Practice guidelines for anterior cruciate ligament rehabilitation: a criterion-based rehabilitation progression

Knowledge related to the anterior cruciate ligament (ACL) and its role in the stabilization of the knee has increased exponentially since the 1980 s. More precise and more anatomic surgical techniques have developed based on a growing body of literature on the anatomy and biomechanics of the anterior cruciate ligament. The rehabilitation arena has also risen to the challenge to provide state-of-the-art rehabilitation to complement advances in surgical stabilization. The understanding and integration of the abundance of literature on surgical reconstruction, graft biology, and behavior guides the design and progress of the rehabilitation program. Effective rehabilitation after anterior cruciate ligament reconstruction must balance the loading of tissues necessary to stimulate the recovery of the knee while at the same time avoiding stresses that compromise graft integrity. Historically, rehabilitation programs have been temporally based. A performance-based decision-making approach may prove to be more universally applicable and less confining. Achieving the critical clinical milestones, the basis for rehabilitation progression, ensures that all patients are adequately challenged while at the same time assuring that none are progressed too quickly. Combining contemporary surgical and rehabilitation techniques will maximize the patient's potential and ensure optimal patient function and satisfaction.     

Induction of Fos-like immunoreactivity (Fos-li) and stimulation of feeding by 2, 5-anhydro-d-mannitol (2, 5-AM) require the vagus nerve

The antimetabolic fructose analogue, 2, 5-anhydro-d-mannitol (2, 5-AM), stimulates feeding. Selective hepatic branch vagotomy has been shown to block feeding induced by low 2, 5-AM doses. However, hepatic vagal fibers are not the sole mediators of 2, 5-AM-induced feeding, since hepatic branch vagotomy does not impair feeding induced by higher doses of 2, 5-AM. To further evaluate the role of the vagus in the response to 2, 5-AM, we examined the effect of total subdiaphragmatic vagotomy on feeding induced by a high 2, 5-AM dose (500 mg/kg). In addition, we assessed the ability of 2, 5-AM (300 and 500 mg/kg) to induce Fos-like immunoreactivity (Fos-li) in the brain in sham-operated (SHAM), hepatic branch vagotomized (HBV) and total subdiaphragmatic vagotomized (TSDV) rats. Both doses of 2, 5-AM, but not control solutions, induced Fos-li in the area postrema (AP), nucleus of the solitary tract (NTS) and lateral parabrachial nucleus (IPBN). Very weak immunoreactivity was present in the central nucleus of the amygdala and none was observed in the locus coeruleus or paraventricular nucleus of the hypothalamus. The effect of the lower 2, 5-AM dose on Fos-li was blocked by HBV. The high dose effect was blocked by TSDV but not by HBV. Feeding induced by the high dose of 2, 5-AM was also blocked by TSDV. Results are consistent with the hypothesis that stimulation of feeding by 2, 5-AM is dependent on the vagus nerve. Hepatic branch fibers may have the lowest threshold for activation, but fibers in other vagal branches independently mediate induction ofc-fos and stimulate food intake at higher doses of the analogue.     

Epidemiology of intestinal helminthiasis (necatoriasis, taeniasis, ascariasis, trichuriasis) in the Kaya Region (Upper-Volta)

Prevalence of intestinal helminthiasis: 1 223 stool specimens are examined in Louda and 690 in Damesma (Kaya, Upper-Volta). In this sample eggs of N. americanus are seen in 14,7% of the specimens in Louda and 9,3% in Damesma. Eggs of H. nana are seen in 10% of the specimens, for the two villages. Eggs of T. saginata are seen in 7.4% of the specimens of the two villages. And eggs of A. lumbricoides, T. trichicera are found inters then 0.5% of the specimens.     

Effect of enterally administered ornithine alpha-ketoglutarate on plasma and urinary amino acid levels after burn injury

Eight severely burned patients received 10 grams twice a day of enterally administered ornithine alpha-ketoglutarate. Variations in their plasma and urinary amino acid levels were compared with those from six severely burned control patients. The study covered the period from the fourth day to the twenty-eighth day after injury. Essential differences between the two groups were that plasma ornithine and proline increased until day 13 in the treated group, plasma phenylalanine levels were higher in the control group except on day 13, the peak, on the twenty-first day, in plasma concentrations of valine, leucine, isoleucine, tyrosine, lysine, proline, and ornithine, in the control group was not found in treated subjects, and urinary amino acids were lower on day 28 in the treated group. These results suggest that ornithine alpha-ketoglutarate administration lowered protein catabolism after injury, probably through a process mediated by increased secretion of insulin and human growth hormone.     

Sterol and bile acid metabolism during development. 3. Occurrence of neonatal hypercholesterolemia in guinea pig and its possible relation to bile acid pool

The relationship of the changes in plasma cholesterol to bile acid pool was studied in the newborn guinea pig. Plasma cholesterol reached the maximum on the fifth day and gradually declined to adult levels. The cholesterol concentration in the high density lipoproteins (HDL) was higher in the newborn guinea pig than in the adult. Plasma triglycerides peaked on the third day and decreased markedly. The bile acid pool increased progressively after birth with a 13-fold increase at 5 days of age. While the hepatic triglycerides decreased sharply in the newborn guinea pig, hepatic cholesterol increased in the first 5 days and then decreased to adult levels. This study has described the occurrence of “neonatal hypercholesterolemia” in the guinea pig and its possible relationship to the low level of bile acid synthesis.     

Processing of complex heteroduplexes in Escherichia coli and Cos-1 monkey cells.

Upon transformation into Escherichia coli or Cos-1 monkey cells, heteroduplex DNA made of two sequences containing many nucleotide mismatches yields a wide array of different molecules, some with a patchwork structure. Thus, complex heteroduplexes can be processed to generate many genetic variants.