High-velocity low-amplitude thrust manipulation of the lumbar spine immediately modifies soleus T reflex in asymptomatic adults

BackgroundHigh-velocity low-amplitude thrust manipulations (HVLAM) are routinely used in osteopathic treatment. Despite the large number of studies that have been realized till now, the effects of spinal HVLAM on the physiological properties of muscles and nerves are not fully characterized.ObjectiveThe present study was designed to investigate the effects of a spinal lumbar L4/L5 HVLAM on the functional properties of the soleus T reflex in asymptomatic young adults.DesignControlled pre/post measures experimental design.MethodsRight and left soleus T reflexes were elicited by striking right and left Achilles tendons with an instrumented reflex hammer and the electromyographic (EMG) signals were monitored in right and left soleus muscles. The amplitude and latency of EMG responses were measured before and after the delivery of a HVLAM targeting the L4/L5 segment. The conduction velocity was calculated from the latency value.Subjects50 asymptomatic adults met all inclusion criteria. They were randomly allocated to either group a) receiving a sham manipulation (SM), or b) a HVLAM. Because of subject loss, the final size of SM and HVLAM groups was 24 and 18, respectively.ResultsOur data show that the conduction velocity, but not the amplitude of the T reflex, is significantly increased by HVLAM in both soleus muscles with small to medium effect size. SM neither changes the amplitude nor modifies the conduction velocity.ConclusionOur data show that a lumbar L4/L5 HVLAM modifies the electrophysiological properties of the soleus T reflex.     

Traumatic pathology of antibrachial interosseous membrane of forearm

The antibrachial interosseous membrane (IOM) is taught over an average length of 10.6cm between the diaphyses of the radius and ulna bone. It looks like a stitch with fibers running from the ulna to the radius and from proximal to distal and fibers running from distal to proximal. The central band, which is the middle part of the fibers directed from distal to proximal has mechanical properties similar to those of a ligament and act as a ligamentous structure embedded in the larger membranous complex of the IOM. The interosseous membrane has a double function: it stabilizes transversally the forearm's two bones and stabilizes longitudinally the two bones by transferring loads from the radius to the ulna. Load transmission varies according to the prono-supination position, the varus-valgus constraints on the elbow and the inclination of the wrist, making interpretation of the experimental data difficult. One should consider the forearm as a whole and the interosseous membrane with the two diaphyses should be regarded as a middle radio-ulnar joint, intercalated between the proximal and distal radio-ulnar joint. Those three articulations or links between radius and ulna act synergistically to stabilize and optimize repartition of loads. Functional loss of one of these links, and of course of more than one, will severely modify the forearm function. Essex-Lopresti lesion, which represents the functional loss of all three links, is the most destabilizing forearm lesion. Imaging of the interosseous membrane is difficult. MRI allows for static imaging of the interosseous membrane but there are often artifacts due to previous trauma or surgical procedures. Dynamic sonography helps to visualize all the lesions and will probably be part of the evaluation of every severe forearm injury. Surgical treatment depends on the gravity of the lesions of the different links. Interosseous membrane reconstruction is still the most difficult technique and most of the previously reported ligamentoplasties cannot answer all the biomechanical constraints. We describe a ligamentoplasty based on the biomechanics whose technique has been validated by cadaveric experiments. First surgical cases are promising.     

Screening of some African medicinal plants for antiulcerogenic activity: Part 1

Aqueous extracts of six plant species used in Cameroonian ethnomedicine for the relief of stomach complaints were tested for antiulcer activity. An HCl/EtOH solution was used to induce gastric lesions in male Wistar rats (140–190 g). The extracts of Voacanga africana, Eremomastax speciosa, Emilia praetermissa, Spilanthes filicaulis and Centella asiatica produced complete mucosal cytoprotection at a dose of 1000, 190, 500, 2000 and 500 mg/kg respectively. The extract of Clerodendrum splendens (500, 750, 1000 mg/kg) showed significant (p <0.01) dose-dependent cytoprotection (50%–75%) compared with the controls. A combination of C. asiastica and S. filicaulis (1:1) (250–500 mg/kg) did not reveal the therapeutic advantage of combining both plant extracts in the clinical management of stomach ulcers. © 1997 John Wiley & Sons, Ltd.     

Effects of in Utero Exposure of C57BL/6J Mice to 2,3,7,8-Tetrachlorodibenzo-p-dioxin on Epidermal Permeability Barrier Development and Function

Background: Development of the epidermal permeability barrier (EPB) is essential for neonatal life. Defects in this barrier are found in many skin diseases such as atopic dermatitis.Objective: We investigated the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the development and function of the EPB.Methods: Timed-pregnant C57BL/6J mice were gavaged with corn oil or TCDD (10 μg/kg body weight) on gestation day 12. Embryos were harvested on embryonic day (E) 15, E16, E17, and postnatal day (PND) 1.Results: A skin permeability assay showed that TCDD accelerated the development of the EPB, beginning at E15. This was accompanied by a significant decrease in transepidermal water loss (TEWL), enhanced stratification, and formation of the stratum corneum (SC). The levels of several ceramides were significantly increased at E15 and E16. PND1 histology revealed TCDD-induced acanthosis and epidermal hyperkeratosis. This was accompanied by disrupted epidermal tight junction (TJ) function, with increased dye leakage at the terminal claudin-1–staining TJs of the stratum granulosum. Because the animals did not have enhanced rates of TEWL, a commonly observed phenotype in animals with TJ defects, we performed tape-stripping. Removal of most of the SC resulted in a significant increase in TEWL in TCDD-exposed PND1 pups compared with their control group.Conclusions: These findings demonstrate that in utero exposure to TCDD accelerates the formation of an abnormal EPB with leaky TJs, warranting further study of environmental exposures, epithelial TJ integrity, and atopic disease.Citation: Muenyi CS, Leon Carrion S, Jones LA, Kennedy LH, Slominski AT, Sutter CH, Sutter TR. 2014. Effects of in utero exposure of C57BL/6J mice to 2,3,7,8-tetrachlorodibenzo-p-dioxin on epidermal permeability barrier development and function. Environ Health Perspect 122:1052–1058; http://dx.doi.org/10.1289/ehp.1308045     

Spoligotypes of Mycobacterium tuberculosis complex isolates from patients residents of 11 states of Brazil

One of the high tuberculosis (TB) incidence countries in the world, Brazil is characterized by considerable differences in TB incidence on regional and state level. In the present study, we describe Brazilian spoligotypes of 1991 Mycobacterium tuberculosis complex (MTC) clinical isolates from patients residents of 11 states from different regions of the country, diagnosed between 1996 and 2005. By performing spoligotyping on a large number of M. tuberculosis clinical isolates, one of the main objectives of this study was to determine the major genotype families causing TB in Brazil and to verify the region-associated genotype distribution. We observed a total of 577 distinct spoligopatterns, 12.6% of these corresponded to orphan patterns while 87.4% belonged to 326 shared-types (SITs). Among the latter, 86 SITs (isolated from 178 patients) had been observed for the first time in this study, the most frequent being SIT2517 which belonged to the T3-ETH lineage and was exclusively found among patients residents of Belém, the capital of the state of Pará (n=8 isolates). Irrespective of shared-type labeling, a total of 19.5% strains were unique (unclustered) in our study as opposed to 80.5% clustered isolates (189 clusters, size range from 2 to 205 isolates). The three largest clusters were SIT42 of the Latin-America & Mediterranean (LAM) 9 clade (10.3%), SIT53 of the T clade (7.6%), and SIT50 of the Haarlem clade (5.4%). The predominant MTC lineages in Brazil in decreasing order belonged to the LAM (46%); the ill-defined T (18.6%); the Haarlem (12.2%), the X (4.7%), the S (1.9%), and the East African Indian (EAI) (0.85%) families. The rest of clades grouped together as Mycobacterium africanum, Mycobacterium bovis, Beijing, Central Asian (CAS), and the Manu types, represented less than 1% of the strains. Finally, about 15% of the isolates showed spoligotype signatures that were not yet classified among well-defined lineages. In conclusion, we provide hereby a first insight into the population structure of MTC isolates in Brazil, showing the predominance of both LAM and T family and the existence of region-associated genotypes.