (G1). The second group (G2) was only exposed to acute UVB irradiation. The third group (G3) received 100 mg/kg/day of EGb 761 orally for 5 days before UVB irradiation and the fourth group (G4) was given only a single dose of EGb 761 immediately after UVB irradiation. Eighteen hours after exposing to UVB, lipid peroxide levels, and superoxide dismutase (SOD) activities were studied and UVB damage was evaluated histopathologically according to ‘sun‐burn cell count’.

Results: The SOD activities and Malondialdehyde (MDA) levels in G2, G3 and G4 were found to be decreased significantly when compared with G1 (P < 0.05). The SOD activities of G3 and G4 were higher when compared with G2 (P < 0.05). The number of sunburn cells (SBCs) was the highest in G2.

Conclusions: Our results suggest that EGb 761 may have an important effect, both as a protective and therapeutic agent, in sunburn after UVB irradiation.
Skin cancer and ultraviolet‐B radiation under the Antarctic ozone hole: southern Chile, 1987–2000
Authors: Abarca Jaime F. , Casiccia Claudio C.
Published: March 2003

Background:  Punta Arenas, Chile, the southernmost city in the world (53°S), with a population of 154 000, is located near the Antarctic ozone hole (AOH) and has been regularly affected by high levels of ultraviolet‐B (UV‐B) radiation each spring for the last 20 years. Large increases in UV‐B associated with the AOH have been measured with increases in UV‐B at 297 nm of up to 38 times those of similar days with normal ozone. Recently we reported significant increases in sunburns during the spring of 1999 on days with low ozone because of the AOH.

Methods:
 A surveillance of skin cancers occurring from 1987 to 2000 was performed. Age, sex, location, type of skin cancer and skin phototype were recorded. A Brewer Spectrophotometer was used in order to obtain in situ measurements of ozone and UV‐B. Total Ozone Mapping Spectrometer (TOMS) data from National Aeronautics and Space Administration (NASA) was used in order to establish pre‐ozone hole climatology.

Results:
 Ozone levels as low as 145 DU (Dobson Units) were recorded, a 56% decrease in ozone, and UV‐B levels up to 4.947 J/m2. These levels are close to summertime levels at mid latitudes. For the 14‐year period – from 1987 to 2000 – 173 cases of skin cancer were diagnosed, 65 during the first 7 years, 108 during the second, an increase of 66%. Cutaneous malignant melanoma (CMM), 19% of the cases, increased by 56%, raising the rate from 1.22 to 1.91 per 100 000. Non‐melanoma skin cancer (NMSC), 81% of the total, increased the rate from 5.43 to 7.94 per 100 000 (P < 0.05), a 46% increase. Patients with CMM and NMSC had skin phototypes I–II in 59% and 54% of cases, respectively. Days with more than 25% ozone loss occurred in 143 days during the last 20 springs. Significant increases of UV‐B were observed under ozone hole conditions, especially around 300 nm, the most carcinogenic wavelengths.

Conclusions:  Highly unusual ozone loss and UV‐B increases have occurred in the Punta Arenas area over the past two decades resulting in the non‐photoadapted population being repeatedly exposed to an altered solar UV spectrum with a greater effectiveness for erythema and photocarcinogenesis. This phenomenon has not previously been reported over other populated areas and an additional increase in the skin cancer rate attributable to the AOH may be occurring. Research on the clinical and subclinical impact of these abnormalities is urgently needed.
Extracorporeal photochemotherapy for secondary chronic progressive multiple sclerosis: a pilot study
Authors: Besnier D. P. , Chabannes D. , Mussini J.‐M. G. , Dupas B. , Esnault V. L. M.
Published: March 2003

Background/purpose:  Extracorporeal photochemotherapy (ECP) has been proposed for the treatment of various auto‐ and allo‐immune reactions. However, a standard ECP regimen did not significantly alter the course of chronic progressive multiple sclerosis (MS). We tested whether an intensive ECP treatment can affect the course of secondary chronic progressive form of MS.

Methods:
  Five patients free of immunosuppression were included. Soluble 8‐MOP was added ex vivo to a mononuclear cell suspension obtained in a cell separator. This cellular suspension was then irradiated using an UVA irradiator and re‐infused into the patient. ECP was performed once a week for 6 weeks and then, depending on clinical evaluation, for a maximum of 6 months, with 2‐year follow‐up after treatment discontinuation. Scoring was performed with the Kurzke scale and EDSS by a single independent neurologist.

Results: One patient was excluded because of recurrent attacks at the very beginning of treatment. Four patients completed the study: one exhibited clinical improvement and three remained stable during the first 6 months of treatment. However, all experienced relapse or worsening of the disease after discontinuation of ECP treatment.

Conclusion:  Our intensive ECP treatment only transiently alters the course of the severe secondary chronic progressive form of MS, with rebound after treatment discontinuation.
Therapeutic effect of melatonin on carbon tetrachloride‐induced acute liver injury in rats
Authors: Ohta Yoshiji , Kongo Mutsumi , Sasaki Emi , Nishida Keiji , Ishiguro Isao
Published: March 2003

The therapeutic effect of melatonin on acute liver injury was examined in rats intoxicated with carbon tetrachloride (CCl4).
Melatonin (10, 50, or 100 mg/kg body weight [BW]) was intraperitoneally
administered to male Wistar rats 6 hr after intraperitoneal injection of
CCl4 (1.6 g/kg BW) at which time an apparent liver injury
occurred. This post‐melatonin administration dose dependently prevented
the progression of liver injury at 24 hr after CCl4 injection,
judging from the levels of serum transaminases, indices of liver cell
damage. Rats injected with CCl4 alone showed an increase in
liver lipid peroxide (LPO) content and a decrease in liver reduced
glutathione content at 6 and 24 hr after the injection. The
post‐melatonin administration dose dependently ameliorated both changes
found at 24 hr after CCl4 injection. Rats injected with
CCl4 alone showed an increase in liver triglyceride (TG)
content and decreases in serum TG concentration and liver tryptophan
2,3‐dioxygenase (TDO) activity, a marker of the inhibition of liver
protein synthesis by CCl4, at 6 and 24 hr after the injection,
and also a decrease in serum albumin concentration at 24 hr. The changes
in serum TG, albumin concentration, liver TG content, and TDO activity
found at 24 hr after CCl4 injection were not ameliorated by
the post‐administration of melatonin. The same administration of
melatonin dose dependently reduced liver LPO content in
CCl4‐untreated rats. These results indicate that melatonin
exerts a therapeutic effect on CCl4‐induced acute liver injury in rats, possibly through its antioxidant action.
Changes of serum melatonin level and its relationship to feto‐placental unit during pregnancy
Authors: Nakamura Yasuhiko , Tamura Hiroshi , Kashida Shiro , Takayama Hisako , Yamagata Yoshiaki , Karube Ayako , Sugino Norihiro , Kato Hiroshi
Published: March 2003

Serum melatonin concentrations were studied in normal pregnant women and in women with several types of pathologic pregnancies, e.g., twins, preeclampsia or intrauterine growth retardation (IUGR). Blood samples were collected from the maternal antecubital vein at 14:00 hr (daytime) and 02:00 hr (nighttime) during pregnancy, and also from the umbilical vein and artery immediately after delivery. Serum melatonin concentrations were measured by radioimmunoassay. Daytime serum melatonin levels in normal (single fetus; singleton) pregnancies were low. While the levels showed an increasing tendency toward the end of pregnancy, no statistically significant changes occurred. On the other hand, the nighttime serum melatonin levels increased after 24 weeks of gestation, with significantly (P<0.01) high levels after 32 weeks; these values decreased to non‐pregnant levels on the 2nd day of puerperium. Nighttime serum melatonin levels were significantly (P<0.05) higher in twin pregnancies after 28 weeks of gestation than in singleton pregnancies, whereas the patients with severe preeclampsia showed significantly (P<0.05) lower serum melatonin levels than the mild preeclampsia or the normal pregnant women after 32 weeks of gestation. Melatonin concentrations in umbilical vessels showed a higher tendency in neonates who were born during at night compared with the other neonates; moreover, those in the umbilical artery were generally higher than those in the umbilical vein. The present results indicate that in humans, the maternal serum melatonin levels show a diurnal rhythm, which increases until the end of pregnancy, reflecting some pathologic states of the feto‐placental unit. Fetuses may produce melatonin with a circadian rhythm.
Thrombopoietic properties of 5‐methoxytryptamine plus melatonin versus melatonin alone in the treatment of cancer‐related thrombocytopenia
Authors: Lissoni P. , Bucovec R. , Bonfanti A. , Giani L. , Mandelli A. , Roselli M.G. , Rovelli F. , Fumagalli L.
Published: March 2003

Recent studies have shown that the hematopoietic system is under neuroendocrine control. In particular, thrombopoiesis has been proven to be stimulated by melatonin, and the pineal indole has been shown to be effective in the treatment of thrombocytopenia resulting from different causes. At present, however, there are no data concerning the possible thrombopoietic activity of pineal indoles other than melatonin. The present study was carried out to evaluate the effect of a concomitant administration of the pineal indole 5‐methoxytryptamine in patients with cancer‐related thrombocytopenia who did not respond to melatonin alone. The present study included 30 patients, who were randomized to receive melatonin alone (20 mg/day orally in the evening) or melatonin plus 5‐methoxytryptamine (1 mg/day orally in the early afternoon). A normalization of platelet count was achieved in 5/14 (36%) patients treated with melatonin plus 5‐methoxytryptamine and in none of the patients treated with melatonin alone (P<0.05). Moreover, mean platelet number significantly increased only in the patients treated with melatonin plus 5‐methoxytryptamine. This preliminary clinical study would suggest that 5‐methoxytryptamine, a pineal indole, may also exert thrombopoietic activity. Further studies, however, will be required to establish whether 5‐methoxytryptamine may play a direct thrombopoietic activity, or whether it may act by improving melatonin's efficacy.
Circadian rhythm of melatonin, corticosterone and phagocytosis: effect of stress
Authors: Barriga Carmen , Martín M. Isabel , Tabla Rafael , Ortega Eduardo , Rodríguez Ana B.
Published: March 2003

Melatonin has a functional connection with the immune system. Phagocyte function is altered by extirpation of the pineal gland, one source of melatonin, or by in vitro incubation of phagocytes with pharmacological concentrations of melatonin. Given that its synthesis by pinealocytes is under the control of the noradrenaline released by the sympathetic postganglionaric nerve endings, the present work was aimed at evaluating the circadian rhythm of melatonin, corticosterone, and phagocytosis in BALB/c mice in basal and stress situations. Peritoneal macrophages were used as phagocytes, latex beads as the particles to be ingested, and forced swimming to exhaustion as the stress situation. Radioimmunoassay was used to determine the animals’ serum hormone levels. Samples were taken every 3 hr in the period from 04:00 to 22:00 hr, and every 30 min during the remaining period from 22:00 to 04:00 hr. Control mice presented a short‐term melatonin peak at 23:30 hr, while the maximum inert‐particle ingestion capacity of the peritoneal macrophages also occurred during the night but at 03:30 hr. The corticosterone levels in control mice presented a circadian rhythm with a day‐time maximum peak (16:00 hr). Compared with the controls, the animals subjected to stress maintained, although at lower values, the melatonin peak at 23:30 hr, but they presented a loss of the rhythm of serum corticosterone levels, and the corticosterone levels and the macrophage phagocytic capacity were greater at all hours of the day.
Protective effect of melatonin against adriamycin toxicity in the rat
Authors: Agapito M. Teresa , Antolín Yolanda , Del Brio M. Teresa , López‐Burillo Silvia , Pablos Marta I. , Recio José M.
Published: March 2003

Adriamycin, an anthracyclinic antibiotic frequently used in quimioterapeutic treatments is highly toxic; it inhibits protein synthesis and provokes prooxidant effects. Melatonin has recently been shown to have high antioxidative properties. We tested if melatonin is able to neutralize the oxidative damage induced by a single dose (20 mg/kg, i.p.) of adriamycin preceded (3 days) and followed (7 days) by a low pharmacological dose (50 μg/kg, i.p.) of melatonin. After the administration of a single dose of adriamycin (20 mg/kg i.p.) to male Wistar rats, the reduced to oxidized glutathione (GSH/GSSG) ratio and the glutathione peroxidase (GPx, E.C. 1.11.1.9.) activity in the brain, intestine, heart, kidney, and lung were significantly reduced. When the treatment of adriamycin was preceded and followed by low pharmacological doses of melatonin, the decrease in the GSH/GSSG ratio was significantly reduced but the reduction in GPx activity was not attenuated. A significant increase in lipid peroxidation products was observed in brain, heart, and kidney tissues after a single administration of adriamycin, which was attenuated by pre‐ and post‐treatment with a low pharmacological dose of melatonin. Our results demonstrate that oxidative damage induced by the antitumor drug, adriamycin, can be reduced by low pharmacological doses of melatonin.
Interaction of serotonin and melatonin with sodium, potassium, calcium, lithium and aluminium
Authors: Lack Barbara , Daya Santy , Nyokong Tebello
Published: March 2003

In the present study, we investigated the ability of serotonin and melatonin to bind metals that occur naturally in the brain. An electrochemical technique called adsorptive cathodic stripping voltammetry (AdCSV) was employed to study the metal–serotonin or metal–melatonin interactions. The results show that both serotonin and melatonin form stable complexes with lithium and potassium, with serotonin favouring lithium over potassium, and melatonin favouring potassium over lithium. Coordination between either serotonin or melatonin and calcium was not favoured. The stability of the complexes formed between serotonin and the metals decreased with the metals as follows: Li+>K+>Al3+>Na+>Ca2+. The trend for melatonin–metal complexes was K+>Li+>Na+>Al3+>Ca2+. The binding and stable complex formation between both ligands, serotonin and melatonin with lithium, potassium and sodium is of biological importance. The binding of serotonin to lithium could provide an explanation for the therapeutic effects of lithium in depression treatment, whereas the binding of aluminium by melatonin could provide insight into the role of this element in the aetiology of Alzheimer's disease.
The pattern of melatonin secretion is rhythmic in the domestic pig and responds rapidly to changes in daylength
Authors: Tast Anssi , Love Robert J. , Evans Gareth , Telsfer Shevahn , Giles Roger , Nicholls Paul , Voultsios Athena , Kennaway David J.
Published: March 2003

The aim of the study was to investigate the capability of pigs to respond to abrupt changes in lighting conditions by means of alterations in circadian melatonin profiles. Sixteen pre‐pubertal crossbred male pigs weighing 40–45 kg were housed in individual pens in four temperature‐ and lighting‐controlled climate rooms (four pigs per room). In two rooms there was a light–dark cycle of 16 L:8 D (Group A) and in two other rooms 8 L:16 D (Group B). Under both lighting regimens light intensity at pig eye‐level was 220–240 lx during the light phase and less than 7 lx (red light) during the dark phase. The lighting regimens were changed after 2 wks to the opposite regimen and the change was repeated after a further 2 wks, so that animals ended up with the same light cycle with which they started. Blood was sampled at 2‐hr intervals for 48 hr spanning each time of change in lighting. A further 24‐hr sampling was performed at the end of the experiment (2 wks after the last change) in both groups and 1 wk after the change from short to long day lighting in Group A. On 83/86 occasions, pigs exhibited a clear circadian rhythm in plasma melatonin under both lighting regimens. Pigs responded immediately to the change from long to short day lighting by advancing melatonin secretion to the earlier lights‐off time and some pigs were able to extend secretion to the delayed lights‐on time. For short to long day changeover there was a small immediate response, with secretion pattern following the previously entrained endogenous rhythm to within 3 hr of the previous lights‐on time. After 1 wk commencement of secretion was delayed by up to 2 hr, while after 2 wks some pigs were able to delay commencement of secretion until lights‐off or to cease at lights‐on. It is concluded that the domestic pig is able to commence adjustment to abrupt changes in photoperiod within a 1‐wk acclimatization by altering circadian melatonin secretion. The present study suggests that it may be possible to use simplified lighting regimens instead of stepwise changing lighting programs in commercial piggeries to reduce the influence of season on production.
Light emitting diodes can be used to phase delay the melatonin rhythm
Authors: Wright Helen R. , Lack Leon C. , Partridge Kelly J.
Published: March 2003

Two portable light sources, comprising light emitting diodes (LEDs) of two different wavelengths, were compared to a standard light box in suppressing and phase shifting nocturnal salivary melatonin. All light sources were equated for illuminance of 2000 lux. Sixty‐six volunteers participated in the 2‐day study and were randomly allocated to one of four conditions; light box, white LED, blue/green LED, or no light control group. Light was administered to the experimental groups from midnight to 02.00 hr on the first night. Half‐hourly saliva samples were collected from 19.00 to 02.00 hr on night 1 and until 01.00 hr on night 2. Percent melatonin suppression on night 1 and dim light melatonin onset (DLMO) for each night were calculated. The experimental groups showed significant melatonin suppression during light stimulation, with the blue/green LEDs producing the greatest (70%) suppression. There was no significant difference between the light box at 63% and white LED at 50% suppression. Similarly, the blue/green LED had a significantly greater DLMO delay of 42 min and no difference between the light box of 23 min and the white LED of 22 min. These data suggest the portable LED light source is an effective way of delivering light to phase shift the melatonin rhythm, with the blue/green LED being the more effective of the two LEDs.
Melatonin protects against gentamicin‐induced nephrotoxicity in rats
Authors: Sener Göksel , Sehirli A. Özer , Altunbas Hale Z. , Ersoy Yasemin , Paskaloglu Kübra , Arbak Serap , Ayanoglu‐Dulger Gül
Published: March 2003

Acute renal failure is a major complication of gentamicin (GEN), which is widely used in the treatment of gram‐negative infections. A large body of in vitro and in vivo evidence indicates that reactive oxygen metabolites (or free radicals) are important mediators of gentamicin nephrotoxicity. In this study we investigated the role of free radicals in gentamicin‐induced nephrotoxicity and whether melatonin, a potent antioxidant could prevent it. For this purpose female Sprague–Dawley rats were given intraperitoneally either gentamicin sulphate (40 mg/kg), melatonin (10 mg/kg), gentamicin plus melatonin or vehicle (control) twice daily for 14 days. The rats were decapitated on the 15th day and kidneys were removed. Blood urea nitrogen (BUN) and creatinine levels were measured in the blood and malondialdehyde (MDA) and glutathione (GSH) levels, protein oxidation (PO) and myeloperoxidase (MPO) activity were determined in the renal tissue. Gentamicin was observed to cause a severe nephrotoxicity which was evidenced by an elevation of BUN and creatinine levels. The significant decrease in GSH and increases in MDA levels, PO and MPO activity indicated that GEN‐induced tissue injury was mediated through oxidative reactions. On the other hand simultaneous melatonin administration protected kidney tissue against the oxidative damage and the nephrotoxic effect caused by GEN treatment.
Melatonin reduces phosphine‐induced lipid and DNA oxidation in vitro and in vivo in rat brain
Authors: Hsu Ching‐Hung , Chi Bei‐Ching , Casida John E
Published: March 2003

Phosphine (PH3), a widely used pesticide, was found in our recent study to induce oxidative damage in the brain, liver and lung of rats. We also observed that melatonin significantly blocked this action. The present study focused on brain and the magnitude and mechanism of protection of PH3‐induced oxidative damage by melatonin in vitro and in vivo. PH3 in whole brain homogenate (3 mg protein/mL Tris–HCl pH 7.4 buffer) induced increasing lipid peroxidation [as malondialdehyde (MDA) and 4‐hydroxyalkenals (4‐HDA)] dependent on concentration (0.25–2 mM) and time (30–150 min), reaching a maximum level of 2.9‐fold at 90 min after PH3 at 1 mM. Elevation of MDA + 4‐HDA levels by PH3 at 1 mM was also observed in homogenates of cerebral cortex, cerebellum, hippocampus and hypothalamus examined individually. Melatonin at 0.1–2 mM progressively inhibited PH3‐induced lipid peroxidation in brain and regions thereof. Additionally, PH3 induced brain DNA oxidation in vitro and in vivo determined as 8‐hydroxyguanosine (8‐OH‐dG). Melatonin at 1 mM significantly suppressed PH3‐induced brain DNA oxidation in vitro. PH3 at 4 mg/kg i.p. significantly elevated 8‐OH‐dG in frontal cortex and melatonin prevented it. PH3 in vivo marginally lowered brain glutathione peroxidase activity and melatonin restored it completely. In contrast, PH3 and melatonin both stimulated superoxide dismutase production. Brain glutathione (GSH) levels in PH3‐treated rats were significantly reduced at 30 min and recovered gradually. It is concluded that melatonin, probably because of its free radical scavenging ability, confers marked protection against PH3‐induced oxidative toxicity in brain.
Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies
Authors: Coleman B. D. , Khan K. M. , Maffulli N. , Cook J. L. , Wark J. D.
Published: March 2003

Patellar tendinopathy is often treated surgically after failure of conservative treatment but clinical experience suggests that results are not uniformly excellent. The aim of this review was to (i) identify the different surgical techniques that have been reported and compare their success rates, and (ii) critically assess the methodology of studies that have reported surgical outcomes. Twenty‐three papers and two abstracts were included in the review. Surgical procedures were categorized and outcomes summarized. Using ten criteria, an overall methodology score was derived for each paper. Criteria for which scores were generally low (indicating methodological deficiency) concerned the type of study, subject selection process and outcome measures. We found a negative correlation between papers’ reported success rates and overall methodology scores (r=−0.57, P<0.01). There was a positive correlation between year of publication and overall methodology score (r=0.68, P<0.001). We conclude that study methodology may influence reported surgical outcome. We suggest practical guidelines for improving study design in this area of clinical research, as improved study design would provide clinicians with a more rigorous evidence‐base for treating patients who have recalcitrant patellar tendinopathy.
Proprioceptive sensitivity and performance in anterior cruciate ligament‐deficient knee joints
Authors: Fischer‐Rasmussen T. , Jensen P. E.
Published: March 2003

We studied the performance and proprioception of the knee joint in a group of non‐reconstructed anterior cruciate ligament (ACL)‐deficient (n=20) patients and compared them with a group of ACL‐reconstructed patients (n=18) and a group of healthy controls (n=20). Each patient was scored according to Lysholm and Tegner and was then asked to subjectively evaluate the performance of the injured knee and the degree of retropatellar discomfort. The knee joint laxity was measured. The performance was assessed based on the performance in a triple jump test and a one‐leg one‐step leap test. The proprioception in the knee was measured as the threshold when passive movement was detected and as the ability to reproduce a flexion angle from a start position of 60° of flexion or from full extension of the knee. All tests were performed on both legs. The scoring systems and the subjective evaluation showed significant differences between the reconstructed and the non‐reconstructed patients. No significant difference in knee joint laxity was found between the two groups. In the triple jump test and the one‐step leap test, both groups performed significantly worse on the leg with the injured knee joint than on the non‐injured leg. The proprioceptive tests showed decreased ability to recognize and reproduce a prior angle from a start position of 60°. The threshold to detection of passive movement with the injured knee was significantly increased in both groups of patients. No difference was found between the dominant and non‐dominant knee in the control group. When reproduction of the same angles started from full extension, the groups did not differ. These data show that decreased performance and changes in the proprioception of the knee joint accompany ACL rupture.
Secondary impingement in the shoulder
Authors: Sørensen A. K. Belling , Jørgensen U.
Published: March 2003

Non‐traumatic shoulder pain in the overhead athlete is a diagnostic challenge. In the last decade shoulder arthroscopy and magnetic resonance imaging (MRI) techniques have extended our knowledge. Previously unknown pathologic changes in the glenohumeral joint have been demonstrated and it is recognized that impingement symptoms and instability are often related. Shoulder dysfunction in overhead athletes may be caused by shoulder instability. However, a possible instability in the shoulder is often “silent” and difficult to demonstrate by ordinary tests and has therefore by some been termed “functional instability”. It is now thought that functional instability in the shoulder may lead to a vicious cycle involving microtraumata and attenuation of the capsular complex, and may eventually lead to shoulder pain. Changes in shoulder proprioception, measured by testing kinaesthetic sense and position sense, can be related to different pathologic changes in the shoulder, and sensory motor control may be an important factor for functional stability in the shoulder. MRI and arthroscopical findings in athletes with shoulder pain are changes in the glenoid labrum, the humeral head, the rotator cuff, biceps tendon and the capsular complex. However, these findings often present other clinical entities than impingement and are not always associated with instability. Clinically, there are tests that can objectively distinguish some of the pathological findings. However, we need more exact methods to further improve our clinical diagnoses of the painful shoulder. One of the keys could be an extended knowledge about the pathophysiology behind functional instability. This review focuses on an improved terminology in impingement based on the current knowledge of impingement and instability in the shoulder.
Sports related hamstring strains – two cases with different etiologies and injury sites
Authors: Askling C. , Tengvar M. , Saartok T. , Thorstensson A.
Published: March 2003

Hamstring strains are common injuries in sports. Knowledge about their etiology and localization is, however, limited. The two cases described here both had acute hamstring strains, but the etiologies were entirely different. The sprinter was injured when running at maximal speed, whereas the hamstring strain in the dancer occurred during slow stretching. Also the anatomical localizations of the injuries clearly differed. Magnetic resonance imaging (MRI) revealed pathological changes in the distal semitendinosus muscle in the sprinter and the proximal tendon of the semimembranosus muscle in the dancer. Subjectively, both athletes severely underestimated the recovery time. These case observations suggest a possible link between etiology and localization of hamstring strains.
Individual factors affecting stabilometry and one‐leg hop test in 75 healthy subjects, aged 15–44 years
Authors: Ageberg E. , Zätterström R. , Fridén T. , Moritz U.
Published: March 2003

The aims of this study were: 1) to investigate whether single‐limb stabilometry and a one‐leg hop test are influenced by age, sex, height, weight or activity level in healthy subjects, 2) to examine possible differences between the right and the left leg, 3) to determine Limb Symmetry Index (LSI) values, and 4) to study the relation between the stabilometric variables, that is, average speed (AS) and amplitude of center of pressure (CP) movements. Seventy‐five healthy subjects (39 women) were studied, with a mean age of 29.5 years (SD 8.2, range 15–44), mean height 175 cm (SD 8.6, range 155–194), mean weight 67.8 kg (SD 9.7, range 50–90) and median value 8 (quartiles 8–9, range 7–10) on a 1–10 activity‐level scale. AS was higher among the men compared to the women and increased with increasing age. The females hopped shorter distances than the males. The hop distance decreased with increasing age among the women. Height, weight and activity level within the actual range had no significant influence on stabilometric or hop‐test values. When comparing patients with healthy subjects, they should be matched according to sex and age, with an age difference of less than 10 years within pairs.
Evaluation of the reproducibility of the KT‐1000 arthrometer
Authors: Sernert N. , Kartus J. , Köhler K. , Ejerhed L. , Karlsson J.
Published: March 2003

The aim of the study was to examine whether the KT‐1000 arthrometer was reliable when it came to distinguishing between a group of patients with a chronic anterior cruciate ligament (ACL) rupture and a group of patients without an ACL rupture, and to examine the reproducibility of the examination between two experienced examiners. The aim was also to examine whether the KT‐1000 measurements were dependent on whether the patients were awake or under anaesthesia. The study comprised 40 patients: Group A consisted of 20 patients who had a chronic unilateral ACL rupture and Group B consisted of 20 patients who were scheduled for arthroscopy due to knee problems other than an ACL rupture. The KT‐1000 examination was performed before surgery by two experienced physiotherapists (PT I and PT II). PT II subsequently performed a retest of the patients under anaesthesia. The mean anterior side‐to‐side laxity difference between PT I and PT II was 0.2 mm in Group A and 1.8 mm in Group B (n.s., P=0.03). The anterior side‐to‐side measurements of knee laxity revealed significant differences between Group A and Group B, independent of who the measurements were made by when the patients were awake (PT I P=0.011, PT II P=0.001). However, no significant difference (P=0.063) was found when the patients were under anaesthesia. The interclass correlation coefficient (ICC) between PT I and PT II in Group A was 0.55 (P=0.005) for the anterior side‐to‐side laxity, while it was 0.60 (P=0.002) in Group B. There were no significant differences within Group A or Group B between the measurements made when people were awake compared with those under anaesthesia. The conclusions of the study were that the KT‐1000 arthrometer was able to distinguish a group of patients with an ACL rupture from a group without one. The reproducibility of the KT‐1000 measurements of anterior knee laxity between two experienced examiners was considered as fair. Furthermore, the measurements were not dependent on whether the patients were awake or under anaesthesia.
Muscle strength, disability and mortality
Authors: Rantanen T.
Published: March 2003

The aims of this review are to address (1) the role of muscle strength in the disablement process and (2) muscle strength as a predictor of length of life using data from prospective studies. Functional limitations, such as slow walking speed, predispose older people to disabilities. How much strength is needed for daily motor tasks such as walking varies according to other impairments present. For example, when postural balance is good, only minimum amount of strength is needed for walking. However, in the presence of balance impairment, having good level of strength may help to compensate for the deficit. Having strength well above the required level indicates reserve capacity. It was studied using data from the Honolulu Heart Program launched in 1965 among 8006 men initially aged 45–68 years, whether reserve of strength would be protective of development of future disability. All men with documented diseases at baseline were excluded from the analyses. Those men who were in the lowest third of the distribution of grip strength at baseline were at two to three times greater risk of developing disabilities assessed 25 years later compared to the highest third. It is possible that before they reach the disability level, those with greater reserve of strength may afford to lose more strength, for example following bed rest and inactivity associated with an illness. Midlife grip strength was also found to predict long‐term total mortality: those with poorer strength at baseline were more likely to die over the follow‐up period of 30 years. The association between muscle strength and disability is largely explained by biomechanical mechanisms. However, the mechanism explaining the association between muscle strength and mortality risk still remains to be explored.
Effects of ageing and human whole body and muscle protein turnover
Authors: Dorrens J. , Rennie M. J.
Published: March 2003

Prevalence of sarcopenia is up to 60% of those individuals over 80 years of age and is associated with increased disability. The causes behind the age‐related loss of muscle are difficult to discern. Measurements of protein synthesis/breakdown and net protein balance are important, and further methodological development is warranted. Whole body protein turnover is changed only little – if at all – with ageing, when corrected for fat free mass of the individuals. Discrepancies in reports are often related to inconsistent recordings of energy intake especially protein and variation in subject, gender and physical activity level. Ageing is associated with reduced sensitivity toward amino acids, increased first pass uptake in a splanchnic region and a reduced postprandial stimulation of protein synthesis. Physical activity and amino acids are additive in effect also in elderly individuals, and timing of training and protein intake is crucial, in that early intake of amino acids is advantageous with regards to stimulation of protein synthesis.
Calculation of nail plate and nail matrix parameters by 20 MHz ultrasound in healthy volunteers and patients with skin disease
Authors: Wollina Uwe , Berger Martin , Karte Kerstin
Published: March 2003

Background/aims: The objective, but noninvasive, assessment of the nail plate and nail matrix is of interest in dermatology, and cosmetics as well. These cutaneous structures were investigated with 20 MHz ultrasound. This study was performed to obtain data on normal nails in adults of different age groups, with a left–right comparison, and to investigate nail changes in selected dermatologic diseases.

Methods: Healthy controls (n=34) and patients with dermatologic complaints and nail disease (n=37) were included after informed consent. In the control group, 18 woman and 16 men with a mean age of 37.2 years (range 15 to 82 years) were investigated for age‐ and gender‐related differences. Patients with one of the following disorders were investigated: systemic lupus erythematosus (SLE; n=11), systemic sclerosis (PSS; n=8), psoriasis (n=9), chronic hand eczema (n=5), and others (n=4). Measurements of length and width of the nail plate and the lunulae were performed with a micrometer device. Sonography was performed with a 20 MHz probe in B‐scan mode.

Results: The mean nail thickness of healthy controls varied between 0.481 mm (right thumb) and 0.397 mm (left fifth finger). The nail volume and the matrix volume disclosed a positive, but mostly nonsignificant, correlation for all controls. Age‐specific differences were investigated for both genders. In men and women, the matrix volume increased significantly with age. The nail and matrix volume was higher in men than in women, independent of age. The left–right comparison disclosed a trend to higher nail and matrix volumes on the right hand. In patients with SLE there was an increase in nail thickness and in matrix volume. Patients with PSS showed a significant decrease in nail thickness and matrix volume. In other diseases the measurements disclosed no confident differences to healthy controls.

Conclusion: The 20 MHz ultrasound offers a noninvasive method to calculate nail thickness, nail volume and matrix volume in healthy volunteers and in nail disease. Skin diseases show characteristic quantitative changes in these parameters.
Comparison of two pH meters used for skin surface pH measurement: the pH meter ‘pH900’ from Courage & Khazaka versus the pH meter ‘1140’ from Mettler Toledo
Authors: Ehlers C. , Ivens U. I. , Møller M. L. , Senderovitz T. , Serup J.
Published: March 2003

Background/aims: Measurement of skin surface pH is used in clinical research to evaluate hazardous shifts in pH following external exposures and to evaluate the state of diseased skin with acute or chronic changes. It is therefore important to measure skin surface pH as precisely as possible. The aim of this study was to compare two commercially available pH meters used for skin surface pH measurement, to reveal differences between them in measured skin pH on the forearm.

Methods: The first pH meter (pH900) had a pointed electrode and a stabilisation period of 3 s. The second pH meter (pH meter 1140) had a circular electrode and no fixed stabilisation period. Twelve healthy subjects (6 male and 6 female Caucasians) entered the study. The pH measurements were performed once an hour from 8 a.m. to 3 p.m. on both forearms in five areas from the elbow to the “wristwatch” zone. In each area, three measurements were performed next to each other with both pH meters (15 measurements per arm per hour per pH meter).

Results: The pH900 has a higher measuring level and a higher variation than the pH meter 1140.

Conclusion: A skin surface pH meter with a circular electrode and with no fixed stabilisation period is preferable. It is recommended that the pH meter be allowed to stabilise for at least 7 s before the result is read.
Females have lower skin surface pH than men
Authors: Ehlers C. , Ivens U. I. , Møller M. L. , Senderovitz T. , Serup J.
Published: March 2003

Background/aims: It is of great interest to describe the many functions and properties of the skin in order to better understand reactions that result in different skin abnormalities, as a prerequisite in the development of skin products and topical medicines. Skin surface pH is considered a critical parameter of skin wellbeing and is typically studied on the forearm skin. Despite many previous investigations, this is an extensive field that still needs a great deal of research. The aim of our study was to investigate gender related differences, differences between right and left arms, anatomical variation and daytime variation in skin surface pH.

Methods: Skin surface pH was measured on the flexor surface of the forearm on eleven healthy volunteers (6 men and 5 women). A Mettler Toledo pH meter (pH meter 1140) was used. The subjects were measured once every hour from 8 a.m. to 3 p.m. in five areas from the elbow to the wrist. In each of the five areas, three measurements were performed next to each other, and the mean of these was used in subsequent calculations.

Results: A statistically significant difference in skin pH between men (mean pH=5.80) and women (mean pH=5.54) was found, with women being more acidic than men (P<0.01). No difference between right and left arm was found. In men, the area closest to the wrist had significantly lower pH values compared with the proximal sites. This was not the case in women. Skin surface pH decreased during normal working hours in both genders.

Conclusion: Spontaneous skin surface pH was found to be significantly lower in women, as compared to men – albeit, the difference was small and of unknown relevance. Nevertheless, comparative studies on skin surface pH should be balanced with respect to gender. There appeared to be no right/left difference and no systematic change during the working day. Also, measurements should not be conducted close to the wrist.
Three‐dimensional analyses of individual corneocytes with atomic force microscope: morphological changes related to age, location and to the pathologic skin conditions
Authors: Kashibuchi Nobuo , Hirai Yoshikazu , O'Goshi Kenichiro , Tagami Hachiro
Published: March 2003

Background/aims: The past morphological studies on individual corneocytes have so far mainly focused on their two‐dimensional characteristics, particularly on their projected area, which have been widely employed for the estimation of the turnover rate of the stratum corneum because of the practical use. However, sometimes a poor correlation has been reported between the projected area of corneocytes and actually measured turnover time of the stratum corneum. The objective of the present study is to perform detailed three‐dimensional measurements of individual corneocytes with atomic force microscope. Through analyses of the obtained data, we tried to find morphological parameters that reflect more closely the differentiation process of the corneocytes in the stratum corneum than the frequently used two‐dimensional projected area.

Methods: We measured such morphological parameters as the volume, average thickness and real surface area of individual corneocytes isolated from the covered skin (the flexor surface of the upper arm) and the exposed skin (the cheek) of 12 healthy individuals belonging to different age brackets, in addition to their projected area. We further introduced a new parameter, a flatness index calculated by dividing the projected area of corneocytes by their thickness. Similarly, we measured corneocytes obtained from eight patients with atopic dermatitis (AD) and psoriatic patients.

Results: Obtained results showed that most of these morphological parameters varied greatly depending upon the anatomical location and age of the subjects. Needless to say great differences were found between healthy skin and lesional skin of atopic dermatitis or psoriasis. However, the volume and thickness of corneocytes collected from the same location of normal skin of the covered area (upper arm) with tape‐strippings were noted to decrease as they differentiated in the stratum corneum, showing an increase in their surface area and projected area with a resultant increase in the flatness index. Moreover, the corneocyte collected from the lesional skin of AD or psoriasis showed a great decrease in flatness index, reflecting their poor differentiation in the stratum corneum due to its enhanced turnover rate.

Most of all, we found a poor correlation between the projected area and the various three‐dimensional morphologic parameters of the corneocytes, indicating that the projected area does not reflect the volume or thickness of corneocytes that are also greatly influenced by the differentiation process of corneocytes in the stratum corneum.

Conclusions: To estimate the differentiation speed of the corneocytes, we suggest using their flatness index rather than the two‐dimensional cell surface area, because the former is a concept that takes into account the three‐dimensional characteristics of corneocytes.
Investigation of basal cell carcionoma by confocal laser scanning microscopy in vivo
Authors: Sauermann K. , Gambichler T. , Wilmert M. , Rotterdam S. , Stücker M. , Altmeyer P. , Hoffmann K.
Published: March 2003

Background/purpose In vivo confocal laser scanning microscopy (CLSM) allows to study human skin up to 200 µm deep non‐invasively. Aim of this study was to investigate basal cell carcinoma (BCC) using in vivo CLSM, and to compare the micromorphologic features of BCC with uninvolved skin.

Methods Twelve patients with histological diagnosis of BCC referred to our department for tumor excision were investigated on the lesion(s) and on clinically uninvolved sites preoperatively by in vivo CLSM using the Vivascope 1000 (Lucid Inc., Rochester, USA). The images were compared to histological examinations of the excised tissue.

Results Typical changes in vasculature such as increase in number and diameter of the blood vessels, loss of the vascular architecture, parallelly and horizontally orientated vessels, and accumulation and rolling phenomena of bright reflecting cells of 11.88 ± 1.75 µm in diameter along the vessel wall were observed in all BCCs. The tumor stroma of the BCCs showed a strong reflectance mainly due to numerous bundles of collagen fibers encoating dark, cell‐rich areas of tumor parenchym. In five patients, slim basaloid cells with relatively large, elongated dark nuclei were observed in the periphery of the tumor parenchym. In the fibrosing type of BCC, curled bundles of collagen with large cells represented the tumor stroma.

Conclusions BCC can be investigated by CLSM and provide typical features. Besides the tumor parenchym and stroma, typical changes in vasculature seem to be a sensitive criteria for BCC and may in future help in diagnosing BCC by CLSM as well as in assessing the margins of large tumors. We suggest that CLSM is a promising non‐invasive tool for the diagnostics of BCC and the assessment of tumor margins prior to surgery.