Can posterior capsular stretching rehabilitation protocol change scapula kinematics in asymptomatic baseball pitchers?

PURPOSE

Scapular dyskinesis is a recognized cause of shoulder pain in the throwing shoulder of baseball pitchers and athletes who participate in overhead sports. Past studies have assessed scapular kinematics using electromagnetic tracking devices and have shown a correlation between posterior shoulder tightness and forward scapular posture. The purpose of our study is to evaluate the scapular kinematics, before and after a 4-week posterior stretching protocol in asymptomatic pitchers.

METHOD

Eleven asymptomatic collegiate baseball pitchers were involved in the study and divided into group A (6 pitchers) underwent 4 weeks of a regimented therapy protocol and group B (5 pitchers) did not receive any treatment. Each pitcher was tested on two separate days: at the first day of the study (S1) and after 4 weeks (S2).

RESULTS

The results demonstrate that there are statistically significant differences in the kinematics of several athletes from the "treated group" (group A) between S1 and S2. It is also important to notice that variations in group A occurred in both flexextension and ab/adduction movements, strengthening the conclusion that the variation was real.

CONCLUSION

The results of the study can indicate that, in order to prevent the pathologic cascade linked to these sports activities, this physical training protocol might become integral part of the normal daily exercises of baseball pitchers and overhead athletes. Level of evidence II.

Effects of indole-3-carbinol on immune responses, aberrant crypt foci, and colonic crypt cell proliferation in rats

Male Sprague-Dawley rats were treated orally with indole-3-carbinol (13C) for 7 wk at levels of 150, 100, and 50 mg/kg body weight. The rats were injected with 10 mg/kg body weight of the colon carcinogen, azoxymethane (AOM) on d 2 and 9 of 13C treatment. At termination of the study, all rats were assessed for immune function (humoral immunity, specific cell-mediated immunity, and nonspecific cell-mediated immunity). Colonic tissue was collected and examined for the presence of aberrant crypt foci (ACF) and proliferation of crypt cells. Antibody responses to antigen challenge were significantly suppressed in the animals exposed to the high dose of 13C. Delayed-type hypersensitivity responses, natural killer cell activity, the number and multiplicity of ACF, and cell proliferation parameters were not significantly different from those of the controls. Therefore, there was no clear protective or enhancing effect of 13C on ACF numbers or colonic cell proliferation indices. There was no strong correlation between changes in immune responses and the preneoplastic biomarkers of colon cancer.

Increased susceptibility of adult rats to azoxymethane-induced aberrant crypt foci

The purpose of this study was to compare azoxymethane-induced aberrant crypt foci development in the colons of young and adult rats. Young (4 weeks of age) and adult (50 weeks of age) Sprague-Dawley rats were treated with two weekly injections of azoxymethane or saline. Rats were killed either 6 or 14 weeks following the first injection, and the number, size and location of aberrant crypt foci were determined. At both the 6- and 14-week time points, the number of aberrant crypt foci in older rats was significantly greater than in young rats (P<0.01). A higher percentage of aberrant crypt foci were found in the region from the mid-colon to the cecum in older rats as compared to young rats. Colonic cell proliferation was evaluated using bromodeoxyuridine immunohistochemistry. Colonic cell proliferation indices in the rectal, mid-colon and cecal regions of young and older rats were similar in young compared to adult rats. Ten large ACF from each group were screened for mutations in the beta-catenin gene (Ctnnb1) by PCR single strand conformation polymorphism. No mutations were detected. These results demonstrate that older female rats are more susceptible to the induction of aberrant crypt foci by azoxymethane than young female rats. Differences in colonic cell proliferation or beta-catenin mutations in these two age groups do not appear to be responsible for differences in aberrant crypt foci development.

Anterograde femoral nailing with a reamed interlocking titanium alloy nail

Intramedullary nailing has become the gold standard for treatment of femoral diaphyseal fractures. Between March 1995 and December 1998 we performed 40 intramedullary nailings using the ACE femoral nail (De Puy). The patients were followed for an average of 27.9 months (range: 6-54 months). The mean age was 33.2 years (range: 17-87 years); the sex distribution was 33 males and 7 females. All fractures were unilateral (right 18, left 22). Most of the fractures were caused by traffic accidents (35), the others originated from sports, work and gunshot (1). Thirty-five fractures were closed and 5 were open: 1 was grade I, 2 were grade II and 2 grade IIIa according to Gustilo's classification. According to the AO classification 18 fractures were type A, 13 type B and 9 type C. The majority of patients had associated injuries: neurotrauma 2, chest trauma 2, and other fractures e.g. of the clavicula, lumbar spine, patella, tibia. Immediate surgery was performed in 34 cases, delayed surgery in 6 cases. All fractures were treated on a fracture table, with closed reduction, reaming of the intramedullary canal, proximal and distal locking and intraoperative control of rotation and length. The mean time to healing was 17.85 weeks (range: 18-50 weeks). The following complications were observed: 3 delayed unions, which united after dynamisation, one malunion, which required corrective osteotomy, and one nonunion, which healed after exchange nailing. We encountered no rotational deformity and no clinically relevant shortening. Six nails were removed due to irritation by locking screws. These results are comparable with those of larger series in the literature with other types of interlocking nails. The union rate in this series was 97.5%.

Effect of dietary chlorogenic acid on multiple immune functions and formation of aberrant crypt foci in rats

Adult male Sprague-Dawley rats were fed 70 mg/kg body weight chlorogenic acid (CHA) for 7 wk. One CHA-fed group was also given 2 injections of the colon carcinogen azoxymethane (AZO) on d 2 and 9 of CHA treatment. Three major types of immune responses were assessed: antibody production, specific cell-mediated immunity, and nonspecific cell-mediated immunity. The formation of AZO-induced aberrant crypt foci (ACF) in the colon were observed, as was colonic cell proliferation. There were no significant effects of CHA treatment on any of the immune parameters examined or on formation of preneoplastic lesions or cell proliferation in the colon. The overall nonsignificant trends in immune function, colon cell proliferation, and ACF development were, however, more consistent with immunosuppression and enhanced preneoplasia.

Dietary quercetin, immune functions and colonic carcinogenesis in rats

Rats fed 100 mg/kg quercetin (QUE) daily for 7 weeks had significantly enhanced natural killer cell activity compared to their vehicle (VEH)-fed control. In contrast, rats fed 100 mg/kg QUE and treated with the colon carcinogen, azoxymethane had significantly reduced natural killer cell activity compared to their VEH-fed azoxymethane-treated control. There was no significant difference in natural killer cell activity between the two control groups. Antibody production and delayed-type hypersensitivity were not altered by QUE feeding in any treatment group. In vitro exposure of splenic natural killer cells to 1mM QUE significantly decreased natural killer cell cytotoxicity. Lower QUE concentrations produced a non-significant reduction in natural killer cell activity that was restored to control values at 1 x 10(-13)M QUE. The distribution, multiplicity and total number of colonic preneoplastic lesions, aberrant crypt foci, was not significantly different in the QUE-fed azoxymethane-treated rats when compared to azoxymethane-treated vehicle-fed rats at the conclusion of 7 week feeding period. We found no correlation between immune function and development of preneoplastic colon lesions in this study.

Dietary curcumin enhances antibody response in rats

The effects of dietary curcumin on three major types of immune function were examined in rats. Antibody (IgG) production, delayed-type hypersensitivity and natural killer cell activity were evaluated after 5 weeks of dietary exposure to 1, 20 or 40 mg/kg curcumin. The highest dose of curcumin significantly enhanced IgG levels. Rats receiving lower dietary concentrations (1 or 20 mg/kg) of curcumin were not different in IgG production from rats receiving no curcumin in their diet. Neither delayed-type hypersensitivity nor natural killer cell activity was different from control values at any dietary concentration of curcumin. In vitro incubation of YAC-1 and EL4 tumor cells and normal splenocytes in varying concentrations of curcumin for varying times revealed differences between cell types in curcumin's effects on cell proliferation and viability. No cytotoxic effect was seen in EL4 cells at 125 micrograms/ml curcumin at 4, 24 and 48 hrs incubations, however, cell proliferation was reduced by almost 50% at 24 hrs. YAC-1 cell viability and cell numbers were diminished at longer incubations. A lower curcumin concentration (1.25 micrograms/ml) enhanced cell growth in the YAC-1 cells at 24 and 48 hr. This enhancement was not seen in spleen or EL4 cells.

Recombinant DNA approaches to feline leukemia virus immunization

We have utilized 2 recombinant DNA strategies for immunization against FeLV in cats: (a) modified live virus was attenuated by mutation and recombination, and (b) an immunogen, consisting of subunit envelope protein, was prepared in genetically engineered yeast. Results indicated that the genetically manipulated live virus preparations were not protective against FeLV challenge because they were either not attenuated in virulence or were not sufficiently antigenic. Immunization with yeast-synthesized FeLV envelope protein followed by the modified live virus gave protective immunity in cats under experimental conditions. Future immunization attempts will concentrate on enhancing the immunogenic potency of the yeast- synthesized FeLV envelope protein.

Cardiovascular and shivering responses in hypothermic and rewarmed young calves

Aortic blood pressure, ECG, electromyogram, and heart rate were recorded in cold-stressed and rewarmed young Holstein bull calves. The calves were anesthetized and then cold-stressed by immersion in cold water until their core body temperature (colonic) was lowered 10 C. Hypothermia was continued for 1 additional hour and then the calves were rewarmed by 3 external rewarming methods or were allowed to recover naturally (unassisted). Aortic blood pressure began to decrease in cold-stressed calves by the time their core body temperature had decreased 2 C and continued to decrease during cooling. Heart rate initially increased then decreased with cooling. Blunting of the systolic blood pressure peaks and appearance of extraneous waveforms that obscured the normal component waveforms of the ECG complex were also observed during cooling. Aortic blood pressure and heart rate of cold-stressed calves increased soon after the start of recovery and eventually returned to base line even though the rate of recovery varied depending on the method of rewarming. The component waveforms of the ECG complex became more discernible as rewarming of the cold-stressed calves progressed.

Regional differences in body temperature in hypothermic and rewarmed young calves

One- to 7-day-old Holstein bull calves were anesthetized and cold-stressed until their core body temperature (CBT; colonic) was lowered by 10 C. The calves were then rewarmed in warm water, by heat pads or heat lamps, or allowed to recover naturally (unassisted). Temperatures of peripheral tissues, muscles, and the body core were recorded. The time required to lower the CBT of the cold-stressed calves was 168 +/- 11.7 minutes (mean +/- SE). Cold exposure caused a linear decrease in blood, colonic, rectal, and oral temperatures, whereas temperature decreases in the thigh and pectoral muscles, dorsal and ventral thoracic regions, and the hock joint region were generally of greater magnitude and were curvilinear in pattern. By the time the CBT had decreased 1 C, tissue temperatures during cooling were less than (P less than 0.01) the respective temperatures obtained before cooling. The mean time required to rewarm the calves in warm water (47.1 +/- 3.5 minutes) was less than (P less than 0.05) that for the other rewarming methods. The mean rewarming times for the heat pad (128 +/- 12.8) and heat lamp (125.4 +/- 10.9) methods were greater than (P less than 0.05) that for the warm water method, but less than (P less than 0.05) that for the unassisted calves (190.7 +/- 23.1). In general, there was a linear increase in most of the tissue temperatures during recovery although temperatures in the hock joint region were variable. Temperature differences were observed between the thigh and pectoral muscles and between subcutaneous tissues during cooling and recovery. There was poor correlation between the ages of the calves and the time required to decrease their CBT during cooling and also the time required to increase their CBT, regardless of the rewarming method used.

Hematologic values in hypothermic and rewarmed young calves

Hematologic values were determined in cold-stressed and rewarmed 1- to 7-day-old Holstein bull calves. The animals were anesthetized and then cold-stressed by immersion in water until their core body temperature (colonic) had decreased by 10 C. They were kept at the hypothermic state for an additional 1 hour and then were rewarmed by 1 of 3 external rewarming methods or by natural (unassisted) recovery. Changes observed in the hematologic values of the cold-stressed calves during cooling represented a trend, rather than a direct effect of cold exposure because the values did not differ (P greater than 0.05) from those obtained from the noncold-stressed animals. Nevertheless, a linear decrease (P less than 0.05) in the total number of leukocytes was observed in the cold-stressed calves during cooling when compared with preimmersion values. The leukopenia resulted primarily from a neutropenia (P less than 0.05) and secondarily from decreases in the number of other leukocytes. Minor increases were noticed in the total number of erythrocytes, hemoglobin concentration, and PCV, whereas mean corpuscular values generally remained unchanged during cooling. A rapid and linear increase in the total number of leukocytes was noticed in all cold-stressed calves during recovery. The increase in total leukocytes occurred in all types of leukocytes and particularly in segmented and nonsegmented neutrophils.

Serum chemical values in hypothermic and rewarmed young calves

Serum chemical values were determined in cold-stressed Holstein bull calves ranging from 1 to 7 days of age. The animals were anesthetized and cold-stressed until their core body temperature (colonic) was lowered 10 C. Animals were then rewarmed in warm water, with heat pads or heat lamps, or were allowed to recover naturally (unassisted) at room temperature. Blood samples were collected at selected intervals during cooling and recovery. Increases (P less than 0.05) were observed in the concentrations of glucose, calcium, phosphorus, iron, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase, total protein, albumin, total globulin, serum urea nitrogen, uric acid, total bilirubin, indirect bilirubin, and cholesterol in the cold-stressed calves during cooling. Concentrations of chloride and insulin decreased (P less than 0.05) during the same period. Changes observed in many of the serum chemical values during rewarming were generally the reverse of the respective changes that occurred during cooling, although insulin values became exceedingly high in some cases midway or near the end of recovery. Serum enzyme values also remained high during most of recovery. Data did not indicate a clear advantage of one method of rewarming over the other methods used in terms of return of the serum chemical values to normal.

Pulpal response in rhesus monkeys to cementation agents and cleaners

The purpose of these studies was to compare pulpal inflammatory responses induced by cementation of precision amalgam inlays with zinc phosphate cement, with and without a Hydroxyline liner, Durelon cement, and ZOE controls. Hydraulic force was induced by the inlay insertion procedure. Cavilax, water, and polyacrylic acid were compared with ZOE controls. Both studies also used untreated teeth for comparison. The use of zinc phosphate luting cement in the 48-hour inlay study was the only condition provoking moderate to severe responses. Zinc phosphate cement over Hydroxyline liner and Durelon cement in the study of inlays and Cavilax cleaner, water, and polyacrylic acid in the study of cleaners showed mild responses comparable to the ZOE control in the 48-hour and in the 45-day periods.