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Purpose: The purpose of this article is to provide clinicians with options to restore the adult patient with an impacted maxillary canine using dental implants. Literature was reviewed to provide evidence for the methods suggested., Methods: The search strategy utilized pubmed.gov to identify articles pertinent to identified treatment options. The search used terms which included dental implants and impacted tooth, tilted implants and fixed partial prostheses, 6 mm dental implants, and 4 mm dental implants. Articles were included if they reported dental implant procedures associated with impacted canines in adults, or if they reported on the use of tilted implants, immediate implant placement at time of canine removal, or the use of short implants. Articles with less than 12 months follow up were excluded., Results: The search identified articles which included dental implants and impacted tooth (n = 142), tilted implants and fixed partial (n = 36), 6 mm dental implants (n = 182), and 4 mm dental implants (n = 162). From this search, 28 articles were collated that satisfied the inclusion criteria. The use of tilted implants had success rates ranging from 93% to 99%. Short implants had success rates ranging from 87 to 90% in the posterior maxilla. Immediate implant placement after removal of the impacted canine lacked long term reports. Two cases are included to demonstrate treatment planning using navigation to guide implant placement in an adult patient with an impacted maxillary canine., Conclusions: The evidence-based literature concerning implant placement associated with adult maxillary canines is limited. There is evidence to support tilting implants to avoid the impacted canine, or the use of short implants splinted together to avoid the impacted tooth. Other options had insufficient data to offer support., (Copyright © 2023 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

A customized healing abutment may be used to create a soft-tissue emergence profile that is more realistic looking compared to when a commercially available stock healing abutment is used. This article describes a workflow for the design and fabrication of a customized healing abutment based on the anticipated final restoration. Utilizing dental CAD/CAM software, a dynamic navigation virtual treatment plan, and 3D printing, this workflow can be accomplished in an all-digital, presurgical fashion.

My Baby's First Teacher is an intervention designed specifically for parents with infants staying in emergency homeless shelters. Infants are overrepresented in shelter populations and face considerable risk to their development, including mental health. We utilized a randomized controlled design across three family shelters to evaluate the program's effectiveness with 24 dyads assigned to the intervention compared to 21 dyads in care-as-usual. Dyads were randomized by round at each site to account for shelter effects. We used path analysis to illustrate change over time and in relation to intervention assignment., (© 2020 Michigan Association for Infant Mental Health.)

Assessment of protocol validity is essential for structured personality tests used in clinical decision making. Measures of inconsistent responding allow researchers and clinicians to identify random or careless response patterns that compromise an accurate interpretation of test results. Keeley and colleagues (2016) developed an Inconsistency scale (INC) for the widely used Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol. 2012. Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42(9), 1879-1890.). The INC produced highly promising results in initial validation studies, and the current study provides a series of additional tests of the adaptability of the INC item pairs across different populations, translations, and versions of the PID-5. Study 1 examines the diagnostic utility of a shortened version of the original INC scale (INC-S) that can be used with the 100-item version of the PID-5; optimum cut scores are identified for this short form adaptation. Study 2 cross-validates the INC-S and compares diagnostic utility to the INC in a sample that completed the full PID-5. Study 3 examines the diagnostic utility of the INC and INC-S using a German translation of the PID-5 with undergraduates and clinical patients. Overall, these validation studies provide robust support for the INC and INC-S scales to discriminate random-generated versus real PID-5 protocols.

The histological effect on the felid uterus of sterilization, via ovariectomy or salpingectomy, is currently unknown. To investigate the association of ovariectomy or salpingectomy with uterine health, it is first necessary to establish if changes are distributed evenly throughout the uterus. Both laparoscopic ovariectomy and salpingectomy with concurrent sampling of the tip of the uterine horn are possible in the cheetah. Currently accepted practice for histopathological screening of the uterus utilizes four biopsy samples. It is not known whether this method accurately reflects the status of the entire uterus. In this study we histologically examined the uteri of six older cheetahs (one 7-year-old and five 10-10.5-year-old animals) via 21 tissue samples (three samples from seven different anatomical regions) per cheetah to determine overall uterine health. Although no defined lesions were detected, mild endometrial gland dilation, assumed to be of no functional consequence, was observed in multiple samples. The odds of observing this dilation was lowest in the uterine body and progressively increased in a cranial direction, being significantly higher at the tip of the uterine horns (OR = 11.5; 95% CI, 2.0-65.1; p = 0.006). This supported the reliability of sampling the tip of the uterine horn to screen for endometrial gland dilation., (© 2020 Wiley Periodicals LLC.)

Less than 7,000 cheetahs survive in the wild. Captive breeding has proved notoriously difficult. The uterotubal junction acts as major barrier and regulator to the passage of sperm. This study describes the morphology of the uterotubal junction of the cheetah. Reproductive tracts were obtained from seven cheetahs that succumbed from natural causes or were euthanized for humane reasons. The uterotubal junction was isolated and examined macroscopically and microscopically. The extramural isthmus made a characteristic 90° bend before entering the mesometrial border of the uterus close to its tip. The intramural isthmus had approximately four primary folds lined by nonciliated cuboidal to low cuboidal epithelium. The Tunica muscularis was robust, merged with its uterine counterparts and consisted of an inner circular layer and outer longitudinal smooth muscle layer. The uterine ostium opened via a muscular and glandular papilla that projected from the apex of the uterine lumen. A sharply demarcated circular zone of simple columnar epithelial cells surrounded the uterine ostium and separated the simple cuboidal to low cuboidal cells of the isthmus and uterine epithelium from each other. Branched tubulo-alveolar glands, some with dilated lumens, were present in the papilla and sometimes extended into the adjacent endometrium. These glands might act as sperm storage areas, and could easily be confused with cystic endometrial hyperplasia. Low transverse endometrial ridges surrounded the papilla and extended caudally for a short distance before disappearing. The uterine glands were lined by a simple cuboidal epithelium. Anat Rec, 302:1855-1864, 2019. © 2019 American Association for Anatomy., (© 2019 American Association for Anatomy.)

Objective:  The purpose of this study was to introduce a modified-Unger fracture classification in impala and report the findings of 58 long bone fractures classified according to this system., Methods:  This was a retrospective radiographical study evaluating 122 radiographs of 58 long bone fractures in 55 impala. The Unger fracture classification was modified and fracture illustrations for the metacarpal and metatarsal bones added. Each fracture was classified and assigned a four symbol α-numeric code using our classification. The patient signalment, skeletal maturity, fracture-associated soft tissue changes, presence of fissure lines, periosteal reaction and cause of the fracture were recorded., Results:  The overall fracture distribution based on location, found tibial ( n  = 17) fractures to be the most common fractured long bone. When combined, the majority of fractures involved the metacarpal and metatarsal bones ( n  = 23). Forty five of 58 fractures occurred in the diaphyseal bone segment. In all long bones, the distribution based on complexity was simple ( n  = 27), wedge ( n  = 16) and multi-fragmentary ( n  = 15) fractures. Thirty one of 58 fractures were open and fissure lines were detected in 20 of 58 fractures., Clinical Significance:  Our modified-Unger fracture classification was applicable in classifying 58 impala long bone fractures. This classification should provide the basis for further advances in veterinary and comparative ungulates, and particularly the antelopes, orthopaedics and traumatology., Competing Interests: None declared., (Georg Thieme Verlag KG Stuttgart · New York.)

The study objectives were to measure gestational sac (GS) diameter and crown-to-rump (CR) length in conscious pregnant rats and to determine the chronological ultrasonographic appearance of heart beat and fetal organogenesis. The study formed part of a unilateral surgical salpingectomy trial with 16 female Sprague-Dawley rats (Rattus norvegicus). Ten rats were operated on while the other six served as controls. After surgery all were mated at 8-10 weeks of age. Gestational length was taken as 22 days. Rats were manually restrained for abdominal ultrasonography and were scanned daily from day 7 until day 19 or 20 post-mating followed by immediate euthanasia. Measurements' were taken from two GSs per rat. The presence of several early GSs in a row were described as a "string of pearls". As a fetus developed features of organogenesis were recorded. There was no significant difference in GS diameters and CR length between the test and control groups. Mean GS diameters ranged from 2.9 mm (day 7) to 18.1 mm (day 20). A string of pearls was seen on days 8-11. The CR length ranged from 1.6 mm (day 11) to 26.4 mm (day 20). A heart beat was first seen on day 11 and the echogenic vertebral column at day 14-15. From day 16, ribs, feet and the isoechoic lungs and liver were seen. The lungs became hyperechoic to the liver from day 18-19. The tail and mandible were visible on day 18 and the aorta and caudal vena cava were seen on day 19, as well as an occasional bladder. These measurements and staged in utero ultrasonographic appearance of various organ and skeletal structures will assist in a reasonably accurate prediction of the day of impending parturition by laboratory personnel and researchers., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Reported mass mortalities in wild pigeons and doves during the 2017/2018 Clade 2.3.4.4 HPAI H5N8 outbreaks in South Africa necessitated an investigation of healthy racing pigeons for their susceptibility and ability to transmit a Clade 2.3.4.4 sub-group B virus of South African origin. Pigeons challenged with medium (10 4.5 EID 50 ) and high doses (10 6 EID 50 ) but not a low dose (10 3 EID 50 ) of virus, shed virus in low levels of <10 3 EID 50 /ml from the oropharynx and cloaca for up to eight days, with peak shedding around 4 days post challenge. Challenged pigeons were able to transmit the virus to contact pigeons, but not contact chickens. Neither pigeons nor chickens presented clinical disease, and only two pigeons in the group that received the high challenge dose developed influenza A-virus specific antibodies. The levels of virus shed by the racing pigeons were well below the published bird infectious dose 50 values for most poultry, especially chickens, therefore the risk that racing pigeons could act as propagators and disseminators through excretion of Clade 2.3.4.4 HPAI H5N8 strains remains negligible., (Copyright © 2018 Elsevier B.V. All rights reserved.)

A 12-year-old spayed Newfoundland bitch was presented with chronic non-productive vomiting, regurgitation and coughing of six weeks' duration. On clinical examination, the dog was depressed with no other significant findings. Haematology and biochemistry investigations detected no abnormalities. Thoracic and abdominal radiographs revealed a megaoesophagus and an abnormally positioned pylorus. A thoracic and abdominal computed tomography scan confirmed the abnormal position of the stomach, together with moderate aspiration pneumonia. Laparoscopic examination of the peritoneal cavity revealed the greater omentum wrapped over the stomach, with a fold visualised between the abnormally positioned pyloric antrum and the gastric corpus. A 180-degree clockwise gastric rotation was laparoscopically diagnosed and corrected. The normal position of the stomach was confirmed before a laparoscopic-assisted incisional gastropexy was performed. Post-operatively the vomiting and regurgitation resolved and the patient was discharged. Twenty-four hours after discharge, the dog was presented with deteriorating clinical signs of aspiration pneumonia. The owner declined treatment, additional diagnostics as well as a necropsy and requested euthanasia. Chronic gastric volvulus should be considered as a rare differential diagnosis in dogs with non-specific, chronic gastrointestinal signs. Radiography, computed tomography and laparoscopy are valuable diagnostic aids in making this diagnosis. Chronic gastric volvulus can be successfully reduced laparoscopically as reported here for the first time.

Objective: To compare the antimicrobial efficacy of a 2% chlorhexidine gluconate and 70% ethanol solution (CG+A) with that of F10 Skin Prep Solution (F10) and electrochemically activated water (EAW) when used as a surgical preparation in canine patients., Study Design: Prospective randomized clinical study., Sample Population: One hundred sixteen dogs presented for ovariohysterectomy., Methods: Dogs were randomly divided into 1 of the 3 antiseptic groups (CG+A, F10, EAW). Skin samples with replicating organism detection and counting plates were taken at 4 different perioperative sites and time intervals (postskin preparation, postskin antisepsis, 2 hours after the second sample, and at the end of surgery) during ovariohysterectomies performed by students. The colony forming unit (CFU) counts from each sample were quantified according to the level of bacterial contamination. Zero CFU was defined as no contamination, 1-12 CFU was defined as low contamination, and greater than 12 CFU was defined as high contamination. The 3 antiseptics were compared with respect to the level of contamination., Results: There was no difference in the level of colonization between the antiseptics at the first sampling time (P = .454). However, the level of contamination for CG+A was lower compared with F10 and EAW at the second, third, and fourth sampling times (P =  .001, P =  .01, P =  .02, respectively)., Conclusion: CG+A was more effective at achieving a zero CFU count and low levels of contamination compared with F10 and EAW for surgical preparation in dogs undergoing ovariohysterectomy., Clinical Significance: This study does not provide evidence to support the use of F10 and EAW instead of CG+A for the surgical skin preparation of dogs undergoing ovariohysterectomy., (© 2018 The American College of Veterinary Surgeons.)

Objective: To compare the effects of thiopentone, propofol and alfaxalone on arytenoid cartilage motion and establish the dose rates to achieve a consistent oral laryngoscopy examination., Study Design: Randomised crossover study., Animals: Six healthy adult Beagle dogs., Methods: Each dog was randomly administered three induction agents with a 1-week washout period between treatments. Thiopentone (7.5 mg kg -1 ), propofol (3 mg kg -1 ) or alfaxalone (1.5 mg kg -1 ) was administered over 1 minute for induction of anaesthesia. If the dog was deemed inadequately anaesthetised, then supplemental boluses of 1.8, 0.75 and 0.4 mg kg -1 were administered, respectively. Continual examination of the larynx, using a laryngoscope, commenced once an adequate anaesthetic depth was reached until examination end point. The number of arytenoid motions and vital breaths were counted during three time periods and compared over time and among treatments. Data were analysed using Friedman and Mann-Whitney U tests, Spearman rho and a linear mixed model with post hoc pairwise comparison with Tukey correction., Results: The median (range) induction and examination times were 2.8 (2.0-3.0), 2.7 (2.0-3.3) and 2.5 (1.7-3.3) minutes (p = 0.727); and 14.1 (8.0-41.8), 5.4 (3.3-14.8) and 8.5 (3.8-31.6) minutes (p = 0.016) for thiopentone, propofol and alfaxalone, respectively. The median dose rates required to achieve an adequate anaesthetic depth were 6.3 (6.0-6.6), 2.4 (2.4-2.4) and 1.2 (1.2-1.2) mg kg -1  minute -1 , respectively. There was no significant difference for the total number of arytenoid motions (p = 0.662) or vital breaths (p = 0.789) among induction agents., Conclusion and Clinical Relevance: The number of arytenoid motions were similar among the induction agents. However, at the dose rates used in this study, propofol provided adequate conditions for evaluation of the larynx with a shorter examination time which may be advantageous during laryngoscopy in dogs., (Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Background: A prospective randomized study was used to compare surgery times for laparoscopic ovariectomy and salpingectomy in female African lion (Panthera leo) (n = 14) and cheetah (Acinonyx jubatus) (n = 20) and to compare the use of a multiple portal access system (MPAS) and single portal access system (SPAS) between groups. Two different portal techniques were used, namely MPAS (three separate ports) in lions and SPAS (SILS™ port) in cheetahs, using standard straight laparoscopic instruments. Portal access system and first ovary was not randomized. Five different surgery times were compared for the two different procedures as well as evaluating the use and application of MPAS and SPAS. Carbon dioxide volumes for lions were recorded., Results: In adult lionesses operative time (OPT) (P = 0.016) and total surgical time (TST) (P = 0.032) were significantly shorter for salpingectomy compared to ovariectomy. Similarly in cheetahs OPT (P = 0.001) and TST (P = 0.005) were also shorter for salpingectomy compared to ovariectomy. In contrast, in lion cubs no difference was found in surgery times for ovariectomy and salpingectomy. Total unilateral procedure time was shorter than the respective bilateral time for both procedures (P = 0.019 and P = 0.001) respectively and unilateral salpingectomy was also faster than unilateral ovariectomy (P = 0.035) in cheetahs. Port placement time, suturing time and TST were significantly shorter for SPAS compared to MPAS (P = 0.008). There was, however, no difference in OPT between SPAS and MPAS. Instrument cluttering with SPAS was found to be negligible. There was no difference in mean volume CO2 required to complete ovariectomy in lions but the correlation between bodyweight and total volume of CO2 in lions was significant (rs = 0.867; P = 0.002)., Conclusions: Laparoscopic salpingectomy was faster than ovariectomy in both adult lions and cheetahs. Using SPAS, both unilateral procedures were faster than bilateral procedures in cheetahs. Placement and suturing of SPAS in cheetahs was easier and faster compared to three separate ports in lions and lion cubs. The use of standard straight instruments during SPAS did not prolong surgery. Surgery was faster in cubs and CO2 required for laparoscopic sterilization in lions could be determined. Predictable surgery times and CO2 volumes will facilitate the accurate planning and execution of surgery in lions and cheetahs.

The study uniquely described the clinical value of transabdominal ultrasonography for monitoring features characterizing the estrous cycle in female cheetahs (Acinonyx jubatus). The reproductive tracts of 21 female, nulliparous, and relatively aged (median: 11 and interquartile range: 9.25-14 years) captive cheetahs resident on two sites in Namibia were assessed by transabdominal ultrasound. Subsequently, the ovarian findings on ultrasound were compared with direct visualization while performing laparoscopic sterilization. A combination of these observations supported by concurrent sampling for vaginal cytology and serum progesterone concentrations defined the estrous status of individual animals. At one site, six cheetahs had been implanted with the GnRH agonist, deslorelin as a contraceptive at least once within the preceding 11 years. On ultrasound, 31 uterine horns and 35 ovaries with discernible structures on 28 (86%) were visualized in the 21 cheetahs. The uterine body was difficult to visualize because of its intrapelvic location. Eleven of 19 uteri (58%) visualized showed endometrial edema suggestive of estrogenization. The uteri of four cheetahs (19%) showed evidence of mild cystic endometrial hyperplasia. Paraovarian cysts were seen on ultrasound (n = 21) and laparoscopy (n = 26) in 16 (76.2%) and 18 (85.7%) cheetahs, respectively. Ovarian volumes obtained from ultrasonographically determined dimensions predicted cyclic activity. Laparoscopy showed that 19 ovaries had discernible follicular structures. In the study population, 10 (47.6%) cheetahs were in proestrus or estrus; none in the luteal phase; and 11 (52.4%) in anestrus. Transabdominal ultrasound, in combination with serum progesterone concentrations and vaginal cytology, was used with acceptable accuracy to assess cyclic ovarian activity in captive cheetahs. A considerable proportion of this aged population showed ovarian activity and the prevalence of paraovarian cysts was notable. A history of prior deslorelin treatment was not associated with either reproductive activity or uterine pathology., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Laparoscopic salpingectomy was performed in two adult leopards (Panthera pardus) using a single portal access system, with a multicannulated single-incision laparoscopic surgery port, without any complications. The poorly developed ovarian bursa provided easy access to the uterine tube for salpingectomy. Laparoscopic salpingectomy can be safely performed in the leopard using a single portal access system.

Background: Fractures of the bony nasolacrimal system (NLS), including the lacrimal sac fossa and nasolacrimal canal, have not been comprehensively described in patients with facial trauma. Characterization of these injuries may help facial trauma surgeons better predict which patients will develop lacrimal outflow obstruction symptoms including epiphora and dacryocystitis and who may eventually need lacrimal surgery., Methods: CT images for all patients seen at the University of Wisconsin Hospital and Clinics for craniofacial trauma were reviewed from January 2001 to December 2005. Patients were included if they had a NLS fracture and at least 1 year of follow-up. Fracture patterns were described and correlated with clinical outcomes documented in the medical record. Outcomes, including the development of epiphora or dacryocystitis and the need for lacrimal surgery, were analyzed using Fisher exact test., Results: We identified 104 patients with NLS fractures among 1980 patients with craniofacial trauma who had at least 1 year of follow-up. Eleven patients (10.6%) developed epiphora or dacryocystitis, and 2 patients (1.9%) required dacryocystorhinostomy (DCR). Ten radiographic injury patterns were characterized. Avulsion of the lacrimal crest, bone fragment in the lacrimal sac fossa or duct, duct compression greater than 50%, and nasomaxillary buttress displacement were significantly associated with the development of epiphora or dacryocystitis (P < 0.05). Nasomaxillary buttress displacement was significantly associated with the eventual need for DCR (P = 0.03)., Conclusions: Patients with radiographic evidence of NLS fracture have an approximately 10% risk of developing epiphora or dacryocystitis. We describe 5 NLS fracture findings that are significantly associated with the development of lacrimal outflow obstruction. The presence of nasomaxillary buttress fracture and displacement suggests a significantly higher risk of eventually needing lacrimal surgery.

Objective: To describe laparoscopic ovariectomy and salpingectomy in the cheetah (Acinonyx jubatus) using single-incision laparoscopic surgery (SILS)., Study Design: Prospective cohort., Animals: Female cheetahs (Acinonyx jubatus) (n = 21)., Methods: Cheetahs were randomly divided to receive either ovariectomy (n = 11) or salpingectomy (n = 10). The use and complications of a SILS port was evaluated in all of cheetahs. Surgery duration and insufflation volumes of carbon dioxide (CO2 ) were recorded and compared across procedures., Results: Laparoscopic ovariectomy and salpingectomy were performed without complications using a SILS port. The poorly-developed mesosalpinx and ovarian bursa facilitated access to the uterine tube for salpingectomy in the cheetah. The median surgery duration for ovariectomy was 24 minutes (interquartile range 3) and for salpingectomy was 19.5 minutes (interquartile range 3) (P = .005). The median volume of CO2 used for ovariectomy was 11.25 L (interquartile range 3.08) and for salpingectomy was 4.90 L (interquartile range 2.52), (P = .001) CONCLUSIONS: Laparoscopic ovariectomy and salpingectomy can be performed in the cheetah using SILS without perioperative complications. Salpingectomy is faster than ovariectomy and requires less total CO2 for insufflation., (© Copyright 2015 by The American College of Veterinary Surgeons.)

Moringa oleifera leaves, seeds, bark, roots, sap, and flowers are widely used in traditional medicine, and the leaves and immature seed pods are used as food products in human nutrition. Leaf extracts exhibit the greatest antioxidant activity, and various safety studies in animals involving aqueous leaf extracts indicate a high degree of safety. No adverse effects were reported in association with human studies. Five human studies using powdered whole leaf preparations of M. oleifera have been published, which have demonstrated anti-hyperglycemic (antidiabetic) and anti-dyslipidemic activities. These activities have been confirmed using extracts as well as leaf powders in animal studies. A rapidly growing number of published studies have shown that aqueous, hydroalcohol, or alcohol extracts of M. oleifera leaves possess a wide range of additional biological activities including antioxidant, tissue protective (liver, kidneys, heart, testes, and lungs), analgesic, antiulcer, antihypertensive, radioprotective, and immunomodulatory actions. A wide variety of polyphenols and phenolic acids as well as flavonoids, glucosinolates, and possibly alkaloids is believed to be responsible for the observed effects. Standardization of products is an issue. However, the results of published studies to date involving M. oleifera are very promising. Additional human studies using standardized extracts are highly desirable., (© 2015 The Authors Phytotherapy Research Published by John Wiley & Sons Ltd.)

Purpose: The broad spectrum of frontal bone fractures, including those with orbital and skull base extension, is poorly understood. We propose a novel classification scheme for frontal bone fractures., Methods: Maxillofacial CT scans of trauma patients were reviewed over a five year period, and frontal bone fractures were classified: Type 1: Frontal sinus fracture without vertical extension. Type 2: Vertical fracture through the orbit without frontal sinus involvement. Type 3: Vertical fracture through the frontal sinus without orbit involvement. Type 4: Vertical fracture through the frontal sinus and ipsilateral orbit. Type 5: Vertical fracture through the frontal sinus and contralateral or bilateral orbits. We also identified the depth of skull base extension, and performed a chart review to identify associated complications., Results: 149 frontal bone fractures, including 51 non-vertical frontal sinus (Type 1, 34.2%) and 98 vertical (Types 2-5, 65.8%) fractures were identified. Vertical fractures penetrated the middle or posterior cranial fossa significantly more often than non-vertical fractures (62.2 v. 15.7%, p = 0.0001) and had a significantly higher mortality rate (18.4 v. 0%, p < 0.05). Vertical fractures with frontal sinus and orbital extension, and fractures that penetrated the middle or posterior cranial fossa had the strongest association with intracranial injuries, optic neuropathy, disability, and death (p < 0.05)., Conclusions: Vertical frontal bone fractures carry a worse prognosis than frontal bone fractures without a vertical pattern. In addition, vertical fractures with extension into the frontal sinus and orbit, or with extension into the middle or posterior cranial fossa have the highest complication rate and mortality., (Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

N-methyltyramine (NMT) is a protoalkaloid isolated from various plant species. It is assumed that NMT is an adrenergic agonist with pharmacological properties similar to other structurally related biogenic amines. Current research studies indicate that NMT is an α-adrenoreceptor antagonist, and exhibits modest inhibitory (antagonistic) activity with respect to the breakdown of fats (lipolysis). Furthermore, NMT has been shown to enhance appetite and digestion of foods through its stimulatory effects on gastrin and pancreatic secretions. As a consequence, NMT is not an ingredient that should be used in dietary supplements designed to promote weight loss. It may result in an increase in perceived energy by promoting appetite and the digestion and absorption of nutrients while inhibiting the breakdown to fats to energy., (Copyright © 2014 John Wiley & Sons, Ltd.)

Objective: To describe laparoscopic ovariectomy and salpingectomy in the African lioness (Panthera leo)., Study Design: Descriptive clinical study., Animals: Female lions (n = 16)., Methods: Lionesses were randomly divided into 2 groups: O = ovariectomy (n = 8) and S = salpingectomy (n = 8) for laparoscopic surgery. Two Veress needle placement techniques were used., Results: Laparoscopic ovariectomy and salpingectomy were performed without complications. The poorly developed mesosalpinx and ovarian bursa rendered the uterine tube more accessible for salpingectomy compared to the dog making the procedure easier in the lioness. Similarly, salpingectomy is a relatively easier procedure compared with ovariectomy especially when the modified Hasson technique for Veress needle placement is used., Conclusions: Laparoscopic ovariectomy and salpingectomy can be safely performed in the African lioness., (© Copyright 2013 by The American College of Veterinary Surgeons.)

An under-sized three-month-old female bull terrier was referred with a history of regurgitation since three days of age. Thoracic radiographs were unremarkable, while abdominal radiographs showed a distended stomach, despite a 12 hour fast. Abdominal ultrasonography revealed gastric outflow obstruction of unclear aetiology. Coeliotomy was performed, during which an excessive mucosal fold at the pyloric antrum was excised. Histopathology of the pyloric fold revealed mild oedema and fibrosis of the mucosal tissue. The dog made a complete recovery, with resolution of regurgitation and grew to within the expected breed size. In the authors' opinion, this is the first canine report of congenital antral mucosal valve resulting in gastric outflow obstruction, and only the second report in any species., (© 2012 British Small Animal Veterinary Association.)

Although uncommon, sinonasal malignancies and aggressive inflammatory processes are entities every radiologist will encounter during the evaluation of routine sinus imaging studies. A high index of suspicion is necessary for prompt diagnosis. It is important to consider aggressive inflammatory disease in all patients having routine sinus computed tomography because any delay in diagnosis can adversely affect the patients' care. Magnetic resonance (MR) will often provide a better assessment of the lesion extent, allowing for better surgical treatment. MR is crucial for the accurate assessment of neoplastic lesions. A proficient understanding of the complex anatomy of the region is essential., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: To investigate the use of a chemical shift-based water-fat separation magnetic resonance imaging (MRI) method, and time-resolved contrast-enhanced MRI at 3 T for improved presurgical localization of parathyroid adenomas., Methods: Twenty-five patients with primary hyperparathyroidism were prospectively enrolled. Patients underwent MRI, which was reviewed by two experienced neuroradiologists who were blinded to Tc-99m sestamibi imaging and operative results., Results: Overall, MRI detected 16 adenomas in 25 patients (sensitivity 64%, positive predictive value 67%), while sestamibi detected 18 of 25 adenomas (sensitivity 72%, positive predictive value 90%). Importantly, MRI was able to detect adenomas in four (57%) of the seven patients whose disease was missed by sestamibi analysis. MRI demonstrated excellent image quality and fat suppression by using a chemical shift-based water-fat separation technique. The time-resolved MRI was considered to be less helpful, although in some cases it was indispensable., Conclusions: MRI is an excellent adjunct for preoperative parathyroid localization. The advent of improved fat suppression techniques in the neck, including chemical shift-based water-fat separation, is critical to its utility. Although time-resolved MRI was not always helpful, it was crucial in certain cases. It may prove to be more useful with the development of faster scanning techniques.

Start time has been shown to be a significant predictor of overall performance in the sport of luge. The starting motion in luge has been described as an explosive upper-body movement that requires significant technique and skill to perfect. This study aims to investigate upper-body factors that may relate to start time in luge. Twenty-two subjects participated in the study as part of their normal off-season training. Each subject had a minimum of 3 years' experience in the sport of luge, and at the time was a member of a U.S. Luge National Team. Subjects completed a 1 repetition maximum (1RM) in the bench press (BP), prone row (PR), and weighted pull-up (WP). Anthropometric distances were taken measuring finger-tip span (FS), biacromial breadth (BB), acromio-radial length, acromio-olecranon length (AO), hand length, and sitting cervical height. Subjects were divided into 2 groups based on which U.S. Luge National team they were currently a member of, Senior National (SN, n = 13) and Junior National (JN, n = 9). A Pearson product-moment correlation coefficient showed several significant (p ≤ 0.05) relationships between upper-body variables and start time among the groups. The BP and PR 1RM were shown to have a significant relationship in both groups. Among the anthropometric variables, AO was also significant in both groups. The WP, FS, BB, and height were all shown to have a significant relationship with start time in the SN group, but not in the JN group. These results suggest that as luge athletes become more efficient in the starting technique, outside factors such as upper-body strength and anthropometric measures play a larger role in performance.

The use of transabdominal ultrasonography to assess the oestrous cycle has not been previously described in the African lion (Panthera leo). Twelve sexually mature lionesses and five female cubs had their reproductive organs assessed by transabdominal ultrasound. Ovarian findings were compared to laparoscopic findings while performing laparoscopic ovariectomy or salpingectomy. Vaginal cytology was performed and serum progesterone levels were determined. By combining all data the oestrous cycle stage of each lion was determined. One lion was far pregnant and was not operated on. In adults a uterine body could be seen ultrasonographically in 67% of lions while mural structures could be distinguished in 44% of lions. Five uterine horns could be seen in 3 lions. In 12 adults 10 ovaries were found of which eight had discernable follicles or luteal structures. During laparoscopy 12 active ovaries were seen with luteal structures seen in 11 ovaries and follicles in 2 ovaries. Using laparoscopy as the gold standard, ultrasonography had a sensitivity of 66% and specificity of 83% to detect ovarian reproductive activity. Two uterine cysts and a cluster of periovarian cysts were seen in three different lions. Three lions were pregnant, two were in oestrus, three in a luteal phase (dioestrus), and four were in anoestrus. Transabdominal ultrasound in combination with serum progesterone levels and vaginal cytology can be used to assess ovarian cyclical activity with reasonable accuracy in captive bred lions., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Lion (Panthera leo) and caracal (Caracal caracal) skeletal muscle samples from Vastus lateralis, Longissimus dorsi and Gluteus medius were analyzed for fiber type and citrate synthase (CS; EC 2.3.3.1), 3-hydroxyacyl Co A dehydrogenase (3HAD; EC 1.1.1.35), phosphofructokinase-1 (PFK; EC 2.7.1.11), creatine kinase (CK; EC 2.7.3.2), phosphorylase (PHOS; EC 2.4.1.1) and lactate dehydrogenase (LDH; EC 1.1.1.27) activities and compared to human runners, the latter also serving as validation of methodology. Both felids had predominantly type IIx fibers (range 50-80%), whereas human muscle had more types I and IIa. Oxidative capacity of both felids (CS: 5-9 μmol/min/g ww and 3HAD: 1.4-2.6 μmol/min/g ww) was lower than humans, whereas the glycolytic capacity was elevated. LDH activity of caracal (346 ± 81) was higher than lion (227 ± 62 μmol/min/g ww), with human being the lowest (55 ± 17). CK and PHOS activities were also higher in caracal and lion compared to human, but PFK was lower in both felid species. The current data and past research are illustrated graphically showing a strong relationship between type II fibers and sprinting ability in various species. These data on caracal and lion muscles confirm their sprinting behavior., (Copyright © 2011 Elsevier Inc. All rights reserved.)

The purpose of this study was to compare the effects of fatigue of the plantar flexors on peak torque and voluntary activation in untrained (UT) and resistance-trained (RT) men. Six men with no previous resistance training experience and 8 men with similar histories of chronic resistance training (9.8 ± 5.9 years, 3.8 ± 0.7 days/week) volunteered for this study. Subjects performed isometric maximal voluntary contractions (MVCs) before and immediately after unilateral dynamic isotonic contractions performed at 40% of MVC until volitional exhaustion. Voluntary activation of the plantar flexors was assessed using the interpolated twitch method (ITT) and central activation ratio (CAR). Surface electromyographic (EMG) amplitude of the soleus and medial gastrocnemius (MG) was measured during the MVC. There were significant reductions in MVC torque in both UT and RT groups after the fatiguing exercise (-10.7 ± 6.8%, p < 0.02; -9.1 ± 8.7%, p < 0.02, respectively), with no difference in the number of repetitions performed between groups. The UT and RT men experienced a significant decrease in ITT after the fatiguing exercise bout (-14.2 ± 11.8%, p = 0.03; -7.8 ± 9.3%, p = 0.045, respectively). The UT group experienced a significant decrease in CAR (99.5 ± 0.8% to 91.4 ± 6.4%, p = 0.025) with no change (p > 0.05) in the RT group. There was also a fatigue-induced decrease in normalized EMG amplitude for the soleus and MG muscles in both groups (p < 0.05). However, no differences were determined between groups for ITT, CAR, or EMG. Despite similar reductions in MVC torque postexercise, the UT men had a significant decrease in CAR and experienced nearly twice the decline in ITT than the RT men. These results indicate that the neural adaptations associated with chronic resistance training may lead to less susceptibility to central fatigue as measured by ITT and CAR.

The purpose of this study was to examine the effects of a moderate dose of creatine monohydrate (CM) and two smaller doses of polyethylene glycosylated (PEG) creatine on muscular strength, endurance, and power output. Fifty-eight healthy men (mean +/- SD: age, 21 +/- 2 years; height, 176 +/- 6 cm; body mass [BM], 75 +/- 14 kg) volunteered and were randomly assigned to 1 of 4 groups: (a) placebo (PL; 3.6 g of microcrystalline cellulose; n = 15), (b) CM (5 g of creatine; n = 13), (c) small-dose PEG creatine (1.25 g of creatine: PEG1.25; n = 14), or (d) moderate-dose PEG creatine (2.50 g of creatine: PEG2.50; n = 16). Testing was conducted before (pre-) and after (post-) a 30-day supplementation period. Measurements included body mass, countermovement vertical jump (CVJ) height, power output during the Wingate test (peak power [PP] and mean power [MP]), 1 repetition maximum bench press (1RMBP), 1RM leg press (1RMLP) strength, and repetitions to failure at 80% of the 1RM for bench press (REPBP) and leg press (REPLP). BM and MP (W) increased (p

Purpose: The objective was to directly compare the strength of 6 different resorbable implant plating systems using an in vitro model before and after heating., Materials and Methods: Red oak wood was cut and fixated using various resorbable plates and screws. Vertical load was applied and the specimens fractured, while a test machine gathered data. This was repeated after heating of the specimens., Results: Several parameters were analyzed, and force versus displacement curves were plotted for each specimen., Conclusions: There were no statistically significant differences for total maximum loads between heat-treated and non heat-treated specimens. There were differences in strengths amongst the various systems.

Background: Ageing is associated with a significant reduction in skeletal muscle carnosine which has been linked with a reduction in the buffering capacity of muscle and in theory, may increase the rate of fatigue during exercise. Supplementing beta-alanine has been shown to significantly increase skeletal muscle carnosine. The purpose of this study, therefore, was to examine the effects of ninety days of beta-alanine supplementation on the physical working capacity at the fatigue threshold (PWCFT) in elderly men and women., Methods: Using a double-blind placebo controlled design, twenty-six men (n = 9) and women (n = 17) (age +/- SD = 72.8 +/- 11.1 yrs) were randomly assigned to either beta-alanine (BA: 800 mg x 3 per day; n = 12; CarnoSyntrade mark) or Placebo (PL; n = 14) group. Before (pre) and after (post) the supplementation period, participants performed a discontinuous cycle ergometry test to determine the PWCFT., Results: Significant increases in PWCFT (28.6%) from pre- to post-supplementation were found for the BA treatment group (p < 0.05), but no change was observed with PL treatment. These findings suggest that ninety days of BA supplementation may increase physical working capacity by delaying the onset of neuromuscular fatigue in elderly men and women., Conclusion: We suggest that BA supplementation, by improving intracellular pH control, improves muscle endurance in the elderly. This, we believe, could have importance in the prevention of falls, and the maintenance of health and independent living in elderly men and women.

Study Design: Repeated-measures experimental design., Objective: To examine the acute effects of different durations of passive stretching on the time course of musculotendinous stiffness (MTS) responses in the plantar flexor muscles., Background: Stretching is often implemented prior to exercise or athletic competition, with the intent to reduce the risk of injury via decreases in MTS., Methods and Measures: Twelve subjects (mean +/- SD age, 24 +/- 3 years; stature, 169 +/- 12 cm; mass, 71 +/- 17 kg) participated in 4 randomly-ordered experimental trials: control with no stretching, 2 minutes (2min), 4 minutes (4min), and 8 minutes (8min) of passive stretching. The passive-stretching trials involved progressive repetitions of 30-second passive stretches, while the control trial involved 15 minutes of resting. MTS assessments were conducted before (prestretching), immediately after (poststretching), and at 10, 20, and 30 minutes poststretching on a Biodex System 3 isokinetic dynamometer., Results: MTS decreased (P<.05) immediately after all stretching conditions (2min, 4min, and 8min). However, MTS for the 2min condition returned to baseline within 10 minutes, whereas MTS after the 4min and 8min passive-stretching conditions returned to baseline within 20 minutes., Conclusions: Practical durations of passive stretching resulted in significant decreases in MTS; however, these changes return to baseline levels within 10 to 20 minutes.

Purpose: To examine the time course (immediate, 10, 20, and 30 min) for the acute effects of 2, 4, and 8 min of passive stretching (PS) on isometric peak torque (PT), percent voluntary activation (%VA), EMG amplitude, peak twitch torque (PTT), rate of twitch torque development (RTD), and range of motion (ROM) of the plantarflexors., Methods: Thirteen volunteers (mean +/- SD age, 22 +/- 3 yr) participated in four randomly ordered experimental trials: control (CON) with no stretching, 2 min (PS2), 4 min (PS4), and 8 min (PS8) of PS. Testing was conducted before (pre), immediately after (post), and at 10, 20, and 30 min poststretching. The PS trials involved varied repetitions of 30-s passive stretches, whereas the CON trial included 15 min of resting. PT, %VA, EMG amplitude, PTT, and RTD were assessed during the twitch interpolation technique, whereas ROM was quantified as the maximum tolerable angle of passive dorsiflexion., Results: PT decreased (P < or = 0.05) immediately after all conditions [CON (4%), PS2 (2%), PS4 (4%), and PS8 (6%)] but returned to baseline at 10, 20, and 30 min poststretching. %VA and EMG amplitude were unaltered (P > 0.05) after all conditions. PTT and RTD decreased (P < or = 0.05) immediately after the PS4 (7%) and the PS8 (6%) conditions only; however, these changes were not sufficient to alter voluntary force production. There were also increases (P < or = 0.05) in ROM after the PS2 (8%), the PS4 (14%), and the PS8 (13%) conditions that returned to baseline after 10 min., Conclusion: Practical durations of stretching (2, 4, or 8 min) of the plantarflexors did not decrease isometric PT compared with the CON but caused temporary improvements in the ROM, thereby questioning the overall detrimental influence of PS on performance.

The purpose of the present study was to compare the mechanomyographic amplitude (MMG(RMS)) and mean power frequency (MMG(MPF)) vs. torque relationships during isometric ramp and step muscle actions for the vastus lateralis (VL) and rectus femoris (RF) muscles. Nineteen subjects (mean+/-S.D. age=24+/-4 years) performed 2 isometric maximal voluntary contractions (MVCs) before and after 2 or 3 isometric ramp muscle actions from (5-95% MVC) to 9 submaximal step muscle actions (15, 25, 35, 45, 55, 65, 75, 85, and 95% MVC). MMG signals were recorded from the VL and RF muscles, and MMG(RMS) and MMG(MPF) values were computed for each corresponding percentage of the MVC. Absolute and normalized MMG(RMS) and MMG(MPF) vs. torque relationships were analyzed and interpreted on a subject-by-subject and composite pattern basis using polynomial regression and repeated measures ANOVAs. For MMG(RMS) and MMG(MPF), only 16-53% and 11-26% of the individual responses were consistent with the composite polynomial models, respectively. In addition, the normalized composite MMG(RMS) values were greater for the RF than the VL from 35 to 85% MVC. Only 47% of the MMG(RMS) and 5% of the MMG(MPF) individual patterns of responses were the same for the ramp and step muscle actions, and differences were also observed for the composite MMG(RMS) and MMG(MPF) patterns between the ramp and step muscle actions. Overall, these findings indicated that the torque-related patterns of responses for MMG(RMS) and MMG(MPF) were different among subjects (i.e., inter-individual variability) and were muscle- (VL vs. RF) and mode-specific (ramp vs. step).

The purpose of this investigation was to study the effects of an 11-week training period performed by female weightlifters. Two weeks before this investigation, baseline measures for total testosterone, cortisol, and testosterone:cortisol ratio were collected. The 11-week training program consisted of the core exercises (i.e., clean, clean and jerk, and snatch) and other supplemental exercises (i.e., clean pull, snatch pull, squat, and front squat). Hormonal, isometric, and dynamic middle thigh pull force-time curve characteristics were assessed biweekly throughout the duration of the investigation, whereas volume load and training intensity were assessed weekly throughout the investigation. The testosterone:cortisol ratio of the baseline (1.19 +/- 0.64) was significantly different from the ratio of weeks 1 (0.67 +/- 0.36) and 9 (0.94 +/- 0.66). When the week-to-week values were compared, week 1 (0.67 +/- 0.36) was significantly different (P < 0.05; eta = 0.84) from week 3 (1.06 +/- 0.54). A very strong correlation (r = -0.83; r = 0.69) was found between the percentage change of the testosterone:cortisol ratio and volume load from weeks 1 to 11. Moderate to very strong correlations were noted between the percentage change in volume load and isometric peak force, peak force during the 30% isometric peak force trial, and peak force during the 100-kg trial during the 11 weeks of training. The primary finding of this study was that alterations in training volume load can result in concomitant changes in the anabolic-to-catabolic balance, as indicated by the testosterone:cortisol ratio, and the ability to generate maximal forces.

The purposes of this study were to examine the mechanomyographic (MMG) and electromyographic (EMG) time and frequency domain responses of the vastus lateralis (VL) and rectus femoris (RF) muscles during isometric ramp contractions and compare the time-frequency of the MMG and EMG signals generated by the short-time Fourier transform (STFT) and continuous wavelet transform (CWT). Nineteen healthy subjects (mean+/-SD age=24+/-4 years) performed two isometric maximal voluntary contractions (MVCs) before and after completing 2-3, 6-s isometric ramp contractions from 5% to 100% MVC with the right leg extensors. MMG and surface EMG signals were recorded from the VL and RF muscles. Time domains were represented as root mean squared amplitude values, and time-frequency representations were generated using the STFT and CWT. Polynomial regression analyses indicated cubic increases in MMG amplitude, MMG frequency, and EMG frequency, whereas EMG amplitude increased quadratically. From 5% to 24-28% MVC, MMG amplitude remained stable while MMG frequency increased. From 24-28% to 76-78% MVC, MMG amplitude increased rapidly while MMG frequency plateaued. From 76-78% to 100% MVC, MMG amplitude plateaued (VL) or decreased (RF) while MMG frequency increased. EMG amplitude increased while EMG frequency changed only marginally across the force spectrum with no clear deflection points. Overall, these findings suggested that MMG may offer more unique information regarding the interactions between motor unit recruitment and firing rate that control muscle force production during ramp contractions than traditional surface EMG. In addition, although the STFT frequency patterns were more pronounced than the CWT, both algorithms produced similar time-frequency representations for tracking changes in MMG or EMG frequency.

Context: Many elite athletes use increased daily training frequencies as a means to increase training load without substantial published literature to support this practice., Purpose: To compare the physiological responses to twice- and once-daily training sessions with similar training volumes., Methods: Ten nationally competitive male weightlifters (age 20.5 +/- 1.2 y, body mass 92.9 +/- 23.6 kg, training history 5.5 +/- 1.5 y) were matched on body mass and training experience, then randomly assigned to train either once or twice daily for 3 wk. Isometric knee-extension strength (ISO), muscle cross-sectional area, vertical-jump peak power, resting hormone concentrations, neuromuscular activation (EMG), and weightlifting performance were obtained before and after the experimental training period., Results: All dependent measures before the training intervention were similar for both groups. A 2-way repeated-measures ANOVA did not reveal any significant main effects (group or trial) or interaction effects (group x trial) for any of the dependent variables. There were also no significant group differences when parameters were expressed as percentage change, but the twice-daily training group had a greater percentage change in ISO (+5.1% vs +3.2%), EMG (+20.3% vs +9.1%), testosterone (+10.5% vs +6.4%), and testosterone:cortisol ratio (-10.5% vs +1.3%) than did the once-daily training group., Conclusions: There were no additional benefits from increased daily training frequency in national-level male weightlifters, but the increase in ISO and EMG activity for the twice-daily group might provide some rationale for dividing training load in an attempt to reduce the risk of overtraining.

Bernard-Soulier Syndrome (BSS) is a disease characterized by prolonged bleeding time, thrombocytopenia, and extremely large platelets and has a prevalence of less than 1 in 1,000,000. Patients with disorders of coagulation and bleeding can be among the most difficult surgical patients to manage. Perioperative hemorrhage can contribute to life-threatening complications in even the most routine surgical procedures. Because of the rarity of BSS, there are no well-defined protocols for the management of perioperative bleeding associated with this condition. Treatment with preoperative and intraoperative systemic aminocaproic acid, HLA-matched platelets, and topical gelfoam and thrombin resulted in sustained hemostasis and a durable healing response. For those rare few afflicted with this disease, we present a combined systemic and topical approach that may be helpful in the control and prevention of perioperative hemorrhage in this and other similar platelet disorders.

The purpose of this study was to examine the inter-individual variability in the patterns of responses for mechanomyographic (MMG) and electromyographic (EMG) amplitude and mean power frequency (MPF) of the vastus lateralis (VL) and rectusfemoris (RF) muscles during isometric ramp muscle actions of the leg extensors. Fifteen participants (mean +/- SD age = 24 +/- 4 years) performed two or three 6-s isometric ramp muscle actions with linear increases in torque from 15% to 90% of the highest maximal voluntary contraction (MVC) torque. Surface MMG and EMG signals were simultaneously recorded from the VL and RF muscles. The composite (averaged across subjects) and individual patterns of responses for the normalized MMG and EMG amplitude and MPF vs. isometric torque relationships were analyzed. The composite patterns for MMG amplitude for the VL and RF muscles were fit with cubic models, although, only 87% of the individual patterns (13 of 15 subjects) exhibited the same cubic pattern as the composite. For MMG MPF, the composite relationships were also cubic, but only 27% (4 subjects) and 40% (6 subjects) of the individuals exhibited the same patterns for the VL and RF respectively. 60% (8 subjects) of the individual EMG amplitude patterns of responses matched the same curvilinear composite patterns for the VL and RE, while only 7% (1 subject) and 27% (4 subjects) of the EMG MPF responses were similar to the composite models for the VL and RF muscles, respectively. Therefore, since the individual patterns did not always match the composite relationships (i.e., inter-individual variability), these findings suggested that the MMG and EMG amplitude and MPF vs. isometric torque relationships should be examined on a subject-by-subject and muscle-by-muscle basis during isometric ramp muscle actions.

The purpose of this study was to examine the inter-individual variability for the patterns of responses for mechanomyographic (MMG) amplitude and mean power frequency (MPF) versus isometric torque in lower-strength (LS) and higher-strength (HS) individuals. Twelve participants (mean +/- S.D. age = 25 + 4 years) performed two isometric maximal voluntary contractions (MVCs) before and after completing nine submaximal step muscle actions (15%, 25%, 35%, 45%, 55%, 65%, 75%, 85%, and 95% MVC) of the right leg extensors. MMG signals were recorded from the vastus lateralis muscle, and MMG amplitude and MPF values were computed for each corresponding percentage of the MVC. Polynomial regression analyses indicated that the composite MMG amplitude versus isometric torque relationship was best fit with a linear model (r(2) = 0.980) for the LS group and a cubic model (r(2) = 0.994) for the HS group. The composite MMG MPF versus isometric torque relationships were best fit with linear models for both the LS (r(2) = 0.529) and HS (r(2)=0.591) groups. However, only 66% of the individuals exhibited the same linear MMG amplitude patterns as the composite relationship for the LS group, whereas only 33% of the individual relationships were cubic for the HS group. Only one subject exhibited a positive linear (r(2) = 0.681) relationship for the MMG(MPF) versus isometric torque relationship for either the LS or HS groups. These findings suggested that strength differences do not affect the patterns of responses for MMG amplitude or MPF. The lack of consistency between the individual and composite patterns of responses suggested some degree of inter-individual variability. Therefore, future studies should examine the individual patterns of response to draw conclusions about motor control strategies.

The purpose of this study was to determine the effect resistance training has on metabolic economy during typical activities of daily living in a geriatric population. Twenty-nine men and women (age: 66.7 +/- 4.4 years, body mass: 72.3 +/- 11.9 kg) participated in a 26-week heavy-resistance training program. Before and after training, heart rate and expiratory gases were measured for subjects performing 3 tasks that would mimic common everyday activities encountered by this population: (a) walking (WLK) at 3 miles per hour (4.8 km x h(-1)), (b) carrying a box (CAR) to simulate holding a bag of groceries with 1 hand (30% of maximal isometric strength) while walking at 2 miles per hour (3.2 km x h(-1)), and (c) climbing stairs (STR). No time by gender interaction was observed for the WLK, CAR, and STR activities; consequently, the values for men and women were pooled. Both strength and fat-free mass increased significantly (p < or = 0.001) after the training protocol, whereas body mass remained constant. Oxygen cost decreased significantly by 6% (p < or = 0.05) only for CAR, whereas the respiratory exchange ratio decreased significantly (p < or = 0.05) for both WLK (0.84-0.81) and STR (0.87-0.83), and heart rate decreased significantly (p < or = 0.05) only for CAR. After the resistance training program, subjects also reported a significant decrease (p < or = 0.05) in perceived exertion during performance of all functional task test conditions. These results suggest that a heavy-resistance training program might affect exercise economy during daily tasks and improve ease of physical activity, thereby providing a possible mechanism for increasing quality of life in an older and geriatric population.

Six elite women weightlifters were tested to evaluate force-time curve characteristics and intercorrelations of isometric and dynamic muscle actions. Subjects performed isometric and dynamic mid-thigh clean pulls at 30% of maximal isometric peak force and 100 kg from a standardized position on a 61.0 x 121.9 cm AMTI forceplate. Isometric peak force showed strong correlations to the athletes' competitive snatch, clean and jerk, and combined total (r = 0.93, 0.64, and 0.80 respectively). Isometric rate of force development showed moderate to strong relationships to the athletes' competitive snatch, clean and jerk, and combined total (r = 0.79, 0.69, and 0.80 respectively). The results of this study suggest that the ability to perform maximal snatch and clean and jerks shows some structural and functional foundation with the ability to generate high forces rapidly in elite women weightlifters.

Objectives: It has been suggested that degranulating platelet alpha-granules release growth factors having a potential to modulate bone formation. The objective of this study was to evaluate the osteoconductive potential of a platelet-rich plasma (PRP) preparation., Methods: Thirty adult male Sprague-Dawley rats were used. The PRP preparation was obtained from 10 ml of whole blood drawn from one age-matched donor rat. The preparation was processed by gradient density centrifugation and stored at -80 degrees C until use. Using aseptic techniques, the PRP preparation soak loaded onto an absorbable collagen sponge (ACS) or ACS alone was surgically implanted into contralateral critical size 6-mm calvaria osteotomies in 18 animals. Twelve animals received ACS versus sham surgery in contralateral defects. Animals were sacrificed at 4 and 8 weeks when biopsies were collected for histologic and histometric analysis., Results: The animals were maintained without adverse events. Bone formation was highly variable in sites receiving PRP and control treatments. Defect bone fill at 4 weeks averaged (+/-SD) 28.8+/-27.4% (PRP/ACS) versus 39.1+/-24.4% (ACS; p=0.2626) and 62.0+/-20.0% (ACS) versus 71.6+/-32.2% (sham surgery; p=0.1088), and at 8 weeks 81.0+/-12.9% (PRP/ACS) versus 64.5+/-28.1% (ACS; p=0.2626) and 75.6+/-34.1% (ACS) versus 74.1+/-24.2% (sham surgery; p=0.7353). Remnants of the ACS biomaterial were observed at both 4 and 8 weeks in sites implanted with PRP/ACS or ACS., Conclusions: The results suggest that the PRP preparation has a limited potential to promote local bone formation.

Background: Platelet-rich plasma (PRP) harbors growth factors identified in bone. It has been suggested that these factors enhance osteogenesis. The objective of this study was to conduct a radiographic evaluation on local bone formation following surgical implantation of a PRP preparation using a critical-size rat calvaria defect model., Methods: Thirty 22-week-old male Sprague-Dawley rats were used. The PRP preparation was obtained from 10 ml of whole blood drawn from one age-matched donor rat. The preparation was processed by gradient density centrifugation and stored at -80 degrees C until use. Using aseptic techniques, the PRP preparation soak-loaded onto an absorbable collagen sponge (ACS) carrier or ACS alone was surgically implanted into contralateral critical-size 6 mm rat calvaria osteotomies in 18 animals. Twelve animals received ACS alone versus sham surgery in contralateral defects. Animals were sacrificed at 4 and 8 weeks when biopsies were collected and radiographs were obtained using a standardized protocol. Three masked examiners independently evaluated the radiographic images of the defect sites. Examiner reproducibility was examined by repeat evaluation of all defect sites (r=0.6; P <0.0001)., Results: The animals were maintained without adverse events. Defect sites in two animals receiving ACS versus sham surgery (4-week healing interval) were not evaluated due to specimen damage. Seventy-five percent of the sites (PRP/ACS or ACS) exhibited partial closure at 4 weeks; one site (ACS) exhibited full closure without significant differences between protocols (P=0.1797). Fifty percent of the sites receiving PRP/ACS exhibited full closure and 20% partial closure at 8 weeks versus 20% and 80%, respectively, for the ACS control (P=0.7532). There were no noteworthy differences between sites receiving ACS versus sham surgery at 4 or 8 weeks., Conclusion: The results suggest that the PRP preparation does not have a significant effect on osteogenesis., (J Periodontol 2005;76: 1287-1292.)

The purpose of this study was to assess the usefulness of the vertical jump and estimated vertical-jump power as a field test for weightlifting. Estimated PP output from the vertical jump was correlated with lifting ability among 64 USA national-level weightlifters (junior and senior men and women). Vertical jump was measured using the Kinematic Measurement System, consisting of a switch mat interfaced with a laptop computer. Vertical jumps were measured using a hands-on-hips method. A counter-movement vertical jump (CMJ) and a static vertical jump (SJ, 90 degrees knee angle) were measured. Two trials were given for each condition. Test-retest reliability for jump height was intra-class correlation (ICC) = 0.98 (CMJ) and ICC = 0.96 (SJ). Athletes warmed up on their own for 2-3 minutes, followed by 2 practice jumps at each condition. Peak power (PP) was estimated using the equations developed by Sayers et al. (24). The athletes' current lifting capabilities were assessed by a questionnaire, and USA national coaches checked the listed values. Differences between groups (i.e., men versus women, juniors versus resident lifters) were determined using t-tests (p < or = 0.05). Correlations were determined using Pearson's r. Results indicate that vertical jumping PP is strongly associated with weightlifting ability. Thus, these results indicate that PP derived from the vertical jump (CMJ or SJ) can be a valuable tool in assessing weightlifting performance.

Study Design: Case series., Objectives: The results of surgical treatment of osteomyelitis with anterior debridement and fusion followed by delayed posterior stabilization and fusion are presented., Methods: Forty-two patients with vertebral osteomyelitis are presented. There were 5 cervical, 12 thoracic, 1 thoracolumbar, 19 lumbar, and 5 lumbosacral lesions. The most frequently identified organism was Staphylococcus aureus. Most patients had significant comorbidities, including diabetes, or were immunocompromised. Ninety percent had elevated erythrocyte sedimentation rates and C-reactive proteins, while white blood cell counts were less reliably elevated. Imaging studies included radiographs, CT scans, and MRIs. All patients were treated with anterior debridement and strut grafting followed by 14.4 days of intravenous antibiotics and delayed instrumented posterior fusions and received 6 weeks of intravenous antibiotics after surgery., Results: All patients had resolution of their infections with no recurrence. There were two deaths. Neurologic deficits resolved in all patients. The diagnosis of pyogenic vertebral osteomyelitis is frequently delayed and presents a significant surgical challenge. The indications for surgical debridement were neurologic compromise, failed medical treatment, soft tissue extension, extensive vertebral body and disc space destruction, and progressive deformity. Many of these patients were severely ill at presentation and required urgent treatment. Anterior debridement and fusion followed by intravenous antibiotics allows for restoration of anterior column support and control of the infection before posterior instrumentation and fusion., Conclusion: This study demonstrates that anterior surgical debridement with fusion, followed by a period of intravenous antibiotics and delayed instrumented posterior fusion, is highly effective in the treatment of pyogenic osteomyelitis that has failed medical management.

To define the role of alpha/beta interferons (IFN-alpha/beta) in simian immunodeficiency virus (SIV) infection, IFN-alpha and IFN-beta mRNA levels and mRNA levels of Mx, an antiviral effector molecule, were determined in lymphoid tissues of rhesus macaques infected with pathogenic SIV. IFN-alpha/beta responses were induced during the acute phase and persisted in various lymphoid tissues throughout the chronic phase of infection. IFN-alpha/beta responses were most consistent in tissues with high viral RNA levels; thus, IFN-alpha/beta responses were not generally associated with effective control of SIV replication. IFN-alpha/beta responses were differentially regulated in different lymphoid tissues and at different stages of infection. The most consistent IFN-alpha/beta responses in acute and chronic SIV infection were observed in peripheral lymph nodes. In the spleen, only a transient increase in IFN-alpha/beta mRNA levels during acute SIV infection was observed. Further, IFN-alpha and IFN-beta mRNA levels showed a tissue-specific expression pattern during the chronic, but not the acute, phase of infection. In the acute phase of infection, SIV RNA levels in lymphoid tissues of rhesus macaques correlated with mRNA levels of both IFN-alpha and IFN-beta, whereas during chronic SIV infection only increased IFN-alpha mRNA levels correlated with the level of virus replication in the same tissues. In lymphoid tissues of all SIV-infected monkeys, higher viral RNA levels were associated with increased Mx mRNA levels. We found no evidence that monkeys with increased Mx mRNA levels in lymphoid tissues had enhanced control of virus replication. In fact, Mx mRNA levels were associated with high viral RNA levels in lymphoid tissues of chronically infected animals.

Ewing's Sarcoma (ES) is a malignant tumor, which arises primarily in children. Most commonly found in the long bones and pelvis, it rarely is found in the bones of the face. This is a report of ES of the mandible in a nine-year-old Caucasian female. Treatment for this malignancy included an incisional biopsy, chemotherapy and radiotherapy protocol to the involved area in accordance with St. Christopher's Hospital and the Children's Hospital of Philadelphia. The patient is currently disease-free and has been for approximately five years.

Reverse transcriptase real-time polymerase chain reaction was used to determine pro-inflammatory, anti-viral and immunoregulatory cytokine mRNA expression levels in peripheral blood mononuclear cells (PBMC) of healthy juvenile, adolescent and adult rhesus macaques. Few age-related changes in cytokine mRNA expression levels were observed. Expression of interleukin 2 and Mx, a type I interferon-inducible gene, decreased with age, whereas interleukin 4 and macrophage inflammatory protein 1 (MIP-1) alpha and beta mRNA levels increased in older monkeys. Independent of age, the pro-inflammatory cytokines [tumour necrosis factor alpha (TNF-alpha) and chemokines] were expressed at higher mRNA levels in PBMC than the immunoregulatory cytokines (interleukins 2, 4, 12). Pro-inflammatory cytokine mRNA expression levels were highest in lymphoid tissues draining mucosal surfaces. Thus, a correlation exists between cytokine mRNA levels in lymphoid tissues and the anatomical site., (Copyright 2001 Academic Press.)