Sports and training injuries in British soldiers: the Colchester Garrison Sports Injury and Rehabilitation Centre

OBJECTIVES: To record and analyse the injuries and conditions requiring referral to the Colchester Garrison Sports Injury and Rehabilitation Centre over a three year period, with special reference to type and site of injury, aetiology, and outcome. METHODS: An ongoing prospective study in which data on the diagnosis, cause of injury, and treatment of all patients referred to the Centre was coded and stored on a database. A total of seventeen variables were recorded. SUBJECTS: All patients were trained, serving soldiers in the British Army referred via their General Practitioner to the Sports Injury and Rehabilitation Centre. RESULTS: A total of 3921 referrals were made over the three-year period. The most common specific condition seen was low back pain (22.2%) followed by sprain of the ankle (15.1%). Lower limb conditions, both overuse and traumatic, accounted for over half (55.8%) of all referrals. Military training was the most common cause of all conditions (35.2%) followed by organised or personal sport (28.5%). In addition to medical treatment and physiotherapy, 30% of patients required formal rehabilitation. CONCLUSIONS: This is the first full review of the data collected by the Sports Injury and Rehabilitation Centre. It defines the injury patterns for trained soldiers rather than military recruits. Low back pain is identified as a major cause of morbidity in this population. The review serves as a benchmark in the planning of injury prevention strategies and the establishment of future rehabilitation services.     

The survivors of gastroschisis

AIMS: To assess the long term morbidity and quality of life in survivors of gastroschisis. DESIGN: All babies born with gastroschisis between 1972 and 1984 and who survived more than one year were identified. Those who could be traced were questioned about their general health, growth, abdominal symptoms, cosmetic concerns, education, employment, and fertility. RESULTS: Of the 35 patients, two have died, seven could not be traced, and three declined to be interviewed. Twenty three subjects (70% of survivors) with a median age of 16 years (range 12-23 years) responded. Twenty two (96%) were in good health and overall growth was within normal limits. Eight subjects (35%) have had further surgery related to gastroschisis, including two for adhesive small bowel obstruction and three for scar complications. In 13 (57%), absence of an umbilicus caused distress during childhood. CONCLUSION: Most gastroschisis survivors can eventually expect normal growth and good health. Adhesive bowel obstruction is an uncommon, but potentially late, complication. The umbilicus should be conserved during gastroschisis repair.     

Functional role of NMDA autoreceptors in olfactory mitral cells

The output of the olfactory bulb is governed by the interaction of synaptic potentials with the intrinsic conductances of mitral cells. While mitral cells often are considered as simple relay neurons, conveying activity in olfactory receptor cells to the piriform cortex, there is strong physiological and behavioral evidence that local synaptic interactions within the olfactory bulb modulate mitral cell discharges and facilitate odorant discrimination. Understanding the circuitry of the olfactory bulb is complicated by the fact that most dendrites in this region are both pre- and postsynaptic. Feedback inhibition is mediated through reciprocal dendrodendritic synapses between the secondary dendrites of mitral cells and GABAergic granule cells. Here we show that glutamate released from mitral cell dendrites also activates local N-methyl-D-aspartate (NMDA) autoreceptors, generating an inward tail current following depolarizing voltage steps. Autoreceptor-mediated self-excitation is calcium dependent, can be evoked by single action potentials in the presence of magnesium, and is graded with the number of spikes in a train. We find that dendrodendritic inhibition also is evoked by single action potentials but saturates rapidly during repetitive discharges. Self-excitation also underlies the prolonged afterdischarges apparent in mitral cells following potassium channel blockade. Both afterdischarges and autoreceptor-mediated tail currents persist in TTX, suggesting that they are produced by local rather than polysynaptic actions of glutamate. Blockade of NMDA autoreceptors with 2-amino-5-phosphonovaleric acid (APV) reduces the firing frequency within action potential cluster. The rapid kinetics of self-excitation suggests a functional role of NMDA autoreceptors in prolonging periods of phasic firing in mitral cells.     

Gamma-frequency excitatory input to granule cells facilitates dendrodendritic inhibition in the rat olfactory Bulb

Recurrent and lateral inhibition play a prominent role in patterning the odor-evoked discharges in mitral cells, the output neurons of the olfactory bulb. Inhibitory responses in this brain region are mediated through reciprocal synaptic connections made between the dendrites of mitral cells and GABAergic interneurons. Previous studies have demonstrated that N-methyl-D-aspartate (NMDA) receptors on interneurons play a critical role in eliciting GABA release at reciprocal dendrodendritic synapses. In acute olfactory bulb slices, these receptors are tonically blocked by extracellular Mg2+, and recurrent inhibition is disabled. In the present study, we examined the mechanisms by which this tonic blockade could be reversed. We demonstrate that near-coincident activation of an excitatory pathway to the proximal dendrites of GABAergic interneurons relieves the Mg2+ blockade of NMDA receptors at reciprocal dendrodendritic synapses and greatly facilitates recurrent inhibition onto mitral cells. Gating of recurrent and lateral inhibition in the presence of extracellular Mg2+ requires gamma-frequency stimulation of glutamatergic axons in the granule cell layer. Long-range excitatory axon connections from mitral cells innervated by different subpopulations of olfactory receptor neurons may provide a gating input to granule cells, thereby facilitating the mitral cell lateral inhibition that contributes to odorant encoding.     

Prevalence of Asherman's syndrome after secondary removal of placental remnants or a repeat curettage for incomplete abortion

This prospective study assesses the prevalence of intrauterine adhesions among women undergoing secondary removal of placental remnants after delivery, or a repeat curettage for incomplete abortions, and evaluates risk factors associated with the presence of intrauterine adhesions. In 50 women, undergoing either a secondary removal of placental remnants more than 24 h after delivery, or a repeat curettage for incomplete abortions, ambulatory hysteroscopy was performed 3 months after the intervention. Intrauterine adhesions were found in 20 of the women (40%): five patients had Asherman's syndrome grade I, six had grade II, six had grade III and three had grade IV. In women with menstrual disorders a statistically significant 12-fold increased risk for Asherman's syndrome grade II-IV was found. Previous abortion as well as infection during surgery were associated with a mildly but non-significant increased risk. Based on our findings, hysteroscopy is recommended only in those patients who develop menstrual disorders, either after secondary intervention for placental remnants after delivery or after a repeat curettage.      

可变误差多面体法用于多种维生素的同时测定

本文基于对多元校正分析模型的简要讨论,探索了应用可变误差多面体法同时测定维生索B₁,B₂,B₆和烟酰胺的可行性。其结果准确度和精密度均较满意。维生素B₁,B₂,B₆及烟酰胺的回收率分别是99.8±0.9%(CV),100.1±0.8%(CV),100.2±2.1%,100.1±0.7%(CV)。结果表明,通过公式K_S=A_SC_S^T(C_SC_S^T)^-1计算校正系数矩阵K_S,并结合可变误差多面体法这一直接求解方法,能有效地提高分析结果的准确度,克服组分间的交互作用及病态,是多元校正分析的较佳策略之一。     

Capillary transit time heterogeneity inhibits cerebral oxygen metabolism in patients with reduced cerebrovascular reserve capacity from steno-occlusive disease

The healthy cerebral perfusion demonstrates a homogenous distribution of capillary transit times. A disruption of this homogeneity may inhibit the extraction of oxygen. A high degree of capillary transit time heterogeneity (CTH) describes that some capillaries have very low blood flows, while others have excessively high blood flows and consequently short transit times. Very short transit times could hinder the oxygen extraction due to insufficient time for diffusion of oxygen into the tissue. CTH could be a consequence of cerebral vessel disease. We examined whether patients with cerebral steno-occlusive vessel disease demonstrate high CTH and if elevation of cerebral blood flow (CBF) by administration of acetazolamide (ACZ) increases the cerebral metabolic rate of oxygen (CMRO₂), or if some patients demonstrate reduced CMRO₂ related to detrimental CTH. Thirty-four patients and thirty-one healthy controls participated. Global CBF and CMRO₂ were acquired using phase-contrast MRI. Regional brain maps of CTH were acquired using dynamic contrast-enhanced MRI. Patients with impaired cerebrovascular reserve capacity demonstrated elevated CTH and a significant reduction of CMRO₂ after administration of ACZ, which could be related to high CTH. Impaired oxygen extraction from CTH could be a contributing part of the declining brain health observed in patients with cerebral vessel disease.     

球体培养人、猪肝细胞：一种理想的体外生物人工肝模式

体外培养的肝细胞有多种临床用途〔１〕。其中将肝细胞置入特殊的生物反应器,构建生物人工肝（ｂｉｏａｒｔｉｆｉｃｉａｌｌｉｖｅｒ,ＢＡＬ）支持系统有重要的临床价值。有研究报道,细胞聚集成多细胞的球体（ｓｐｈｅｒｉｏｄ）更类似于体内条件;并且可在有限的容积内高密度地培养肝细胞〔２〕。因此,我们实验构建人、猪肝细胞球体,并比较肝细胞普通培养与球体培养蛋白分泌功能的变化。１．材料和方法：试剂：Ｄｕｂｅｃｃｏ′ｓ磷酸盐缓冲液;Ｈａｎｋ′ｓ平衡盐;ＩＴＳ（胰岛素,运铁蛋白和硒,ｉｎｓｕｌｉｎ,ｔｒａｎｓｆｅｒ…