Experimental infections of herring gulls (Larus argentatus) with H5N1 highly pathogenic avian influenza viruses by intranasal inoculation of virus and ingestion of virus-infected chicken meat

The present study investigated the susceptibility of herring gulls (Larus argentatus) exposed to two strains of Asian lineage H5N1 highly pathogenic avian influenza (HPAI) virus by evenly separating six gulls into two groups and inoculating them intranasally with 10(6) median embryo infectious doses of either A/whooper swan/Mongolia/244/05 (H5N1) or A/duck meat/Anyang/AVL-1/01 (H5N1). Two additional gulls were fed 5.0 g meat from a specific pathogen free chicken that died after experimental infection with A/whooper swan/Mongolia/244/05. Morbidity and mortality were observed in the gulls infected with A/whooper swan/Mongolia/244/05 by both routes of exposure. Gulls infected with A/duck meat/Anyang/AVL-1/01 exhibited high morbidity, but no mortality. The concentration and duration of viral shedding were similar between gulls infected with either strain of H5N1 HPAI virus by intranasal inoculation and gulls exposed to A/whooper swan/Mongolia/244/05 through ingestion of virus-infected chicken meat. The susceptibility of herring gulls in this study varied between the two strains of Asian lineage H5N1 HPAI virus. These results also provide preliminary data to support that ingestion of virus-infected raw or uncooked chicken meat is a viable route of exposure to some H5N1 HPAI viruses in herring gulls. Additional studies are necessary to further evaluate the efficiency of this route of exposure to a variety of H5N1 HPAI virus strains in herring gulls and other avian species in order to better understand the potential role of scavenging species in the epidemiology of H5N1 HPAI virus.

Thyroid hormone effects on LKB1, MO25, phospho-AMPK, phospho-CREB, and PGC-1alpha in rat muscle

Expression of all of the isoforms of the subunits of AMP-activated protein kinase (AMPK) and AMPK activity is increased in skeletal muscle of hyperthyroid rats. Activity of AMPK in skeletal muscle is regulated principally by the upstream kinase, LKB1. This experiment was designed to determine whether the increase in AMPK activity is accompanied by increased expression of the LKB1, along with binding partner proteins. LKB1, MO25, and downstream targets were determined in muscle extracts in control rats, in rats given 3 mg of thyroxine and 1 mg of triiodothyronine per kilogram chow for 4 wk, and in rats given 0.01% propylthiouracil (PTU; an inhibitor of thyroid hormone synthesis) in drinking water for 4 wk (hypothyroid group). LKB1 and MO25 increased in the soleus of thyroid hormone-treated rats vs. the controls. In other muscle types, LKB1 responses were variable, but MO25 increased in all. In soleus, MO25 mRNA increased with thyroid hormone treatment, and STRAD mRNA increased with PTU treatment. Phospho-AMPK and phospho-ACC were elevated in soleus and gastrocnemius of hyperthyroid rats. Thyroid hormone treatment also increased the amount of phospho-cAMP response element binding protein (CREB) in the soleus, heart, and red quadriceps. Four proteins having CREB response elements (CRE) in promoter regions of their genes (peroxisome proliferator-activated receptor-gamma coactivator-1alpha, uncoupling protein 3, cytochrome c, and hexokinase II) were all increased in soleus in response to thyroid hormones. These data provide evidence that thyroid hormones increase soleus muscle LKB1 and MO25 content with subsequent activation of AMPK, phosphorylation of CREB, and expression of mitochondrial protein genes having CRE in their promoters.

Chlorine inactivation of highly pathogenic avian influenza virus (H5N1)

To determine resistance of highly pathogenic avian influenza (H5N1) virus to chlorination, we exposed allantoic fluid containing 2 virus strains to chlorinated buffer at pH 7 and 8, at 5 degrees C. Free chlorine concentrations typically used in drinking water treatment are sufficient to inactivate the virus by >3 orders of magnitude.

Experimental infection of swans and geese with highly pathogenic avian influenza virus (H5N1) of Asian lineage

Susceptibility to infection, duration of illness, and concentration of asymptomatic viral shedding vary between species of swans and geese.

The role of wild birds in the epidemiology of the Asian lineage highly pathogenic avian influenza (HPAI) virus subtype H5N1 epizootic and their contribution to the spread of the responsible viruses in Eurasia and Africa are unclear. To better understand the potential role of swans and geese in the epidemiology of this virus, we infected 4 species of swans and 2 species of geese with an HPAI virus of Asian lineage recovered from a whooper swan in Mongolia in 2005, A/whooper swan/Mongolia/244/2005 (H5N1). The highest mortality rates were observed in swans, and species-related differences in clinical illness and viral shedding were evident. These results suggest that the potential for HPAI (H5N1) viral shedding and the movement of infected birds may be species-dependent and can help explain observed deaths associated with HPAI (H5N1) infection in anseriforms in Eurasia.

AMP-activated protein kinase phosphorylates transcription factors of the CREB family

AMP-activated protein kinase (AMPK) has been identified as a regulator of gene transcription, increasing mitochondrial proteins of oxidative metabolism as well as hexokinase expression in skeletal muscle. In mice, muscle-specific knockout of LKB1, a component of the upstream kinase of AMPK, prevents contraction- and 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside (AICAR)-induced activation of AMPK in skeletal muscle, and the increase in hexokinase II protein that is normally observed with chronic AICAR activation of AMPK. Since previous reports show a cAMP response element in the promoter region of the hexokinase II gene, we hypothesized that the cAMP-response element (CRE) binding protein (CREB) family of transcription factors could be targets of AMPK. Using radioisotopic kinase assays, we found that recombinant and rat liver and muscle AMPK phosphorylated CREB1 at the same site as cAMP-dependent protein kinase (PKA). AMPK was also found to phosphorylate activating transcription factor 1 (ATF1), CRE modulator (CREM), and CREB-like 2 (CREBL2), but not ATF2. Treatment of HEK-293 cells stably transfected with a CREB-driven luciferase reporter with AICAR increased luciferase activity approximately threefold over a 24-h time course. This increase was blocked with compound C, an AMPK inhibitor. In addition, AICAR-induced activation of AMPK in incubated rat epitrochlearis muscles resulted in an increase in both phospho-acetyl-CoA carboxylase and phospho-CREB. We conclude that CREB and related proteins are direct downstream targets for AMPK and are therefore likely involved in mediating some effects of AMPK on expression of genes having a CRE in their promoters.

Wild bird surveillance for the avian influenza virus

Avian influenza (AI) viruses have been isolated from a wide diversity of free-living avian species representing several orders. Isolations are most frequently reported from aquatic birds in the Orders Anseriformes and Charadriiformes, which are believed to be the reservoirs for all AI viruses. Since their first recognition in the late 1800 s, AI viruses have been an important agent of disease in poultry and, occasionally, of nongallinaceous birds and humans. However, the recent highly pathogenic avian influenza (HPAI) H5N1 virus epidemics have increased the awareness of AI viruses and their potential implications among the scientific community, politicians, and the general public. In response to the spread of HPAI H5N1 viruses to Europe and Africa in 2005-2006, many countries developed surveillance plans to detect AI viruses; a large portion of these sampling efforts was targeted at migratory avian species. This chapter is intended to give general concepts and guidelines for surveillance of the AI virus in wild birds. Separate sections are included for low pathogenicity avian influenza (LPAI) and HPAI H5N1 viruses because the unique biological characteristics of HPAI H5N1 require a modified surveillance plan tailored to these viruses.

LKB1 and the regulation of malonyl-CoA and fatty acid oxidation in muscle

5'-AMP-activated protein kinase (AMPK), by way of its inhibition of acetyl-CoA carboxylase (ACC), plays an important role in regulating malonyl-CoA levels and the rate of fatty acid oxidation in skeletal and cardiac muscle. In these tissues, LKB1 is the major AMPK kinase and is therefore critical for AMPK activation. The purpose of this study was to determine how the lack of muscle LKB1 would affect malonyl-CoA levels and/or fatty-acid oxidation. Comparing wild-type (WT) and skeletal/cardiac muscle-specific LKB1 knockout (KO) mice, we found that the 5-aminoimidazole-4-carboxamide-1-beta-d-ribofuranoside (AICAR)-stimulated decrease in malonyl-CoA levels in WT heart and quadriceps muscles was entirely dependent on the presence of LKB1, as was the AICAR-induced increase in fatty-acid oxidation in EDL muscles in vitro, since these responses were not observed in KO mice. Likewise, the decrease in malonyl-CoA levels after muscle contraction was attenuated in KO gastrocnemius muscles, suggesting that LKB1 plays an important role in promoting the inhibition of ACC, likely by activation of AMPK. However, since ACC phosphorylation still increased and malonyl-CoA levels decreased in KO muscles (albeit not to the levels observed in WT mice), whereas AMPK phosphorylation was entirely unresponsive, LKB1/AMPK signaling cannot be considered the sole mechanism for inhibiting ACC during and after muscle activity. Regardless, our results suggest that LKB1 is an important regulator of malonyl-CoA levels and fatty acid oxidation in skeletal muscle.

Persistence of H5 and H7 Avian Influenza Viruses in Water

Although fecal-oral transmission of avian influenza viruses (AIV) via contaminated water represents a recognized mechanism for transmission within wild waterfowl populations, little is known about viral persistence in this medium. In order to provide initial data on persistence of H5 and H7 AIVs in water, we evaluated eight wild-type low-pathogenicity H5 and H7 AIVs isolated from species representing the two major influenza reservoirs (Anseriformes and Charadriiformes). In addition, the persistence of two highly pathogenic avian influenza (HPAI) H5N1 viruses from Asia was examined to provide some insight into the potential for these viruses to be transmitted and maintained in the environments of wild bird populations. Viruses were tested at two temperatures (17 C and 28 C) and three salinity levels (0, 15, and 30 parts per thousand sea salt). The wild-type H5 and H7 AIV persistence data to date indicate the following: 1) that H5 and H7 AIVs can persist for extended periods of time in water, with a duration of infectivity comparable to AIVs of other subtypes; 2) that the persistence of H5 and H7 AIVs is inversely proportional to temperature and salinity of water; and 3) that a significant interaction exists between the effects of temperature and salinity on the persistence of AIV, with the effect of salinity more prominent at lower temperatures. Results from the two HPAI H5N1 viruses from Asia indicate that these viruses did not persist as long as the wild-type AIVs.

Susceptibility of North American ducks and gulls to H5N1 highly pathogenic avian influenza viruses

Species-related differences in clinical response and duration and extent of viral shedding exist between North American ducks and gulls infected with H5N1 HPAI viruses.

Since 2002, H5N1 highly pathogenic avian influenza (HPAI) viruses have been associated with deaths in numerous wild avian species throughout Eurasia. We assessed the clinical response and extent and duration of viral shedding in 5 species of North American ducks and laughing gulls (Larus atricilla) after intranasal challenge with 2 Asian H5N1 HPAI viruses. Birds were challenged at ≈10 to 16 weeks of age, consistent with temporal peaks in virus prevalence and fall migration. All species were infected, but only wood ducks (Aix sponsa) and laughing gulls exhibited illness or died. Viral titers were higher in oropharyngeal swabs than in cloacal swabs. Duration of viral shedding (1–10 days) increased with severity of clinical disease. Both the hemagglutination-inhibition (HI) and agar gel precipitin (AGP) tests were able to detect postinoculation antibodies in surviving wood ducks and laughing gulls; the HI test was more sensitive than the AGP in the remaining 4 species

Characterization of the Bacterial Microflora of the Tympanic Cavity of Eastern Box Turtles With and Without Aural Abscesses

Aerobic bacterial cultures of the tympanic cavity of the middle ear were performed in eight eastern box turtles (Terrapene carolina carolina) with aural abscesses and 15 eastern box turtles without aural abscesses (controls) that were admitted to The Wildlife Center of Virginia, Virginia, USA during 2003. Twenty-two bacterial isolates were identified from 17 turtles including 10 gram-negative and 12 gram-positive bacteria. Ten of 15 control animals had bacterial growth, resulting in identification of 13 bacteria, including six gram-negative and seven gram-positive agents. Seven of eight turtles with aural abscesses had bacterial growth, and 10 isolates were identified, including four gram-negative and six gram-positive organisms. The most frequently isolated bacteria from control animals were Micrococcus luteus (n = 3) and Pantoea agglomerans (n = 2). Morganella morganii (n = 2) was the only species isolated from the tympanic cavity of more than one turtle with aural abscesses. Staphylococcus epidermidis (n = 2) was the only species isolated from both groups. A trend toward greater bacterial growth in tympanic cavities of affected turtles compared with turtles without aural abscesses was noted. No single bacterial agent was responsible for aural abscesses in free-ranging eastern box turtles in this study, an observation consistent with the hypothesis that aerobic bacteria are not primary pathogens, but secondary opportunistic invaders of environmental origin.

Absence of detectable Salmonella cloacal shedding in free-living reptiles on admission to the wildlife center of Virginia

Salmonellosis is an important reptile-associated zoonotic infection in the United States. Cloacal swabs were collected from reptiles admitted to the Wildlife Center of Virginia, Waynesboro, Virginia, cultured for Salmonella using Hektoen and xylose lysine deoxycholate agars, and inoculated in selenite broth. All three were incubated at 37 degrees C for 18-24 hr. Seventy-five animals were included in the study, representing eight species, 34 eastern box turtles (Terrapene carolina carolina), 14 eastern painted turtles (Chrysemys picta picta), 14 snapping turtles (Chelydra serpentina), 6 black rat snakes (Elaphe obsoleta obsoleta), 2 redbelly turtles (Pseudemys rubriventris), 2 yellowbelly sliders (Trachemys scripta scripta), 2 eastern garter snakes (Thamnophis sirtalis sirtalis), and 1 eastern river cooter (Pseudemys concinna concinna). All cultures were negative for Salmonella spp., which is in contrast to the high prevalence of Salmonella cloacal shedding reported in captive reptiles but similar to previous reports in free-living North American reptiles. We recommend, nonetheless, practicing proper hygiene methods when handling and housing all reptiles.

An integrated methodology for recording uncertainties about environmental data

Understanding the limitations of environmental data is essential both for managing environmental systems effectively and for encouraging the responsible use of scientific research when knowledge is limited and priorities are varied. Using a combination of quantitative and qualitative techniques for assessing probabilities, and acknowledging the importance of scenarios where probabilities cannot be determined, an integrated methodology is presented for handling uncertainties about environmental data. The methodology is based on a fourfold distinction between the empirical quality of data (and the ancillary information, such as 'scale', required to interpret this), the sources of uncertainty in data, the 'fitness for use' of the data, and the quality or 'goodness' of an uncertainty model.

Running performance in middle-school runners

AIM

This study examined the relationship of 3-km run time to indices of aerobic and anaerobic ability in 9 male runners (13.4+/-0.6 years, mean+/-SD).

METHODS

Anthropometric measurements were made, and an exercise test to determine running economy at 187 m x min(-1) and (.-)VO(2max) were assessed on a treadmill. On a separate day, 2 55-m sprints followed by a 3-km run were performed on a 200-m indoor track. Capillary blood samples were obtained from a finger tip immediately after the run to determine blood lactate level. Fractional utilization (%(.-)VO(2max) used during the 3-km run) was calculated. Correlations were used to examine the relationship between run time and the physiological measurements.

RESULTS

Mean values for (.-)VO(2), HR and RER at maximal exercise were 61.7+/-4.4 ml x kg(-1)xmin(-1), 198.9+/-6.7 b x min(-1), and 1.16+/-0.04, respectively. The average time to run 3 km was 13.27+/-0.97 min (90.1+/-7.2% of (.-)VO(2max)). Post-run blood lactate level was 8.3+/-3.2 mmol x L(-1) and was significantly related (r=-0.73, p=0.02) to 3-km time. Fractional utilization tended to be related (r=-0.56, p=0.12) to time.

CONCLUSIONS

In this age group the ability to run at a high percentage of (.-)VO(2max) and tolerate a high blood lactate appear to be important determinants of running performance in young male runners.

PATHOLOGY OF AURAL ABSCESSES IN FREE-LIVING EASTERN BOX TURTLES (TERRAPENE CAROLINA CAROLINA)

Aural abscess or abscess of the middle ear is common in free-living Eastern box turtles (Terrapene carolina carolina) of Virginia (USA) and elsewhere. Although its etiology remains unknown, hypovitaminosis A has been suggested on the basis of similar lesions occurring in captive chelonians fed diets that are deficient in vitamin A. This hypothesis was supported by significantly greater body burdens of organochlorine compounds (reported disruptors of vitamin A metabolism) and a nonsignificant trend toward lower serum and hepatic vitamin A levels in free-living box turtles with this lesion. The tympanic epithelium was evaluated in 27 box turtles (10 with aural abscesses and 17 without). Lesions of the tympanic epithelium of box turtles with aural abscesses included hyperplasia, squamous metaplasia, hyperemia, cellular sloughing, granulomatous inflammation, and bacterial infection. These changes were more severe in turtles with aural abscesses than in those without and were more severe in tympanic cavities that had an abscess compared to those without when the lesion was unilateral. Organs from 21 box turtles (10 with aural abscesses and 11 without) from the study population were examined for microscopic lesions, and minimal histopathologic changes were found, none of which were similar to those found in the tympanic epithelium. Histopathologic changes in box turtles with aural abscesses were consistent with a syndrome that may involve hypovitaminosis A.

Epidemiologic determinants of aural abscessation in free-living eastern box turtles (Terrapene carolina) in Virginia

Epidemiologic determinants of 46 cases of aural abscessation in free-living eastern box turtles (Terrapene carolina) admitted to the Wildlife Center of Virginia (Virginia, USA) from 1991 to 2000 were evaluated. County human population density, year and season of admission, weight, and sex did not affect the risk for box turtles to develop aural abscessation. Counties with cases of aural abscessation were not randomly distributed, but rather were clustered into two multi-county regions. Geographic location was the only risk factor associated with aural abscessation in box turtles found in this study. Possible etiologies could include chronic infectious disease, malnutrition, or chronic exposure to environmental contamination with organochlorine compounds.

An NMR shielding model for protons above the plane of a carbonyl group

Covalently bonded hydrogen nuclei located over the plane of a carbonyl group in a strong magnetic field experience magnetic shielding (or deshielding) that results from the combined effect of the magnetic anisotropy of the carbon-oxygen double bond and various other intramolecular shielding effects. GIAO-HF in Gaussian 98 was employed to calculate isotropic shielding values and to predict the net proton NMR shielding increment for a simple model system: the proximate proton of methane held in various positions over formaldehyde. The net shielding increments of the proximate proton of methane, plotted against its Cartesian coordinates relative to the center of the carbon-oxygen double bond, led to the development of a single empirical equation for predicting the NMR shielding experienced by a covalently bonded proton over the plane of a carbonyl group. The predictive capability of this equation has been validated by calculating the shielding increments of protons over the plane of a carbonyl group in known structures, using this as a correction to the chemical shift estimated by subtituent effects and comparing the result to experimentally observed chemical shifts. Shielding is predicted by this equation for protons located in the region from over the center of the carbon-oxygen double bond to beyond the carbon atom; deshielding is predicted for protons located above and beyond the oxygen atom. This prediction differs from those made by the long-held "shielding cone" model found in nearly every textbook on NMR, but is consistent with experimental observations. The algorithm for predicting the shielding increment for a proton over a carbonyl group can be used in a spreadsheet or incorporated into software that estimates chemical shifts using additive substituent constants or a database of structures. Its use can improve the accuracy of the estimated chemical shift of a proton in the vicinity of a carbon-oxygen double bond, and thus assist in spectral assignments and in correct structure determination.

Genetic loading in familial migraine with aura

Migraine with aura (MA) arises from a combination of genetic and environmental factors. The sibling risk, age at onset, and aura type were compared in 54 MA probands categorised by family history of MA. Three family types were ascertained each having an MA proband and: (1) an MA parent and MA offspring (three generation; n=15), (2) either an MA parent or an MA offspring (two generation; n=20), and (3) neither an MA parent nor an MA offspring (one generation; n=19). The crude recurrence risk to siblings of probands was 2.7-fold higher in three generation compared with two generation MA families (chi(2)=6.24, p=0.0125) and 4.8-fold higher in three generation compared with one generation MA families (chi(2)=9.95, p<0.002). The mean age at onset decreased with an increase in genetic load. The MA probands from three generation families were significantly younger than probands from the one generation families (F=5.14, p=0.030). MA probands from three generation families were more likely to report more than one type of aura than MA probands from two generation families (chi(2)=4.44, p=0.035). The significant difference in genetic loading and the earlier age at onset in the three generation families add further evidence for a genetic basis for MA and the difference in sibling risks demonstrates that the MA population is heterogeneous.

Interspecific hybridization induced amplification of Mdm2 on double minutes in a Mus hybrid

We report a case of interspecific hybridization induced amplification of Chromosome 10 on double minutes (dm) in the karyotype of a hybrid Mus embryo. Stable, non-mosaic dm were previously found in tissues of a 16.5-day Mus Musculus x Mus Caroli hybrid (Graves, 1984). Dm in tissues of the hybrid was of interest to us because of previous reports of genomic instability in interspecific hybrids (O'Neill et al., 1998) and thus we decided to characterize the dm in the hybrid karyotypes. Whole chromosome painting of the hybrid cell lines showed amplification of Chromosome 10 sequences. Southern analysis with a probe for the candidate gene Mdm2 showed amplification of the paternal allele of this oncogene. Overexpression of Mdm2 was confirmed by a western analysis that also showed an associated inactivation of the tumor suppressor, Trp53. Evidence indicates that the event leading to the instability observed was an early adaptive response to stress on the genome, i.e. interspecific hybridization.

An unusual presentation of tarsal tunnel syndrome caused by an inflatable ice hockey skate

BACKGROUND

Tarsal tunnel syndrome is a rare form of entrapment neuropathy. In athletes, it is usually the result of repetitive activity, local injury or a space-occupying lesion. Rarely, athletic footwear has been described as the primary cause of this syndrome.

METHODS

A 37-year-old male recreational hockey player was examined clinically and electrophysiologically because of spreading numbness in the toes of his left foot while playing hockey and wearing inflatable ice hockey skates designed to promote a better fit.

RESULTS

Clinical and electrophysiological studies revealed evidence of left medial and lateral plantar nerve involvement. Reduced amplitudes of mixed and motor plantar nerve responses with fibrillation potentials and positive sharp waves and no evidence of conduction block suggest that the primary pathology was axonal loss. Follow-up examination showed significant clinical and electrophysiological improvement after the patient stopped wearing his inflatable ice hockey skates.

CONCLUSION

We report an unusual case of tarsal tunnel syndrome caused by an inflatable ice hockey skate. The patient improved clinically and electrophysiologically when he stopped wearing the boot.

Migraine with aura is not linked to the FHM gene CACNA1A or the chromosomal region, 19p13

Two microsatellite markers, tightly linked to CACNA1A, were genotyped in migraine with aura (MA) families to determine if this gene, which underlies the 19p13 linked forms of familial hemiplegic migraine, is also linked to MA. Two-point parametric lod and nonparametric linkage scores did not support linkage. Transmission disequilibrium testing provided no evidence for linkage of MA to CACNA1A. In a large dataset of 64 Canadian MA families, the authors did not find evidence to support an MA susceptibility gene in the region of 19p13.

Morbidity and mortality of reptiles admitted to the Wildlife Center of Virginia, 1991 to 2000

Medical records from 694 reptiles admitted to the Wildlife Center of Virginia (WCV; Waynesboro, Virginia, USA) from 1991 to 2000 were reviewed to determine causes of morbidity and mortality. Eighteen species were represented but the majority of cases were four species; eastern box turtle (Terrapene carolina) (66%), eastern painted turtle (Chrysemys picta) (11%), common snapping turtle (Chelydra serpentina) (10%), and rat snake (Elaphe sp.) (6%). There was a significant increase in reptile cases during the study period both in absolute number and in proportion to the total caseload. Trauma (74%) was the most frequent cause of morbidity and mortality followed by unknown or undetermined (13%), aural abscessation (7%), infectious diseases (2%), and one nutritional disorder (0.1%). In addition, 3% of the cases were healthy animals that had been removed from the wild and consequently brought to the WCV. Causes of morbidity and mortality differed between the four most numerous species. Impact with a motor vehicle was the most frequent cause of trauma for eastern box turtles, eastern painted turtles, and common snapping turtles; however, garden-equipment-related trauma was the most frequent cause for rat snakes. Aural abscessation was only seen in eastern box turtles. Eighty percent of cases occurred between May and September and 65% occurred within the five counties closest to the WCV. The majority of morbidity and mortality was the result of human activities. The expanding human population in Virginia likely will continue to have an impact on the health of wild reptiles.

Attainment of maximal exercise criteria in boys and men

BACKGROUND

This study tested the hypothesis that the occurrence of a VO(2) plateau at maximal exercise would be greater in men versus boys. Secondary indicators of maximal effort also were examined.

METHODS

Sixteen boys (10.7+/-0.6 yrs) and 21 men (22.5+/-2.0 yrs) performed a graded exercise test on a treadmill at a constant speed of 8.04 km x hr(-1) with 2.5% increments in elevation. The men also performed a second test at 11.26 km x hr(-1) with similar increases in slope.

RESULTS

At 8.04 km x hr(-1) , VO(2) max was 52.3+/-6.0 and 52.5+/-5.1 ml x kg(-1) x min(-1) in boys and men, respectively (p>0.05). In the men, VO(2) max (53.3+/-5.4 ml x kg(-1) x min(-1) ) was higher (p<0.05) in the faster protocol. The percentage of men achieving the criterion was nearly double the percentage of boys (23.8 vs 12.5%), although the difference was not significant. Age-specific criteria heart rate (HR) and respiratory exchange ratio (RER) were achieved in a similar manner; however, more men (100%) than boys (86.7%) achieved an age-specific blood lactate (BLa) criterion (p<0.05). Plateau achievement increased to 33.0% in the 11.26 km x hr(-1) protocol, but was not significantly different from 8.04 km x hr(-1). HR, RER and BLa criteria achievement were comparable.

CONCLUSIONS

Maturation may influence the achievement of a plateau and BLa criteria, but not age-specific criteria for RER or HR.

Isolated brachialis wasting: an unusual presentation of neuralgic amyotrophy

Although neuralgic amyotrophy can selectively affect discrete components of the brachial plexus including individual peripheral nerves, involvement of an individual nerve fascicle is rare. Discrete fascicular musculocutaneous neuropathy as a manifestation of neuralgic amyotrophy has not previously been reported to our knowledge. We report two cases of otherwise typical neuralgic amyotrophy with isolated brachialis muscle wasting. Abnormal spontaneous activity, motor unit remodeling, or both, was observed only in the brachialis muscle. Lateral antebrachial cutaneous nerve conduction studies were normal. These cases serve to broaden the spectrum of the clinical presentation of neuralgic amyotrophy.