Proximal iliotibial band thickness as a cause for recalcitrant greater trochanteric pain syndrome

To investigate iliotibial band (ITB) diameter thickness at the greater trochanter in patients requiring iliotibial band release who have failed conservative modalities, in comparison to an asymptomatic patient population. A total of 68 subjects were selected to be reviewed using T2 axial plane MRI. The ITB diameter thickness was measured in 34 subjects who underwent surgical ITB release, and compared with a match-paired asymptomatic hip cohort consisting of 34 subjects. ITB diameter thickness was measured at the thickest location for each subject twice by two different examiners. Inter/intra class correlation coefficient was determined for ITB measurement technique accuracy, and the presence of recalcitrant proximal hip pain was evaluated. Interclass correlation coefficient with 95% confidence was measured to be 0.953. The average thickness for ITB surgical release subjects was measured to be 5.61 ± 2.10 mm, and for asymptomatic subjects 3.77 ± 0.79 mm (P < 0.001). The results of this study demonstrate a statistically significant positive relationship of an increased diameter thickness in the ITB in symptomatic patients who failed conservative therapy and underwent surgical intervention for treatment.

Explosions of xenon clusters in ultraintense femtosecond x-ray pulses from the LCLS free electron laser

Explosions of large Xe clusters (<N> ~ 11,000) irradiated by femtosecond pulses of 850 eV x-ray photons focused to an intensity of up to 10(17) W/cm(2) from the Linac Coherent Light Source were investigated experimentally. Measurements of ion charge-state distributions and energy spectra exhibit strong evidence for the formation of a Xe nanoplasma in the intense x-ray pulse. This x-ray produced Xe nanoplasma is accompanied by a three-body recombination and hydrodynamic expansion. These experimental results appear to be consistent with a model in which a spherically exploding nanoplasma is formed inside the Xe cluster and where the plasma temperature is determined by photoionization heating.

Effects of restricted feed intake on heat energy by different goat breeds

Sixteen Boer goat doelings, 16 Spanish doelings, and 8 Angora doelings and 8 wethers, 283, 316, and 330 d of age initially (SEM = 5.0), respectively, were used to evaluate effects of nutrient restriction on heat energy (HE). During the first and second 10-wk phases, 8 animals of each breed were fed a 50% concentrate pelletized diet at a level adequate for maintenance and moderate energy accretion (CONT). Other animals were fed approximately 50% of these amounts in phase 1 relative to initial BW, followed by the greater level of feeding in phase 2 based on initial or actual BW when greater (REST). Average daily gain was 43, -20, 16, -78, 8, and -48 g in phase 1 (SEM = 5.0) and 26, 44, 50, 65, 27, and 32 g in phase 2 (SEM = 3.5) for Angora-CONT, Angora-REST, Boer-CONT, Boer-REST, Spanish-CONT, and Spanish-REST, respectively. Total HE was greater for CONT vs. REST in both phases (P < 0.001), greater in phase 1 for Angora than for Boer (P < 0.01) and Spanish (P < 0.01), and greatest (P < 0.01) in phase 2 among breeds for Angora [481, 347, 430, 356, 424, and 338 kJ/kg of BW(0.75) per day in phase 1 (SEM = 11.1), and 494, 479, 445, 397, 444, and 406 kJ/kg of BW(0.75) per day in phase 2 (SEM = 11.3) for Angora-CONT, Angora-REST, Boer-CONT, Boer-REST, Spanish-CONT, and Spanish-REST, respectively]. Equations describing the temporal pattern of HE (kJ/kg of BW(0.75) per day), expressed as a percentage of the wk-0 value and corrected for corresponding breed × week CONT means, in phase 1 were 95.8 ± 2.43 - (8.18 ± 1.144 × week) + (0.655 ± 0.1098 × week(2)) for Angora (R(2) = 0.58), 95.3 ± 2.63 - (4.34 ± 1.237 × wk) + (0.271 ± 0.1187 × wk(2)) for Boer (R(2) = 0.41), and 97.4 ± 2.21 - (4.69 ± 1.068 × wk) + (0.282 ± 0.1021 × wk(2)) for Spanish (R(2) = 0.53). Phase 2 equations were 78.9 ± 2.22 + (8.74 ± 1.036 × wk) - (0.608 ± 0.0095 × wk(2)) for Angora (R(2) = 0.60), 77.5 ± 2.10 + (3.30 ± 0.978 × wk) - (0.153 ± 0.0942 × wk(2)) for Boer (R(2) = 0.39), and 80.6 ± 2.50 + (4.50 ± 1.165 × wk) - (0.208 ± 0.1122 × wk(2)) for Spanish (R(2) = 0.43). These equations indicate that changes in HE in response to nutrient restriction and realimentation were more rapid and of greater magnitude in Angora vs. Boer and Spanish. The temporal pattern of decline in HE by Boer and Spanish during restriction was similar, but the subsequent rise with realimentation was slower and smaller for Boer. In conclusion, most appropriate methods of predicting change in the maintenance energy requirement during and after periods of limited feed intake may differ among breeds of goats.

Joining the pillars of Hercules: mtDNA sequences show multidirectional gene flow in the western Mediterranean

Phylogenetic analysis of mitochondrial DNA (mtDNA) performed in Western Mediterranean populations has shown that both shores share a common set of mtDNA haplogroups already found in Europe and the Middle East. Principal co-ordinates of genetic distances and principal components analyses based on the haplotype frequencies show that the main genetic difference is attributed to the higher frequency of sub-Saharan L haplogroups in NW Africa, showing some gene flow across the Sahara desert, with a major impact in the southern populations of NW Africa. The AMOVA demonstrates that SW European populations are highly homogeneous whereas NW African populations display a more heterogeneous genetic pattern, due to an east-west differentiation as a result of gene flow coming from the East. Despite the shared haplogroups found in both areas, the European V and the NW African U6 haplogroups reveal the traces of the Mediterranean Sea permeability to female migrations, and allowed for determination and quantification of the genetic contribution of both shores to the genetic landscape of the geographic area. Comparison of mtDNA data with autosomal markers and Y-chromosome lineages, analysed in the same populations, shows a congruent pattern, although female-mediated gene flow seems to have been more intense than male-mediated gene flow.

Alu insertion polymorphisms in NW Africa and the Iberian Peninsula: evidence for a strong genetic boundary through the Gibraltar Straits

An analysis of 11 I Alu insertion polymorphisms (ACE, TPA25, PV92, APO, FXIIIB, D1, A25, B65, HS2.43, HS3.23, and HS4.65) has been performed in several NW African (Northern, Western, and Southeastern Moroccans, Saharawi; Algerians; Tunisians) and Iberian (Basques, Catalans, and Andalusians) populations. Genetic distances and principal component analyses show a clear differentiation of NW African and Iberian groups of samples, suggesting a strong genetic barrier matching the geographical Mediterranean Sea barrier. The restriction to gene flow may be attributed to the navigational hazards across the Straits, but cultural factors must also have played a role. Some degree of gene flow from sub-Saharan Africa can be detected in the southern part of North Africa and in Saharawi and Southeastern Moroccans, as a result of a continuous gene flow across the Sahara desert that has created a south-north cline of sub-Saharan Africa influence in North Africa. Iberian samples show a substantial degree of homogeneity and fall within the cluster of European-based genetic diversity.

The primary care physician's role in evaluating the pediatric amputee

The clinician must have an understanding of the spectrum of potential problems that can occur in the pediatric patient with a limb deficiency. These various complications-osseous, nonosseous, infection, phantom limb phenomenon and pain, pre-existing conditions, and psychosocial-are discussed.

Membrane isoforms of human immunoglobulins of the A1 and A2 isotypes: structural and functional study

As for IgM, human IgA occurs either as soluble molecules in plasma and various other body fluids, or as membrane-bound molecules on differentiated B cells, where they are part of the B-cell receptor for antigen (BCR). We studied the structure of transcripts encoding the membrane-anchored alpha-chain of the human BCR alpha, which may be present in two different forms resulting from alternate splicing of the alpha-chain mRNA (type I or type II). The ratio of type I versus type II did not vary upon stimulation of a B-cell line with various cytokines. Rather, it differed strikingly in cells expressing either the IgA1 or IgA2 isotype of the BCR alpha, with virtually no type II alpha-chain in the latter. Co-modulation experiments also yielded different results for both isotypes, since they demonstrated a physical association of both membrane (m)IgA1 and mIgA2 with CD79b, the beta component of the BCR Ig alpha/Ig beta heterodimer, but only of mIgA1 with CD19. Whatever the isotype, the BCR of the IgA class was able to carry out signal transduction upon cross-linking by specific monoclonal antibodies but, in contrast to mIgM, it relied mainly on the entry of extracellular Ca2+ rather than on the release of intracellular stocks.

Salivary IgG subclasses in individuals with and without homozygous IGHG gene deletions

In this study, the levels of salivary IgG1, IgG2, IgG3 and IgG4 from individuals with and without homozygous immunoglobulin heavy chain constant gene deletions were quantified by enzyme-linked immunosorbent assay (ELISA). To analyse the restriction of salivary IgG subclasses, we used unstimulated whole saliva and sera collected at the same time from individuals with homozygous gene deletions, two with G1 deletion, one with G4 deletion, six with both G2 and G4 deletions and from eight individuals without IGHG gene deletions and expressing all four IgG subclasses. The median values of salivary IgG from individuals with homozygous G1, or G4, or both G2 and G4 deletions, and from individuals expressing all four subclasses were 24.2 mg/l and 23.4 mg/l, respectively. The median values of serum IgG were 13.7 g/l and 15.9 g/l, respectively. Our results show that the salivary and serum IgG levels were both within the normal range in individuals with homozygous gene deletions of either G1, or G4, or both G2 and G4.

Expanding spectrum of cocaine induced central nervous system malformations

Two patients born of mothers who abused cocaine during pregnancy were found to have various brain malformations, some of which were not previously reported. Children who were exposed to cocaine or polysubstances prenatally and who present with a neurologic deficit require neuroimaging studies to detect abnormalities.

Molecular analysis of the T17 immunoglobulin CH multigene deletion (del A1-GP-G2-G4-E)

In the human, the order of the immunoglobulin heavy chain constant region (Ig CH) genes is the following: 5'-M-D-G3-G1-EP1-A1-GP-G2-G4-E-A2-3'. Extensive multigene deletions have been described in the Ig CH locus, some of these encompassing up to 160 kb. To date six different multigene deletion haplotypes have been identified, designated I to VI according to the chronological order of their being found: deletion I (del G1-EP1-A1-GP-G2-G4), II (del EP1-A1-GP), III (del A1-GP-G2-G4-E), IV (del EP1-A1-GP-G2-G4), V (del GP-G2-G4-E-A2), VI (del G1-EP1-A1-GP-G2). Individuals were found either homozygous for one type of deletion or heterozygous for two different deletions, mainly (17 cases out of 18) in the Mediterranean area. So far, deletions I and II have been found in Tunisia, deletions III, IV and V in Italy, and deletion VI in Sweden. In this paper, we show that a Tunisian, T17, previously reported as being homozygous for a deletion of type IV, is, in fact, homozygous for a deletion that encompasses A1-GP-G2-G4-E. Therefore T17 is the first case of a deletion of type III reported in the Tunisian population. Molecular analysis demonstrates that the T17 deletion occurred between highly homologous regions located downstream of IGHEP1 and IGHE, respectively. In contrast to the EZZ deletion, the recombination occurred near or in the switch regions, since the homologous regions involved in the deletion extend over 4.5 kb of DNA and encompass the I alpha 1-S alpha 1 and I alpha 2-S alpha 2 regions, respectively.

Hypertension following orthopaedic surgery in children

Five patients developed hypertension after undergoing orthopaedic surgery. Three of four patients in whom serum renin was assayed had significant elevation, suggesting a possible renal-mediated etiology. Two patients required the addition of an angiotensin-converting enzyme (ACE) inhibitor to control hypertension while continuing the prolonged orthopaedic procedures. The need for careful blood-pressure monitoring of children undergoing orthopaedic surgery is emphasized in this article.

Six generations of a family with multiple limb deficiencies

Ectrodactyly, with or without other limb reduction defects, is a rare congenital anomaly. The pattern of inheritance is usually autosomal dominant, but with variable morphology. We report six generations of a family with this anomaly, with a progressive increase in severity and extent of involvement. Implications of genetic counseling are discussed.

Epidemic cholera in West Africa: the role of food handling and high-risk foods

During an epidemic of cholera in Guinea, West Africa, in 1986, the authors conducted two studies of risk factors for transmission. In the capital city, 35 hospitalized cholera patients were more likely than 70 neighborhood-matched controls to have eaten leftover peanut sauces (odds ration (OR) = 3.1, 95% confidence interval (CI) 1.2-8.2), but less likely to have eaten tomato sauces (OR = 0.2, 95 percent CI 0.1-0.9). Hand washing with soap before meals by all family members protected against cholera (OR = 0.2, 95 percent CI 0.02-0.96), suggesting that persons asymptomatically infected with Vibrio cholerae 01 may have been the initial source for contamination of the leftover foods. Laboratory studies demonstrated that V. cholerae multiplied rapidly in peanut sauce (pH 6.0), but not in the more acidic tomato sauce (pH 5.0). In an outbreak of cholera-like illness after a rural funeral, illness was strongly associated with eating a rice meal served over many hours without reheating. These studies demonstrated that, in this epidemic, many cases of severe cholera were associated with eating specific cooked foods that could support bacterial growth after contamination of these foods with V. cholerae within the household. Epidemic control efforts should include identification of high-risk foods and promotion of simple changes in food handling behaviors to lower the risk of foodborne transmission.