Functional performance deficits in patients with CAI: validity of the multiple hop test.

OBJECTIVES: To investigate the reliability and validity of a functional performance test in patients with chronic ankle instability (CAI). DESIGN: Cross-sectional study. SETTING: All tests were conducted in the practice room of the physical therapy department of the Vrije Universiteit Brussel. PARTICIPANTS: Twenty-nine healthy subjects and 29 patients with CAI were selected. For the main outcome measurements, participants performed a multiple hop test two times, within a 1-week time interval. Subjects hopped on 10 different tape markers and had to try to avoid making any postural correction. Only when subjects stood still were they allowed to continue hopping. The time needed to complete the test and VAS scores for the perceived difficulty were assessed. RESULTS: In unstable ankles, ICCs of time values were >0.90 (SEM = 2.3 seconds); Spearman rho values of VAS scores were >0.80. When hopping on their unstable ankles, patients (41.1 +/- 12.6 seconds) needed significantly more time to complete the test than healthy subjects (31.4 +/- 5.0 seconds; test: P = 0.000; retest: P = 0.002) or when compared with their unaffected contralateral ankles (38.0 +/- 7.1 seconds; test: P = 0.047; retest: P = 0.009). Only with respect to the dominant ankles, patients (median = 64 mm) perceived the test as significantly more difficult than did healthy subjects (median = 37 mm; test: P = 0.018; retest: P = 0.002). VAS scores of unstable ankles in patients (median = 50 mm) were significantly higher than their contralateral, unaffected ankles (median = 30 mm; test: P = 0.001; retest: P = 0.002). CONCLUSIONS: The multiple hop test is a reliable test demonstrating functional performance deficits in patients with CAI.     

Identification of testosterone and progesterone in hemolymph of larvae of the fleshfly Sarcophaga bullata

Testosterone- and progesterone-like substances were detected by radioimmunoassay (RIA) in chromatographed extracts of hemolymph from larvae of Sarcophaga bullata (S.B.). Gas chromatographic (GC) analysis after heptafluorobutyric acid (HFBA) derivation of hemolymph extracts, purified by paper and silica gel column chromatography, showed a peak in the GC recordings with the same retention time as the HFBA derivative of pure testosterone. A testosterone concentration of 92 ng/100 ml hemolymph was found by GC; the concentration of progesterone, calculated on the basis of the RIA, was about two times higher. After preparing the o-pentafluorobenzyloxime (OPFB)-heptafluorobutyryl ester (HFB) derivatives of the hemolymph extracts, negative ion chemical ionization capillary gas chromatography-mass spectrometry (NCI/GC-MS) proved that hemolymph of larvae of the fleshfly Sarcophaga bullata indeed contains testosterone and progesterone. Several metabolites and precursors of the latter compounds could also be detected during the NCI/GC-MS analyses. Estrogens could not be traced by any of the methods we used. This is the first time that these steroids have been identified in insect hemolymph. These results add interesting perspectives for comparative endocrinology.     

Reliability and discriminative validity of sudden ankle inversion measurements in patients with chronic ankle instability

BackgroundStudies investigating peroneal muscle reaction times in chronically unstable ankle joints present conflicting results. The degree of reliability and accuracy of these measurements is unknown in patients with chronic ankle instability (CAI).Methods40 patients with CAI and 30 healthy subjects were tested using a sudden ankle inversion of 50° while standing on a trapdoor device. Sudden ankle inversion measurements were registered using electromyography, accelerometry and electrogoniometry. For reliability testing, intra-class coefficients (ICCs; model 3,1) and standard errors of measurements of the latency time, motor response time and electromechanical delay of the peroneus longus muscle, the time and angular position of onset of decelerations, the mean and maximum inversion speed and the total inversion time were calculated in 15 patients with CAI. To assess between-group differences, t-tests for independent samples (p < .05) were used.ResultsICCs ranged from .20 (angular position of onset of the second deceleration) to .98 (electromechanical delay of the peroneus longus muscle). Significant between-group differences were observed in only 2 of the 12 variables (for the electromechanical delay of the peroneus longus muscle, p = .001; time of onset of the second deceleration, p = .040).ConclusionsThe latency time and motor response time of the peroneus longus muscle, the total inversion time and the mean inversion speed demonstrate acceptable reliability in healthy subjects and patients. The latency time and motor response time of the peroneus longus muscle are not delayed in patients with CAI. Ankle inversion measurements are not discriminative for CAI.     

The subcellular localization of the neu protein in human normal and neoplastic cells

We have examined the subcellular localization of the neu protein by immunohistochemistry and immuno-electron microscopy, associated with immunoblotting of normal and neoplastic tissues with 2 monoclonal antibodies (MAbs). Immunoelectron microscopy clearly reveals that neu protein resides only on the lateral plasma membrane of the simple epithelium of the breast and on the plasma membrane of malignant breast cells. It is also found on the membranes of the microvilli and the apical vacuoles of the cells of the proximal convoluted tubule of the kidney. In the cytoplasm, the only immunoreactivity detected with both antibodies was on the membrane of the mitochondrial cristae of normal and malignant cells. Immunoblotting reveals that the molecular weight of the membrane protein is 185 and 155 kDa for the mitochondrial protein. The cell membrane staining pattern can be revealed by light microscopic immunohistochemistry only in malignant cells and is therefore specific for malignancy. The membrane expression in normal cells cannot be visualized in this way. The mitochondrial reactivity appears as a cytoplasmic granular staining when examined under the light microscope. Similar cytoplasmic staining has been described previously in other studies with other antibodies against the neu protein and has lead to speculation about its function in normal and malignant cells. However, it is demonstrated in this study that it is not the known neu-oncogene product.     

The chronic ankle instability scale: Clinimetric properties of a multidimensional, patient-assessed instrument

ObjectiveTo construct the chronic ankle instability scale (CAIS) and evaluate its clinimetric properties.Design/settingValidation study. The test procedure was conducted at the University Hospital of the Vrije Universiteit Brussel, Brussels, Belgium.ParticipantsTwenty-nine patients with chronic ankle instability (CAI) were selected.Main outcome measuresContent validity, test–retest reliability, internal consistency, floor-ceiling effects, construct validity and the minimal detectable change of the CAIS were investigated.ResultsAfter final item reduction, the CAIS contains 14 items. Weighted kappa coefficients of the items ranged from .50 to .94. The intraclass correlation coefficient for the total score was .84 (p<.05). The standard error of measurement of the total score was 2.7 points; the minimal detectable change 4.7 points. Cronbach alpha coefficients for the subscales ranged from .62 to .80.The “impairments” subscale score of the CAIS did not correlate significantly with talar tilt values (Rho respectively −.05 and −.07; p>.05). The “disabilities” subscale score of the CAIS correlated significantly with both the timed test performance (Rho respectively −.38 and −.40; p<.05) and the perceived difficulty of the multiple hop test (Rho respectively −.41 and −.49; p<.05).ConclusionThe CAIS is a valid and reliable instrument for quantifying the multidimensional profile of patients with CAI. Future research should investigate the responsiveness of the CAIS and determine its minimally clinical important difference.