Physical Education and its Role in School Health Promotion

In this article, the authors promote the concept of health-oriented physical education, discuss professional standards, examine the current status of physical education programs, and discuss trends affecting physical education. Recommendations to make physical education more effective are provided.     

Intravenous digital subtraction renal angiography: use in screening for renovascular hypertension

Intravenous digital subtraction renal angiography (DSRA) has been compared with conventional angiography only in small, selected series of hypertensive patients. The authors prospectively examined with intravenous DSRA 94 patients at increased risk for renovascular hypertension and compared these studies with conventional angiography. A stenosis of at least one main renal artery was identified with intravenous DSRA in 22 patients and confirmed in 20 patients. No significant stenoses were seen with conventional angiography in any of the 64 patients in whom lesions were not seen with intravenous DSRA. Since inadequate DSRA studies were considered positive for renal artery stenosis, the sensitivity of intravenous DSRA was 100% (25 of 25); specificity, 93% (64 of 69); positive predictive value, 83% (25 of 30); and negative predictive value, 100% (64 of 64). The authors conclude that intravenous DSRA is a sensitive test for identifying stenosis of the main renal arteries and is appropriate to use as a screening test among patients at increased risk for renovascular hypertension.     

Automatic control of anesthetic delivery and ventilation during surgery

Use of a closed rebreathing circuit for anesthesia delivery offers several advantages: conservation of anesthetic agent, natural heating and humidification of inspired gases, less pollution, and improved monitoring. However, the technique requires careful control of the fresh gas and anesthetic delivery. An anesthesia delivery system has been developed which automatically controls fresh gas delivery, anesthetic delivery, and ventilation in order to regulate circuit volume, oxygen concentration, end-tidal anesthetic concentration, and end-tidal PCO2. This system makes available the advantages of closed-circuit anesthesia without encumbering the anesthesiologist with its more demanding control tasks. The system has undergone clinical testing in adult surgical patients. Maintenance of circuit volume, oxygen concentration, end-tidal anesthetic concentration, and end-tidal PCO2 was achieved by the system in all patients but the first. The anesthetic delivery controller required tuning on the first patient. No further tuning was required for any of the other patients or controllers. During abdominal surgery, the end-tidal bellows position measurement and end-tidal anesthetic concentration measurement increased in variability. The cause of the variability and its elimination are discussed in the article.     

Perfluoroctylbromide as a contrast agent for computed tomographic imaging of septic and aseptic arthritis

Perfluoroctylbromide (PFOB), a perfluorocarbon macrophage-labeling contrast agent, was applied to computed tomographic imaging of septic and aseptic arthritis models in rabbits. Marked enhancement of induced pyarthrosis was observed in both the knee and the sacroiliac joint. Moderate enhancement was noted in tetracycline-induced synovitis of the knee. Sterile synovitis of the sacroiliac joint and simple knee joint effusion showed no enhancement. These results suggest that PFOB is a useful contrast medium for the diagnosis of and distinction between septic and sterile arthritis.     

Indacrinone (MK-196) - a specific inhibitor of the voltage-dependent CI- permeability in toad skin

The effect of indacrinone (MK-196) on Cl^- transport through toad (Bufo bufo) skin epithelium was studied by the voltage clamping technique. At the transepithelial potential, V = 50 mV (serosal bath grounded) the unidirectional fluxes, governed by a Cl^- self-exchange diffusion pathway, were not affected by 1 mM racemic MK-196 in the outer bath. Likewise at V = 0 mV, the unidirectional fluxes as well as the active (net) inward flux of Cl^- were unaffected by MK-196. Voltage clamping the epithelium in the physiological range of potentials activated a Cl^- specific passive conductance that saturated for V ±– 90 mV. The influx and efflux of Cl^- through this pathway were inhibited by MK-196, and the (passive) Cl^- current was inhibited in a dose-dependent way for [MK-196] ± 50 μM with about 70% inhibition for [MK-196] = I mM. The maximum Cl^- conductance was decreased without shifting the position along the V-axis of the inverted S-shaped conductance–voltage relationship. The time constants for the voltage-stimulated Cl^- conductance activation were not affected by MK-196 (50 μM ± [MK-196] ± 1 mM). The (+) and (–) isomers and racemic MK-196 affected the voltage-dependent Cl^- conductance in similar ways. It is concluded that MK-196 has the properties of a Cl^- channel blocker which is specific for the voltage-dependent Cl^- permeability of the epithelium. The time course for development of inhibition exhibited a fast (min) and a slow (h) component. The fast component may reflect a direct interaction of MK-196 with an extracellular site of the Cl^- channel, whereas the slow one may reflect impairment of a metabolic pathway regulating the Cl^- permeability, or an interaction of MK-196 with a cytoplasmic site of the anion permeation pathway.     

Perspective: three-dimensional imaging of the musculoskeletal system

An evaluation of musculoskeletal disorders in 202 patients using three-dimensional CT displays has revealed the usefulness of the technique, especially in patients with fractures of skeletal areas with complex anatomy, articular disorders of the hip, and spinal stenosis. In some cases, plastic models of diseased areas have been created from the CT data and are reasonably accurate, providing a graphic representation of the disease and the ability to perform rehearsal surgery. A preliminary investigation of three-dimensional displays of MR images indicates that the technique is feasible, although its clinical practicality requires further analysis.     

Lesions of the putamen: their relevance to dystonia

Two patients with acquired dystonia were studied by computed imaging techniques and found to have lesions predominantly involving the putamen. The implications of these findings are discussed, and it is concluded that, for the genesis of dystonia, a relative increase of other inputs to the pallidum may be important, such as those from the caudate and subthalamic nuclei.