Conservation of the 168 divIB gene in Bacillus subtilis W23 and B. licheniformis, and evidence for homology to ftsQ of Escherichia coli

Recent reports indicate that combined anterior cruciate ligament/medial collateral ligament (ACL/MCL) knee injuries are usually associated with a lateral meniscus tear. In our center, snow skiing is the athletic activity most frequently associated with this double-ligament injury complex. A sports-specific analysis was undertaken to evaluate the hypothesis that the snow skiing ligament injury is different from similar injuries caused by other athletic activities. Of a total of 64 acute arthroscopically confirmed tears of both the MCL and ACL, 23 were caused by snow skiing and 41 by nonskiing activities. There were fewer lateral meniscus tears in skiers (43%) when compared with the nonskiers (88%). Skiers also had fewer medial meniscus tears (13%) than did nonskiers (37%). No medial meniscus tears occurred in the absence of a lateral meniscus tear. Although 78% of the skiers were women, only 12% of the nonskiers were women. Skiers were older (average age 35 years) than the nonskiers (average age 28 years). The right knee was injured almost twice as frequently as the left. These data suggest that the double (ACL/MCL) ligament injury in skiers might be distinctly different from that in nonskiers.     

Evaluation of alpine skiing and snowboarding injury in a northeastern state

BACKGROUND: To demonstrate the injury patterns of Alpine skiing and snowboarding in a northeastern state and evaluate potential risk factors. METHODS: The medical records of a single pediatric and adult Level I trauma center were evaluated from January 1, 1990, through December 31, 1995. All admissions with injuries caused by Alpine skiing or snowboarding were reviewed. Those patients arriving from two local ski resorts, all of whose injuries are referred to the institution for care, were separated out for consideration. Age, sex, type of injury, date of injury, Injury Severity Score, operations performed, and outcome (including mortality) were evaluated. In addition, resort utilization for the study period was obtained from the two resorts included in the evaluation. Mortality data was obtained from the Vermont office of the Chief Medical Examiner for the same time period. RESULTS: For the 6-year period of the study approximately 2,978,000 skier and snowboarder days were recorded at the study sites. Approximately 447,000 of those days were attributed to snowboarders (15%). In all, 279 patients were admitted for injuries (0.01%), 238 were related to Alpine skiing (incidence 0.01%) and 40 to snowboarding (incidence 0.01%). Snowboarders were statistically younger (20 years; range, 4-44 years) than skiers (29 years; range, 6-70 years) (p < 0.001) and had a significantly lower Injury Severity Score (15 in snowboarders vs. 27 in skiers, p < 0.03). Two female patients were injured snowboarding and 68 female patients were injured skiing. Eight percent of injured snowboarders and 16% of injured skiers sustained multiple injuries (p < 0.01). Injury patterns were significantly different. Upper extremity injuries were almost exclusively found in snowboarders (24% vs. 7%, p < 0.003), whereas cruciate ligament injuries occurred far more commonly in skiers (45% vs. 4%, p < 0.001 Lower extremity injuries in general were more common in skiers (78% vs. 38%, p < 0.001). Central nervous system injuries, including head and spine, were evenly distributed over the two groups, although the snowboarders with central nervous system injuries were younger. In addition, splenic injuries were more common in snowboarders (13% vs. 2%, p < 0.01). Snowboarding accidents were far more common in December, March, and April than other months. Fifty-one patients sustained abdominal or chest injuries and only two of these required operative intervention (two splenectomies). Other operative interventions were limited to extremity injuries, injuries of the spine, or placement of an intracranial pressure monitor. There were no fatalities recorded in this population, although over the 6.5 years, there were 25 deaths related to alpine skiing and one to snowboarding in the State (incidence 0.0000009 skier days). Victims tended to be male: 96% of the skiers and the one snowboarder. The predominant cause of death was blunt head trauma followed by blunt chest trauma. Helmets were not worn by those sustaining head injuries or fatalities. Spine injuries were recorded only in extremely young snowboarders and skiers out of control. CONCLUSION: Snowboarders and Alpine skiers are equally prone to injury. Snowboarding accidents are typically less severe and show significantly different injury patterns than skiing accidents. Abdominal and chest injuries in this population are generally amenable to nonoperative management. Prevention programs are best targeted at safe skiing and snowboarding practices, not skiing or snowboarding in poor conditions, use of helmets for skiers, and restraint of snowboard use in very young children.     

Recurrent anaphylaxis: diagnostic approach and management

The purpose of this study was to examine the effect of cycle rate (CR) variations on the metabolic cost and upper body forces during roller skiing with the V2-alternate technique on flat terrain. Nine highly skilled cross-country skiers roller skied at a paced speed of 18.0+/-0.1 km x h(-1) using their chosen CR, and CRs that were 10% slower and 20% faster. Oxygen uptake (VO2) was determined through collection of expired gases into a meterological balloon and poling forces were measured with piezoelectric transducers during the last 30 s of each four minute trial of roller skiing. One-way repeated measures ANOVA revealed that VO2 varied significantly with CR (p=0.02) with the chosen CR being significantly lower than the higher CR (p < 0.05). Poling forces and poling time were not significantly different among the CR conditions. The present results demonstrate that 1) an alteration in cycle rate affects metabolic cost of roller ski skating, 2) skiers tend to naturally select the most economical cycle rate, and 3) moderate variations in cycle rate do not appear to affect propulsive force generation through the poles in roller skiing.     

Cardiovascular effects of nepicastat (RS-25560-197), a novel dopamine beta-hydroxylase inhibitor

PURPOSE: The aim of the present study was to develop a standard protocol for evaluating peak oxygen uptake and anaerobic threshold during upper body work by cross-country skiers. METHODS: All tests were performed on a specially developed ski ergometer and incorporated the double poling technique. In series I, continuous and discontinuous protocols for measuring VO2peak at different inclinations of the ski ergometer were performed. In series II, a protocol for evaluating anaerobic threshold during upper body work was established. Eleven well trained regional male cross-country skiers participated in the study. All tests in each series were carried out during a period of 14 d. RESULTS: VO2peak did not differ using continuous or discontinuous protocol while working on the ski ergometer. Inclination was found to influence VO2peak, which was reduced at 7 degrees compared with 3 degrees, 5 degrees, and 6 degrees. Th(an) working on the ski ergometer was reached at a power output, VO2, or fc, which gave on average a blood lactate concentration of 1.8 mmol.L-1 higher than those found after the warm-up period during a graded protocol. CONCLUSIONS: Testing only the traditional Th(an) and VO2max while running on a treadmill hides important determinants of endurance in cross-country skiing as shown by that no correlation was found between VO2max and VO2peak in the present study.     

Urinary excretion of ifosfamide, 4-hydroxyifosfamide, 3- and 2-dechloroethylifosfamide, mesna, and dimesna in patients on fractionated intravenous ifosfamide and concomitant mesna therapy

Injuries of the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) are common, accounting for 90% of all knee ligament injuries in young and active individuals. During the last decade, our research center has focused on MCL healing and ACL reconstruction. We have found that the MCL heals without intervention after an isolated injury, and that primary repair offers no apparent advantage. After a combined injury of the ACL and MCL, the ACL requires reconstruction, whereas primary repair again contributes little or nothing toward MCL healing. Midsubstance ACL injuries have limited healing ability. Hence, the treatment of choice for a torn ACL in a young, active patient is generally reconstruction with an autograft or allograft. However, the appropriate replacement graft and reconstruction technique to use are still debated. Current research efforts have been placed on investigating the magnitude and direction of in situ forces in the human ACL. We use a six-component universal force moment sensor combined with a six-degree-of-freedom (DOF) robotic manipulator to learn as well as to reproduce the six-DOF motion of the knee before and after ACL injury. This way, the in situ force in the ACL under an anterior posterior tibial load of 110 N was obtained. This methodology should make it possible to obtain the needed data to aid in better understanding of ACL reconstruction and possible development of improved clinical management.     

Snowboarding injuries

Snowboarding is a popular winter sport that involves riding a single board down a ski slope or on a half-pipe snow ramp. Compared with injuries resulting from traditional alpine skiing, snowboarding injuries occur more frequently in the upper extremities and ankles and less frequently in the knees. Different types of snowboard equipment, rider stance and snowboarding activity tend to result in different types of injury. Snowboarder's ankle, a fracture of the lateral talus, must be considered in a snowboarder with a "severe ankle sprain" that has not responded to treatment. Risk of injury may be lowered by using protective equipment, such as a helmet and wrist guards.     

Poling forces during roller skiing: effects of technique and speed

PURPOSE: A substantial proportion of the propulsive forces required for uphill skiing are generated from the upper body, but no study has systematically examined poling forces at different slopes. In the present experiment, poling forces and timing were examined during roller skiing on 2.1% and 5.1% uphills. METHODS: Nine highly skilled cross-country skiers roller skied at paced submaximal and at maximal speeds using the V1 skate (V1) and double pole (DP) techniques. Poling forces and timing were measured with piezoelectric transducers. RESULTS: Peak force (PF), average force (AF) and average force over the entire cycle (ACF) were significantly greater (P < 0.01) at the steeper grade with both techniques. Values for the ratio of V1 to DP did not differ between the two grades for PF, AF, and ACF but tended to increase with velocity for both techniques. With both V1 and DP, upper body recovery time was shorter (P < 0.01) at the steeper grade, and cycle rate was greater (P < 0.01) at the steeper grade. CONCLUSIONS: We conclude that 1) the relative demands on the upper body with V1 compared with DP were similar between the two grades, and 2) the responses to an elevation in grade of increased poling forces, shortened poling recovery times, and increased cycle rate are comparable to the responses to an increase in speed.     

Genetic mapping of the mouse stromal cell-derived factor gene (Sdf1) to mouse and rat chromosomes

OBJECTIVE: To establish the demographics of ski injury in relation to age, gender, and perceived cause during a representative season to identify potential injury prevention strategies. SETTING: Blackcomb Mountain, a world class ski resort in British Columbia, Canada. METHODS: Data were collected from the lift ticket records and from ski patrol injury reports for one season, November to May 1991-2. RESULTS: There were 720,066 skier and snowboarder day visits counted by the mountain's lift ticket records, with a total of 2,092 injury reports (incidence 2.91 per 1,000 day visits). Of those with significant injuries (those requiring physician care), 1,210 (58%) were male. The highest injury rate was among children (age 7-12) and teens (age 13-17) with incidences of 3.18 and 3.34 significant injuries per 1,000 skier days, respectively. Head and face injuries constituted 17% and 22% of injuries, respectively in these groups. Overall 22% of head and face injuries were severe enough to cause loss of consciousness or clinical signs of concussion. This was the body region injured most frequently in males. For females over 7 years of age, the knee was the most common site of injury. For youths, the incidence of injuries during school organized activities was 25% higher than during other outings. CONCLUSIONS: The vulnerability of school group participants suggests special education is warranted. The high incidence of head injuries, particularly among young males, needs to be addressed. In light of the high proportion of this group who already wear helmets, the role of helmets in both protection and possible causation of head injury needs objective research.     

Thyroid gland surgery in pregnancy]

Carving is a new version in alpine skiing. The continuous decrease of participants in alpine skiing beginning 1987 has been stopped, as carving has a modern image and as skier find new motivation in wintersports. The effect of carving on the incidence of injuries cannot yet be answered accurately. It is assumed that the increase of carvers will lead to a high number of accidents related with it. In this article, the existing data about carving injuries in Austria is analyzed to find out the necessary steps for injury prevention in the future.     

Magnetic resonance imaging of knee injuries in children

The appearances of knee injuries on MR imaging are less well documented in children than adults. Some patterns of injury are shared by both groups of patients, e. g. meniscal damage. The frequency of specific injuries may differ, e. g. anterior cruciate ligament (ACL) tear. Congenital abnormality, coexistent pathology and previous treatment of the knee appear to be associated with meniscal problems. Discoid menisci are seen most frequently in children and have unique features on MR scans. Cruciate ligament tears are difficult to diagnose in the smallest children. The ACL may not be identified due to its small size. Normal bone marrow signal may be confused with marrow infiltration or bone microfracture. Radiographically occult fractures around the knee appear to be strongly associated with ligamentous injury as in adult patients. Osteochondral fractures, osteochondral lesions and articular cartilage damage are revealed on MR scans, but their long-term effects are uncertain. It is possible to diagnose a range of knee injuries on MR scans in children. The biggest diagnostic challenge is in pre-school children.     

Carving expands the skiing field

Carving is only the logical consequence of the past developments in alpine skiing. The modern ski-theories as well as the professional racing aim for a perfect control over the ski to master the variable conditions. New is not the technic but the equipment. Driving on the edge covers everything from drifting up to carving. Carving is a big chance for the alpine skiing to break up old standards and experience a new quality in skiing.     

The impact of surgical timing on postoperative motion and stability following anterior cruciate ligament reconstruction

A prospective study was designed to determine the impact of surgical timing on postoperative motion and stability following anterior cruciate ligament (ACL) reconstructive surgery. The study population was limited to acute ACL ruptures from downhill skiing undergoing arthroscopic ACL surgery without arthrotomy or surgical intervention for other ligamentous structures; 185 patients were entered into four separate groups based on the time interval from injury to surgery. Motion and stability were tested at multiple time points from the index surgery and adverse events were recorded. We found no statistical difference in restoration of extension or flexion in any group at any time point. KT-1000 data at 12 months showed a side-to-side difference of < or = 3 mm in 94%, with 6% showing a side-to-side difference of > 3 and < or = 5 mm. We conclude that, in this population, by using modern arthroscopic surgical techniques and an aggressive postoperative physical therapy protocol, motion and stability can be restored in a high percentage of patients and that surgical success is independent of the timing of surgery.     

Construction d’une échelle de prise de risques et validation auprès d’adolescents pratiquant un sport alpin de glisse.

This study aimed at assessing the psychometric properties of an self-report inventory designed to tackle risk-taking behaviors in snowboarding and alpine skiing in adolescents. Data from a sample of 684 teenage snowboarders and alpine skiers were collected in 2 high schools located close to ski stations in the Province of Quebec, Canada. A maximum likelihood exploratory factor analysis yielded a 3-factor solution: (1) Recklessness, (2) Safety behaviours, and (3) Substance use while snowboarding or skiing. Internal consistency of the scales is generally satisfactory. The weak-to-moderate correlations among the scales suggest that these dimensions are distinct latent constructs. Multiple regression analyses showed that the 3 dimensions are statistically associated to sensation seeking (AISS; Arnett) and impulsiveness (BIS-10, Barratt). Gender (male) and type of sport (snowboarding, emerging sports) are related to Recklessness and Substance use. Number of years of experience is positively associated with both Recklessness and Safety behaviours, while self-esteem is uniquely related to Safety behaviours. The discussion highlights the value of distinguishing between intentional risk-taking behaviour (Recklessness) and precautionary behaviour (Safety behaviour) in studies investigating risk taking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knee injuries in female athletes

Female athletes are at increased risk for certain sports-related injuries, particularly those involving the knee. Factors that contribute to this increased risk are the differences in sports undertaken and in gender anatomy and structure. Gender differences include baseline level of conditioning, lower extremity alignment, physiological laxity, pelvis width, tibial rotation and foot alignment. Sports like gymnastics and cheerleading create a noncontact environment, but can result in significant knee injuries. In quick stopping and cutting sports, females have an increased incidence of anterior cruciate ligament (ACL) injury by noncontact mechanisms. Patellofemoral (PF) disorders are also very common in female athletes. Awareness of these facts helps the sports medicine professional make an accurate diagnosis and institute earlier treatment-focused rehabilitation with or without surgery. Further prospective and retrospective research is needed in areas of epidemiology, mechanisms, severity and types of knee injuries. The goal is to lessen the severity of certain knee injuries and to prevent others.     

Gait adaptations before and after anterior cruciate ligament reconstruction surgery

Gait analyses of rehabilitated individuals with anterior cruciate ligament (ACL) deficiency and reconstruction have identified the final adaptations of increased hip extensor torque and hamstring electromyography (EMG) and decreased knee extensor torque and quadriceps EMG during stance. The initial adaptations to injury and surgery are, however, unknown as are the factors that influence the development of the adaptations. Identification of the initial response to injury would provide a basis for determining whether the final adaptations are learned automatically or if they are the result of a lengthy training period in which various factors may affect their development. The purpose of the study was to evaluate the initial effects of ACL injury and reconstruction surgery on joint kinematics, kinetics, and energetics, during walking. Injured limbs from nine subjects with ACL injury were tested 2 wk after injury, and 3 and 5 wk after surgery. Ten healthy subjects were tested. Kinematic and ground reaction data were collected and combined with inverse dynamics to calculate the joint torques and powers. A knee extensor torque throughout most of stance was observed in the injured limbs at all test sessions. This result was in conflict with previous observations of reduced extensor torque or a flexor torque in rehabilitated patients with ACL reconstruction and patients with ACL deficiency. This result also differed from the typical midstance extensor then flexor torque in healthy control subjects. Trend analysis showed a significant (P < 0.001) change in average position at the hip and knee, extensor angular impulse at the hip, and positive work done at the hip 3 wk after surgery followed by a partial rehabilitation at 5 wk after surgery. Power and work produced at the knee were reduced fivefold (P < 0.001) after 5 wk of rehabilitation and did not recover to pre-surgical levels. The existence of a long-lasting knee extensor torque 2 wk after injury indicated that the adaptation process to ACL deficiency is lengthy, requiring many gait cycles, and that numerous factors could be involved in learning the adaptations.     

Displaced bucket handle tears of the medial meniscus masking anterior cruciate deficiency

Traditionally, anterior cruciate ligament (ACL) injuries have been difficult to diagnose in the Casualty Department. Studies have shown that the anterior drawer test has a poor sensitivity both in acute and chronic ACL deficient knees [4, 6, 9]; thus, more emphasis has been placed on the pivot shift and Lachman tests [3]. We report four cases of proven ACL rupture where clinical examination revealed an absent pivot shift and a near normal Lachman test following a displaced bucket handle tear of the medial meniscus. This finding has been reproduced in cadaver studies, and we conclude that if the history strongly suggests an ACL injury and examination reveals a stable knee, then the dual pathology of medial meniscus tear and ACL rupture should be suspected.     

An analysis of hip joint loading during walking, running, and skiing

PURPOSE: It was the purpose of this study to investigate loading of the hip joint during various skiing activities and to compare the results with walking and running. The results are relevant to determine which skiing activities can be recommended for patients after total hip replacement. METHODS: Nine male subjects were instrumented with a 12-channel accelerometer system mounted on the upper body. Data were collected during walking, running, and six skiing activities and used as input for an inverse dynamic analysis that resulted in the time histories of the intersegmental force and moment at the supporting hip joint. Joint contact force was computed using a simple muscle model. Peak values were determined, averaged over all loading cycles, and compared between activities. RESULTS: Intersegmental force, indicating the influence of upper body weight and accelerations, was highest during running. Intersegmental moments were highest during the alpine skiing activities and indicated large extensor muscle forces at the hip joint. The peak joint contact force during walking at 1.5 m x s(-1) was 2.5+/-0.3 times body weight (BW). Running at 3.5 m x s(-1) produced a joint contact force of 5.2+/-0.4 BW during the push-off phase. Joint contact forces during four different alpine skiing conditions ranged from 4.1+/-0.6 BW (long turns, flat slope) to 7.8+/-1.5 BW (short turns, steep slope). Cross-country skiing had lower hip joint loading than running but higher than walking: 4.0+/-1.1 BW for classical technique and 4.6+/-0.6 BW for skating technique. CONCLUSIONS: Assuming that walking is a "safe" activity for a hip prosthetic patient, controlled alpine skiing and cross-country skiing appear relatively safe with respect to the magnitude of loading. However, the skiing activities showed considerably higher mediolateral and anterior-posterior forces than walking. Mechanical testing of prosthetic devices with loading conditions specific to these activities is needed to assess the effect of these force components on hip prostheses and to allow interpretation with respect to potential effects of skiing for a hip prosthetic patient.     

The conservative treatment of complete tears of the anterior cruciate ligament in skeletally immature patients

We describe the results of conservative treatment for complete midsubstance tears of the anterior cruciate ligament (ACL) in 18 skeletally immature patients, followed for a minimum of 36 months. Six patients had an ACL reconstruction during the follow-up period and were assessed immediately before their operation. The average time from initial injury to evaluation was 51 months. All patients had symptoms when reviewed. The modified Lysholm knee score showed one excellent result, one good, eight fair, and eight poor with a mean score of 64.3. Only one patient had returned to her preinjury level of athletics. Secondary meniscal tears were confirmed in six patients, and three more had the clinical signs of a tear at follow-up. Radiological evidence of degenerative changes was found in 11 of the 18 patients. We conclude that the results of non-operative treatment for ACL injuries in this age group are poor and not acceptable.     

Test of Stice''s dual pathway model: dietary restraint and negative affect as mediators of bulimic behavior

Many investigators have used animal models to clarify the role of the human anterior cruciate ligament (ACL). Because none of these models are anatomically and biomechanically identical to the human ACL, there exists a need for an objective comparison of these models. To do this, we used a universal force-moment sensor to measure and compare the in situ forces, including magnitude and direction, of the ACL and the anteromedial (AM) and posterolateral (PL) bundles of human, pig, goat, and sheep knees. An Instron was used to apply 50 and 100 N anterior tibial loads at 90 degrees of knee flexion, while a universal force-moment sensor was used to measure the forces applied by the ACL to the tibia, the in situ force of the ACL. We found significant differences between the magnitude of force experienced by the goat and sheep ACL and AM and PL bundles when compared with the human ACL and AM and PL bundles. Also, the direction of the in situ force in the ACL and AM bundles of the goat and sheep were different from the human. The pig knee differed from the human only in the magnitude and direction of the in situ force in the PL bundle in response under anterior tibial loading. A tally of the significant differences between the animal models and the human knees indicates that goat and sheep knees may have limitations in modeling the human ACL, while the pig knee may be the preferred model for experimental studies.     

Comparisons of the ski turn techniques of experienced and intermediate skiers

We compared selected kinematic variables for four different ski turn techniques performed by five experienced and five intermediate male skiers. The four ski turn techniques were the upstem turn, the downstem turn, the parallel turn and the parallel step turn. Each turn was divided into the initiation phase and the first and second steering phases. Most of the statistically significant differences (P < 0.05) between the two groups were found for the initiation phases of the four turns. Both the hip axis-hand axis angle and the edging angle of the uphill ski were significantly different between the two groups for the upstem turn at the beginning of the initiation phase. For the downstem turn, significant differences between the groups were found at the start of the initiation phase for the hip axis-hand axis angle, the shoulder axis-fall line angle, and the edging angle of the uphill ski. The standard deviation of the distance between the tips of the two skis over the second steering phase also differed significantly between the two groups. For the parallel step turn, significant differences were found at the start of the initiation phase for the edging angle of the downhill ski and the downhill ski to movement direction angle. Significant differences were also found for the edging angle of the downhill ski in the middle of the second steering phase and the shoulder axis to movement direction angle at the end of this phase. For the initiation phase of the parallel turn, significant differences were found for the timing of setting the ski pole, the uphill knee angle at the start of this phase and the range of the knee angle of the uphill leg from the start to the end of this phase. For this turn, significant differences between the two groups were also found for the edging angle of the downhill ski in the middle of the second steering phase and the shoulder axis to movement direction angle at the end of this phase. One of the reasons it was possible to identify a few significant differences only for the turns analysed, was the variability within the intermediate group: for most of the variables analysed, the standard deviation was much higher for the intermediate than for the experienced group.