Nonoperative Management of Sublime Tubercle Fractures in Adolescent Throwing Athletes: Improved Results With Cast Immobilization.

Background: Avulsion fractures of the sublime tubercle of the ulna are a cause of medial elbow pain and instability in overhead athletes.

Purpose: To compare outcomes after sublime tubercle avulsion fracture managed as a fracture (with cast immobilization) versus a soft tissue injury (without immobilization and with early range of motion [ROM]) to determine how to achieve the best outcomes for these injuries in adolescent throwing athletes.

Study Design: Cohort study; Level of evidence, 3.

Management of Pediatric and Adolescent Sublime Tubercle Injuries: Isolated and Complex Patterns Demonstrate Distinct Etiologies and Radiographic Outcomes.

Background: The aim of this study was to assess the patient demographics, epidemiology, mechanism of injury, and natural history of sublime tubercle avulsion injuries.

Methods: A multicenter retrospective study was performed in which sublime tubercle avulsion injuries were identified by surgeon records and database query of radiology reports. Demographic data and imaging were reviewed for each case, and injuries were classified as type 1 (isolated injuries with a simple bony avulsion or periosteal stripping) or type 2 (complex injuries with an associated elbow fracture or dislocation).

A Simple and Versatile Test for Elbow Posterolateral Rotatory Instability.

Background: Posterolateral rotatory instability (PLRI) results from lateral ulnar collateral ligament (LCL) deficiency. The lateral pivot shift test is used to diagnose PLRI but can be difficult to perform and is poorly tolerated. We present a new maneuver, the Posterior Radiocapitellar Subluxation Test (PRST), that we believe is easier to perform.

Infection of a Retained Peripheral Nerve Stimulation Lead: A Case Report.

Percutaneous peripheral nerve stimulation is used to provide analgesia for weeks or even months. While infection of any percutaneously implanted object is a concern, it is exceedingly rare for helically coiled leads, with a reported incidence of less than 1 infection for every 32,000 indwelling days. We now report an infected helically coiled lead requiring sedation for extraction and complicated by lead fracture during removal, leaving a remnant in situ.

Recurrent Carpal Tunnel Syndrome Associated with Mycobacterium szulgai Infection: A Case Report.

Case: We present the case of an otherwise healthy 77-year-old male retired firefighter and recreational pheasant hunter who presented with recurrent symptoms of carpal tunnel syndrome and tenosynovitis because of Mycobacterium szulgai. He was initially treated unsuccessfully for a presumed seronegative rheumatologic flare, followed by surgical diagnosis and treatment including revision carpal tunnel release with tenosynovectomy, and a secondary debridement and wound closure. His symptoms resolved after several months of multidrug antibiotic therapy with only mild residual median nerve deficit.

A biomechanical assessment of tendon repair after radiofrequency treatment.

After acute tendon injury, rapid mobilization prevents adhesions and improves the ultimate strength of the repair. Radiofrequency (RF) ablation is proposed to enhance angiogenesis in the early stages of healing. The mechanism and effect of RF have not yet been described in an animal model of tendon injury.

Augmentation of tendon healing with butyric acid-impregnated sutures: biomechanical evaluation in a rabbit model.

Background: Butyric acid (BA) has been shown to be angiogenic and to enhance transcriptional activity in tissue. These properties of BA have the potential to augment biological healing of a repaired tendon.

Purpose: To evaluate this possibility both biomechanically and histologically in an animal tendon repair model.

Comparison of mechanical stability in double-row rotator cuff repairs between a knotless transtendon construct versus the addition of medial knots.

Purpose: Our purpose was to investigate the importance of medial-row knot tying to mechanical stability in a double-row rotator cuff repair by comparing a knotless construct with transtendon anchor passage versus a similar construct implementing medial knots.

Methods: A standard defect was created in the infraspinatus tendons of 14 bovine humeri. All defects were repaired with 2 medial and 2 lateral anchors (SutureCross System; KFx Medical, Carlsbad, CA).

The effect of kneeling during spine surgery on leg intramuscular pressure.

Background: Acute compartment syndrome has been an underreported complication during spine surgery with the patient positioned on the so-called 90/90 kneeling frame (with 90 degrees of both hip and knee flexion), presumably because of elevated intramuscular pressures in the dependent leg compartments. The purpose of the present study was to characterize and quantify certain parameters that affect the risk for acute compartment syndrome experimentally and to make objective comparisons with other spine surgery positions.

Methods: Eight healthy volunteers were positioned in three spine surgery positions: the 90/90 kneeling position, the so-called 45/45 suspended position (with the hips and knees both flexed to 45 degrees with the legs suspended on a sling), and the prone position.

Noninvasive measurements of intramuscular pressure using pulsed phase-locked loop ultrasound for detecting compartment syndromes: a preliminary report.

Objectives: To develop a human model for compartment tamponade and test the efficacy of ultrasonic pulsed phase-locked loop (PPLL) fascial displacement waveform analysis for noninvasive measurement of intramuscular pressure (IMP).

Design: Human subject experiment.

Setting: University Level 1 trauma center.

Paraspinal muscle vasculature contributes to posterolateral spinal fusion.

Study Design: Study of posterolateral fusions in a rabbit model.

Objectives: To characterize the contribution of paraspinal musculature to the healing of posterolateral spinal fusions in a rabbit model.

Summary Of Background Data: Previous studies have demonstrated that successful spinal arthrodesis requires vascular ingrowth from adjacent decorticated bone.

Reduced mechanical efficiency in chronic obstructive pulmonary disease but normal peak VO2 with small muscle mass exercise.

We studied six patients with chronic obstructive pulmonary disease (COPD) (FEV1 = 1.1 +/- 0.2 L, 32% of predicted) and six age- and activity level-matched control subjects while performing both maximal bicycle exercise and single leg knee-extensor exercise.

Effect of acute exercise on citrate synthase activity in untrained and trained human skeletal muscle.

Maximal citrate synthase activity (CS) is routinely used as a marker of aerobic capacity and mitochondrial density in skeletal muscle. However, reported CS has been notoriously variable, even with similar experimental protocols and sampling from the same muscles. Exercise training has resulted in increases in CS ranging from 0 to 100%.

Review: reticuloruminal motility--a pharmacological target with a difference?

The vagal sensory inputs to and motor outputs from the hindbrain gastric centres required for reticuloruminal motility were sampled directly in anaesthetized sheep using electrophysiological 'single fibre' techniques and indirectly in conscious, surgically prepared sheep. Drugs were administered by close-arterial injection into a carotid artery to observe central effects and into the coeliac artery to observe peripheral effects on the reticulorumen. Escherichia coli lipopolysaccharide produced intermediates responsible for the smooth muscle relaxation in the first phase of reticuloruminal stasis and for gastric centre depression in the second phase.

Adrenergic influence of uterine muscle contractions stimulated by a glycoside from the root of Dalbergia saxatilis.

The mechanism of uterine muscle contraction stimulated by a triterpenoid glycoside (dalsaxin) isolated from the root of D. saxatilis was investigated by in vitro methods in the rat. Dalsaxin caused a dose-related increase in uterine muscle contraction.

Transient global amnesia: a complication of incremental exercise testing.

Incremental exercise testing is routinely used for diagnosis, rehabilitation, health screening, and research. We report the case of a 71-yr-old patient with chronic obstructive pulmonary disease (COPD) who suffered an episode of transient global amnesia (TGA) several minutes after successfully completing an incremental exercise test on a cycle ergometer. TGA, which is known to be precipitated by physical or emotional stress in about one-third of cases, is a transient neurological disorder in which memory impairment is the prominent deficit.

Ultrastructural changes in the nerve fiber population of anastomosed vagal and spinal accessory nerves in the sheep.

Background: The ultrastructure of the vagal and spinal accessory nerves was studied 1) in normal sheep and 2) in sheep in which an experimental crossed-nerve anastomosis had been made by sectioning the supranodose vagal and spinal accessory nerves, then suturing the distal end of the vagal nerve to the distal end of the spinal accessory nerve, and allowing time for regeneration to occur. This study was carried out in order to analyze the modifications liable to occur when this technique is used and to specify the origin and the nature of the fibers that colonize the spinal accessory nerve.

Methods: The study was performed in 4- to 5-month-old-sheep.

The effects of intracoeliac injections of alpha-adrenergic agonists and veratridine on reticuloruminal motility and the evocation of rumination in sheep.

The ability of alpha-2 adrenoreceptor agonists and veratridine to evoke rumination and to modify reticular motility in adult Suffolk-cross sheep when injected by close-arterial injection into the forestomach was investigated. The specific alpha-2 adrenoreceptor agonists, xylazine and medetomidine, evoked rumination and increased reticular motility. The Na+ channel activator veratridine also evoked rumination and dramatically increased reticular motility.

Mechanoreceptors in the crop of the domestic fowl.

Electrophysiological "single fiber" experiments were conducted on the vagal nerves of the domestic fowl to confirm the presence of mechanoreceptors in the crop and to study their properties. The afferent activity of the left vagus nerve was recorded in nine anaesthetized laying hens with and without the crop being artificially distended. Twenty-two units were found to respond to the crop inflation, 18 of them being slowly adapting mechanoreceptors.

The effects of experimentally induced fever on the estimated blood flow to and oxygen utilization by the liver and the viscera drained by the portal vein in sheep.

Intrajugular injection of a purified E. coli lipopolysaccharide induced a biphasic fever in sheep after a latent period of 12 to 20 min. The changes in the blood flow from the liver and from the viscera drained by the portal vein were: (a) in the latent period, decreases in total hepatic blood flow (THF) due to decreased portal venous blood flow (PVF); (b) during the first febrile phase, increases in THF due to increased hepatic arterial blood flow and, (c) in the second febrile phase, decreases in THF due to decreased PVF.

Rumination in pregnant ewes.

The daily rumination time (DRT) and the nycterohemeral pattern of rumination were recorded in six ewes before mating and during late pregnancy and in one unmated ewe. The mean DRT was shorter during pregnancy (mean: 329 min/day) than before mating (mean: 435 min/day). The DRT of the unmated ewe remained constant.

The evocation of rumination in sheep by the close-arterial injection of catecholamines, cholinergic drugs, autacoids and gastrointestinal hormones into the forestomach.

The effect of alpha-2 adrenoreceptor agonists, cholinergic drugs, autacoids and some gastrointestinal hormones upon the evocation of rumination in sheep when injected by close-arterial injection into the forestomach was examined. Apart from adrenaline, noradrenaline, dopamine and xylazine only one alpha-2 agonist (BHT933) evoked rumination effectively. Acetylcholine, neostigmine, the gastrointestinal hormones and the autacoids examined did not evoke rumination consistently.

Dopamine-sensitive receptors that evoke rumination and modify reticulo-ruminal activity in sheep.

Dopamine (20 micrograms/kg) evoked rumination in sheep when injected as a bolus into the coeliac artery or into the left gastric artery but not when injected into the carotid artery. A mixed alpha-adrenoreceptor antagonist (phentolamine) and an alpha 2-adrenoreceptor antagonist (yohimbine) prevented dopamine from evoking rumination, but a dopaminergic antagonist (metoclopramide) did not. These findings suggest that dopamine stimulated rumination by acting upon alpha 2-adrenoreceptors situated in the area supplied by the left gastric artery, whereas dopamine injected intracerebrally may have evoked rumination by an alpha 2-adrenoreceptor effect in the central nervous system (Bueno et al.

Parotid secretion and associated efferent activity inhibited by pentagastrin in sheep.

The inhibition of parotid secretion by pentagastrin increased with dose for jugular and carotid injections (0.01-0.16 micrograms/kg) in acute preparations of 3 sheep anesthetized with sodium pentobarbital.