Mechanisms of orientation of the pelvifemoral base during static loading of the lumbar spine in weight-lifters

Summary Under static loading during weight-lifting, the lumbosacral spine essentially exhibits horizontalisation of the base of the sacrum (superior plateau of S1). We have attempted to elicit the mechanism of this horizontalisation by means of radiographs. These do not demonstrate any movements of the sacroiliac joints or plasticity of the hip bones. However, a symmetrical rotation of the hip joints conditions a retroversion of the pelvic girdle which explains the horizontalisation of the upper sacral plateau. This fixation of the block of the pelvic girdle is under muscular control, so that this mechanism can be improved by appropriate training.

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Mécanismes d'orientation du socle pelvi-fémoral au cours de la mise en charge statique du rachis lombaire chez l'haltérophile

Resumé Sous charge statique, chez l'haltérophile, le rachis lombosacré présente essentiellement une horizontalisation du plateau supérieur de S1. Par radiographies, nous avons tenté de déterminer le mécanisme de cette horizontalisation. Les mouvements au niveau de la sacro-iliaque et la plasticité des os coxaux ne peuvent pas être mis en évidence sur les radiographies. Par contre, une rotation symétrique des coxo-fémorales détermine une rétroversion de la ceinture pelvienne permettant d'expliquer l'horizontalisation du plateau sacré. Ce verrouillage du bloc de la ceinture pelvienne est sous la dépendance des muscles et en conséquence, ce mécanisme peut être amélioré par un entraînement approprié.

     

Identification and characterization of a de novo partial trisomy 10p by comparative genomic hybridization (CGH)

We report the characterization of a de novo unbalanced chromosome rearrangement by comparative genomic hybridization (CGH) in a 15-day-old child with hypotonia and dysmorphia. We describe the combined use of CGH and fluorescence in situ hybridization (FISH) to identify the origin of the additional chromosomal material on the short arm of chromosome 6. Investigation with FISH revealed that the excess material was not derived from chromosome 6. Identification of unknown unbalanced aberrations that could not be identified by traditional cytogenetics procedures is possible by CGH analysis. Visual analysis of digital images from CGH-metaphase spreads revealed a predominantly green signal on the telomeric region of chromosome 10p. After quantitative digital ratio imaging of 10 CGH-metaphase spreads, a region of gain was found in the chromosome band 10p14-pter. The CGH finding was confirmed by FISH analysis, using a whole chromosome 10 paint probe. These results show the usefulness of CGH for a rapid characterization of de novo unbalanced translocation, unidentifiable by karyotype alone.     

Hypothesis: primary antiangiogenic method proposed to treat early stage breast cancer

Background  

Women with Down syndrome very rarely develop breast cancer even though they now live to an age when it normally occurs. This may be related to the fact that Down syndrome persons have an additional copy of chromosome 21 where the gene that codes for the antiangiogenic protein Endostatin is located. Can this information lead to a primary antiangiogenic therapy for early stage breast cancer that indefinitely prolongs remission? A key question that arises is when is the initial angiogenic switch thrown in micrometastases? We have conjectured that avascular micrometastases are dormant and relatively stable if undisturbed but that for some patients angiogenesis is precipitated by surgery. We also proposed that angiogenesis of micrometastases very rarely occurs before surgical removal of the primary tumor. If that is so, it seems possible that we could suggest a primary antiangiogenic therapy but the problem then arises that starting a therapy before surgery would interfere with wound healing.     

P08 Comparing study in self-motivation learning： PBL vs LBL

In order to clarify which teaching form encourages student＇ s self-motivation learning ability better, we did a comparison experiment between problem-based learning （PBL）and lecture-based learning （LBL） in a 3rd year course in basic pharmacology. Of 224 students who participated （124 PBL, 100 LBL） in pharmacology course, the experimental group was divided into 6 teams（20 - 21 students for each team with one tutor）using PBL method with 7 clinical cases discussion while o.ther 100 students held in the same lecture-based format as the traditional LBL course as a control group. In 224 students, 50.4% using PBL method self-directed learning ability had increased compared with 35.3% in LBL teaching mode. The test score indicated that students using LBL teaching method scored overall higher than those using PBL mode, especially at objective items, this result was significant.. iy different（P =0.009）. However, as far as subjective items are concerned, students accepted PBL mode showed their superior advantages over the LBL ones. Similarly, the result was significantly different（ P =0.001 ）. On the whole, PBL method supported by appropriate technology and teachers, has allowed our students to analyze authentic situations as a doctor status and the active learning ability by self-motivation study will be undoubtedly beneficial for their becoming life-long learners and excellent doctors in the future.     

Optimal nutrition during the period of mechanical ventilation decreases mortality in critically ill, long-term acute female patients: a prospective observational cohort study

Introduction

Infusing arginine vasopressin (AVP) in vasodilatory shock usually decreases cardiac output and thus systemic oxygen transport. It is still a matter of debate whether this vasoconstriction impedes visceral organ blood flow and thereby causes organ dysfunction and injury. Therefore, we tested the hypothesis whether low-dose AVP is safe with respect to liver, kidney, and heart function and organ injury during resuscitated septic shock.

Methods

After intraperitoneal inoculation of autologous feces, 24 anesthetized, mechanically ventilated, and instrumented pigs were randomly assigned to noradrenaline alone (increments of 0.05 μg/kg/min until maximal heart rate of 160 beats/min; n = 12) or AVP (1 to 5 ng/kg/min; supplemented by noradrenaline if the maximal AVP dosage failed to maintain mean blood pressure; n = 12) to treat sepsis-associated hypotension. Parameters of systemic and regional hemodynamics (ultrasound flow probes on the portal vein and hepatic artery), oxygen transport, metabolism (endogenous glucose production and whole body glucose oxidation derived from blood glucose isotope and expiratory¹³CO₂/¹²CO₂ enrichment during 1,2,3,4,5,6-¹³C₆-glucose infusion), visceral organ function (blood transaminase activities, bilirubin and creatinine concentrations, creatinine clearance, fractional Na⁺ excretion), nitric oxide (exhaled NO and blood nitrate + nitrite levels) and cytokine production (interleukin-6 and tumor necrosis factor-α blood levels), and myocardial function (left ventricular dp/dt_max and dp/dt_min) and injury (troponin I blood levels) were measured before and 12, 18, and 24 hours after peritonitis induction. Immediate post mortem liver and kidney biopsies were analysed for histomorphology (hematoxylin eosin staining) and apoptosis (TUNEL staining).

Results

AVP decreased heart rate and cardiac output without otherwise affecting heart function and significantly decreased troponin I blood levels. AVP increased the rate of direct, aerobic glucose oxidation and reduced hyperlactatemia, which coincided with less severe kidney dysfunction and liver injury, attenuated systemic inflammation, and decreased kidney tubular apoptosis.

Conclusions

During well-resuscitated septic shock low-dose AVP appears to be safe with respect to myocardial function and heart injury and reduces kidney and liver damage. It remains to be elucidated whether this is due to the treatment per se and/or to the decreased exogenous catecholamine requirements.     

Open-label, long-term safety study of zonisamide administered to children and adolescents with epilepsy

BACKGROUND: Zonisamide is licensed in the EU and USA for the adjunctive treatment of partial-onset seizures in adults but there are few data about its use in children. AIMS: To assess the long-term safety and efficacy of zonisamide in children and adolescents. METHODS: Zonisamide-na?ve patients (n=109, aged 3-15 years, weight >or=12.5 kg) with a clinical diagnosis of epilepsy (>or=4 seizures/month, receiving 1-2 antiepileptic drugs [AEDs] daily) received zonisamide once or twice daily in an open-label trial. The starting dose was 1mg/kg/day, increased by 2 mg/kg/day every 1-2 weeks at the investigator's discretion to an initial maximum of 12 mg/kg/day. The occurrence of adverse events (AEs) was the primary safety measure. Efficacy was measured via the reductions in seizure frequency and via investigator- and carer-rated global assessment ratings. RESULTS: The mean dose received was 8.5 mg/kg/day. Of the 109 children, 52 (48%) completed 15 months' treatment. Treatment-related AEs, mostly mild-to-moderate in severity, were reported by 58 patients. Seven patients discontinued due to treatment-related AEs. Serious AEs (pancreatitis, decreased sweating, and vertigo) were reported by three patients. A significant (p=0.033) median reduction in 'all seizure' frequency of 2.60 seizures per week was observed. Additionally, a significant (p=0.029) median reduction of 1.80 seizures/week in 'complex partial' seizures was reported. Improvements in investigator- and carer-rated global assessments were noted. CONCLUSIONS: Zonisamide treatment was generally well tolerated and was associated with significant reductions in seizure frequency in this pediatric population with a variety of both partial and generalized medically refractory epilepsy syndromes.     

Birthweight and aerobic fitness in adolescents: the Northern Ireland Young Hearts Project

The purpose of this study was to examine relationships between aerobic fitness and birthweight in adolescents. A representative cohort of 1015 males and females aged 12 and 15 y was studied, at baseline, with 89% of the 12-y-olds being re-examined 3 y later.The main outcome measures were an index of aerobic fitness, measured in laps completed at voluntary exhaustion by a twenty-metre shuttle run test, and recorded birthweight. Multiple linear regression, with and without adjustment for known and potential confounding variables, was performed to examine associations between fitness and birthweight.Birthweight and aerobic fitness were positively related so that for each kg decrease in birthweight, there was a mean (95% confidence interval) decrease in fitness score of 4.84 (0.35 to 9.33) laps and 3.21 (0.32 to 6.10) laps, in 12-y-old boys and girls respectively. This relationship is of a similar order to the strength of association between birthweight and adult blood pressure previously reported. Associations between birthweight and physical fitness at the age of 15 were weaker and were not significant.Our findings suggest that aerobic fitness may be involved in mediating the association between birthweight and cardiovascular disease risk later in life. The weakening of the association between birthweight and fitness between the ages of 12 and 15 y is similar to the weaker associations between birthweight and blood pressure seen among adolescents compared to younger children. We are currently re-examining this cohort to see if, as with blood pressure, the association with fitness re-emerges at an older age.