bluuebunny/crossref_metadata_2025 huggingface dataset:
An optimized embryonic stem cell model for consistent gene expression and developmental studies
Authors: Gissel Cornelia , Voolstra Chris , Doss Michael Xavier , Koehler Christoph I. , Winkler Johannes , Hescheler Jürgen , Sachinidis Agapios
Published: September 2005

In vitro differentiation of embryonic stem (ES) cells results in generation of tissue-specific somatic cells and may represent a powerful tool for general understanding of cellular differentiation and developmentin vivo. Culturing of most ES cell lines requires murine embryonic fibroblasts (MEF), which may influence adventitiously the genetic differentiation program of ES cells. We compared the expression profile of key developmental genes in the MEF-independent CGR8 ES cell line and in the MEFdependent D3 ES cell line. Using neomycin-resistant MEFs we demonstrated that MEFs are able to contaminate the D3 ES cells even after removing the MEFs. Subsequently, optimal differentiation conditions were established for the differentiation of CGR8 ES cells into various germ layer cells. Detailed gene expression studies in differentiating CGR8 cells were done by RTPCR analysis and by microarray analysis demonstrating a general trend of the assessed genes to be expressed either in 3 days- or 10-days old embryoid bodies (EBs) when compared to undifferentiated ES cells. Subsets within the various functional gene classes were defined that are specifically up- or down-regulated in concert. Interestingly, the present results demonstrate that developmental processes toward germ layer formation are irreversible and mostly independent of the culture conditions. Notably, apoptotic and mitochondrial ribosomal genes were downand up-regulated in 10-days old EBs, respectively, whereas compared to the 3-days old EBs whereas the activity of the extracellular signal-regulated kinase (ERK)1/2 decreased with progressive development. This article defines a platform for ES cell differentiation and gene expression studies.

Supplementary information available online atwww.uni-koeln.de/med-fak/physiologie/np/sachinidis.htm
Assessment of venous thromboembolism risk and the benefits of thromboprophylaxis in medical patients
Authors: Alikhan Raza , Arcelus Juan I. , Bergmann Jean-François , Haas Sylvia , Merli Geno J. , Spyropoulos Alex C. , Tapson Victor F. , Turpie Alexander G. G. , Cohen Alexander T.
Published: September 2005

Hospitalized patients with acute medical conditions are at significant risk of venous thromboembolism (VTE): approximately 10–30% of general medical patients may develop deep-vein thrombosis or pulmonary embolism, and the latter is a leading contributor to deaths in hospital. Despite consensus-group recommendations that at-risk medical patients should receive thromboprophylaxis, there is currently no consensus as to which patients are at risk, and many patients may not receive appropriate thromboprophylaxis. This paper reviews evidence for the risk of VTE associated with different medical conditions and risk factors, and presents a risk-assessment model for risk stratification in medical patients. Medical conditions associated with a moderate to high risk of VTE include cardiac disease, cancer, respiratory disease, inflammatory bowel disease, and infectious diseases. Importantly, analyses of data from the MEDENOX study show that thromboprophylaxis significantly reduces the risk o f VTE in these patient subgroups. Risk factors in medical patients include a history of VTE, history of malignancy, increasing age, thrombophilia, prolonged immobility, and obesity. These medical conditions and risk factors are included in a risk-assessment model which is hoped will provide a simple means of assisting clinicians in deciding whether thromboprophylaxis should be used in an individual patient.
Transient receptor potential protein subunit assembly and membrane distribution in human platelets
Authors: Brownlow Sharon L. , Sage Stewart O.
Published: September 2005

We have previously suggested that the human homologue of theDrosophila transient receptor potential protein, TRPC1, is involved in conducting store-operated Ca2+ entry (SOCE) in human platelets since an antibody raised against the poreforming region of TRPC1 inhibited SOCE. Here we have investigated plasma membrane expression of TRPC1 in human platelets and have probed for the presence of otherTRPC proteins in these cells. Biotinylation revealed the presence of TRPC1 in the plasma membrane of resting platelets. Surface expression was not detectibly changed following Ca2+ store depletion or stimulation with thrombin. Western blotting demonstrated the presence of TRPC1, TRPC3, TRPC4, TRPC5 and TRPC6 in platelet lysates. TRPC1, TRPC4 and TRPC5 coimmunoprecipitated, as did TRPC3 and TRPC6. TRPC1, TRPC4 and TRPC5 were associated with detergent-resistant platelet membranes, from which they were partially released when the cells were cholesterol-depleted using methyl-β-cyclodextrin. The distributions of TRPC3 and TRPC6 between soluble and membrane fractions were not affected by methyl-β-cyclodextrin treatment. These results suggest that TRPC1,TRPC4 and TRPC5 form a heteromultimer associated with platelet lipid raft domains, whereas TRPC3 and TRPC6 associate independently of lipid rafts.
Tissue factor pathway inhibitor and the risk of recurrent venous thromboembolism
Authors: Hoke Matthias , Kyrle Paul A. , Minar Erich , Bialonzcyk Christine , Hirschl Mirko , Schneider Barbara , Kollars Marietta , Weltermann Ansgar , Eichinger Sabine
Published: September 2005

Tissue factor pathway inhibitor (TFPI) regulates factor X activation. LowTFPI is a risk factor for a first venous thrombosis. We evaluated whether low TFPI confers an increased risk of recurrent venous thromboembolism (VTE). TFPI–free antigen was measured in 611 patients with a first spontaneousVTE, and who were prospectively followed after withdrawal of anticoagulation. The endpoint was symptomatic recurrent VTE. The relative risk (RR) of recurrence increased from 1.0 (95% CI 0.4–2.6) in patients with TFPI levels ≤ 5th percentile to 2.7 (95% CI 1.0–7.4) in patients with levels ≤ 2nd percentile as compared with higher levels. At five years, the probability of recurrence was 48.6% (95th CI 19.0–78.1) among patients with TFPI ≤ 2nd percentile and 16.8% (95th CI 13.8–19.8) among those with higher levels (p=0.04). Compared to patients with wild type factor V and high TFPI, the RR of recurrence was 1.1 (95% CI 0.7–1.7) in patients with factorV Leiden and high TFPI, 2.3 (95% CI 0.6–9.5) in patients with wild type factor V and low TFPI and 3.5 (95% CI 0.9–14.3) in patients with factor V Leiden and low TFPI. In a multivariate analysis, the high risk of recurrence in carriers of factor V Leiden and low TFPI slightly decreased [RR 2.8 (95% CI 0.6–9.5)]. We conclude that thrombosis patients with low levels of freeTFPI are at an increased risk of recurrent VTE.
Early Endothelin-A Receptor Blockade Decreases Blood Pressure and Ameliorates End-Organ Damage in Homozygous Ren-2 Rats
Authors: Vanêčková Ivana , Kramer Herbert J. , Bäcker Angela , Vernerová Zdena , Opočenský Martin , Ĉervenka Ludêk
Published: September 2005

We have recently found that nonselective endothelin ET
A
/ET
B
receptor blockade markedly improves survival rate and ameliorates end-organ damage in male homozygous rats transgenic (TGR) for the mouse Ren-2 renin gene without lowering blood pressure. Because activation of the ET
A
receptor may be responsible for the detrimental effects of ET in the development of hypertension, this study was performed to determine whether ET
A
or ET
A
/ET
B
receptor blockade exerts these beneficial effects. TGR and age-matched normotensive Hannover Sprague-Dawley rats fed a high-salt diet received either vehicle or bosentan and atrasentan (ABT-627) as nonselective ET
A
/ET
B
and selective ET
A
receptor blockers, respectively, from 29 until 90 days of age. The survival rate of 48% in untreated TGR was significantly (
P
<0.01) improved to 79% by bosentan and to 92% by ABT-627 (ABT-627 versus bosentan
P
<0.05). Proteinuria, glomerulosclerosis, and cardiac hypertrophy, as well as ET-1 content in left ventricular tissue, were significantly reduced by bosentan and to a greater degree by ABT-627, which also significantly attenuated the rise in blood pressure (
P
<0.05). Our data indicate that the ET system, especially via ET
A
receptors, plays an important role in the development of hypertensive end-organ damage and confirm the concept that the predominant role of ET
B
receptors within the peripheral vasculature is to mediate the vasorelaxant actions of ET-1. They also demonstrate that selective blockade of ET
A
receptors is superior to nonselective ET
A
/ET
B
in attenuating hypertension, hypertensive organ damage, and survival rate.
Sex Differences in Blood Pressure Response to Intermittent Hypoxia in Rats
Authors: Hinojosa-Laborde Carmen , Mifflin Steven W.
Published: September 2005

Intermittent hypoxia is used to mimic the arterial hypoxemia that occurs during sleep apnea. The present study examined the blood pressure and heart rate responses to exposure to intermittent hypoxia in male rats and in female rats before and after ovariectomy. Rats were instrumented with telemetry transmitters and blood pressure, heart rate, and activity measured during 7 days of exposure to intermittent hypoxia (3 minutes of normoxia [21% oxygen] alternating with 3 minutes 10% oxygen between 8
am
and 4
pm
, remainder of day at normoxia). Blood pressure increased in males, females, and ovariectomized females in response to 7 days of intermittent hypoxia during the hours of exposure to hypoxia. Blood pressure increased less in intact females (average change in blood pressure 1.6±0.6 mm Hg, n=11) than in females studied after ovariectomy (5.1±1.1 mm Hg, n=6) or males (5.4±1.0 mm Hg, n=10). This elevated blood pressure persisted throughout the remainder of the day when the animals were not exposed to intermittent hypoxia and remained significantly attenuated in female rats. Ovariectomy abolished the protection against the elevated blood pressure response to intermittent hypoxia in females. Heart rate increased only in males, and only during the period of the day associated with intermittent hypoxia. Female rats were protected against this tachycardia independent of the ovarian hormones. These results indicate that females are protected from the hypertensive and tachycardia effects of intermittent hypoxia.
Hypertension and Exercise Training Differentially Affect Oxytocin and Oxytocin Receptor Expression in the Brain
Authors: Martins Adriano S. , Crescenzi Alessandra , Stern Javier E. , Bordin Silvana , Michelini Lisete C.
Published: September 2005

We have previously shown that exercise training activates nucleus tractus solitarii (NTS) oxytocinergic projections, resulting in blunted exercise tachycardia. The objective of this study was to determine the effects of hypertension and training on oxytocin (OT) and OT receptor expression in the hypothalamic paraventricular nucleus (PVN) and projection areas (dorsal brain stem [DBS]). Male, normotensive, Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats were trained (55% maximal exercise capacity, 3 months) or kept sedentary, and pressure was measured weekly. DBS sections were processed for immunohistochemistry (polyclonal guinea pig anti-OT) or in situ hybridization for OT and OT receptor (
35
S-oligonucleotide probes). Other groups of rats had brains removed and frozen to isolate the DBS and PVN; samples were processed for OT and OT receptor cDNA reverse transcription–polymerase chain reaction amplification with β-actin as the housekeeping gene. Training was equally effective in improving running distance in both groups, with pressure reduction only in SHR (−10%,
P
<0.05). In trained WKY, baseline bradycardia (
P
<0.05) occurred simultaneously with increased NTS OT immunostaining and mRNA expression (+3.5-fold), without any change in OT receptor mRNA expression. PVN OT mRNA and DBS OT receptor mRNA expressions were significantly lower in SHR versus WKY (−39% and −56%, respectively). Training did not alter DBS OT receptor density in the SHR group but increased OT mRNA in both PVN and DBS areas (+78% and +45%, respectively). Our results show a marked hypertension-induced reduction in OT receptor mRNA expression, not altered by training. In contrast, training increased OT mRNA expression in sedentary and hypertensive rats, which may facilitate training-induced cardiac performance.
Evidence for a Functional Interaction of the Angiotensin-(1–7) Receptor Mas With AT
1
and AT
2
Receptors in the Mouse Heart
Authors: de Castro Carlos Henrique , Souza dos Santos Robson Augusto , Ferreira Anderson José , Bader Michael , Alenina Natalia , Pinto de Almeida Alvair
Published: September 2005

The aim of this study was to evaluate the angiotensin (Ang)-(1–7) effects in isolated mouse hearts. The hearts of male C57BL/6J and knockout mice for the Ang-(1–7) receptor Mas were perfused by the Langendorff method. After a basal period, the hearts were perfused for 20 minutes with Krebs-Ringer solution (KRS) alone (control) or KRS containing Ang-(1–7) (0.22 pmol/L), the Mas antagonist A-779 (115 nmol/L), the angiotensin type 1 receptor antagonist losartan (2.2 μmol/L), or the angiotensin type 2 receptor antagonist PD123319 (130 nmol/L). To evaluate the involvement of Ang receptors, prostaglandins, and nitric oxide in the Ang-(1–7) effects, the hearts were perfused for 20 to 30 minutes with KRS containing either A-779, losartan, PD123319, indomethacin, or
N
G
-nitro-
l
-arginine methyl ester (
l
-NAME) alone or in association with subsequent Ang-(1–7) perfusion. In addition, hearts from Mas-knockout mice were perfused for 20 minutes with KRS containing Ang-(1–7) (0.22 pmol/L) and losartan. Ang-(1–7) alone did not change the perfusion pressure. Strikingly, in the presence of losartan, 0.22 pmol/L Ang-(1–7) induced a significant decrease in perfusion pressure, which was blocked by A-779, indomethacin, and
l
-NAME. Furthermore, this effect was not observed in Mas-knockout mice. In contrast, in the presence of PD123319, Ang-(1–7) produced a significant increase in perfusion pressure. This change was not modified by the addition of A-779. Losartan reduced but did not abolish this effect. Our results suggest that Ang-(1–7) produces complex vascular effects in isolated, perfused mouse hearts involving interaction of its receptor with angiotensin type 1- and type 2-related mechanisms, leading to the release of prostaglandins and nitric oxide.
Effects of Endurance Training on Blood Pressure, Blood Pressure–Regulating Mechanisms, and Cardiovascular Risk Factors
Authors: Cornelissen Véronique A. , Fagard Robert H.
Published: September 2005

Previous meta-analyses of randomized controlled trials on the effects of chronic dynamic aerobic endurance training on blood pressure reported on resting blood pressure only. Our aim was to perform a comprehensive meta-analysis including resting and ambulatory blood pressure, blood pressure–regulating mechanisms, and concomitant cardiovascular risk factors. Inclusion criteria of studies were: random allocation to intervention and control; endurance training as the sole intervention; inclusion of healthy sedentary normotensive or hypertensive adults; intervention duration of ≥4 weeks; availability of systolic or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. The meta-analysis involved 72 trials, 105 study groups, and 3936 participants. After weighting for the number of trained participants and using a random-effects model, training induced significant net reductions of resting and daytime ambulatory blood pressure of, respectively, 3.0/2.4 mm Hg (
P
<0.001) and 3.3/3.5 mm Hg (
P
<0.01). The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (−6.9/−4.9) than in the others (−1.9/−1.6;
P
<0.001 for all). Systemic vascular resistance decreased by 7.1% (
P
<0.05), plasma norepinephrine by 29% (
P
<0.001), and plasma renin activity by 20% (
P
<0.05). Body weight decreased by 1.2 kg (
P
<0.001), waist circumference by 2.8 cm (
P
<0.001), percent body fat by 1.4% (
P
<0.001), and the homeostasis model assessment index of insulin resistance by 0.31 U (
P
<0.01); HDL cholesterol increased by 0.032 mmol/L
−1
(
P
<0.05). In conclusion, aerobic endurance training decreases blood pressure through a reduction of vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favorably affects concomitant cardiovascular risk factors.
Cardiovascular Mortality in Overweight Subjects
Authors: Thomas Frédérique , Bean Kathryn , Pannier Bruno , Oppert Jean-Michel , Guize Louis , Benetos Athanase
Published: September 2005

The role of obesity and overweight as independent risk factors for cardiovascular disease is still debated. The aim of this study was to evaluate the impact of overweight on cardiovascular mortality according to the presence or absence of associated risk factors. This study included 139 562 men and 104 236 women, aged 18 to 95 years, who had a standard health checkup at the IPC Center between 1972 and 1988. The follow-up period for mortality ended in December 1997. In both genders, the prevalence of hypertension, diabetes, and hypercholesterolemia increased with body mass index (
P
<0.001). When compared with subjects with a body mass index <25 kg/m
2
without associated risk factors, overweight subjects without associated risk factors did not have an increased risk of cardiovascular mortality. Risk of cardiovascular death increased significantly when overweight was associated with hypertension alone [hazard ratio: 2.05 (1.71 to 2.46) in men; 2.15 (1.48 to 3.11) in women]. In both genders, the association of overweight with diabetes alone or hypercholesterolemia alone did not increase the risk. By contrast, in the presence of hypertension, cardiovascular mortality dramatically increased in overweight subjects with hypercholesterolemia [hazard ratio: 2.65 (2.20 to 3.19) in men, 2.57 (1.80 to 3.68) in women] or diabetes [hazard ratio: 3.01 (2.29 to 3.95) in men; 4.50 (2.67 to 7.58) in women]. The data suggest that the presence of high blood pressure in overweight subjects is the key factor leading to a significant increase in cardiovascular mortality. Because overweight significantly increases the prevalence of associated risk factors, especially hypertension, it should be considered as a major cardiovascular risk determinant.
Prednisolone Inhibits Proliferation of Cultured Pulmonary Artery Smooth Muscle Cells of Patients With Idiopathic Pulmonary Arterial Hypertension
Authors: Ogawa Aiko , Nakamura Kazufumi , Matsubara Hiromi , Fujio Hideki , Ikeda Tetsuya , Kobayashi Kaoru , Miyazaki Ikuko , Asanuma Masato , Miyaji Katsumasa , Miura Daiji , Kusano Kengo Fukushima , Date Hiroshi , Ohe Tohru
Published: September 2005

Background—

Idiopathic pulmonary arterial hypertension (IPAH) is associated with proliferation of smooth muscle cells (SMCs) in small pulmonary arteries. There is no therapy that specifically inhibits SMC proliferation. Recent studies reported that prednisolone (PSL) inhibits the postangioplasty proliferation of SMCs in atherosclerotic arteries. In this study, we tested the hypothesis that PSL has antiproliferative effects on pulmonary artery SMCs of patients with IPAH.

Methods and Results—

Pulmonary artery SMCs were harvested from the pulmonary arteries of 6 patients with IPAH who underwent lung transplantation. Control SMCs were obtained from 5 patients with bronchogenic carcinoma who underwent lung lobectomy. After incubation in the presence of platelet-derived growth factor (PDGF), PSL was added at different concentrations and cell proliferation was assessed by
3
H-thymidine incorporation. PSL (2×10
−4
and 2×10
−3
mol/L) significantly inhibited PDGF-stimulated proliferation (
P
<0.05) of SMCs from patients with IPAH but did not affect cell viability of SMCs, as confirmed by trypan blue staining. In cell cycle analysis using a microscope-based multiparameter laser scanning cytometer, PSL inhibited the progression of SMCs from G
0
/G
1
to the S phase. This inhibition was associated with increased p27 expression level. PSL (2×10
−4
mol/L) also inhibited PDGF-induced SMC migration.

Conclusions—

Our results indicate that PSL has an antiproliferative effect on cultured SMCs of pulmonary arteries from patients with IPAH and suggest that PSL may be potentially useful therapeutically in patients with IPAH.
Intellectual Schisms in Philippine Psychology are Schisms of the Self: Meditations from an East-West Comparative Standpoint
Authors: Tiangco Joseph Anthony Narciso
Published: September 2005

Critical reflection on the study of psychology situates both students and practitioners in a position to ponder upon not only the conceptual, methodological, and perhaps, theoretical advances within the discipline, but more so, in rediscovering what psychology is in the first place. The first part of this paper provides a discussion on how psychology can be remembered and studied within the backdrop of a condensed history of intellectual progression. Within this context, intellectual schisms can be understood as prompted by the value system held by members of a scientific community. Such a value system, therefore, is also attributable to the emergence of contending perspectives and systems that characterize psychology within a postmodern context. The second part of this paper argues that since psychology is the study of the self, then Eastern re flections have a place in situating Zen Buddhism as it correlates with Western postmodernism. The problem of the self in Eastern philosophy is a source of rich insight in arguing that the emptiness of the self is, in fact, due to its fluidity. Given this, I conclude in this paper that the fluidity of the self accounts for the fluidity of knowledge in psychology and the rest of the social sciences. I pose the challenge that the practice of psychology in the Philippines, as a science and profession, should take on a spiritual depth in consideration of the positive values espoused by postmodernism from an East-West comparative standpoint.
Oil Platforms: Lessons of Dissensus
Authors: Heiskanen Veijo
Published: September 2005

The recent judgment of the International Court of Justice in the Case Concerning the Oil Platforms ('Oil Platforms') is a fascinating and confusing mix of formal consensus and substantive dissensus. By fourteen votes to two, the Court dismissed both the United States defence and Iran's substantive claim in the case. Yet the Court's nearly complete unanimity is belied by a considerable substantive disagreement on the reasoning leading to this outcome, as reflected in the numerous separate and dissenting opinions appended to the judgment. An analysis of these opinions reveals that the disagreement within the Court cannot be considered simply a reflection of varying judicial appreciations of law and fact; it reveals a fundamental, even philosophical disagreement relating to the very function of the Court: Is the principal function of the Court the adjudication of claims brought by States, or the settlement of disputes between States? The fundamental disagreement among the Judges on this issue seems a reflection of their training and background – between Judges trained in the common law tradition and those hailing from the civil law or similar more policy-oriented backgrounds. Apart from the jurisprudential disagreement relating to the function of the Court, the judgment also raises important issues of substantive international law, in particular those relating to the relationship between the law of peace and the law of armed conflict. The judgment testifies to the continuing validity of this distinction, despite the many attempts of international legal scholarship to move beyond this distinction to a more enlightened era of international relations.
Tarsal Navicular Stress Injury
Authors: Burne Scott G. , Mahoney Chris M. , Forster Bruce B. , Koehle Michael S. , Taunton Jack E. , Khan Karim M.
Published: September 2005

Background

Tarsal navicular stress fracture is a condition that has curtailed many athletic careers. Management protocols remain varied and somewhat controversial.

Hypotheses

(1) Clinical practice does not mirror the recommendations reported from previous case series. (2) Clinical outcome is poor when navicular stress fracture is managed in a variety of ways. (3) Imaging does not correlate strongly with clinical status at long-term follow-up after navicular stress fracture.

Study Design

Case series (prognosis); Level of evidence, 4.

Methods

From a computer registry, we identified patients who had attended a university sports medicine center between 1996 and 2002 and whose final diagnosis was navicular stress fracture (n = 11) or navicular stress reaction (n = 9). All patients had provided demographic and clinical data at their original evaluation, and all had undergone bone scans and computed tomographic imaging. These data were extracted by chart review. Follow-up clinical and imaging assessments took place a median of 3.7 years later (range, 1-15.7 years). At these assessments, we administered a questionnaire, performed a structured physician examination (blinded to other data), scanned both feet with computed tomography, and obtained magnetic resonance images of the affected foot.

Results

Only 2 of 11 patients (18%) with navicular stress fractures received the literature-recommended treatment of at least 6 weeks’ nonweightbearing cast immobilization. Of these 11 patients, only 6 (55%) returned to sports at their previous level. Only 3 patients with navicular stress fractures regained normal imaging appearance at follow-up. Pain score, stiffness, sporting success, current sporting involvement, and recurrence/time to recurrence were not statistically associated with computed tomographic or magnetic resonance imaging parameters. Of 9 patients with navicular stress reactions, 7 developed clinical and radiological features of navicular stress fracture, but 6 of 9 patients (67%) returned successfully to sports.

Conclusions

Contemporary management of navicular stress fracture differs from that recommended in the literature. This stress fracture prevented almost half of the participants in this study from returning to sports at their previous level. Imaging parameters do not correlate with the clinical assessment of a patient at long-term follow-up of navicular stress fracture.
Biomechanical Evaluation of Meniscal Repair Systems
Authors: Chang Haw C. , Nyland John , Caborn David N. M. , Burden Robert
Published: September 2005

Background

The biomechanical characteristics of the Meniscal Viper Repair System have not been previously studied.

Hypothesis

Comparable meniscal lesion fixation standards will exist among the Meniscal Viper Repair System, the vertical FasT-Fix device, and vertical mattress sutures.

Study Design

Controlled laboratory study.

Methods

Porcine menisci (3 groups of 7 menisci each) were repaired using different devices. A servohydraulic device cycled each construct between 5 N and 50 N for 500 cycles before load to failure (5 mm/min). Group differences were evaluated with 1-way analysis of variance and Tukey post hoc tests.

Results

During cyclic testing, the vertical mattress suture group (2.3 ± 0.2 mm) showed less mean displacement than did the vertical FasT-Fix or the Viper system groups (3.9 ± 0.7 mm and 3.9 ± 0.5 mm, respectively); the vertical mattress suture group (21.8 ± 2 N/mm) also displayed superior mean stiffness to the vertical FasT-Fix or the Viper system groups (13.2 ± 2 N/mm and 13.1 ± 1.8 N/mm, respectively). During load-to-failure testing, the vertical FasT-Fix group (145.9 ± 9 N) withstood greater mean loads than did the Viper system group (111.2 ± 30 N), but it did not differ significantly from loads withstood by the vertical mattress suture group (133.4 ± 10 N). The Viper system and vertical FasT-Fix groups (14.6 ± 2 N/mm and 12.1 ± 1 N/mm, respectively) displayed superior mean stiffness to the vertical mattress suture group (9.8 ± 0.5 N/mm) during load-to-failure testing.

Clinical Relevance

Standard vertical mattress sutures provided superior fixation during cyclic loading compared with the 2 all-inside methods of suture fixation, suggesting a potential for better meniscal lesion healing with vertical mattress sutures when confronted with the stresses associated with early, progressive rehabilitation activities. Stronger sutures and less meniscal segment purchase in tears located 3 to 4 mm from the periphery may contribute to the failure of the Viper repair system.
Assessment of Lower Limb Neuromuscular Control in Prepubescent Athletes
Authors: Barber-Westin Sue D. , Galloway Marc , Noyes Frank R. , Corbett George , Walsh Catherine
Published: September 2005

Background

Although neuromuscular indices have been extensively studied in adolescents and adults, limited data exist for prepubescent children.

Hypothesis

No differences exist between prepubescent boys and girls in lower limb strength, symmetry on single-legged hop testing, and limb alignment during drop-jump testing.

Study Design

Cross-sectional study (prevalence); Level of evidence, 1.

Methods

The authors tested 27 female and 25 male athletes who were aged 9 to 10 years and matched for both body mass index and years of organized sports participation. In a drop-jump screening test, the distance between the right and left hips, knees, and ankles was measured as an indicator of lower limb axial alignment in the coronal plane. The distance between the knees and ankles was normalized by the hip separation distance. Quadriceps and hamstrings strengths were measured isokinetically at 180 deg/s. Lower limb symmetry was determined from 2 single-legged hop function tests.

Results

Boys demonstrated greater mean absolute and normalized knee and ankle separation distances on the drop-jump test. Even so, 76% of boys had a normalized knee separation distance of 60% or less of the hip separation distance, as did 93% of girls, indicating a distinctly valgus alignment. There were no differences between the sexes in quadriceps and hamstrings peak torques, hamstrings/quadriceps ratio, time to peak torque, total work, or lower limb symmetry values.

Conclusions

A high percentage of the prepubescent athletes studied had a distinctly valgus lower limb alignment during the drop-jump test and a lack of lower limb symmetry during the hop tests. These same indices have been hypothesized to increase the risk for knee ligament injuries in older athletes. Neuromuscular training may be needed to address these issues in children.
Intra-articular Repair of an Isolated Partial Articular-Surface Tear of the Subscapularis Tendon
Authors: Kim Seung-Ho , Oh Irvin , Park Jun-Sic , Shin Seong-Kee , Jeong Woong-Kyo
Published: September 2005

Background

Partial-thickness tear of the subscapularis tendon in the articular surface is common.

Hypothesis

Intra-articular repair of a partial articular-surface tear of the subscapularis tendon will provide a successful outcome.

Study Design

Case series; Level of evidence, 4.

Methods

A total of 29 shoulders with an isolated partial articular-surface tear of the subscapularis tendon without another rotator cuff lesion were treated with arthroscopic intra-articular repair using suture anchors. Biceps tenodesis was performed in 16 patients. Outcomes were prospectively evaluated at a mean of 27 months (range, 19-41 months) using 3 objective (University of California at Los Angeles, American Shoulder and Elbow Surgeons Shoulder Index, Simple Shoulder Test) and 2 subjective (pain and function visual analog scales) measurements.

Results

There were 21 men and 8 women, with a mean age of 54 years (range, 41-65 years). Tear widths were small (<1 cm) in 16 shoulders and large (>1 cm) in 13 shoulders. Twenty-six shoulders had articular cartilage erosion on the adjacent humeral head. Lesions of the biceps tendon were noted in 25 patients (partial tear in 15 shoulders; subluxation in 13 shoulders). Shoulder pain scores improved after surgery (5.0 ± 2.7 to 0.3 ± 0.7, P <. 05). According to American Shoulder and Elbow Surgeons Shoulder Index scores, 18 were excellent; 10, good; and 1, fair. Internal rotation strength deficit improved from 32% to 4%. Twenty-six patients returned to more than 90% of previous activity. There were no surgical complications; tear size and biceps tenodesis did not affect outcome (P >. 05).

Conclusion

Arthroscopic intra-articular repair of a partial articular-surface tear of the subscapularis tendon is an effective procedure that spares the intact tendon attachment in the bursal surface. Short-term outcomes were reliable by both objective and subjective measurements.
Mosaicplasty with Autogenous Talar Autograft for Osteochondral Lesions of the Talus after Failed Primary Arthroscopic Management
Authors: Kreuz Peter Cornelius , Steinwachs Matthias , Erggelet Christoph , Lahm Andreas , Henle Philipp , Niemeyer Philipp
Published: September 2005

Background

There have been limited data in the literature reporting the results of osteochondral autografting for osteochondral lesions of the talus that have failed arthroscopic treatment.

Hypothesis

Osteochondral autografting can produce significant clinical improvement and a high rate of healing of osteochondral defects of the talus that have failed arthroscopic treatment.

Study Design

Cohort study; Level of evidence, 4.

Methods

Between 1998 and 2003, 35 patients (18 men, 17 women) with osteochondral talar lesions for which arthroscopic excision, curettage, and drilling had failed, underwent mosaicplasty with an osteochondral graft harvested from the ipsilateral talar articular facet. A malleolar osteotomy or a tibial wedge osteotomy was used for central or posterior lesions that could not otherwise be reached. The mean age of the patients was 30.9 years, and the mean follow-up was 48.9 months.

Results

The American Orthopaedic Foot and Ankle Society Ankle Hindfoot scale score in patients without osteotomy rose by 39 points (P =. 0001); with malleolar osteotomy, by 30.1 points (P =. 017); with tibial wedge osteotomy, by 34.9 points (P =. 0002); and with the posterolateral approach, by 32 points. The Wilcoxon test revealed a significant difference between patients without and with osteotomy (P =. 027) and between patients with malleolar and tibial wedge osteotomies (P =. 046). There were no patients with nonunion or malunion in the osteotomy groups. The score values corresponded with the subjective patient evaluation. The Spearman coefficient of correlation was. 89.

Conclusion

Osteochondral autografting with tibial wedge osteotomy is a good alternative to malleolar osteotomy in osteochondral talar lesions that have failed arthroscopic treatment and that cannot be reached in spite of a forced plantar flexion of the ankle. Patients with small osteochondral lesions accessible through an anterior approach without additional osteotomy have the best prognostic factors.
Comparison of 2 Surgical Techniques of Posterolateral Corner Reconstruction of the Knee
Authors: Nau Thomas , Chevalier Yan , Hagemeister Nicola , deGuise Jacques A. , Duval Nicolas
Published: September 2005

Background

Various surgical techniques to treat posterolateral knee instability have been described. To date, the recommended treatment is an anatomical form of reconstruction, in which the 3 key structures of the posterolateral corner are addressed: the lateral collateral ligament, the popliteofibular ligament, and the popliteus tendon.

Hypothesis

Two methods of surgical reconstruction will restore posterolateral knee instability, in terms of static laxity as well as dynamic 6 degrees of freedom kinematics, to statistically significant levels compared with the intact state.

Study Design

Controlled laboratory study.

Methods

Two surgical techniques (A and B) were used to reconstruct the posterolateral structures in 10 cadaveric knees. Static tests were performed on the intact, sectioned, and reconstructed knees at 30° and 90° of flexion for anterior-posterior laxity and external rotational laxity, as well as at 0° and 30° of flexion for varus laxity; dynamic 6 degrees of freedom kinematic testing, through a path of motion from 90° of flexion to full extension, was also performed.

Results

For the static varus tests, external rotation and varus laxity were significantly increased after the posterolateral structures were cut. Both reconstruction techniques restored external rotation and varus laxity to levels not significantly different from the intact state. For technique B, dynamic testing did not show any significant difference for all degrees of freedom kinematics compared with the intact state. However, for technique A, a significant internal tibial rotation was observed throughout the entire path of motion from 0° to 90° of knee flexion.

Conclusions

Both surgical techniques for anatomical posterolateral corner reconstruction showed good results in the static laxity tests. The anatomical reconstruction of all structures, including the popliteus tendon, resulted in an abnormal internal tibial rotation during dynamic testing.
An Assessment of the Methodological Quality of Research Published in the American Journal of Sports Medicine
Authors: Brophy Robert H. , Gardner Michael J. , Saleem Omar , Marx Robert G.
Published: September 2005

Background

Evidence-based medicine has become a popular topic in academic medicine during the past several decades and more recently in orthopaedics and sports medicine.

Hypothesis

Articles published in The American Journal of Sports Medicine have shown an improvement in methodological quality in 2001-2003, compared with 1991-1993.

Study Design

Systematic review.

Methods

All articles published in The American Journal of Sports Medicine during the periods 1991-1993 and 2001-2003 were reviewed and classified by type of study. The use of pertinent methodologies such as prospective data collection, randomization, blinding, and controlled studies was noted for each article. The frequency of each article type and the use of evidence-based techniques were compared across study periods.

Results

Case series and descriptive studies decreased during the study period, from 27.4% to 15.3% (P=. 00003) and from 11.9% to 5.6% (P=. 001), respectively, of articles published. Prospective cohort studies increased from 4.7% to 14.1% (P=. 000005), and randomized, prospective clinical trials increased from 2.7% to 5.9% of articles (P=. 04). More studies tested an explicit hypothesis (P=. 0000002), used prospective data collection (P=. 000003), and used blinding (P=. 02), and more studies identified a funding source (P=. 004).

Conclusions

Overall, there was a shift toward more prospective and randomized research designs published in The American Journal of Sports Medicine during 2001-2003 compared to 1991-1993, demonstrating an improvement in the methodological quality of published research.
The Effect of Relaxin Treatment on Skeletal Muscle Injuries
Authors: Negishi Shinichi , Li Yong , Usas Arvydas , Fu Freddie H. , Huard Johnny
Published: September 2005

Background

Injured skeletal muscle can repair itself via spontaneous regeneration; however, the overproduction of extracellular matrix and excessive collagen deposition lead to fibrosis. Neutralization of the effect of transforming growth factor-β1, a key fibrotic cytokine, on myogenic cell differentiation after muscle injury can prevent fibrosis, enhance muscle regeneration, and thereby improve the functional recovery of injured muscle.

Hypothesis

The hormone relaxin, a member of the family of insulin-like growth factors, can act as an antifibrosis agent and improve the healing of injured muscle.

Study Design

Controlled laboratory study.

Methods

In vitro: Myoblasts (C2C12 cells) and myofibroblasts (transforming growth factor-β1-transfected myoblasts) were incubated with relaxin, and cell growth and differentiation were examined. Myogenic and fibrotic protein expression was determined by Western blot analysis. In vivo: Relaxin was injected intramuscularly at different time points after laceration injury. Skeletal muscle healing was evaluated via histologic, immunohistochemical, and physiologic tests.

Results

Relaxin treatment resulted in a dose-dependent decrease in myofibroblast proliferation, down-regulated expression of the fibrotic protein α-smooth muscle actin, and promoted the proliferation and differentiation of myoblasts in vitro. Relaxin therapy enhanced muscle regeneration, reduced fibrosis, and improved injured muscle strength in vivo.

Conclusion

Administration of relaxin can significantly improve skeletal muscle healing.

Clinical Relevance

These findings may facilitate the development of techniques to eliminate fibrosis, enhance muscle regeneration, and improve functional recovery after muscle injuries.
Evaluation of Risk Factors for Injury in Adolescent Soccer
Authors: Emery Carolyn A. , Meeuwisse Willem H. , Hartmann Sara E.
Published: September 2005

Background

There are limited data on the epidemiology of adolescent soccer injury across all levels of play.

Hypothesis

Through implementation and validation of an injury surveillance system in adolescent soccer, risk factors for injury will be identified.

Study Design

Descriptive epidemiology study.

Methods

The study population was a random sample of 21 adolescent soccer teams (ages 12-18). A certified athletic therapist completed preseason baseline measurements and did weekly assessments of any identified soccer injury. The injury definition included any injury occurring in soccer that resulted in 1 or more of the following: medical attention, the inability to complete a session, or missing a subsequent session.

Results

Based on completeness of data in addition to validity of time loss, this method of surveillance has proven to be effective. The overall injury rate during the regular season was 5.59 injuries per 1000 player hours (95% confidence interval, 4.42-6.97). Soccer injury resulted in time loss from soccer for 86.9% of the injured players. Ankle and knee injuries were the most common injuries reported. Direct contact was reported to be involved in 46.2% of all injuries. There was an increased risk of injury associated with games versus practices (relative risk = 2.89; 95% confidence interval, 1.69-5.21). The risk of injury in the under 14 age group was greatest in the most elite division. Having had a previous injury in the past 1 year increased the risk of injury (relative risk = 1.74; 95% confidence interval, 1.0-3.1).

Conclusion

There were significant differences in injury rates found by division, previous injury, and session type (practice vs game). Future research should include the use of such a surveillance system to examine prevention strategies for injury in adolescent soccer.
Ulnar Wrist Pain in Athletes Caused by Erosion of the Floor of the Sixth Dorsal Compartment
Authors: Carneiro Ronaldo S. , Fontana Rosana , Mazzer Nilton
Published: September 2005

Background

Ulnar-side wrist pain can be disabling for athletes because of limitation of pronation-supination during sports such as tennis and golf. Erosion of the floor of the sixth dorsal space should be considered for unresponsive ulnar-side wrist pain.

Study Design

Case series; Level of evidence, 4.

Methods

Four athletes with severe unresponsive ulnar-side wrist pain were identified. Because the usual treatment regimens were ineffective in all cases, surgery was indicated to attempt mitigation of symptoms. During surgical exploration, all patients had inflammatory tendon changes and erosions in the floor of the sixth dorsal space, deep to the extensor carpi ulnaris. A soft tissue interposition flap fashioned from the roof of the sixth compartment was used to cover the defect.

Results

Patients were evaluated by reexamination for range of motion, ability to perform daily and sports activities, strength, and residual pain. All patients had relief of their symptoms, had normal range of motion with no residual pain, and returned to tennis and golf. Strength improved a mean of 15 lb after surgery. The follow-up was 19 to 40 months (mean, 33 months).

Conclusion

Erosion of the sixth compartment floor has been given very little attention in the literature. It should be suspected when severe ulnar-side pain persists in athletes after the usual methods of treatment. The interposition surgery described herein has been effective in 4 cases previously unresponsive to the usual methods of treatment for chronic tendinitis of the extensor carpi ulnaris or triangular fibrocartilage rupture.
Clinician/Patient Connections in Ethnoculturally Nonconcordant Encounters With Political-Asylum Seekers: A Comparison of Physicians and Nurses
Authors: Koehn Peter H. , Sainola-Rodriguez Kirsti
Published: September 2005

The article compares the ability of nurses and physicians to connect with patients in ethnoculturally nonconcordant clinical encounters with 41 randomly selected political-asylum seekers (PAS) residing at five Finnish reception centers in summer 2002. Doctors and nurses were equally unlikely to draw congruent assessments of the patient’s past and present health condition, mixed use of biomedical/ethnocultural practices, adherence with medication and eat/drink instructions, (dis)satisfaction, and future confidence in recommended biomedical and ethnocultural approaches. Nurses were considerably more likely to hold views that were congruent with the patient’s reported health care effectiveness in Finland. The findings suggest that doctors should request and place special weight on the insights of the principal attending nurse when assessing the potential contributions of personal, family, and host-society health care assets and inhibitors to a migrant patient’s overall health plan. The results also suggest that culturally sensitive health care training offers specific advantages to nurses who attend to PAS.
Screening Performance of the Postpartum Depression Screening Scale—Spanish Version
Authors: Beck Cheryl T. , Gable Robert K.
Published: September 2005

The purpose of this study was to further assess measures of validity for the Postpartum Depression Screening Scale (PDSS)- Spanish Version on sensitivity, specificity, and predictive values. The convenience sample consisted of 150 Hispanic mothers from New England and Texas. Each woman first completed the PDSS-Spanish Version followed by a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV ) diagnostic interview. For analysis purposes, the Hispanic women were divided into three subgroups: Puerto Rican/Caribbean (n = 68), Mexican (n = 64), and Central/South American (n = 18). For the three subgroups, the PDSS total score alpha reliabilities were .96, .95, and .95, respectively. Based on the reciever operating characterisitc (ROC) curve analysis, a cutoff score of 60 is recommended as a positive screen for combined major and minor depression. This cutoff point obtained a sensitivity of 84% and specificity of 84%. When compared to the original English version of the PDSS, the psychometrics for the Spanish version were slightly lower but well within the acceptable range.
Mexican Immigrants’ Explanatory Model of Latent Tuberculosis Infection
Authors: McEwen Marylyn M.
Published: September 2005

This article reveals how the multiple and disparate explanations of latent tuberculosis infection (LTBI) from the U.S. and Mexico professional health sectors and the popular sector are used to inform the explanatory model (EM) of LTBI for Mexican immigrants residing in the U.S.-Mexico border region. Fourteen immigrants, nine diagnosed with LTBI (n = 9) and their spouses (n = 5) participated in this critical ethnographic study. Because care seeking and treatment decisions are influenced by EMs, the results indicate that it is imperative that interventions for Mexican immigrants with LTBI are built on an understanding of their illness experience and are contextually meaningful.