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Biomedical subjects

A Eller

Publications and source records attributed to A Eller.

14 recordsLinked to original sources

The anterior glenohumeral joint capsule: macroscopic and MRI anatomy of the fasciculus obliquus or so-called ligamentum glenohumerale spirale.

The purpose of this study was to demonstrate the macroscopic and MRI anatomy of the fasciculus obliquus, otherwise known as the ligamentum glenohumerale spirale or spiral GHL of the anterior shoulder joint capsule. Conventional and MR arthrography (1.5-T device Somatom Symphony, Siemens with shoulder coil) images in standard planes were compared with gross anatomic dissection findings in six fresh shoulder specimens from three cadavers. The MR imaging protocol included T1, PD and DESS 3D WI sequences. The macroscopically recognisable band-the spiral GHL-was identified by anatomic dissection and MRI in all the specimens. It was best visualised by MR arthrography on axial and oblique sagittal planes (T1; PD WI) and appeared as a low signal intensity stripe within the superficial layer of the anterior joint capsule. The absence of the variable middle glenohumeral ligament did not influence the anatomic properties and the MR imaging of the spiral GHL. Diagnostic visualisation of the normal anatomic structures is a prerequisite to distinguish between normal and pathologic conditions. Anatomy of the spiral GHL can be used by radiologists for more detailed interpretation of the anterior shoulder joint capsule ligaments on MR images.

Aged↗

Anatomical composition of the anterior shoulder joint capsule. A cadaver study on 12 glenohumeral joints.

Twelve right cadaver shoulder joints were investigated after alcohol-formalin-glycerol fixation. The tendons of the "rotator cuff" were separated from the joint capsule. The capsulo-ligamentous structures: Lig. coracohumerale, Lig. coracoglenoidale and Ligg. glenohumeralia were dissected. In addition to the Ligg. glenohumerale superius, medium et inferius, an "unknown glenohumeral ligament" coursed in the midline of the superficial layer of the anterior shoulder joint capsule. It arose from the axillary part of the Lig. glenohumerale inferius and the insertion tendon of the Caput longum m. tricipitis brachii, coursed upwards laterally and fused with the Lig. glenohumerale medium. Between the Ligg. glenohumerale medium et inferius it was connected with the shoulder joint capsule by loose connective tissue. Craniolaterally it melted into the superior portion of the M. subscapularis and inserted together with its tendon to the Tuberculum minus of the Humerus. The ascending fibres of the "unknown glenohumeral ligament" and the oblique, descending fibres of the Ligg. glenohumeralia medium et inferius crossed twice and formed X-shape connections between the ligaments. In external rotation and abduction or anteversion the course of fibres of the "unknown glenohumeral ligament" was spiral. According to the shape and anatomical position of the "unknown glenohumeral ligament" we propose to name it "Lig. glenohumerale spirale".

Aged↗

Isokinetic torque deficit of the knee extensor muscles after arthroscopic partial meniscectomy.

Isokinetic torque deficit of the knee extensor muscles in the operated leg was measured in 21 male patients (mean age 26.4 +/- 1.9 years) who had undergone arthroscopic partial medial meniscectomy. The isokinetic torque testing was performed 1, 3, and 6 months postoperatively using the Cybex II dynamometer according to standard technique. Isokinetic knee extension peak torque (PT) at angular velocities of 60 degrees and 180 degrees/s was determined in both legs, and the proportional PT deficit in the operated leg was compared with that in the nonoperated leg. A significant (P<0.001) isokinetic PT deficit in the operated leg in testing with angular velocity of 60 degrees and 80 degrees/s was observed at 1 month (28.6% and 31.0%, respectively) and 3 months (19.8% and 15.8%, respectively) postoperatively. At 6 months postoperatively a significant (P<0.001) isokinetic PT deficit (18.2%) of the knee extensor muscles in the operated leg was observed only in testing with angular velocity of 60 degrees/s; no significant differences (P>0.05) in isokinetic PT between the operated and nonoperated leg in testing with angular velocity of 180 degrees/s was found 6 months postoperatively. Thus in patients with arthroscopic partial meniscectomy the postoperative recovery of isokinetic strength of the knee extensor muscles in the injured leg is closely related to testing velocity, while it is more delayed at low than intermediate angular velocities.

Adult↗

Anatomy of the coracohumeral and coracoglenoidal ligaments.

The Ligg. coracohumerale and coracoglenoidale are constant anatomical structures, represented in all the 34preparations investigated. The Lig. coracoglenoidale is a strong band of dense connective tissue, running from the Processus coracoideus to the Tuberculum supraglenoidale. In 27 specimens out of 34 it was the continuation of the M. pectoralis minor tendon. The Lig. coracohumerale consists of two separate parts. The "inferior part" originates from the Processus coracoideus and the Lig. coracoglenoidale, which separates it from the base of the coracoid process. It is composed of the joint capsule anteriorly and a remnant of the M. pectoralis minor tendon posteriorly. The "superior part" arises from the medio-posterior surface of the Processus coracoideus, just below the Lig. coracoacromiale. Both parts of the Lig. coracohumerale run into the shoulder joint capsule under the M. supraspinatus tendon and insert into a capsular semicircular band. According to the shape and course of fibres between the greater and lesser tubercles of the Humerus, we propose to name it the "Lig. semicirculare humeri". None of the two parts of the Lig. coracohumerale begins from the base of the Processus coracoideus, and fibres of the Lig. coracohumerale do not reach the Tuberculum majus et minus directly.

Aged↗

Changes in functional characteristics and myosin heavy chain composition in m. vastus medialis before and after arthroscopy for knee injury.

The aim of this study was to investigate the influence of restriction of movement on the functional characteristics and myosin heavy chain composition of m. vastus medialis. The subjects of this study were 13 arthroscopically treated patients with meniscus lesions (both men and women, mean age 28 years). All measurements were performed and biopsies were taken bilaterally before and 6 months after knee arthroscopy. Thigh girth was measured to determine the degree of atrophy. A tendency towards decreased thigh girth in the injured leg was noted. As an estimate of functional characteristics, maximum voluntary contraction (MVC) was measured. The MVC of the injured limb was lower than that of the non-injured limb (mean values 548.2 +/- 54.1 and 705.4 +/- 48.2 N respectively; P < 0.05). The myosin heavy chain (MHC) composition was determined electrophoretically. The proportion of MHC I isoform decreased from 59.35% to 47.97% (P < 0.05).

Adult↗

HIV transmission through donor artificial insemination.

OBJECTIVE: To investigate and report cases of human immunodeficiency virus (HIV) transmission through donor artificial insemination (AI) before 1986 at five infertility clinics. DESIGN: Two types of look-back studies were performed: (1) identification of an HIV-infected woman who reported previous AI, followed by identification of the infected donor(s) and contact tracing of women who were inseminated with his semen, and (2) identification of an HIV-infected donor and subsequent examination of women receiving AI procedures using his semen. SETTING: Five infertility clinics in Los Angeles County, California; San Diego County, California; Arizona; and Vancouver, British Columbia. PATIENTS: A total of 230 women were inseminated with semen from any one of the five identified HIV-infected donors; 199 (87%) consented to HIV testing. MAIN OUTCOME MEASURE: Seropositivity for HIV among AI recipients. RESULTS: Seven (3.52%) of the 199 women (95% confidence interval, 1.55% to 7.41%) who were artificially inseminated with semen from any of five HIV-infected donors and consented to HIV testing tested HIV-seropositive. Information on HIV risk was available for three of the five donors; all three reported a history of having sex with men. Four HIV-infected women were identified through uncommon circumstances, rather than through routine look-back studies of donors. CONCLUSION: Infection with HIV through donor AI performed before routine HIV screening of semen donors represents a potentially serious threat to women who underwent AI procedures. Public health policies requiring retrospective identification of HIV-infected semen donors and patients receiving AI before 1986, especially in acquired immunodeficiency syndrome (AIDS)-prevalent areas, should be considered routine. Women diagnosed with AIDS or HIV infection, in whom no identified risk of HIV acquisition is established, should be questioned about previous AI procedures.

AIDS Serodiagnosis↗

Listeriosis: a previously unreported medical complication in women with multiple gestations.

OBJECTIVE: Our purpose was to determine whether women pregnant with multiple gestations are at greater risk for perinatal listeriosis than are women pregnant with singletons. STUDY DESIGN: Active surveillance for perinatal listeriosis was carried out in Los Angeles County, California, medical records were reviewed, and rates of listeriosis were calculated from live birth and fetal death data. RESULTS: From January 1985 through December 1992, 12 (4.0%) of 301 perinatal listeriosis cases occurred in pregnant women with multiple gestations, almost four times the overall multiple gestation rate in Los Angeles County. Rates of listeriosis in pregnant women per 100,000 live births and fetal deaths were 19.8 for singleton and 74.9 for multiple gestations (risk ratio 3.8, 95% confidence interval 2.1 to 6.8). Compared with singleton pregnancies, greater risk of listeriosis was observed in pregnancies with triplet gestations (risk ratio 38.4, 95% confidence interval 9.6 to 153.3) than in those with twin gestations (risk ratio 3.2, 95% confidence interval 1.7 to 6.0). Increased risk of listeriosis during multiple-gestation pregnancies was most notable among women > or = 35 years (risk ratio 13.6, 95% confidence interval 5.2 to 35.5) and Hispanic women (risk ratio 5.3, 95% confidence interval 2.8 to 10.0). CONCLUSIONS: To reduce the risk of listeriosis, obstetricians should incorporate dietary recommendations into routine prenatal nutritional counseling for all pregnant women and should especially counsel women pregnant with multiple gestations of their greater risk.

Adult↗

Progression of human immunodeficiency virus disease among infants and children infected perinatally with human immunodeficiency virus or through neonatal blood transfusion. Los Angeles County Pediatric AIDS Consortium and the Los Angeles County-University of Southern California Medical Center and the University of Southern California School of Medicine.

Using community-based surveillance data for pediatric human immunodeficiency virus (HIV) infection, we examined disease progression using survival analysis among perinatally HIV-infected children and children HIV-infected through a neonatal blood transfusion. As of December 31, 1991, 238 HIV-infected children (classified P-1 or P-2 according to the Centers for Disease Control and Prevention classification system) were identified. Median symptom-free survival time from birth to symptomatic infection (P-2) was different for perinatally acquired (n = 166) and neonatal transfusion-acquired (n = 72) infection (6.4 months vs. 17.8 months, respectively; P < 0.001). Survival after development of symptomatic infection (P-2) did not differ by transmission mode. Survival differences from birth to death were significant at P < 0.05 (75% of perinatally HIV-infected children survived 44 months vs. 71 months for transfusion-associated children). Although survival estimates improved for those receiving antiretroviral treatment, differences by mode were still observed. For perinatally HIV-infected children, mortality was highest in the first year of life (12%). Those remaining symptom-free beyond their first year demonstrated survival experiences similar to those for children with transfusion-associated infection.

AIDS Serodiagnosis↗

Lipolytic actions of hormones on adipocytes in exercise-trained organisms.

Adipocytes from sportsmen exhibited lower basal rate of lipolysis but higher response to adrenaline than those from untrained persons. Dexamethasone exposure for 30 min enhanced the adrenaline effect both in sportsmen and trained rats. Insulin abolished this glucocorticoid action. A rapid permissive action of glucocorticoids was suggested in the trained organism.

Adipose Tissue↗

Adipocyte responses to adrenaline and insulin in active and former sportsmen.

The rates of lipolysis and lipogenesis in adipocytes, isolated from biopsy samples of subcutaneous fat, was assessed by estimation of glycerol release during a 30-min incubation, and of the incorporation of 14C-glucose into lipids during a 1-h incubation at 37 degrees C, respectively. The subjects were six highly-qualified, active endurance sportsmen, eight former endurance sportsmen of international class, and six untrained young men. In the active sportsmen the basal rate of lipolysis was about half of that in the previously-active sportsmen and the untrained subjects, but after the addition of adrenaline (10(-4) or 5 x 10(-4) mol.l-1) the lipolysis rate was the highest. No differences were observed in the lipolytic rates in the former sportsmen compared to the untrained subjects. Gases of a comparatively high level of lipogenesis were found in the trained subjects. The addition of insulin (9 microU.ml-1) to isolated adipocytes caused a significant augmentation of individual rates of lipogenesis in the active sportsmen and the untrained persons but not in the previously-active sportsmen. In comparison with the active sportsmen, the previously active sportsmen revealed an increased basal rate of lipolysis and a reduced sensitivity to the lipogenic action of insulin. These findings suggest that these changes may have had significance in avoiding an increase of adipose tissue after a decrease in energy expenditure due to a change in physical activity.

Adipose Tissue↗

CD4 T-lymphocyte counts and Pneumocystis carinii pneumonia in pediatric HIV infection.

The relationship between CD4 T-lymphocyte counts and infection with the human immunodeficiency virus (HIV) is retrospectively investigated for 266 HIV-infected and uninfected children who were born to infected women, including 39 with Pneumocystis carinii pneumonia (PCP), in a population-based surveillance study. Of 21 perinatally HIV-infected children with PCP only 10 (48%) had CD4 T-lymphocyte counts that were less than 500 x 10(6) cells/L (500 cells/mm3), compared with all 18 who were infected via blood transfusions or clotting factors. Among 68 children who were 1 year or younger, 18 (90%) of 20 PCP cases had CD4 T-lymphocyte counts that were less than 1500 x 10(6) cells/L (1500 cells/mm3) compared with only five (10%) of 48 children who did not have the acquired immunodeficiency syndrome (odds ratio, 77.4; 95% confidence interval, 19.7 to 313.4). The mean CD4 T-lymphocyte count was lower for the 39 PCP cases when compared with the 188 children who were at different stages of HIV infection and did not have the acquired immunodeficiency syndrome (AIDS) independent of age. The majority of perinatally HIV-infected children with PCP were 6 months or younger and 50% were previously unknown to be infected. Thus, HIV-positive children should be identified early and followed closely. CD4 T-lymphocyte counts may be useful in monitoring HIV-positive children and determining when to begin PCP prophylaxis.

Acquired Immunodeficiency Syndrome↗

Corticosterone binding in myocardial tissue of rats after chronic stress and adrenalectomy.

Male rats were trained to swim for 9-10 days to assess the effect of chronic stress on the capacity and affinity of specific glucocorticoid binding in the cytosol fraction of myocardial tissue. A significant decrease in the binding capacity for corticosterone (Cpd B) was found 24 hours after the last swimming test, while the affinity constant remained unchanged. Contrary to Cpd B binding, there was no change in the capacity of dexamethasone binding, and there was no decrease in the Cpd B binding capacity in rats which had been adrenalectomized 2 days prior to the training period. We conclude that daily swimming for 9-10 days alters the numbers of cytoplasmic Cpd B binding sites in the face of increased adrenocortical activity, while not affecting dexamethasone binding in the cytosol fraction of myocardial tissue.

Adrenalectomy↗