Biomechanical and Neuromuscular Effects of Ankle Taping and Bracing

OBJECTIVE: An extensive review of clinically relevant research is provided to assist clinicians in understanding the underlying mechanisms by which various ankle-support systems may provide beneficial effects. Strategies for management of different types of ankle ligament conditions are also discussed. BACKGROUND: Much of the literature pertaining to ankle instability and external support has focused on assessment of inward displacement of the hindfoot within the frontal plane. Some researchers have emphasized the importance of (1) pathologic rotary displacement of the talus within the transverse plane, (2) the frequent presence of subtalar joint ligament lesions, and (3) the interrelated effects of ankle support on deceleration of inversion velocity and facilitation of neuromuscular response. DESCRIPTION: The traditional method for application of adhesive tape to the ankle primarily restricts inward displacement of the hindfoot within the frontal plane. The biomechanical rationale for a method of ankle taping that restricts lower leg rotation and triplanar displacement of the foot associated with subtalar motion is presented. CLINICAL ADVANTAGES: The lateral subtalar-sling taping procedure may limit strain on the anterior talofibular ligament associated with subtalar inversion, restrain anterolateral rotary subluxation of the talus in the presence of ligament laxity, and protect the subtalar ligaments from excessive loading. The medial subtalar sling may reduce strain on the anterior-inferior tibiofibular syndesmosis and enhance hindfoot-to-forefoot force transfer during the push-off phase of the gait cycle.     

Pulmonary O2 uptake on-kinetics in rowing and cycle ergometer exercise

The purpose of this study was to characterise, for the first time, the pulmonary O2 uptake (V(O2)) on-kinetic responses to step transitions to moderate and heavy intensity rowing ergometer exercise, and to compare the responses to those observed during upright cycle ergometer exercise. We hypothesised that the recruitment of a greater muscle mass in rowing ergometer exercise (Row) might limit muscle perfusion and result in slower Phase II V(O2) kinetics compared to cycle exercise (Cyc). Eight healthy males (aged 28+/-5 years) performed a series of step transitions to moderate (90% of the mode-specific gas exchange threshold, GET) and heavy (50% of the difference between the mode-specific GET and V(O2) max) work rates, for both Row and Cyc exercise. Pulmonary V(O2) was measured breath-by-breath and the V(O2) on-kinetics were described using standard non-linear regression techniques. With the exception of delta V(O2)delta WR which was approximately 12% greater for Row, the V(O2) kinetic responses were similar between the exercise modes. There was no significant difference in the time constant describing the Phase II V(O2) kinetics between the exercise modes for either moderate (rowing: 25.9+/-6.8 s versus cycling: 25.7+/-8.6 s) or heavy (rowing: 26.5+/-3.0 s versus cycling: 27.8+/-5.1s) exercise. Furthermore, there was no significant difference in the amplitude of the V(O2) slow component between the exercise modes (rowing: 0.34+/-0.13 L min(-1) versus cycling: 0.35+/-0.12 L min(-1)). These data suggest that muscle V(O2) increases towards the anticipated steady-state requirement at essentially the same rate following a step increase in ATP turnover in the myocytes, irrespective of the mode of exercise, at least in subjects with no particular sport specialism. The recruitment of a greater muscle mass in rowing compared to cycling apparently did not compromise muscle perfusion sufficiently to result either in slower Phase II V(O2) kinetics or a greater V(O2) slow component amplitude during heavy exercise.     

Ribosomal DNA ITS2 sequences differentiate six species in the Anopheles crucians complex (Diptera: Culicidae)

Anopheles crucians Wiedemann (sensu lato) was investigated for the presence of cryptic species using rDNA ITS2 sequences. This complex of species presently contains the named species An. crucians, An. bradleyi King, and An. georgianus King. Adult female mosquitoes were collected at 28 sites in Alabama, Florida, Georgia, North Carolina, Mississippi, and Louisiana, resulting in 245 progeny broods. Species were identified using preliminary morphological characters, and the internal transcribed spacer two (ITS2) was amplified from all broods. The result was five distinct sizes of amplification product, and based on morphological characters, one of the size classes was suspected to consist of two species. All six putative species were then sequenced: five directly, and the sixth, because of extreme intragenomic (each individual with many variants) size variability, cloned. The ITS2 sequences were markedly distinct for all six species. Species designations and ITS2 sequence lengths (base pairs in parentheses) were A (461), B (1,000+), C (204), D (293), E (195), and An. bradleyi (208). Species B showed both large intraspecific and intragenomic sequence variability and is distinguished by having the longest ITS2 found so far in an Anopheles. Based on these data, we found that all species could be identified with polymerase chain reaction (PCR) using a mixture of four primers in a single reaction. Members of this complex were often found in sympatry, with the adults of five species collected at a single site in central Florida.     

New technique for stabilizing umbilical artery catheters in very low birthweight infants

The securing of umbilical artery catheters (UACs) with tape bridges has been associated with significant dermal complications in the very low birthweight neonate. We describe a new technique for UAC stabilization using an anchoring adhesive tape applied directly to the catheter, which is in turn sutured to the cord. This technique provides a very satisfactory method of UAC stabilization and avoids skin complications associated with the standard methods.     

Inhibition of human corneal epithelium with immunotoxin 454A12-rRA.

We examined the effects of the immunotoxin 454A12-rRa on proliferating and confluent human corneal epithelium (HCE) in vitro. Proliferating HCE was sensitive to 454A12-rRA in a dose-dependent fashion. At immunotoxin concentrations of 1,000 ng/ml for 7 days we observed an 86% reduction in cell counts. Confluent HCE was not sensitive to 454A12-rRA at equivalent concentrations of immunotoxin. These data confirm previous observations regarding selective sensitivity of proliferating ocular tissue to immunotoxin, but suggest that HCE is less sensitive to 454A12-rRA than other ocular cell types.     

VH and VL gene analysis in sporadic Burkitt's lymphoma shows somatic hypermutation, intraclonal heterogeneity, and a role for antigen selection

Tumor cell lines and one tumor biopsy from seven cases of Epstein-Barr virus (EBV) genome-negative sporadic Burkitt's lymphoma (BL) have been investigated for usage and mutational pattern of Ig variable region genes. The VH genes were derived from the VH 3 (one) and VH4 (six) families and both the IgM-positive (six) and the IgA-positive (one) were all mutated from their germline counterparts. The VL genes were derived from V kappa 1 (one), V kappa 3 (one), V lambda 1 (four), and V lambda 2 (one) families and were also somatically hypermutated. Biopsy material from one of the IgM-positive cases showed VH and VL sequences that matched the derived cell line, with additional intraclonal sequence heterogeneity, indicating that the tumor cells had undergone posttranformation somatic mutation. Mutational patterns in V(H) genes did not show a conventional role for antigen in selecting tumor cell sequences. In contrast, patterns in VL sequences were consistent with a role for antigen in five of seven cases. The pattern of extensive scattered somatic hypermutation and intraclonal variation is similar to that in VH sequences of EBV genome-positive endemic BL, although the degree of mutational activity is less. These common features indicate that B cells involved in the two variants of BL may share a common clonal history.     

An association between aerobic fitness and lung closing volume

This study was performed to determine whether an association exists between relative aerobic fitness (fitness index) and lung closing volume (CV). The subject population consisted of 100 healthy nonsmoking adults (50 males and 50 females) divided equally into five age groups; 20-29, 30-39, 40-49, 50-59, and over 60 years. Each subject underwent four to six closing volume and forced vital capacity (FVC) tests followed by a modified Balke maximal oxygen uptake test on a motor-driven treadmill with a constant treadmill speed. Relative VO2 maximum (VO2 max, mlO2 X kg-1 X min-1) was determined from the exercise test and was used to define subject rank on the fitness index. CV, as a % of slow vital capacity (SVC), had a negative linear correlation (r = -0.53, P less than 0.05) with the fitness index. Slope of phase III (%N2/L) and FEV1/FVC (forced expired volume in 1 s as a % of forced vital capacity) also had significant correlation coefficients (r = -0.31, r = 0.24, respectively; both P less than 0.05) with the fitness index. The correlation coefficients, with age partialled from the relationships, between FVC/body weight (kg) and VO2 max were r = 0.59 for females and r = 0.43 for males (P less than 0.05, both groups). We hypothesize that the effects of aerobic fitness on lung function may be the result of changes in autonomic nervous system activity and may represent a situation where a high level of aerobic fitness affects the aging process of the lung beta-adrenergic nervous system.     

Demographic and socioeconomic differences in beliefs about the health effects of smoking.

To assess sociodemographic differences in beliefs about the health effects of cigarette smoking and passive smoke exposure, we recently surveyed 2092 adults in St. Louis and Kansas City, Mo. The percentages of respondents who knew that smoking causes lung cancer, emphysema, and heart disease were 76.7, 74.1, and 67.2, respectively. After multivariate adjustment, knowledge about smoking's health effects was generally lower among women, older respondents, those of lower education level, and current smokers. Blacks were generally less likely to appreciate the health effects of active smoking, but were more likely to acknowledge the health effects of passive smoking.     

Intraoperative cytology of osseous lesions

Cytologic preparations were made from 53 biopsies of osseous and related lesions submitted for intraoperative diagnosis. Smears made by scraping the surface of the lesion and spreading the material obtained on a glass slide were most commonly used. These preparations were found to be valuable adjuncts to frozen sections because cytologic details were so much more clearly visible. Among specific diagnostic features found to be particularly helpful were the large numbers of nuclei found in most of the multinucleated cells from giant-cell tumors but in few osteoclasts from other lesions; the metachromatic staining of osteoid in air-dried, Romanowsky-stained smears from osteosarcomas; and the ease with which multinucleated cells can be identified in smears from chondrosarcomas. The characteristic appearance of chondroblasts from a chondroblastoma; the distinctive appearances of osteoclasts and multinucleated histiocytes from eosinophilic granulomas; the unique appearance of synovial cells from pigmented synovitis; and the ease with which small cells of a metastatic carcinoma could be distinguished from hematopoietic bone-marrow cells were other significant findings. These and other features of the lesions encountered are presented in greater detail.