Metabolic efficiency during arm and leg exercise at the same relative intensities

This study was conducted to compare gross efficiency (GE), net efficiency (NE), work efficiency (WE), and delta efficiency (DE) between arm crank and cycle exercise at the same relative intensities. Eight college-aged males underwent two experimental trials presented in a randomized counterbalanced order. During each trial subjects performed three intermittent 7-min exercise bouts separated by 10-min rest intervals on an arm or semirecumbent leg ergometer. The power outputs for the three bouts of arm crank or cycle exercise corresponded to 50, 60, and 70% of the mode-specific VO2peak. GE, NE, and WE were determined as the ratio of Kcal.min-1 equivalent of power output to Kcal.min-1 of total energy expended, energy expended above rest and energy expended above unloaded exercise, respectively. DE was determined as the ratio of the increment of Kcal.min-1 of power output above the previous lower intensity to the increment of kcal.min-1 of total energy expended above the previous lower intensity. GE and NE did not differ between arm crank and cycle exercises. However, WE was lower (P < 0.05) during arm crank than cycle exercise at 50, 60, and 70% VO2peak. DE was also lower (P < 0.05) during arm crank than cycle exercise at delta 50-60 and at delta 60-70% VO2peak. It is concluded metabolic efficiency as determined by work and delta efficiency indices was lower during arm crank compared with cycle exercise at the same relative intensities. These findings add to the understanding of the difference in metabolic efficiency between upper and lower body exercise.     

A time-course study of the transfer of immunoglobulin G from blood to tracheal and lacrimal secretions in young turkeys

Three-week-old turkeys were injected intravenously with Bordetella avium-specific immunoglobulin G (IgG), and absorbance readings were measured in blood, tracheal washings, and lacrimal secretions using an enzyme-linked immunosorbent assay at various time intervals. IgG was detected in tracheal and lacrimal secretions as early as 5 minutes after injection and peaked at 10 minutes after injection. Thereafter, IgG absorbance declined rapidly, reaching background levels by 24 hours. The absorbance readings of IgG in all three sites were comparable at all times from 10 minutes to 24 hours after administration. The results indicated that movement of IgG from blood to mucosal surfaces in turkeys occurs rapidly.     

The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Pediatric Outcomes Instrument Development Group. Pediatric Orthopaedic Society of North America

The goal of orthopaedic interventions is to improve the functional health of patients, particularly physical function. The American Academy of Orthopaedic Surgeons and the Pediatric Orthopaedic Society of North America (POSNA) commissioned a work group to construct functional health outcomes scales for children and adolescents, focusing on musculoskeletal health. The work group developed scales assessing upper extremity function, transfers and mobility, physical function and sports, comfort (pain free), happiness and satisfaction, and expectations for treatment. Parent and adolescent self-report forms were developed and tested on 470 subjects aged 2-18 years. The POSNA scales demonstrated good reliability, construct validity, sensitivity to change over a 9-month period, and ability to outperform a standard instrument, the Child Health Questionnaire physical functioning scale. They were useful for a wide variety of ages and diagnoses. They appear to be ideally suited for orthopaedic surgeons to assess the functional health and efficacy of treatment of their patients at baseline and follow-up.     

Natural deaths while driving: would screening for risk be ethically justified?

OBJECTIVE: Right-angle dual-headed tomography has increased cardiac SPECT utility by cutting acquisition time in half which enhances gating capabilities. When gating, however, a deceleration in heart rate, due to a return to baseline rate after stress or lessened anxiety at the end of a study, may significantly affect the last step(s) of a gated study with possible frame or information loss. The purpose of this study was to illustrate the artifacts produced in myocardial perfusion studies when a frame or frames are lost in single- and dual-detector SPECT imaging methodologies. METHODS: A near-normal 99mTc-sestamibi study was obtained using a dual-headed camera system fitted with high-resolution, long-bore collimators. The normal study was processed including all frames (1-32). To demonstrate the effect of losing frames on a dual-headed system, the study was processed three different ways to simulate frame loss. RESULTS: Loss of frames at the end of a SPECT acquisition results in significant inferoseptal wall defects, left ventricular lumen narrowing, as well as thinning of the anterior and lateral walls. The overall appearance of the heart is a more oval-shaped heart with decreased perfusion. The effect of losing the last frame in a dual-headed camera system as opposed to losing the last frame in a single-headed camera system is more substantial. CONCLUSION: A scan resulting in the loss of a frame in either a single- or a dual-headed camera system creates artifacts in the myocardial wall and should always be repeated. It is significant to note that artifacts present in a dual-headed system are much more prevalent than in a single-headed system due to the nature of dual-headed acquisition parameters.     

Orthognathic surgery: the patients'' perspective

We have evaluated our practice of tube caecostomies in 21 children operated on from January 1982 to December 1987 at the Royal Hospital for sick children, Bristol, and 18 children operated on at the Paediatric Surgery Unit of the Korle-Bu Teaching Hospital, Accra, Ghana from January 1989 to December 1996. The indications for surgery were, Hirschsprung's disease (36) and idiopathic constipation (3). The definitive procedures involved were Duhamel's procedure in 36, Soave's procedure in 2 and colo-anal anastomosis in 1 case. This method reduces the total number of surgical operations required by the child from 3 to 2, thereby reducing the total period of hospitalisation for the child. A sample technique of tube caecostomy is described in 39 children undergoing corrective surgery.     

Identification of a novel cysteine string protein variant and expression of cysteine string proteins in non-neuronal cells

Cysteine string proteins (Csps) are synaptic vesicle proteins thought to be involved in calcium-dependent neurotransmitter release at nerve endings. Here, we report the cloning of two Csp variants, termed Csp1 and Csp2, from bovine adrenal medullary chromaffin cells. The bovine Csp1 appears to be the homologue of rat brain Csp, sharing 95% identity at the amino acid level. The nucleotide sequence of csp2 is identical with that of csp1 except for a 72-base insert which introduces a stop codon into the coding sequence, which would be predicted to result in a truncated protein 3.3 kDa smaller than Csp1. Furthermore, polymerase chain reaction analysis detected homologues of Csp1 and Csp2 in rat kidney, liver, pancreas, spleen, lung, and adrenal gland. Expression of Csps in non-neuronal tissues was confirmed by Northern blotting and by immunoblotting with anti-Csp1 antiserum which also demonstrated expression of both full-length and truncated Csps in spleen. The widespread tissue distribution is inconsistent with a role of Csps as specific regulators of presynaptic calcium channels as previously proposed. We suggest that Csps may have a more general role in membrane traffic in non-neuronal as well as neuronal cells.     

Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups

BACKGROUND: Exercise testing is useful in the assessment of symptomatic patients for diagnosis of significant or extensive coronary disease and to predict their future risk of cardiac events. The Duke treadmill score (DTS) is a composite index that was designed to provide survival estimates based on results from the exercise test, including ST-segment depression, chest pain, and exercise duration. However, its usefulness for providing diagnostic estimates has yet to be determined. METHODS AND RESULTS: A logistic regression model was used to predict significant (>/=75% stenosis) and severe (3-vessel or left main) coronary artery disease, and a Cox regression analysis was used to predict cardiac survival. After adjustment for baseline clinical risk, the DTS was effectively diagnostic for significant (P<0.0001) and severe (P<0.0001) coronary artery disease. For low-risk patients (score >/=+5), 60% had no coronary stenosis >/=75% and 16% had single-vessel >/=75% stenosis. By comparison, 74% of high-risk patients (score <-11) had 3-vessel or left main coronary disease. Five-year mortality was 3%, 10%, and 35% for low-, moderate-, and high-risk DTS groups (P<0.0001). CONCLUSIONS: The composite DTS provides accurate diagnostic and prognostic information for the evaluation of symptomatic patients evaluated for clinically suspected ischemic heart disease.